WESTON, Florida – At the age of 88, Marvin Wiener still enjoys a good game of golf.
"It's a very good challenge, it's outside."
But Marvin's swing stopped when he needed shoulder replacement surgery. Like most patients, he worried about pain after the operation.
A recent study found the number of seniors who misuse pain pills will have doubled between 2004 and 2020.
Orthopedic surgeon Dr. Vani Sabesan says that chronic pain can lead to opioid dependence in the elderly population.
That's why she's changing the patient-doctor approach to surgery at Cleveland Clinic Florida.
"I think opioids are not the only way, they're honestly probably not the best mechanism, to treat patient's pain," said Dr. Sabesan.
Instead, she educates the patient beforehand about the opioid crisis.
Then she provides alternatives that minimize pain starting in the O-R.
"We do a block where we put local anesthetic around your nerves and that is effective in providing pain relief for the first 12 to 24 hours," she said.
Patients are encouraged to ice the area and take anti-inflammatory medications.
"I've had 40 patients, who've had a shoulder replacement, a rotator cuff surgery, and they've not taken a narcotic medication after surgery."
Follow-ups found those patients had better function after their operation.
OPIOIDS: Opioids prescribed during and after surgery may trigger long-term use in patients regardless of whether or not they are opioid tolerant, taking opioids regularly before surgery, or ever been exposed to opioids in the past. Even opioids prescribed for low-pain, outpatient, or short-stay surgeries increase the risk of persistent opioid use, and over 60 percent of people receiving 90 days of continuous opioid therapy remain on opioids years later. Patients receiving an opioid prescription after short-stay surgeries have a 44 percent increased risk of long-term opioid use. Even prescribing opioids at hospital discharge to previously opioid-naive patients is a risk factor for chronic opioid use one year after discharge.
Marvin shocked his doctors when he was asked to describe his pain level.
"They were somewhat surprised when I said zero a few days after surgery," he recalled.
Now he's back to the links and enjoying life to the fullest.
Dr. Sabesan says she hopes this new approach to managing pain will become a global standard of care. she also recommends early rehabilitation to patients after surgery to get the joints moving.
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