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72 hrs. Post TTS release - like razor blades slashing over incision

Posted by Donna H on 2/28/03 at 01:31 (111120)

I feel less than 100% coherant right now, but can't sleep due to the pain. Using crutches & wheelchair as instructed. I know to expect post surgical pain. But it is sudden slashing feeling in area of incision, several times daily, and each episode lasts from off/on over 10 minutes to app 2 hrs.- also tightness in lower leg, above ankle. Almost like the electrocution of the TTS. I end up screaming, groaning. Don't know 4 sure, but I don't believe there's any drainage or other signs of infection. I thought I was supposed to keep foot elevated; but every time I lay down & elevate, the severe pain/razor blade slashing retns. Surgery was Mon. afternoon-had great deal pain after surgery; was given 5 gms morphine, then demerol, then 10 morphine; then the nurse asks if morphine usually doesn't work. I told her I never had it, so they gave me something else iv,(I wasn't told what) then finally 2 percocet pills. Shortly thereafter pain decreased from 10+ to 8. Currently 750 vicoden every 4 hrs., & the neurontin 600's.
Would appreciate feedback on the symptoms I'm having. Postop appt next Thurs. Is this type pain normal, for post op?

Re: 72 hrs. Post TTS release - like razor blades slashing over incision

Sharon W on 2/28/03 at 07:28 (111131)

Donna,

I am so sorry for your suffering. No, that level of pain (WITH Vicodin on board) is not normal 4 days after surgery. The first thing you need to do is CALL YOUR SURGEON. CALL HIM EVERY DAY, including the weekend, until the pain is under control. Be a 'squeaky wheel,' don't just suffer in silence. Tell him exactly what you just posted here. Tell him you need stronger pain meds and you think something may have gone wrong. That level of pain 4 days after surgery certainly CAN mean infection.

If you were in the hospital and I were your nurse, I would definitely call the doctor about this.

Sharon

Re: PS:

Sharon W on 2/28/03 at 08:07 (111133)

Are you running a fever?

Re: 72 hrs. Post TTS release - like razor blades slashing over incision

Marty on 2/28/03 at 09:43 (111148)

Donna,

I'm so sorry your in so much pain, it can be frightening. I wish there was something I could do.

Are you in a walking cast? If so how tight is it? Does it feel like your foot is jammed down into it around your heel and ankles?
How tight is your wrappings?
What color are your toes?
Do you have a fever?

You need to get in to your doctor asap and have it looked at. I know that this may seem like a daunting task when your in as mush pain as you are.

Marty

Ps. I just had the same surgery and my surgeon warned me and my wife that it was going to be a rough ride for about 4 days. After surgery he again told my wife it was going to get interesting and my wife said he rolled his eyes at her. When I went in for my first checkup monday he asked my how the shocks had been. I told him not to bad, he seemed surprised and told me that it must of been the Neurontin. I'm taking 2400mg a day. It might be to late for you to amp up but ask if this might help.

Hang in there and keep us posted if you can get to your computer.

Re: 72 hrs. Post TTS release - like razor blades slashing over incision

Dr Z on 2/28/03 at 17:21 (111202)

The incision needs to be looked .!!!

Re: 72 hrs. Post TTS release - like razor blades slashing over incision

Ed Davis, DPM on 2/28/03 at 21:35 (111231)

Donna:

You had surgery on last Monday but your post operative appointment is not until next thursday? If I am understanding you correctly, first post operative appointment is 11 days from the surgery and that would be very unusual. Do you have a fever? How soon after surgery did the pain start?
One of the biggest reasons for difficult to control post-operative pain is swelling in excess of what was expected so the bandages which were loose when initially applied have become constrictive. Infection is another thing to be concerned about. Most wound infection start 3 to 4 days after surgery and that is when surgeons generally do the first dressing change -- that is why I asked about the 11 day interval.
Ed

Re: 72 hrs. Post TTS release - like razor blades slashing over incision-Yes Dr Davis

Donna H on 3/02/03 at 14:38 (111441)

I looked @ my post op paperwork again after reading your post to me. It says to 'call office to schedule appointment next week...' Surgery was on Mon. 2/24. So that would definitely correspond with his saying(verbally) to see him in 10 days.
I ended up in ER last nite-couldn't take pain anymore. Of course, not being the surgeon, the ER doc only treated my symptoms. There was some blood on the bandages, but it was probably 1st day post op. ER Doc says 'incision looks clean,' but he said that w/out removing all dressings. I noticed that there IS REDNESS around the incision,even though there is no drainage. Also, altho' ER doc says circulation is good, I believe the swelling is more significant than normal.
I was given injection of 10 mgs morphine & told to contact surgeon to get in Monday, which I will definitely do. I appreciate your response, as everything you said are symptoms I experience, plus you gave me some very good insight into what should be happening post-op and now I can make sure there is appropriate followup and care. Thanks again

Re: 72 hrs. Post TTS release - like razor blades slashing over incision

Donna H on 3/02/03 at 14:43 (111442)

Thanks Dr. Z. I went to ER due to significant pain. They only gave me morphine injection, but told me to make appt w/ surgeon earlier than scheduled. Hopefully I will receive appropriate post op care now.

Re: 72 hrs. Post TTS release - like razor blades slashing over incision

Donna H on 3/02/03 at 14:57 (111444)

No Marty. My TTS was very severe- was diagnosed all the way back in 7/02. But they tried evry available non-surgical tmt 1st. I was being 'electrocuted' in my foot several times a day, in spite of the neurontin, and was frequently limping so badly I could hardly walk. I am now in a wheelchair and using crutches.
So I am not in a walking cast. My splint/wrappings seemed much too tight. I think there must be abnormal swelling. The 1st day and 2nd day were MUCH better than the past few days. So believe me AS SOON AS the surgeons' office opens tomorrow, I will be the 1st patient on the phone! I really appreciate your concern. I am going to get that neurontin increased like you suggested. I have TTS in my other foot & right now, I really think that would help alot. Hope your recovery continues to go well. The best to you. Donna

Re: 72 hrs. Post TTS release - like razor blades slashing over incision

Donna H on 3/02/03 at 15:04 (111445)

Hey Sharon, Sorry it took so long to respond-the past couple days have NOT been fun! I had to go to ER last nite because the pain got really bad, & even vicoden 750 mgs and neurontin 600's were not helping. They gave me morphine injection & I will most definitely be seeing surgeon asap. thanks for your info and concern. Donna

Re: 72 hrs. Post TTS release - like razor blades slashing over incision

wendyn on 3/02/03 at 23:19 (111539)

Donna - had they ruled out anything like RSD before your surgery?