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Harm Reduction Pain Management - In need of a hip replacement

sworddish

Greenlighter
Joined
Aug 3, 2016
Messages
1
Hi all,

I'm a 24 year old male who has had type 1 diabetes from the age of 6 and USED to love sport & the outdoors (although i keep a healthy lifestyle). To my knowledge myself and no one in my suffers from any mental illness.

5 years ago through a rock climbing accident i tore large amounts of cartilage in my left hip and both knees.

From my hip i had about 40% of total cartilage removed, the femur had a bone chip smoothed over. My knees were not too bad but had about 15-25% cartilage removed. From the MRI's that were performed prior to surgery this was expected. The surgeon and other specialists advised that i was on the cusp of needing a hip replacement but recommended i wait to see how the surgery went as it's a large operation and as im so young (comparatively to the demographic usually needing hip replacements) and would impact me. I agreed with this.

After surgery i felt like a new man. it was amazing, I walked to the bathroom(albeit carefully) and there was no longer any pain. The pain free period lasted about 1 year as the injuries started re-surface. It is now very painful,with every step i getting stabbing pains up and down the left side of my body. Nerves continually get caught and ground between the joint which is agonising. A good gym/yoga/reformer pilates regime has had the pain to a fairly manageable level but is starting to get worse and worse again.

Over the last 2 years i've been through a whole range of drugs listed below, trying to dull and manage the pain. I really don't enjoy the opiates - Yes they help with the pain but feel "dopey" and blocked up, the NSAID's are not good for long term use. For a few months i would have considered myself dependant on the opiates, not really being able to manage without them. I finally stopped abusing the opiates. These days i just take Neurofen Plus & Panadeine Extra (seperately) throughout the day, following the maximum recommended dosages. Every couple of weeks i go without and opiates for a few days to prove to myself i can, and don't have any trouble doing so.

Panadeine Forte
Tramadol
Endone
Oxycontin SR
Endep
Voltaren 50's
Naproxen SR1000

A few weeks ago i went to my GP and had a good conversation with her. She is aware of all the drugs for pain management i've been prescribed as well as my medical history as she has been my GP since i've been a baby. The drug Lyrica came up and i thought that it couldn't hurt trying as there aren't any (that i'm aware of) downsides, unlike the semi serious opiates, NSAID's and generous amounts of paracetamol and ibuprofen i was taking. I was prescribed 150mg (2 x 75mg tablets) to be taken before bed.

Wow, What a drug! within a few weeks pain had decreased massively, movement wasn't restricted as much, i wasn't taking pain killers and if i was it was without the codeine. The only downside is it makes me ridiculously drowsy/groggy from about 6AM till 1-2PM and it's getting harder and harder. My body feels like it's not getting enough sleep even though it is. It is starting to negatively impact my ability to work and socialise.

From the research i've done, long term use of Lyrica is far healthier than any previous drugs i was using for pain management but i don't think i will be able to continue like a zombie for half a day for much longer. From my understanding Lyrica isn't a "depressant" as such and i was wondering has anyone doctors prescribed stimulants to counteract this. I was speaking with my pharmacist this evening and had this similar conversation and the only thing she could think of was through the use Modafinil after suggesting numerous red bulls and no doze tablets (GREAT Idea with someone with Type 1 Diabetes!!!). I'm of the opinion that my GP should weigh up the pro's and con's of prolonged pain management with opiates/NSAID/paracetamol/ibuprofen V.S. Lyrica and a stimulant (or any other similar drugs).

Has anyone had any other positive experiences with combing Lyrica and a stimulant, purely at prescribed doses as i don't want to screw around with something that has the potential to help me immeasurably. I really don't want to come across to my GP as just trying to score some sweet stimulants. Has anyone got any advice or possible alternatives that i could explore with my GP as if i show that i'm open to other avenues of treatment, which i am.

Any experience or guidance would be appreciated.

Regards,

Scotty
 
Last edited:
Wow, never would have thought my PhD in osteoarthritis research would be of any use here! :)

In that regard, I can't really advise you on what meds to take or not. However I do know a thing or two about joint replacement surgeries. I understand why your surgeons would advise on waiting with it, not merely since it can be quite a serious operation. On the other hand, these days they do work really, really well. Apart from undergoing the surgery, the only downside presently is the fact that after 15 to 25 years (there is a lot of variation across the elderly population) the implants can start getting loose and revision surgery is consequently required. You, however, are still young and probably do not suffer from degenerating bone tissue.

So I guess it is whether you would want to take meds for a long time with the potential consequences of that, or give the hip surgery a go..
 
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