Scoliosis Surgery at 75

[Josana13]

I finally went through the Scoliosis Surgery that I had scheduled and canceled a couple of times. I had been on Buprenorphine for over a year and was RLS free. The minute I woke up from my surgery, that ugly monster showed up again. This time I could not even move, much less walk. It started very Suttle and increased in intensity as time goes by. I am on 8mg of Buprenorphine with no help for the RLS, but controls the pain rather well.

Does anybody have any suggestions? Maybe getting back on OXy or I wonder if Hydrocodone? Please help I can hardly walk due to the pain from my back. I sleep with my shoes on, which helps somewhat, or I wrap them with Ace Bandages.

What should my iron levels be?

Thank you all got your wonderful help. This is so very hard.

Blessings and love to all from Josana13

[ChrisColumbus]

Hi Josana: I may not be able to help personally, but how recent was the surgery?

Did you get confirmation from the surgical team that they'd use(d) an RLS safe anti nausea med like Zofran with the anaesthetic as Joolsg advised?

According to the Mayo Algorithm up to 6mg of buprenorphine is a usual effective total daily dose for RLS, but I'll have to leave it to others to suggest possible additions or changes to your regime.

Yes, surgery can cause iron levels to drop and worsen RLS symptoms: you probably know this from past posts, but you should have a full panel iron test to include serum ferritin and transferrin saturation (TSAT) numbers. It should take place in the morning, after fasting overnight (nothing other than water), having not taken iron supplements or multivitamins containing iron for 48 hours before.

You must then insist on getting the actual numbers: there's a very wide range of ferritin numbers that a doctor will call 'normal'. We benefit from ferritin levels over 100, preferably 200 or higher. On the basis of a consensus of RLS experts, it is recommended that all RLS patients with serum ferritin concentration of 75 μg/L or less and transferrin saturation below 45% should receive a trial of oral iron therapy......

[Joolsg]

I'm so sorry to hear this Josana. Spinal surgery is a known trigger/cause of RLS.When did you have the surgery?

It's possible that the anti emetic they gave you caused the severe RLS.

Also, blood loss during surgery can reduce iron levels. Your serum ferritin needs to be above 100ųg, preferably 200ųg/L. Ask for a blood test and if serum ferritin is below 100ųg/L & percentage saturation is under 45%, you can supplement with ferrous bisglycinate every other night or ask for an iv iron infusion.

I suspect it will settle as your dopamine levels settle. The theory is that surgery interrupts the flow of dopamine up the spinal cord.

8mg is already a high level for RLS. Ask your doctor if you can add the occasional hydrocodone or codeine at night time. Or medical cannabis.

I do think it will settle.

Make sure you're not taking any trigger meds.

[SleeplessinNC]

I had scoliosis surgery at 47 with fusion at 8 levels. My RLS stopped when they put me on dilaudid and fentanyl for pain and my RLS disappeared. . I insisted on tapering off after a few months and my RLS returned. I don’t have med advice. I just wanted to reach out to you regarding your surgery. Hang in there. You will receive top notch medication advice on this site.

[Merny5]

Hi Josana13, I’m sorry that you are suffering so. I had a shoulder replacement 15 months ago and had the same experience that you are having. My RLS returned when I woke up after surgery. Fortunately I was able to walk the hospital floor all night. My RLS symptoms were elevated for about 3 months or so. My suspicion is that it is a combination of loss of iron and inflammation. I really don’t think you can increase your Buprenorphine dosage. I went back to taking Oxy for awhile and I think it helped. It might be worth a try and speak with the doctor who treats your RLS.

Good luck to you!