Surgery is officially recommended

[SatoriFround]

I do not pay my cardio. Insurance like Medicare does. And it never plays. And I think you meant Covid, for Opioid addiction has been around for many years. LOL!

No, I was talking about how doctors were paid for prescribing oxycontin.

 

[SatoriFround]

I’m 54 and need surgery within the year. What age range are you in that the surgeon is recommending a tissue valve as I am trying to decide what to do as well.

I am 50, oh wait, 51. It was my birthday the day he said I needed surgery. The surgeon who said he would recommend it isn't my surgeon, just a friend. My Cardiologist was the one who said tissue valve was the way to go. I haven't talked to the surgeon yet. I am getting my angiogram tomorrow.

 

[pellicle]

I’m 54 and need surgery within the year. What age range are you in that the surgeon is recommending a tissue valve as I am trying to decide what to do as well.

Welcome aboard Kristianna ... I hope you find information here on these pages to help you.

My advice is to step back from whatever you "think" you know right now; spend time reading, ask questions, read papers.

Or just flip a coin (no, seriously).

Best Wishes

 

[carolinemc]

No, I was talking about how doctors were paid for prescribing oxycontin.

And I have yet to be prescribed Oxycontin. it is very addictive.

 

[SatoriFround]

And I have yet to be prescribed Oxycontin. it is very addictive.

YES! In the early days the doctors were told it wasn't though. Even a lot of the doctors who were skeptical ended up believing the pharmacy reps lies.

My ex-husband was prescribed it after shattering his wrist and shoulder blade because he had to wait a couple of days for surgery and was in a LOT of pain. I remember he took one and was SO out of it. He only took it a couple times after that first dose, and he halved the dose. It scared him a little how hard it hit him. We ended up having that bottle sitting up on the shelf forever until I finally threw the remaining pills away. We had to jump through hoops to even get the prescription filled. Our insurance was out of a state that was hit hard by opioid abuse, and refused to pay. His doctor had to call them and explain this was a case where the medication was actually needed.

 

[carolinemc]

YES! In the early days the doctors were told it wasn't though. Even a lot of the doctors who were skeptical ended up believing the pharmacy reps lies.

My ex-husband was prescribed it after shattering his wrist and shoulder blade because he had to wait a couple of days for surgery and was in a LOT of pain. I remember he took one and was SO out of it. He only took it a couple times after that first dose, and he halved the dose. It scared him a little how hard it hit him. We ended up having that bottle sitting up on the shelf forever until I finally threw the remaining pills away. We had to jump through hoops to even get the prescription filled. Our insurance was out of a state that was hit hard by opioid abuse, and refused to pay. His doctor had to call them and explain this was a case where the medication was actually needed.

It is tougher to get pain relief. Even in the early stage of recovery. I tried to get that same med I had in hospital, for I am bad when it comes to taking pills for pain, hardly touch unless the pain is too much. And it is due to the Opioid abuse.

 

[SatoriFround]

It is tougher to get pain relief. Even in the early stage of recovery. I tried to get that same med I had in hospital, for I am bad when it comes to taking pills for pain, hardly touch unless the pain is too much. And it is due to the Opioid abuse.

Yes, It was blue cross/blue shield of Illinois, and Chicago had been going through major difficulties with fraudulently acquired prescriptions. *sigh*

I am not looking forward to the pain. I still have trauma from my childhood chest surgery and that was 45 years ago. This is a different surgery though, and surgical procedures/pain management techniques have improved since then....

 

[carolinemc]

Yes, It was blue cross/blue shield of Illinois, and Chicago had been going through major difficulties with fraudulently acquired prescriptions. *sigh*

I am not looking forward to the pain. I still have trauma from my childhood chest surgery and that was 45 years ago. This is a different surgery though, and surgical procedures/pain management techniques have improved since then....

It will be a lot different after all the years that have passed on pain management. Improvements on how long surgery is. But there is the memory fog, referred to as Pump Head, from the use of meds on the heart/lung machine. Good luck and keep us informed.

 

[Gail in Ca]

I don’t remember horrible pain from my 3 surgeries in 20 years. The coughing after surgery for surgeries 1&2 was kind of painful but I was given a heart hugger for 1 which was very helpful, and a heart shaped pillow for 2, which was not as helpful. I hardly coughed for 3, so not a lot of pain. For all 3 I was nauseous from the anesthesia. Phenergan helped me with that. You may not need major pain meds in CCU. I did best with Darvocet for my first surgery but it was taken off the market.
Try to think positive about your recovery.
When they have us on meds at first, I found I was just falling asleep, even in a chair they transitioned me to. It’s better when you are off the pain meds. Then you can walk by yourself at all hours up and down the halls of the CCU.
You recover better when you are more alert.

 

[Chuck C]

I am not looking forward to the pain. I still have trauma from my childhood chest surgery and that was 45 years ago

When my wife had a caesarean in 1995, the philosophy of the nursing staff was to stay ahead of the pain. It worked. By the time I had my surgery in 2021, the nursing staff was mixed. Some believed in staying ahead of the pain, but many of the younger nurses seemed to have been convinced in nursing school that it was their job to stop the opioid epidemic and that meant being stingy with pain meds for their patients. My first night, that was the nurse I had- hardly wanted to give me anything and I was in a lot of pain. The morning nurse came in and he was of the old school philosophy and was able to get me what I needed so that I was comfortable. The game changer was the Dilaudid PCA pump. Dilaudid is heavy duty stuff and if I felt I needed it, I could just push the button. It is designed to limit how often you can push it- I think it was set at one push per 30 minutes max. I only ended up pushing it a handful of times that first day, and hardly pushed it at all the next day. By day 3 I did not need it anymore.

My suggestion would be to self advocate about the pain meds, if you are in pain and get resistance. I totally get that there was a time when hospitals were too loose with pain meds, but I feel that they have swung a little too far in the other direction now. Getting open heart surgery is exactly a time when it is appropriate to be on pain meds if needed- even if they are strong ones for a couple of days. So, don't hesitate to speak up if you feel that you need something a little stronger than what they are giving you to control the pain. Properly controlled pain will also help you feel more comfortable getting up and walking, which is very important while in recovery.

 

[pellicle]

but many of the younger nurses seemed to have been convinced in nursing school that it was their job to stop the opioid epidemic and that meant being stingy with pain meds for their patients.

its like this really ...

 

[3mm]

Now there are also topical pain medications which are very helpful for appropriate cases. By my 2nd day after open heart surgery (mitral valve repair and installation of a mechanical On-X aortic valve) I was using only Tylenol, but that night my back started cramping painfully. The nurse gave me a topical pain killer, something they stuck on my upper back with a slight adhesive. It worked; or at least, I thought it worked, which, for a pain killer, is the same thing.

 

[ncw3642]

Now there are also topical pain medications which are very helpful for appropriate cases. By my 2nd day after open heart surgery (mitral valve repair and installation of a mechanical On-X aortic valve) I was using only Tylenol, but that night my back started cramping painfully. The nurse gave me a topical pain killer, something they stuck on my upper back with a slight adhesive. It worked; or at least, I thought it worked, which, for a pain killer, is the same thing.

For me, this was in the form of lidocaine patches that they were allowed to put on me 2x a day. It helped somewhat.

On the topic of pain management- the Norco (Acetaminophen-Hydrocodone) they gave me worked the best with minimal side effects compared to the stronger stuff however what worked better than the Norco was the muscle relaxer (they used Robaxin for me). That is less addictive than the painkiller but actually dulled and removed most of my pain. I noticed way more pain when I skipped a dose of that versus my Norco.

It was a godsend at home prior to my discontinuation after a couple weeks.

 

[SatoriFround]

When my wife had a caesarean in 1995, the philosophy of the nursing staff was to stay ahead of the pain. It worked. By the time I had my surgery in 2021, the nursing staff was mixed. Some believed in staying ahead of the pain, but many of the younger nurses seemed to have been convinced in nursing school that it was their job to stop the opioid epidemic and that meant being stingy with pain meds for their patients. My first night, that was the nurse I had- hardly wanted to give me anything and I was in a lot of pain. The morning nurse came in and he was of the old school philosophy and was able to get me what I needed so that I was comfortable. The game changer was the Dilaudid PCA pump. Dilaudid is heavy duty stuff and if I felt I needed it, I could just push the button. It is designed to limit how often you can push it- I think it was set at one push per 30 minutes max. I only ended up pushing it a handful of times that first day, and hardly pushed it at all the next day. By day 3 I did not need it anymore.

My suggestion would be to self advocate about the pain meds, if you are in pain and get resistance. I totally get that there was a time when hospitals were too loose with pain meds, but I feel that they have swung a little too far in the other direction now. Getting open heart surgery is exactly a time when it is appropriate to be on pain meds if needed- even if they are strong ones for a couple of days. So, don't hesitate to speak up if you feel that you need something a little stronger than what they are giving you to control the pain. Properly controlled pain will also help you feel more comfortable getting up and walking, which is very important while in recovery.

I didn't even realize this could be an issue. I am not afraid to speak up for myself though and my wife will make a stink on my behalf if needed. I don't think after major surgery is the time to be questioning whether your patient is actually in pain. This sort of makes me lean towards the non-teaching hospital where they have old hands and not a bunch of super young people. LOL

 

[SatoriFround]

For me, this was in the form of lidocaine patches that they were allowed to put on me 2x a day. It helped somewhat.

On the topic of pain management- the Norco (Acetaminophen-Hydrocodone) they gave me worked the best with minimal side effects compared to the stronger stuff however what worked better than the Norco was the muscle relaxer (they used Robaxin for me). That is less addictive than the painkiller but actually dulled and removed most of my pain. I noticed way more pain when I skipped a dose of that versus my Norco.

It was a godsend at home prior to my discontinuation after a couple weeks.

Thank you for this. I will keep it in mind. I would much prefer a muscle relaxant to the hard stuff.

 

[Gail in Ca]

I was happy to go to a teaching hospital near me, Stanford, since it’s one of the best for cardiac surgery. All 3 of mine were done there and I never felt I had an uninformed person helping me. The chief surgical resident was my surgeon’s second for my 2nd, and a different chief surgical resident was his second on my long, complicated, risky 3rd surgery.
These doctors were both very confident and had a great bedside manner.
All the nurses had been at their job many years. They knew what they were doing.
But, it’s important you feel good about the hospital you choose. My first surgeon and the top surgeon I had for #’s 2,3 were at Stanford, so I went there for them to save my life 3 times.
When you awaken from surgery, you will be amazed it’s over. What a feeling!!

 

[SatoriFround]

I was happy to go to a teaching hospital near me, Stanford, since it’s one of the best for cardiac surgery. All 3 of mine were done there and I never felt I had an uninformed person helping me. The chief surgical resident was my surgeon’s second for my 2nd, and a different chief surgical resident was his second on my long, complicated, risky 3rd surgery.
These doctors were both very confident and had a great bedside manner.
All the nurses had been at their job many years. They knew what they were doing.
But, it’s important you feel good about the hospital you choose. My first surgeon and the top surgeon I had for #’s 2,3 were at Stanford, so I went there for them to save my life 3 times.
When you awaken from surgery, you will be amazed it’s over. What a feeling!!

I have no problem with teaching hospitals. The one I that is one of my two top picks is very well rated, one of the best. I was only talking about the specific statement made, about the newer nurses being stingy with the pain meds due to the opioid epidemic. The one thing I didn't like when I went to that hospital for my angiogram was the rooms. They just seem old and outdated, I don't know, maybe it is just the day surgery area. If this is a place that I may have to stay a week in I would like it to not seem dingy. I know, stupid thing to think about. I am setting up appointments with two doctors, one from that hospital and one from the other I am considering. The second surgeon is actually the head of the department and trained under DeBakey...

 

[Gail in Ca]

Oh man, I wouldn’t want a dingy room
in a hospital . I get what you’re feeling.

 

[3mm]

If this is a place that I may have to stay a week in I would like it to not seem dingy.

The surgical team (surgeon AND nurses, technicians, etc) is far more important than your room. However, if everything else is equal, then a nicer room/environment will help your recovery.

When I was hospitalized for endocarditis, I was in a 2 patient room in a 3 room pod off a hallway. So in addition to my roommate, I could look straight to my right from my bed and see another patient in another room. Very noisy, very difficult to sleep.