Thursday, June 2, 2011

Pain Management and Healing: Part II

After the abysmal failure of oxycontin and endone, a solution of ibuprofen and panadeine forte was suggested (all at the highest possible daily doses).  I was a little scared of the ibuprofen as some of the nurses had gone on about it upsetting my stomach again.  I was already on maxalon to stop vomiting and I didn't want anything that could start that again.  I asked the doctor if I could take the Voltaren again instead.  One said yes, one said that the Voltaren was more harsh on the stomach.  The reason that I had asked is that I new that I didn't have any adverse affects to it and while I was still in a paranoid sick state, I really didn't want to take any more risks.  In the end I tried it and it was ok.  I was still on the maxalon for a while as I still had nausea problems when I ate (though that very well could have been a problem with hospital food - not actually meds or illness).  Together the ibruprofen and panadeine worked out and there weren't any further adverse reactions.

There was some other drug that I could try if this didn't work out though from what I can gather the back up plan wasn't a favourable one.  In the beginning as I got closer to the times when I was due to have medication, I would wait on it.  I knew when it was due as the discomfort was increasing.  I never waited so long that it was unbearable, though there was one day when they were just over an hour late and I was stuck in a chair in my room when I really was ready to press the buzzer again almost at the point where I thought I couldn't handle it anymore.  I still wouldn't say that the pain was high on the pain scale, maybe a five, but I was exhausted and I felt like I didn't have the strength to hold my body up any more and everything was uncomfortable and I wanted to move but I couldn't.    I had learnt the hard way that the doctors were right, staying on top of the meds at that point was important to my rehabilitation.  There was no way that I was doing anything that afternoon for at least three or four hours while I rested and got on top of things again.  Normally I would have done another set of my physio exercises.

In the last week or so we started to cut down the amount of codeine that I was having, so the panadeine forte was changed to panamax and codeine tablets.  I didn't notice a huge difference.  During a big rehab day, I'd say I was more aware of the joints but overall I wouldn't say that the pain had increased.  There certainly wasn't any sharp pain anymore, just occasionally a dull ache which was only a one or two on the pain scale and significantly less than what I was used to pre-op.  I had started to be able to stretch some of the muscles a little and as my overall wellbeing improved, my confidence in my body also started to improve.  I think that this was the turning point for getting results as I was less tentative in trying to trigger point tight areas (obviously within reason - I wasn't digging into the wound just yet) and moving more (within the range of restriction).  As muscles loosened, I felt that I could do more and it felt like the joint was moving more freely and with more control.  Exercises like heel slides on the left and abduction were still difficult to start off but I could do a lot more without assistance and I could now visibly see some definite results.   The more I could do, the better my body felt.

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