How do I ask for really good pain control after surgery without sounding like a drug seeker ?

[CMOTdibbler]

I'm having my wrist fused tomorrow, and am bricking myself as after my last surgery on my wrist I was in terrible, terrible pain. I developed CRPS which means that I am always in pain with a huge reaction to cold/touch etc.

So obv, am v concerned about coming round in lots of pain tomorrow, and pain control after. But not sounding like a whinger etc

Any advice on how to approach this ?

You need to say what you've just posted to your anaesthetist and be guided by what they say. They are extremely knowledgeable on pain control. its what they do. Many trusts also have a pain nurse specialist, be guided by what the anaesthetist says, the pain nurse may be suggested.

Dont worry about sounding like a drug seeker. You wont, unless you go in demanding pethidine by dose! It doesn't sound like you will.

Hth.

Also, make sure you request your analgesia before the pain becomes too bad. It is easier to keep on top of pain, than to start all over again ITMS.
You may qualify for patient controlled analgesia which is a little watch type thing that you press, it goes straight into a vein.

Thank you both - I think I am getting a bit panicked about it as last time it was like pulling teeth to get any pain relief, and because the ongoing nerve pain has worn me down

Have a good chat to the aneasthetist before hand.

Good pain control is all about not allowing the pain to breakthrough; you can ask him to impress this on the nurses to make you sure you get your pain meds on YOUR schedule, not the ward drug round schedule.

Ask him about - paracetamol before surgery. Paracetamol is an excellent analgesic if taken continously before and after surgery, but useless if taken once pain has already started. Take it alongside any other pain meds such as Volterol.

Volterol 75mg is also excellent - only needs taken X2 daily. Is good in combination with codeine for horrible pain. Ask if it's appropriate to be given this straight after surgery. If you are having a GA, it can be administered rectally in theatre.

Once the acute post-op is over (24-36 hours), you could consider exchanging the Volterol for Ibuprofen and contiuning the paracetamol.

If your pain is likely to continue for weeks, ask about the side-effects of long-term use of Volterol/Ibuprofen adn what he suggests (I'm thinking stomach ulcers).

Good Luck!

I agree with the having the discussion beforehand rather than after the surgery.

You could also ask for a referral to a pain clinic to look at other more holistic approaches to pain management. Given your history, it's legitimate to be asking now (and by asking now, you could save yourself some time on the waiting list) and by showing that you're looking beyond the drugs, you'll be able to pre-empt any junkie allegations.

Although, really, it'd be a heartless professional to cast you as a drug seeker with all you've been through. I would really hope the anaesthetist, surgeon, nursing staff, GP etc will be more sympathetic. They should be...

Thank you - am back home now, and in stark contrast to when I was in another hospital for the other surgeries pain control seemed to be very high on the agenda. They put a local block in place during the ga, but it didn't fully work so needed other stuff. But pain relief was offered frequently and given promptly. And have been sent home with a plan

That's great. I hope the plan works, and that the pain is more manageable this time...