How do you handle severe pain?

[jaimee1024]

I'm going to try to make this LONG story short. I am recovering from a staff infection. I had an abcess on my stomach that had to be lanced and drained. The inch deep hole it left is packed with gauze and the packing has to be removed and replaced daily. There has been a lot of pain and discomfort from the beginning, but the MOST painful thing...more painful than anything I've ever experienced (including labor and kidney stones) is when the gauze is being put back in. I'm about to cry just thinking about it. The first time they put the gauze in was when I was still numb from them lancing it, so I didn't really feel it. The second time a surgeon did it in his office and it was excruciating, but I figured that as I healed it would get better. Today my sister (who is an RN with over 25 years experience) did it for me and...well, I can't even really describe it other than to say that as I am typing this I am tearing up just knowing that I have to do it again tomorrow. I have a pretty high tolerance for pain. I grit my teeth, dig my nails into my hands...but rarely utter a noise or cry. Tonight I literally screamed. And sobbed and begged my sister to stop. How the heck can I get through this tomorrow. Any advice is welcome. I know there are many who have suffered much worse, but I honestly don't know if I can keep this up. They said it would take at least two weeks to heal. HELP!!!

 

[frndofpooh]

First off, I am sorry to hear you are in such pain!!! May I ask what they prescribed for you? I am a Burn ICU nurse and I do lots of dressing changes like that but we medicate well for them. Pain is anathema to healing and if you are having this much stress about a dressing change your healing will be affected. So - can you tell me what they gave you for pain relief?

 

[honeymom]

I'm going to try to make this LONG story short. I am recovering from a staff infection. I had an abcess on my stomach that had to be lanced and drained. The inch deep hole it left is packed with gauze and the packing has to be removed and replaced daily. There has been a lot of pain and discomfort from the beginning, but the MOST painful thing...more painful than anything I've ever experienced (including labor and kidney stones) is when the gauze is being put back in. I'm about to cry just thinking about it. The first time they put the gauze in was when I was still numb from them lancing it, so I didn't really feel it. The second time a surgeon did it in his office and it was excruciating, but I figured that as I healed it would get better. Today my sister (who is an RN with over 25 years experience) did it for me and...well, I can't even really describe it other than to say that as I am typing this I am tearing up just knowing that I have to do it again tomorrow. I have a pretty high tolerance for pain. I grit my teeth, dig my nails into my hands...but rarely utter a noise or cry. Tonight I literally screamed. And sobbed and begged my sister to stop. How the heck can I get through this tomorrow. Any advice is welcome. I know there are many who have suffered much worse, but I honestly don't know if I can keep this up. They said it would take at least two weeks to heal. HELP!!!

Have you told your doctor? Can he give you any painkillers (perhaps strong ones) to take until you feel better? I know a lot of people get fearful about getting hooked on narcotics, but sometimes they are needed after medical procedures. Just make sure that you get yourself off them as the pain subsides.

I had a staph infection lanced (in an embarassing spot that I won't mention) when I was in 8th grade. I still remember lying in my mom's car and shaking with severe pain once the anesthesia wore off. I don't remember the gauze changing hurting as much as you describe. The only other thing that was as severe in pain was dry socket following an impacted wisdom tooth removed last year. I have also been in child labor, had a tonsillectomy, and a hysterectomy. Those were a breeze in comparison. I was discharged a day early following the hysterectomy because I was doing so well - I am not a complainer.)

 

[RNMOM]

I am sorry you are having to go through this. Are you taking pain meds? If not, why? Ask your surgeon for a dozen or so percocets and take one one hour before you are having the dressing changed. It will have kicked in to it's peak by then and will last a few more hours.

You might also try putting an ice pack on your abdomen over the wound for about 20 min. before the proceedure to reduce the blood supply and maybe offer a little numbing. You can do this over the dressing.

Honestly, the pain should be getting less with each change, hopefully. If you continue to have this degree of pain you should speak with your doctor about it tomorrow. This could be a sign of it not healing properly. I understand yeast infections like this are difficult to heal up and take time. Don't be afraid of pain medication and if you need more let them know. You can cut back on the amount as the wound heals and addiction takes some time to develop. Good luck.

 

[Aimeedyan]

I had a surgery that required having the wound packed everyday for weeks - turned into months - and it IS the most painful thing I've been through in my life. I screamed and cried a lot those months... I honestly do feel your pain.

I am in a different kind of pain right now and Vicodin really helps take the edge off. Your doc should give you some kind of Rx pain medication to help. I used to take the pain med about 30 minutes before packing changes and it helped some. I would call the doc tomorrow about getting something called in for now.

The packing will get better as it heals but I know it's bad right now... I would often take a cold wet rag and bite down on it during my packing changes. Somehow that made me feel a little better...

 

[Aimeedyan]

Also - make sure the packing is really wet before it's pulled out. I learned this the hard way! Make sure whomever is changing it really soaks it with saline before pulling it out and make sure the packing going in is nice and wet. I used to take a shower and let the water just soak it completely, then pull it out, then soak the new packing in saline before putting it back in.

Course, that is what my doc told me to do and yours might have different instructions but I found that if that packing got dry at all it was even more painful.

 

[jaimee1024]

First off, I am sorry to hear you are in such pain!!! May I ask what they prescribed for you? I am a Burn ICU nurse and I do lots of dressing changes like that but we medicate well for them. Pain is anathema to healing and if you are having this much stress about a dressing change your healing will be affected. So - can you tell me what they gave you for pain relief?

I have vicodin (sp?) They gave this to me when I had the abcess (before it was lanced). It helped...took the edge off. But this pain is different. I feel like...well, like someone is digging into and open wound which is basically exactly what's happening. Would vicodin help with that? How long before the dressing change should I take it? Part of the problem is that the cut they made in the ER is tiny...the surgeon said they should have made it longer so there would be more room to get the gauze in.

Thanks to everyone for your input. I feel like such a baby...but the pain continues to shock me. (by the way...it doesn't hurt now...just when the dressing change takes place...I'm a little sore and uncomfortable, but otherwise ok)

 

[frndofpooh]

Take your vicodin at 30-45 minutes before dressing changes and it should take some of the edge off. If you don't get relief, you might need to try percoset - it's not necessarily stronger, but it does have a more relaxing effect (on most people) in addition to working on the pain. It will get better as your wound edges heal but that will take 3-4 days at least.

Another option would be to have the hole opened up a bit but lots of surgeons don't want to do that because it's adding tissue damage. I would not soak the packing unless you were instructed to when they taught you the dressing change. Chances are they want the hole "debrided" and having the packing material dry pulls out infected tissue better that wet (although wet is more comfortable).

Is the wound in an area that you can reach? I know it may sound crazy, but you might do better with packing it yourself. You can take your time and do it gently - sometimes it is hard for us nurses to know how hard to push. As long as you thing you can get the packing in deep enough, you may be better off doing it yourself.

Please take your pain meds for dressing changes - they really help the procedure go well and they can help you heal if the pain is lessened. As I said before, pain is contrary to healing so it needs to be controlled (even if only during the dressing change) for maximum wound healing. Do not worry about addiction - you will know when you don't need them. A good rule of thumb is this. If you are taking the narcotics and they are making you really loopy, you may be taking too much. Your body is telling you it has more than is needed. If they are taking the edge off your pain and you're still relatively clear headed, they are working at the correct level. Good luck - hope this helps!

P.S. - you are not a baby - this stuff hurts!!!

 

[DisnyMama]

Oh my God! First I want to say that I feel so terribly sorry that you are having to endure such awful pain and that I am glad that you are on the mend. However, you just made me "painfully" aware of something that I never knew and please forgive me for this hi-jack. When I was 16 my mother had one of her very large tumors (melanoma) removed from her side. The tumor was about the size of a softball so the incision was about eight inches long. After about 3 days her incision opened up. She drove herself back to the Dr. (I didn't have my permit yet) and when she came home she instructed me how to irrigate the incision which looked like a shark bite and then pack it with gauze. I had to do this twice a day for weeks till it healed from the inside out. My point for telling this is your story brought me to tears because my mom never told me how painful that was and never flinched or uttered a word. She was the most stoic person I have ever known. I hope you are feeling better very soon.

 

[jaimee1024]

Thank you guys. I just can't imagine the pain some people must suffer through with major injuries/surgeries/burns etc... The only other pain that has ever made me cry (as an adult) was the first kidney stone. And I think that was more out of anxiety than pain because I didn't know what was going on and I was scared. This is definitely the first pain that has ever brought me to tears just thinking about it.

 

[frndofpooh]

I hope you feel better soon!

 

[Rafiki Rafiki Rafiki]

My DD got an MRSA on her forehead this past fall. I've never seen anything more disgusting in my life. Her entire head swelled and her eyes turned gray. It was awful.

Are they treating you VERY agressively for the staff? She had this oral medicine she took that smelled awful and then they used a topical thing too. The doctor had to lance her head and drain it twice, but they didn't have to pack it.

Hang in there. Make them give you medicine before getting it drained.

 

[sumrmist]

You poor thing !!! Makes me remember when I had my first c-section and evidently had a bleeder they didnt get cauterized...well one week later I wake up and can no longer walk upright and I had been fine the day before...well that little bleeder had gotten infected and when I got in a hot shower my belly broke open....2 inches wide about 1 inch deep and we had to irrigate it everyday and pour betadine into it....OMG but at least I didnt have to pack it.And once it ruptured it really didnt hurt anymore. Heres to you and wishing you the best in a speedy painless recovery !!

 

[rie'smom]

I'm so sorry you're having this awful pain. Call your doctor and ask what you can take-then take it at least 45 minutes before the dressing is changed. Hugs.

 

[tar heel]

This sounds awful -- I'm glad the medical folks have given you some good advice.

Staph infections are terrible and hard to get rid of. My dad has fought multiple ones during his now eight months of serious illness. If you get a fever or any symptoms like that, head straight to the doctor. My parents waited until morning last time, which was only four-five hours, and he almost didn't make it.

 

[LindsayDunn228]

After reading the title I had an answer prepared, but after reading the OP I have no advice. I have never experienced pain like this and I'm truly sorry you are having to deal with this.

 

[DawnCt1]

Thank you guys. I just can't imagine the pain some people must suffer through with major injuries/surgeries/burns etc... The only other pain that has ever made me cry (as an adult) was the first kidney stone. And I think that was more out of anxiety than pain because I didn't know what was going on and I was scared. This is definitely the first pain that has ever brought me to tears just thinking about it.

I am thinking that the Vicodan isn't strong enough. You need to ask your surgeon for something stronger. Its important to achieve pain control. There are stronger medications. My rotator cuff was the most painful thing that I ever had. It hurt when I was asleep. Fortunately my surgeon antipated that and I had very strong narcotics available to me. Believe me, when you feel better you won't want them so I wouldn't worry about addiction. You won't get addicted by taking drugs for severe pain. I am supposed to take percocet before I go to physical therapy and the hardest thing for me is remembering to take it. Best wishes to you and a very speedy recovery.

 

[arminnie]

Thank you guys. I just can't imagine the pain some people must suffer through with major injuries/surgeries/burns etc.

I'm sorry that you are in such pain, but don't let yourself develop an abnormal fear of surgery because of this. Pain management can handle a LOT. Sometimes you have to be aggressive about demanding it.

I've had some MAJOR surgeries (the kind where you stay in ICU for two days afterwards). I had a terrible experience with having my tonsils out at 23. After that I learned to inform my doctors that I wanted my pain under control. That doesn't mean no discomfort - but discomfort is totally different from the agony that you are experiencing.

The worst pain I've ever had was a gallstone stuck in a bile duct, when it was removed by a tube going thru my liver the tube had to be left in for another six weeks. My body treated that tube like a stuck gallstone - so I had the equivalent of an acute gallbladder attack for WEEKS. My doctor originally did not order any meds for this - YIKES. I soon got that changed ,and it then was under control and became tolerable.

I've never worried about addiction. For me it's pretty apparent when I can switch to Ibuprofen. When the pain meds start making me "feel happy" then I know that I can move to something less strong.