Two Weeks Post-Surgery: Pain & Medication

My pain is generally well-managed but there is a lot of it still lurking below the painkiller block. When the pain does break through, it has usually moved to one or another of its favorite places to surface -- sometimes over the incision, sometimes on the outside of my hip, sometimes deep within the joint, sometimes at the top of my iliac crest (where I think there is a screw head), sometimes in the back of my hip joint (deep inside behind the bottom of my right buttock), sometimes shooting itself like a racing stripe down the outside of my thigh, knee and calf.

There is still a numb spot about the size of my hand on the outside of my thigh, right below where the greater trochanter of the femur sticks out to form the widest part of the hip. The numb spot is normal; Dr. Millis said they have to move a significant nerve aside when they are doing the surgery, and this causes some damage to the nerve that gradually repairs itself over a few months. But there will be a steadily receding numb spot there until the nerve has completely healed.

My incision is usually the least of my problems. It is not generally tender, but it itches sometimes under the dressing, and as I mentioned above, it does sometimes hurt. We changed the dressing two days ago, so I saw the scar (through the steri-strips, which means I didn't see much). Not much to report until I really see it when the dressing and the steri-strips come off. The dressing is set to come off this Thursday.

There does not seem to be much swelling at all in the hip area or the leg on my operated side. I am not even sure there was that much swelling in the hospital.

My current pain medication regimen is:

-- 1 Oxycodone every 5 hours during the day
-- 1 Oxycontin twice daily
-- 1 Valium at bedtime
-- 1 Valium kept at bedside if needed for pain during the night

Some PAO bloggers I have read have been on less medication (or less frequent dosing) by this point in their recoveries, so I'm not sure why I'm still needing such high or frequent amounts of pain medication. I have, on occasion of missing a dose or taking a dose too late, had breakthrough pain, and it is not at all tolerable -- about a 5 on my pain scale if I let it get too far. Since leaving the hospital I have stepped down to one Oxycodone every five hours instead of two every four hours, and have switched to taking Valium at nights instead of Oxycodone.

Unlike others, however, I don't find the painkillers make me feel mentally foggy in the slightest. Only Valium makes me a bit scatterbrained and sleepy, which is why I take it at nights now and leave the Oxys for the daytime. But on the current regimen I have been reading varied, mentally stimulating books and magazines, playing (and winning) fierce games of Trivial Pursuit and staying generally awake and alert all day, save an afternoon nap. So I'm in no rush to get off the pain killers for any philosophical or mental acuity reasons, I just find it interesting that others have weaned off them tolerably so much more quickly than I seem to be doing.

Of course, one must consider that my surgery took seven hours rather than the four and a half hours Dr. Millis had originally predicted, and my bones were, according to him, incredibly strong and difficult to cut. I have five screws rather than the usual number of three most often used in these operations. Also, I came out of surgery with an elbow injury on top of the hip situation (and then there was the heat rash!), so maybe my body's healing department has had a lot a lot of balls in the air and that is why my pain has been persisting longer than that of my PAO peers. Or maybe everyone is different in their healing and it is what it is.

Speaking of heat rash, I've been applying the prescription rash cream twice daily since I left the hospital. The dragonhide that formed after the fiery welts I had in the hospital has completely flaked off by now and the marks of the rash are reportedly looking much better and almost dissipated.

The itchy-red-spots problem (which apparently is a side-effect of the pain medications, although I have not read of similar reactions among any of my PAO peers) persists, but seems to have been lessening steadily. For that I try (usually unsuccessfully) not to scratch at the spots and I apply Gold Bond lotion twice daily. Mostly it feels like I have a mild but chronic case of chicken pox.

I am also still taking the Atarax pills (twice daily) that I was taking when I left the hospital for the itching/spots. I think I will reduce the Atarax as the pain medications are reduced.

I was never given Lovenox or even Coumadin at the hospital, just aspirin, so I keep taking that once daily to keep my blood thin and clot-free as I'm healing. I stopped wearing my TED stockings after a few days at home. Even in the hospital they weren't very tight and didn't seem to be doing anything that a pair of drug-store knee-highs couldn't do. Plus, no one told me I had to wear them when I got home.