Post operative pain relief, or not!


(Sara Snell) #1

Hi,


My husband is currently recovering from a fairly extensive abdominal surgery (correcting the last botched one) and is in a great deal of pain. The only pain relief that the surgeon will prescribe is 1000mg Paracetamol ev


en though he has been asked several times for something stronger.




Does anyone know if th


ere's a good medical basis for refusing stronger pain relief? No organs were involved this time (although we've we been told nothing about the op). We, regrettably, strongly suspect that the surgeon is not a fan of the Anglais given his manner and hope this is not some form of vindictiveness.


Is there anything we can do to improve my husband's comfort?


(Peter Bird) #2

The obvious path for me is to ask your GP for stronger painkillers, I would imagine (on past personal experience) the surgeon is expecting you to visit your GP in such a case.


(Véronique Langlands) #3

The difficulty is also that opiates slow down gut function which isn't a good thing after abdominal surgery, and anti inflammatories used as a painkiller can eat their way through gut lining - so that's two classes of painkiller off the list of possibles, so as others have said talk to the surgeon or your GP again.


(Marie-Claire Gauthier) #4

Have you asked the surgeon or an intern why your husband is being denied more efficient pain killers? It is quite unusual in France as doctors tend to over prescribe comfort medication. I would be extremely surprised if your doctor was acting on "anti-English" grounds, still, get another opinion just in case. Be sure to go to your surgeon first as he may be withholding information from you, especially if he isn't certain yet that everything is going smoothly

We had a similar situation with my mum (not in France, but in Italy) and the surgeon said that as her gall bladder had just been removed it would be dangerous for her to have anything more potent. He also said she wasn't really in pain, but ended up giving in and handing her the pain killers she needed.


(Sara Snell) #5

Brian, this guy knows a LOT about pain, which is how I know he's in agony. He never takes pan killers if he can avoid them......but, now when he needs them, they refuse!


(Sara Snell) #6

It's only been 24 hours. He's in agony.


(Brian Milne) #7

Jane, I have been going on about it for three and a half years as you will know. I had the option of 'dosing up' but dependency is one problem and detrimental build up in both the neural and metabolic processes, liver the latter, the other so the preferred way is actually none. The real difference is that some doctors do it the 'old way' and give what people believe they want. That is deadly if habitual. The maximum amount of paracetamol for adults is 1 gram (1000mg) per dose and 4 grams (4000mg) absolute maximum per day for three or four days. Taking more paracetamol can cause damage to your liver, therefore a daily dosage of 2000mg is about as much as any properly informed doctor will give. Then only for a few days, certainly not more than about two weeks. The issue is serious because paracetamol and similar are not meant to be taken daily but in the event of pain and for ideally a single day. There is plenty to read about pain killers, especially paracetamol, including from manufacturers who are also not out to do people damage.


(Jane Williamson) #8

You should always have sufficient pain relief to be fairly comfortable.

The nerve pathways can become accustomed to feeling pain and this state of affairs can continue for longer than it should, sometimes permanently.

I cannot understand why your surgeon is acting in this way, except possibly he thinks that if he gives him anything stronger he will become dependent.

Good luck.


(Brian Milne) #9

Sara, go to your médecin traitant and explain very carefully. I doubt the surgeon is being malicious and bear in mind that the longer pain killers are taken, the less effect they have although long term even paracetamol can have bad side effects. 1000mg paracetamol is quite a big dose for continual use beyond a couple of weeks. I also know that pain is often better than relieving it. Mine only hurts when I think about it, as seeing this made it hurt because it reminded me. Anyway, your regular doctor is better than any lay opinion you may get from us lot.