Pain Medication Post-op in Germany (& Pain Med Sensitivity Concerns)

[Justin]

I had my 2-level Artificial Disc Replacement with Dr. Bertagnoli on 11.15.03 in Austria. In regard to pain medication post-op, I was only on a PCA pump in the ICU. When I was released to my room after 5 hours, I was only on my own oral pain medication (as far as I can remember ).

For those that have traveled recently to Germany, is this still the case? How long were you on a PCA pump, if at all?

Thanks for any insight, as I'm having another spine surgery in Germany with Dr. Bertagnoli on 5/14.

(FYI: the treatment of pain post-op varies greatly from country to country. This is not to say that the doctors, nurses, etc. care "any less" for a patient--it is rather just a difference in philosophy.)

[trkdoc714]

Justin,

I was on an epidural morphine pump for a day and a half after surgery. They then gave me 20 mg daily of Targin which is Oxycodone with an anti-constipation drup included. They gave me enough for my entire stay in both the hospital and hotel. I actually had 5 or 6 doses left when I got back home. This really came in handy when I had a bout with constipation. It really works well but is only available in EU countries from my understanding.

Bob

[Alastair]

I was given nothing at the AK no pump etc just my own meds I took with me, because you know what works for you, I would take your own stuff as much as possible

[Terry Newton]

I used the pump maybe the first day after the surgery. When they realized I was not using it they took it away. I brought my own Methadone with me and they utilized my own medications for pain management. The most I ever took was 20 Mg per day. Not a lot of medication but, enough to control the pain. BYOD = Bring Your Own Drugs.

Terry Newton

[treefrog]

See, this is what I am very concerned about. I haven't taken any of the "heavy hitters", except a Fentanyl patch which made me throw up.

Tramadol (Ultram-ER) also made me sick.
Higher levels of hydrocodone (vicodin) affected my vision and made me feel "out of it".

Oxycodone (percocet) is okay, I take that for breakthrough pain.
And I take oxymorphone (Opana-ER), but since it is extended release, it won't be good for post-op.

I am going to see my PM on Friday. I hope she will be willing and able to prescribe adequate meds to take with me.

[Cheryl]

Cathy -

The doctors were very willing to help adjust meds as needed. I don't do well with pain meds either and the oyxgesic was fine for me over there. If you do not have meds with you do not fear they will give you enough. They have a chart that gives you the conversions of what our drug names are vs. the ones you are taking.

I don't remember a pump. I went into what I'd call a recovery room (maybe thats what ya'll are calling ICU)? and I was back in my hospital room the same day.


Cheryl

[Justin]

The treatment of my pain post-op has been great. I've had no issues getting pain meds when I feel like I need them. They also gave me a pill to help sleep last night and I only woke up once during the night due to discomfort.

The ProSpine staff and nurses really make sure you are comfortable post-op and check on patients frequently. Of course, each room has a nurse call button that is bedside and enables patients to call for a nurse if needed.

I just wanted to update everyone, as I know pain management control is a general concern post-op. No worries.

[Katie]

Hi Cathy,

It's really interesting to see that most other drugs make you very ill, or out of it. And from your avatar, you look like a redhead. While I don't have the same gorgeous tone that you do, I have red 'genes' in me as well...you can see it when the sun hits my hair....through the grey.

One of my best friends is a veterinarian (and a strong red head in many ways ), who has gone through extensive medical treatments from two serious car accidents (neither of them her fault). She found out then that she too is hypersensitive to most pain medications. Morphine will kill her, quickly. She has done some extensive research and found out that those of us with red hair often react very differently to medications, in a bad way. She was the one who told me about this phenomenon after I started having weird side effects.

After three hours into my first twelve hour Fentanyl patch, I was vomiting severely and incoherent in the back of an ambulance. Oxycodin, Lyrica, and every other medication I've taken except for Statex, straight old short acting morphine, has had very bad side effects as well. Even the long-acting morphine does not work well on me...go figure. Steroid injections in my spine (and elsewhere before) have no effect, pain wise. The anti-depressant that doubles for pain medication gives me bad nightmares, and on and on. I've had trouble with general anesthetic over a long surgery as well, so I'm very leary of doing that again. Twilight doesn't seem to have the same effect, thankfully.

Oddly enough, while my pain management doctor is an anesthesiologist, she is very skeptical and says there is no reason why I shouldn't be able to use a general. Thankfully, as good a doctor as she has been for me so far, she will not be involved in this next major event

I've developed numerous other sensitivities that the allergy specialist thinks has been triggered by the medications I've been trying to take. I'm hoping that when I am off all pain drugs, they will go away.

Just out of curiousity, is there anyone else out there that has noticed these reactions in themselves or with relatives with red hair?

It certainly makes pain control very interesting and challenging.

And I just realized that I am hijacking this thread. Justin, should I move it to its own spot? Sorry!

[treefrog]

Hi Katie. Well, I do have some red genes in me, but my red hair is not natural . Though, I think the red really matches my skin tone well, my natural color made me look very washed out.

But my Mom is a redhead and she has some very weird tolerances. She has had the unfortunate situation of waking up during procedures, and sometimes will be conscious, but unable to alert anyone of the situation.


I also had a similar reaction to Fentanyl, though not as serious as yours. About 15 hrs after putting the patch on, I was feeling very dizzy and nauseated. Until I finally threw up, took the patch off and flushed it down the toilet. For the rest of the night, I was throwing up, and couldn't keep anything down.

My PM doc did prescribe 20 mg Opana-ER, 1-2 tablets every 12 hours, for after surgery. Currently I'm taking 1-2 10mg tablets every 12 hours (usually 2 though). Plus she gave me 15 mg oxycodone, and zofran for nausea.

I am hoping this will be enough for me, and I won't be sick for too long post-op. But I am expecting some nausea post-op, I think it's inevitible.

I did try taking one amitriptyline last night, and I didn't have any negative effects. Though I did feel a little groggy this morning. I think it did help a little bit with sleeping, I did get up once to go to the bathroom, but that's better than 2-3 times on most nights. The prescription says 1-2 at night, so 2 might just really have me sleeping soundly.