Pain med options?

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Red_34
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Date Joined Apr 2004
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   Posted 6/15/2011 5:49 AM (GMT -6)   
I may be going in soon for tendon release surgery for Trigger finger. I will find out more next week. But I just want to know what you all would recommend in regards to pain meds post-op? I am highly allergic to codeine in any form nor can I take anti-inflammatories except occasionally Naproxin (Aleve). I'm also allergic to Ultram.

Are there any meds out there that are completely codeine free?
SHERRY
Moderator-Allergies/Asthma and Alzheimer's, Co-moderator-UC
~Left sided Uc-'92**Unable to tolerate ALL mesalamines**
Colazal(9 daily)/6mp(50mgs)/Bentyl-Prilosec~allergies-Singulair/Zyrtec~Reynauds~OA-Tylonel Arthritis~Scoliosis~Sacroilitis~Dry eye-Restasis~GAD-Klonopin (.25mgs)~Rosacea-Metrogel/Elidel~IBS~Diverticulosis~Fibromyalgia

Snowbunny21
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Date Joined Jan 2010
Total Posts : 3557
   Posted 6/15/2011 2:15 PM (GMT 0)   
Hi Red...sorry to hear you are having surgery...but hope it will be able to take away the pain you are having in that area...

It's really too hard to 'recommend' any pain medicine as it's going to be up to your Dr. to decide..you need to ask BEFORE the surgery...who is going to be handling your post op pain....Is this out patient surgery?

Do you see a PM now? and what, if any, pain meds are you on now?
 
If you see a PM...he would work with the Dr. who is doing the surgery....if you don't see one...then it will be the surgeon to handle the post op pain for the few weeks recovery...

The good thing is there is a lot of choices for the DR...nothing has codeine in it except the old Tylenol 3....they never use that anymore really...people mistake 'codone' for 'codeine'....completely different medicines..

So if they choose a narcotic, it's most likely going to be Vicodin which is Hydrocodone and acetaminophen...or Percocet which is Oxycodone and acetaminophen...

And yes...after surgeries...they usually stay away from any NSAID's...like Aleve of Advil...

Just talk to your Dr. about this and I'm sure they will take care of you....hope everything goes well:)

Red_34
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Date Joined Apr 2004
Total Posts : 23551
   Posted 6/15/2011 8:50 AM (GMT -6)   
Thanks for the reply Snowbunny. I like to know my options before I go into surgeries because it seems 9 times out of 10 the docs don't know how to treat me pain wise because I have adverse reactions to many pain meds and other health conditions. The last time I had Vicodin, I had to be taken to the ER by ambulance due to an adverse reaction (however, that was also mixed with other medications - docs fault, not mine). I haven't had Vicodin since but I guess I can give it a go...perhaps half the dose.

Yes, this will be outpatient and fairly straight forward. Recovery may take a while but I am ready to get out of this pain now after suffering with it for 3 years (had many cortisone injections). No PM doc btw. The hand surgeon will be the one that will take over my care after my primary signs off.
SHERRY
Moderator-Allergies/Asthma and Alzheimer's, Co-moderator-UC
~Left sided Uc-'92**Unable to tolerate ALL mesalamines**
Colazal(9 daily)/6mp(50mgs)/Bentyl-Prilosec~allergies-Singulair/Zyrtec~Reynauds~OA-Tylonel Arthritis~Scoliosis~Sacroilitis~Dry eye-Restasis~GAD-Klonopin (.25mgs)~Rosacea-Metrogel/Elidel~IBS~Diverticulosis~Fibromyalgia

Snowbunny21
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Date Joined Jan 2010
Total Posts : 3557
   Posted 6/15/2011 9:37 AM (GMT -6)   
I totally agree it's very smart to ask about pain control before you go in for surgery...you have every right to talk this over with the surgeon...make sure he knows of your allergies...I haven't seen too many have a life threatening issue with Vicodin..and you said it was with other medications...so hard to tell which one...but even so...there is Percocet or OxyIR or Roxicodone which is straight Oxycodone (also immediate release) or even MSIR which is morphine sulfate immediate release..

So as mentioned...there are plenty of choices to use that have nothing to do with codeine..

Keep us posted on the actual day.and your recovery...we will be saying prayers for you and I truly hope it helps that pain and maybe even have it go away!..
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006
 
 

sunflower7
Regular Member


Date Joined Jul 2008
Total Posts : 75
   Posted 6/15/2011 9:43 AM (GMT -6)   
Hi
I am also have adverse reactions to pain meds.
Codeine is also from the opiate family so you should be careful taking any opiate medications.
That about covers all of the pain meds unfortunately.
You could try minute amounts of one of them and see what that does.
I recently started using a medication that is legal here in Canada ( with a license) and am not having any adverse
reaction to it. I was desperate for some pain relief. We are not allowed to discuss this on here however.
I hope you find something that will help.
Bonnie

Alcie
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Date Joined Oct 2009
Total Posts : 5004
   Posted 6/15/2011 10:18 AM (GMT -6)   
I've had the surgery and don't tolerate codeine or Aleve either. I do take Ultram, but it's not anywhere near enough for the pain of this - although I had 3 done at the same time. I get in trouble when I mix Ultram with just about anything, so I switch to just Vicodin for a few days for surgery.

I took Vicodin starting right in recovery. You'll have a local and think you won't really need anything, but especially since you have fibro it's necessary to get started to prevent a flare. (I get a double whammy because of post-polio, which causes the same kind of pain flare.) It's a nerve ending thing from the fibro. I prefer to start the Vicodin a couple of hours before any surgery. (There are some good websites on this.) You might ask for a Rx for Zofran too in case you get nauseous from the Vicodin. They'll probably prescribe 4 mg which may not be enough. I always need 8 mg.

Before surgery - It's not required to have Versed! That stuff only provides amnesia, has no pain relieving qualities at all. I had nothing but the local and felt nothing, not even any pulling or pressure, just nothing. There was a drape so I couldn't watch, but I would have loved to. The operation is VERY short. My 3 fingers took only 15 minutes, including the few stitches. Then they wrap it up and give you a big foam gadget that looks like Swiss cheese to protect you from bumps. Local anesthetic wore off at 3 AM, and I wished I'd taken more care to keep up the Vicodin. Pain stopped in a couple of days. Not bad.

Afterwards, the physical therapy is critical!!! You must do the exercises when the wrap comes off and stitches are out. If you don't do them vigorously enough you will get a bunch of scar tissue building up and never get your range of motion back, and it will hurt. I'm still working on my own therapy - op last summer. Scars hardly show because doc used the natural creases in my hand.
Alcie
 
 

Snowbunny21
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Date Joined Jan 2010
Total Posts : 3557
   Posted 6/15/2011 10:23 AM (GMT -6)   
Sunflower...not trying to argue with you...but codeine is only in Tylenol 3....it is not in any narcotic that is widely used like Vicodin, Percocet, Roxicodone, OxyIR, Oxycontin...to name some...
It's not in Tramadol...which is narcotic 'like' but not Schedule 2..

So...anyone allergic to codeine should not have any trouble with narcotics...and if they do...it's a totally separate issue from codeine.
 
As I wrote earlier...people often mistake 'codeine' for 'codone' the active narcotic ingredient in many of the meds I listed above...

Please discuss with your Dr. as you have been given some incorrect information..

Post Edited (Snowbunny21) : 6/15/2011 10:27:09 AM (GMT-6)


sunflower7
Regular Member


Date Joined Jul 2008
Total Posts : 75
   Posted 6/15/2011 11:21 AM (GMT -6)   
Codeine is derived from Morphine (Opiates) just like all of the painkillers. Yes it is not classified as it is a low dosage.
See below what is in Wikipedia:

Codeine or 3-methylmorphine (a natural isomer of methylated morphine, the other being the semi-synthetic 6-methylmorphine) is an opiate used for its analgesic, antitussive, and antidiarrheal properties. Codeine is the second-most predominant alkaloid in opium, at up to 3 percent; it is much more prevalent in the Iranian poppy (Papaver bractreatum), and codeine is extracted from this species in some places although the below-mentioned morphine methylation process is still much more common. It is considered the prototype of the weak to midrange opioids

Of course there is more but this says it all.

Snowbunny21
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Date Joined Jan 2010
Total Posts : 3557
   Posted 6/15/2011 11:34 AM (GMT -6)   
I really don't want to argue...if anyone has any questions...please discuss with your Dr. and/or Pharmacist...

But it really isn't the same thing at all...lots of narcotics are derived from Morhpine...like codeine is...but codeine is not Morphine and vice-versa...there are synthetic and non synthetic opiates...
 
As well as I mentioned this to another poster...Wikipedia is not a Dr.s website...it is written by people like you and me and not all factual...

So...since neither of us are Dr.s...it's best that Red or anyone else check with their Dr...

Red_34
Forum Moderator


Date Joined Apr 2004
Total Posts : 23551
   Posted 6/15/2011 12:35 PM (GMT -6)   
Thanks Alcie for your recount of your surgery. It is always nice to hear of others who have had it done. I have TF in all my fingers of my left hand, but only one is giving me a bunch of pain, it's curved (can't straighten it nor bend it), swelling and I have pain at the A1 pulley (index finger) that runs down to my palm. The last cortisone injection did absolutely nothing so that is why I want to have the release so hopefully I will get function back in that finger. I'm fully prepared for the post-op pain, physical therapy and recovery....as long as it means good things at the end of it all! :)

Snowbunny and Sunflower, thank you for your replies. If I do get prescribed Vicodin or any other "codone" med, I will definitely ask for anti-nausea med as well just to be on the safe side.
SHERRY
Moderator-Allergies/Asthma and Alzheimer's, Co-moderator-UC
~Left sided Uc-'92**Unable to tolerate ALL mesalamines**
Colazal(9 daily)/6mp(50mgs)/Bentyl-Prilosec~allergies-Singulair/Zyrtec~Reynauds~OA-Tylonel Arthritis~Scoliosis~Sacroilitis~Dry eye-Restasis~GAD-Klonopin (.25mgs)~Rosacea-Metrogel/Elidel~IBS~Diverticulosis~Fibromyalgia

Snowbunny21
Veteran Member


Date Joined Jan 2010
Total Posts : 3557
   Posted 6/15/2011 1:22 PM (GMT -6)   
Red....that's a great idea...just a thought too...I had trouble with nausea after taking Percocet for a few years...I was well below the daily limits for the acetaminophen as that is the other ingredient besides oxycodone...

And both my Dr. and I thought it just might be irratating my stomach and causing issues...I will take pain over nausea any day!! LOL...

So I am now prescribed OxyIR....that is plain oxycodone...and then if I want...I can always add a Tylenol...or I can use an Advil as needed (I know you won't use the Advil because of the surgery)...

I'm just noting that there are short acting medicines...OxyIR or Roxicodone that don't have acetaminophen...and sometimes that can cause nausea as well...

I also can't stand the old Tylenol 3's with codeine...I would get sick on those too...

I think you can't go wrong with an anti-nausea med just in case!...

I'm very glad you will discuss your post op pain care with your Dr. before surgery.....I will be praying...and sending some pre surgery hugs (( ))
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006
 
 
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