Hip Operation

[Ray64]

good morning over the last few nights I have had horrendous what I think is RLS. I just wondered if there is a connection between coming off my blood thinning medication and the onset of the problem. I had a complete hip replacement five weeks ago, I have never suffered before with symptoms of RLS.

[Joolsg]

Very possible. Hip operations can trigger RLS for 4 reasons.1. Any bone operation can interfere with dopamine flow.

2. The anti nausea med they use with anaesthetic can trigger RLS.

3. Blood loss can reduce brain iron- the main cause of RLS.

4. If they gave you opioid pain killers ( codeine, morphine, oxycodone, tramadol) for pain relief- stopping them can cause opioid withdrawals & the main symptom is RLS.

If it's reason 4 - it WILL settle. You just have to wait it out. My sister had it after a broken femur and it took 6 weeks for symptoms to settle after stopping oxycodone.

If it's reason 2- it should have settled by now.

If reason 3- arrange full panel, morning, fasting iron blood tests. Raise serum ferritin above 100ųg/L initially by taking iron pills every other day or via an iron infusion.

If it's reason 1 then it might settle.

What other meds are you taking?

Many medications can cause or trigger RLS. Anti depressants, sedating anti histamines, statins, beta blockers, diuretics, melatonin.

The blood thinning pills MIGHT be the reason - but they are more likely to worsen RLS.

Here's a thread on the subject.

healthunlocked.com/rlsuk/po...

In the meantime, there are ways to minimise RLS without meds.

Hot/cold showers, magnesium tablets, magnesium cream, deep tissue massage gun, squats, stretches.

But get the blood tests asap as I think low serum ferritin may be the cause.

[Ray64 in reply to Joolsg]

thank you for taking the time to respond, the last time i took strong painkillers was Tuesday of last week, codeine phosphate. i take the occasional paracetamol and of course have just finished my blood thinning medication Apixaban. i hope it does settle and soon as the lack of sleep is making me miserable.

[Joolsg in reply to Ray64]

oxfordtreatment.com/substan...

Restlessness and sleep issues are listed as apixaban withdrawal symptoms.

It does say they settle after a week or two.

[SueJohnson in reply to Joolsg]

I couldn't find that page. I got a 404 not found when I clicked on the link.

[Joolsg in reply to SueJohnson]

It's my stupid phone Sue. I add a link & leave at least 2 spaces. But then the link appears right next to the first word.I've edited it to add 2 spaces - so should now work.

[Madlegs1]

It's quite possible that you are suffering withdrawals from stopping the blood thinning medication.

What is that med?

Otherwise ,as Jools has said.

[Ray64 in reply to Madlegs1]

my medication is in Apixaban

[Madlegs1]

That doesn't seem to create withdrawal effects.

So- back to Jools reply!👍😎💚

[SueJohnson]

Welcome to the forum. You will find lots of help, support and understanding here.

First let's check it is RLS. All of the following must be true for a diagnosis of RLS: 1) The urge to move the legs and sometimes the arms 2) The onset or worsening of symptoms during periods of inactivity when lying down and sometimes when sitting 3) Symptoms occur or worsen in the evening or bedtime. They are usually dormant in the morning 4) Symptoms get better when walking or stretching as long as it is continued. 5) Can't be explained by another medical or behavioral condition.

Do you meet all of these?

If so I can give you some advice.

[Ray64 in reply to SueJohnson]

yes it’s when i sleep. i have no symptons during the day.

[SueJohnson in reply to Ray64]

Have you had your ferritin checked? If so, what was it? Improving your ferritin to 100 or more helps 60% of people with RLS and in some cases completely eliminates their symptoms. If not when you see your doctor ask for a full iron panel. Stop taking any iron supplements including multivitamins that have iron in them 48 hours before the test, don't eat a heavy meat meal the night before, fast after midnight and have your test in the morning before 9 am if possible. When you get the results, ask for your ferritin and transferrin saturation (TSAT) numbers. You want your transferrin saturation to be over 20% but less than 45% and your ferritin to be at least 100. If they are not, post them here and we can give you some advice.

Meanwhile some things that can make RLS symptoms worse for some people are alcohol, nicotine, caffeine, sugar, carbs, foods high in sodium(salt), foods that cause inflammation, ice cream, eating late at night, estrogen including HRT, dehydration, MSG, collagen supplements, electrolyte imbalance, melatonin, eating late at night, stress and vigorous exercise. It is a good idea to keep a food diary to see if any food make your RLS worse.

Some things that help some people include caffeine, moderate exercise, weighted blankets, compression socks, elastic bandages, masturbation, magnesium glycinate, fennel, low oxalate diet, selenium, 5 minute shower alternating 20 seconds cold water with 10 seconds hot water finishing with hot water for another couple of minutes, hot baths, distractions, CBD, applying a topical magnesium lotion or spray, doing a magnesium salts soak, vitamins B1, B3, B6, B12, D3, K2, if deficient, and potassium and copper if deficient, massage including using a massage gun, vibration devices like therapulse, using a standing desk, listening to music, meditation and yoga.

Many medicines and OTC supplements can make RLS worse. If you are taking any and you list them here, I can tell you if any make RLS symptoms worse and if so may be able to give you a safe substitute. I have a list of more than 300 medicines and OTC supplements that make RLS worse and have safe alternatives for most of them.

There are medicines that can be taken for RLS but it is a little premature to take any as things may settle down. If they don't post back and I can give you more information. Let me just say don't let your doctor prescribe a dopamine agonist like ropinirole (requip), pramipexole (mirapex)or Neupro (rotigotine) as they can eventually make RLS worse.