What Is the Best Pain Management Strategies After Surgery?

Dr Daniel Amen and Tana Amen BSN RN On The Brain Warrior's Way Podcast

One of the biggest issues we face directly after a surgery is how to manage the pain. We need to be careful how we approach this crucial time to avoid lasting brain fog or even addictions. In the final installment of a week-long series on Surgery, Dr. Daniel Amen and Tana Amen discuss the use of narcotics, over the counter meds, and even less conventional treatments such as acupuncture.


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Dr. Daniel Amen: Welcome to the Brain Warriors Way podcast. I'm Dr. Daniel Amen.

Tana Amen: And I'm Tana Amen. Here, we teach you how to win the fight for your brain to defeat anxiety, depression, memory loss, ADHD, and addictions.

Dr. Daniel Amen: The Brain Warrior Way podcast is brought to you by Amen Clinics, where we've transformed lives for three decades using brain spect imaging to better target treatment and natural ways to heal the brain. For more information, visit AmenClinics.com.

Tana Amen: The Brain Warriors Way podcast is also brought to you by Brain MD, where we produce the highest quality nutraceutical products to support the health of your brain and body. For more information, visit BrainMDHealth.com. Welcome to The Brain Warriors Way podcast. And stay tuned for a special code for a discount to Amen Clinics for a full evaluation, as well as any of our supplements at BrainMDHealth.com.

Dr. Daniel Amen: Welcome back. We are continuing on Tana's recovery. We are two weeks post-surgery. And as we do, whether it's raising kids or being married or dealing with a mental health issue, whenever they affect us, we're gonna share them because we know that they may help you.

Tana Amen: Well, there's a lot of people dealing with similar stuff.

Dr. Daniel Amen: I'm gonna read a couple of testimonials. "I'm a month into the supplements after having my spect scan done through my psychiatrist, and it's making a world of difference. I love the books," [Dina Bear Time 00:01:43]. Thank you so much. We're here to make a difference in your life. Also, from Dane the dancer. I love that, Dane the dancer. "I feel less alone with the struggle of telling that my form of autism caused by a vaccination at 12 months, I had the similar symptoms. That episode makes you more of a saint than ever. Feel that spect scans should be the norm for all children diagnosed with autism." Yeah, how do you know unless you look?

Tana Amen: You know, it's one of the things that I've often, as a parent, I often tell my daughter. Feeling alone is the worst thing. And anything you're going through, people tend to feel, whether it's shame or pain or fear or whatever it is, when you do it alone, it's so hard. Pain shared is pain divided. It's really important that you don't feel that aloneness. You need to have someone that you share that with.

Dr. Daniel Amen: Well, and building a community. That's why we're grateful you're part of our community, but being connected through the podcast, through church, through your family, through your friends, it's just super important.

Tana Amen: Yeah.

Dr. Daniel Amen: You had a number of epiphanies around drugs.

Tana Amen: So, you have to excuse me. I'm wearing my yoga clothes today because I still can't wear anything tight on my body, so everything's just loose and t-shirty today. If you're watching the video, that's why. But yeah, we've been talking about all the things you do to prepare going in, and all the things you can do afterwards to make sure you heal faster and feel better fast, right? But something happened that just really woke me up to what some of our patients must feel. And I had just this different level of empathy. It was sort of weird.

I don't do well with a lot of ... I don't do well with pain medications to begin with. I just don't really ... I hate the way they make me feel, just that nauseous. Don't like it. But you have to take them for a couple days, right? I took pain medicine for the first 48 hours because that was really the rough part. Then after that, I only took them for a couple of nights because I couldn't sleep at night if I moved, so I took just one pain pill at night before I went to bed. But I still had to do something for sleep, so I started taking over-the-counter. You'd think over-the-counter medication, no big deal. I tool some Advil with Benadryl in it. The lowest dose of Benadryl, 12.5 milligrams. The lowest dose you can do, just to help me sleep so that I could get my sleep. We just got done talking in the last episode about how important sleep is, so I knew I needed to sleep. I don't want to be waking up all night.

So, I am doing everything I can to not take these toxic levels of drugs, take the minimal amounts, take things that I can. What's the balance between not feeling so much pain and sleeping and all that. And I was doing really well. I was sleeping a lot. I was doing really well. The first couple days were fine. And all of a sudden, by about day six when I should be doing a lot better, I start noticing that I'm just very apathetic. And I thought, "Okay. Well maybe that's just still surgery." There's a lot of apathy. I get up. Even Chloe got really nervous. My daughter got really nervous and she came down. She's like, "I am not used to seeing you like this." I was so tired. I felt like I was walking through mud, couldn't focus. I sat down to try and do my meditation. Could not focus on meditation. Could not focus on my Bible study. Couldn't focus on anything. I just didn't care, and I was so tired. Nothing made sense. I just laid there, like a bump on a log.

And then I tried to go out and do something on the first day that I could finally go out and do something. I barely made it through. Came back home, went right to bed. Then it occurred to me on about the eighth day. I'm like, "I'm gonna try sleeping without the Benadryl because I don't know what's doing this, but I feel terrible. Maybe it's just post surgical. I don't know." So, I went to sleep without the Benadryl. Woke up the next morning, bam. Jumped out of bed. I was like, "Whoa. It's a whole new day," like someone lifted the fog. From that point on, I was fine. I was absolutely fine, back to myself. Still tired, don't get me wrong. I still have to recover and I'm tired, but I didn't have that depressed, apathetic, can't focus on anything, don't care about anything feeling.

Dr. Daniel Amen: A lot of people use Benadryl to go to sleep at night.

Tana Amen: Yes. My sister was using 50 milligrams. I don't even know if that's allowed, but anyway, it's definitely not suggested. My point is, yes we want you sleeping, but my epiphany was this. People are coming in here. Sometimes things are so broken. They're hurting so badly. They're so broken. They're doing everything they can. I know. I've seen it. I've experienced it personally with my family. Where they are so broken, they don't know what else to do, so they're just doing what they can and taking whatever medicine they can to help them survive the moment. I get it, but we're giving them stuff to do that's gonna help them feel better, and they can't focus on it. I know they can't because I certainly could not. I could not. And I was taking the minimal amount of an over-the-counter medication, and within a couple of days I was not myself. It just occurred to me that we need to be really aware.

I know you are aware. I'm not saying you're not, but it really helped me think about what people are going through internally if they've been taking these drugs for a long time. This epidemic with opiates is tragic.

Dr. Daniel Amen: I want to actually say that in a published study, in a report published in JAMA internal medicine this month, that long term use of anticholinergic medicine-

Tana Amen: Like Benadryl.

Dr. Daniel Amen: These are medicines that decrease the neurotransmitter acetylcholine, like Benadryl, increase the risk of dementia. And I think you were feeling ... I mean obviously you weren't demented, but you were beginning to feel cognitively I'm not as sharp, I'm not as happy.

Tana Amen: I just felt terrible. Definitely not happy.

Dr. Daniel Amen: So, this is really important because the medications that your doctor put you on often without much thought, right? Benadryl.

Tana Amen: But wait, some of these you can just go get on your own. You don't even know anything about them. You don't know what the side effects are, and people just go buy it. They just indiscriminately-

Dr. Daniel Amen: You're not supposed to be this excited after surgery.

Tana Amen: No, I was so ... I'm telling you, this struck me so strongly.

Dr. Daniel Amen: I'm your nurse. You have to calm down. Let's calm down.

Tana Amen: This is important. People are able to take this stuff with really no knowledge of what it's doing to their brain.

Dr. Daniel Amen: You're absolutely right. The other huge issue that we haven't talked about is naïve systems, so people who've never had narcotics, are getting narcotics and then they get hooked on them because-

Tana Amen: I don't know how.

Dr. Daniel Amen: They're getting ... because you're not like, well in so many ways. You're not like everybody.

Tana Amen: I'm not normal.

Dr. Daniel Amen: But a lot of people, once they start narcotics, they can't stop them.

Tana Amen: I know. I understand that.

Dr. Daniel Amen: Because wen they take them, all of a sudden, they feel better than-

Tana Amen: But I think it's-

Dr. Daniel Amen: Wait, let me finish. They feel almost what they believe other people think as normal. Now obviously these opiates, opiate-narcotics, they're dangerous long term, and they can cause addiction. And as we've seen in this country, they can steal your life. So, the take home point for this is if you have had surgery, or your wisdom teeth removed, and somebody gave you an opiate, like Norco or Vicodin or Percocet or Percodan or Morphine, and you felt really great, don't keep taking them. Bad idea. Really, really, really bad idea.

Tana Amen: So, I-

Dr. Daniel Amen: Let me finish.

Tana Amen: Okay, then I have a question.

Dr. Daniel Amen: Let me finish. Go do acupuncture.

Tana Amen: I love acupuncture.

Dr. Daniel Amen: Because acupuncture has been found in studies to actually work through the same endorphin mechanism in the brain, but rather than make you stupid over time and give you constipation and addict you to it, it can actually increase blood flow, improve your mood, and help rebalance your system overall. Okay, I'm done.

Tana Amen: So, two things. Two things, because acupuncture, you thought I was being ... You thought it was all in my head because I just tried acupuncture for the first time prior to surgery. I wanted to get my body all ready for surgery. So, I tried acupuncture, and I cannot believe how good it made me feel. I'm like, "This can't be real. This cannot be real." You just started laughing at me because I'm like, "There's no way that someone sticking needles in my body is making me feel this good," but I felt so good and I slept so good. It was amazing.

Dr. Daniel Amen: You were so much better.

Tana Amen: I was so happy.

Dr. Daniel Amen: And I don't usually think of you as a placebo responder.

Tana Amen: No, I'm actually cynical. I'm pretty cynical actually. Now, one more thing I want to go back to. This is too important and I didn't want to forget about it. That's why I kept bothering you. You talked about people feeling normal when they take the painkillers. When people start taking painkillers like that, if they have to take it for any length of time, because I have somebody that I know right now who's gone through a surgery where they're actually just really in a lot of pain long term. It's a long term chronic pain. That's where it's dangerous I think. Are those opiates one of the drugs that actually change your brain function and make you dependent chemically?

Dr. Daniel Amen: Yes. There are actually many medicines that, I call them insidious, in that once you start them, they change the function of your brain-

Tana Amen: And you need them.

Dr. Daniel Amen: In order to need them.

Tana Amen: And that's scary.

Dr. Daniel Amen: So, you just want to be thoughtful, careful. Like Benzos, opiates, serotonin drugs. That doesn't mean you don't need them and it doesn't mean they're not helpful, but if there's another way to do it, it's worth thinking about the other ways to do it. So, hypnosis can be really helpful for pain. Omega 3 fatty acids. Cumin.

Tana Amen: Yeah, now I'm back to my meditation.

Dr. Daniel Amen: Well, and I think for you, since you got that really great response from acupuncture-

Tana Amen: I can't wait to go back.

Dr. Daniel Amen: That it's not a bad thing to do. I'm getting ready to film my new public television special, Feel Better Fast and Make it Last. I was reading through the acupuncture and acupressure literature, and just a super simple exercise like rubbing the bottom-

Tana Amen: And this feels good.

Dr. Daniel Amen: Of your ear lobes, so just slowly rubbing your ear lobes between your thumb and your first finger, that it sends a relaxation response. Now, if you have big ears like me, then you've got a lot of rubbing room to go. Another one-

Tana Amen: Is this one, yeah.

Dr. Daniel Amen: It's-

Tana Amen: Feels good.

Dr. Daniel Amen: There's an acupressure point, actually it's over here. An acupressure point on your writs that when you hold it, again it has an anti-anxiety effect. So, so many simple things we want you to do before you go after some of the heavy duty meds that you may have trouble stopping.

Tana Amen: Yeah, one of the things that made me realize that it might be the Benadryl that was doing it, that made me like, "Okay, maybe I just need to try stopping this all together." It just didn't occur. I didn't ask anybody. I was just taking Benadryl. I was taking a tiny dose. You just don't think about it, but I remembered that I had taken, god many years ago, I was prescribed after some procedure, they gave me Ambien to sleep. And after two days of taking Ambien, two nights of taking it, I would burst into tears uncontrollably. I was like, "What the heck?" It made me crazy.

Dr. Daniel Amen: That was actually a huge gift for you.

Tana Amen: Oh my god, it was terrible.

Dr. Daniel Amen: Because Ambien's another one of those medications that once you start it, it's really hard to stop.

Tana Amen: Terrible.

Dr. Daniel Amen: The New York Times just did a whole article on psychiatric meds you cannot stop.

Tana Amen: Oh, that one was awful.

Dr. Daniel Amen: I would never want to start something that I couldn't stop that I would begin to lose control over my own mind. I have enough trouble controlling it.

Tana Amen: So I just wanted to put that out there because I want people to think about-

Dr. Daniel Amen: This was a really good podcast. You're so smart.

Tana Amen: Well actually, I don't know if I'm smart. It was just an epiphany I had that I think it gave me a lot of empathy because people start taking these meds for a lot of various reasons, and they end up in trouble. And it just made me realize, "Wow. They can't" ... Well it's not that they can't. It's hard to do some of the things, even though you know they're the right things. I was eating terrible for a couple ... Well, there's not really much terrible in my house, but I was eating terrible for me. I even asked you to go get me this bean and cheese burrito, and you looked at me like, "What?" Like, "What are you doing?"

Dr. Daniel Amen: I can't be seen in public with a bean and cheese burrito.

Tana Amen: But my point is I just didn't feel good and I didn't care and I wanted something like comfort. I was just like, "What is going on with my ... What is the matter with me?"

Dr. Daniel Amen: Are we blaming that on Benadryl?

Tana Amen: My overall mindset was completely not the same. It was just not the same. It was just very weird.

Dr. Daniel Amen: So, what is the parting word you want to leave with people for surgery week? What are the big ideas that came from your experience?

Tana Amen: I think these podcasts will help, so be prepared in advance. Get your body completely ready in advance. Ask the right questions. Prepare your environment. Prepare your mind. Do everything you can on your side to be as healthy as you can going in. So, build your reserve. You've got to build your reserve. That's really important.

Dr. Daniel Amen: Armed, prepared, and aware.

Tana Amen: And you've got to have that physical reserve.

Dr. Daniel Amen: A warrior doesn't start training on fight day.

Tana Amen: Right. You've got to train before fight day. You've got to be ready. So, build that reserve. Be ready to go. But then also have this knowledge about what's gonna happen, not just with your body. I asked all the questions about what's gonna happen with my body. What's gonna happen with the recovery? What's gonna happen ... I knew all that stuff. I didn't really think about some of the other things. This podcast can help. Know what's gonna happen with the drugs. Know what's gonna happen with the recovery. Know what the potential complications are, so you can just have a plan.

Dr. Daniel Amen: And get your mind and your body in the right state. Don't pollute it with a lot of negativity. Start with, "Today is going to be a great day." Finish each day with what went well today. That'll get your internal environment to be healthier.

Tana Amen: And have a really good support system. That was just so ... That really made all the difference.

Dr. Daniel Amen: Stay with us. Thank you for listening to The Brain Warriors Way podcast. Go to iTunes and leave a review, and you'll automatically be entered into a drawing to get a free signed copy of The Brain Warriors Way and The Brain Warriors Way cookbook we give away every month.