Susan's Place Transgender Resources

Community Conversation => Transitioning => Gender Correction Surgery => Topic started by: ashadyna on April 21, 2017, 10:13:18 AM

Title: Avoiding opioids post-surgery?
Post by: ashadyna on April 21, 2017, 10:13:18 AM
My partner is very concerned about the risk of developing an opioid (i.e. hard painkiller) addiction post-surgery. He sent me an article from the CDC with this figure, which shows that after being on opioids for about 3 days, the risk of long-term addiction increases significantly.

(https://www.cdc.gov/mmwr/volumes/66/wr/figures/m6610a1f1.gif)
Source: https://www.cdc.gov/mmwr/volumes/66/wr/mm6610a1.htm#F1_down

I would like to assure him that I will either not use opioids or at the VERY MOST use opioids for 3 days post-surgery. Given your experience, is this a realistic promise? Thoughts?

Edit: To be clear, I am referring to GRS. Also fixed spelling.
Title: Re: Avoiding opioids post-surgery?
Post by: jfong on April 21, 2017, 10:19:10 AM
It will depends on your personal situation post GRS. I never had to take the opioid past day 1 post and still have the stuff they sent me home with, but my roomate was on it continuously and seems to be in bed a lot. My personal preference was if the pain is unbearable then I had to take it, if it is minor then no biggie.

Sent from my SM-G935W8 using Tapatalk

Title: Re: Avoiding opioids post-surgery?
Post by: AnonyMs on April 21, 2017, 10:20:56 AM
I think I've only heard of one case of someone becoming addicted to drugs after GRS. I think you usually only get them in hospital, then after that it's things like tramadol which are far less addictive.

I know of one case, on YouTube, where a women was on opiates for months for serious pain after grs. Her doctor told she'd end up addicted, but she had no trouble getting off it.
Title: Re: Avoiding opioids post-surgery?
Post by: Gail20 on April 21, 2017, 10:30:31 AM
I guess this is not too scientific but I had a girlfriend go though SRS who is one of the strongest women I know.  She was in incredible shape (regularly rode her bike 75 to 100 miles a day just for fun) She still needed opiads to get through.
Title: Re: Avoiding opioids post-surgery?
Post by: ashadyna on April 21, 2017, 10:35:37 AM
Quote from: Gail20 on April 21, 2017, 10:30:31 AM
I guess this is not too scientific but I had a girlfriend go though SRS who is one of the strongest women I know.  She was in incredible shape (regularly rode her bike 75 to 100 miles a day just for fun) She still needed opiads to get through.

Thank you for sharing! If you do not mind me asking, how long ago did she have her surgery?

Edit: Nevermind - I misread your post as saying that your partner was still on opioids to this day.
Title: Re: Avoiding opioids post-surgery?
Post by: EmmaLoo on April 21, 2017, 12:43:58 PM

I totally understand your fear...BUT

Take what they give you to keep the pain down in the 3/10 range. Your body needs to relax and rest/sleep in order to heal. If you are consciously fighting the pain over the paranoia of a graph, your working against yourself. Unless you're predisposed to opioid addiction, the short-term opioid pain relief far outweighs the potential for abuse. Plus, it's obvious you are aware of the risks already.

I'm 3 weeks +4 post and went from Dilaudid until day 3 then switched to Vicoden 535 until day 6 then on to Ibuprophen. The only thing the Vicoden were doing by day 5 were giving me headaches. You will be fine, don't make it an issue unless you have a history of opioid problems. If that's the case...well you're screwed. lol. >:-)

Goodluck on your surgery.





Title: Re: Avoiding opioids post-surgery?
Post by: LizK on April 21, 2017, 03:09:53 PM
Appropriate and timely delivery if pain relief is paramount to a good recovery from any surgery,. You are more likely to become dependant rather than addicted which are two totally different things.

Dependence is a physical thing where your body is used to receiving a certain substance into your system and reacts when it is not there, so you experience withdrawal symptoms on a physical level. This is normal and is why they ween you off after a period of a few days. You can get the same thing from heavy constant coffee drinking...when you stop you nay experience some withdrawal as the caffeine leaves your system...don't get me wrong coming off a drug as an addict getting clean or as a patient coming off narcotic meds can be really tough due to the physical discomfort.

I was on large amount of opioid pain killer for 18months and decided that I had enough of the terrible side effects turning me into a constipated zombie... time to reduce...so I did...I experienced physical withdrawal symptoms which were horrible but psychologically it was not an issue for me and reduced it by over 120mg a day.   

Addiction is a totally different ballgame and involves a psychological need for the medication long after the physical pain has been taken care of. This is not normal and is not that common.

Don't be afraid to take the appropriate amount of medication to get comfortable and promote healing. Most people will be fine and not have any issues. Trust the expertise of your medical team.

IMHO addiction is about the individual...opioids won't make you into an addict. If however you have an addictive personality then you are likely to have difficulties but I would suspect, if that was the case, you would be "using" long before you got to surgery.

Hope that helps

Liz

Title: Re: Avoiding opioids post-surgery?
Post by: Dena on April 21, 2017, 05:08:54 PM
Pain is something very personal. If you need pain medication, you should ask for it or use the pain pump that they may provide. On the other hand, not everybody needs pain medication. The only pain medication I received was what they gave me in surgery. Others in my therapy group also stated that the pain was bearable. After about the first day or two there is a sizable drop in the amount of pain you might feel. A secondary possibility is many doctors use ice to control the swelling which would also reduce the pain.

This is something that needs to be judged as you go along but  pain management involves both doctor and patient. The doctor makes the medication available in safe qualities and the patient has the option not to use it if they don't need it. Because you tend to sleep the better part of the first day after surgery, you don't feel much of the initial pain after surgery so pain management may be minimal.
Title: Re: Avoiding opioids post-surgery?
Post by: SadieBlake on April 21, 2017, 11:12:46 PM
As I'll be in hospital 3 days after, I may be past the need for pain meds by the time they release me.

I react badly to the nausea caused by Percocet/oxycodone and have never taken more than a couple of these post-op however I've also always been released from hospital within 36 hours of the surgery. Then again this time my recovery meds include a couple of anti nausea meds so maybe this time will be different.

I'm not worried about forming a dependency.
Title: Re: Avoiding opioids post-surgery?
Post by: Janes Groove on April 21, 2017, 11:51:06 PM
I had a root canal last winter. They gave me a script for pain that had 7 days worth of meds.  I used them all. I'm not sorry.
Title: Re: Avoiding opioids post-surgery?
Post by: Maybebaby56 on April 22, 2017, 08:34:31 AM
Quote from: ashadyna on April 21, 2017, 10:13:18 AM
My partner is very concerned about the risk of developing an opioid (i.e. hard painkiller) addiction post-surgery. He sent me an article from the CDC with this figure, which shows that after being on opioids for about 3 days, the risk of long-term addiction increases significantly.

(https://www.cdc.gov/mmwr/volumes/66/wr/figures/m6610a1f1.gif)
Source: https://www.cdc.gov/mmwr/volumes/66/wr/mm6610a1.htm#F1_down

I would like to assure him that I will either not use opioids or at the VERY MOST use opioids for 3 days post-surgery. Given your experience, is this a realistic promise? Thoughts?


Hi Ashadyna,

Do you use drugs recreationally now?  Have you ever had a dependence on opiates or alcohol, or other drugs? If not, then I would offer that your chances of developing an opioid addiction are very small. 

I was prescribed Vicodin for FFS recovery.  I was sent home with a prescription for 40 pills and used about half of them over the first ten days.  The rest have sat around in my medicine cabinet for the last few months, and I am a former meth addict.  Addiction depends so much on context. It's not just the drugs.

As other have said, for a good post-surgical outcome, you should not be in significant pain. There is no good reason to suffer.  You will do better psychologically if you are not in constant pain, and where the mind leads, the body will follow.

Just my opinion.

With kindness,

Terri
Title: Re: Avoiding opioids post-surgery?
Post by: ashadyna on April 24, 2017, 12:37:57 PM
Thanks everyone for the feedback! Fortunately, I have no personal or family history of drug addiction. It's nice to hear that people's experiences with pain medication has not been too problematic.

Thanks again for the responses!
Title: Re: Avoiding opioids post-surgery?
Post by: denimandlace on April 25, 2017, 07:13:24 AM
Like your partner, I was quite fearful of becoming addicted to the pain meds following surgery.  I also received counsel from anesthesiologists that once you allow your body's pain sensory system to begin working after anesthesia, it is much harder to get it back under control.  Therefore, I was advised to take the drugs but extend the period between doses gradually to "test the water" and wean myself off as quickly as I reasonably could.  I took Percocet for 6 days.  By day 8 I was off it completely and using Advil and Tylenol as needed (once per day if that).  FYI: I am in very good physical condition, mid 40's and I'm doing GCS in two stages which I think may be a little easier to recover from that the one-and-done methods.  Best of luck to you with your surgery.
Title: Re: Avoiding opioids post-surgery?
Post by: SadieBlake on April 30, 2017, 07:51:47 PM
As suspected, I was tapering myself down by the 2nd day post op and took no opiates after midnight if the 3rd day. I took some Tylenol before leaving their facility and was glad of it but the reason for pain that night (Sat) was diarrhea, nothing to do with the incisions or healing. Anyhow I took 2 more single doses.

Today I took a single Percocet when pain was beginning to feel a bit edgy (my swelling has been up today and we didn't have any Tylenol), that's been addressed now so barring complications I doubt I'll be using any more, I hate the haziness that comes along with them.