COVID-19 vaccines: medical concerns and recommendations

[JohnO]

Had a laparoscopic bi-lateral inguinal hernia repair earlier this year. I told my Doc no opioids I'll be okay. He insisted by saying, "better to have and not need than to need and not have". I got by on ibuprofen the first few nights, never touched the oxy.

My wife has been through Hell this year, still there and pushing through. Breast cancer diagnosis (FUCK CANCER!). Double mastectomy and post surgery she took a couple oxy's for 2-3 days. She quickly discovered that she did not like the way the drug made her feel. She couldn't function. Fast forward to 3 weeks ago. Another surgery to remove tissue expanders and replace with silicone implants. When asked at the pre-surgical consult if she needed more pain meds she said she had plenty from the previous surgery. She hasn't touched them, just ibuprofen as needed. Watching what she is going through and worrying about her is taking a toll on me. Fortunately for me there is ice cream! <- I'm going to need to get that monkey off my back before I need a new wardrobe.

[blues]

Had a laparoscopic bi-lateral inguinal hernia repair earlier this year. I told my Doc no opioids I'll be okay. He insisted by saying, "better to have and not need than to need and not have". I got by on ibuprofen the first few nights, never touched the oxy.

Five years ago, when I got a number of stitches in both hands, they gave me Vicodin to take home in case I needed it...despite my objections saying I wouldn't take it.

Five years later it's still sitting in my medicine cabinet, (I think it was only one or two), though I realize I should have found a way to safely dispose of it.

[HeavyDuty]

When I lost my wife in 2015, I ended up depositing two 2 gallon ziplocks of her old pain meds at the collection box - whenever they changed dosage, she kept the old ones. Large quantities of Oxy from 20 to 80mg, Norco, you name it. I probably could have sold it all at the bus station and bought a nice used car.

[MickAK]

Five years ago, when I got a number of stitches in both hands, they gave me Vicodin to take home in case I needed it...despite my objections saying I wouldn't take it.

Five years later it's still sitting in my medicine cabinet, (I think it was only one or two), though I realize I should have found a way to safely dispose of it.

It's a huge problem. There's a lot of people talking about the issue but a lot less taking action. Even when the patient directly states no opiates.

Last year 5 days after my surgery I decided no opiates and I told my doctor and the head of the nursing staff no opiates. They were just going to have to listen to me scream. They came in every 3 hours saying 'Time for your Oxy!' without fail. No amount of insistence would get them to stop coming in with that pill, and man, was it hard to say no.

Later they said 'Well, you can take Tramadol, it's non-narcotic.' Which is of course hooey. But it took me a couple of weeks to find that out.

I get that it's annoying to have patients changing their mind on prescriptions after the pain hits but with all we're dealing as a society it seems like 'no opiates, please' should mean no opiates, not 'Well you don't have to take them if you don't want to'.

[Doc_Glock]

It's a huge problem. There's a lot of people talking about the issue but a lot less taking action. Even when the patient directly states no opiates.

Last year 5 days after my surgery I decided no opiates and I told my doctor and the head of the nursing staff no opiates. They were just going to have to listen to me scream. They came in every 3 hours saying 'Time for your Oxy!' without fail. No amount of insistence would get them to stop coming in with that pill, and man, was it hard to say no.

Later they said 'Well, you can take Tramadol, it's non-narcotic.' Which is of course hooey. But it took me a couple of weeks to find that out.

I get that it's annoying to have patients changing their mind on prescriptions after the pain hits but with all we're dealing as a society it seems like 'no opiates, please' should mean no opiates, not 'Well you don't have to take them if you don't want to'.

Five years ago, when I got a number of stitches in both hands, they gave me Vicodin to take home in case I needed it...despite my objections saying I wouldn't take it.

Five years later it's still sitting in my medicine cabinet, (I think it was only one or two), though I realize I should have found a way to safely dispose of it.

Had a laparoscopic bi-lateral inguinal hernia repair earlier this year. I told my Doc no opioids I'll be okay. He insisted by saying, "better to have and not need than to need and not have". I got by on ibuprofen the first few nights, never touched the oxy.

My wife has been through Hell this year, still there and pushing through. Breast cancer diagnosis (FUCK CANCER!). Double mastectomy and post surgery she took a couple oxy's for 2-3 days. She quickly discovered that she did not like the way the drug made her feel. She couldn't function. Fast forward to 3 weeks ago. Another surgery to remove tissue expanders and replace with silicone implants. When asked at the pre-surgical consult if she needed more pain meds she said she had plenty from the previous surgery. She hasn't touched them, just ibuprofen as needed. Watching what she is going through and worrying about her is taking a toll on me. Fortunately for me there is ice cream! <- I'm going to need to get that monkey off my back before I need a new wardrobe.

Vicodin is just the trade name of hydrocodone mixed with acetaminophen (aka Tylenol).

A significant factor in our prescription drug / opioid epidemic is the practice of physicians, and particularly surgeons, providing too long of a narcotic prescription (ie too many pills) for a procedure. This causes patients to save unused pills for a “rainy day” which is really a bad idea on multiple levels. Several studies have look at this and most patients need less than a week of opiates for surgery with the possible exception of gyn surgeries where the pain lasts a little longer. We now know that using an opiate like hydrocodone for more that 5 days is associated with a small but statistically significant increase in long term use of narcotics one year later. Having “extra” opiates on hand “just in case” is also a problem for family members - think kids who sell them to their friends or spouses who have an secret substance use disorder. You are far better off disposing any unused narcotics than saving them for a rainy day.

I know that I’m sounding like a fuddie dud, but ask me how many lives I’ve seen ruined by prescription narcotics leading to an opioid use disorder. The purpose of my earlier post was to shock you. Now that I have your attention, consider the fact that you just came onto a public forum and described abusing a prescription narcotic by taking it for purposes other than for which it was prescribed. We call that self-medicating and it’s often an early sign that there is a problem.

Bottom line, I suggest that you rid of all the left over opiates in your house and only take such medications for the original conditions for which they are prescribed. They aren’t helping you. I’d also inquire from your surgeon and anesthesiologist about opiate-sparing strategies ahead of any planned surgeries in your future. You might be surprised at how much they can help you.

I was actually shocked by your reaction and checked my prescription. What I took was Hydrocodone, not Vicodin as I had incorrectly written in a previous post. Not that I would know one from the other. I have the Hydrocodone prescription left over from some surgery and other pain issues that I have had. I can't take anti-inflammatories because of ulcer issues. The second day after the third dose I felt worse than any sickness that I can remember in recent times. But I still lobby people I know to get a third dose. And things will likely get worse for me on Thursday painwise since I will be having tendon sheath surgery on my dominant hand for middle and ring fingers. It is a two hour out patient procedure for which I will be under some type of twilight anesthesia. I am not looking forward to the recovery and glad that I have voice recognition software. I supposed to have someone with me for 48 hours afterwards. I think that is just something they tell you for liability reasons and to make sure you don't buy anything stupid. I have my list made.

I have done every surgery mentioned here:

You can absolutely do inguinal hernias without opiates. I do it all the time with patients. I give them long acting numbing medicine (bupivicaine). Lots of that. Then put them on a tylenol/advil protocol. 1/10 request something stronger.

Trigger finger release needs nothing more than Acetaminophen.

Fact is Sensei and I were trained in the era of "Pain is the fifth vital sign" and everyone expected 20 or so vicodin with every surgery. That age has passed and we were absolutely wrong. The history is sad and essentially there was deception/lobbying going on via the drug company. Can't remember the name, but they were in Indiana and essentially out of business now.

Anyway the practice should be changed at this point. I talk almost every patient out of opiates and rarely, maybe less than ten time a year prescribe them, and I do easily 400-500 surgical procedures a year.

[Spartan1980]

I had an inguinal hernia surgery done a few years ago. Not laparoscopic, but old school. Surgeon said it could be done laparoscopic with mesh but didn't recommend it. He said I'd just be back in a year getting it done again the "right way".

I went home about 3-4 hours after with a script of Norco that only ran for 3 days or so. I lived but I'll never take Norco as labeled again. Two of them made me hold onto a pillow and wish I could throw up for 3 solid hours. They didn't really do anything for the pain anyway, they just made me not care much about it is all and I could sleep a bit on them. That 3 day script stretched to about 7 and I haven't had any since.

[ccmdfd]

I had an inguinal hernia surgery done a few years ago. Not laparoscopic, but old school. Surgeon said it could be done laparoscopic with mesh but didn't recommend it. He said I'd just be back in a year getting it done again the "right way".

I went home about 3-4 hours after with a script of Norco that only ran for 3 days or so. I lived but I'll never take Norco as labeled again. Two of them made me hold onto a pillow and wish I could throw up for 3 solid hours. They didn't really do anything for the pain anyway, they just made me not care much about it is all and I could sleep a bit on them. That 3 day script stretched to about 7 and I haven't had any since.

Reminds me of when I was a teenager and I had my wisdom teeth taken out. The doctor sent me home with some form of a narcotic, don't remember the exact brand name at this point. It made me sick as a dog.

Nothing like endless vomiting when your mouth is full of cotton bandages and stitches which feel like fishing wire.

[Balisong]

I have done every surgery mentioned here:

You can absolutely do inguinal hernias without opiates. I do it all the time with patients. I give them long acting numbing medicine (bupivicaine). Lots of that. Then put them on a tylenol/advil protocol. 1/10 request something stronger.

Trigger finger release needs nothing more than Acetaminophen.

Fact is Sensei and I were trained in the era of "Pain is the fifth vital sign" and everyone expected 20 or so vicodin with every surgery. That age has passed and we were absolutely wrong. The history is sad and essentially there was deception/lobbying going on via the drug company. Can't remember the name, but they were in Indiana and essentially out of business now.

Anyway the practice should be changed at this point. I talk almost every patient out of opiates and rarely, maybe less than ten time a year prescribe them, and I do easily 400-500 surgical procedures a year.

Do you have any experience with Exparel? The surgeons where I work are having good luck with it and using it on a variety of cases from hernias to gastric sleeves to anal hemorrhoid stuff. I only work inside the OR but they say their patients need far less meds/narcs after. Also doing a lot of blocks on ortho stuff and seeing more and more tap blocks for some general surgeries.

[RoyGBiv]

Five years later it's still sitting in my medicine cabinet, (I think it was only one or two), though I realize I should have found a way to safely dispose of it.

Your local PD probably has a drop box.

Local PD here also does 2 take-back events each year in conjunction with the local DEA. Next one is in about 2 weeks.

[ccmdfd]

Your local PD probably has a drop box.

Local PD here also does 2 take-back events each year in conjunction with the local DEA. Next one is in about 2 weeks.

Local hospitals and pharmacies around here do the same thing.