Posts Tagged ‘pain medication’

Don’t Let Surgery Bog You Down-How To Recover Quickly From Surgical Procedures

July 18, 2015

I have many patients who have had major surgery and are back on their feet within days and back to normal activity within weeks. I have made several recommendations to them that I would like to share with you in this blog.

Your doctor or nurse will probably recommend that you discontinue use of food and fluids at 12:00 midnight before your procedure. The purpose of this recommendation is to empty your stomach so there will be no vomiting of food or fluids during your surgery. Not consuming any food before surgery and for hours after surgery when the anesthetic wears off is like fasting at a time when your body is craving good nutrition. My recommendation is to avoid eating solid food up to six hours before surgery and to drink clear liquids containing electrolytes and carbohydrates such as is found in Gatoraid up to two hours before surgery to aid in your recovery. I suggest you discuss this recommendation with your doctor and the anesthologist who will be putting you to sleep to be sure they are on board with this recommendation.

The use of post operative pain medication and narcotics can slow recovery. These medications lead to decrease in the peristalsis or squeezing of the small and large intestines which can contribute to nausea and constipation if used in excess. These drugs can also lead to dizziness and a dizzy patient may lose their balance and fall and puts the patient at a risk of a hip fracture which may be worse than the surgical procedure they had in the first place. I recommend pain medication be given before surgery and actually during the operation itself. I also recommend the use of acetaminophen during surgery as this decrease the need for pain medication after the procedure.

Finally, get moving. I recommend that my patients start walking as soon as they are taking fluids and have recovered from the anesthetic. Staying in bed is detrimental to the recovery process. Immobility leads to decrease in motility of the gastrointestinal tract and if prolonged can result in deep vein thrombosis which can lead to a fatal pulmonary embolus. Immobility increases the risk of pneumonia. Walking exercises the muscles in the lower extremities, promotes bowel function, and prevents pneumonia.

Bottom Line: Surgery can be a daunting event for even the most sturdy of patients. However, with the advice I have provided you, you can shorten the recovery period and be back on your feet in no time.

Constipation-Not All That It’s Cracked Up To Be

January 2, 2012

I try to lead a very transparent life and I would like to share an experience with the readers of my column. Recently I’ve had knee surgery and have taken pain medication to make it possible to work and sleep. However, I experienced one of the side effects of pain medication, i.e., constipation. I’ve discovered various myths associated with the dreaded “C” that I think is worth passing along.
What’s “normal” varies from person to person. Some people go three times a day; others, three times a week. Although having a bowel movement once a day is common, it’s fine to go a few days without one.
Some people believe that constipation causes the body to absorb poisonous substances in stools. But there’s no evidence that the stools produce toxins or that colon cleansing, laxatives, or enemas can prevent cancer or other diseases.
Older people are more likely to become constipated. This can be because of medical conditions, poor nutrition, greater use of medications, or not enough physical activity. But constipation is one of the most common issues among other age groups, too. For example, it’s not unusual during pregnancy or after childbirth or surgery.
Increasing the fiber in your diet can often help constipation. But chronic constipation can signal a real problem. In rare cases, it can signal illnesses such as colorectal cancer or autoimmune disease. In my case, the constipation was due to inactivity and the use of pain medication, which result in a decrease in peristalsis or rhythmic contraction and relaxation of the colon.
Travel can change your daily routine and diet, contributing to constipation. Avoid dehydration-related constipation by drinking water, especially if you’re flying. Also move around when you can — for example, while waiting for plane connections or by taking rest stops when driving. Other travel tips: Exercise, limit alcohol, and make a point of eating fruits and vegetables.
Depression may trigger constipation or make it worse. Reducing stress may help. Massaging the abdomen may help relax the muscles that support the intestines and get your bowels moving.
You may feel too busy at work to have a bowel movement. Or you’d rather wait until you’re home. But ignoring the urge when it comes may not only make you physically uncomfortable — it can cause or aggravate constipation by weakening the signals over time. Some people find it helps to set aside time after breakfast, when the coffee “kicks” in, or another meal for a bowel movement. But no matter when nature calls, answer.
Besides medications for pain, medications for depression, high blood pressure, and Parkinson’s disease are associated with constipation. Too much calcium and iron can also lead to constipation. Calcium supplements, especially if taken with another supplement or medication that binds the stool, may also cause problems.
Fiber Fixes for Feces
Try to get at least 20 grams a day of fiber. Eat more whole fruits and vegetables; replace white rice, bread, and pastas with whole-grain products and brown rice. And don’t forget to drink at least 2 to 4 extra glasses of water a day.
Eating foods with fiber helps you feel full and stay regular. Insoluble fiber in particular can help ease constipation because it’s indigestible and doesn’t dissolve in water. It adds bulk to stool and helps it pass through the intestines faster. Good sources of insoluble fiber are whole-grain breads, pasta, and cereal.
This small, dried fruit has earned a big reputation as “nature’s remedy” for constipation. Prunes (often called dried plums) can prevent or improve constipation symptoms. They’re packed with insoluble fiber, as well as the natural laxatives sorbitol and dihydrophenylisatin.
Get moving since lack of physical activity can contribute to constipation. Exercise, however, can help make your bowel movements more regular and can reduce stress. Try a 10- to 15-minute walk several times a day. Stretching and yoga can also help constipation.
Coffee and constipation. It’s true that the caffeine in coffee can stimulate the muscles in your digestive system to contract, causing a bowel movement. So why isn’t it recommended as a fix for constipation? Coffee can actually make stools harder to pass because it is also a diuretic, so it draws liquid out of stools. If you are constipated, avoid coffee and other diuretics such as alcohol and caffeinated tea and cola.
Depending on the type of over-the-counter laxative you use, you may need to wait a few minutes or a few days to produce a bowel movement. A suppository, like Ducolax, might work within an hour.
Stool softeners prevent constipation by allowing stools to absorb more water from the colon. They prevent feces from hardening — softer stools are easier to eliminate from the body. In some cases, your doctor prescribes stool softeners after surgery when you need to avoid straining during bowel movements.
Castor oil is a powerful laxative. But like other laxatives, it should not be used long-term. Overusing laxatives can hurt your body’s ability to absorb nutrients and some medications. Castor oil can damage the bowel muscles, nerves, and tissue if overused — all of which can cause constipation. Use it only with a doctor’s guidance.
Blood in a bowel movement is not always serious, but you should always call your doctor if it happens. Bright red blood is usually from hemorrhoids or tears in the anal lining called fissures. Constipation and straining during bowel movements can be the cause. Maroon or tarry black blood or clots usually mean bleeding is coming from higher in the gastrointestinal tract. The cause may be more serious.
Bottom Line: It is nice to be normal and have a BM every day. Failure to do so, is not a reason to call 911. If you have a change in your bowel habits contact your physician. Your colon will thank you!