"instructions" for my APR surgery...tylenol...walking after 3 hours!!!

This is a huge surgery. You need strong painkiller for at least a couple days. Often I have to give narcotics for a tooth extraction. 

You can't and shouldn't get up after 3 hours. Maybe a tiny walk next day. 

You have to be assured of proper pain management. Pain is not just an uncomfortable sensation. It causes even more stress on an already stressed out body after surgery slowing down the recovery.

Also I and many people took 400mg Cimetidine twice a day 2 weeks prior and 2 weeks after the surgery. It may reduce the chance of the cancer spreading during surgery.

Did you choose to have the abdominal muscle flap option too?

Be your own advocate and I wish you the best of luck with everything.

Laz

Are you sure you are understanding them correctly?

I cannot believe that they want to use Tylenol to treat pain post surgery.  I had a LAR and was cut from belly button to pelvis.  I had Dilaudid - which apparantly didn't work for me because when I remember coming around after the surgery, my husband told me that the meds weren't working for me and they added Toradol to the mix.  I was on that for a good couple of days and didn't get up to walk until day 2 (which would have been 12-14 hours post surgery).

I didn't stay on pain meds very long - as I don't really like them. But they are crucial the first few days and I firmly believe you heal better with them.  Mostly because they allow you to get up and get moving - which in turn helps you heal faster.

Again - I'd question the surgeon to make sure.

Prayers for a successful surgery and good pain management!

J

Yeah, their "non-narcotic" emphasis and "in and out" approach to major surgery stinks. It should be about what you need, and your comfort, find some place that cares without having such an agenda...................................................Dave

I had a similar problem at Sloan. They are on crack. That stupid push when you are in pain machine doesn't work. You can't push it while you are sleeping and wake up in pain. Be very clear, your body, your pain. I switchedto pill form of morphine and that worked great. These doctors are SO arrogant because it's not their body. After my surgery I continued to be in pain and they thought I was imagining g the pain. I am not a winer typ . I had a prolapsed uterus and I was sitting on it for two whole years. Screw them. Make sure you get what you need and if your doctor says no, ask for a different docto . 

I was really hoping that you were joking when I was reading what they were wanting you to do.  I guess you're being serious.  

I had an LAR back in 2009.  I was in the hospital for 5 days.  I had an epidural that pumped pain meds  at a continuous rate.  They pulled that three days post-op and I took percocet after that.  It's not realisitic to make you take tylenol or any other form of non-narcotic after surgery -- unless it's torodol.  Torodol is an anti-inflammatory, and works wonders after surgeries... and they can surely give narcotics for breakthrough pain.  

Your NP is dilusional if she thinks that "most LAR patients don't use narctoics".  Spreading that nonsense is what makes trusting medical personnel so hard -- and I am one!   I had my second surgery just this past December for a recurrence and was horribly undermedicated to the point where I didn't want to move and I didn't want to breathe for fear of pain.  It finally got to the point of wanting to go home because I had a bottle of percocet that I could use.  They gave me tramadol to go home on which was about the same as taking a tic-tac now and then.  The pain was outrageously bad.  

Just an FYI... I got a colostomy on the second surgery.  The hospital I was at had excellent stoma nurses and I learned a lot.  I am a nurse, but I haven't taken care of a stoma patient for over 25 years.  It was an education!  Still, no stoma nurses around here, but I've learned so much from research and there are a ton of youtube videos that taught me a lot.  I've talked to many at coloplast, convotec, hollister, etc... I've experiemented with a lot of their free samples.  I know which I like, which I don't.  Most of all, I'm loving this colostomy because for the last 6 years, I've known where every bathroom was in a 50 mile radius; I don't have to worry about that anymore.  It's freeing and wonderful.  

Good luck with everything!  

Sharronoffaith said:

thanks Holly,

thanks so much for your input.  Whatever happened to do no harm?  I could see if they were moving people along in order to help more people, but that is not the case.  It is "ERAS protocol" for all colon surgeries that has a goal and have achieved a 30% reduction in hospital stays.  I researched this, and in no way is it focused on the patient's comfort.  The basis for non-narcotics is that it slows down the gi-tract to use narcotics.  

You are very wise, and I am laughing (almost) that you wanted to get the heck out of the hospital so that you could medicate at home.  I currently have an Oxycontin prescription, prescribed 20mg bid, that I would like to be taking to offset the pain I still have from the chemoradiation (burning, gnawing, buttock pain) but, I have stopped them with the thought of getting the heck out of the hospital and healing at home.  

I also nearly broke my left hand a couple days ago (door jammed) and I was offered pain meds...i didn't want to look bad asking for something like percocet, so I said, ok, how about something mild.  So, I now have 20, 50mg Ultram to add to my homecare plan.

I am hoping the surgery goes well, and we know the clock then starts ticking, and I am strong so, I will get up and walk....and if I can...I will keep right on walking....right out the front door.

the alternative is to sit there and be asked how my pain is....and to be given next to nothing.

call me a cab....

 

20th century health care has now gone back to the wild wild west....

 

Sharron, not taking the Oxy before surgery seems smart to me for a couple of reasons, one of which would be to get the maximum effect from whatever pain meds they are going to give you, post surgery. Tramadol works for the pains I get occassionally and being a non-opoid means you won't be raising the bar for the level of narcotics needed later. If it's me, I might be figuring how to get my Oxy's in if they hold to their ridiculous med plan. Best of luck................................Dave

My husband had an APR in December.  He was in the hospital on heavy pain medicine for 8 days was released from the hospital and went back in 6 days later with an infection caused by an abcess.  He spent 14 additional days int he hospital fighting the infection.  He was sent home with a prescription for 12 hour Morphine and immediate release Morphine that he could take every 4 hours.