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Topic: Pain Pills - How long?

Forum: Breast Reconstruction — Is it right for you? Discuss timing and various procedures and techniques.

Posted on: Jun 27, 2007 06:28PM

LauraR wrote:

Could you please tell me how long you were on pain pills after a mastectomy with expanders?
Last Friday I had a mastectomy on the left side with expanders put in. Yesterday, I tried to cut back but ended up giving in to taking another one at night time. Today I took one in the morning and swore that was the last one. Late this afternoon I bent over to pick up something of the floor and it felt like someone put a knife into my chest and was turning it around and around. I thought if I rested for a while it would quit. It got better but then started up again, so I finally gave in and took 2 pain pills. I am now down to one pain pill with no refills but thank goodness I have an appt with the surgeon in morning. Hopefully he will give me a refill. I really was trying to quit because I live alone and I wanted to try to drive by tomorrow but it's not going to happen. When I had a lumpectomy a month or so ago. I only took one pain pill after I came home and I was just fine. This is different. In fact it wasn't too bad until tonight. Tonight was by far the worse. Before and even in the hospital, it only hurt if I moved. If I was still it was OK.

So I am curious as to how long you were on pain pills? I am on percocet 5/325 tablets (one or two every 4 hours as needed). Until yesterday, I was taking 2 at a time every 4 hours while I was awake. Log in to post a reply

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Jun 27, 2007 07:41PM iodine wrote:

Everyone is different. If you have pain, take the med. What you may want to try is taking tylenol or advil in between times. Like the pain pill at 8 and advil at 11, the pain pill at 2 or 3 pm and the advil at 5 or 6 pm. then the pain pill at bed time.
Or you can just try to streach the times between pain pills. What you don't want to do is make the times between pills tooooo long. So long that it will take more meds to dull the pain. See what I mean?
Don't feel bad about asking the doc for more meds tomorrow. You have had major surgery and deserve to have proper rest, especially at night. Just know that you cannot drive and take these meds.
Keep in mind that you will heal faster and better with proper pain control
Dotti---BE NOT AFRAID, Pope John Paul
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Jun 28, 2007 12:18AM saluki wrote:

Don't feel bad about taking 2 at a time if you doc allowed you to. 5/325 is a very low dose. You do have to be aware that that 325 is Tylenol, ---so figure you are getting 650mg of tylenol every 4 hours--- So, if you are going to be taking extra Tylenol on top of that you have to take that into account as cumulative for the day.

People don't consider the cumulative amount of all the Tylenol
from different medications they are taking. Tylenol can be Toxic to the liver. I don't know what the upper allowable limits are but I would find out so you don't exceed it.

As to driving after about 2 weeks or so most patients
get past that sleepiness and are able to drive fine while on

It is important not to get behind in pain control or it
becomes more difficult to bring you back to a manageable
level. You can wind up having to take more than if you had nipped it in the bud as it was coming on. I know the inclination is to hold off--but this may not be the time to be stoic.

Talk to your Doctor about the medication and voice your concerns. He may have something that may cover you better or put you at ease. Its less than a week since major surgery and comparing the pain of a lumpectomy, to a mastectomy and expanders is comparing apples to oranges.
You shouldn't expect to have the same pain level.

Its good you are seeing the Surgeon. He may have something
you can take that would allow you to go a longer time between pills that would not leave you without coverage.

Take care
Susie, member since Jan. 2003 Dx 12/12/2002, IDC, 2cm, Stage IIB, 0/1 nodes, ER+/PR+, HER2-
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Jun 28, 2007 01:42AM roseg wrote:

I went onto Advil ASAP. The narcotic pain pills had a very definite wear off, and it would wake me up at night.

Once you get Advil going, taking it regularly for a day or two then it builds up and doesn't wear off so suddenly.

My discharge instructions specified that I could take 600mg of Advil at some interval. Do your discharge instructions make mention of this?
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Jun 28, 2007 06:43AM figsgirls wrote:

I had a bilateral with expanders exactly 2 weeks ago (6/14). I had a prescription for Lortabs 7.5, and I could take up to 2 at a time. The last time I felt I needed one was on the Monday after surgery. Do you have saline in your expander? If so, could the amount in your expander be contributing to your pain, I wonder?
And, as you live alone, are you doing more bending/lifting, etc. than is advisable? (It's sooo hard to try to sit still and heal!)
Just thoughts.

Good luck with your healing.
Diag. 4/11/07 ILC 4.3cm 1/14 nodes ER+/PR+ Her2-. Lump., bilat.mast. 4AC 12 Taxol, Tamox. Implant recon.
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Jun 28, 2007 06:48AM Sandra1957 wrote:

Be careful with the Advil. It raised my blood pressure.

I used those pads filled with grain that you heat in the microwave. It helpe me relax and eased the discomfort.
I'm always steppin' in and out of crap!
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Jun 28, 2007 07:42AM mbordo wrote:


I had my bilateral w/expanders on 6/8, and I took Rx pain meds for a full week after I came home, then was able to switch to Tylenol. I cannot take NSAIDS (ibuprofen, advil etc. b/c of another condition I have - though I suspect it would be more effective!).

My surgeon gave me darvocet for my first lumpectomy, and I needed only a single pill after those procedures (I had 2) - so I was a bit surprised to need more this time! Also, I've determined the pain is from the tissue expanders, and is mostly caused by spasming chest muscles.
I let the pain get ahead of me in the hospital, and had to stay a second night...once my surgeon told the nursing staff to give me *2* pain pills if I wanted - it made a WORLD of difference!!

I also found out my PS filled me up w/ 275 (ml, cc?) during surgery - so that explains a lot of my pain - but I've got a good start on my recon at least!

I started driving a week ago after I saw my surgeon for post-op, and had been off Rx meds for a few days...I have taken one @ bedtime a couple of times since - once when I overdid activity and was hurting, and once for menstrual cramps - but figured that was okay, since it would wear off long before I might drive...and I'm driving very limited distances and not every day...

I also found a spike happened about 10 days out. Personally I think it was related to having the drains removed and some of the retained fluid causing increased pressure - it resolved in a day or 2, but was pretty intense...I had some increased swelling, as well.

Good luck with your continued recovery - each week it gets better!

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Jun 28, 2007 06:00PM LauraR wrote:

I went back to the doctor today. I got a refill on the Percocet (the doctors in the hospital had said not to take tylenol while on this). He also give me Hydromorphone HCL 2MG which he said was a much stronger pain pill. He said if the Percocet didn't work to take it, so far I haven't taken any. This morning was really awful. I had awful pains when walking down the stairs. I would take one step at a time and the pain was just awful. I would wait a couple of minutes for the pain to lessen before I took the next step. I have never had any problems with steps or walking until this morning. I told the docotor that maybe I had pulled someout. He didn't see anything wrong. I just went back upstairs for the first time today. I went slowly but at least I didn't have any pain.

No I don't have any idea if I have saline in the implant. He said I didn't have to make the decision until I have the exchange. He may have told me at some point but I don't remember him telling me. The drains are still in and from what you'll have said there will be more pain then. What fun. Sometimes I wonder if I will ever feel normal again. I thought while I was on leave from work, I'd do a lot of reading but I haven't felt like doing anything.
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Jun 28, 2007 08:00PM iodine wrote:

Glad you got some meds for break thru pain. Your doc is on the ball. You probably have just a little saline in the expander for now. When you start fills, he or his staff will be adding more, a little at a time. Most times it will not be painful, but can be uncomfortable if too much is added too quickly. You can help them know by telling them how it feels to you and you can take advil or the like before the appt. I took a muscle relaxant like Robaxin befoe the appt and it helped.

You will begin to feel normal about next week, a little at a time. When you begin to rest better and start to get around better and more sure of yourself. Don't be so hard on yourself and expect so much of yourself so quickly-- you have had MAJOR surgery, Dear, and your poor body needs time to recover.
Please give yourself time to recover and take care.
Dotti---BE NOT AFRAID, Pope John Paul
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Jun 29, 2007 05:49PM leener wrote:

I just had my 5 th surgery in 10 mos on Tuesday. My expereience, with each surgery, is that especially in the first 3-5 days take is as prescribed. (I waited with baited breath for those 4 hourd to pass). I have learned that It helps recovering time and it's effectivenessess (at least for me) if I was not in pain or if I was having spasams..

Good luck.
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Jun 29, 2007 06:35PM saluki wrote:

I don't know whether this is appropriate or not since my pain is of different origins.

Since a great component of my pain is caused by spasms, I find
that I get much more relief from Zanaflex (Tizanadine) a muscle relaxant, than any painkiller, opiate or otherwise.

It allows me to significantly reduce my pain meds. In fact my current regimen includes a blood pressure patch called Catapress TTS-2. Funny that its a blood pressure med yet fucntions similarly to Zanaflex.

If spasms are a component of your pain Zanaflex may be worth
looking into.

The main drawback is that it may make you sleepy, which doesn't resolve in time as it does with other meds.
So, its not anything you want to be driving with.

But at night it may give you relief and if your job doesn't require operating machinery or driving; You may want to ask your surgeon.
Susie, member since Jan. 2003 Dx 12/12/2002, IDC, 2cm, Stage IIB, 0/1 nodes, ER+/PR+, HER2-
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Jun 29, 2007 07:56PM Methusala wrote:

I kept reading that cancer tumours weren't painful, but I have horrible pain in my right breast, through to my shoulder and arm. I was leary of taking so many pills too.. but without them, I'd be suffering. i can still feel the throbbing but it takes the edge off. I have vicodin 10/325. I usually break them in half. Ask your dr. about a drug called Ultracet (TRAMADOL). It's NON NARCOTIC and it really works! I used it in conjunction with the narcotics. I also have RLS and the tramadol 100% stops the pain in my legs, too. Tramadol says to take on or two, but I take 3 and am pain free for hours with no side effects. It's been like a miracle drug. best wishes, i hate to know someone is in pain.
BRCA 1 + and the BIG 3, triple negative.. Life is short. Pray hard with your kids. Dx 6/2007, IDC, 3cm, Stage IIB, Grade 2, 1/38 nodes, ER-/PR-, HER2-
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Jul 4, 2007 09:46PM cheekymonkey wrote:

I just had a prophylactic mastectomy and lat flap on Monday, July 2nd, and they gave me 2 mg of Morphine I think every 8 hours in an IV (although I got horrible headaches...did this happen to anyone else?). On Wednesday they put it down to 1 mg. every 8 hours. I was in constant pain and told them. Then they cut off Morphine and gave me a Vicoden (1) 5/325 every 6 hours. I only had surgery 2 days ago, and my breast is swollen and red and my incision on my back is about 8 inches long and also red and swollen. I can't believe they could care less about my pain level. Is there anything anyone can suggest that could I say or do to get my pain alleviated?


Cancer, like any other illness, is a bore...... Alan Bennett, Dramatist Dx 2/28/2005, IDC, 6cm+, Stage IIIB, Grade 3, 2/9 nodes, ER-/PR-, HER2-
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Jul 4, 2007 10:51PM saluki wrote:

Who is prescribing? Is it your surgeon or is it the resident on the floor?

If its the resident, I would put in a call to your surgeon
and ask him what he can do. If he doesn't want to do it, see if you can get a pain management department consult. Every major hospital has that.

I'm sorry you are going through this. Quite frankly, everyone wants to pass your pain control to someone else. I'm not surprised that they stopped the IV morphine --that is customary and is to be expected.

But you may need a low dose of a long acting med which Vicoden is not.

Vicoden is a breakthrough pain med and if you are having to wait 6 hours --the pain has to be getting ahead of you and you; and you will have a harder time bringing it down to a more manageable level.

It could be that a lower dose of a long acting pain control med would leave you more comfortable
and enable you to need and use something less strong even an advil in between and not have any hesitation about taking the breakthrough med when you need it.

Pain is hard to bring down to a manageable level once you let it get out of control. You should not be playing catch up.

Sorry to say pain is frequently, under treated in the hospital whether its because of fear of medication audits, or just inadequate knowledge. I think its unconscionable.
Susie, member since Jan. 2003 Dx 12/12/2002, IDC, 2cm, Stage IIB, 0/1 nodes, ER+/PR+, HER2-

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