To be shocked at how much post-op pain I'm in?

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A week ago, two weeks into a lovely honeymoon that should have lasted 3.5 weeks, I fell and broke my wrist very badly (displaced distal radius Smith fracture). It was in Japan, they x rayed and assessed me, gave me a temporary splint and was told I had to go home asap for surgery. Sorted insurance stuff and they flew us back mid week, have managed pain with OTC meds plus codeine. A & E Thursday and they got me in for my surgery Saturday as an urgent case. I've had a plate and screws inserted and my fracture realigned with a cast, signed off work for a month.

The nurses were kind, but my pain management for the 36 hours I was in hospital was totally inadequate. They gave one ibuprofen with two paracetamol every 6-8 hrs, I know that's first line pain relief and then low dose oromorph every 4 hrs. I've had oromorph before after knee surgery and it was good, but it wasn't helping this time- not sure if dose too low? It wasn't enough, my pain was still so bad so they reluctantly got me a tramadol to take the edge off. When my nerve block wore off yesterday morning, I was crying in pain and despite asking, my tramadol doses only came 7-8 hrs after the last one (they need 2 nurses to sign for it and it was often hard to find another one to do it), meaning I had severe breakthrough pain that was then very tough to get on top of. My husband was horrified when he came in and saw the state of me. I was discharged yesterday afternoon and thought well at least I can now take my pain meds on a proper schedule.

I suffer from adenomyosis and cripplingly painful periods, and I've had several surgeries so I understand some post-op pain is normal, but this is another level of pain and I can barely get it to a manageable level. I've usually coped overnight with a bedtime opiate plus OTC painkillers, but I've woken in severe pain after 5 hours. I'm taking ibuprofen, paracetamol and tramadol at the intervals indicated, although 4 doses in 24 hours seems to go quickly. Can't use ice as it won't penetrate the thick cast.

My knee ligament repair a few years back was bloody agony but this is another level, maybe due to the broken limb as well. Anyone else who has had surgery on a broken bone, how long until the pain reached manageable levels? I'm just sat quietly sobbing right now while DH sleeps peacefully ( he has been brilliant so I don't begrudge him his sleep). Going slightly mad and still heartbroken that our beautiful honeymoon was cut short by all this pain.

I had a similar surgery a few years ago. I was prescribed codiene like sweeties and had a bottle of liquid morphine to take home. It was painful but I did get through it with decent pain management. It took a year to fully recover and I’m weight limited to about 10kg but fully recovered.

They can probably prescribe some oxycodone which is better than oral morph. Like any strong painkiller watch out for constipation so you might need a low dose laxative too.

My DH badly broke his ankle, needed plate and pins. He was sent home with a bottle of morphine.

@Zanatdy I'm on the Fybogel already haha! I know those side effects only too well.

Still waiting to be seen by ortho, got given a bit of oromorph which has taken a bit of the edge off.

@Abitorangelooking Glad you're feeling better now. Hoping if I can just manage acute pain for the first week, things will get a bit more bearable from that point on.

Currently recovering from a broken shoulder. I was on slow acting morphine twice a day, fast acting morphine 4 times a day and paracetamol 4 times a day for 10 days. Then tapered off the morphine over the following 3 weeks.

You shouldn't take nsaids (ibuprofen/naproxen etc) if you have a broken bone as they interfere with the bone healing process.

I meant I had the artificial morphine, which is stronger than actual morphine. Can't remember the name, oxy something or other.

Glad you’re getting seen and checking out the loss of sensation.
we all feel pain differently so should all be treated differently but the NHS doesn’t always get that bit right.

I broke my wrist last January and had to get a plate and pins, and they gave me solpedeine for a few days, then just paracetamol. They didn't put a new plaster cast on (having removed the one I got in A&E) but a sort of stiff dressing and velcro splint. It was somewhat painful but nothing like you are experiencing - I am glad you are getting it checked.

I'm glad you are being seen, the intractable severe pain could be a sign of compartment syndrome and needs urgent proper assessment - mine was ignored in the hospital despite blacking out due to pain and describing it as a lorry parked on my arm and unfortunatly it has had lifelong consequences for me

@MrTiddlesTheCat I have read that about NSAIDs and broken bones, but at this point the hospital still advise them as part of pain management.

The advice to go straight to the plaster room is good. When I broke my ankle and had swelling and numbness in my leg they removed the cast and reset it. They showed me the slight indentations in the skin which showed where the first cast had been digging in a little bit, and would have been causing the numbness. Other than that, whilst you can achieve a lot with painkillers, it is still a broken bone and subsequent surgery that you have and sadly it is painful. My broken ankle was so painful I could do nothing more than lay there and practice breathing techniques for about 3 weeks, however I chose to go without painkillers as I was still breastfeeding my baby at the time the level of painkillers I needed and breastfeeding were incompatible. (This meant I also had to have the surgery to screw it under a local anaesthetic.) I have had other surgeries for a variety of reasons, and nothing has ever been like the pain of the broken bone. Hopefully with painkillers you will be feeling better long before then. I found pain started to subside once the swelling began to reduce.

Could the swelling have gone down and the cast become loose and pressing on the break? I had that when I broke my elbow and had it surgically fixed. Woke up completely unable to lift the cast without blacking out.
Hope you get it sorted soon its horrible to be in so much pain. X

Bone pain is just so much worse. I had a plate put in my arm at 14 and yes it is bloody awful. Hopefully you can get on top of it now.

I'm shocked at that. I'm in Sweden and my doctors were very clear that I must not take them. Last week I was told it's now ok to take them occasionally but not every day. I'm 10 weeks post surgery.

@backinthebox Gosh that sounds like an awful experience.

Unfortunately, you can't go straight to fracture/plaster room in the hospital at this time, and I wasn't able to contact the ward so having to be triaged in A & E.

Definitely agree there will of course be pain with surgery on a broken bone and I don't expect to be pain free, but having had surgeries previously, the pain should be at least held at a manageable level and it absolutely isn't.

I had ankle surgery and was on bed rest for 2 weeks after, keeping my leg higher than my heart to reduce swelling and help healing

The first few days I was in agony, despite all the pain killer, and then it started to subside

I hope you feel better soon

Have you tried telephoning the plaster room? The one in the hospital where I was treated was fairly well guarded by reception staff, but once I managed to get through on phone they sent someone to come and find me and take me straight there, despite the reception staff saying you weren’t allowed to go there without being seen by someone. The plaster room staff told me they quite often have to recast a broken bone after it has been initially cast by a surgeon (apologies to all surgeons here!) as the surgeon’s speciality is surgery, but the plaster technician’s speciality is casts. They seemed quite proud of this fact!

I got pretty poor pain relief after a broken shoulder. As in"get some paracetamol ". After a hideous day or two I contacted a consultant and was given cocodemol. That was actually too strong, so I spent ages dividing them up 🤣

Perhaps contact the hospital?

To add insult to injury, since arriving at A & E I've had explosive diarrhoea three times. Feel all hot and shivery. Maybe it was the oromorph given to me on an empty stomach? Still waiting.

You poor thing OP, I’m so sorry you had to cut your honeymoon short. I am living with cancer & have a tumour in my clavicle 😩 so I can fully relate to how painful bone pain is. I can also relate to what a lot of posters say about inadequate pain relief in hospital. In my case my GP while well meaning was pretty useless on the pain management front & I’m now under a specialist pain management team who are excellent. I take slow release oxycodone twice a day, pregabalin (for nerve involvement) & paracetamol. On this protocol I’m a lot more comfortable although sadly not pain free. I wonder if there’s some sort of specialist pain management team that could be involved in your case? Do let us know how you get on at A&E. It’s awful being in so much pain.

I’m sorry you are in so much pain - we find these I shaped pregnancy pillows help after some surgeries - you might be able to prop your arm up as part of a pillow adjustment? There are different size and shape pregnancy pillows on Amazon might be worth a look
https://www.amazon.co.uk/CHILIMILII-Maternity-Pregnancy-Sleeping-Back-pillowcase/dp/B0B3DWY2C8/ref=mp_s_a_1_4?crid=3LKRP34ADE0HM&dib=eyJ2IjoiMSJ9.AkON1NRgcoGfJqzDEaMUbb4i_nPN-51nZhGLqmeqlpI44Kb72ThpYxY9LzE-qWZROOwb4bejAD0ZIoz71SPJB4hXAWSI0Iu3jQzJx_dQ6FnIySMkNDvXPxd2dhxYBdOH3UMNu-NxjpEvS2b3nyobHrPTc0AAp7wDn33U8qQSeuiaWEa1tb704PNGrb3oXuoI87mlJwxFmsu-0tXNkpdBuQ.OpD79GCoJN2jbt0PRzwQ-myFqPLVF0haqXAbEgiq7rk&dib_tag=se&keywords=u+pillow&qid=1716190920&sprefix=u+pillow%2Caps%2C146&sr=8-4

Should you be in this much pain after wrist surgery? I don't know. It sounds very very painful. I'm a fellow adenomyosis sufferer and can also handle pain so I can imagine how bad it must be for you to post about it.

I'd be worried about there being a complication.

I assume you’ve let them know about this? Extreme pain and feeling shaky may be pointing towards infection? Or it may not - but they need to be considering it, surely!

Explosive diarrhoea and shaky suggests infection.

I hope you are seen soon.

I had strong antibiotics for about a week afterwards to prevent infection as it can be unpleasant.

Thinking of you.