RLS after surgery

[branti]

It's been quite awhile since I've been here. My RLS has been reasonably well controlled until now. I had total hip replacement surgery 2 weeks ago & have had very little sleep since. My surgeon refused to order my meds for RLS & by the time I could take my own meds it was too long without. Now I am trying to juggle my meds & so far no success. I currently take Mirapex .25 mg I pill after dinner along with Elavil 25 mg. At bedtime I take Lyrica 75 mg ii plus another 11/2 Mirapex. Does anyone have any suggestions, may have gone through a similar experience? I wouldreally appreciate some help getting through this.
Thanks.

[debbluebird]

It's possible that Elavil might be making your WED worse, most antidepressants do.

[ViewsAskew]

If you've taken the Elavil for awhile without issue, my guess is that it's related to either getting behind the symptoms (that can happen and make it hard to get back on a even keel), or because of the surgery.

No one knows why, but a lot of people say their symptoms are worse after surgery. You may have lost a lot of blood, which is one potential reason. A serum ferritin test and a hemoglobin test would tell if you are iron deficient in some way.

It also could be that the Mirapex is not longer working so well - and could be causing problems.

Have you ever written to Dr Buchfuhrer? somno@verizon.net. Tell him what you told us and see what he says - I'm curious.

[branti]

Thanks. I'm hoping the dose & scheduling of the Mirapex is all that has to be done. I did e-mail Dr.Buchfuhrer as you suggested. Will let you know of any reply.

[ViewsAskew]

It's really important that you keep your ferritin at least 100 when you are taking pramipexole. When it's lower, you run the risk of the medications causing a weird (and all too common) problem called augmentation. It's when the symptoms get worse because of the medicine. When that happens, you need to stop taking the medication. Same thing applies to ropinerole/Requip.

Have you had your serum ferritin level tested? Many doctors are unaware that it needs to be at least 100 and don't test it. Always a good idea to ask if they don't suggest it.

Let us know what Dr B says. He was emailing me earlier about my medication (he's my doctor), so hopefully he is online and will have time to answer you tonight.

[branti]

I had a reply From Dr. B & he said that surgery can sometimes make RLS worse, up to & including permanently. He suggested using an opioid in the meantime & to get expert revaluation for treatment in the long term. My GP does try but he's certainly not an expert on this condition. The Dr. From the sleep clinic who was quie familiar with it is no longer here & a new referral is necessary. Wait time can be a long time. My initial referral took almost a year( we're talking Canada here)

My ferritin levels & Hemogloban are actually within normal limits. I have heard of augmentation. In fact I have tried various recommended drugs, different combinations & different schedules until I found something that worked. I'm frightened of going on like ths, indefinitely,especially after everything was going so well.

[ViewsAskew]

Shoot - just lost my reply (my mistake).

It is one of the worst moments when you realize that it has to change....again. I can imagine how you feel. I hate to say it, but many of us go through that moment multiple times. While it must happen to people, here we rarely see people who stay on the same thing for many years. We get a few months to a few years most times.

I hope your GP will prescribe an opioid for you and that it does go away as you heal.

Don't post where you are if you're not comfortable; we do have some other Canadian members who have doctors they like. If you are anywhere near them (a small chance, I know), their doctors might help.

You mentioned your ferritin and hemoglobin were normal. Surgery often includes blood loss. I have no idea how much would be lost in hip replacement - might be very little. Just in case, though, might be good to get retested. It would be great if some additional iron would help. And, at the risk of being annoying since you clearly know a lot, normal levels of serum ferritin can be as low as 15 depending on the lab. That is much too low for any of us. If the doctor didn't share the reading, ask to make sure it's at least 100.

[rthom]

Are you able to see a dr in toronto?

[branti]

I live in British Columbia, Canada

[rthom]

ok

[Polar Bear]

Hmmm... I wonder did I read of a WED aware doctor in Edmonton, which may be too far.
(Here in N.Ireland we have little concept of such vast distances, we can cross our little province in a morning)

[rthom]

I have sent am email to someone in bc to see if they know anyone there

[rthom]

how about vancouver, or vancouver island?

[ViewsAskew]

I can't think of anyone who's mentioned a good doctor located in BC.

I honestly hate that it's like this!

[rthom]

I spoke to somone today from the foundation that knows somone there