Patients give high marks for opioid sparing pathway

Published 08/07/2018

Watch this HealthCheck 10 report with Barbara Morse Silva to learn more about the opioid sparing pathway used at South County Hospital and hear from Nick Bailey, a patient who traveled from the Virgin Islands to get his orthopedic care here.

When Wil Snodgrass (pictured) needed hip surgery in June 2018, he looked forward to finally getting relief from the pain he had experienced for years. But he wasn’t looking forward to the after effects of surgery.

In 2015 he had knee replacement surgery at South County Hospital. The procedure went perfectly, and he is very satisfied with his new-found mobility. For him, it was the narcotic pain medication that marred the otherwise positive experience.

“When I had my knee surgery I was in a fog,” Wil said. “I don’t like taking (narcotic) pain medication. It made me feel weird. I wanted to get off them as soon as I could.”

Once he realized he would need to have a partial hip replacement, he returned to South County Hospital and the orthopedic surgeons from Ortho RI. During one of the pre-operative visits, Wil learned about the opioid-sparing pathway that offered an alternative to narcotic pain medication.

The pathway, developed by anesthesiologist, Dr. Henry Cabrera, and orthopedic surgeon, Dr. Michael Bradley, is designed to reduce or eliminate the need for opioid-based drugs for pain management. Instead, patients are prescribed non-narcotic medications proactively, beginning days before the actual surgery, and a mild analgesic such as Tylenol after surgery.

“I was expecting pain, but it wasn’t painful,” Wil said of his experience.

Besides the pain, Wil was concerned about the side effects of prescribed narcotics, including memory loss and dizziness, particularly because patients begin walking only hours after their surgery. The day after his hip procedure, Wil was walking the hall and visiting the nurses’ station.

“I wasn’t nauseous, I didn’t have headaches, I didn’t feel dizzy,” he said. “I asked the nurse, ‘Are you sure that’s all I’m on is Tylenol’”?

Since experiencing the opioid sparing pathway for pain management, Wil is convinced that the lighter combination of drugs together is better than one narcotic than kills everything.

“When I had my knee surgery my pain scale reached five and six,” he said of the system of 1-10 used to gauge patient pain. “The highest amount of pain I’ve gotten with this surgery was a four.”

He described the sensation as “more of a pressure than a pain.”

“I’ve done more than they thought I’d do,” he said of his recovery. “I’m really happy with it.”

Wil attributes both his knee and hip issues to heredity and obesity. In 2015, when he had his knee replaced by Dr. Mark Coppes, he weighed 356 pounds. On his 57th birthday in 2017, he recalled struggling to get out of bed due to hip pain. That prompted him to take a closer look at his health.

“I wouldn’t mind living another 20 years,” he said. “But I don’t see many 356 pound people who are 77 years old.“

He recognized that patients who need knee or hip replacements often learn to cope with the pain during their daily lives, adding to the success of the opioid sparing pathway.

For Wil, now 120 pounds lighter, and with a new knee and hip, his next 20 years is off to a pain free start.