Expert: Ronald Levy, M.D. - 10/1/2009

Question
Hello,

I am a 30 year old female who has to date had 14 surgeries.I also have been married for almost 15 years!I have 2 boys that are 13 and 14.That has nothing to do with my problem, but I thought I would let you know who I am.I had a car accident in 2004 which caused me to have 2 back surgeries:Feb 05 micro discectomy? and the same year in August a fusion at L4-L5.My other surgeries had to do with endometriosis.Then about 2 weeks ago I had 2 surgeries in 1, I had my gallbladder taken out and my gyn dr took out a cyst.More than a year ago I had a hysterectomy at 29.I just found out a few months ago that a recent MRI of my back showed a 2x9 millimeter herniated disc at T12 and degeneration from T12-L5. As you can imagine I am in constant pain.I have seen pain management doctors and all they do is do all the injections and there is still no relief.In fact the last set I had got my back so messed up I could barely sleep.I was also diagnosed with bi polar after my accident, but I often wonder if it wasnt the stress of the accident and many surgeries that brought that on. So last night I was in pain I guess from the weather changing and I finally got to sleep at 9am!My question is....can you look at the meds I am on below and tell me what would happen if I just stopped everything cold turkey? I have been on alot of pain pills, but I want to make clear that the most I have to take is 1-2 pills a day for pain and some days none.I know my thyroid medicine I cant come off of but the others?The problem is I have been on so much that it would probably take a whole bottle of something to knock me out.When I went to surgery a couple of weeks ago they gave me the versed before and I was still talking and could remember everything in the OR before I was put to sleep.I am thinking that my body is just so use to all of this that it doesnt react.I am wondering if stopping it all and slowly going back on will help.I know that I will be in pain for the rest of my life, but if I am I want to be able to control it better and not to take so many meds.Right now it is 4am and I still cant sleep even when I take ambien.I refuse to be like the people on tv who take more and more meds when they stop working.So let me know if you can and any advice you have would be greatly appreciated.Thanks!

Meds:
Seroquel 400mg 1x night
Effexor Xr 300mg 1 x night (2 150mg pills)
Klonipin .5mg can take up to 4 a night as prescribed
Levoxyl 50mcg 1 x night
Bentyl 10mg? This is as needed was prescribed before gallbladder surgery
Benedryl at night as needed for itching from pain med
Percocet 10/650 1 as needed 4-6 hours.(I take 1 x daily %26 2 x daily if its a bad day
Ambien 10 I dont take this regular just as needed. 1 x night.

Thank you again so much!

Answer
First of all, I would never recommend stopping all drugs cold turkey.  I would also like to preface by saying that I am not a pain specialist. That all being said, I would recommend returning to your pain specialist (hopefully an anesthesiology pain specialist) and having him review your medications an perhaps consolidate or change them as appropriate. Your concern about future anesthetics is mostly unwarranted. While you will certainly have a higher threshold for pain meds, we can still safely anesthetize you and provide appropriate pain relief.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston