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Post‐Operative Pain Management
In an effort to control post operative pain as effectively as possible, Dr. Krause uses multiple avenues to alleviate pain. He may recommend one or a combination of the following medications following surgery. Contact our office if you have questions about surgical pain control.  Narcotics (Hydrocodone, Oxycodone, Codeine)—Block transmission of pain signal to brain o Dose: 1‐2 tablets every 4‐6 hours for pain as needed. Take only as needed for pain. Do NOT take if not having pain. Frequency of dosing is related to the maximum dose  A common side effect of Narcotics is constipation. Dr. Krause recommends that patients take Colace, a stool softener, or Miralax to help with constipation. In the event that constipation occurs despite taking a stool softener, a mild laxative such as Dulcolax suppository or pills are recommended. Both the stool softener and laxative are sold over the counter. o Dose: Colace 100 mg two times per day; Dulcolax suppository 1 per rectum; Dulcolax pills 1 ‐2 by mouth. Miralax 2 teaspoons dissolved in 8 oz of water once daily. Miralax may take 2 ‐4 days for results.  Nerve Block—The Anesthesiologist may recommend a nerve block with a long acting anesthetic to control post‐operative pain. The nerve block can lessen or eliminate pain for 18‐36 hours following surgery. You may experience a numb feeling while the nerve block is working. This is typically performed prior to going into the operating room  Cold Therapy—Keeping a traumatized (from surgery) extremity cool helps to minimize the swelling and pain. Ice packs have been used for centuries and still work very well. Companies have developed devices to deliver a constant, steady circulation of cold water (Polar Care) that can be applied to a traumatized extremity. If your insurance company does not pay a significant amount of the cost of the polar care, patients may choose to purchase the Polar Care ($225).  Prescriptions‐The Corner Pharmacy offers a delivery service for Dr. Krause’s patients. The pharmacy will fill the patient’s post operative prescription and deliver the medication to the surgery center on the day of surgery. There is no fee charged for the delivery service. The medication will be billed to the patient’s insurance. The patient will only pay the required copay with cash, credit card or check. If you choose to have your prescription filled at a different pharmacy, please notify us and we will provide you with a written prescription. Acetaminophen (Tylenol) Information Sheet
Acetaminophen (a‐seet‐a‐MIN‐oh‐fen) is one of the most common medications found in households. Over the years, it has been proven to a safe and effective medication. However, if taken in excess amounts, Acetaminophen can cause life threatening illness. Acetaminophen overdose can seriously damage the liver and/or cause death. Acetaminophen is found in many over the counter and prescription medications. Common names include: Actifed, Alka‐Seltzer Plus, Benadryl, Butaibital, Co‐Gesic, Contact, Darvocet, Excedrin, Fioricet, Lortab, Midrin, Norco, Percocet, Robitussin, Sedapap, Sinutab, Sudafed, TheraFlu, Unisom with Pain, Vick’s Nyquil and Dayquil, Vicodin, Wygesic and Zydone. Following an overdose of Acetaminophen, you may remain symptom free for up to 24 hours. Common Symptoms include: Nausea, vomiting, not feeling well, loss of appetite, abdominal pain, jaundice, sweating, and diarrhea. If you suspect that you have ingested an overdose of Acetaminophen, you must seek immediate medical care by calling 911, the local poison control center, or the American association of Poison Control Centers at 1‐800‐222‐1222. The poison control center will instruct you on the appropriate course of action. The maximum dose of acetaminophen is 4000 mg per day. Your prescription pain pills frequently contain acetaminophen. Dr. Krause frequently prescribes Norco. Norco is a combination of Hydrocodone (narcotic pain medication) and Acetaminophen. The dosage is labeled 5/325 (or 7.5/325) where the 5 represents the dosage of Hydrocodone (5 mg) and 325 represents the dosage of Acetaminophen (325 mg). Vicodin is a trade name for a medication very similar to Norco. Odin (5mg/500) has 500mg of Acetaminophen for same dosage of Hydrocodone (5mg/325). If you are taking pain pills, you should monitor the amount of Acetaminophen you ingest. If you are taking Norco without any other medications containing Acetaminophen, you can take up to 12 tablets per day. If you are taking Vicodin, You can only take 8 tablets per day. You need to take less if you are ingesting Acetaminophen from other sources. Please notify Dr. Krause or his staff if you have any questions regarding your pain medication

Source: http://www.drjohnkrause.com/pdf/surgery/Pain%20Management.pdf

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The “Reality Check” is a policy review process aiming to gather insights from top domestic and international analysts, practitioners, diplomats and policy-makers working in and on the EaP countries, with the ambition to discuss these behind closed doors. Under the aegis of the Lithuanian EU Presidency the first such a review was the Belarus Reality Check, held in Vilnius, Lithuania in The


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