Discharge and Pain Management

Why is it so important to control pain?

Keeping you comfortable and reducing suffering is important, but pain prevention and control can also:

• help speed up your recovery
• improve healing
• reduce complications (e.g. pneumonia, poor healing, potentially fatal blood clots)
• help you complete important tasks such as walking, deep breathing and coughing exercises

What kinds of pain might I feel?

After surgery, you may feel pain:

• at the surgical site, especially when you move
• when sitting up, walking and coughing. Though sitting up and walking are important for your recovery, they may cause some discomfort. This can be reduced with pain medicine
• in your neck, shoulders or back from lying on the operating table

You may also have a sore or scratchy throat due to a breathing tube during your surgery. This should get better after a few days.

What are my pain control options while in hospital?

There are different options for pain control. Depending on your surgery, you may receive:

• a patient-controlled analgesia (PCA) pump
• an epidural pump
• a spinal, nerve block, injectable or oral pain medication

Some medications are narcotics (opioids), and some are not. You may receive a combination of non-narcotic and narcotic pain medications.

What can I do to help relieve pain?

While you are in the hospital, let us know immediately if your pain is not under control and you need pain medication. It helps to:

• describe your pain (e.g. sharp, dull, crampy, constant, with movement, etc.)
• rate your pain on a scale from 0 to 10, where 0 is no pain and 10 is the worst pain imaginable

Here are some tips to help keep your pain at a manageable level:

• take pain medication 30 minutes before activity if you experience pain with movement
• use heat or cold therapy if your surgeon recommends this for you
• combine periods of rest with movement at regular periods during the day
• try guided imagery. This focused relaxation helps create calm, peaceful images in your mind. You can listen to music through earphones, meditate and visualize. Books and online videos are available to help you practice this before and after your surgery. Living Engaged and Actively with Pain (LEAP) offers gentle exercises and relaxation techniques created by therapists from the Toronto Rehabilitation Institute

If you have had chest or abdominal surgery, you can splint your incision for comfort while deep breathing and coughing. To do this, place your hands flat on top of each other and apply slight pressure to your surgical site. You can also firmly hold a pillow across your surgical site to help you breathe deeply and cough.

What if I have pain after I am discharged?

When you are discharged from hospital, we will give you a prescription for pain medicine to take at home.

Your pain should gradually lessen. With time, usually less than two weeks, your use of pain medicine should lessen too. If you are prescribed an opioid upon hospital discharge, after one week you will likely not require the opioid and be able to manage with non-opioid pain medicine and non-drug treatments.

Possible side effects of narcotics (opioids) include:

• nausea
• vomiting
• constipation
• dry mouth
• itchiness
• dizziness
• drowsiness
• confusion

In particular, constipation is a common side effect of narcotics. An over-the-counter laxative such as Lax-A-Day or Senokot can help. Stay hydrated and have a sensible diet. Eating fruit, especially prunes and prune juice, can help keep your bowels regular.

If you experience gas pain and bloating, avoid using narcotics as they can worsen the gas pain. Try to walk and keep moving as this will help you release the gas.

If you have been prescribed a narcotic, use the lowest possible dose for the shortest possible time. If your pain is not severe, reduce the amount of narcotics you are taking or use over-the-counter pain medicine, like Tylenol (acetaminophen) or Advil (ibuprofen).