One week post surgery, excruciating pain - what's normal?

So sorry to hear you had to go through so much. 

I cannot answer about movement in your little toe, as this didn't happen with me, but all of the rest of your symptoms seem to be pretty much the normal. 

Of course any worries or concerns are best taken up with your doctors.

Pins and needles and the blood rush your experiencing when standing will eventually improve as time passes. 

Good luck and a speedy recovery.

Hi Natasha,

Sorry to hear about all the pain and suffering you been through!

I am 2 weeks post-op , not much pain ... taking only couple of Tylenols for night time. First two days ater the trama were the worst for me, I was waiting for the surgery in a splint and could not move without pain...after they put a plate and screws pain settled in two days.

I am a nurse myself, so I was working on pain management or some time...In my opinion what your describe is too much pain considering my personal experience and what other people describe here. Possible reasons? Cast too tight due to swelling? I loosened my cast myself a bit on a second day post-op, it helped a lot, but you should go back to the doctor for this, I think better to be on a safe side. If I would be you, I would go to the doctor on Monday to check that cast. If you pain will increase tonight, I would even go to Emergency to adjust it in case you are having a progressive swelling, that actually a dangerous condition with a cast...In case the cast is okay, but still severe pain that might be you own body individual response to trauma. Everybody's pain threshold is different, there are no even reasons or rules why some people having it in a worse way then others....Narcotics don't work or many people and I am one of them. Found Tylenol more effective to my suprise. Keep your doctor posted about you pain, don't be shy...first of all it is doctor's job to keep you comfortable, secondly pain can be a sign (I hope not) that something went wrong with the surgery.

Hope this can help. Good luck!

Hi Natasha

I was in the same pain as you.

I complained in hospital every night. I was screaming for pain meds. It took nurses 5 days to get doctor to see me and increase/change meds.(morning rounds doctors never stayed long enough to speak to!).

I was released after 7 days and the pain and numbness in toes continued.

I finally went to emergency at private hospital (I'm in Australia, have full private health cover but wasn't admitted so had to pay $800 out of pocket instead of $250 if admitted).

The doctor was amazing. Removed the cast and said it had been cutting off circulation to my toes. I had ultra sound to make sure I didn't have any clots. New cast put on.

It wasn't cheap but so worth every cent.

Trust yourself, and get back to hospital to see someone asap.

I agree with all the comments here.  If the cast is too tight from swelling, it's best to keep it elevated above the heart and iced.  Is there a way to have the cast loosened before Monday, ER or Urgent Care?  Narcotics didn't help me for pain.  I only used Tylenol, however my pain was not bad after 2 days.  I would have pain in the evening after swelling and then in the morning in would be better.  You may have more serious breaks than I  had, so I'm not diminishing the pain you are experiencing. Numbness and pain could be due to the cast being too tight.  

Hi Natasha

I was in so much pain I could have ended my life. Far worse than child birth and all I could think was how did they go on many years ago ?? I called for pain relief all the time in hospital. I was in there 4 days. The good point is I was sent home with plenty of tramadol and for a few weeks all I did was sleep. I either sat in a chair or I was in bed. It was that bad. I couldn't have possibly have gone out. I had an ambulance pick me up to take me to the fracture clinic to be assessed. You say you shattered your ankle as I did. Yes you will be in a lot of pain for a while, but remember you can always go back and see them about it. 🙂

I had a half cast after a similar operation to you but the dislocation was corrected on admission in A&E with strong pain relief.  The half cast allowed the swelling to go up and down so was comfortable.  A full cast was put on after 2 weeks at my local hospital and left on a month to allow the bones to heal.  As described by others the blood rush pain and the oher symptoms seem to be normal.

I did experience once not being allowed pain relief one night being told I had had my quota for the 24 hours. It was awful and when I complained at the next nurse shift I was put out of my agony.  Why the medics don't give pain relief when needed is beyond my understanding.  They wouldn't allow their pet animals to suffer in such a way.  I hope you get your problem sorted very soon.

Dear Natasha,

I feel your pain!!

Although in my case I broke 3 bones tib, fib, and malleous I also dislocated my foot at the same time with a twisting fall.  I had plates and screws inserted to repair the damage.    The fact that you describe the fib as shattered highlights the complexity of the fracture and the fact that a woman wrenched your foot at right angles suggests to me that you dislocated something as well.

Your hospital stay sounds very similar to mine also. I had 6 days waiting for the swelling to go down sufficiently to perform the internal fixation (ORIF). Fortunately I had the dislocation manipulated the night of the injury under twilight anaesthesia and was assured by staff that the pain would diminish greatly once this was done.  I came to after the manipulation with a back slab on the ankle but remained in constant severe pain for the 6 days prior to the surgery.  My surgeon ordered heaps of pain relief including tramadol, Endone, oxycodiene, in varying doses prior to surgery and I believed that once the surgery was done I would be dealing with normal post op pain.  To my shock I woke from the surgery in pain that wasn't relieved at all from even high doses of IV Fentanyl.  Staff would ask my level of pain 4 th hourly and tell me how important it was to get on top of the pain through adequate pain relief then tell me I shouldn't need the amount of pain relief I was requesting!  In the end they convinced me that I couldn't be having so much pain, I must be amplifying it in my head.  I went home 7 days post surgery in  extreme pain and soon realised it was genuine not amplified pain and in desperation had an after hours home visit from mobile Doctor Service who ordered slow release oxycodiene.  Still not out of pain 2 days later I contacted my General  Practitioner who doubled the dose!  All this did was drop my blood pressure dramatically and cause me diarrhoea and vomiting.

The reason I am telling you all this is that what you describe of your injury it sounds like you have NERVE damage!  Nerve pain will not be relieved by just opiod, narcotic,  or traditional pain medications. 

From my research you could have damaged the nerve in the shattering of your fibular in the original injury, the nerve could have been damaged by too tight a cast,  the manipulation of your foot to re align your ankle could have damaged the nerve or the surgeon may have damaged the nerve at the time of surgery!  

Two weeks after my surgery i had the had the cast removed and was given the choice of having a cast applied for six weeks or going into a camboot for six weeks.  Thank god I decided on the Camboot as I was allowed to take it off to sleep and only had to put it on to do transfers.  If I had had a cast applied for those 6 weeks I think I would have ended up chewing it off with my teeth lol as I am now 14 weeks post surgery and still cannot tollerate anything applying pressure to the top of my foot or toes.   The strange part is that although the top of my foot from the toes up to mid calf is numb underneath the numbness all the burning, tingling, pins and needles goes on.  I was 8 weeks post op before my GP diagnosed the pain as nerve pain and started me on Lyrica (pregamalin) for the nerve pain and Palexia (tapanadol) for generalised pain that I have weaned down now at 14 weeks for overnight as that is when the pain is worse.  The physiotherapist I see said the symptoms I describe are typical nerve pain and that it is only treated by medication and time for the nerves to repair themselves which can take months to years!

What ever you do Natasha find out as soon as you can whether it is nerve damage and get it treated as such from the start.  I only wish I had!  I got so depressed and ashamed of myself in those early days that I was being such a sook when in reality my pain was very genuine and real!  Hopefully your pain resolves quickly and your recovery is straight forward but if not keep complaining until you get a firm diagnosis and targeted treatment. 

Keep the the forum informed of your progress as you will find participants very caring and supportive iat all stages of recovery.      

 

    I am so sorry for all of your pain and suffering. These horrible stories: We The People continue to endure; suffering from pain in an American Hospital is unbeliveable. Their is absolutely no reason that any citizen should have to suffer in pain especially when they have just come from an horrific trauma, "Like an Automobile Accident". 

    1987 an uninsured driver t-boned the car I was driving with my 10 month old baby girl (buckled in carseat) and my four yr old daughter sitting next to the baby. I am very lucky we all survived, but with severe suffering, almost losing my four yr old, I suffered severe internal injuries, crushed pelvis, traction, surgery, broken neck, ribs, lungs, jaw, tailbone. Seperated from both my girls for at least four months. It was a nightmare. But thank god I was never to suffer in pain and was able to recover with no painful experiences.

    2012, I am a passenger on a motorcycle (no helmet) and an uninsured driver pulls out in front causing us to crash. Mind you, I am now almost 50 with arthritis from previous injuries and a plate in my pelvis, when I arrive at another emergency hospital again. But this time: My Pain was Never Alleviated! My ankle was shattered, the same side as my pelvis was, and my head was split open (I tucked and rolled hitting my head over 10 times). 

    Immediately the on-call surgeon gave me very bad vibes crying throughout xrays in severe pain, suffering from 38 incorrect staples being put into my head, again sheer pain, then having a wire brush taken to my elbows and knees scraping the pavement in severe pain. My pain became so bad I started hallusinating, asking about my little girls; thinking I was back in my first accident. The next morning I was prepped for surgery while my head continued bleeding through the staples; clearly seeing an open gash in my head. After sugery, the surgeon woke me, demanding that I tell him why my red blood count was so low, for that I was below "5" and their was no way I could of lost that much blood in surgery. I explained I had to have blood transfusion from first accident when that surgeon thought the same thing. Regardless, he would not give me a blood transfusion, made me take pain shots every four hours after surgery, then released me the following morning.

   My point, I am still sick. In fact, I now have a pituitary tumor, hypokalemia, weight gaining, nasea with vomiting, vertigo, extreme fatigue, doctor's gave me hard time signing my PIP benefits but they finially did and now my insurance company won't pay. I am losing my home, I have had to have another surgery on my ankle. Their is a large deep gash into my head from the staples not being done correctly, and I am just exhausted with pain. Doctors say I have PTSD. I say: Did I get PTSD from having intense continued pain for over three years now? Granted, my pain is finally started to allieviate, but I can't get over how badly I was treated and how badly I suffered. Put it this way; when I asked the surgeon to sign my PIP benefits: he said it was people like me who make our insurance rates so high. And then he added, perhaps if I had broke both ankles my friends and family would deserve payment for their care, but since I had only broke one ankle (not too mention my head injury) that my friends and family are suppose to care for my nursing needs for free because: That is the Christian Thing To do.

   I was shocked. Somehow I looked up at him with raccoon eyes, bruising behing my ears, a hole in my spinning head, unfocused eyes with eyes ringing like a sob and said, "I guess my seven hour pelvis surgery that has a plate holding me together for life means nothing, or the neck I busted, or my jaw that had to have braces put back on, or my busted ribs with in infected lung collapsing wasn't enough? I needed to break both ankles too?

    I cannot believe that twice in my lifetime I have been severely injured from the negligence of others and I have lost everything. In two months I must put my dog down and go live at a homeless shelter. That is the God's Christian truth. I now wish I would of asked that surgeon, "Did you put my ankle back together for free"? "That is the Christian thing to do"! Even though I had to have a corrected surgery fixing it! Sincerely,

 

Hi Natasha. If I were you I would get back to a doctor ASAP. sounds like nerve damage or a cast too tight. I never had a full cast after orif surgery just a back slab as I am very claustrophobic and can't handle anything that feels as if it is restricting me. I was very thankful for this as it helped a lot when my ankle was swollen. Keep your leg elevated all the time and also keep the room you are in as cool as possible. I have a aircon. in my bedroom and I kept the temperature so cold it felt like winter, but it help with the swelling. Another thing I would have checked is that you don't have blood clots. Also they normally put staples in to close the wounds after surgery and something pressing on them will be very painful, once mine were removed I felt a lot better. Get help soon and a speedy recovery. X

I'm not sure of anything but one thing - post screws and plates was the worst pain I have ever been in. Worst of it was three or four days post surgery.

Thanks everyone for your messages!! Julie your story made me cringe in pain just reading it. I'm so sorry and hope things improve for you.

I feel like maybe some of my pain is normal and some is not. Saturday night I woke up in the night feeling like my leg was suffocating. They had already pre-cut the sides so I pried one side open about 0.5cm and felt instant relief. I noticed also when I stand up now the pins and needles are worse and my toes turn purple. So I am back in a&e waiting to see someone. I will write an update later.

Sorry I didn't get to reply individually to everyone. I read them all and am so appreciative to have had so many varied responses.

Talk soon!