Kicking the Painkillers after Surgery

[HorseLuvr]

It has been a good 2 months now since my ruptured disc surgery, I had previously been in horrible pain due to the sciatic nerve both before and after surgery. Well, the nerve has finally settled down and my pain level is now very little to none. My next challenge is getting off of these painkillers for good. I had been taking a dose of 10mg of hydrocodone up to 8 pills a day during the whole ordeal in order to be functional, now I have weaned it down to 1 or every now and then on a bad day 2 pills.

I am trying to take none but everytime I go without I am having physical withdrawals. Such as…depression (crying, hopelessness, etc), extreme insomnia (can’t sit still, no sleep, tossing and turning) I feel exhausted mentally but my body is WIDE awake almost feels like a restless leg syndrome type of twitch where I just can’t lay still! Needless to say it is driving me crazy! I don’t feel I am mentally addicted as far as just needing the pills but I do feel that my body is now used to me taking them if that makes sense. I am ready to start riding again but would like to be off of these things first so that no pain is masked. I know many of you have probably dealt with this same issue! Suggestions/Advice?? Help!

[Candle]

Can you cut the pills to further taper the dose? Just wanted to pop in and remind you (you already know this) that physical withdrawal is normal when coming off long-term doses of painkillers, it doesn’t mean you’re an addict, and it shouldn’t stop you from asking for or receiving adequate pain relief. Off soapbox now

[WaningMoon]

It would be well worth your while to just stop taking them now. I WELL know the feeling you are talking about. You really are very lucky although it may not feel like it right now. You could be throwing up constantly, while sitting on the toilet with diarhhea, while sweat drips off you and at the same time you are just bone chilling cold.

I have had to come off very large doses(600mg) a day of morphine and it is not pleasant. BUt hte longer you keep taking that one or two pills a day the longer you will keep these issues. It WILL go away, with what you are on, four or five days should do it. You still may have sleeping issues for several months but maybe you will find that will not happen. I have done this a lot of times since 1979, it’ll be okay, just don’t seem so good right now. At least there was help for you and you are feeling better. It is far better than living your life on pain meds forever, believe me, I will never be off of them, no fix for me they say. I used to stop taking them inbetween the horrid spine/sciatic spells I had but then they were intermittent. Since 1995 the pain is constant and now always will be. I do wish you luck, I well know the problem.

[Laurierace]

Talk to your doctor today. You shouldn’t have to go through this alone. I am sure they can come up with an alternative that will get you over the hump without too much trouble. You might need a non-narcotic pain med for awhile as well as a sleep aid. You can do it, your horse is waiting!

[wateryglen]

Sounds like a normal rehab!!!

You can switch over to Acetometaphen or Nsaids (Ibuprofen, Naproxen, etc) instead. You can go up to 2400 mg of Ibuprofen in a 24 hr. period if you can tolerate it taken w/food. Remember…doses of painkillers you’re taking are only in your system for 4-6 hours so you CAN go ride! Taking one at night is perfectly ok to get to sleep. Some of us have to take one months/years later when we have an over active day. OR take a muscle relaxant instead at night only. THAT’LL help you sleep!!! :winkgrin: You sound like you are having a perfectly normal recovery from your major surgery.

Dont’ be so hard on yourself. You are not addicted physically at this point if your doses are as you say. And could your mental symptoms be from something else? I think so…Anxiety, agitation, insomnia can be caused by the depression you also likely had/have from your injury. Being depressed is a normal reaction to chronic pain. Some of your symptoms can also be explained by anesthesia ie: it can take up to 3 months to get physically over general anesthesia and major surgery.

Being fearful of movement is also normal. You might be instictively protecting yourself from re-injury too. Slowly start challenging yourself to see how you do. Follow your PT’s suggestions for activity. I’m sure you are frustrated no being able to be active and riding. It’s coming! Be patient. Things sound normal to me!

You CAN take a pill, let it start wearing off - ride quietly- take a pill later and rest. Thats’ moving forward in rehabilitation ie: weaning off your meds and increasing your activity. You CAN take a tylenol/nsaid and ride. If you’re hurting bad after it wears off then don’t do that again!!

If it hurts; don’t do it!! :yes:

[whicker]

You have my respect: It is Hard to Do!

Yup, you have company. My DH is going through the same bundle of joy. The withdraw is such a bummer. Like you, the original surgery/disc/fusion pain isn’t the issue. It is the tapering off process that has him so frustrated. I think that this is hard, and it taked gritty determination.

He also has memory lapses and gets a bit edgy. Wants stuff done NOW. I have trouble, being ADHD, dis-engaging in whatever I am doing to handle whatever is the new need. So I am whining, too!

But, in the longer scheme of things, his life is much better now than before surgery. He can pick up the exercise pace and work on losing weight, He doesn’t look ashen gray, more “life-like” now:winkgrin:.

He can come out to the barn and snuggle the horses, feed carrots, help feed and turn out the easy ones.

He can enjoy dinner outside after doing steaks on the grill. It is just hard to taper the doses, knowing that he will feel awful, like the flu, and not be able to work while he is adjusting.

Good Luck! Hang in there! I will be thinking of you more times a day than you think!

[Blinkers_On]

Been there done that. And cold turkey sucks but if you have an 8 pill “habit” I would just buck up, know it’s going to suck, and get off the pills. Hard to taper when your body thinks it needs the pills. You will think you will only take one or two… 8 pills later you failed and feel terrible about the failure.
WD for me was being ill, cold, under 4 winter horse blankets in a cold sweat in August, Aching body, irritation (kinda a normal state for me tho;)) I lost stupid amounts of weight as I had no apetite for anything but the meds, and the meds were better on an empty stomach… It was miserable. percocet ruled my life. Get off of them ASAP!

The thing that people don’t understand is it isn’t the painkiller your brain/body wants, it is the euphoric stone that the narcotic of oxy, hydro,… give you. And when one isn’t enough, two are better and when 8 aren’t enough… chase with alcohol or mix with muscle relaxants or xanex… it is a vicious cycle… there is a reason they call it hill billy heroin…

[FrenchFrytheEqHorse]

Call your doctor. Yesterday. As I’m sure you’re well-aware, any kind of addiction to painkillers is very serious. And if you’re experiencing withdrawal symptoms without them, you are most certainly physically addicted.

Your doctor should be able to prescribe other medications to address the withdrawal symptoms. It is critical that you get off the narcotic. Taking something like flexeril to treat the muscle spasms, meclazine for the nausea, etc. will make it much easier to go through the withdrawal stage. Talk to a doctor, ASAP.

[wateryglen]

forgot to add…

I forgot to also say…Percocets come in 5 mg tablets. Use those or only take half pills of your 10mg tabs.
Important…each tablet of percocet has the equivalent of 1 tablet of tylenol(acetometaphen) in it too. So…to make a 5 mg dose work better… take a perc plus 1 tylenol each time. Keep track of that. That’s a good weaning way too. If you take a half tablet of it; then you are taking half a dose of 1 tylenol. Get it?

But taking smaller concentrations of doses is good. Taking only “as needed” is ok; not addictive. But talking to your doc is always a good thing. But he’s already monitoring your drug use if he’s prescribing for you. He’d talk to you if he was concerned. Do not self diagnose “withdrawl symptoms”. Those symptoms are almost always indicative of something else.
Best wishes! You’ll do fine!!!

[FrenchFrytheEqHorse]

Sorry if I sound harsh, but taking narcotic painkillers “as needed” is most certainly potentially addictive. No if, ands, or buts about it. I am not implying that you should never take them, but it is important to be aware of the risks involved with the long term use of these drugs, even if they are deemed necessary by you and your doctor.

I have personally seen several incidents that involved post-trauma “as needed” addictions that required professional detox which included the proper administration of other medications to treat withdrawal symptoms.

If you don’t feel your physician is adequately addressing your well-founded concerns, you should ask to be referred to a pain management specialist. These types of doctors are well versed in weaning their patients off narcotic drugs, and can help immensely with the crappy withdrawal process in addition to making a good plan to manage residual pain you might still have.

I’d also like to know exactly what “something elses” withdrawal symptoms are indicative of? Of all things, I think withdrawal is probably the easiest thing to self-diagnose (again, personal experience). And simply because a physician is prescribing medication does not mean he’s monitoring the health of his patient in regards to dependency. You’d be shocked at the number of doctors that have absolutely NO CLUE when it comes to the long term use of these medications. This is why “so many” well-educated, intelligent, productive people in this country end up in this situation, and then end up embarrassed to tell someone they’re having a hard time reducing their intake.

When my best friend’s mother finally “broke up” with her surgeon (“minor” spinal surgery to correct nerve pain in her neck) because of the overwhelming amount of painkillers he was prescribing her, shrugging off her concerns about dependency, she ended up going to the ER she was in so much pain. Sweating, freezing cold, nausea, muscle spasms, etc. This pain was in no way related to her surgery, and fit all the classic symptoms of withdrawal. What did they do at the ER? Gave her a script for oxycontin. She sought the care of a physician that specialized in detox and was able to kick the habit quickly and nearly painlessly. And let me be clear, this is NOT my only experience with painkiller dependency. It’s just one of several anecdotes.

OP- you’re right to be concerned! Good for you for realizing it’s not as simple as putting down the bottle. I strongly recommend having a serious chat with your doc regarding your feelings. There’s absolutely nothing to be embarrassed about or ashamed of- the way these drugs are designed simply creates physical dependencies that our bodies can’t easily shake cold turkey. Good luck with everything, and PM me if you’d like to hear a few more of my own experiences…

[pharmgirl]

So when you can’t sleep- is it more anxiety related or can you truly not get comfortable b/c of your back? How often is “every now and then”? When do your symptoms (the depression, crying, etc) show up in relation to the last pill you took?

When I had surgery for my obliterated elbow, I can tell you that two months out I was still taking something on occasion- especially to sleep at night!! I tried just plain advil (once I was allowed to take it, that was part of the problem early on in rehab is that I wasn’t allowed for many weeks) and benadryl but sometimes I needed something more in order to get some sleep! (shoot, I was also using a special pillow set up so I could lay down comfortably!) I think early on in rehab I gave up the narcotics for the most part, but sometimes I felt it was better to get some sleep or take something so I could focus instead of suffering (especially b/c I couldn’t take advil for 6 weeks post-op, and tylenol really didn’t cut any discomfort at all). Often I wouldn’t need a full dose, just maybe half or something- just enough to cut the discomfort a bit, which usually worked well for me.

I think maybe talk with your doctor about it and see if they have any suggestions, or something else you could try instead of the pain meds (like benadryl or something at night to help you sleep)

[LauraKY]

Oh for Pete’s sake all of you “you’re addicted” people. She’s already cut down to 1 a day from 8. That’s a lot of cutting down! She has a physical dependence which, by the way, can happen with a lot of drugs other than narcotics. Cut back to one half for a week or so, then every 1/2 every other day. You might be a little sleepless but shouldn’t have too many other effects.
You can also get your doctor to prescribe lower amounts of hydrocodone (7.5 mg, 5mg), etc. which also can be cut in half.

For the sleeping, Ambien does work, but SURPRISE, it causes a physical dependence, so unless you want to be back where you started with several sleepless nights, I would try stay away from that solution.

And yes, talk to your doctor about alternative pain meds.

[wateryglen]

don’t get me started!!

Like LauraKY (a truly wise person :winkgrin:) said!!!

Taking narcotic painkillers “as needed” to me means every now & then, coupla times a week, or just at night even. You are taking them when you are having a pain level that is interfereing with functioning & sleep. It’s very, very common to have pain that interferes with sleep. It’s often the last thing to improve during rehabilitation. It’;s allowed! It’s normal!! The pain causes the restlessness and anxiety they are experiencing. So treating the pain treats the insomnia.

Yes it’s potentially addictive to want to be pain free!! Yes that class of drugs can cause dose/drug dependency, need for increasing dosages & frequency. But the OP is going the other way!!! She’s decreasing frequency. She has a RIGHT to be pain free. In this case; it sounds normal to me! :yes:

Oh and yes there is a lot of judgemental thinking in our society about pain and it’s treatment. Don’t get me started!!! :winkgrin:

[pharmgirl]

I definitely didn’t think I had an addiction problem! (or should say don’t currently either) (esp. since I had my hardware out 11 months later and probably took narcotics for a day or so with that, and pretty much that was it).

I did try Ambien once, and at least for me that was a serious no-go drug! I basically had a massive mental breakdown the day after taking that (and never had another like it since) so I stay away from it.

[Addison]

I agree with LAURIEACE. Call your doctor…they help patients deal with this all the time.

[Penthilisea]

And if you REALLY can’t do it on your own, check in through the local er for a 2-5 day detox stay on their in patient mental health ward. It’s a safe place where the medical folks are used to dealing with withdrawal issues, and you should also receive counseling etc.

I really prefer my fentanyl patches to any oral pills. The up/down dose/ re-dose thing triggers all sorts of addictive and dependent things in my head. The patch is a steady dose for 72 hours. And the lowest dose is 12.5 micro grams per hour, not much at all.