When do you take Percocet

hercules411
on 6/13/11 3:36 pm
I'm home from outpatient sinus surgery this morning.  They gave me 325 mg percocet pills.. Take two tablets every four hours as needed.  I had my surgery this morning and it is now about 6:30PM. I really don't feel a lot of pain. The area around my nostrils are tender to the touch and I feel as if I have a dull sinus headache. They gave me Fentanyl for pain at the hospital.

I'm one of those people who don't like to take a lot of pills. (Pretty funny, considering how many vitamins and minerals we RNY patients take). But I also was sent home with Percocet after my RNY and never took one of them.

I guess I'm looking for feedback from people (especially with sinus surgery experience) if they experienced more pain the night of surgery.. the day after... or days after.

I don't know if I should take one or two just as a precaution before bedtime or just wait for signs of pain. I don't know how long the effects of Percocet takes to kick in.


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PatXYZ
on 6/13/11 3:42 pm
Percs will start to take effect in about 15 mins. You'll probably feel sleepy and relaxed if you've not taken a lot of painkillers. I take these occassionally for migraines and have had them for oral surgery as well. My understanding is that it is not neccesary to wait for the pain to set in, for the first couple of days simply take one every 4 hours as prescribed to avoid pain, if one isn't enough, take 2.
Susan S.
on 6/13/11 3:55 pm - Roselle, NJ
RNY on 02/06/07 with
If you don't feel terribly uncomfortable I wouldn't take them. I was given vicodin after my plastics and never ran into a problem, but was given percocet after my shoulder tendon surgery (I needed serious pain relief) and I ran into Opoid addiction very quickly....just a few days and I was having withdrawal at the end of every 4 hour dose. Both drugs are notorious for addiction in the general population and post WLS patients have even more problems with them (transfer addiction?) according to some of the studies I've seen. I worry about serious pain as the number of effective drugs is limited for us because of the no NSAIDs thing, but I'm very afraid of those drugs now. The most pain really occurs from swelling which occurs immediately postop. If you can tolerate it nnow.....chances are you can do without. I never needed pain meds after my RNY either. That was a walk in the park! Feel better. Glad it's behind you! Susan
Obesity Help Support Group Leader - The Woman Warrior
286/170/131 (starting/goal/current)
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286/170/140/131 (starting weight/goal/surgeons goal/current)

LBL 10-30-08 - Joseph Fodero
Brachioplasty/Breast Augmentation - 2=24-09


 

PatXYZ
on 6/13/11 6:14 pm
It's unfortunate that the other poster had issues with painkiller addiction, but her telling you not to take them is irrational, it's like me telling you never to have a glass of wine because I'm an alcoholic. Irrational fear of addiction is no reason to not take prescribed pain medication. The rate of addiction amongst LONG TERM opioid painkiller users is 3%, even lower amongst those to whom they are occasionally prescribed. The likelihood of experiencing pain and discomfort from not taking prescribed painkillers is probably 100%. Recent studies actually suggest that doctors are under prescribing and patients are under dosing opioid painkillers due to utterly overblown fears about addiction.
PatXYZ
on 6/13/11 6:24 pm
BTW - I'm getting my info from studies and meta-analysis from the Centre for Addiction and Mental Health.
H.a.l.a. B.
on 6/14/11 8:30 am
RNY on 05/14/08 with
post op RNY we have much higher risk of developing addiction to pills and to alcohol due to lack on intristic factor and the rerouted intestines.  It is not same in general populations that the research you mention is based on. 

H.a.l.a RNY 5/14/2008    

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PatXYZ
on 6/14/11 10:07 am
I don't believe this to be true for several reasons;
1) RNYers still have intrinsic factor, it just joins with what they consume further down in the digestive tract and therefore has a smaller window of time for it to act and assist in absorption of B vitamins, that's why oral B supplementation is somewhat effective, just often not enough so.
2) I am unaware of any relation between intrinsic factor and and the body's ability to absob or not absorb orally taken opioids - are you saying there is a connection?
3) opioid addiction occurs due to reactions in two brain systems, the locus coeruleus and the meso-limbic dopamine system and neither of these are mediated by stomach intrinsic factor.

The only connection I can see between some RNY surgery patients and people at higher risk for drug addiction would be amongst those who were specifically food addicts, there might be a hightened response from the reward system with the meso-limbic response (because you can see that this response is abnormal in some food addicts) when opioids are taken and thus drives the person to take more - but this is purely speculative, and would only apply in certain cases.

Can you present any scientific, journal based evidence for what you're claiming, because I've got a degree in bio psych and I'd be interested in expanding my knowledge on this.
H.a.l.a. B.
on 6/14/11 10:41 am
RNY on 05/14/08 with
google it..

H.a.l.a RNY 5/14/2008    

Need to bitch?  or Rave?  To find new R&R - 3.0 group..- send a PM -  to get included...

"Failure is not falling down, It is not getting up once you fell..."

 "So pick yourself up, dust yourself off, and start all over again...." 

H.a.l.a. B.
on 6/14/11 10:54 am
RNY on 05/14/08 with
You made a few good points. I mixed a few terms.  Intristic factor has nothing to do with the alcohol or opiates breakdown or absorbtion. But some of the enzymes and the "whole stomach" can influence how fast and how much alcohol or opiates can enetr the blood stream. 
In RNY

H.a.l.a RNY 5/14/2008    

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 "So pick yourself up, dust yourself off, and start all over again...." 

PatXYZ
on 6/14/11 2:34 pm
I thought that might be what you were getting at, but I can't find anything to support it. I scanned medical and science journals this afternoon and online articles from hospitals, etc, but can't find a thing about this. It also doesn't make any sense logically. We have reduced absorption in the stomach and small intestine where most drugs are absorbed. This is exactly why we are warned to stay away from coated or extended release drugs. I can't find anything in the medical literature that says that we have either faster or increased absorption of opioids, so I will continue to disbelieve it. The only thing I can find it that high levels of gastric acid inhibits absorption, so if you previously had opioid therapy and had poor absorption due to acid, I suppose that normal absorption post surgery when acid levels are likely to be normal or low would seem more 'intense' by comparison - but again, this only puts an RNY patent on equal footing with anyone else with normal or low acid levels and doesn't support the idea that RNY patients are at a higher risk of addiction due to some physiological reason. Again, if you have medical or scientific literature from a journal, I'd be happy to be directed to it.
Linda_S
on 6/13/11 6:27 pm - Eugene, OR
Since you are on your first day out of surgery and it's been about 12 hours, I think I'd take one and see how you feel in three-four hours.  It is very likely that they gave you a topical anesthetic, so when that wears off, you could be in a world of hurt -- most likely some time during the middle of the night.  I have oxycodone (percocet without the tylenol) that I take for back pain.  I had a three level spinal fusion 2.5 years ago.  I have these powerful drugs at my disposal when I need them, but I've never had a problem with addiction.  When I am in pain I take them, but can go months without needing any of them.  Apparently, my biggest addiction in life has been food.
Success supposes endeavor. - Jane Austen

Chilipepper
on 6/13/11 6:48 pm
You need your rest to heal...I would take it before bed so you can get some sleep....better to stay on top of the pain, rather than trying to medicate it after it starts...after tomorrow...I am sure you probably won't need them...

Good luck Sugar!

"Who are you to judge the life I live? I know I'm not perfect -and I don't live to be-
but before you start pointing fingers... make sure your hands are clean!"

— Bob Marley

Judi J.
on 6/13/11 6:51 pm - MN
Herc, if you do take them, pain killers constipate, take preventative action! (and I can't believe I just typed that but my husband learned the hard way after his hernia surgery!)

I vote for staying ahead of the pain.
Stephanie W.
on 6/13/11 7:00 pm - MA
 In My expierience and advice of taking them....is that you should take as perscribed, for the first few days, stay on top of the pain, after those few days, you should stretch the doses out a few hours, and kinda see how you feel. Byt hen your body will tell you what you should do. As far as addiction you'd have to be taking A LOT of them daily for about 10 days straight for you the end up with a psysical addiction. Take as directed, and if you have other questions about it, call your Docs office, most weight loss teams are more than happy to halp you...Good Luck, and rest, rest and moe rest are the best things right now!
Lifebeauty
on 6/13/11 7:51 pm
Lap Band on 11/16/07 with
Take it before the pain sets in.  I don't have any addictions and I hate pain.  After surgery I took the meds for the first couple of days.  Felt I no longer need them so didn't take any more.  Seems like you are a sensible person that is taking precautions.  Best wishes on your recovery from sinus surgery.
Z

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Z

hercules411
on 6/14/11 4:25 am
Update. So far  about ten ours post op, I really only feel a dull headache. A couple of Extra Strength Tylenol got me through the night. Thanks for all the feedback.
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H.a.l.a. B.
on 6/14/11 8:32 am, edited 6/14/11 8:33 am
RNY on 05/14/08 with
If you do not really need to - don't take them. 
Narcotics nauseate me and I had a hard time dealing with that. Sometimes - the Tylenol is all you need. (I found that the hard way)

The narc and alcohol have a funny way to work on some of us post op RNY.
And if you do decide to take same - start with one pill and go from that. 

H.a.l.a RNY 5/14/2008    

Need to bitch?  or Rave?  To find new R&R - 3.0 group..- send a PM -  to get included...

"Failure is not falling down, It is not getting up once you fell..."

 "So pick yourself up, dust yourself off, and start all over again...." 

hercules411
on 6/14/11 12:01 pm
15 hours after sinus surgery, all I took was the extra strength tylenol last night.  The drainage from my nostrils has decreased markedly.  That's more of a bother than any pain issues. It was the same with my RNY. I hated emptying that damn drain coming out of my side more than any pain.
Max wt. 500+  WLS workshop  4/6/09 440 Surgery  9/21/09  324   9/21/10  218
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