Pain Management

Pain management is a big deal in hip replacement surgery. In 2004 for my first hip replacement I opted for the maximum pain medication. As a result, I could not eat for three days and vomited the first few meals I managed to eat. The narcotics had shut down my digestive system. Very unpleasant.

So this time I wanted to trade a little pain for a working digestive system. I started out at half of the recommended maximum. (The maximum is 3900 mg/day Tylenol and 40 mg/day Oxycodone.) That worked well until post-op day 7, when the pain got ahead of me. I was using a spreadsheet to keep track of the medications I was taking while at home. (I assume I was medicated at my desired half-maximum while in the hospital.) Here is the data for Tylenol, Oxycodone, and the stool softener Docqlace by post-op day number:

  1. In hospital. Assume 2000 mg Tylenol, 20 mg Oxycodone, 300 mg Docqlace.
  2. In hospital. Assume 2000 mg Tylenol, 20 mg Oxycodone, 300 mg Docqlace.
  3. In hospital half the day. Assume 2000 mg Tylenol, 20 mg Oxycodone, 300 mg Docqlace.
  4. 2000 mg Tylenol, 15 mg Doxycodone, 100 mg Docqlace.
  5. 2500 mg Tylenol, 15 mg Doxycodone, 200 mg Docqlace.
  6. 1500 mg Tylenol, 20 mg Doxycodone, 100 mg Docqlace.
  7. 2500 mg Tylenol, 20 mg Doxycodone, 200 mg Docqlace.
  8. 2500 mg Tylenol, 25 mg Doxycodone, 200 mg Docqlace.
  9. 3000 mg Tylenol, 30 mg Doxycodone, 200 mg Docqlace.
  10. 2500 mg Tylenol, 20 mg Doxycodone, 200 mg Docqlace.
  11. 2500 mg Tylenol, 20 mg Doxycodone, no Docqlace.
  12. 4000 mg Tylenol, 20 mg Doxycodone, no Docqlace.
  13. 3500 mg Tylenol, 15 mg Doxycodone, no Docqlace.
  14. 3500 mg Tylenol, 5 mg Doxycodone, no Docqlace.
  15. 3000 mg Tylenol, 5 mg Doxycodone, no Docqlace.
  16. 2500 mg Tylenol, no Doxycodone, no Docqlace.
  17. 2000 mg Tylenol, no Doxycodone, no Docqlace.
  18. 2000 mg Tylenol, no Doxycodone, no Docqlace.
  19. 1500 mg Tylenol, no Doxycodone, no Docqlace.
  20. 2000 mg Tylenol, no Doxycodone, no Docqlace.

I am now taking 1000 to 1500 mg of Tylenol a day.

So you can see I was close to my desired one half maximum levels once I got home until the pain got bad. And then 3/4 max for a few days worked to bring the pain back down. I then weaned myself from the narcotic after the second week. The pain is now almost not there. I have eaten three meals a day starting with dinner four hours after surgery. Bowel movements have been OK. I think my plan was a good one.