Life with a Pain Pump - Part 6
Pre-Surgery Preparations & Precautions
Prior to your pain pump implant surgery, there will be many tasks to complete before it can take place. Your pain management doctor, surgeon, and the hospital will each give you lists of items to complete before and on the day of your surgery. Following is a partial list of the requirements I was given prior to my surgery.
Drug Taper
If you are a long-term opioid therapy patient, your pain management doctor, working in concert with your surgeon and the pump manufacturer’s representative, will likely put you on a drug taper to wean you entirely or partially off all pain meds prior to your pump implant surgery. This step is to prevent a potential overdose when the pump is implanted, filled, and begins to pump whatever medication you and your doctor agreed on, typically either morphine, ziconotide (Prialt), or hydromorphone (Dilaudid). For long-term opioid therapy patients, I know this is a scary, anxiety-filled situation as those living in pain rely on their pain meds to make life somewhat bearable. Be prepared to state your case with your pain management doctor, and hopefully, you’ll both arrive at a safe and comfortable taper plan without excessive withdrawal symptoms.
Time of Surgery
While you may be given a firm date for your surgery, it’s likely that you won’t know the time for your operation until the day before. A surgeon typically schedules multiple surgeries on their surgery days, and your hospital must also align their operating room availability with the surgeon’s schedule before finally arriving at a firm time for your operation. For example, my surgery was scheduled for 7:00 a.m., which meant I had to be at the hospital for check-in before 5:00 a.m. Your schedule may be different, but you should be prepared to arrive very early. (Yawn!)
Driver Requirement
You will need someone to drive you to the hospital and pick you up after your surgery. We were under COVID-19 restrictions during my surgery, so my driver was not allowed to wait inside the hospital. However, post-COVID, I believe your driver is required to remain in the hospital until you are released. My implant surgery only took about one and a half hours, plus about two hours in recovery, so my driver dropped me off and went back to work until the hospital called him to come back and pick me up. Make sure you will be driven home in a vehicle that doesn’t require too many acrobatics to get in and out of, as you will be very, very tender when you leave the hospital to go home. Think Cadillac instead of Corvette!
NSAID Restrictions
You will likely be asked to stop taking all NSAIDs (non-steroidal anti-inflammatory drugs, like ibuprofen) and certain anti-clotting drugs several days to a week before your surgery to help avoid excessive bleeding. Check with your doctor for specifics.
Anti-bacterial Shower
Most surgeons will request that you shower with Dial Anti-bacterial soap the day of your surgery to lower the chances of infections.
Fluids In
Drink plenty of fluids the day before your surgery to stay hydrated.
Fluids Out
If you’re male and over a certain age (you know what I’m talking about!), remember that all of the fluids you’re intaking must eventually come out, so you should take appropriate actions just before going into the operating room to avoid waking up from surgery in pain and about to burst. ‘Nuff said! ;-)
Home Precautions
Your home should be especially clean when you come home after surgery. This precaution includes fresh bed linens and a clean bathroom to help avoid the possibility of infection. You should also make sure that throw rugs are removed and that you have support bars around your toilet and in your shower. While you probably won’t be in tremendous pain, you will have a three or four-inch incision which you need to guard against strains and pulls from quick moves such as reaching high and low, getting in or out of chairs, and getting on and off of the toilet.
Medications List
If you don’t already have one, you should list all your medications with their dosages, and dosing frequency, as you will be asked for them many times during this process. I always carry a printed list created with a spreadsheet so I can easily keep it up to date and just hand it to a nurse to copy as needed.
This is a good pre-surgery starter list, but if you need more details about how to prepare for and recover from spine surgery or a pain pump implant surgery, my medical memoir, “War on Chronic Pain,” has many more in-depth details that will help you survive your surgery more safely and comfortably.
All the Best!
Franklin