Talking With Your Doctor
The sooner the better. There are treatment options to consider before, during and after surgery that can impact the medications used, for example, opioid versus non-opioids and for how long they're needed.
Let your doctors know how much technical detail you're comfortable with so they can use language that makes things clear to you. Your doctors want you to feel informed, so don't hesitate to tell them if you don't understand what they're explaining.
The Doctor Discussion Guide is a good place to start preparing for conversations with your doctor. The Guide will help you organize the information that your doctors will want from you and help you create a list of talking points that you want to touch upon. Try to remember that these conversations are as important for the doctor as they are to you, so don't be shy.
Preparing for Your Surgery
Giving up smoking as soon as possible before surgery and not smoking after surgery has been shown to reduce wound complications significantly.
Will your surgery affect your mobility? Can anything be rearranged to make it easier for you to maneuver at home or make you more comfortable? If you need caregivers, will they be available when needed and aware of your needs and limitations? Will you need transportation? Your medical team can provide you with a detailed list to help you prepare for your recovery at home. The sooner you discuss this with your doctor, the more time you'll have to prepare.
You can also read other post-op recovery tips here.
Pain and Pain Management
Patients and doctors use many words to describe pain — sharp, shooting, splitting, stabbing, tender, and throbbing are just a few. Try to note how long it hurts, where, and if the pain is triggered by anything, such as a specific movement – but don't worry if you're not sure how to describe your pain. Your doctors can use questionnaires with many terms to help you describe your pain and when you feel it.
Your doctor has several measurement scales to help you describe your level of pain. Some use numbers or scales to rate your pain, or you may see a chart of “smiley face” style cartoons. The important thing is that your doctor has several options to keep an accurate record of any pain you might experience.
Acute pain refers to pain that comes on suddenly, lasts for a limited time, and usually has a known cause. It's another way to describe pain after surgery because the pain has a known cause and with proper management and care, eventually stops. Chronic pain is a long-term condition that can have multiple causes and is more difficult to manage. Preventing acute pain from becoming chronic pain is an important objective of your pain management plan.
Talk with your doctors and share your concerns in detail. The more they know about you before the surgery, but the better they can plan to meet your pain management needs.
Your doctor can tell you what to expect in general terms based on what patients facing similar surgery experienced, but pain is very personal, meaning no two people experience pain the same way. Organizations such as the American College of Surgeons and the Medline Plus website discuss in general terms what to expect after certain types of surgeries, but can't predict your situation.
The general recommendation is to stay ahead of your pain — don't wait for it to build before you treat it.
In addition to your comfort, controlling pain can reduce the risk of the pain becoming chronic and get you back on your feet and walking, which can lower the risk of complications such as blood clots and certain infections.
A pain management strategy is unique because there are many factors that can affect a person's response to treatment, but your doctor has guidelines to follow based on extensive research on what worked with other patients. So along with your doctor's experience, a comprehensive understanding of your needs that you discussed and monitoring your comfort, your medical team can create a pain management plan that's right for you.
Multimodal means that different treatments can be included in a pain management plan. Because pain can have many causes, different treatments may be combined to provide the most effective relief. Another reason for a multimodal approach is that by varying the types of pain medicines used, your doctor can avoid exposing you to very high doses of any one medication, which can help to reduce your experience of side effects.
Your doctors consider many issues to customize your pain treatment plan — what was learned about you as an individual during discussions, what medical guidelines recommend for your surgical procedure, and experience with other patients.
While there are many different combinations of treatments that can go into a multimodal plan, the trend is to use non-opioid medications at the start of treatment, and to use opioids only if non-opioid treatments fail to manage the pain.
While it’s great that your pain is decreasing, you should continue treatment as directed until you speak with your doctor. If you need to take an opioid, talk with your doctor about the expectations for how long you should take the medication and when you should reduce your dose.
Local electrical stimulation of the painful area, behavioral methods (such as hypnosis, guided imagery and other relaxation techniques), cold and heat treatments, massage and acupuncture have been used to manage pain, but only some of these procedures (such as electrical stimulation and behavioral methods) are recommended in the guidelines provided to doctors. Your doctor can explain why some treatments aren't included in the guidelines even if they may work for some people.
CAM treatments include acupuncture, meditation, relaxation techniques, massage therapy, spinal manipulation, tai chi, yoga, dietary supplements and other natural products. While relaxation and other behavioral techniques are recommended in pain management guidelines, it's essential that you discuss this with your doctor to determine if these or other CAM treatments are right for you.
A reliable resource to learn about CAM treatments is the National Center for Complementary and Integrative Health (NCCIH), a National Institutes of Health research center.
Integrative usually refers to the coordinated use of CAM treatments and conventional treatments such as acetaminophen and anesthetics.
A safe or locked cabinet is an ideal location to keep your pain medications, as these places can keep prescriptions out of sight and properly secured. It’s important to take these precautions to prevent diversion or misuse of these highly addictive medications.
It’s best to get unused, unwanted or expired pain medications out of your home as quickly as possible. To ensure they are disposed of properly, bring leftover pain medications to your local police department. You can also ask your doctor for a deactivation pouch or call a local pharmacy to see if they have a disposal kiosk. Be sure to remove any personal, identifiable information from prescription bottles or pill packages to help prevent unauthorized refills. To learn more about proper medication disposal, visit https://thfp.com/zeroleft.
In addition, the U.S. Drug Enforcement Administration (DEA) hosts National Prescription Drug Take-Back events in communities nationwide for safe disposal of prescription drugs. The DEA typically hosts National Take Back Day twice a year – in April and October. For more information visit https://takebackday.dea.gov.