Multimodal pain management sucks

[Psynaught]

So I just had full shoulder replacement a little bit more than 3 days ago. I was optimistic because I was getting the new high tech pain management program that use Jornavx and Gabopentin thus reducing the need for opioids. I only got Tylenol 3's and Hydrocodone with Tylenol.

I had full facial reconstruction years ago (from an MMA match) and a previous shoulder surgery. For those I got the old school Vicodin Oxy combo. Maybe it is because I am older and take lots of other meds (never took a thing when I was younger) but this has been the worst recovery ever.

I have had more pain, am sick as a dog/nauseated, and massively constipated. I need protein for recovery but ave been struggling to eat. I probably have taken more opioids this time (Vicodin/Tylenol 3's) than I did before, but I feel way, way worse. The opioids are making me sick this time, maybe because I am taking so much Tylenol. Hopefully in a few days I can stop taking everything

 

[Rectify]

You Really Need To Get Sone Amphetamines.

 

[Keif' Richards]

Hey @Psynaught how do you feel about turning this into a Blog? I think a lot of other people would benefit from hearing your experience. I´m talking to another BL´er right now as a matter of fact who has a lot of apprehension/anxiety regarding surgery. I think it would be cool. You might want to flesh it out a bit more, but we would all love to hear your story. There are a lot of people afraid regarding the ¨what ifs¨ of surgery. Are they going to be medicated appropriately? That sort of thing.

Let me know if you don´t already know how to make a blog.

 

[WellTram]

Multimodal pain management is actually very good. I don't know if u take any serotonergic meds but instead of acetaminophen ( this is cns multimodal analgetic agent actually ) they should give you
1, tylenol + tramadol ( opioid, endogenous opioid, monoamines, cannabinoid receptors and other effects which reduce pain intensity ).
2, Pure tramadol so u can but don't have to use tylenol ( I understand u feel sick from acetaminophen, it should be used only as an optional add-on painkiller not as something u have to take all the time.
3, Dihydrocodeine sustained release - take as much as u require. Simple and effective opioid which can be combined with some tramadol for that monoaminergic pain relief - it really works. Gabapentin was useless for my pain they should provide you with pregabaline.
Also, tizanidine which is muscle relaxation medication is in fact wonderful painkiller and it helps with falling asleep.

In your situation, try to use tylenol+opioid pills after food or just take less and add some nsaid - according to the new research nsaids combined with acetaminophen are more effective than acetaminophen with codeine. For some reason codeine at 60mg was weaker than 400mg ibuprofen ( tylenol 500 + 60 codeine reduced pain less than tylenol plus ibuprofen.
But this may be problem only with codeine because other opiates/opioids including tramadol and low - medium dose of hydrocodone still provided better relief.

Try to take dextrometorfan 60mg with your pain medication - this will provide much better pain relief.

 

[Psynaught]

Multimodal pain management is actually very good. I don't know if u take any serotonergic meds but instead of acetaminophen ( this is cns multimodal analgetic agent actually ) they should give you
1, tylenol + tramadol ( opioid, endogenous opioid, monoamines, cannabinoid receptors and other effects which reduce pain intensity ).
2, Pure tramadol so u can but don't have to use tylenol ( I understand u feel sick from acetaminophen, it should be used only as an optional add-on painkiller not as something u have to take all the time.
3, Dihydrocodeine sustained release - take as much as u require. Simple and effective opioid which can be combined with some tramadol for that monoaminergic pain relief - it really works. Gabapentin was useless for my pain they should provide you with pregabaline.
Also, tizanidine which is muscle relaxation medication is in fact wonderful painkiller and it helps with falling asleep.

In your situation, try to use tylenol+opioid pills after food or just take less and add some nsaid - according to the new research nsaids combined with acetaminophen are more effective than acetaminophen with codeine. For some reason codeine at 60mg was weaker than 400mg ibuprofen ( tylenol 500 + 60 codeine reduced pain less than tylenol plus ibuprofen.
But this may be problem only with codeine because other opiates/opioids including tramadol and low - medium dose of hydrocodone still provided better relief.

Try to take dextrometorfan 60mg with your pain medication - this will provide much better pain relief.

I actually have some Tramadol, its 3-4 years old. I took one Vicodin earlier, I think one Tylenol 3 and a Tylenol 500 today in total. I will take the Tramadol in a couple of hours, thanks.

I can tell you with certainty that I did better on the old school combo of Vicodin and Oxy. I did not even need to take that much Oxy. I did take some Oxy at the end of the day/at night, but by then I was already sick as a dog/nauseated. Honestly, at this point I would prefer to take nothing at all, but the shoulder pain is still pretty severe.

 

[Psynaught]

Hey @Psynaught how do you feel about turning this into a Blog? I think a lot of other people would benefit from hearing your experience. I´m talking to another BL´er right now as a matter of fact who has a lot of apprehension/anxiety regarding surgery. I think it would be cool. You might want to flesh it out a bit more, but we would all love to hear your story. There are a lot of people afraid regarding the ¨what ifs¨ of surgery. Are they going to be medicated appropriately? That sort of thing.

Let me know if you don´t already know how to make a blog.

Sure. This is a great forum. Typing is a bit painful so my responses are limited. I have had a shoulder surgery before, full facial reconstruction to the left side of my face. However this has been the worst recovery of all. A lot of pain, nausea, and a terrible constipation problem. I finally was able to go after using enimas.

My only concern is my experience might prevent others from getting shoulder replacement, although I am pretty sure that in the long run it will be worth it.

 

[WellTram]

I actually have some Tramadol, its 3-4 years old. I took one Vicodin earlier, I think one Tylenol 3 and a Tylenol 500 today in total. I will take the Tramadol in a couple of hours, thanks.

I can tell you with certainty that I did better on the old school combo of Vicodin and Oxy. I did not even need to take that much Oxy. I did take some Oxy at the end of the day/at night, but by then I was already sick as a dog/nauseated. Honestly, at this point I would prefer to take nothing at all, but the shoulder pain is still pretty severe.

I know, shoulder pain is very unpleasant. Just use your meds ( acetaminophen, codeine and vicodin ) and if necessary add that tramadol but maybe try dextrometorfan if u can get it. Not big doses, it will potentiate your painkillers without additional mu-opioid effect so your tolerance to opioids won't grow it's even possible that dxm as an nmda antagonist will reverse your tolerance a little bit. And NSAID skin patch or topical formulation would also help a lot. Well, u can just eat nsaid pills and it will work but they can definitelly damage your stomach. But taking one with your tylenol at the time when your pain is at its peak should be ok.
If u try something let us know what helped you.