Pain management after surgery

[logansaunt]

Hello all,  I am new to the forum and looking for some honest information.  I am in the process of donating a kidney to my 17 year old nephew.  I've researched the boards and feel I'm totally informed regarding the actual procedure and how everything takes place but I have to admit, I am absolutely terrified of the pain involved immediately following the surgery.  I'm also a little confused at the conflicting reports that I read.  Don't get me wrong, I know that each individual will heal at a different speed and I realize that we all have our own tolerance level dealing with pain.  I've delivered two children and also had a major surgery in 2009 (breast reduction) and feel like I did quite well.  (The labor and delivery was much worse!)  I had no complications during labor but after I woke up in recovery after the BR, I was so sick from the anesthesia that I spent the next several hours vomiting into a bowl.  I wasn't in alot of pain, just mostly discomfort, but they kept shooting me full of pain meds until I finally begged them to stop and just give me a bag of fluids because I could tell I was dehydrated since I was then having dry heaves.  After I received the fluids, I was so much better.

I guess my question is, since anesthesia and enormous amounts of pain meds seem to be a problem for me, how in the world am I going to get through a tough recovery?  I've read some accounts where people say they had very minor pain and discomfort and then I've ready some accounts where people say they felt like they were hit by a train.  Help me, please.  Would anybody care to share their actual details of their pain immediately after they woke up in recovery?  Thanks so much!

[Annie]

Hi Logan's Aunt,
Not sure if you've read my posts on here, but I donated my kidney a little over a month ago. A few years before that, I had my gallbladder removed. The two surgeries are very similar, recovery and pain-wise. I woke up in recovery from the gallbladder surgery in terrible pain. The nurse in recovery seemed somewhat indifferent and didn't give me any additional meds. When I got to my room, the nurse was wonderful and gave me pain meds right away, which worked well.

For the kidney surgery, I woke up in my room, feeling comfortable but tired. I was not in any pain, really. I wasn't nauseous, either. I'd say my worst day for pain was the third day after. The first two days were only painful getting up or down. The third day it was like my body finally realized what had happened. I took the pain pills all day that day. Each day after that got better and better, and I switched to Tylenol. To help with the pain getting up and down, try to use your arms, have someone hold out their arm for you to use for support, or steal my method of tying a belt to the bedpost so you can do it yourself. Lots of walking helps, too- I went for short walks at first, a few times a day. I worked myself up to longer and longer ones. It helps with the inflammation and constipation, and I think it just makes you feel mentally like you are taking charge to feel like yourself again.

It sounds to me like your problem is really with anesthesia. This seems like something you need to discuss with your coordinator and surgeon. Make sure they know how nauseous you were afterwards. They can combat this before it happens. I know they gave me anti-nausea stuff post-gallbladder surgery, and I'm nearly positive they did after the kidney one, too. It worked, because I did not throw up after either one. I would also mention your concern about waking up in pain. I did, and they were careful to make sure it didn't happen again.

Good luck to you in this whole process. If I can answer any more questions, don't hesitate to ask.

-Annie

[Orchidlady]

It is good that you have had some experience in the hospital and know what to expect and how to prepare. As Annie suggested, if it were me, I would make sure they know beforehand how you react to anesthesia and pain meds.

I had never been in the hospital before in my life, so had no idea how I would react to everything. The anesthesia really threw me for a loop. When I first woke up I was so thirsty. My sister in law and nephew were there along with the nurse, and they gave me some water. I immediately threw it right back up. The nurse gave me anti nausea meds in my iv (Zofram?) and I had no problems after that. Everyone is different, but I really never felt as much pain as I did discomfort. They had one of those pain management iv's where you can press the button. I was so loopy from the anesthetic, and whatever they had in there for pain medicine made me feel even loopier, so I didn't use it very often. The surgeon even commented the next day when he came in for his rounds that I hadn't pressed the button much. I asked for tylenol instead the second day and that seemed to help more so than anything.

One thing they did do that I thinked really helped immediately post recovery was that they gave a numbing shot near the largest incision. I wouldn't have known if it hadn't been for the fact that it left a bruise.They told me the hypodermic  is what caused it. My sister in law, who is a nurse, said that not everyone does this, but it is common practice in some hospitals to do this with all abdominal surgeries. I prevents the patient from waking up and immediately hunching over in pain from the incision.

Just make sure everyone knows ahead of time of your issues, and I would also make sure you have a friend or family member there who also knows the same information and can advocate for you.

Best of luck to you both.

[jstx]

I woke up in quite a bit of pain & very nauseous. They gave me something for the nausea that helped & they kept giving it to me for the first couple days. I woke up so thirsty too but they'd only give me a spongy "lollipop" to swab my mouth because they didn't want me to get sick. Then gradually I got ice chips. Finally that night-late-I got to sip some water. I had to take it slow or else I'd start to feel sick. I'd never had surgery or even been in the hospital. I had quite a bit of pain the first few days but my hospital managed it well & I'd do it all over again. Just seeing my recipient feeling better took my focus off me, the pain, and my loopy state from the meds! You are very fortunate to go into this knowing how you react to anesthesia & pain meds. As others have said, tell your transplant team....and everyone you meet in the hospital that day so they are prepared to take care of things as soon as you feel bad. I found the hospital staff was very good at managing my symptoms & I didn't shy away from telling them how I was feeling!  :D They took very good care of me!

Good luck! You'll do great!!

[logansaunt]

I can't thank you all enough for sharing your experiences with me. This will be my nephew's second transplant. His mother (my sister) donated to him six years ago and they were just informed in June that it's only functioning at 15 percent. He lost his other kidney when he was three years old.

This board has provided a wealth of information for me!

[CK]

I had never been in the hospital or had surgery before I donated 8 months ago. I expected terrible pain and a long recovery but hoped for the opposite!

I wouldn't say I ever had a lot of "pain". I was sore and stiff, for sure. To me, it felt like I had done 500 sit-ups (sore abdomen), rode a bike for 10 hours (sore legs, don't know why) and drank 10 glasses of wine the night before (dizzy) but not what I would call pain. Apparently, my recovery was out of the norm, because everyone kept commenting on how good I looked. I was out of bed walking the evening of the surgery and went home the next day.

They gave me a scopolamine patch for nausea related to the anesthesia, after I told them I tended towards motion sickness. It helped, but when I took it off, I got incredibly dizzy and motion sick for about 2 days. I only took Vicodin and only at night when I tended to get more stiff and sore, but soon discovered Tylenol worked just as well. I was back to work in 3 weeks and able to drive/help my recipient after one week.

Perhaps you should ask the doctors the specifics about how to avoid your past experiences in surgery.  Your nephew is lucky to have such a great aunt. :)

[lawphi]

I donated the same place as JSTX and my experiences were similar.  I had a fentanyl pump and got three zofran shots.  I was exercise sore, but dizzy when I woke up.  My dizziness was fine as long as my eyes were closed.

My first words were for zofran. It was a heavenly combination. I was minimally sick after burping. Your body will compensate for the sickness and vomiting is not as traumatic as it usually is. 

.

[sandypandy]

Hi

I have fibromyalgia so when i donated my kidney i was expecting lots of pain but i had minimal pain and my body didnt ache as bad as i thought i would when i woke up, for me tho it got worse but thats cos i started to have chest pain bad and it turns out i had fluid on my lungs but that was a complication for me, and i ended up staying in a week when i was meant to go home the next day.... so what im thinking is if i didnt have such bad chest pain, i dont think the normal after op pain would of been as bad.

Hey i hope i havent worried u but im sure you have been told to expect the fact that complications do happen, but after a week theere was no harm done after antibiotics and im healthy with my remaining kidney  ;D

[logansaunt]

Well, my surgery date is getting closer (July15) and the nerves are really kicking in. I'm anxious for the date to get here but scared at the same time.  Would love to hear from others regarding your particular pain management experience.  Thanks so much!

[elephant]

Dear logansaunt,

For me the anesthesia was more of an issue than pain.  I was definitely nauseated, but the IV zofran eliminated it 99%.  By the second day the nausea had passed, but I did not have an appetite for quite a while. 

I was also given IV Toradol for pain after surgery.  It is a non-narcotic drug and worked very well.   I did not have a morophine pump and did not need it.  I might have had morophine once when I woke up after surgery and said "My tummy hurts".  When I left the hospital I did switch to vicodin for a little while. 

Do take a small firm pillow with you to hold over the incision.  It is a huge help when you are moving around and especially if you have to sneeze. 

And eat prunes or drink prune juice!  Prunes are awesome! 

Love, elephant

[dodger]

Hi logansaunt!  Here is my story

I have had 3 children, natural childbirth, but had a tubal liagation after the 3rd.  The discomfort is much like that.  I had lower abdominal, laproscopic.  Below the bikini line removal, with main port in belly button and 3 out ports.  I also had a BR 2 years ago, which went much better after knowing how I am with sedation.

Be really well hydrated going in, drink all you can before the cut off time.  Eat lightly, no dairy, cream sauces, no salads the day before.  Some homemade chicken veg soup is the best. Have a normal breakfast the day before and then eat soup the rest of the day. Little to no sodium as that retains fluid.

Tell the antheseologist your previous experiences.  They can do a lot to prevent you from getting sick.  I hadn't had surgery that I could remember, so I was sick.  They gave me zofran and that made me dizzy, great.  I also had a very elevated sense of smell.  Food made me ill, cooked smells, coffee.  My daughter finally brought me a chicken salad sandwich, that tasted good.  Hot hospital food, which I normally find fine, not so much.  This went on for several weeks, maybe the trach tube bothered me. 

I did have the pain pump the first day, that really knocked me out, maybe something not so strong would have been better, who knows now?  Anyway, I tried walking but the CO2 gas made me sick as well, so back to bed. Tried again later, that was a little better. The pain is managable as long as you aren't so sick.  That was worse really.  The third day I was up and walking, took a shower, felt better after that.  Keep walking as soon and as much as you can is good advise. 

Is you belly sore, yes but it is manageable, as someone else said, use your arms to more around and help you up.  Just tell them what you experienced before and they will take care of you.  You will be fine.

The extra pillow from home is great as it is your fav to sleep with and you can put between you and the seatbelt for the ride home..  I also had some lung congestion that I coughed for about a week and that helped to hold on the abdomine as well.

I couldn't sleep in the hospital, not sure if it was the pain meds or that they came around all night, haha.  Sound canceling headphones, ear plugs, sleep mask are big helps, practice at home for a week before surgery to get ready.  Oh and sleeping on your back as well like with the BR surgery, pillow nest.  If you get a binder, wear it until you can't stand it any longer, at least 3 weeks it helps put everything back where it should be after taken apart.

The BR surgery went much better, they used the scolopamine patch behind my ear, I had eaten properly the day before.  When i woke up yes I had the discomfort of the surgery but they gave me something for that.  Then it was great after that.  No sickness!  Felt great, went home and slept, then ate supper.

The CO2 gas and the sickness got to me, the pain would have been manageable if those two other things had been out of the picture.  So don't obsess about the pain, you will get through it after a couple of days for the most part.  After you look down at your poor swollen belly you might wonder what you have done, haha, but it is all so worth if for our recipients!

[snoopy62]

Dear Logansaunt (and whoever else....)
    The main thing really is that everybody is different with pain.  In a way, I sort of over-prepared for my surgery, and I had very very little pain.
    I remember when I first woke up in Recovery, I was very cold, and my teeth were chattering.  They quickly bundled me up, and then asked if I was in pain.  When I said I was, I heard the nurse say, "Oh, so there is pain, let's give him something."  They must have increased some drip, because the pain went away and I think I went back to sleep.
   But that was the only time I ever complained of post-op pain and, it was literally seconds after I woke up from surgery, so I figure I was entitled.  :)
   Here's what did happen:  although I don't recall reading about it here on the board before my surgery, it was impossible for me to stand at all straight.  I mean, for a couple of days, I was a human ironing board, hunched all the way over.  From what I could see, several other post-donation patients in my unit had similar reactions, but less pronounced than mine.  The nurse kept pressuring me to take pain meds, but I refused--I wasn't suffering too much pain; I just couldn't straighten up.  Finally, the nurse threatened that, if I didn't take a pain pill, I'd never stand straight enough to clear up the cough I had (I had it already before the surgery)...and they wouldn't discharge me till I did.  That did it: I took one half of one pain pill, once, and that was all I needed.  Even the pain right when I woke up after surgery was no big deal at all. Had I been alert, I never would have taken pain meds, but my defenses--right after waking up from surgery--were down.  At no point did I find the pain bad enough to take any pain meds.
   Longer-term, there were two other issues.  For quite a while, it was hard for me to open heavy doors or lift without some pain in my abdomen. Also, for many months, going over bumps on the bus was not fun.  But still, it never occurred to me to take a pain pill for any of this.  I wish you all the same luck!
   Be well, Snoopy
   

[thomasrmcgee]

Hi Logans Aunt,

     My name is Thomas and I donated a kidney to my grandfather three weeks ago today. I also have never taken well to pain medicine so when I recovered from the surgery they placed me on Deloted instead of Morphine because I wasn't responding well to the Morphine. The biggest issue that I have had with pain or discomfort has just come with always having to lay on your back. Due to the scars you are not able to lay on your side or stomach without it feeling weird or hurting. When I was released from the hospital, they gave me Hydocodone to take and I have been off all pain medicine except Tylenol for over a week now and I am back at work with no problems what so ever. One last piece of advice, be careful on the food choices that you make after the surgery and that includes when you go home, with the lack of food in your system plus the pain meds, you will get just as much pain from your stomach as you will from the surgery. Please let me know if if I can answer anything else for you and congrats on the opportunity, it truly is a blessing!!

[logansaunt]

Thanks so much for all the help and great advice!  That's what I love about this board. 

As the day gets closer, I'm really starting to have my "freak-out" moments but you guys have really calmed my nerves. Monday is the day!

Thomas, I'm so glad everything went smooth  Hope your grandfather is doing great as well!

[snoopy62]

Dear Logansaunt,
   Good luck with the upcoming surgery!
   One angle to remember about pain is that, for people who have donated a kidney, certain kinds of common pain-killers are forbidden (forever, essentially). 
   Make very sure you know which things you can and cannot take.  I'm not talking so much about in the hospital (though it never hurts to be alert for medication errors), but you should definitely mention your one-kidney status to your family doc, pharmacist, etc.--and don't be shy to remind them.  And be careful if, for example, some helpful co-worker says, "Headache? I have just the thing in my purse".  You are your own best protection, so be very clear about long-term medication do's and don't's for kidney donors.
   Along those lines, remember that certain medical imaging procedures are ideally performed with contrast dye, which might not make your kidney happy.  So remind the doctors, so they can factor that into their thinking. Perhaps it's still worth using the dye, but they should be aware of the total picture.
       Be well, Snoopy