I've been wanting but dreading to write this particular entry for a number of months. I didn't write this as an instruction manual, it's more a series of observations and decisions that I think have worked for me. If you have wisdom to share or dispute some of mine, please share!
Pain is always subjective
For any given wound or procedure different people will experience different types and levels of pain. Also drugs work differently for different people and, in my opinion, different drugs work better for some types of pain and not very well for other types of pain. The only person who knows your types and levels of pain is you. The only person who knows how well pain medications are working and how much you may need is also you.
If you are in a hospital setting with your heart rate monitored, then moderate to intense pain will cause your heart rate to be higher than normal. Similarly, relief from that pain will allow your heart rate to return to a more normal rate. So doctors can sometimes objectively see when you are experiencing pain.
HR increases with pain in men - not in women.
Absolute and relative pain are both important
On my pain scale, a '5' denotes enough pain to waken me from a sound sleep and a '4' denotes enough pain to keep from falling asleep. When in the hospital immediately after surgery, I used the IV pain meds to keep me in the 3-5 level of pain. Later towards the end of my hospital stay, I found that I used pain medication to keep my pain at a level or 3 or lower. Since getting home, I've noticed that I started using pain medication to keep my pain levels at a 2 or lower. I'm not certain why I have become less tolerant of pain or more willing to take medication to control pain over time. My suspicion is that part of the decision has to do with the relative amount of pain. Meaning if I'm used to have no or minimal pain, then pain at a level of 3 is a dramatic difference. Lately, I've mostly had no pain, then pain at a level of 2 is a noticeable difference and I take medication for it. Now that I can take ibuprofen (2+ weeks after surgery), that is sufficient to treat this level of pain.
Use the right medication for your pain
On another note, over the last 2 weeks I've developed aches and pains around my joints, in the tendons and ligaments. The pain is bad enough to make me grimace and grunt when moving around and it also makes me walk with a very odd gait - having to sway my hips to ensure my legs move enough on each stride. The hydrocodone / Tylenol combination pain medication doesn't affect this aching joint pain (it also seems to make headaches worse). However, starting this week I was permitted to use begin using OTC ibuprofen. The ibuprofen completely eliminates this aching joint pain.
Opiate medications lose effectiveness over time
I've been taking hydrocodone based pain medications at least intermittently since December of 2013. From my surgery on 8/11 until very recently, I've taken them daily and in the days immediately after surgery, I had taken up to 8 norcos in a day. Each of those used to make me feel drowsy and light headed. Now when I take a 5 / 325 mg norco, I no longer feel even slightly drugged. However, they do still provide pain relief and we should not assume they don't affect our ability to drive.
If your pain permits it, stop taking these medications as soon as you can, so that they are effective when you need them.
More on pain medication tolerance
Tell your doctor about your pain levels
After my wound debridement, my wound hurt way more than I expected and I went through my pain medications far faster than I expected. I had to call my doctor's office and ask for more pain medication.
After my fistula/abscess incision and drainage, my wound hurt much less than I expected. In fact, it hurt less than the wound debridement that I had 3 weeks earlier. To this day, my most recently wound rarely hurts more than my belly wound. When I communicate with my doctor's office, I make sure to tell them of this lack of pain. I suspect the lack of pain is due to the tissue over the abscess having already died, but that is a total guess. But it is important for your doctor to know.
Pain is always subjective
For any given wound or procedure different people will experience different types and levels of pain. Also drugs work differently for different people and, in my opinion, different drugs work better for some types of pain and not very well for other types of pain. The only person who knows your types and levels of pain is you. The only person who knows how well pain medications are working and how much you may need is also you.
If you are in a hospital setting with your heart rate monitored, then moderate to intense pain will cause your heart rate to be higher than normal. Similarly, relief from that pain will allow your heart rate to return to a more normal rate. So doctors can sometimes objectively see when you are experiencing pain.
HR increases with pain in men - not in women.
Absolute and relative pain are both important
On my pain scale, a '5' denotes enough pain to waken me from a sound sleep and a '4' denotes enough pain to keep from falling asleep. When in the hospital immediately after surgery, I used the IV pain meds to keep me in the 3-5 level of pain. Later towards the end of my hospital stay, I found that I used pain medication to keep my pain at a level or 3 or lower. Since getting home, I've noticed that I started using pain medication to keep my pain levels at a 2 or lower. I'm not certain why I have become less tolerant of pain or more willing to take medication to control pain over time. My suspicion is that part of the decision has to do with the relative amount of pain. Meaning if I'm used to have no or minimal pain, then pain at a level of 3 is a dramatic difference. Lately, I've mostly had no pain, then pain at a level of 2 is a noticeable difference and I take medication for it. Now that I can take ibuprofen (2+ weeks after surgery), that is sufficient to treat this level of pain.
Use the right medication for your pain
On another note, over the last 2 weeks I've developed aches and pains around my joints, in the tendons and ligaments. The pain is bad enough to make me grimace and grunt when moving around and it also makes me walk with a very odd gait - having to sway my hips to ensure my legs move enough on each stride. The hydrocodone / Tylenol combination pain medication doesn't affect this aching joint pain (it also seems to make headaches worse). However, starting this week I was permitted to use begin using OTC ibuprofen. The ibuprofen completely eliminates this aching joint pain.
Opiate medications lose effectiveness over time
I've been taking hydrocodone based pain medications at least intermittently since December of 2013. From my surgery on 8/11 until very recently, I've taken them daily and in the days immediately after surgery, I had taken up to 8 norcos in a day. Each of those used to make me feel drowsy and light headed. Now when I take a 5 / 325 mg norco, I no longer feel even slightly drugged. However, they do still provide pain relief and we should not assume they don't affect our ability to drive.
If your pain permits it, stop taking these medications as soon as you can, so that they are effective when you need them.
More on pain medication tolerance
Tell your doctor about your pain levels
After my wound debridement, my wound hurt way more than I expected and I went through my pain medications far faster than I expected. I had to call my doctor's office and ask for more pain medication.
After my fistula/abscess incision and drainage, my wound hurt much less than I expected. In fact, it hurt less than the wound debridement that I had 3 weeks earlier. To this day, my most recently wound rarely hurts more than my belly wound. When I communicate with my doctor's office, I make sure to tell them of this lack of pain. I suspect the lack of pain is due to the tissue over the abscess having already died, but that is a total guess. But it is important for your doctor to know.
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