Pain Killers Post Takedown

Well, the narcotics are for the incisional pain, which should be subsiding more and more each day. They slow the gut, which in turn, can increase abdominal distension, leading to more cramping (making them counter-productive). The better option, if you need it, is antispasmodics, not opiates.

So, while it is true that it is not uncommon to still have pain a couple weeks after take-down, the residual pain is not directly related to the minor surgery, but the effects on the gut as you adapt.

Percocet is strong stuff and for short term use only. Same as Oxycontin with added Tylenol.

Jan

There was no way in hell I could be off them until 3 months post op.

Vanessa, remember that the BCIR is WAY different than an ileostomy take-down...

So, apples and oranges!

Jan

A lot of Drs are under the microscope with prescribing pain medicines due drs losing their licenses for issuing it in mass quantities to a variety of patients. There are also so many dr shoppers that go around trying to get different drs to prescribe them pain medicine that it is ruined for the people that actually need it. Its evident that you would fall into the category of needing it just a couple weeks out of surgery. My surgeon promoted it especially to take before bed due to incontinence. He didn't want me having accidents every night. I believe in pain medicine if used correctly. If you are still in a lot of pain and you are not getting the relief in what you have now the Dr should have your best interest in mind and want you to be as comfortable as possible as you transition. Luckily I have a great surgeon that is understanding and not a gustopo when it comes to pain medicine. I would see if your surgeon is not on your side to contact a pain management clinic and see if you can be treated if things are that bad.

If you do still need pain medicine, it is more appropriate at this time to be on Norco or Vicodin, not Percocet. Still, nothing is set in stone. The type of pain you describe sounds like cramping pain, not surgicL pain. That was why I suggested antispasmodics.

It seems that your surgeon did not offer you good options others than to tough it out.

Jan

The cramping pain should subdue over time though shouldnt it? I get these short burst of urgency and internal cramping for about 10-20 seconds where i tighten up down there and after a few seconds it does go away. This happens frequently throughout the day, just wondering if this is normal?

Jan - just curious - why is Norco considered more appropriate than Percocet in this situation?

Hi Manny, I am two weeks out too (my op was the day before yours I think ) and I have the same kinds of cramps. I know some people find that eating triggers them, for me it is changing positions, so like when I stand up from sitting down I tend to have them the most. Anyway, everyone including my surgeon insists it will go away with time and is nothing to worry about.

This might be total placebo effect but I was having trouble falling asleep because the spasms were waking me up whenever I started to fall so I started taking 650 mg of regular Tylenol before bed (two regular strength) and it helped a lot. I don't know why Tylenol would stop spasms... maybe it just dulls the pain of them... but it helped me. I can't take oral opiates because they stop my gut almost completely so Tylenol is all I use.

is there specific type of tylenol we should get as well as stay away from? Gel vs hard ones?

Tylonal is the best to take to avoid additional GI problems. Unfortunately I have such a high tolerance for pain medication I could take them like candy call day with no result which you don't want to start taking massive amounts because I believe 5000mg a day gives you extreme risk for liver damage. Tylinal is a type of medicine that is not directed to attack pain but put a block on the pain receptors in the brain. You can easily get a tolerance to it though and that's where the increased dosage comes in. I pretty sure Jan in mentioning Norco or Vicodin because they have less codeine content and add more acetaminophen which is the active ingredient in tylonal so you have a lot less chance for a blockage due to a slowed down gut from the codeine. Is that right Jan?

Percocet has oxycodone (same opiate as OxyContin). It is more potent, highly addictive and mostly for the more serious post op pain. Generally, it is for the immediate post op recovery time. As, you heal, you are supposed to either wean off or step down to less potent opiates, like Norco or Vicodin, which contain hydrocodone. All these meds contain Tylenol. Norco has less Tylenol than Vicodin, so they are moving more toward Norco over Vicodin, because of the increasing instances of Tylenol poisoning, leading to liver failure. Tylenol is in too many OTC preparations.

They say that you cannot become addicted if you use opiates for pain, but that is nonsense. The use for pain conditions is the primary way most become addicted.

It is a difficult balancing act, because we all feel pain our own way. It is highhly subjective. Plus, we each have our own perception of what is considered acceptable discomfort. Unfortunately, the symptoms of opiate withdrawal are similar or the same as what you describe with crampng abdominal pain. So, the big question you need to ask yourself is whether your pain and spasms are due to the take-down surgery, or because your last dose of Percocet is wearing off (withdrawal). I can't tell you which it is for you. But, often people underestimate how difficult it can be to get off oxycontin. This was why I suggested asking for a lower potency of opiate and/or antispasmodics to help with your symptoms.

Your surgeon was probably doing you a favor. He just did a lousy job of explaining it, not to mention not offering alternantive treatment for your symptoms.

Jan

Thank you all so much for your input/advice and Jan i agreee. I understand now why my surgeon did not want me to continue taking percocet I just wish he wouldve explained it a little better.

Liz, i will definitly be taking your advice and trying tylenol when the spasms take place as I do tend to see them more right after any food consuption but i must say I have seen a huge improvement over the last 24 hours. I have only had a handful of spasm attacks which would normally happen within the course of an hour or less.. Maybe im finally over the hump, at least the spasm part of it anyway. Sleeping has been an issue as well, not so much because of the spasming but more so due to the fact I have to empty the pouch every 2-3 hours. However, I am grateful that my body wakes me up so i can go to the bathroom because that avoids any accidents which im happy to report I have been able to avoid up to this point. I attribute that to the kegal exercising, which I highly recommend.

I was on Oxycontin and I tell you what....I had to chuck it in the garbage because I started liking it a little too much. I needed it after my first surgery but not so much after takedown (not sure why I even filled the script). That's when I threw it out and dealt with the little pain I had. That stuff is really addicting.

Its your Drs job to ween you off of any type of addictive pain meds. I would not suggest you just stop taking pain meds on your own if you've been on them for a while you will pay the price with a terrible withdrawal. I don't believe 5/325 of percocet is that big of a deal to stop I mean you should be weened off by going down to vicadin or norco and then off totally. I'm on 30mg of oxycontin every 12 hours and would never even think of just tossing them and put myself through that hell that would do me more harm than good. I know because I've been through it before and wouldn't wish that feeling of withdrawal on anyone. I'm surprised anyone would be able to just stop taking an extremely potent drug like oxycontin and its not recommended to do that with any medicine you've been on for a decent amount of time. Good Luck.