PAIN MANAGEMENT GUIDELINES

Pain control is a major goal of your continued care. In order for you to do a good job of controlling your pain, you need to know what makes your pain worse and what helps to relieve it. The following suggestions will assist you in making safe decisions at home.

  1. Only take pain medications according to the directions from your doctor. If he says, "take it as you need it", be sure you do not exceed the limit of the number of tablets at a single time or how often you can take the medications.
  2. Be sure the doctor prescribing pain medication is aware of ALL the medications you take. This includes any over- the- counter medications like aspirin, Tylenol, ibuprofen, antacids, or cold medications.
  3. You should take the pain medication with food, as they may upset an empty stomach.
  4. Do not wait until the pain is severe. Pills take 30-45 minutes to begin to work and if the pain is severe, relief will be slower and less effective.
  5. You should be more active at home so you may want to take your medication regularly for several days after surgery, and then taper off to "as you need it".
  6. Pain medication is most often needed with increased activity, physical therapy, and before bed.
  7. Notify your doctor if pain medication makes you nauseated, shaky, or if you have difficulty urinating.
  8. Do not operate a car while taking pain medication, as it may alter your senses.
  9. Do not drink alcohol while taking pain medication.
  10. Monitor your bowels, as pain medication may cause constipation. Taking Colace (stool softener) immediately following surgery may help with this.
  11. Call your doctor with any questions/concerns.
  12. Cryotherapy, or ice treatment, is one of the safest and most effective means of pain control. Ice should be applied with a barrier between it and your skin. Surgical wounds should be covered. The initial surgical bandage should be continued 48 hours after surgery. Following this, a sterile gauze purchased at the drug store should be placed over the wounds until the wounds stop draining. Tegaderm may be placed over the incision as well while icing. This is an adhesive sterile bandage that may be purchased at the drug store as well. Ice cooling systems may be purchased or rented prior to surgery. Many patients swear by these. Contact Dr. Portland's nurse if you wish to inquire regarding these.
  13. If you historical have problems with nausea, let Dr. Portland know at the time of surgery so he can prescribe anti-nausea medication.
  14. If you chronically are on narcotic pain medication, Dr. Portland or his nurse can help facilitate an appointment with a pain specialist.
  15. Blocks (injecting local anesthesia by the major nerves supplying either the shoulder or leg) are an effective tool for blocking the initial pain response from both shoulder and knee surgery. These also minimize the amount of anesthetic needed, and are especially useful in individuals who tend to get nauseous. Blocks about the shoulder are called interscalene blocks; those about the knee are called femoral nerve blocks. Small, but real risks, are associated with these. Dr. Portland's nurse would be able to provide you with the number of the Department of Anesthesia at North Shore University Hospital Medical Group (the anesthesiologists for his surgeries) to discuss this preoperatively.
  16. Tylenol (acetaminophen) is included in many narcotic pain medications. Please do not take plain Tylenol with narcotic pills to prevent unsafe levels of acetaminophen in your system.
  17. When cleared by Dr. Portland, it often is helpful to take anti-inflammatory one hour before physical therapy. This will help with your pain and recovery.