Guidance for Fibromyalgia Patients Who Are Having Elective Surgery
by The Oregon Fibromyalgia Team ImmuneSupport.com
07-09-2007
We highlight the following guidelines from time to time for the benefit of patients facing surgery.
If you are having a major surgical procedure there are some issues that you may wish to discuss with your surgeon and anesthesiologist that could reduce the ``fibro-flare'' that often occurs after surgery in Fibromyalgia patients.
1. Request that you wear a soft neck collar and minimize neck hyperextension (if an endotracheal tube is anticipated).
2. Request that your arm with the intravenous line be kept near your body, not away from your body or over your head.
3. Request that you be given a pre-operative opioid pain medication - about 90 minutes prior to surgery. Opioids are morphine or morphine related drugs.
The rationale for the pre-operative use of opioids is to minimize ``central sensitization'' - as this inevitably worsens the widespread body pain that you are already experiencing.
4. Ask to have a long-acting local anesthetic infiltrated into your incision - even though you will be asleep during the procedure. The rationale for this is to minimize pain impulses reaching the spinal cord and brain, which in turn drive central sensitization.
5. As a Fibromyalgia patient you will need more, a usually longer duration, of post-operative pain medication. In most cases opioids should be regularly administered or self administered with a PCA pump (patient controlled analgesia).
6. Most Fibromyalgia patients require a longer duration of post-operative convalescence, including physical therapy in many cases.
Many patients have reported owing Dr. Robert Bennett's recommendations in this article made a big difference in their post-surgical pain and recovery time. They advise printing several copies of the article and giving it to all doctors, surgeons, and anesthesiologists involved.
And don't just assume they've read it. *************************************
Make sure they explain to you in detail what steps they're going to take to reduce the intensity of any post-surgical flare-up.
Also talk with your doctors about your immune system concerns to see if there are additional preventative measures you can take.
Even under the best of circumstances, people with FM and ME/CFS generally have a longer post-operative convalescence period than most.
So allow yourself plenty of extra time to recuperate and don't push yourself too soon. We wish you the best in your upcoming surgery.]
___ This article is reproduced with permission from the Oregon Health & Science Fibromyalgia Research and Treatment Team, headed by Robert Bennett, MD. For information on the team's frequently scheduled speaking engagements in the states of Washington and Oregon and elsewhere, go to their Web site at www.myalgia.com
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major surgery Posted by: crumpton Dec 20, 2006 Was this review helpful? 5 1 Total Score: 4
I had a hysterectomy on Oct 25th by an abdominal incision. The only thing that I would add is that if you are seeing a pain management doctor is to have the pain management doctor to dicuss the post op pain issues with the surgeon.
AFter I came to, I was in terrible pain. The pain meds that were given to me didn't address the pain because of the high doses of pain meds that I was taking for the fibro before surgery.
I was on methadone 5mg 4 times a day and because of this, the morphine pump that was intalled did not touch my pain. The gyn finally fixed my pain doses but only after having 12 hours of intense pain. I believe that this could have been taken care of if the two doctors had spoken to each other.
FM and Surgery Posted by: segrin Dec 20, 2006 5 0 Total Score: 5
I also had surgery in July of '06 and I brought the FM and Surgery article to my appts with both the Dr and anesthesiologist who Both ignored the literature and my attempt at explaining the pain tolerance issues, and how I'd need more/stronge for surgery.
It was very disheartening in this day and age to be ignored with this issue. I was treated like I was a junkie looking for more drugs. Needless to say I had a much longer healing time, the whole ordeal threw me into a huge flareup and had to go to my Rheumatologist for a different pain med. Some how General Sergeons and anesthesiologists need to be better educated and informed about FM.
Surgery (hysterectomy) June 2006 Posted by: cmarie3 Jul 12, 2007 Was this review helpful? 3 0 Total Score: 3
For over a year I have had severe new and different pain and aggravated ME/FM/CFS symptoms. I had to cut down my hours at work and actually had to let one company go.
I have had to take hydrocodone now or I am in tears due to the ongoning pain if I don't. I try to take only 1-2 a day and when I do work that increases to 3 or 4. The DR's have bounced me around, dropped me as a patient, not returned my calls and many have been rude.
I don't understand why I have not healed and have this ongoing pain still from the surgery. Any advice would be appreciated, I feel so alone in this. Thank you, Cindee Reply
SURGERY Posted by: cfidsmedia Jul 11, 2007 Was this review helpful? 3 1 Total Score: 2
THANK YOU SO MUCH FOR THE ADVISE ON SURGERY. I HAVE ONE COMING UP AND WILL GIVE THIS INFO TO MY DR. KINDEST REGARDS THEA SCHLOSSER
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