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Recovery After Surgery: New Approaches to Treating Pain

June 26, 2018 12:00 PM with Dr. Jennifer Paruch

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Surgical teams are working harder than ever to find the best way to treat post-surgery pain. Helping patients get back to life with little pain and fewer medications is the goal of physicians like Dr. Jennifer Paruch, NorthShore Surgeon. Join her for an online chat about the latest recovery methods for surgery patients. She’ll answer questions about new strategies and treatment options for pain, ways to improve recovery time with alternatives to opioids and how NorthShore's Enhanced Recovery After Surgery protocol is helping patients get back on their feet.

Colie (Moderator) - 12:00 PM:
Our chat on recovery after surgery is now open. You can submit questions at any point during the hour.

Dr. Jennifer Paruch (NorthShore) - 12:00 PM:
Hello everyone. I am Dr Jennifer Paruch, one of the Colorectal Surgeons at NorthShore. I am ready to take your questions.

  Taryn (Evanston, IL) - 12:01 PM:
I will be in the hospital for a night or two after surgery. What items should I pack to stay comfortable?
Jennifer Paruch (NorthShore)
The hospital can provide most of the things you will need. If there is a special pillow you like that can help. I also recommend things to do (books, games, movies, etc), a robe for walking around the floor, and ear plugs or a sleep mask if you have a hard time sleeping.

  Jordan (Chicago, IL) - 12:05 PM:
After surgery, should I be contacting my surgeon or primary care doctor with questions?
Jennifer Paruch (NorthShore)
It depends on the question. If it is something related to your surgery (i.e., pain, drainage from your incision, etc) then you should contact the surgeon. If it is about your blood sugar or high blood pressure or something your primary usually manages, then you should contact your primary care doctor.

  RJ (Wilmette, IL) - 12:08 PM:
How long should I be in pain after surgery? At what point do I need to talk to my doctor?
Jennifer Paruch (NorthShore)
That will vary depending on what type of surgery you are having, and that's a great question to ask your surgeon before surgery so you know what to expect. For most surgeries I do, I generally tell patients that the worst part of the incision pain should only last ~3 days. After that, they may still need some pain medication (Tylenol, Advil) for another 1-2 weeks. You should talk to your doctor if the pain is preventing you from doing light daily activities (walking, getting out of bed, etc), or if it starts getting worse instead of gradually getting better each day.

  Catherine (Chicago,IL) - 12:14 PM:
Are there any supplements or vitamins I can take to reduce scarring after surgery? Are there any creams or ointments that are effective for reducing the appearance of scars?
Jennifer Paruch (NorthShore)
In general, there is not great data that a specific supplement or cream will reduce the scar. Always check with your surgeon before applying creams after surgery. I recommend a multivitamin, and using a cream with Vitamin E after 2 weeks. It is also important to protect the scar from the sun (either covering or a strong sunscreen), as this will cause some hyperpigmentation.

  Marcus (Kenosha, WI) - 12:18 PM:
I am having surgery on my hand and I am worried about infection. What can I do to prevent it?
Jennifer Paruch (NorthShore)
The risk of infection should be low for hand surgery. Your surgeon may recommend a cleasing wipe the day before surgery, or may give you a dose of antibiotics during surgery to help prevent infection. After surgery, make sure you understand what the surgeon recommends to do with the dressing. If you are unsure, ask questions. In general, keeping the incision clean and dry is best. I also recommend looking at it 1-2x per day, so that you can monitor for signs of infection like redness, warmth, or drainage of fluid.

  Stephanie (Northbrook, IL) - 12:22 PM:
Last time I had surgery I was constipated from the pain meds. How can I prevent that from happening this time?
Jennifer Paruch (NorthShore)
That's a great question. First, see if there are pain medications that are not narcotics that your surgeon recommends (Tylenol, Advil, etc). Even if these can decrease the amount of narcotic you need, this will help. Make sure you drink plenty of water, at least 64oz per day. Finally, I recommend taking a daily fiber supplement AND a stool softener (Colace or MiraLax) as long as you are on pain medications. You should check with your surgeon to make sure this is all safe for the type of surgery you are having.

  Angel (Prospect Heights, IL) - 12:29 PM:
My mom might need hip replacement surgery and she is concerned as she is a recovery alcoholic. What can we expect in her recovery for pain management?
Jennifer Paruch (NorthShore)
That's a great question. I would encourage you to talk with her surgeon about that before surgery. There are a lot of pain management options available now that do not require narcotics. This includes nerve blocks performed during surgery, non-narcotic pain medications, and other therapies like massage/accupuncture/and icing. While everybody is different, you and the surgeon may be able to formulate a plan that avoids narcotics altogether.

  Catherine (Chicago,IL) - 12:34 PM:
I was informed of some of the possible complications of surgery. One of which was possible blood clots or embolism. I am currently taking a birth control pill and I know that may increase the risk of clots. Do I need to stop taking it before surgery? If I do, how far in advance should I stop taking it. Do clots occur shortly after surgery or can it still occur months afterwards? Are there ways of decreasing the risk of clots?
Jennifer Paruch (NorthShore)
I would ask your surgeon. In general, I do not have otherwise healthy patients stop their birth control. Find out if other family members have had blood clots, as this may increase your risk. Depending on what surgery you are having, your surgeon may use compression stockings on your legs and low-dose blood thinners to prevent blood clots. These clots generally happen soon (in the first few weeks) after surgery. Making sure you are up and walking around after surgery will also help decrease the risks of these clots.

  Alex (Park Ridge, IL) - 12:39 PM:
My son is having surgery and I want to help it be as pain-free as possible. How can I help manage his medications to ensure he is not in pain? I heard that you’re not supposed to ‘chase the pain’ but I’m not sure what that means.
Jennifer Paruch (NorthShore)
Make sure you talk to his surgeon about what medications are safe for him to take after surgery, and in what doses. 'Chase the pain' usually means waiting until the pain is severe before taking a medication. That can make it harder to get his pain under control. I usually recommend taking a non-narcotic pain medication (Tylenol, Ibuprofen, or both) on a regular basis (i.e., every 6 hours) for the first week after surgery, and then taking a stronger medication as needed in addition if he is having pain. This makes sure that there is always something in his system.

  Laura (Gurnee, IL) - 12:46 PM:
Are there any medications that I should not be taking after surgery?
Jennifer Paruch (NorthShore)
That is a great question for your surgeon. After surgery, they will review your medication list and tell you what changes to make before you leave the hospital. For most surgeries, you can stay on most of your medications. If you take a blood thinner (like Coumadin, Plavix, Xarelto, Eliquis) make sure you know if you need to stop taking it, and for how long.

  Clifton (Highwood, IL) - 12:50 PM:
I am going to be prescribed opioids after surgery but I am afraid to take them after everything in the news. Is it okay to take them?
Jennifer Paruch (NorthShore)
That's a great question. There has been a lot of information in the news about opiates, but this is generally about overprescribing. Our goal is to keep your pain under control after surgery. It is always good to ask your surgeon if there are other medications (Tylenol, Ibuprofen, Gabapentin, Tramadol, Celebrex, etc) that you can use instead or in addition to opiates. Depending on what surgery you are having, you may not need to take the opiates if you can use these other medications. If you do need opioids after surgery, they are safe to take for a short period of time as long as you follow the instructions provided by your surgeon, and taper off of them when your pain goes away.

  Jessica (Highland Park, IL) - 12:56 PM:
I’m scheduled for back surgery and want to know what I can eat to fuel my body for recovery.
Jennifer Paruch (NorthShore)
In general, a healthy diet high in lean protein, fruits and vegetables is good before surgery. I also recommend staying active before surgery; a good goal is to get 30min of activity 4-5 days a week.

Colie (Moderator) - 1:00 PM:
The chat is now over. Thank you Dr. Paruch for your help and expertise. For more information about surgery and recovery, please visit NorthShore's website.

Jennifer Paruch (NorthShore) - 1:01 PM:
Thanks for your great questions everyone!
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