Sorry to hear you're in so much pain. I thought I'd throw in my "two cents" for what it's worth.
First, it seems like most docs are careful to say that the pain meds should not be eliminating your pain. If your pain is well enough controlled for you to get out of bed, complete self-care activities (shower, dress, prepare & eat simple meals) and participate in certain socially required activities (generally, either part-time work or homemaking) then they don't seem prone to write for more narcs. I know it seems like we should have a right to be able to do these things without being in so much pain, "like the rest of the world", but that's simply not the case. For that matter, it should seem we should have a right to have some energy left for socializing, hobbies, travel or just having fun, but again, not the case. I'm not sure why the docs seem to believe this, but it's my observation that it generally holds true.
If, on the other hand, you are bedridden, unable to participate in your therapy routines, unable to take care of yourself or, to a more varying degree of importance, if you can't make any contribution to society [which includes contributions that would require further job training/eduction], it seems docs are more likely to up your meds, at least on a short-term, wait and see basis. If you can't do these things, you need to be honest with your doc. Tell him that the only time you are able to [get out of bed, do your therapy exercises ... or whatever the case may be] is when you have just taken your meds / or if you are not able to do those things at all, tell him that.
Keep in mind that in most cases the doctor's whole goal is to get you healthy. Bedridden, sedentary, malnourished and unbathed people are far more likely to get sick or experience serious complications. Also, if the only thing holding you back from work is poorly-managed pain, again it's pretty likely your doc will work with you to resolve that.
I admit that I have a pretty good relationship with my PM. He's gotten me taken care of with very strong narcs when I needed something much stronger than my regular routine just to be able to get myself up out of bed to go to the washroom. The bedbugs told a pretty clear story of how sad of shape I was in then :) & my PCP agreed to help monitor me for the short term while I was on the super high dose. If things are super bad & you still can't get through to your surgeon on your own, maybe your PCP or neurologist or someone can help take up your cause.
On the opposite end of the spectrum, I've had other times where I was just plain exhausted of being in pain all the time & wanted a break for a few days. On occasion, my PM has been willing to help me out during those times, but most of the time he tells me I need to be more consistent with my therapy exercises. Even for my sister's wedding, I was told to manage my activity time and mostly just tough it out (I did get one extra dose of meds for that day, but I'll admit it took every ounce of love I had for my sister & brother-and-law to smile for the pictures). I know it's a lot of responsibility to take on yourself, especially if you're young, but try to hang in there & hold on to hope that things will get better, easier, happier, etc. if you just keep working at it.
Wishing you the best,