Getting off pain meds post-myectomy

[bigschwa]

Hi. I think the pain meds I'm on, Oxycodone, are wreaking havoc with my innards, and I really want off them. I had a myectomy 12 days ago and an ICD about a week ago. I've cut down on dosage, but by doing so my meds would last longer than they would have at full dose. I went cold turkey a time or two, and that proved unwise because I woke up in a lot of pain. Maybe it wouldn't be so bad if I stopped now. I know everyone's different, but I am interested in when you stopped pain meds post-myectomy. Because I'm on Coumadin/Warfarin, hopefully just temporarily, I can't substitute the Oxy with
Aspirin/Advil/Tylenol. Thanks for any input.
David S

[eric3729]

Hey Big -

i had my surg on the 12th

oxy is a very strong one and cause some issues
i had it once and didnt like it so i switched to percocets for a few days before a switch to the more milder vicodin....the step down helped and now i only take vic about every 7 to 8 hours or so and it seems to be just enough to take the "edge of the pain" ....managing the pain is important to healing right so you take full deep breaths

-eric

[imagemover]

I was discharged from Mayo with a scrip for codeine to supplement extra strength Tylenol on an as needed basis. I used the codeine only when the Tylenol wasn't enough to take the edge off. I was also on warfarin for post-op a-fib issues.

For me this worked well, but you have to remember everyone's pain perception and tolerance is different.

[Cynaburst]

Yes, I am also wondering why you can't take Tylenol? That is what I took after my surgery to control pain. I took Extra Strength Tylenol (OTC) after day 2 and just made sure not to exceed 4000 mg. a day (which is very impt!). I took 500 mg. every 6 hours

[LindaSo]

You should consider Motrin. I was discharged on Tylenol/Motrin (max dose on each) and weaned myself off in about 2-3 weeks. I'd get off the narcotic as soon as you think you can.......not by cold turkey, but by switching the drug out.

[Pam Alexson]

Yeah... you should be basting yourself with the OTC meds in between... if you really, really need something stronger then percocets or something not so over the top for pain control... should be able to get you through.

[Woody]

Dude, Just take your pain pills, when you get low call for more if you need them, Dont cut yourself short. You just had your chest sawed open.

Gene
Myectomy Nov 9th 2009
Loma Linda Univ
Redlands, California

[bigschwa]

Gene, come spend some time in my stomach and intestines, and you will understand it's not a happy place. Thanks for the replies. I'm going to take a few more small doses of Oxy to get me through the night, and then I'm going to ask the Coumadin clinic folks at my cardio why can't I take Tylenol instead of Oxy.

[mbcube]

Dave, Once I read your last posting I think I know why they don't want you taking tylenol. When you first go on thinners it really takes a while to adjust the medicine to not only your diet but your other meds. Now, I'm not aware of any conflict (and I'm not a pharmacist) but I'm sure the Blood Girls (Thats what I called them) don't want any changes while they are trying to adjust your thinner levels. I think you should you be oK to swap (slowly) but discuss your plans with not only your surgeon, but your pharmacist and your blood girls. All three should be aware of whats going on with your meds.

Aren't you glad those nurses aren't bugging you about your bowel movements?

[Woody]

Dave, My stomach is pretty much cast iron, I can take and eat anything without problems. Sorry about your problem.

Gene

[gfox42]

Dave,
I got off narcotics while I was still in the hospital, for the same reason (what they were doing to my digestion) and others (hot flashes and light-headedness). For the rest of my recovery, I just took tylenol, and usually only at bed time. I was also on coumadin, and had no real problems with the combination. Your mileage may differ, of course.

Gordon

[bigschwa]

My wife looked up Oxycodon and saw that it was some % Tylenol, so I substituted Tylenol for Oxy to the extent of the composition of Tylenol. Ie., I'm just swapping out Tylenol for Tylenol, and getting rid of the other stuff that comprises Oxy. So, I'm taking 1 extra strength Tylenol every 4 hours, and will work toward only taking it at bedtime. I will talk with the Coumadin clinic about it tomorrow. I will also call the surgeon and pharmacy. I just can't deal with Oxy anymore. I had a LONG fall in a dream last night and woke up silently screaming and A-fibbing. It was disturbing. I've had a much better day so far. I don't know if it's Oxy, Oxy withdrawal, who knows. I'll just be happier when I'm down to a smaller amount and mix of meds. Have a good one.
David S

[tenor12bucks]

Hi David,

I'm with you in a desire to get off the hard stuff. I'm on high doses of Advil and Tylenol throughout the waking hours, and I've been taking a single Percocet at bedtime. Besides the GI complications of narcotics, they make me loopy, and I've decided I dislike cognitive impairment just a little more than I dislike pain. I'm still in moderate, sometimes borderline severe pain a little less than 3 weeks post-op, which I suspect is normal recovery. It's worse in the early mornings and at the end of dosing intervals, and interestingly seems to be relieved by walking (endorphins, perhaps?), which is powerful incentive to stay active.

For what it's worth, both my internist and Dr. Ho (my HCM expert at Brigham & Women's, an HCM center of excellence) told me bluntly to not be a hero and take the Percocet whenever I want. Clearly they don't want their patients in pain.

Off-subject, but worth mentioning, Dr. Ho came back from her maternity leave and saw my operative report in her inbox (which I can only imagine was crammed full of paperwork). She called me on my cell phone the other day to check on me and offer any assistance she could. She's not local to me nor was the surgery done at her center, so I thought this was a classy thing to do, and I'm grateful for her follow-up.

Best,

Michael

[bigschwa]

Michael, good luck with your pain management. We'll plow through this.
To give you all an update on the pain meds, I talked with the head of the Coumadin clinic at my local cardio, and she said no problem with a little Tylenol. What we did was nixed the Percocet (I said Oxy, but it's actually Oxy + Tylenol that are in the Perc), and substituted only the amount of Tylenol that I was taking via the Perc already. I think I'm doing much better on the pain management front now. I believe I took 1 extra strength Tylenol and a sleeping pill last night, maybe another Tylenol in the a.m., and I haven't had anything else in the way of pain meds all day. My incisions (sternum & ICD area) are a little sore to the touch, but very bearable. I'm no fan of sleeping pills either, but I can say it made a world of difference to sleep through the night and not wake up to my alarm every 4 hours for pain meds. I think I'll go with this approach until I can sleep a little better on my own. So far, my belly issues, which are improving, and sleeping, have been my biggest complaints. Anyway, there you have it. Thanks for the feedback. If you have anything to add, by all means. Otherwise, I'm going to carry this all back to my Bigschwa Myectomy thread. Best to everyone.
David S

[mtlieb]

My personal experience post-myectomy was that the sooner I got off the narcotics, the better. As soon as you are able to tolerate just Tylenol for the pain, by all means please do so. In the long run it was better to have a bit more pain than withstand the side-effects of the narcotics. Get your body back to normal operating status as soon as possible, even if it involves a short-term tradeoff between pain and drugs.

[bigschwa]

I totally agree, Mtlieb, Michael, and Gordon. I've been completely off pain meds for several days now, and I stopped the sleeping pills. I'm trying to do everything to get my stomach and body back in order. I really don't have much pain now, anyway. The incisions are sensitive to the touch, but they aren't persistently hurting. I want to get off most all my meds, but I've got to keep taking Coumadin and an anti-arrhythmia drug for now, so there's no choice and I've got to be patient. Take care, everyone.
David S

[Twalker]

I came home 4 days after having my surgery, they gave me oxy's and tylenol to take inbetween, I took these for 3 days after discharge and then switched to tylenol only, I think you will find that pain killers like oxy's only seem to really work for the worst of pains, once you reach a certain level of lower pain they don't seem to work as well as something like tylenol, at least for me. I'm so anti pain meds though I tend to push myself off them quickly. dang things scare me :)

[kfults]

The oxy was making Brian very dizzy. Being a nurse and aware of med, we changed him to Ultram which is tylenol based and stronger than tylenol but not a narcotic and no where nearly as strong as oxy. Working well. He can have two every 6 hours or 1 every 3hrs.... so far so good. Much less complications.