Re: My surgical experience

[Guest guest]

Hi, Chris.

See responses below:

> some reason I thought that I needed to walk right away to avoid a

> Pulmonary Embolism. I took that advice a bit too seriously I

This is good to know, because I had every intention of hauling my ass

off the OR table in order to start walking right away!

> At 7pm the transferred me to ICU. My heart was still running fast.

Was this heart rate considered normal? Was it anxiety?

> I didn't so much feel pain as discomfort and total disorientation.

THIS is what scares me! As a total control freak I want to know

what's going on! Also, the dizziness and nausea--get me some Xanax,

Compazine, and Antivert on the double!

> To this day (16 days postop) I still take some pain meds

You mean narcotics, right? Which one? Doesn't it make you more

nauseated and disoriented?

> The epidural comes highly recommended though, as it really

> worked for me.

Yeah, baby! I remember having one during both of my children's

births! They are heavenly! Dr. Gagner doesn't do them, however,

maybe because the whole procedure's done laparoscopically?? I'll get

a morphine pump, but I'm nervous about it because I know that I've

never tolerated vicodin or codeine well, and I don't want to be dizzy!

I'm glad to hear that you made it through surgery with such success

so far. I continue to be worried about the fact that, 2 weeks out,

you're still having drinking and pain problems. I hope those issues

improve right away.

All my best to you and your wife,

[Guest guest]

In a message dated 11/12/01 11:59:42 AM, duodenalswitch

writes:

<< Yeah, baby! I remember having one during both of my children's

births! They are heavenly! Dr. Gagner doesn't do them, however,

maybe because the whole procedure's done laparoscopically?? I'll get

a morphine pump, but I'm nervous about it because I know that I've

never tolerated vicodin or codeine well, and I don't want to be dizzy!

>>

: Maybe Dr. Gagner has changed his policy, but he did mention to me

that he *would* do an epidural for pain relief if I really, really wanted it.

I researched Mt. Sinai's policy (speaking with a nurse and someone who was a

pain control specialist there), and they do 'blind insertion'. Since I had

previous serious problems getting the needle inserted in this manner during

my two births, I really preferred floroscopy-guided insertion.

They said that they *could* do this, but it would involve a special

reservation of the room in floroscopy beforehand and coming much earlier to

prepare for the surgery. After long thought and Dr. Gagner's explanation

that he provides deep-tissue anesthization and that his pump (which combines

the morphine/demerol drip WITH scheduled doses of Torodol, which he has found

to be very effective for relief of swelling, etc.) was sufficient, I decided

to go with the traditional pain relief offered.

It worked fine! They couldn't even get me a pump immediately after su

rgery (can you believe I had to be put on a WAITING list???), but thank God

the recovery nurse on duty then was very good about giving me injections when

she could (I requested them too frequently, I guess and had to wait until the

morphine level was reduced in my bloodstream). I didn't have any pain other

than these really, really annoying stomach spasms. And, then I experienced

some nausea (the nurse was very attentive in recovery and gave me anti-nausea

meds immediately - not sure if it was Compazine or whatnot). The spasms

subsided with quite a large amount of morphine (I knew this would be the case

since I'm really tolerant of pain meds and had a similar experience with

morphine before with back surgery). The morphine made me really, really

woozy.

I think my pain was the worst in the first few hours after the surgery. It

subsided quite a bit after that. Then, not even 24 hours after the surgery,

my vein blows and it's the midnight shift and the nurse doesn't know how to

re-insert a new one! She does get it in, but it blows right away. So, I'm

put on oral (crushed) percocet not even 24 hours out of surgery! It was

fine! I was worried that I'd get nauseous or something but not having that

damn IV antibiotic made me MUCH less sleepy and able to get up and walk

around! :) I did with the IV but I was so out of it!

So, if someone really wants an epidural at Mt Sinai, I'd discuss it with

one's surgeon to see if it would be feasable or whether they are open to it.

It certainly is NOT the preferred method of pain control but I researched all

the options and concluded that the method chosen by Gagner was adequate. I

think that the Mt Sinai group uses the pumps routinely even during OPEN

surgeries (some of these are open from the start whereas I've heard of others

being 'converted to open' during the procedure due to complications). So,

although having the procedure done laparoscopically may be part of the reason

to use the pump over an epidural, I think it isn't the sole reason for this

preference. Dr. Gagner told me that the epidural still carries risks (spinal

headache, etc.) mainly with insertion problems. Even though these risks are

*minimal*, he thought they were greater than the possible risk of having to

adjust the pump for pain control.

PS --- the shaking mentioned *could be* due to the epidural (and the

nausea could have been partly due to it, although nausea can certainly be

caused by the surgery alone not the form of pain control used)... I remember

having terrible shakes and chills with my (pregnancy) epidural. They had

such difficulty trying to insert it with my second child that I told them to

leave me alone and had the kid 'au natural'! ROFL

all the best,

lap ds with gallbladder removal

January 25, 2001

Dr. Gagner/Mt. Sinai/NYC

nine months post-op and still feelin' fabu

preop: 307 lbs/bmi 45

now: 205 lbs/size 16/large!!!

[Guest guest]

:

Thank you so much for your detailed reply. It's been very helpful in

reducing my fear. Couple more comments and questions below:

> : Maybe Dr. Gagner has changed his policy, but he did

> mention to me that he *would* do an epidural for pain relief

This is so good to know; I don't entirely trust doctors who give out

blanket statements about what's best. I, however, love to hand out

those same black and white generalizations!

> After long thought and Dr. Gagner's explanation that he provides

> deep-tissue anesthization and that his pump (which combines

> the morphine/demerol drip WITH scheduled doses of Torodol,

OK, help me out here. Is my understanding of drugs incorrect?

Opium is the mother of all narcotics. Morphine is the daughter and

she has many derivative children herself, including Demerol,

Percoset, Vicodin, Codeine, Oxycontin, etc. Opium has stepdaughter

synthetic narcotics such as Ultram. The benzodiazepines that I enjoy

so much (no yucky reactions such as nausea; only m-e-l-l-o-w-n-e-s-s)

have nothing to do with pain relief and so are not relevant to our

conversation at all. Did I get it right? Any RNs out there reading?

> It worked fine!

Thank God! I wonder if you're as much of a baby as I am?

> They couldn't even get me a pump immediately after surgery (can you

> believe I had to be put on a WAITING list???),

NO! This is WRONG! Gee, wait 'til they find out what a bitcher I am!

> And, then I experienced some nausea (the nurse was very attentive

> in recovery and gave me anti-nausea meds immediately -

Want to know how *sick* I am? I'm putting in my order tomorrow for

25 mg. Compazine suppositories (just in case) AND 5 mg. epam

(Valium) liquid suppositories. I don't want anyone running out of

anything in the hospital or afterwards, and if it won't go in one

orifice, I'll put it in another! Aren't I weird and paranoid?!

> Then, not even 24 hours after the surgery, my vein blows and it's

> the midnight shift and the nurse doesn't know how to re-insert a

> new one!

This, too, is awfully disturbing. Mount Sinai is supposed to be a

GOOD hospital!

> So, I'm put on oral (crushed) percocet not even 24 hours out of

> surgery! It was fine!

Wow! This is amazing. The fact that your surgery was done

laparoscopically MUST have a lot to do with your reaction.

> PS --- the shaking mentioned *could be* due to the epidural

>(and the nausea could have been partly due to it, although nausea

> can certainly be caused by the surgery alone not the form of pain

> control used

Really? I thought that the nausea, etc. was almost always due to

pain medicine (see how I love to toss around those generalizations?).

Thanks again,

[Guest guest]

> > At 7pm the transferred me to ICU. My heart was still running

fast.

>

> Was this heart rate considered normal? Was it anxiety?

My heart rate was apprently 160 beats/min which is NOT normal. That

is the kind of rate you expect to get during a vigorous workout. By

the next morning it dropped to 105 beats/min, which is still high,

but within normal range.

> > To this day (16 days postop) I still take some pain meds

>

> You mean narcotics, right? Which one? Doesn't it make you more

> nauseated and disoriented?

Yes I take narcotics. The label says that it is some kind of codine,

my wife insists that it is " bactrate " and the nurse said something

about generic vicodin. So I am not really sure. I don't think the

meds make me more nausiated. Up until today, when I took the meds I

would feel a warm rush over my body and most of my nausia and pain

would vanish for a few hours. We have been cutting my dose down

steadily and today I didn't feel that effect. My wife is worried that

I am addicted.

Hull

[Guest guest]

Dr. A. gives a generic Vicodin a widely used pain reliever.

People do not get addicted to narcotics in such a short period of

time and when they have pain. We have all have different pain levels

and different ways of dealing with it. You are not addicted.

> Yes I take narcotics. The label says that it is some kind of

codine,

> my wife insists that it is " bactrate " and the nurse said something

> about generic vicodin. So I am not really sure. I don't think the

> meds make me more nausiated. Up until today, when I took the meds I

> would feel a warm rush over my body and most of my nausia and pain

> would vanish for a few hours. We have been cutting my dose down

> steadily and today I didn't feel that effect. My wife is worried

that

> I am addicted.

>

> Hull