Susan's Place Transgender Resources

Hello,

I am having top surgery soon (this sounds so good! ;D) and I was planning, for many reasons, to refuse to take any opioid analgesics after surgery (although I might take NSAIDs if I can't sleep at all for several days, maybe also to help against swelling). I recently heard a rumor according to which pain slows down recovery, but I can't seem to understand/find out why.
Is it because of the lack of sleep pain causes? Or is it because the pain will discourage the amount of movement/walking required to avoid clots and thrombosis ?
If anybody has more information/experience to share about this I would really appreciate.

Unless you abused opiates in the past or have side effects you probably want to take them for the first few days. Your not going to be driving and need to rest, so if you reason is I need to do stuff your not going to do much while drains are in.

My doctor gave me Percocet and Celebrex (expensive $30 with coupon). They afterwards realized that I needed Valium due to muscle spasms. The Percocet and Valium suck be cause it make my memory fuzzy. I stopped taking them during the day, but I still need the Valium at night for painful muscle spams. The Celebrex reduces swelling, so that is why she prescribed that. Also Ibuprofen she said was not allowed due to it's effect on blood thinning.

Sleep is a wonder drug, so yeah if you can't sleep your body won't be able to rest and repair. The pain wasn't that bad after my drains were out. Walking afterwards wasn't painful, but you have to get use to the shift in center of gravity. The compression things on you legs suck and my mom is a nurse, so I walked at least 1/4 mile to appease her as they would bunch up in my knee crease.

Some surgeons advise against using NSAIDs just after surgery because of its affect on blood. Tylenol, at least by my surgeon is allowed. Is there a reason you're worried about the narcotic painkillers?

The one time I had surgery before, I had tried to avoid taking the Vicodin the doctor have me. It ended up that I had to get a new prescription for Percocet due to my body's freakish ability to keep me in pain out of spite. I did notice when I did not take the painkillers, my life was less than pleasant. I don't know if it slows healing by itself, but lack if sleep and stress from being in pain certainly do.

It absolutely will slow down a recovery.  You will stiffen up due to the lack of movement and then that will cause further pain and discomfort.  If there are no other medical reasons that you would not take opioids then I truly recommend taking what is needed.  You will recover faster as your body will be able to relax and not waste energy telling you it is in pain.  (20 years of nursing) just my two cents

I agree with Christinetobe.  Pain will also keep your pulse elevated and could cause complications with your blood pressure if not kept properly in check. 

I only took opioid painkillers the first 2 days and then was only on Panadol (Tylenol) after that.  So it's not like you'll need to be taking them for weeks.

I didn't take anything at all, but I'm a lot older than you are. Older guys are tougher. If you need to take it it's not going to hurt you for short periods. I felt more in discomfort than pain actually, and didn't think it would actually help that much. If you aren't sleeping due to pain or discomfort it can help you sleep, but I slept okay. I didn't expect I would sleep like a baby the second night or so, so I guess it sort of met my expectation. I slept off and on and I was okay with that whole thing.

--Jay

No, I don't have a particular medical reason or history of addiction to avoid taking opioids, I am just worried about the side effects, hallucinations and not having a 'clear mind'. Family members who have had a surgery or given birth have all refused any pain medication and said it was bearable, so I kind of assumed I could do the same thing. I also think that if pain restricts movement, it's probably for a reason, whereas if I don't feel it, I might do more movements than I should and do more harm because of the lack of pain. I also want to "earn it" and don't want to sleep through recovery without any pain (I know it's strange).

After reading your comments I'm still quite torn but I've decided that I will either take everything they give me or nothing at all, and forget the NSAIDs idea.
Thank you all for all your comments !  :)

At best, take the opioids if and when you want to rest/sleep and take general tylenol or some sort of other painkiller that's not an nsaid during the waking hours so you don't feel as if you are in less control.
It's what I do if my back starts to act up or if I had just gotten a tooth pulled.

Sleep is a miracle drug and the less moving and more resting you're doing in those first few days will help a ton.

Get the prescription just in case you want it.

You can't take NSAIDs after surgery. By the time you can take them, you shouldn't have any pain anyway.
NSAIDs would encourage bleeding, hence are absolutely forbidden. You can take Tylenol. For me I might as well take a sugar pill.


--Jay

Quote from: David27 on May 21, 2014, 03:33:16 PMyou have to get use to the shift in center of gravity.

I never experienced this, so it's not universal.

I took the meds for a few days and then at night only for a couple of nights. I expected to take prescription meds for a lot longer because I had the impression that I have a low pain threshold, but now I'm not so sure about my ability to withstand pain. Maybe I was so happy to have those things gone that the pain was muted. But I did need the prescription at first; I was able to get almost enough sleep, whereas I would have been quite sleep-deprived without it.

re: getting used to a change of the center of gravity.

I didn't have this issue. But I had not phantom pain exactly but a feeling of where my chest was previously. Also very odd where the nipples were initially. You don't feel them and you have a kind of where they might be (it's probably where they were). I saw this in someone's video. The guy's gf says his nipples are (close to) where they are. He says no way. I can find them now, but almost 7 months post op I can feel them.

--Jay

I have relatives who refuse to take drugs because they don't trust doctors. Your situation isn't completely out of the ordinary.

My subjective experience is that people who don't take opioids after surgery have a lot more stress than those who do. The stress may be worth it if you would face hangups due to previous addiction issues, but it sounds like you don't have that.

If I were you, I would ask for minimal pain relief and anesthesia. Explain to the doctor that you value alertness and awareness over comfort. I don't think you should aim for complete abstinence from narcotics unless you have a serious chip on your shoulder about medication.

I personally recover much more slowly when my pain isn't under control. Feeling physically bad can derail anything else I might have going on in my life, so I try to be careful to advocate for enough drugs and/or rest to not hurt too much.

So the surgery is done :D

I did fill the prescription, just in case, and managed not to take anything so far (it's been almost a week so I don't think pain levels will increase now). Strangely, I haven't had that much pain and sleeping was no problem. I guess I worried too much, this was actually easier than expected!
Thank you for all your interesting replies, they have been very useful ! :)

Quote from: Transguy on June 05, 2014, 12:43:12 PM
So the surgery is done :D

I did fill the prescription, just in case, and managed not to take anything so far (it's been almost a week so I don't think pain levels will increase now). Strangely, I haven't had that much pain and sleeping was no problem. I guess I worried too much, this was actually easier than expected!
Thank you for all your interesting replies, they have been very useful ! :)

I filled too and didn't use. I do not regret filling, it was good to know it was there in case I would have needed it.

--Jay

Quote from: aleon515 on June 05, 2014, 02:27:43 PM
I filled too and didn't use. I do not regret filling, it was good to know it was there in case I would have needed it.

--Jay

You're right, I'm going to look at it this way :)

Quote from: Transguy on June 05, 2014, 02:35:24 PM
You're right, I'm going to look at it this way :)

For the whole price of surgery the $15 of meds is hardly important.

--Jay