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Advice please re pain.
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07/09/2013 15:41
Kags 
07/09/2013 15:41
Kags 
Advice please re pain.

Hi

This is my first post as I have only just found this site.

As a bit of background, I am a type 1 diabetic female and my nodules started before I was 40 - both hands are affected and although ring finger and small finger are the worst hit, I have cords between thumb and forefinger and nodules on the middle finger.

13 years on, I have tried needle therapy 4 or 5 times with some small success however, my contracture became problematical on my left (dominant) hand so I agreed to surgery to remove the cords. This I had done 3 weeks ago under GA here in France at a specialist hand/plastics hospital. The hand was opened with a zigzag incision, stitches out after 2 weeks and yesterday the dead skin and scabs were removed to reveal the healing skin, my extensions are good and I have my exercises to regain the ability to make a fist - so all good so far.

However, the thing that has surprised is the pain, especially as I have a fair pain threshold (being female ). I was given Tramadol when I came out of hospital but stopped taking it during the day as it made me light-headed and nauseous. I took it of an evening as the pain during the night kept me awake but was worried I'd get addicted, so I stopped and now spend all night climbing the wall not knowing what to do with myself. Paracetamol and anti-inflamms don't touch it but I haven't been taking them regular, cold packs help - so my question is.....any advice please?

07/09/2013 19:49
spanishbuddha 

Administrator

07/09/2013 19:49
spanishbuddha 

Administrator

Re: Advice please re pain.

Welcome kags

Good to hear there is possibly some success with the extension, but sorry to hear about the pain. There is always a risk of some pain after surgery, especially in something like the hands which are rich in nerves. There is also a risk with Dupuytren's surgery of having 'complex regional pain syndrome'.

I would start with your surgeon. What does he/she advise. You could ask for a referral to a pain clinic or specialist as they can usually make accurate diagnosis and suggest different treatment for managing pain.

Maybe others who have experienced this will offer further suggestions.

SB

07/29/2013 22:46
bstenman 
07/29/2013 22:46
bstenman 
Re: Advice please re pain.

Doctors as a whole underproscribe pain killers. Surgeons can be the worst as they do not as a rule deal with a patient of theirs after the surgery but send them off to a physical therapist. I had a neighbor who was head of the Walter Reed military hospital's surgery staff and he told me that pain would actually slow the healing process and that I should take as much in the way of pain killers as I needed.

Drug addicts do not benefit from the level of narcotics proscribed in a hospital setting. Some drugs are more addictive than others but some of this is behavioral as well. Some people cannot stop smoking to save their lives and others simply stop one day and move on.

Sleep deprivation is a favorite form of torture by the US government and it certainly does you no good to not be able to sleep from the pain you are experiencing. Taking pain meds it is important to take them before you feel the pain which also minimizes the dosage required overall.

I have had some meds that have made me drowsy and others that resulted in severe diarrhea. I avoid those pain medications and find that the generic Vicodin pain killers work fine. If someone is going to be taking pain meds for months then more research is needed but your hands have been traumatized by the surgery and so pain is to be expected until they fully heal.

One caveat is that with the pain masked one might overuse their hands and cause damage that would delay their healing. Important to keep that in mind.

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traumatized   contracture   deprivation   surgery   behavioral   extensions   underproscribe   specialist   experiencing   government   experienced   hospital   suggestions   light-headed   important   especially   anti-inflamms   Paracetamol   problematical   medications