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Anti-inflammatory vs pain meds

Discussion in 'Hip Replacement Pre-Op Area' started by Toddlermom, Sep 13, 2018.

  1. Toddlermom

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    I spent many years on meloxicam. 5+. My mother did too and experienced some dramatic problems due to her own overuse (at times she unwisely doubled her own dose). After my mother’s hospitalizations, I have stopped using anything except Ibuprofen for the past 18 months. And it is no longer helping.

    Well......my pain levels have ramped up on my right hip that needs replacing. And I am in a quandary......anti inflammatory or prescription pain meds? Or maybe crutches, lol? No shots because I am just getting the new joint and start recovering. I have been taking the steps toward full bionic babe status. (Future double hippie here). Until then, are there anti-inflammatory meds that are gentler on your intestines? Have some had relief with prescribed pain meds? I am having a bunch of trouble sleeping at night.

    My doctor seems to be dismissing my worries about the anti-inflammatory. However, I am new to this doctor and find her general tone dismissive about lots of things. (New HMO insurance, ). Gotta manage some young kids 4&7 with this ridiculous hip. And I work on a college campus with quite a bit of walking. Any experiences with specific medications or pain management are welcome. My physical therapist taught my husband how to gently pull on my ankle to create some temporary relief at night, and I am very familiar with ice packs.

    Thank you in advance!
     
  2. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    Welcome back to BoneSmart! Sorry that you are here due to more surgery!

    As a person who only used NSAIDs for both spinal and hip surgery I have to say they worked well for me in terms of pain management. But at what price? For years I heard the warnings about these drugs. I was only after having a routine angiogram and then emergency angioplasty and stents that I began to wonder if the use of anti-inflammatories contributed to my heart issues.

    Truth is NSAIDs are dangerous. Here's an article from our Library NSAIDs Diclofenac. ibuprofen increase risk of heart problems: new study There is a risk of heart problems as well as the issues with stomach bleeds. Your doctor may be dismissing your concerns as she assumes you will be on the drugs short term. But I would try and have a good discussion with her about alternatives.

    Also, if you are not using any walking aid I would recommend you start. At least one crutch will reduce the weight on that sore hip.
     
  3. Toddlermom

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    @Jaycey

    Yes. My mom’s problem was intestinal and YIKES! I don’t need that kind of major trouble in my 40’s. I have been taking the standard OTC dose of Ibuprofen at night a few nights this week. (Without much success)

    My mother mentioned tramadol, but ugh. I am not sure that I want to go there yet.......crutches it is!
     
  4. Layla

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    My heart goes out to you.
    I can't imagine going through this with two young children.
    But you're doing it!
    Wishing you comfort as you move forward.
    @Toddlermom
     
  5. Bionic

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    @Toddlermom
    If the ibuprofen you are taking at night is having little success then you might as well stop taking it. You would probably get as much relief from a placebo.
    I was taking arcoxia for a while alongside another drug to settle the stomach. The arcoxia also stopped working so I stopped everything, apart from paracetamol, a couple of months before my op and used a walking stick.
     
  6. Jaycey

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    Yes, I hear you! I just don't react to the heavy pain meds well. Does Tylenol take the edge off at all?
     
  7. Eman85

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    Ice shouldn't do much for a bad joint. I used Ibuprofen but did worry about stomach problems if over used. Most times I went with nothing unless it was a totally sleepless night with intense pain.
     
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  8. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    There is an in-between which is Tylenol but take 1,000mg 4 times a day. It might not help though as there is nothing much that helps with arthritis pain.
     
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  9. Going4fun

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    Great question @Toddlermom. Unfortunately, I think the answer is that you need to just experiment with various pain meds to see how they feel and how they work for you. The extra-strength Tylen (two 650mg tabs) works well for me ... But I alternated by Tylenol, Alleve and ibupropen ... Just randomly, I would say. On really bad days two Alleve tablets sometimes helped.

    Sorry to hear of your pain. I had my surgery yesterday ... and am doing reasonably well. I hope you are able to find doctors and a surgeon that you really trust. Just speaking for myself, if you are in agonizing pain, I would just take something and worry later about the bad side effects later. That's the nature of excruciating pain, it's sometimes worth it to risk the side effects, especially since you know surgery is around the corner and you can stop then.

    At a certain crucial point, pain becomes an emergency situation ... where you have to take something. And I sorta shift my thinking from finding the best option to finding the least worst option. So truthfully, I'd find something that limited the pain and I wouldn't worry about long term potential side effects. Before emergency pain, sure ... worry about long-term stuff ... After emergency pain sets in, treat that pain ... or else it'll disrupt your entire life.

    Just my two cents offered as a thought. My thinking may not work for you.
     
  10. Rascali

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    Ya, I used to love my ibuprofen... The Ortho allowed a dosage not on the bottle, and it allowed me my fantasy of not needing surgery, for awhile! My stomach didn't like that plan and it took months of antibiotics and Prilosec to repair my stubbornness.
    I received Tramadol in the hospital and post-op and didn't find it difficult at all.
     
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  11. InkedMarie

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    Is Aleve better, worse or the same as Advil as far as your stomach?
     
  12. Mojo333

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    No pain meds touched my pain pre-op...want worth the side effects and all I could when I finally got through the day was use a heating pad...never tried the heat type rubs...might help some?
    Sorry you are dealing with this!:console2:
     
  13. Toddlermom

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    @Going4fun
    Sadly, I am an ortho pro for such a young one! This will be my 3rd hip surgery (my 2nd THR). I have always just used meloxicam, pre op. And heavy pain meds following surgery. So I generally just cope with the pain. I am not willing to risk that med this time around. My mom lost 18 inches of her large intestine, and I figured that I might have inherited this trait along with her crummy hips! I can suck it up if necessary.

    @Josephine
    Thank you! I can try Tylenol at those levels. Meloxicam worked well in the past, and I hate giving it up. But Mom’s bowel obstructions scared the bejesys out of me! I never really experimented with things outside of the NSAID world pre-op. And I hesitate in starting the hard pain relievers now, because I will need them to be very effective post-op.

    Right now, I generally hop in a warm bath at 2 am for some relief when needed. But I probably need to grab some crutches to prevent the inflammation—- And probably fewer bedtime dance parties to Justin Timberlake! That can’t be good for hip inflammation, right?!?!!
     
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  14. Eman85

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    I've had a hot tub for years, bad hips for decades, bad hips like hot tubs. My Mom over medicated with NSAIDS for her arthritis for years and it ruined her stomach.
     
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  15. Toddlermom

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    @Rascali
    Sorry it caught up with you! I was lucky enough to learn that lesson without experiencing it firsthand. Tramadol worked prettty well for me during the day....post op. Now, I am trying to get my surgical plans lined up as quickly as possible to get on the recovery side.

    @Mojo333 I have started with the heating pad again this week. I have never tried any of the anti-inflammatory topical rubs. Hmmmm....I always thought they were for knees and hands. Wonder if anyone felt any relief on hips?
     
  16. dlp

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    I think it has similar side effects - nausea, potential stomach bleeding, etc. Other potential issues include kidney trouble and heart/cardiovascular issues like heart attack or stroke.
     
  17. Jamie

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    They both have the same risks. They are just different types of NSAIDs.

    The only NSAID that is generally considered less of a risk for stomach issues is Celebrex. It functions differently from all the others. It is expensive and comes in a generic form. I've used it off and on for years and have had no problems. However, if you have any stomach problems at all, it would be wise not to risk NSAIDs at all. One thing....in my case the generic doesn't work as well as the name brand so I'm stuck with the higher cost. But when I have arthritis pain, taking a 200mg dose 3 days a week seems to work for me to calm things down.

    The Tylenol would be your best bet if it will work for you. Please realize there are limits to the dose. You should not take more than 1000mg with each dose and no more than 4000mg total in a 24-hour period. Be sure and count all other medications (like cold and sinus meds) that have acetaminophen in them in that daily total. The 625mg Tylenol that was recommended above is a slow-release product and I would not suggest using it on a continuing basis. You'll be better off with the regular Extra Strength Tylenol (500mg) taken on a schedule throughout the day and night every 6 hours so that medication is always available in your system.
     
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  18. InkedMarie

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    @Jamie ive been doing this schedule:

    6am: 2 Tylenol 500mg
    10am: 2 Advil
    2pm: 2 Tylenol 500mg
    6pm: 2 Advil
    Bedtime: 2 Tylenol PM

    Been doing this for last week & half or so. My knee is the same size so I guess the Advil isn’t doing much.

    Wonder if I should try the Tylenol Arthritis in the morning, which never bothered my tummy, 8 hrs after that and the Tylenol PM at bedtime.

    What is it about the Tylenol Arthritis that you don’t recommend taking on a continual basis?
     
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  19. Josephine

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    I can assure you that pre-op there is nothing that will help you much with the pain

    I don't recommend Advil (ibuprofen) because of these issues
    Medications: acetaminophen (Tylenol, paracetamol) and NSAIDs, differences and dangers
    NSAIDs Diclofenac. ibuprofen increase risk of heart problems: new study
    Tylenol Arthritis is just 650mg acetaminophen. I don't recommend it because people tend to take it 2-3 times a day which is inadequate. I'd suggest taking 1,000mg 4 times a day for better pain relief.
     
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  20. InkedMarie

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