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ACDF Pain (allergy to narcotics)

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Chronic Pain
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colochick
New Member
Joined : Dec 2020
Posts : 3
Posted 12/9/2020 10:21 AM (GMT -7)
I am scheduled for ACDF surgery on Dec 15. I am allergic to narcotics (mast cell disorder causes anaphylaxis reaction.) I may be okay with fentanyl, but is typically only through iv so I won't be able to use it once at home. Surgeon has said we will have to manage pain with tylenol, gabapentin, celebrex (for a couple days), and muscle relaxers. Can anyone provide insight if they were able to manage post-surgical pain without narcotics or tips for recovery?
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straydog
Forum Moderator
Joined : Feb 2003
Posts : 18325
Posted 12/9/2020 11:37 AM (GMT -7)
Hi colochick & welcome to the forum. We just recently had a new member Anet have a fusion & she was sent home with Tylenol only. The medications you listed should give you some relief, some of the big university hospitals are doing surgeries & they are offering zero narcotics but giving the medications you have listed. A lot of drs are rxing Gabapentin instead of a narcotic. Celebrex & the Gabapentin will also help with inflammation. I suggest that you take these medications on a schedule, set alarms on your phone. If you find yourself in trouble, don't hesitate to contact your surgeon regardless of the time of day/night.

Ice packs are very beneficial too. Do not use heat, heat will aggravate the post op inflammation. Do not try to lay with your head propped up on the arm of a couch. Keep your posture in check. A lot of our members use a recliner to recline in & sleep for a few weeks. They find it too difficult to get up & down out of a bed. If you don't have one, consider renting one or borrowing one from a friend or family member. Get a "grabber" to pick things up off the floor. These can be bought at the drug store & they are not expensive. Be sure to have plenty of water on hand, if you will be alone during the day have foods that can be heated in the microwave. Basically, you will need a lot of patience during the healing process, it will take many months to completely heal & recover, not 6 weeks. Get a comfy recliner & rest. Yes, you will need to get up & walk around in the house too. Nothing wrong with stepping outside to get some sun & fresh air every day. I'm sure I am missing some things, if I remember more I will post here. Follow your post-op directions to the letter.

Take care.
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colochick
New Member
Joined : Dec 2020
Posts : 3
Posted 12/9/2020 12:26 PM (GMT -7)
Thank you so much Susie. That is exactly what I needed to hear. My surgeon hasn't had a patient not use narcotics before, so I haven't had much confidence in recovery.
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biggienpain
Veteran Member
Joined : Mar 2010
Posts : 533
Posted 12/9/2020 5:43 PM (GMT -7)
Susie I’m confused which doesn’t take much. If fentanyl is ok through Iv why wouldn’t it work using a patch?

Good luck with your surgery.
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colochick
New Member
Joined : Dec 2020
Posts : 3
Posted 12/9/2020 9:25 PM (GMT -7)
My surgeon did mention a fentanyl patch- he just said he would have to look into it because he didn’t like the idea of the rx being given full time.

So I’d be curious the answer to @biggienpain’s question also. Thanks for bringing that up!
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straydog
Forum Moderator
Joined : Feb 2003
Posts : 18325
Posted 12/10/2020 6:56 AM (GMT -7)
I am sure your surgeon will be checking into the Fentanyl compounds closely. Something else I will suggest, get bendable straws, you will not want to tilt your head back to drink. Also, no pullover shirts, get some shirts that either button or zip up. Do not try to do anything overhead, reaching up with your arms. Make sure your shoes are slip on with a good grip, not slick.
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Mercy&Grace
Veteran Member
Joined : Jun 2013
Posts : 1874
Posted 12/10/2020 10:16 PM (GMT -7)
Fentanyl patches are not indicated for acute pain. Even if your doctor prescribed it for post op pain. I seriously doubt your insurance would cover it for that. Susie, what do you think?
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straydog
Forum Moderator
Joined : Feb 2003
Posts : 18325
Posted 12/11/2020 7:56 AM (GMT -7)
colochick will be be meeting with the anesthesiologist at a pre-op visit & will be discussing her issues with narcotics. Fentanyl is often used as anesthesia for surgeries of various types. I really doubt an anesthesiologist would consider using it if this was his/her plan & this will be in her chart along with bold warnings.

What I can't tell from her original post is her comment of "I may be ok with IV Fentanyl". My question is has she had IV Fentanyl in the past & how did she tolerate it? If she has tolerated it in the past, my only guess is the surgeon sending her home with a low dose patch already in place. It will last the max of 72 hours, but again, this is strictly a guess. Usually patients get a steroid block to help with the post-op pain, this block can last up to 24 hours. One thing I do hope is that she is kept in the hospital over night & not sent home same day of surgery.

I would be surprised if she was rx'd a script to get filled, look at the meds above the dr has discussed for post-op pain.
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biggienpain
Veteran Member
Joined : Mar 2010
Posts : 533
Posted 12/11/2020 8:54 AM (GMT -7)
Also I would give a warning about them. When you no longer need there may be withdrawal symptoms. I have weened off twice in the past thinking I could live without. Not the case. I have to have my patch always.

Thanks Susie. I knew you would be very helpful.
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Alcie
Veteran Member
Joined : Oct 2009
Posts : 5156
Posted 12/12/2020 2:07 PM (GMT -7)
What about tramadol?
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Mercy&Grace
Veteran Member
Joined : Jun 2013
Posts : 1874
Posted 12/16/2020 5:29 PM (GMT -7)
Usually patients meet the anesthesiologist shortly before surgery. It might be different in different facilities. Where I live, we have several large hospitals including a teaching hospital. The anesthesiologist in each of these facilities meet with the patient shortly before surgery or procedure. Sometimes when the patient is already in the hospital. The anesthesiologist meets with them the night before.
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