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Dealing with Surgery in Recovery

Pain Management

Dealing with Surgery in Recovery

Rigorous and relentless honesty.

That’s what it would take for me to maintain the delicate balance of postoperative pain management and long term substance use recovery.

As I am sure most people can imagine, having to undergo surgery can present unique sobriety challenges for those of us in short or long-term recovery. It doesn’t matter if the surgery is major or minor, postoperative pain must be managed.  And, it often cannot be done without prescription-narcotic pain medication. I have had to deal with managing pain medications after surgery twice since I got sober in April 2007.

For years, doctors told me that at some point, I would need a full right-hip replacement.  Since I was relatively young for such a diagnosis, I put it off as long as possible. My doctors and I worked together to manage the pain through anti-inflammatory steroid injections and non-narcotic pain meds. Being in long-term recovery from substance use disorder primarily, cocaine and alcohol, this was very important to me.

 

This substance use history had to be taken into account in formulating my surgery recovery plan. Rigorous and relentless honesty.

 

Adding to the mix of issues I have had to deal with, my history involved sporadically misuse of prescription narcotics when I could get my hands on them. Doctor shopping and black market purchases were the order of the day.  Oxycontin and Hydrocodone were among my favorites.  I also used black-market Xanax (in yet another classification of drugs called benzodiazepines, or “benzos”) and Ambien, a prescription sleep aid that many cocaine bingers know so well.

Up all night. Sleep all day.  Uppers and downers. Anything that would achieve the needed “feeling” at that moment.  Anything that would mask lifelong shame about who I was and quell the monster I saw in my reflection — biologically based and environmentally triggered injuries that cannot be healed by narcotic medication.

This substance use history had to be taken into account in formulating my surgery recovery plan. Rigorous and relentless honesty.

The key for me in approaching my hip replacement and subsequent heart surgery was  that honesty, self-awareness and having a strong support system of friends, loved ones, caretakers and, most importantly, medical staff who knew about my past, but could empathize with my current predicament.  I also had to understand fully that even in long-term recovery, I could be susceptible to wanting that “feeling” and cross the line from pain management into dependence, both physical and psychological.

I had to be meticulously upfront and forthright with all those in the chain of treatment and support about my past and my concerns of how narcotic medication could affect me physically and mentally.  After all, I couldn’t hold back without risking my sobriety.

 

I was successful in my “minimalist” pain management and suffice it to say, it can be done. But, what I needed was a solid, detailed game plan as to how to handle it.

 

From the start,  I told my surgeons I was in long-term recovery. We then discussed what medication would be needed to manage the pain after the surgery. We agreed that my doctor would be prescribing me Percocet, so we talked about how long other patients normally took it, the standard dosage, etc.

I made it clear that post-op, I would in no way be allowed to self-administer narcotic pain medication. Upon discharge , we also agreed that I was not to be allowed a refill without a face-to-face consultation with my doctor to discuss why. The rule would always be to take the smallest dose possible to manage the pain and to eventually taper off to aspirin only.  Every situation will be different, but there is one constant in a successful pain management program:

Honesty. 

Honesty with friends and loved ones. Honesty with doctors. Honesty with myself.  Understanding my weaknesses and the level of support I needed to counteract those weaknesses.

I was successful in my “minimalist” pain management and suffice it to say, it can be done. But, what I needed was a solid, detailed game plan as to how to handle it. Don’t be afraid of surgery because of your recovery or having a substance use disorder.  Deal with the past right up front and have a plan that involves everyone in the chain.  You can do it!

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An authority on body dysmorphic disorder, male eating disorders and addiction(including steroids), Brian Cuban is the author of the best-selling book, Shattered Image: My Triumph Over Body Dysmorphic Disorder. It chronicles his first-hand experiences living with, and recovering from, twenty-seven years of eating disorders, alcoholism, drug addiction and Body Dysmorphic Disorder (BDD). Cuban has appeared on prestigious talks shows such as the Katie Couric Show as well as numerous media outlets around the country.

brian@briancuban.com

Comments
  • Great post Brian. I have always worried what will happen when I need a surgery. Perhaps more so with an unplanned surgery where I could not discuss with my doctor. I have made it a point that my medical records all show an allergy to narcotic medication – though I do not know if this is the best route to take.

    December 21, 2016

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