Josephine
NURSE DIRECTOR EMERITA
It's a known side effect of oxycodone but not of Tramadol.
THR So many ups and downs<
- Thread starter MobiM
- Start date
OP
OP
MobiM
member
Three weeks five days since the surgery and I’m feeling so down and anxious and in pain. Have changed my meds from the oxycodone SL & oxycodone non SL to Tramadol, 100mg every 6 hours and paracetamol 1000 mg also every 6 hours. I wanted to get off the morphine based drugs as I have had nervousness and hyper feelings with morphine in the past.
However, the new regimen doesn’t seem to be holding the pain at bay. I’ve been icing constantly. Yesterday I showered and did my hair (blow dried sitting) which is a big event as even sitting is very hard in terms of pain. After I decided to go for a bit longer walk - through the house, out the side door, down three steps and to the agapanthus’ that run beside our dirt driveway (with crutches). Then back. I tried to walk “normally”. But the rest of the day I was in hell. Pain in my SI joint on the operated side (like it was going to pop out) and the buttock on that side with cramps. Had a horrific afternoon and evening. Trying to even get back on the bed was agony.
So today I feel just so discouraged. I feel like a failure - not even able to walk 60 meters. The pain is so bad. Anxiety doesn’t help. Any feedback would be greatly appreciated. I have the PT coming tomorrow and am not at all sure I can handle him.
However, the new regimen doesn’t seem to be holding the pain at bay. I’ve been icing constantly. Yesterday I showered and did my hair (blow dried sitting) which is a big event as even sitting is very hard in terms of pain. After I decided to go for a bit longer walk - through the house, out the side door, down three steps and to the agapanthus’ that run beside our dirt driveway (with crutches). Then back. I tried to walk “normally”. But the rest of the day I was in hell. Pain in my SI joint on the operated side (like it was going to pop out) and the buttock on that side with cramps. Had a horrific afternoon and evening. Trying to even get back on the bed was agony.
So today I feel just so discouraged. I feel like a failure - not even able to walk 60 meters. The pain is so bad. Anxiety doesn’t help. Any feedback would be greatly appreciated. I have the PT coming tomorrow and am not at all sure I can handle him.
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MammaT
supremo
Wow @MobiM - I don't know what to say! I was not familiar with gluteus minimis tears and the little bit I read said recover from that repair can take awhile. It could be with the two procedures you have extra swelling (that's just my common sense talking, not real knowledge). Have you called your doctor's office? In terms or drugs causing problems, I think side effects of medications can hit different people differently. I know folks who have not tolerated tramadol at all, (itching, etc.) and for others it was just the ticket, so it is hard for anyone to have a definite answer (my husband developed a cough after going on a new blood pressure medicine, doctor tried everything to figure out cough, I kept asking if it could be bp med--doctor assured me no. Finally went to another doc, got a different med and cough went away! Doc said he hadn't have anyone have that side effect.
Perhaps the pt can give some advice on rehab for hip and glut repair? Maybe no pt? If he gives you stuff that hurts, you can kick him out!
I hope you get some relief. Sorry I can't be much help but I am pulling for you!
Perhaps the pt can give some advice on rehab for hip and glut repair? Maybe no pt? If he gives you stuff that hurts, you can kick him out!
I hope you get some relief. Sorry I can't be much help but I am pulling for you!
OP
OP
MobiM
member
@MammaT thank you. I made a mistake when reading the operation report from my surgeon. He repaired a full thickness tear in the gluteus MEDIUS tendon. And yes, I’ve been wondering the same thing as you mentioned. According to the report it says: “There was a full thickness tear in the gluteus medius tendon. The bone was prepared and the repair was performed with 2 x interosseus Ethibond sutures.”
For me, the bulk of my pain is on the outside of my hip - which would be where that repair was done. According to several orthopedic sites, it says recovery from a glute med repair is six weeks where the patient should be on crutches with a stabilising hip support and only touch weight bearing. But my surgeon never mentioned the tendon repair when I saw him in hospital, and his postoperative instructions simply say “Full weight bear.”
He was meant to call me two weeks ago, but I haven’t been contacted yet. I called and they said they’d try to have him contact me tomorrow. But honestly, to me that tear repair seems to be adding greatly to my inability to walk far. Personally, I think my whole problem for the past four years was the tear. MRIs show another one on the left side. Both were deemed by the scans as “minor”. Obviously not picked up until my hip surgery - not even during the hip arthroscopy.
I understand about meds! They can have the strangest and different effects on everyone. I’m particularly sensitive to any meds except the clonazepam. Even paracetamol upsets my gut.
Sorry to yammer on. Thank you so much for your reply.
For me, the bulk of my pain is on the outside of my hip - which would be where that repair was done. According to several orthopedic sites, it says recovery from a glute med repair is six weeks where the patient should be on crutches with a stabilising hip support and only touch weight bearing. But my surgeon never mentioned the tendon repair when I saw him in hospital, and his postoperative instructions simply say “Full weight bear.”
He was meant to call me two weeks ago, but I haven’t been contacted yet. I called and they said they’d try to have him contact me tomorrow. But honestly, to me that tear repair seems to be adding greatly to my inability to walk far. Personally, I think my whole problem for the past four years was the tear. MRIs show another one on the left side. Both were deemed by the scans as “minor”. Obviously not picked up until my hip surgery - not even during the hip arthroscopy.
I understand about meds! They can have the strangest and different effects on everyone. I’m particularly sensitive to any meds except the clonazepam. Even paracetamol upsets my gut.
Sorry to yammer on. Thank you so much for your reply.
Horseshoe
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Welshgirl
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OP
OP
MobiM
member
Hi @Horseshoe. Thanks for the reference. I read about Krista’s glute med repair. It frightens me that I was given NO info on that by my surgeon, and have been treated like any other regular hip replacement patient. Full weight bearing, no brace, etc. I will have some questions for my surgeon if he ever calls. I just hope I haven’t already retorn it.
@Welshgirl thanks so much for your kind post. Wish I were in Cyprus!
@Welshgirl thanks so much for your kind post. Wish I were in Cyprus!
Mojo333
Former BoneSmart Staff Member
It would seem to me a tear repair would need no aggravations.
So sorry you are not able to manage your pain. I put up with and tried to mediate some of the side effects from the opioid medication in able to handle some pretty severe pain...then transitioned to tramadol and Tylenol very regularly and that worked well. Also took clonazapam mostly for relaxing and resting easier.
Sounds like a recheck is in order?
So sorry you are not able to manage your pain. I put up with and tried to mediate some of the side effects from the opioid medication in able to handle some pretty severe pain...then transitioned to tramadol and Tylenol very regularly and that worked well. Also took clonazapam mostly for relaxing and resting easier.
Sounds like a recheck is in order?
OP
OP
MobiM
member
@Mojo333 yes, that’s what I’ve done. I’ve quit the morphine based meds and am now on tramadol and paracetemol.
@Josephine yes, I’m happy to answer questions. Thanks.
@Josephine yes, I’m happy to answer questions. Thanks.
Mojo333
Former BoneSmart Staff Member
Hoping that works well for you...but let me clarify. I was on my first pain meds for two and one half months...not that you should...but I was on them too twice as long.
OP
OP
MobiM
member
I felt I had to get off the morphine because of nervousness and hyper feelings, though I’m still feeling anxious and down - mostly because of the sensitivity. That said, I slept well last night. But after the terrible ordeal following my last “longer” walk (about 60 meters), I’m losing confidence to try. Also feeling nauseus...could be all nerve related.
MammaT
supremo
I wouldn't worry about length of walk yet--we all seem to be different on that. Going from my lift chair to bathroom was a challenge for me (about 50 normal steps there and back, 5,000 steps with walker!). Move a bit each hour you are up and you will do more as your body is ready.
Mojo333
Former BoneSmart Staff Member
Totally agree..anxiety is very hard on our immune systems also.
Try your best to do what your body says you are up to.
Some walk sooner and more, some take meds longer than others, some spend more time icing...great thing by the by...but our recoveries are all different so take what you can from others stories and certainly DON'T compare.
All hopefully temporary, early days.
Try your best to do what your body says you are up to.
Some walk sooner and more, some take meds longer than others, some spend more time icing...great thing by the by...but our recoveries are all different so take what you can from others stories and certainly DON'T compare.
All hopefully temporary, early days.
OP
OP
MobiM
member
Thanks everyone! It really helps to know I’m not weird for having trouble walking further yet. I spoke to my surgeon yesterday and we are both hoping the replacement etc will help the unknown problem that’s kept me immobile and on crutches for the past four years - bedridden for the six months prior to surgery. He asked if I thought it had helped but I honestly can’t tell at this point. Walking and exercise are difficult for me for both sides because it’s been so long since I could. The surgeon did say that I was a special case and the “No restriction” meant no restrictions for what I DO, but also no restrictions on what I DON’T do. He said it would take me much longer to recover because of my extended immobility.
I would get up and walk every hour if I didn’t have the horror of trying to get back on the bed with the sensitivity. And unfortunately I can’t sit for long, either.
And yes, constant low level anxiety is exhausting. I am having my hypnotherapist come tomorrow to help with the anxiety.
Everyone’s kind feedback and wishes are so greatly appreciated.
I would get up and walk every hour if I didn’t have the horror of trying to get back on the bed with the sensitivity. And unfortunately I can’t sit for long, either.
And yes, constant low level anxiety is exhausting. I am having my hypnotherapist come tomorrow to help with the anxiety.
Everyone’s kind feedback and wishes are so greatly appreciated.
Mojo333
Former BoneSmart Staff Member
You have alot to come back from. I believe you will get there and your doctor sounds like he has exactly the right take on how you should get there.
Glad you are doing all you can. Try not to get discouraged. Rooting for you!
Glad you are doing all you can. Try not to get discouraged. Rooting for you!
Josephine
NURSE DIRECTOR EMERITA
Here y'go then!
It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are
1. what approach did you have for your surgery? Anterior, posterior, lateral? You can look here to see the various types THR approaches or incisions
2. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).
3. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?
4. are you icing your painful area at all? If so, how often and for how long?
5. are you elevating your leg. If so how often and for how long?
6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and
7. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)
Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.
Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.
It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are
1. what approach did you have for your surgery? Anterior, posterior, lateral? You can look here to see the various types THR approaches or incisions
2. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).
3. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?
4. are you icing your painful area at all? If so, how often and for how long?
5. are you elevating your leg. If so how often and for how long?
6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and
7. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)
Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.
Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.
OP
OP
MobiM
member
@Josephine here are my answers. I hope I’ve done it right.
1. Anterior but included a repair of a full thickness tear of the gluteus medeus tendon.
2. Today I’d say a 7 or 8, but not just hip. This includes back pain and the dreaded allodynia, as well as intestinal pain from meds and anxiety/tension makes all the pain worse.
3. I was originally prescribed:Targin CR (oxycodone HCL/Naloxone) 5/2.5mg twice per day with Endone (oxycodone hcl) 5 mg one four times a day as required and Esomeprazole RBX 20 mg for stomach once per day. This is what they gave me in hospital, as well as the occasional Tramadol 50 mg. However, after coming home for the first two weeks I was developing nervousness and a feeling of hyperactivity, so decided to try Tramadol as I took that after spinal surgery in 2009 and seemed to tolerate it ok. So three days ago I switched to Tramadol Sandoz SR 100mg twice daily with Tramadol Sandoz 50mg when needed and paracetamol 1000mg every six hours. When I first started the Tramadol SR I mistakenly took it every six hours as I didn’t realise it was slow release. My GP straightened that out and said no harm done.
I am also sceptical about continuing the slow release Tramadol because my blood pressure plummeted (around 96/65 for two days) making me feel very faint and nauseous and my nervousness and tension seemed worse after taking it. (Sorry this one is so long, but my meds are a constant source of problems with my nerves, BP, intolerances and intestinal sensitivities.)
4. Yes. I ice my hip at least three to five times per day for up to an hour depending on how the ice feels.
5. I have had to have a bolster under my knees whenever I lie on my back since my spinal surgery. Since I can only lie on my back, I virtually have the pillow under my knees all the time, except when I’m up.
6. My activity level is very low as I was bedridden before the surgery for so long. I would also try to do more if not for the allodynia that makes lying down a hugely painful ordeal. Prior to surgery, “complex pelvic pain” as my specialist labelled it, struck just over four years ago. I’ve been unable to do much of anything since, although I would paddle a lap of our pool each day unable to use my legs much.
7. I was unable to walk far enough to go into shops and the pain prevented me from home duties. I would go out in the car as a passenger for about two hours daily, but had to stay in the car. It was very painful to sit and I was in agony by the time we’d get home. Six months ago it got worse and I was virtually bedridden except for bathroom and pool.
Walking to and from the bathroom, occasionally further - into the dining room or a circuit of the inside of our house maybe about 30 meters at a guess. I did a 60 meter walk a week ago, trying to walk “normally” (i.e. no limp) but it was too much and I was in awful pain for the next three days.
PT comes to my home once per week. He showed me standing exercises but have only done one set which left me in so much pain I stopped - so hardly worth mentioning (I will list if you want?) Two days ago he had me stepping up on a step (with crutches) operated leg first, five reps. I have been too dizzy from the BP drop though to do much the past two days.
I apologise for not being very succinct. It’s very difficult to get the information into short form. My PT did file a report with my surgeon saying I was doing well. He said I am walking better each visit. But the jury is still out as to whether this THR has helped the original “complex pelvic pain”. BP ATM is 113/73 pulse 66 (lying down) which is more normal for me. But am still a bit scared to take the Tramadol slow release.
Thanks for your help.
1. Anterior but included a repair of a full thickness tear of the gluteus medeus tendon.
2. Today I’d say a 7 or 8, but not just hip. This includes back pain and the dreaded allodynia, as well as intestinal pain from meds and anxiety/tension makes all the pain worse.
3. I was originally prescribed:Targin CR (oxycodone HCL/Naloxone) 5/2.5mg twice per day with Endone (oxycodone hcl) 5 mg one four times a day as required and Esomeprazole RBX 20 mg for stomach once per day. This is what they gave me in hospital, as well as the occasional Tramadol 50 mg. However, after coming home for the first two weeks I was developing nervousness and a feeling of hyperactivity, so decided to try Tramadol as I took that after spinal surgery in 2009 and seemed to tolerate it ok. So three days ago I switched to Tramadol Sandoz SR 100mg twice daily with Tramadol Sandoz 50mg when needed and paracetamol 1000mg every six hours. When I first started the Tramadol SR I mistakenly took it every six hours as I didn’t realise it was slow release. My GP straightened that out and said no harm done.
I am also sceptical about continuing the slow release Tramadol because my blood pressure plummeted (around 96/65 for two days) making me feel very faint and nauseous and my nervousness and tension seemed worse after taking it. (Sorry this one is so long, but my meds are a constant source of problems with my nerves, BP, intolerances and intestinal sensitivities.)
4. Yes. I ice my hip at least three to five times per day for up to an hour depending on how the ice feels.
5. I have had to have a bolster under my knees whenever I lie on my back since my spinal surgery. Since I can only lie on my back, I virtually have the pillow under my knees all the time, except when I’m up.
6. My activity level is very low as I was bedridden before the surgery for so long. I would also try to do more if not for the allodynia that makes lying down a hugely painful ordeal. Prior to surgery, “complex pelvic pain” as my specialist labelled it, struck just over four years ago. I’ve been unable to do much of anything since, although I would paddle a lap of our pool each day unable to use my legs much.
7. I was unable to walk far enough to go into shops and the pain prevented me from home duties. I would go out in the car as a passenger for about two hours daily, but had to stay in the car. It was very painful to sit and I was in agony by the time we’d get home. Six months ago it got worse and I was virtually bedridden except for bathroom and pool.
Walking to and from the bathroom, occasionally further - into the dining room or a circuit of the inside of our house maybe about 30 meters at a guess. I did a 60 meter walk a week ago, trying to walk “normally” (i.e. no limp) but it was too much and I was in awful pain for the next three days.
PT comes to my home once per week. He showed me standing exercises but have only done one set which left me in so much pain I stopped - so hardly worth mentioning (I will list if you want?) Two days ago he had me stepping up on a step (with crutches) operated leg first, five reps. I have been too dizzy from the BP drop though to do much the past two days.
I apologise for not being very succinct. It’s very difficult to get the information into short form. My PT did file a report with my surgeon saying I was doing well. He said I am walking better each visit. But the jury is still out as to whether this THR has helped the original “complex pelvic pain”. BP ATM is 113/73 pulse 66 (lying down) which is more normal for me. But am still a bit scared to take the Tramadol slow release.
Thanks for your help.
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