Just a note of advice regarding pain meds (spinal surgery experience)

I wrote this in response to a specific query from a prospective surgery patient at Wooridul. She had asked me (via email) about pain meds... This is in specific reference to spinal fusion surgery conducted by the Wooridul surgeons at Saudi German Hospital in Dubai, and is based entirely on personal experience

All information, comments and references are purely my opinion, and not meant to be taken in any form as medical advice in any way.

Regarding which pain medication you need to take with you to hospital, you do not need to take any at all. The hospital will fill out your prescription to take home.

Immediately after your surgery you will be put on a morphine drip which is called PCA. This stands for patient-controlled activation which means that you can press a button to get a dose of morphine whenever you need it. Most people out of North America tend to rely a lot on the PCA and they will end up usually using a lot of this morphine during their initial recovery. I used this pump perhaps 3 - 4x max during my entire a night after the operation. The nurses will remove the pump and access to morphine as soon as possible because they say that you can get used to it very very quickly.

You are also given a IV drip pain medication which is mild but in combination with the morphine and later on the water and injection that they will give you you should be ok for pain during your two day stay at the hospital. When you're ready to go home the doctor will write out a prescription with the nurse will fill for you and bring up to you with instructions. This has a full course of antibiotics and the red panadol. I think this is called panadol extra it is really an over the counter pain reliever and is nothing really special to handle your pain at home.

Because you mentioned that you have a low pain threshold I suspect that you will want to have access to Voltaren and 75 milligram slow release dosage. I don't think that you should be taking anything stronger than that and I will explain why in the next paragraph. 

As far as you're taking proxen 500 which is a NSAID you should not be taking any nsaid or any medication that thins your blood before your surgery. This includes aspirin and sadly also includes ibuprofen so you really cannot take Advil either. Obviously anything that is your blood causes excessive and additional bleeding during surgery and that's not something that the doctors like to see. So if you can please stop taking proxen before your surgery at least this is what I have read in at least a dozen different references.

Again I would have a box of voltaren 75 at home because that will help you take the edge of your pain if you feel that panadol is not sufficient. By the way, panadol and Tylenol are both the same medicine meaning they are both acetaminophen family. Extra strength tylenol is something that has worked for me over the years and I like it a little bit better than I like panadol extra or exercise or any of the other panadol versions but that's me.

 

Here is why the Korean doctors do not like to give you strong medication for your pain and I believe that once you really understand why - you too wouldn't really want to mask your pain with heavy duty pain meds. When you take strong pain medication you are actually unable to realistically respond to any queries by your doctors as to how your pain is. Essentially this means that you are unable to give a proper evaluation of how you're really feeling from a pain perspective. So if someone asks you as to how is your pain today - and you were under pain medication - your answer would be not accurate because your pain could be less because of the heavy medication or because it is actually getting better. All heavy pain medication such as tramadol oxycodone etcetera are narcotic blockers which actually stop the pain message from reaching your brain. In that sense your body is no longer able to signal to your brain what is your real pain situation is. Trust me I too am not a huge fan of pain but I have learned from this experience that one can really do without all those heavy duty drugs.