Postoperative pain: Don’t take it lying down

You’re scheduled for surgery, but you’re worried about the pain: How much is this going to hurt and for how long afterward?

You’re scheduled for surgery, but you’re worried about the pain: How much is this going to hurt and for how long afterward? The answer is: It depends.The kind of pain you experience and the kind of relief you need may depend on:The type of surgery. If your surgery is extensive, you may experience more pain than someone undergoing a minor procedure. Surgery to replace a joint is more painful and longer lasting than surgery to remove a mole. Your previous experience with pain and pain medications. Each person experiences pain differently. Moreover, if you’re taking pain medications regularly to control pain, you might be less responsive to a drug for pain control after surgery than someone who doesn’t regularly take pain medication. What the pain means to you. If surgery causes pain but you expect a positive benefit, such as the possibility of restored function, you may experience the pain differently from someone undergoing surgery for cancer that is found to be malignant. The side effects. Anesthesia used during your surgery and pain medications given to you afterward may cause side effects. Narcotics such as morphine can cause nausea, constipation, urine retention, drowsiness, sedation and itching. Some of these factors are beyond your control. But managing pain is important to your recovery from surgery. After surgery, pain can keep you from getting up, moving and gaining back your strength – activities that are key to healing and recovery. Moving after surgery can prevent blood clots from forming. Coughing can help prevent pneumonia. Pain can keep you from doing these things. Pain can also keep you from getting the rest you need.So what can you do to keep your postsurgical pain to a minimum? And how can you manage your pain before surgery, after surgery and at home to help your body heal and recover as quickly as possible? Before surgery: Talk with your doctorThe time to begin working with your doctor on managing pain is before surgery. Talk with your doctor or nurse about your concerns and about how your pain will be managed. You may want to discuss:What to expect. Is there usually pain after the kind of surgery you’re having? Generally, how severe is the pain and how long does it last after this surgical procedure? The plan for treating your pain. Will you take medicine before the surgery? Will pain medication be given during surgery? What kind of medicine will you get after surgery, and how will it be given to you? What are the possible side effects of these medications? Your concerns regarding surgery and the pain it may cause. Your previous experiences with different kinds of pain control. Tell them what has worked for you and what hasn’t worked for you. Talk about any concerns you have about pain medication. Your medications. Be ready to name all prescribed and over-the-counter medications that you’re taking and have taken in the past month and in what doses. Drug allergies you have and any reactions you have had to medications. Any supplements and herbs that you may be takingHerbs and surgery After surgery: Pain relief while limiting side effectsComplete relief of pain after your surgery may not be possible, but it’s important for you to be as comfortable as possible. Treating your pain can speed your healing and recovery. But side effects can cause misery, too. You and your medical team need to balance pain control with side effects.”Doctors try to find that sweet spot that provides sufficient pain relief with minimal side effects,” says David Martin, M.D., an anesthesiologist who specializes in pain medicine at Mayo Clinic, Rochester, Minn.Take these steps to help relieve pain while minimizing side effects:Talk with your doctors and nurses about pain that you experience after surgery. Let them know what hurts, how much it hurts and where it hurts. Your doctors and nurses may ask you to rank your pain on a scale from zero to 10. Zero is no pain, and 10 is the worst you can imagine. What you tell them helps manage your pain. Tell your doctors and nurses if you feel constipated or sick to your stomach. Nausea and constipation can be side effects of some medications. Take or ask for pain medication when you first feel pain. At home: Stick to your game plan You may have to deal with pain after you’ve returned home. Here are some strategies for helping manage postoperative pain at home:Follow your doctor’s instructions for taking pain medication and any other medication in addition to pain medication. Follow your doctor’s instructions about how physically active you should be. If your pain medicine causes constipation, drink eight to 10 glasses of water a day, eat a well-balanced diet that includes fruits and vegetables, and try a gentle laxative. Call your doctor if you feel tired, drowsy, sluggish or dizzy. Call your doctor if your pain increases while taking pain medication. Call your doctor if you run out of pain medication and you feel that you need more to keep your pain under control. Stretching and exercising may be part of your recovery. “Pain control allows appropriate rehabilitation,” Dr. Martin says. “That doesn’t necessarily mean you have to be free of pain, but good pain control can give you the desire and ability to do the exercises and make better progress.” (Source: Mayo Clinic, 23 June 2003)