RPLND Pain Relief

[nzsteve]

Hi,

Ive had a quick scan through the RPLND threads, but couldnt see anything specifically on this so thought Id ask!

Im going in for RPLND on 14th, and they are giving me a choice of either an epidural or a self controlled morphine pump. Does anyone have any strong arguements for or against either?

From what theyve told me:

Epidural I wont feel as drowsy, but can cause leg weakness so might be very hard to move around and it can have extremly rare but very serious complications.

PCA I'm in control of what I take, which means I can feed myself some more before moving around, but I could also let the pain level get too high if I dont give myself enough. They also said I'll be pretty sleepy on morphine.

At the moment Im pretty much going to leave it for the docs to recommend the best one - anyone got any advice?

Cheers,


Steve

[Chris'Mom]

Hi Steve, my son Chris had a RPLND at Sloan Kettering in NY this summer, he definitely says go with the Morphine pump, he had not one bit of problem with it. Before he would get up to walk (which they make you do pretty quick after surgery) he would push it, and during his walks too. I think he got a lot of comfort knowing he had it if he needed it,and it gave him a sense of control over his own pain..... and they do monitor how many times you do it, and they told us they were shocked Chris used it so infrequently, even to us it seemed he was always pushing it...especially right after surgery and a couple of days after. He was not drowsy from it at all...hope that helps...Mary Ellen

[Martin]

My RPLND was done at Brigham in Boston. I was told that they would lay an epidural if the pain meds didn't kick in well enough. I ended up never needing one. The self controlled pump works very well (can't accidentally overdoes, either!) and I actually never got to the limit the machine would allow me.

- Martin

[jdbob]

I went with a Epidural and didn't have any pain problems. It made moving around a little difficult afterwords, and eventually it got pulled out and I decided to have them just remove it. By that time I was just doing something mixed in with the IV and didn't have any pain.

This is one of those situations where it is unlikely someone can give a comparison, since they would have one or the other.

[nzsteve]

Thanks All, Ive been thinking it over and I think I like the idea of the self controlled pump. Will talk it over with the docs and decide for sure when I get into hospital.

Thanks,


Steve

[JimmyDean]

i remember

having a morphine pump.. self-controlled. the quicker you get off the stuff, the quicker you'll pass food and released. but its necessary the first few days i think. good luck! you'll be fine eventually :-)

[Don]

I was also a user of the pump. I liked the idea of being able to control the pain myself-- Especially when standing or walking post-op--hit that button about 5 minutes before you walk and you will feel no pain.

[justinsmom]

Justin had the epidural-but he got a set amount & then also had a pump to self administer a booster every 15 minutes or as needed. One drug was a narcotic & one a numbing medication. It worked wonderfully-Justin was numb abdominally & it didn't affect his walking or anything. He swore by it. Iwould ask your anesthetist more about it. Justin's was in for 5 days & he never had a problem. They told us that the guy before him with the same situation( large abdominal tumor) opted to not get the epidural & ended up having to have it after 3 days anyway....but Justin's situation may be totally different as his incision is really large-midway underhis right arm & then over to the center of his abdomen & down -talk to the Dr. to decide,and it will be right for you- God Bless

[Don]

One of the drugs administered by pump is Fentinaul(spell?) which is actually a little stronger than morphine and the numbing agent is usually a patch put on both sides of the incision called Lightoderm(spell?) which are both great for pain and discomfort and as justinsmom said they generally don't affect your ability to walk,stand etc........... DON

[nzsteve]

Thanks again everyone - it's really helpfull to hear what other people have used. With 2 days to go I thought Id be getting nervous by now but Im not really, just ready to get it over with!

cheers,

Steve

[Kev332]

Just to chime in, I had the epidural with a controled pump also (like Justin had) and it worked great... had no problems walking around etc. I didn't know just how good it worked till they took it out!!

Good luck and I hope everything goes well.

Kevin

[nzsteve]

Just to close this one up, I got out of hospital this morning after 10 nights in there.

After talking to the docs some more before hand I went for the epidural. At first it didnt actually work that well - they managed to insert it too far into my back, bending the end round so while my right side was numbed the left side wasnt, and I has a pretty painfull couple of days! I ended up with the PCA and a semi working epidural until my third night post op, when the oncall night Anaesthetist worked out what was going wrong and pulled it back out abit. After that no problems, and I was up and walking the next day

thanks again everyone for all your input,

Steve

[dadmo]

nzsteve:
I'm glad to hear that everything went well with the RPLND. Your holiday will certainly be special after 10 days away. Have a great time with your family and friends and make sure they spoil you, you deserve it.

[jdbob]

Good to see you back on here Steve, I was getting worried. Welcome to the "zipper" club

Any word on what they pulled out of you?

[Don]

Congratulations on the successful surgery and I hope you have a quick and painless recovery!!!!! Happy Holidays!!!!!! DON