Limb Lengthening Forum

Limb Lengthening Surgery => Limb Lengthening Discussions => Topic started by: tacoma94 on July 15, 2021, 05:49:28 AM

Title: Painkiller thread
Post by: tacoma94 on July 15, 2021, 05:49:28 AM
Considering this procedure, worried about painkiller usage and potential addiction, especially considering the large range of outcomes.

Wondering for LL veterans, what was:
1) your method / doctor
2) lengthening amount
3) painkillers used + number of painkillers + time period (e.g. tramadol - 45 - 1 month post op)
Title: Re: Painkiller thread
Post by: RB on July 15, 2021, 08:39:30 AM
Considering this procedure, worried about painkiller usage and potential addiction, especially considering the large range of outcomes.

Wondering for LL veterans, what was:
1) your method / doctor
2) lengthening amount
3) painkillers used + number of painkillers + time period (e.g. tramadol - 45 - 1 month post op)

1) Internal femurs with Betz
2) 7.1cm
3) Tramadol twice a day + Novalgin 2/3 times per day - up until 3.5 months post op. Have been off all painkillers for 4 weeks now (5 weeks into consolidation) and found it quite easy to stop. Have only been taking paracetamol for my recent ITB release.
Title: Re: Painkiller thread
Post by: tacoma94 on July 15, 2021, 10:41:35 AM
Hey RB,

Thanks for your response! I read through your diary. Did you feel like the pain was constant and hence you needed pills throughout for you primarily due to the constant 1mm rate of lengthening?

Also, did you notice any cognitive sides (e.g. brain fog) due to the medication? Understand that it could have resulted from sleep deprivation as well, but did it have an effect on its own?
Title: Re: Painkiller thread
Post by: Dark on July 15, 2021, 11:55:25 AM
1) Internal femurs with Betz
2) 7.1cm
3) Tramadol twice a day + Novalgin 2/3 times per day - up until 3.5 months post op. Have been off all painkillers for 4 weeks now (5 weeks into consolidation) and found it quite easy to stop. Have only been taking paracetamol for my recent ITB release.

Good for you!
My roommate took Tramadol twice a day for 2 month, and he had significant withdraws when he tried to quit, like coughing, runny nose, anxiety, bodily chills, restlessness, suicidal thoughts etc.
It's crazy how different the experiences can be when it comes quiting
Title: Re: Painkiller thread
Post by: tacoma94 on July 15, 2021, 01:13:12 PM
What method and amount did your roommate gain? Was there no way for him to reduce his painkiller use?
Title: Re: Painkiller thread
Post by: RB on July 15, 2021, 01:39:39 PM
Hey RB,

Thanks for your response! I read through your diary. Did you feel like the pain was constant and hence you needed pills throughout for you primarily due to the constant 1mm rate of lengthening?

Also, did you notice any cognitive sides (e.g. brain fog) due to the medication? Understand that it could have resulted from sleep deprivation as well, but did it have an effect on its own?

During lengthening it was more of a constant feeling of discomfort rather than extreme pain and I found that when I would take the painkillers it would help with sleep and lessen the discomfort a little bit.

I noticed that I would be very irritable while on them and very up and down with my mood but to your point sleep deprivation also plays a part in that. Something like tramadol will definitely have some sort of effect on cognition but its temporary.

Good for you!
My roommate took Tramadol twice a day for 2 month, and he had significant withdraws when he tried to quit, like coughing, runny nose, anxiety, bodily chills, restlessness, suicidal thoughts etc.
It's crazy how different the experiences can be when it comes quiting

I started to wean off them towards the end of lengthening (as in 1 a day instead of 2, then every 2nd day etc) so I think that's why my withdrawal wasn't as bad but I did have a runny nose for about a week.
Title: Re: Painkiller thread
Post by: SirStretchAlot on July 15, 2021, 09:52:21 PM
I have the same prescription as RB and his experiences are quite consistent with mine.

However, I do not consistently take painkillers. If you lengthen at 0.5mm per day, there is minimal discomfort and no need for painkillers.

If you consistently lengthen at 1mm per day, painkillers will only alleviate the discomfort slightly.

Rather than painkillers, you need muscle relaxants like Tizinadine and neuropathic pain medication like Pregabalin.

Pills aside, hot water is the most effective non-medical treatment for any lengthening related pain/discomfort.
Title: Re: Painkiller thread
Post by: tacoma94 on July 16, 2021, 03:41:29 AM
Thanks for this reply SirStretchAlot.

Would you say that painkillers have a ramp up period? I've heard people say you need to "stay ahead" of the pain, and be taking it consistently for it to work.

Also, have you considered using anything to slow bone consolidation so that you can increase lengthening?
Title: Re: Painkiller thread
Post by: SirStretchAlot on July 16, 2021, 09:15:51 AM
Pregabalin may need a ramp up period, but all other painkillers should work immediately. If anything, their effectiveness diminishes over time as your neuro receptors adapts to them. This is especially true for opoids as dosage has to be increased to maintain the same effect.

Ibuprofen or any anti-inflammatory drug will theoretically slow lengthening, since you need inflammation to increase blood flow to the injured area (your osteotomy). By reducing bone growth, you can lengthen slower, further reducing discomfort. However consudering the average femur consolidates at 0.25mm per day, it should not be a problem unless you grow twice as fast as the average person.

If you want maximum length, there are many factors you should consider

1) Longer femurs are more susceptible to fractures due to torque. It's easier to break a long tree branch than a shorter one.

2) Your long femurs will be very noticible past 6cm of lengthening, especially if you were already proportional pre-operation.

3) The most important aspect is soft tissue recovery. Like any rubber band, there is a finite length that your muscles/tendons/fascae will stretch. You risk permanent impairment if you lengthen too far. Stryde caps at 8cm for this reason. I personally may consider a max length of 9cm on Betzbone, even though the cap is 12cm.