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OpanaE.R and Surgery
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dillray1 posted:
I have been taking Opana E.R. 30mg.every 12 hours for about 9 months now and Percocet 5/325 2x day for breakthrough pain, for my chronic pain condition related to my spine. I have had 5 Cervical surgeries and 2 Lumbar Surgeries. I am on this medicine per P.M. Doctor and have been disabled since 2002.
I have another surgery coming up in a couple of weeks on my Lumbar spine,and this will be the 1st time going into a surgery while taking Opana E.R.
Neither the surgeon or the PM doc told me if i have to stop the Opana before surgery,and i'm getting paranoid because if i am late by only 2 hours taking the Opana,i start feeling real strange,like a withdrawal symptom. My surgery is on Labor Day,and the hospital will call me on Friday before Monday,the surgery date to let me know what time to be there on Monday,and i'm hoping they don't tell me to stop the Opana over the weekend. That would be terrible to go into surgery while withdrawling.
Also i know that the Opana will not be very good for acute post-op pain. Does anyone know how much Percocet can be taken with the Opana? I was not told anything by the surgeon,and the PM doc just told me that he could adjust the Percocet if needed after surgery.
You all know how hard it is to get in touch with docs,and i don't want to be left in a bad situation.
It's possible that the only one that can answer this question would be someone who has gone into surgery while on Opana E.R.,or..........
I may have to contact the PM doc. ahead of time to find out for sure what will be done.
The ultimate answer would come if both the PM doc. and the surgeon discussed this over the phone,but i can't see that happening.
As it stands,i'm not supposed to see any docs until the surgery day,when i see the surgeon right before he cuts me open.

If anyone has had a similar experiance,or might know an educated guess,i'm all ears,and eyes.
My guess is that you will tell me to contact one or both of the docs,but i thought i would run this by you all for a possible guess.
Thank You All in advance for any and all comments.
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TDXSP08 responded:
I have no answer as far as the Opana E.R..

I will however say that YOU need a straight answer Before any cutting or any Pre OP stuff the Friday Before, WHO will be managing your pain Post Op, are you going to have a PCA ? who will write the orders. get all the facts way before.

Peace
 
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billykurch responded:
It's customary that prior to your surgery, that the Anesthetists who will be assisting your doctor in your procedure usually visits with you prior to the day of the operation, generally the night before. But well prior to this, your own doctor will most likely advise you as to how to or how not to medicate yourself during the time prior to your procedure.

Keep in mind also, that should you undergo a procedure over the weekend, and your doctor decides to have you stay in the hospital, then you should arraign to have your regular meds with you! Laying in pain over the weekend, or even a long weekend like a holiday period, it's truly imperative to keep your own meds near! Good luck.
 
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annette030 responded:
Of course you need to talk to your own doctors about this.

That said, my husband was on long-acting and short-acting pain meds for a couple of years prior to his ortho surgery, and he stayed on them. The surgeon continued them while he was in the hospital, and gave him additional short acting meds for post op pain. When he was discharged from the hospital, the nurse gave us a RX for more short acting meds, but we gave it back to her, as his pcp managed his pain meds before surgery, and said he would continue to do so after the surgery. He did as he said he would.

I have never heard of requiring someone to taper off their pain meds prior to surgery, but I can only speak for my own experience. You are right, you need to call your surgeon, you have plenty of time to clear this all up before you get there.

I would also have a friend or family member bring your regular meds to the hospital when you have your surgery, just in case they don't have them or some crazy thing happens. Don't bring them yourself, put someone else in charge of them that you trust. DO NOT take them without discussing it with your doctor and nurse.

Take care, Annette
 
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_swank_ replied to billykurch's response:
In my experience, my pain management doctor managed my pain after surgery. While in the hospital my surgeon was in charge. You should not have to bring your own pain meds to the hospital if you have to stay. It's their job to manage your pain.

When I recently had my knee replaced I was on a morphine pump for the first 24 hours. After that they started me on Lortab which did not work, then Percocet which also did not work. I ended up on Dilaudid while in the hospital due to my high tolerance. But my surgeon had no problem upping my dosages until we got it right.

Also, I didn't not have to taper off or quit taking pain killers before surgery.
 
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annette030 replied to _swank_'s response:
I totally agree that you should not have to bring your own meds with you, it is their job to manage your pain. I just don't entirely trust them to do it, lol. Too many scary stories that I have heard from other people. When my husband was in the hospital, they continued his methadone as he was on it at home. But I still took it with me that first day, just in case.Thankfully, he didn't need it.

A new person here just got a RX for Exalgo, a new form of long acting dilaudid. She said the pharmacy had to order it and it would be in on Monday. I would not want that to happen after I had surgery with the hospital pharmacy. Luckily, most opiate pain meds are old and common so hospitals will have them on hand.

I am happy to hear the knee replacement surgery is behind you.

Take care, Annette
 
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barbsays replied to annette030's response:
This is something I wouldn't worry too much about. But, maybe I should because I have had bad experiences. Your meds are E.R. so I would (but I'm not an expert and do not understand why you don't have clear directions by now) take it the night before and they will not let you go into withdrawals or shouldn't and they know what you take and you should be fine.

But I try to cover my needs in case others don't. I would have my husband bring it if I need it. Sorry, medical folks, but sometimes you don't cover all bases. Iti's a shame, really. But you do need to ask someone about this for your own relief and peace of mind. I've had many surgeries and it came out fine. They know what you take so try not to worry and I would (not encouraging you to officially) cover my a.. just in case...
 
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CTBeth responded:
Hello dillray1.

Your scenario should work like this:

You should/must schedule an appointment with your pain management MD soon as possible. He/she needs to explain the protocol.

It is best if you request that your surgeon consult with your PM, by phone, letter, in person, with your PM, if he/she as practicing rights in the same hosp as your surgery, will be responsible for your post-op (and pre-op) management. You will have to sign release forms so they can speak with each other regarding your care.

Typically, you would take your scheduled Opana the morning of surgery. Ask to be sure. The ansethesiologist does not want to anaesthetize a patient on withdrawal, either and your PM does not want you to experience withdrawal or additional pain.

The anaesthesiologist will make pain management decisions while you are in PACU (recovery room). This is usually not a problem.

That you are taking Opana indicates that you are opoid tolerant, so this is where your PM or his/her recommendations come in. After you have recovered from anaesthesia, your pain management needs will be different than a non-opoid tolerant patient. The surgeon is aware of this and dosages should be prescribed by, or at least recommended by, your pain management MD.

Your part of assuring this works properly is to make an appt with your PM and voice your concerns. Be assertive as you must.

You do not need to worry about awakening from surgery in pain and withdrawal. If you are pro-active now, the situation should go smoothly.

Remember, this is a situation that occurs in surgery on a daily basis.

Please let us know what is going on, okay.

If I can be of further assistance, you may email me at:

BethHuntington@live.com

I have been through six surgeries while on long-term opoid pain management. I am also a Registered Nurse.
 
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CTBeth replied to annette030's response:
PS I am the person who is waiting for the Exalgo which should be here on Monday. My pain management MD has instructed me to remain on the med I'm currently taking with all its gruesome side effects until Sunday night than start the new med on Mon AM.

Hospitals all have their own pharmacies which more-extensive formularies than retail pharmacies. I wouldn't worry that the hospital won't have the meds for you. This just would not happen except maybe on a battlefield hospital in a drought or war zone.

PLEASE talk to your pain management MD who can assure you of protocol.

You have too much else on your mind to worry about this.
I am sure your questions will be answered then you can relax and go into surgery confident that you will not be faced with needless suffering.

We all deserve this.
 
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CTBeth replied to annette030's response:
ANNETTE: Are you on Facebook? If so, I'd like to invite you to be my facebook friend.

As my profile is private, you cannot locate it/me via search. What you can do is email me your Facebook name and I'll friend you. I'm open about my name and email address.

Let me know, ok.

Beth
 
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annette030 replied to CTBeth's response:
I am on Facebook, but it is also private. I only joined so my daughter-in-law and some close family friends and I could exchange photos and news.

I appreciate your invitation but let's wait awhile and see how it is as we get to know each other. I have only exchanged emails once before with someone I met online here, and it turned out really badly. So, I generally just stay in touch on this board.

Take care, Annette
 
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annette030 replied to CTBeth's response:
I do understand how it is supposed to be at hospitals, but it does not always turn out that way.

Some of the very small rural hospitals where I have worked in the past did not have extensive pharmacies, one had a drug pantry, and a pharmacist on duty in the day time only. At night a nurse had the keys to the drug closet.

I have known people who went into withdrawals the day after their surgery due to a lack of communication between doctors.

As I said, it IS their job to take care of this, but I would rest better knowing I had my medicine accessible if necessary. With my husband's surgery, I had his meds in my purse, and he didn't need them, because the hospital did their job. Big city hospital, lol. That way, he rested comfortably, and so did I.

Take care, Annette


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