Managing Your Pain

Types of pain after surgery

Muscle Pain: You may have sore muscles, especially around your neck, back, and shoulders from lying on the operating table. Sometimes you need to be positioned in specific ways for your surgery that can cause discomfort afterward. These special positioning needs should be discussed by your surgeon before surgery.

Throat Pain: If you had general anesthesia for your surgery, you may have a sore or scratchy throat from the breathing device that was used to help you breath during surgery. This usually lasts only 1-2 days and improves with soothing liquids and lozenges.

Incision/Surgical Pain: You should expect to have some pain from the surgery itself. Your anesthesiologist, surgeon, and post-anesthesia nurse will all work with you to help control your pain after surgery. Having realistic expectations prior to surgery of what to expect for post-surgical pain is important. If you have a history of chronic pain or narcotic medication use, it may be more difficult to control your post-op pain. If this is your case, please discuss this during your POSH phone call or telehealth visit. This will allow us to make a plan to help with pain control after surgery.

Rating your pain

It is important that you help your healthcare team “rate” your pain so it can be treated appropriately. Sitting up, walking, coughing, and deep breathing are all important activities after surgery that are easier to do if your pain is controlled.

You will be asked to rate your pain on a numeric pain scale, with “0” being no pain and “10” being the worst pain you could ever imagine. After surgery, you will be assessed frequently using this scale to ensure that your pain is being adequately treated. Your vital signs, particularly blood pressure and breathing, will be monitored while you are receiving narcotic pain medication to ensure you are safe.

Make sure you ask for pain medication before the pain becomes too severe! Once pain has escalated to “severe” levels, it is much harder to manage.

Types of oral pain control

Non-narcotic medication

Medicines like acetaminophen (Tylenol) and ibuprofen can be very effective after surgery. If taken around-the-clock, instead of on an “as needed” basis, these medicines help keep a steady level of pain-reducing-medicine in your system and decrease your need for narcotics.

Narcotics

Medications like fentanyl, morphine, hydromorphone, and hydrocodone can be effective at reducing pain. If narcotic pain medication is needed, your doctor will prescribe this on an “as-needed” basis. They also may be used when your pain level cannot be managed with non-narcotic medication alone.

Narcotic pain medication is not without risk, which is why they are used only “as-needed.” These medications are helpful, but they can cause nausea, vomiting, itching, drowsiness, constipation, and slowed breathing. Using them has been known to lead to dependence and addiction. The risk of this happening, though, is less if the medications are used properly and for a short period of time.

Helping us help you manage your pain

Since you are the only one who knows where your pain is and what it feels like, you have a key role in managing your pain. Together, we will come up with a pain management plan that keeps you safe and meets your needs.

Why does walking help reduce pain?

After surgery, rest is not the best medicine. After recovering from anesthesia, early mobility is the key to reducing pain and improving recovery outcomes. Walking early and often after surgery:

• Improves blood flow- better blood flow speeds up wound healing and reduces pain.
• Helps get rid of gas that can be a significant source of pain after many surgeries.
• Prevents constipation that causes pain and other complications after surgery.

Questions to ask your doctor or post-anesthesia nurse:

• What will I be given for pain?
• How long should I expect to need pain medicine?
• When should I take it?
• What are the side effects?

Preventing constipation

Constipation, or difficulty having a bowel movement, is the most common side effect of pain medicines called “opioids” or narcotics. Most people who take these medicines will also need medication to have regular bowel movements. Constipation can lead to serious complications after surgery. Here are some things you can do to prevent this from happening to you:

• Drink lots of water. Eat ice chips. Sip on broth or tea. Staying hydrated is the best thing you can do to help prevent constipation
• Eat more fiber, such as in prunes, oatmeal, etc.
• Get active. Once it is safe to move around, take walks around the nursing unit. If you are at home, build frequent walks into your routine. Physical activity helps move your bowels.
• Talk to your doctor about medicines you can take to help you safely move your bowels.

 

Caring for Your Incision