Short Term Pain for Long Term Gain

The fear of the unknown, especially as it relates to pain in the period immediately following surgery, can be a major deterrent for patients who would benefit long-term from a surgical intervention. Most everyone worries about "how bad this is going to hurt." Indeed, no surgery is completely pain free. Some can come close, but most every surgery will be accompanied by some level of discomfort.

The better question you might ask is will the pain you experience in the short-term be worth the long-term benefits and do you have the best plan and the right team to get you through it? We put a great deal of effort into helping patients answer those questions and into making sure you have a plan of treatment and pain management plan that is individualized and updated to meet your ongoing needs.

Customizing your pain management plan

One of the best ways to ease anxiety about a major event, like surgery, is to plan ahead. Conversations about postsurgical pain management need to happen before your procedure, so you can focus on your recovery after surgery is complete.

The creation of a pain management plan is an incredibly individualized experience. Your initial pain management plan will be determined before you go into surgery based on:

• Review of your medical and surgical history
• Physical exam
• Information you share with your surgeon and anesthesia team regarding your previous experiences, perceptions of pain, and the planned procedure.

A combination of medications and comfort measures may be used to block the pain in different areas. There are options for pain management that you may not be familiar with, and your health care professional will advise you about which therapies may be best suited to safely minimize your discomfort. 

What should I do before my surgery?

The most important thing for you to do before surgery is to be an active participant in setting realistic expectations and goals for post-surgical pain management. Pain following surgery should not be severe or intolerable, but it is reasonable to expect some degree of discomfort. 

Make sure you receive education about what to expect following surgery and that you understand your recovery plan. We work to make sure our patients understand the type and level of pain to expect, where they can expect to feel it, and the best interventions to control specific types of pain.

Speak up if you still have unanswered questions before surgery, and ask your surgical team about the risks and benefits of medications being used along the way.

Be patient and understand the mental side of pain. If you move forward with surgery, know that surgery is traumatic on your body and healing takes time. Cut yourself some slack and give yourself the time you need to heal.

What can I expect on the day of my surgery?

Before surgery it is common to receive preemptive or preventive pain relievers. We have found that engaging pain receptors with medication before surgery can dramatically reduce pain in the immediate recovery period.

It is highly likely that local anesthetics will be used during any surgery that requires an incision. Local anesthetics are numbing medications that can be used to numb the area where you had surgery from anywhere between a few hours to a few days. These may be placed directly into the surgical site or into or around a nerve ("nerve block").

How will my pain be managed after surgery?

Depending on the type of procedure you're having, a combination of narcotic and non-narcotic medications may be used before, during and after surgery to block the various sources and pathways of pain. Essentially, these drugs may work in different areas or in different ways to better address your specific needs.

In the immediate recovery phase, we will make sure you are recovering in a calm and quiet environment where you can rest comfortably. Our pain management plan is centered upon the use of narcotic and non-narcotic IV pain medications and comfort measures such as ice packs and dim lighting.

As soon as you are ready we will want to get you up and moving after surgery, because monitored activity can dramatically reduce post-operative aches and pains.

 

How will we measure my pain?

One of the best signs of proper pain management is being able to start moving and resume normal activities. You will also be periodically asked to measure your pain on a scale from 1 to 10 (with 10 being the worst pain and anything above 7 being severe, 0 being no pain). A pain score of 2-5 is reasonable and expected. If you're taking pain medication, it's important to stay ahead of your pain and not let your pain levels get out of control.

What do you need to know about me to individualize my treatment plan?

Sharing information about yourself and your medical history will help your surgeon better understand your treatment needs and tailor a pain management plan that's right for you. Let your health care provider know if you are:

• Allergic to certain medications
• Pregnant or breastfeeding, or planning for either
• Taking other pain medications or sedatives
• Nervous about taking narcotic medications, or if you've had a previous negative experience
• Personal or family history of opioid dependency/addiction
• Sleep apnea
• Asthmatic, or have COPD or other breathing problems
• Suffering from a stomach ulcer or other gastrointestinal problems
• Currently taking blood thinners or medications for other conditions
• Have ever been diagnosed with heart, liver, or kidney disease

How can I minimize exposure to narcotics? What options do I have?

There are a variety of products your surgeon may give you before and during surgery to minimize your need for narcotics after surgery, including local anesthetics. If long-lasting local anesthetics are used during your procedure to numb the surgical site, you may require less narcotic pain medication afterwards.

After surgery, there are several non-narcotic options that may be appropriate for you, including common over-the-counter (OTC) pain relievers like acetaminophen, and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen. These may be prescribed in higher doses than the OTC dosages. All can help control mild to moderate pain, while NSAIDs may help reduce swelling and inflammation. Once you're in the recovery room, your pain medication may be given orally or through an IV. 

As health care professionals who prescribe opioids (narcotics) to surgical patients, we recognize the important role we play in combatting this epidemic while still improving the lives of our patients through high quality surgical interventions. For more information, click here.

What side effects can I expect?

The kinds of side affects you may experience will depend on the type of medications used before, during and after your surgery. For example, narcotics may cause constipation, nausea and vomiting, while nerve blocks can cause muscle weakness. Ask your health care provider about the side effects that can be expected with all the pain medications you will receive.

How will I manage pain at home?

Before you leave, the staff at CSA Surgical Center will make sure you feel 100 percent comfortable about how your pain will be managed at home. We will provide education specific to your surgery regarding all kinds of home comfort measures including review of your written home pain medicine schedule, ice/heat therapies, ways to minimize pain with certain activities, and the use of stool softeners, sitz baths, massage, and even essential oils as applicable. We want to make sure you and your responsible party understands your recovery plan and have all questions answered before you leave the facility.

In most cases, you will be given a prescription for pain medication before or after surgery. You may be able to fill the prescription at your local pharmacy for pickup on your way home. Making sure you have your pain medication in hand when you reach home, will help you stay ahead of your pain and not let it get out of control.

Before you take your medication, be sure to read the enclosed instructions about how often to take the medication and what side effects to look for. If you have any questions about your pain medication, ask your local pharmacist or your health care professional.

Make sure to get enough rest and call your surgical team with any concerns or questions you develop following you surgery. Your recovery and pain management plan may need to be updated or modified based upon what you are experiencing in real time… that's why we're here!

The actual surgery is only one piece of your surgical experience and we are never more than a phone call away every single step of the way!

Additional post-surgical tips from our staff include:

• Keep up with your icing after surgery! Typically, icing is recommended 4-5 times a day for 15-20 minutes. This helps with swelling, and therefore cuts down pain.
• Fear and anxiety about pain actually contributes to the amount of pain you feel. Employing mindfulness meditation and other stress-reducing breathing techniques are a great way to manage pain.