Recovering from major surgery is an active process that typically takes 6 weeks. Surgical pain is normal and expected, but the pain experience may be different for individuals. Since pain can interfere with your ability to participate in activities to prevent complications (coughing, deep breathing, walking), treating pain is critically important for a successful surgical recovery. Many patients are afraid to take prescription narcotics or “pain killers” because they do not want to become “addicted.” However, untreated pain can lead to the development of permanent pain pathways to the brain, which can delay your recovery and possibly even result in chronic pain.
Narcotic use varies among individuals and there is a big difference between drug dependence and addiction. Dependence is when the body has become accustomed to the medication. This can occur anywhere from a couple of days to a couple of weeks after you start taking pain killers regularly, like after surgery. Addiction, however, generally implies that the medication or substance is interfering with your life in some way. You can become dependent on pain killers during your surgical recovery, but with medical management of your withdrawal from these medications, you will avoid addiction. It is important to use your prescription pain killers as directed to avoid overuse. On the other hand, you do not want to avoid using pain killers when you need them to remain comfortable and active. Stopping your pain killers “cold turkey” can be dangerous and it may cause considerable discomfort. The surgical team will work with you to develop a plan to wean you off your pain killers gradually and safely, at a time when you are ready.
The universal goal is to taper as quickly as your physical, mental and emotional status allows. Since there is no single way to taper off pain killers, each situation should be managed on an individual basis. In general, a slow taper is better tolerated by the majority of patients. This usually involves gradually reducing the dosage of the pain medication over time. For example, you may reduce the dose by 10% every 3-7 days until you are taking the lowest available dose. After dose reductions, you then decrease the number of tablets you take per day until you are off pain medications completely. Other medications may be added to treat possible side effects of withdrawal and to keep you comfortable.
Even with a slow tapering of your pain killers, you may still experience some withdrawal symptoms. The common withdrawal symptoms include: anxiety, increased heart rate, high blood pressure, rapid breathing, sweating, nausea, vomiting, abdominal cramps, insomnia, muscle aches and restlessness. These symptoms can be mild to severe and can last up to 5 days after stopping your pain killers. The surgical team will want to stay in close communication with you to help you manage your medications and to monitor how you are feeling.
There are also several things that you can do during the weaning process to help minimize withdrawal symptoms. These include drinking lots of water, avoiding caffeine and alcohol, taking vitamins, eating a balanced diet with lots of fresh fruits and vegetables, and staying active. Six weeks after an operation, you should be able to increase your diet and activity, as tolerated, until you return to your usual activities. You will feel better once you have transitioned off of your pain killers and your surgical team will help you through that process.