Friday, September 4, 2009

Pain Management dilemma

So, as I posted prior I have serious back pain right now. It is extremely painful to the point of feeling nauseated and in tears. Sitting is really painful and standing up is scary because my back suddenly spasms in such a sharp and severe way it is paralyzing causing me to either not stand at all or tightening my back so bad that I cannot stand straight. Some things that trigger the pain more is slight bends like over the sink to wash my hands, showering, going to the bathroom, sitting, standing up, picking up Morgan, and standing for long periods like cooking, etc. Basically, the only time I am semi-comfortable is laying in bed which even that has its downsides after so long.

I wanted to share what it's like not for sympathy but so that I could explain my dilemma more clearly. I have 18 days until my C-section. I have been taking Percocet to ease the pain so that I can care for Morgan. The scary thing is I am taking 4-5 pills a day and I am still in pain. I am home alone with him 4 days a week from 6am-4pm. I have to cuddle him, cook for him, feed him, change him, etc. However, the pain is much more tolerable and allows me to function at a basic level while taking the pills. When I am not taking them I cannot pick him up and I can barely walk.

My dilemma is this, I am frightened to death that Lily will be born with withdrawal symptoms from the Percocet. If this was to happen she would be placed in the NICU and not with me in my room. I would not get that invaluable bonding time with her the very first days and other people would be caring for her which kills me. What kills me more is the thought of her suffering any kind of side effect from me taking the Percocet. My plan has been to stop taking the Percocet a week before the c-section and Steve will be able to work from home so I would be on bed rest. I was told by my primary care doctor this would be the safest way to avoid her being born with withdrawal symptoms. My thoughts right now are what if she comes early?? I wouldn't have been off the Percocet to allow her to get it out of her system. Also, what if I do stop a week before but she still suffers some side effect from me taking the pills at all??

Right now I don't know what to do. I am in severe pain yet the health of my baby is high priority to me. At the same time I have to be able to care for Morgan too. I just don't know what to do. I keep thinking perhaps I can tough it out and not take the Percocet. Today I only took two in the morning and then I let it wear off which caused me to not be able to stand straight and I was literally sweating from the pain. I took two in the evening so that I could function again after this little experiment.

I am looking for opinions, advice, random thoughts, anything. Let me know what you think. You can either comment here or email me at melissawax@comcast.net or you can call me too!

4 comments:

Kelly said...

Here is my medical opinion, first off, don't let the pain get out of control. It is much harder to get pain back under control once it reaches a certain level. If you take lower doses of Percocet all day with extra tylenol you may get relief but without so much narcotic. The half life of the drug (the time it takes for 1/2 the medicine to be gone from your system) is only 4.5 hours. Is the percocet the 5/325 type or something stronger? If it is the 5/325, you really aren't taking a level of narcotic that is that much of a concern. They even let nursing mom's take that! Remember too that the placenta does a great job protecting her, I am sure she probably gets a little in her system, but not much. If you go to the Dr and you are getting more and more dilated and more and more effaced, then I would stop it and just go to tylenol. So: Pain wise, I would take 1 percocet every 4-6 hours. Sample schedule:
6am- 1 percocet and one 325mg tylenol, 8am-if needed 1 or 2 325mg tylenol, 12p 1 percocet and 1 325mg tylenol, 4pm 1 percocet and 1 325mg tylenol, 8pm 2 percocet, and Midnight you could have 1 500mg tylenol. This would give you constant pain control, but very low levels of narcotic. This is only based on the 5/325 percocet and may have to be adjusted. Sorry this is so long! I hope it helps!

Waxing and Waning said...

Wow! First off, Kelly thank you so much for taking the time to respond. I seriously appreciate it!

I am taking the 5-325 type. The OB said I could take up to 8 a day without over dosing so perhaps I need to relax about it a little. Right now I take two in the morning with breakfast because the pain is the worst then since all the meds have worn off over night. Then around noon I take one more and again I take one more around bedtime. On bad days I take two at noon. So, 4-5 a day. I tried just taking one every 4-6 hours but it was like I wasn't even taking anything. The Dr's mentioned a concern about taking too much Tylenol since there is Tylenol in the Percocet. Plus, I cannot tell when I take Tylenol, it seems to do nothing. Perhaps it's working in ways I just don't know.

That is a very good point about the dilation. I start getting checked this week for that so I will keep it in mind in regards to the pills.

I am wondering if my primary care Doctor made the effects on the baby sound worse than what would actually happen so I wouldn't go overboard because when I spoke with the OB he made it sound like women take narcotics all the time up to birth and beyond and everything is find. I really need to discuss it in more detail with the OB.

Thank you so much, you actually eased my mind a lot and gave me several things to think about.

Kelly said...

Tylenol works at the brain receptors, as does the percocet. I calculated out the tylenol dosage so you are well under the 4,000 mg limit. I wish you could take Ibuprofen as well, but you can't take it this late in pregnancy, especially with a c-section. Ibuprofen works at the site of the pain, reducing the swelling, so when you take it along with tylenol you get the benefits of both...a moot point at this time. Have you thought about seeing a chiropractor? They adjust people in pregnancy all the time. I hope this pain is all related to the big belly and it will disappear once the baby is out!

Waxing and Waning said...

Chiropractors unfortunately would just make it worse. This is actually an old injury flaring up from the excess weight and pressure on my spine. I have a protruding disc and fracture in my low back. Sometimes my back will go out and I have been dealing with chronic back pain for about 11years now just not even close to this bad typically. I used to go to chiropractors but it just made it worse. So, physical therapy is the only option yet they don't want to mess with me right now while I am this pregnant.

Ugh.