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THR Review after 1 year - is it necessary?

:hi: @Fiona444
I would describe the pain I experienced as mainly stiffness also.
Or simply an awareness that something was off. We each describe pain differently and do have varying pain thresholds. What someone refers to as extreme pain, another may feel as a strong discomfort. I'm sorry you have to worry about prescription refills this soon. Hopefully your pain eases through icing / elevation and rest. Wishing you lots of comfort :console2:
 
@linette333 tramadol is a horribly addictive drug. I cannot believe your doctor told you different. I think you can get it in liquid form to help you wean down slowly. The increments will be smaller than cutting a pill or splitting a capsule
 
I hope you're feeling better today, @Fiona444, it sounded wretched not to have your pain management sorted out very well. For me, I needed the strong stuff (oxy) mostly at night the first week, then I switched to Tramadol at night with Tylenol extra strength during the day the second week, and by the third week I only took one Tramadol before bedtime and then just the Tylenol and then--poof--I didn't use anything other than the occasional Tylenol when I needed it. I think everyone's ability to manage pain, and response to pain medication is very different, and it will take some time to get it sorted. When I was discharged from the hospital I got bottles of pills but no clear understanding of a schedule on which to take them! I had my pre-op visit today, and I mentioned that so maybe this time around they'll give me something with clearer instructions for post-op. I did manage last time around, without much pain (just aching and stiffness mostly) so I "sort of" figured it out, but I wish I'd had more help up front to have a schedule. Good luck as you sort your way through it. PS I hated the oxy (fog brain) and did think the Tramadol was useful, especially at night, and I had no problems mentally or with weaning myself off of that.
 
I hope you sort out a medication schedule that allows you to rest comfortably and get up for brief bathroom and kitchen trips in the house with nothing more than discomfort, @Fiona444 . Also: icing reduces pain because it numbs the sore spots. Elevating reduces swelling, so it reduces pain that way. And sleep really reduces pain, because it helps us heal and because we do better when we are rested. Everything works together - the pills are really important but they don’t do it all. You will get the hang of this very very soon.
 
Fiona444 said:
@linette333 tramadol is a horribly addictive drug. I cannot believe your doctor told you different. I think you can get it in liquid form to help you wean down slowly. The increments will be smaller than cutting a pill or splitting a capsule
Click to expand...
Tramadol is not known as a "horribly addictive drug." Some people taking it for an extended period of time may become dependent on it (this is not addiction) and need to wean off gradually, but it can be done on a schedule over several weeks. Tramadol is actually a very effective pain reliever, especially when combined with acetaminophen (Paracetamol in the UK) and taken on a set schedule and it's frequently successfully used after joint replacement surgery.

If you continue to have pain, be sure you are taking your prescribed meds at the maximum allowed level. If that still doesn't work, then you'll need to let your GP know so something else can be tried. The two meds you've been sent home with are not strong medications by any means and they may not be enough for you in these early days. Both are only for moderate pain levels. Even with meds you can expect some discomfort, but pain levels should stay around the 2-3 level most of the time. Be sure and use ice as much as you can as it helps significantly. You can ice as much as you like as long as you keep a towel between your skin and the ice source so as not to damage your skin.
 
Thank you @Jamie. I am icing and I took Nefopam and ibuprofen at 12 midnight than now at 2am I am woken up with pain enough to make me cry out. I have just taken codeine and ibuprofen which is probably an hour earlier than I should have as they tell me codeine is every 6 hours. I think in the UK they expect us to tough it out or maybe I'm just a wuss.
 
Fiona...I'm sure no one wants you to just tough out the pain. But sometimes you must be an advocate for yourself and become a bit of a "squeaky wheel" in order to get the attention of overworked doctors. Don't give up! You must not allow yourself to be in pain that is making you cry.
 
@Fiona444 so sorry you're still dealing with pain issues. I've just been laying on the couch all day and icing, only getting up when I had to use bathroom. Actually had a couple of moments where I was almost pain free, of course I've been a slug all day. Hope you find some relief and get some rest.
 
My poor Fiona! I totally agree with Jamie's message. Clearly you need a doctor's help to get the right mix and no, you're not a wuss! Pain is pain and needs to be controlled for you to heal. I took codeine at max dose for 3 days then half dose (but regularly) 3 more days, in addition to paracetamol 1000 g 4 times a day, which I continued for 3 weeks. (Don't forget senna or stool softener and prunes with codeine). If I had needed more codeine I would have called the GP. I got 28 tablets at discharge. I also elevated a lot, almost all the time, first week. I went to bed with leg elevated too. I was told no nsaids although naproxen was my best friend before the op. (Something about they adversely affect the bone growing into the implant, I was uncemented if that has any bearing). Anyway I wish you help soon to solve your pain! :angel:
 
Hello all feeling brighter this morning and less pain thankfully. I think in the night it's worse for some reason

@Elf1 I am still in bed except for trips to bathroom and up to do my standing exercises. How are you feeling today? Did you sleep?

@Calgal this will be my third day on codeine at full dose but I am not ready to cut down yet. Interesting they told you no NSAIDs? I wasn't told that and am now a bit worried.

I have my op leg on a pillow. Is that ok do you think or should it be higher?

How long were you taking codeine all together was it just the 6 days?
 
Glad to hear you are feeling better today! I think all pain is always worse at night - probably because there is nothing else to occupy the mind.
I'm also in the UK, but was bombarded with painkilling meds.!! In addition to the Tramadol, celecoxib and paracetamol, I was given a huge bottle of oramorph "just in case". I never actually took any. Then in hospital ( I was in private hospital, but an NHS patient like you), they actually woke me up both nights to ask how my pain was and if I would like more painkillers!! :scratch:
I discovered later that there were only 2 patients in the place , so maybe they were bored! :snork:
I have also heard that NSAIDS are not good for joint replacements, but they were insistent that I have them. Only had them for 6 days, (like you, I think?) So I don't think you should worry.
Because we don't know what is right or normal, everything is just so difficult- but you are doing really well !
What would we do without this forum? :tada:
 
I was told NSAIDS slow down the healing process in the early days after surgery. As far as pain meds, take as much as you need or are allowed and worry about quitting later, when the pain subsides. If we have to go through a little withdrawal , so be it, I quit cigarettes, can’t be worse than that.
 
I discovered staying ahead of the pain these early days was definitely the trick.
linette333 said:
they actually woke me up both nights to ask how my pain was and if I would like more painkillers!! :scratch:
I discovered later that there were only 2 patients in the place , so maybe they were bored! :snork:
Click to expand...
This is likely why you were wakened..once it gets on you...very hard to tamp back down...so I took mine on schedule for first weeks.
I also don't like NDAIDS...except for the aspirin protocol of course...

It does get better @Fiona444
Hang in there.
 
@linette333 you are very lucky. I think because I was in such agony when I came round from the anaesthetic and it wasn’t under control for over an hour and then they halved my codeine so I went through another huge bout of pain. I kind of lost confidence in myself that I could cope.

They also woke me in the night for antibiotics in my drip but I had to ask for pain meds. The nurses were all lovely but I don't think my pain was managed well which is a shame. And I was given some conflicting information e.g. when I was coming round my while body was spasming causing huge pains in my leg. They told me it’s because I had had a tourniquet on to stop bleeding which the physio said was rubbish.

Also the nurse who cut my meds down said I could use the toilet which didn't have a riser on. I said I wasn't happy to do that and she checked with the physio who went a bit mad. I did lose confidence in how I was being looked after.

@Marvin L you are right. I am not going to let myself be in pain like that again.

I am going to dump the ibuprofen. Does anybody know if nefopam is an NSAID? I am a bit worried about the advice I have been given now by the hospital. Thank god for Bonesmart!
 
@Fiona444 About the NSAIDs I too did not take any after surgery. I was concerned about being on aspirin 325mg for one month as my blood thinner. Aspirin I read is considered an NSAID, but works differently and does not affect the healing process or affect how the bone grows info the implant. So you could Google aspirin yourself to see what it says as I did and perhaps take aspirin to help with pain instead of the ibuprofen.
 
@Fiona444 glad to hear things are looking up a bit. I'm still couch surfing for now, may try the bed later today to see if I can get out of it by myself. I'm hanging in there, still taking the pain meds as prescribed, don't want the pain to get ahead of me. I am sleeping in bits and pieces here and there. I usually doze off for a while after I take my pill. I think I actually get about two hours at a time but I'll take it!
 
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