Pain relief options after OHS

[MPort]

I had open heart surgery on 23 January to repair mitrial and tricuspad valves plus 2 small bypasses. Graft site above right ankle.I was out for 2 days after op. Couldn't surface. Severe reaction to opiates was reason.

So now I am 18 days post op. I have been on paracetamol only since day 3. I have had multiple night sweats since. So last night as an experiment I took last paracetamol in afternoon at 3pm. No sweats, HURRAY. But pain overnight pretty bad. And this restricted breathing. And I have mild and moderate fluid on each lung!

My question is as I can't take codeine, cocadamal or ibuprofen does anyone know of any other pain relief options?

2md question ankle below graft site has pooled blood/bruising and it and foot are still swollen and painful. Should I worry?

Many thanks

Mairead

[Lopas]

".....ankle below graft site has pooled blood/bruising and it and foot are still swollen and painful. Should I worry?"

Frankly, don't "worry" -----see a doctor! Do you have access to your ward/surgical team/ surgeon's secretary/GP - ask about the fluid too, I'm on diuretics (op 5 weeks ago)

[MPort in reply to Lopas]

Ok thanks. I was on diuretics for week after op. Not now.

[Lopas in reply to MPort]

I was on Furosemide before, during and after the operation. I'm expecting a discussion after 6 weeks when I see the surgical team again. - might stop, might not! When I got home from Hospital I still had swollen ankles so the GP and I agreed at the 2 week point to stay on Furosemide longer

[MPort]

Interesting. I will bear that in mind when I see GP on Friday. Many thanks.

[Daffodilia]

My husband had night sweats for some time after open heart surgery - stopped eventually - never got an explanation. He had blood vessel taken from thigh for bypass and then got swollen leg - was given a diuretic eventually which cleared it and hospital checked for blood clot. Ask your GP or practice nurse? My husband didn’t take much codeine - made him feel bad. Took paracetamol for headaches.

[MPort in reply to Daffodilia]

Very interesting re codeine. I keep resisting it I feel it's not right. But have come off paracetamol after 5pm so get no night sweats. But pain kicks in about 1 and it's difficult to breath and sleep. Thanks for the info. Appreciated

[Daffodilia in reply to MPort]

Husband much better 6 months on - it takes time - more than they tell you - good luck

[MPort in reply to Daffodilia]

Thanks for hope. Long haul then 😊

[bikebabe]

I had an overlong stay in high dependency as well for same reason -hallucinating. Happened before when had 20mg cocodamol after hip op. I have Gilbert’s syndrome so cannot process most painkillers opiates codeine or paracetamol (liver can’t process efficiently due to UDP pathway issues) so they don’t break down efficiently and become toxic ) and ibuprofen was contraindicated with anticoags. I did get intense pain in right side chest (small amt fluid) requiring A&e twice. Mostly just had paracetamol, tried to keep mobile, used a wedge /pillows to sleep semi upright at night and a side bar on my bed To help lever myself up and tried not to get constipated. It will get less and in a few months hopefully you won’t remember the pain. But I don’t have your issue with grafts and it sounds like that needs medical attention.

[MPort in reply to bikebabe]

Most helpful. Many thanks

[bikebabe]

you could ask GP to be tested for Gilbert’s which consistently increases blood bilirubin but has no overt symptoms. Just slows down the breakdown of some meds that use UDP pathway particularly when ill /injured.

[Beanlover]

My husband had OHS not long before you. He has only been taking paracetamol, but he is 79, and most other painkillers are not considered suitable. He did have tramadol after a previous hip replacement, but paracetamol was the only thing offered after his Heart op.He had an animal tissue valve as replacement so has no other wounds.

He has been very breathless for a while, and now has fluid in I think one side of his lungs. His legs are weeping and I am changing dressings several times a day. GP is trying to zap the fluid with large doses of diuretic, which don't seem to be working. He has a chest X ray tomorrow, and seeing GP on Tuesday who is likely to send him to hosp for a chest drain if no improvement. Are you having any treatment for the fluid. Its difficult as he is very breathless if he tries to lie flat, which is of course good for his legs, but not for breathing and sleeping.

[MPort in reply to Beanlover]

I am very sorry to read this. There seems to be many complications. Has he had follow up appointment for 6 weeks check? I had x-ray last Tuesday and see GP tomorrow for report on it - although reports of x rays take 2 plus weeks. So I don't know what I shall hear tomorrow. Re weeping in legs. My sister has this for about 18 months. Twice weekly change of dressings and replacement with tight bandages. They can't get to bottom of it. Your husband's source may be different but it would be interesting to know how you get on.

Your don't mention that paracetamol makes your husband sweat overnight. Is he still taking the full quota? I cut mine back 6 days ago but I've had to increase them during the day. I'm taking about six a day as I seemed too weary and in too much pain if I don't trying to keep off them at night and sleep through the pain.

I hope you get some results soon. Wishing you the best.

[Beanlover in reply to MPort]

His 6 wk post op is next week. saw practice nurse last Thurs because of huge blister on his leg. She put dressings on and a prescription for more. Just absorbent covered by stockinette. He has had problems with his legs before, but not to this extent.Nurse was worried about an irregular pulse, and went to see doctor who was tutoring students but he saw him afterwards, He had checked his chest a week or so before and it was clear, but checked it then and said there was fluid there. He said he could send him to hospital or give a go at zapping it with diuretic. He wanted the X ray as a baseline. XRay people said the result would take 7 days, but we are in Scotland where everything goes on the same IT system. Don't know whether it will be there on Tuesday, but I think if he doesn't think he's improved he will send him to hospital to have a drain put in. GP sort of said if you get worse go to A& E. We have tried to avoid A&E.

My husband has stopped taking paracetamol. Because he had a bovine valve replacement, he didn't have any other wounds etc and his sternum is healing. He says he had no night sweats, he thought paracetamol reduces the body temperature.I will let you know how it goes. I would be interestedin how you get on.

[MPort in reply to Beanlover]

Hi I had my appointment with Doc who is cardiac specialist at local surgery. What luck. My x-ray showed left lung was improving but right had pocket of trapped liquid, repeat x-ray in 6 weeks. . Plus I have a slight cough. Back on antibiotics. I thought of your husband and accepted them. Plus a agreed to 2 10ng codeine at bedtime to hopefully allow sleep and continue paracetamol during the day. Red blood count low which will hinder heart recovery. Red meat plus spinach with lemon juice to enhance iron. Hope this helps.

[Beanlover]

Received your message while waiting for X Ray results which were given straightaway by a Radiologist. He has fluid and infection, so will need to go into hosp. Trying to avoid Mon A&E which radiologist describes as carnage.!!. GP has the X Ray. We have appt at 11 tomorrow, or he will arrange something before that. It is as we thought really. Glad you are improving. though not entirely well. I hope you get on with codeine. Gives me terrible constipation, so be prepared. Best wishes.