Ibuprofen after THR

Pam:

I'm very much on same regimen as you. The docs want to move you off opioid ASAP. Ibuprofen is excellent. It is also an antinflammatory. Tylenol does nothing for me as well. My doc prescribed a special formulation of ibuprofen called Duexis. It is 800 my combined with a buffering agent for those who have stomach issues with this high dose.

Nothing wrong with taking ibuprofen. But I wouldn't take it along with asprin.

Take care

Apparently Ibuprofen does thin the blood - there is an article on the Medicinenet website about it - so it is much like aspirin, so I can understand the doctors office telling you not to take that in conjunction with aspirin as they may well affect each other.

Graham

Hi Pam. Same here, except I was on hydromorphone, no aspirin but levonox as an anti coagulant to avoid clots. Ibuprofen can compound the thinking of the blood and increase chances for internal bleeding. I tried the Tylenol for 2 weeks and then got some medicinal marijuana, mostly cbd and with the Tylenol it provided relief so I could sleep. Then I started reducing both Tylenol and cbd and after 2 months, I do not need to take anything for pain unless I over do it. Hang in there. I also used topical analgesic like rub 535, heat and ice and massages.

Ask them to prescribe a different anti inflammatory that does not thin the blood. However when i had my op, I was put on blood thinning tablets for 6 weeks but also told i could take Ibruprofen. I am allergic to it so cannot anyway. I ma in the UK however. I was prescribed Oxycodon as i could not take codeine or Tramadol, I was on that for around 3 weeks, however nurses in hospital told me to cut it right down and when early discharge team came in, they said no you need to take it to get on top of the pain. I was probably on one a day by three weeks though and just took paracetamol after that.

Hi Pam

I'm not in a position to advise you, but I can share my experience.

Ibuprofen and aspirin both irritate my stomach, and I believe this is a common side effect

when they are taken repeatedly or over a long period.

I was prescribed co-codamol tablets (30mg codeine:500mg paracetamol) for the first few

days after my op (paracetamol is apparently the same as Tylenol). I then reduced to

8mg: 500 mg cocodamol tablets. I believe the equivalent in the US is Vicodin?

After about 10 days I was able to stop using pain killers completely, but I had to

take blood thinner tablets (apixaban) for another two weeks after that.

The post-op swelling in my hip and leg went down by itself after the first week.

Hope this helps

sjhips

 

Dear Pam

Do you actually still need pain relief?  You may find that the stretch stockings and occasional leg elevation and ice is more than enough.

All the best, Richard

I would not recommend taking both ibuprofen and 325 mg asprin at same time ,,,,will thin blood too much and slow down healing,,,i would take one or the other but not both

 

Extra strength Tylenol works for me for pain....try one of those. I still take it before PT and sometimes to sleep solid and I'm 6 weeks post op. That can be taken with the aspirin.

Sounds tricky to me. I don't like going against doctor's advice. My following account of my progress includes blood thinning meds.  I usually take aspirin but was taken off them because I had to take coumadin for 3 weeks.

Daily  Chronologue:

I am 80 years old and have had 3 stents installed-no heart attack.  My only other hospital problem has been getting a new shoulder-good health otherwise.  I am doing everything I have been told to do.

Posterior procedure.   

I am using coumadin for blood clots. They take my blood twice a week to monitor the level.  Since coumadin I have only taken 3 BP pills out of a possible twenty. MY BP apparently has been driven down by the coumadin.

Have not used pain meds yet

Day 1 & 2: in hospital 

In the following days cited. I have not taken any pain meds yet 

Day 3: Getting home no problem-just followed instructions-now that the hip was done tryng to understand how to organize the house needed changes. Which chair? How many pillows? What to use to get up out of chair? Where to sleep? These would all change as the days went by. I found out what better or worse means. My wife, always my hero, was awesome.

I did the basic therapy for the day and I felt fine. I am walking fine.

That night we got me into our bed which we thought would work well because it is like a hospital bed. The head and foot can be adjusted. No good. (I simply could not use the leg wedge provided in the hospital. It did not work in the hospital as I wound up in the chair every night.) So we decided to use the couch which would keep me on my back. We put some barriers next to the couch.  I slept for three hours and had to get up. Yes, she was there to help.  Anyway it was somewhat of a fitful night.

Day 4:Thanksgiving-The therapist showed up and we went through some extra exercises. I again felt fine.

Sleeping was about the same. I was sleeping during the day sitting up. I used an airplane pillow. I am still feeling only discomfort-not pain. Eating normal. No problem walking.

Day 5: My leg is swelled-the hip and calf about 11/2 /  2 inches larger. We were concerned because no where were we told to expect swelling. So we called the VNA visiting nurse association.A nurse was dispatched. We began icing and raising the leg.. In the meantime I looked on line and found this site which affirmed that some people had swelling-it was a relief. The nurse affirmed it was onl swelling and not a blood clot. Sleeping improved but still somewhat fitful

Day 6: Therapist shows up and we do some exercises and he also affirms swelling is just trauma.

Sleeping still fitful.Walking good. Struggling with swelling.

Day 7: Sunday       Walking well. Icing leg a lot-keeping elevated as much as possible. Doing exercises.

Struggling with swelling.

Day 8: Therapist showed and we do our workout-helpful with ideas and knowledgeable about other folks problems. Struggling with swelling. Sleeping a little better but still getting up a few times at night. Sleeping during the day a lot.

Nurse took blood.

Day 9: Therapist showed. Walking getting better-went outside for a walk. Still no real pain just limping along.

While I still got up two times I slept much better-a good 8 hours.  Still struggling with swelling but I am winning. This morn I was able to jog my leg off the couch while sitting up.

I have decided to do this chronologue because It might help. I will be glad to answer specific questions. I will do a complete update every few days.

Doctor office called and doubled my coumadin dose.

Day 10:  Still not taking any pain meds or other OTC stuff.  Therapist showed.  Total walking inside and outside for day about ½ hour.  Still struggling with swelling and winning but I am forgetting about the swelling at the top of the hip above my butt. I have to ice that once a week. It seems.  While I feel more power in my leg I still can only lift it about 15-20 degrees above the floor while sitting. I was quite tired at the end of the day. 

Day 11.  Sleep was not great.  Started the day dong ankle pumps, knee presses and hip squeezes before getting up.  I also iced the calf and hip area before rising.  No therapist today. I did exercises and then walked our circle outside my house.  I skipped the BP pillls again because my numbers were in line. Later in the day I did the exercises again and also walked the circle two more times.  Total walking for the day about 25 mins.  

It appears that I now have a very sore op side butt. When I sit it hurts. I get up a lot and put a pillow on the side that does not hurt to ease the pressure.  I am lying down now when icing. It is easier on my buttock. 

At this point I cannot imagine I will have to use pain meds. But I have not eliminated the possibility.  

Doctor called and increased my intake of coumadin again. He wants my blood to show a certain level.

Day 12:  Slept well-only got up once. Did icing and exercises before rising. Completed standup exercises. Went for a walk on our circle. Later walked again on circle.  Then still later did icing lying down and exercises. Again completed standup exercises. Later took a walk on circle.  I wanted to go again but decided to wait another day. Did more icing lying down.  Practiced quite a bit walking around house with cane staying close to things I could grab with free hand.  Did icing and exercises before going to sleep.

Day 13: Sunday.  Slept well-up twice.  Still sleeping only on back-not easy.  Very similar to Day 11.  My op butt is not hurting today. I am still getting up often. Swelling there but not bad. Therapist put me through exercises. 

Day 14: Slept well on back-up once.  Similar to Day 13. No therapist.

Day 15: Slept on back-ok not great.  Icing and exercises before rising. Able to get out of bed by maneuvering my op foot.  Therapist put me though entire exercises and added another where I move my op foot to the rear while standing. Marching exercise is getting better with a higher step. Walked circle 4x. And leg did not feel very much discomfort. Butt is not hurting very much.  Practiced walking with cane and also on my own for short distances.  Kept up icing and did the final icing while laying down ready to sleep.

Day 16: Slept on back-sleep ok Visited Doctor -xrays look good. Stopped iron and vit C pills.  Coumadin untill next Tuesday.

Similar day as before.  But seeing a vast improvement in leg mobility. I can get leg into and out of bed without much effort. Swelling still there but getting more under control. Still practicing with a cane. I am also walking, albeit with a gimp, without anything, but only short distances and again able to grab on if necessary.   Have to be very careful turning.  Getting up and down on chair without any extra effort. Legs showing strength.

Day 17: Tried to sleep with pillow on non op side-fuhgeddaboudit. Still cannot sleep on op side because it feels bulky and uncomfortable-no pain. Any ideas on sleeping would be welcome.

I walk around the house without a cane or walker. I am doing 4 or 5 trips around our circle using only a cane. I need someone with me because I have a tendency to lean left at certain times, My op is on the right leg. I no longer have a bandage and can shower with no problem. Iam just supposed tolet water run over the wound. The wound was glued so there are no stitches or staples.

Day 18: Still sleeping on back. Still icing for swelling. Walking without aid around house with a shuffle and a gimp.. Day  similar to Day 17.  Went to a restaurant for my 80th B’day. I start outpatient therapy on Monday.  The idea is to strengthen  and stabilize my leg. I will go 3x per week-perhaps for 4 weeks. As long as my insurance pays for it no problem. Nevertheless I may go less because of Christmas and New Year. Life goes on.

Day 19: Still sleeping on back. Swelling has reduced a lot-foot swelling the most.  Walked outside with cane but did not need it-using it as a precaution. I can now get up and down with a lot less effort. I still feel stiffness around my knee and calf. My blood pressure which had been lowered by using Coumadin for blood clots has gone back up again and I am using BP meds again based on BP readings

Good luck>