Pain, surgery and the aftereffects.

May 26, 2005 7:42 AM

My 13 y.o. son had a metal plate screwed onto his radius on Tuesday afternoon to correct the way it was healing from a break about 3 weeks ago. He's in a LOT of pain still and I'm hoping that anyone who has had this kind of surgery can tell us something about recovery time, medication and how much pain they experienced.

You can see the plate here and here. The doctor said there would be some "discomfort" and kind of dismissed my questions. My son is really in a lot of pain - and he has the highest pain threshold of any person I know, routinely comes home scraped, bloody and banged up without wincing or even, sometimes, noticing. The doctor gave him 500 mg hydrocodone tablets - take one or two - and it's a big prescription, with 2 refills. It takes two pills right now to give him any relief. Does the big prescription mean the pain is going to stay at this level? How long before he feels basically okay again? And how long should he keep on taking that many pain killers? While we're at it, how long until the swelling in his hand goes down?

posted by mygothlaundry to health & fitness (13 comments total)

A couple of years ago I broke my finger and they put 5 pins in it. The aftermath of the surgery hurt astronomically more than the actual break. Even though it was only my pinky finger, my whole arm would throb. I was given percocets and lortabs. Even all doped up on those, I could still feel the throb though the drugs.

A good friend of mine just broke his leg really badly and now has three titanium plates. Even though he has no shortage of pain killers, he is still in a lot of pain.

I think with this kind of surgery, pain is kind of par for the course. I would definitely call the doctor and tell him that your son is still in a lot of pain and ask him what else you could give him. But, really, unless you want him doped out of his mind than I think the best solution is just to try and keep your mind off of it. Play games, watch TV, listen to loud music, whatever. I think on about the 4th or 5th day after the surgery I started getting some relief from the throbbing sensations. I would get him off of the pain killers as soon as you can. Some people start to like those things way too much.
posted by trbrts at 8:16 AM on May 26, 2005

Hmm, I'm in the exact opposite position of trbrts, I just recently (6 weeks ago) had two plates put into my arm (ulna and radius), for the first 2 days I was pretty drugged up, for the next two days, I had some tylenol, since then, other then a few twinges, it hasn't hurt at all.

As for pain tolerances... umh well, Lets just say that after noticing that I broke my arm and the bones were sticking out, I calmly asked my girlfriend to take a picture (she wouldn't) before I went to the hospital. So pain tolerance is pretty high with me.

Overal, the first two days were pretty bad, but mostly seemingly from the surgery, since then, pain has been remarkably limited, so if your son is still in a lot of pain by the time their pain prescription runs out (I'm assuming he has one), then would be the time to worry about it.

Also, it might be complicated by the fact that they were trying to correct a somewhat healed break... in that the broken bone might have healed at a bad angle, and the plate is actually pulling it back into proper position, which would be fiendishly painful I imagine.

If your really concerned though, call up another doctor (perhaps your regular doctor if this isn't him) and ask them, just explain that your doctor is unavailable right now and you had a question about pain levels.
posted by KirTakat at 8:49 AM on May 26, 2005

If your doctor brushed off pretty much every question you can ask after a surgery, I'd consider looking for a new doctor. These aren't really questions you should be having to ask the internet.
posted by undertone at 8:54 AM on May 26, 2005

When I broke a femur into three pieces and had a rod inserted to hold it all together, the pain was significant, and I spent two weeks on hydrocodone before stepping down to vicodin for a couple of months. But I believe most of the pain was not coming from the bone and rod, rather from the tissue damage of the injury.

For your son to still be in such searing pain 3 weeks later sounds a little unusual - was this plate screwed on such that it actively bending bone into the desired position, like staking a tree? I'd imagine a corrective splint like that would hurt like hell for quite a while. But maybe I'm not clear on the situation.

Don't deprive him of painkillers - "keeping your mind off it" can only work for short bursts. But do be aware that the stuff is shockingly addictive. I once had screaming headaches coming off vicodin after just a couple weeks. OTC painkillers had no effect - the only thing that worked was, hey, vicodin!
posted by Tubes at 9:02 AM on May 26, 2005

I have the same kind of plate.

It hurt like hell, that's for sure. It's been a few months and I still occasionally get pain shooting up my arm if I do the wrong thing with it. The swelling went down after about a month, but he may have weird numbness in his hand that'll linger indefinitely.

The pain will go down noticibly in the next week or two. The doctor probably gave you a large prescription because it really sucks to run out of painkillers. Note that those pills are primarily acetomeniphine, I'd be surprised if there's more than 5 or 10 mg of actual hydrocodone in them. 15 mg of hydrocodone is rougly equivalent to a moderate shot of morphine.

I took 20mg of oxycodone twice a day for the first week, and that left me quite comfortable. I have a history of narcotic abuse, though, your son may require less.

So yeah, he'll get through it soon.
posted by cmonkey at 9:03 AM on May 26, 2005

The doctor said there would be some "discomfort" and kind of dismissed my questions

If you possibly can, look for a new doctor, and let this one's handlers know why. You DO NOT have to put up with this sort of treatment.

Your questions are valid and important, and you should be getting full and frank answers to them from a professional medic. (I could guess at answers, but I'm a biologist not a clinician, so I won't.)
posted by sennoma at 9:10 AM on May 26, 2005

Oh, and doctors are usually jerks, especially surgeons, so I can't say I'm surprised at the dismissiveness.
posted by cmonkey at 9:16 AM on May 26, 2005

I just talked to the doctor's nurse and she said this is all to be expected, great. The original injury was 3 weeks ago, then he went 3 weeks in a cast but the xrays showed it was healing all wrong, so they basically, yes, rebroke the arm to set it properly and put in the plate. Keep the stories coming, please, just knowing that other people have been through this and are now okay is really, really helpful.

Cmonkey, don't know how I missed your thread on search - it's a good one for us since we have to add Battlefield 42 & Halo II withdrawal to my son's list of pain. He can't play games at all - can only use his one (left, nondominant) hand and it's really bumming him out.
posted by mygothlaundry at 9:19 AM on May 26, 2005

He can't play games at all - can only use his one (left, nondominant) hand and it's really bumming him out.

Luckily it should only be a few weeks until he's able to use his right hand to control a mouse again, if he has any PC games.
I wasn't able to actually use a controller for at least a month, but netflix filled the gap fairly well.
posted by cmonkey at 9:37 AM on May 26, 2005

Approach the doctor and ask about combining anti-inflammatories (ibuprofen) with the pain pills. When I had my wisdom teeth out, the hydrocodone didn't do jack, but tylenol and ibuprofen did wonders together.
posted by Fuka at 10:22 AM on May 26, 2005

I'm sure you know this but the more time and the higher your child's arm stays above his heart, the faster the swelling will subside. A sling-type arrangement tied up to a hat rack or somewhere above where he's resting would suffice -- better than just an ordinary sling. Keeping him relatively still during all this (yes yes, as probable as a lottery win) will aid the process. I suppose I would be worried a bit if after say a week or 10 days there wasn't some improvement in the pain situation. At the 10 day mark, if you hadn't already arranged for a followup appointment, do so.
posted by peacay at 11:03 AM on May 26, 2005

Best of luck to your son - that's an awful thing to have happen after a break. I had a similar treatment for a break in about the same location. It hurt hurt hurt for a couple weeks despite the painkillers, but it goes away.

The swelling lasted about two weeks, as did the worst of the pain. I think I stopped the real drugs after a week, then had super-doses of Advil on a nurse's recommendation, then nothing. It was four to six weeks before I could do most stuff normally, and for a year or so I still had strength issues and sometimes carried the arm protectively instead of naturally.

One thing to keep in mind long-term is whether or not it creates discomfort. I could still feel the plate in my arm whenever I put my arm down on a table, and it was so uncomfortable it was worth removing it. That was the best decision I'd made, even though the doctors had said it would not be necessary to do.

If you've any other questions, feel free to email. This was only two or three years ago.
posted by whatzit at 11:30 AM on May 26, 2005

Make sure you are following the prescription dosages EXACTLY. When I had a pin inserted in my foot, I tried to extend the time between dosages of the pain pills. I was afraid of becoming addicted, (and I thought I was tough enough to deal with pain) so if the prescription said take every 4 hours, I would take every 4.5 or 5 hours. I was in a lot of pain, and when I told my aunt (a nurse) what I was doing, she advised me to get back on the schedule laid out by the doctor's prescription. She was right. When I followed the directions, it turned into a "discomfort" instead of blinding pain.
posted by achmorrison at 11:32 AM on May 26, 2005