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My "pain surprise": Now I need advice

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    My "pain surprise": Now I need advice

    I haven't been around here for the past week because I was admitted to the hospital for a "surprise" gall bladder removal and I wound up having _four_ unexpected procedures in the first few days. This all came at me totally out of the blue and I'm still a little in shock how this could all hit me at once.

    I'm past most of the serious problems, and it's likely that Saturday or Sunday they'll send me home. My biggest problem now is facing twice-a-day dressing changes. After I go home some agency is going to take care of them, but I'm having a serious problem with them even while I'm still in the hospital. They hurt *a lot* and nothing seems to do much of anything to help the pain, not an injection of 4 of morphine, even if you add in a couple of "extra strength" lortabs on top of that. I'm afraid that the pain from the dressing changes is going to be the primary factor in my recovery period.

    Because of my work on PainOnline I usually seem to find myself focusing on neuropathic pain almost exclusively, and now I'm almost at a loss for dealing with serious "normal" pain. What "tricks" can anyone offer for dealing with this sort of situation, and exactly how do you pull them off? I mean, should I be trying to work on learning imagery? biofeedback? meditation? I've had severe pain before in my life, certainly worse than anything I've experienced this past week, but they were occasions where I was dealing with a single, acute pain episode. Now I'm facing a on-going series of severe (even if not outrageously extreme) episodes of pain that I find myself dreading.

    Any brilliant ideas I can use to cope?

    David Berg

    [This message was edited by David Berg on September 29, 2001 at 02:03 PM.]

    What hurts and where?

    Hi, David, fancy meeting you here? [img]/forum/images/smilies/smile.gif[/img] My condolences on your surgeries. Hope you get well soon.

    Are the incisions themselves hurting? Fess up, what other sorts of procedures did they do? We need to know what hurts and how before anyone would offer any advice. My first instinct is to use ice (15 minutes on/an hour off) for the first few days.

    Of course, tell your doctor about the pain and ask for whatever you think you will need. It is going to hurt for quite some time but be thankful it will eventually go away.

    "And so it begins."
    "And so it begins."



      I guess I'm kinda out of it this week. I really should have prefaced my message a bit. As you can see, I'm the moderator of this Pain forum. I'm not an SCI patient, just a writer who maintains a site, PainOnline, that specializes in central pain syndrome (which can result from SCI and a number of other conditions). After I responded to someone's message awhile back, Wise Young created this new pain forum and asked if I would moderate.

      I really needed to describe the surgeries a little, considering the SCI context of this forum. I guess I left that out originally by rationalizing that I didn't want to look like I was trying to attract pity for that, compared to what so many people here have had to endure. I've been doped up most of the week and I wrote my message in the middle of the night, so I don't claim that I've been thinking clearly.

      In short, I was having abdominal pains and they admitted me to do a laproscopy to remove my gall bladder. Also, the little bump on my belly button I've had as long I can remember turned out to be a hernia that was right in the way of getting to the gall bladder, so that had to go. The following day they took me back to go after a stone in my main bile duct on my liver that they couldn't get to during the lap on my gall bladder. Thankfully, they didn't do any external slicing to go after this stone since they used endoscopy to just make a little internal snip on my liver duct, but the position they insisted I contort into for the procedure would have been painful on a good day, let alone with my belly freshly wounded from the previous day's surgery.

      Then, two days later a stitch pulled loose or something and my bowels punched through my abdominal wall and they had to rush me back to surgery for a redo of my hernia. That was probably my worse day for pain, overall.

      The dressing changes are described as a basic wet-dry dressing change on what I have to admit that my inexperienced eye considers a fairly ugly wound with holes nearly 2 inches deep on each end. They pack each hole with gauze twice a day, and therein lies my current problem with pain. I'm trying to time my Percocet doses in anticipation of the home-care nurse's arrival to hopefully take the edge off of the dressing changes a little.

      I hope that helps.

      David Berg

      [This message was edited by David Berg on September 30, 2001 at 09:30 AM.]


        David, I am sorry to hear about your "complications". I hope that everything heals up soon.

        In my opinion, most doctors are not adequately trained to provide medications for postoperative pain. For example, I don't remember having had any lectures on the subject of pain management and most of the practices are simply handed down to you as a resident. Nurses know more about pain management than most doctors because they are the ones who have to make the "prn" pain med decisions.




          If you still are having such severe pain with the dressing changes, talk with your nurse and ask them if they can ask your physician for a prescription for Morphine Sulfate IR (MS IR) 15 mg.. This is "instant release" oral morphine and is equal to about 2 mg. IV Morphine. It also comes in 30 mg. doses if needed. It works in about 5-10 minutes, so you would take it before they start changing the dressing.



            Thanks for the idea. I may give this a try. However, in the hospital they'd give me 4 mg. of morphine, and once I even had 2x 7.5 mg Lorcet tabs plus the morphine and it just took the edge off of the pain a little....there was still a huge amount of break-through. Heck, on my worst day at the hospital I had 4 mg. of morphine injected every 60-80 minutes in an semi-successful attempt to just keep up with the baseline of the pain for the day. Did I mention that I've always been highly resistant to pain killers? [img]/forum/images/smilies/wink.gif[/img]

            Thankfully, I realize that the pain ramps down from day-to-day. I don't need buckets of morphine amymore, and bit by tiny bit the dressing changes will be a little less torturous. It's already better than it was at my worst points in the hospital. The one thing today that was no fun was when the homecare nurse had to measure the depth of the wounds (3+ cm). They'll probably have to do that from time to time to see how the healing is coming along.

            I know that sometimes life holds a few surprises, and some of the times things can sort of snowball from there. So, did anyone get the number of that huge snowball that mowed me down (and gored my tummy in the process)???

            David Berg