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Pain Management Pain Management

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  #1  
Unread 03-25-2010, 12:48 AM
Pain Management

I am having a complete hyst on March 31, Uterus, ovaries, tubes and cervix. I have not had any major surgery before or had a child. So I am not sure about pain managment afterward.

I want to get back on my feet as soon as possible, should I accpet that there will be pain and just try and deal with it until it is unbearable? Or should I keep the meds going so there is no pain?

I know these sound like stuping questions but I really don't know. I asked the nurses at pre-op and they kept talking about the 1-10 pain chart. So I don't know, I don't really feel like anyone answered my question.
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  #2  
Unread 03-25-2010, 02:08 AM
Re: Pain Management

I had a complete TAH/BSO 13 days ago. I have had major surgery before, so perhaps I was mentally prepped a bit - but the experience is different for everyone.
I can say as advice:
- listen to the docs & nurses on how to get out of bed, etc - it will help lessen the strain / use of your abs @ first
- everyone reacts to pain differently & reacts to pain meds different. For me i can "deal" with a low level of pain ( 3-4 on the scale) but at about 5 i'm taking something so it doesn't ever escalate to a "6" or above.
Everything I've read here for different women all talk about trying to stay on top of the pain, if you have pain. i.e. don't try to be too "tough" since pain is a way of your body telling you to slow down & take it easy
I'm pretty type A & antsy as well - i was up walking the halls 1 day post op feeling pretty "good" - but i'd still take something if i felt i needed it - the meds i had once off pain pump (percocet 5/325) aren't super "strong" so i could take one to help take edge of pain, but not be "out of it." I'm post op day 13 now and can get around fine - but again, i still take it easy. Theres a lot of healing & swelling still going on, but I'm independent except not driving yet. Still taking 2 pain pills a day.

I found the following info/ descriptions helpful about the "scale" - since you're not used to surgeries:
Minor

Does not interfere with most activities. Able to adapt to pain psychologically and with medication or devices such as cushions.
1
Very Mild Very light barely noticable pain, like a mosquito bite or a poison ivy itch. Most of the time you never think about the pain.
2
Discomforting Minor pain, like lightly pinching the fold of skin between the thumb and first finger with the other hand, using the fingernails. Note that people react differently to this self-test.
3
Tolerable Very noticable pain, like an accidental cut, a blow to the nose causing a bloody nose, or a doctor giving you an injection. The pain is not so strong that you cannot get used to it. Eventually, most of the time you don't notice the pain. You have adapted to it.
Moderate

Interferes with many activities. Requires lifestyle changes but patient remains independent. Unable to adapt to pain.
4
Distressing Strong, deep pain, like an average toothache, the initial pain from a bee sting, or minor trauma to part of the body, such as stubbing your toe real hard. So strong you notice the pain all the time and cannot completely adapt. This pain level can be simulated by pinching the fold of skin between the thumb and first finger with the other hand, using the fingernails, and squeezing real hard. Note how the similated pain is initially piercing but becomes dull after that.
3
Very
Distressing Strong, deep, piercing pain, such as a sprained ankle when you stand on it wrong, or mild back pain. Not only do you notice the pain all the time, you are now so preoccupied with managing it that you normal lifestyle is curtailed. Temporary personality disorders are frequent.
6
Intense Strong, deep, piercing pain so strong it seems to partially dominate your senses, causing you to think somewhat unclearly. At this point you begin to have trouble holding a job or maintaining normal social relationships. Comparable to a bad non-migriane headache combined with several bee stings, or a bad back pain.
Severe

Unable to engage in normal activities. Patient is disabled and unable to function independently.
7
Very
Intense Same as 6 except the pain completely dominates your senses, causing you to think unclearly about half the time. At this point you are effectively disabled and frequently cannot live alone. Comparable to an average migraine headache.

8
Utterly
Horrible Pain so intense you can no longer think clearly at all, and have often undergone severe personality change if the pain has been present for a long time. Suicide is frequently contemplated and sometimes tried. Comparable to childbirth or a real bad migraine headache.
9
Excruciating
Unbearable Pain so intense you cannot tolerate it and demand pain killers or surgery, no matter what the side effects or risk. If this doesn't work, suicide is frequent since there is no more joy in life whatsoever. Comparable to throat cancer.
10
Unimaginable
Unspeakable Pain so intense you will go unconscious shortly. Most people have never experienced this level of pain. Those who have suffered a severe accident, such as a crushed hand, and lost consciousness as a result of the pain and not blood loss, have experienced level 10.


Best to you & let us all know if you have more questions!
  #3  
Unread 03-25-2010, 05:20 AM
Re: Pain Management

Thanks so much for that post, that really answered my questions. I did not feel like I had anything to compare it to so I would know what to expect. Can I just be honest with with you ladies say my fist goal is to be able to get up and go the bathroom myself and I am hoping once I do that they will let me wear underwear.

I know it sounds stupid but I really HATE not wearing underwear....
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  #4  
Unread 03-25-2010, 07:04 AM
Re: Pain Management

  Quote:
Originally Posted by patriotette View Post
I want to get back on my feet as soon as possible, should I accpet that there will be pain and just try and deal with it until it is unbearable? Or should I keep the meds going so there is no pain?
I am still pre-op like you. But I have read quite a few times on here where everyone is saying stay on top of the pain by taking your meds as your Dr. perscribes. It is my understanding that will help in your recovery time.

  #5  
Unread 03-25-2010, 07:46 AM
Re: Pain Management

Remember something like Percocet takes 20 min to kick in and 45 min for max effect. So if you wait until pain is too bad, it'll take a while to get to tlerable. And it can take a long time to catch up. So do medicate per orders and "as needed" means before pain is mod to severe. Also keeping on an antiinflammatory like ibuprofen really helps, take it on a schedule. Getting the catheter out early and using the bathroom is usually the hospital's goal too and can happen in hours often, but you might want looser panties than usual, so be prepared for that, esp if you have abdominal incisions. Good luck.
  #6  
Unread 03-25-2010, 08:26 AM
Re: Pain Management

Take your pain meds on schedule the first few days or week and then stretch them out as tolerated. Don't wait until you are really hurting to take something as it is hard to catch it when it gets ahead of you! Also...you'll probably get to wear some "sexy" mesh panties with a pad initially in the hospital after your catheter is removed...so never fear...lol! Prayers and hugs...and remember the waiting is truly the worst!
  #7  
Unread 03-25-2010, 08:27 AM
Re: Pain Management

Patriotette,

All of us of course are different and have different caregiving plans. I had a nerve block medication the whole time I was in (surgery 12:30 Thurs. and left castle at 2 pm Sat.). The catherter was taken out 7 am Fri. and went to the bathroom every 2 hrs. after that. I walked the halls at least 3 times Fri. and twice Sat. and sat up in the rocker in the room for at least an hr. several times a day.

I did not turn down any shots (toridol) or oral pain meds while in the hospital. I figured they know more about that than I did. Once home I did follow directions on dose and timing for a few days as the nerve block wore off. My DH was a hospice chaplain so he told me what his nurses had told him about pain mangement. If you are on a schedule and sleep past your time you probable can cut back on amount or frequentcy. The first days home I was taking 2 hydrocodone every 4 hrs. Sun. night I started taking only 1. Mon. night I went all night without one. Only took 2 Tues. and yesterday only took Tylenol. I am walking every hour or so, washing a few dishes, and folding clothes. No lifting, no bending. I have already been walking in stores. It depends on your surgery, your pain threshhold, and how physically fit you were before surgery. For me so many of the pains are not directly related to the surgical site but are bowel, bladder, muscular due to staying in one position too long, and stomach irritations. They are short and don't last long.

Honestly, the pain was worst the first 2 hrs. after getting to the room and after taking something was very manageable. I was anxious to stay pretty active because of past blood circulation and clot problems.

I hope this helps you. Have a blessed day.
  #8  
Unread 03-25-2010, 05:08 PM
Re: Pain Management

Patriotette -

You should not try to deal with the pain until it is unbearable. By the time the pain meds kick in you could really be in some big pain.

Also it can inhibit your healing.

Check out this post-op article on Managing pain .

Also check out the Hysterectomy Checkpoints for weeks 1 & 2 where they discuss managing your pain.

You don't get extra credit for not using your pain meds.



G.
  #9  
Unread 03-25-2010, 05:23 PM
Re: Pain Management

Nothing wimpy about pain meds! Meds help us to move around and get better. You get no points for deciding to be miserable and not use the pain meds. You will find that anti inflammatories like ibuprofen will help wonders!
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