after foot surgery

[maybe]

after foot surgery can your rest less legs get worse while the foot heals. I was fine before surgery after the legs that had surgery is causing problems. I do not know what to do. I could use some advice

[Polar Bear]

When you say you were fine before the surgery do you mean absolutely no RLS/WED symptoms at all, or do you mean that they were under control.

If your symptoms were under control - I think it would be very easy to have worse symptoms while waiting for your foot to heal.
How long is it since you had your surgery.

Also, I wonder do you mean it is worse at night, or is it worse in general, i.e. also during the day. Are the symptoms more frequent, or are they more severe, or perhaps both.
You have tried Requip and then you were taking Mirapex. Are you still taking Mirapex?
It has been commented here on the discussion board that symptoms can start, or get worse, following surgery - although it is quite often back surgery that is involved.

If you are still recovering from foot surgery you are likely to be less mobile and this would be a big contributing factor.
Please let us know what medication you are taking, what you have tried since the surgery.

Before taking medication I found that really icy water could often put the symptoms to rest for a while. Get the foot/leg into a bucket of icy water and it could take perhaps 20 minutes... splashing the cold water up your leg as far as possible. Others find that a hot bath will help.

[ViewsAskew]

As Polar Bear noted, surgery is a common cause of worsened WED/RLS. Any kind of surgery, but we hear of foot/leg/back surgery most often. The doctors aren't sure why - could be the blood loss, could be the medications they gave you, along with other things Polar Bear mentioned.

[debbluebird]

If you have an incision from the surgery on the foot. ( and I bet you do ) I wouldn't soak the foot until doctor gives the ok. Good luck. With all of my surgeries, the pain pills kept my WED/PLM at bay.

[Polar Bear]

debbluebird - thank you for that

[maybe]

I am on Mirapex as I said my nerves are also shot and not sleeping well. I can take a bath. The leg that bothers me is the one that had foot surgery.The trouble with RLS did not start right after surgery but a few days later.it has been 3 weeks since the surgery. would a muscle relaxer help. It is not as bad but some days a little worse' The foot is not healed as yet still swollen Thank you I will have to wait it out I do use ice bags thank you

[ViewsAskew]

I am on Mirapex as I said my nerves are also shot and not sleeping well. I can take a bath. The leg that bothers me is the one that had foot surgery.The trouble with RLS did not start right after surgery but a few days later.it has been 3 weeks since the surgery. would a muscle relaxer help. It is not as bad but some days a little worse' The foot is not healed as yet still swollen Thank you I will have to wait it out I do use ice bags thank you

There are many possibilities.

First, are you on opioid pain relievers - codeine or similar? If you stopped them about 3 days after surgery, it's possible they were keeping the WED under control and when you stopped them, it got worse.

Second, pramipexole (Mirapex), is known to cause worsening of symptoms in some people. This phenomenon is called augmentation.

A muscle relaxer will not help, unfortunately.

[maybe]

I have always worried about augmentation. I have been on mirapex a long time but the doctor I go is a GP I can not get him to change. I tried requip but he started me on quarter of a mg I thought I would go crazy. I went to a neurologist she suggested to take 1 and a quarter Mirapex a day, I know I could used something else or add something. I am 86 yrs old, I have not idea what to add ; but thank


maybe

[Polar Bear]

1.25mg mirapex daily is over the recommended limit and it is likely that you are indeed augmenting.
I think that .25mg is now the maximum recommendation.
This is a recent recommendation and the daily limit used to be considered ok at a higher level.
I am in the same position as I started on Requip many years ago when 4mg daily was considered acceptable and now 1mg daily is now the recommendation.

Coming off a DA such as mirapex is a very difficult journey and would need the full support of your GP to provide alternative (opiate ? ) medication to help you.

I wonder, in the meantime, at least until your foot is healed, would your GP prescribe a lower end opiate and see if it helps. Perhaps tramadol or codeine.
I use both of these and would be desperate without them.

As per Views comment, did you come home from hospital with pain relief and what was it. Would a further prescription for this be of help.

[ViewsAskew]

I have always worried about augmentation. I have been on mirapex a long time but the doctor I go is a GP I can not get him to change. I tried requip but he started me on quarter of a mg I thought I would go crazy. I went to a neurologist she suggested to take 1 and a quarter Mirapex a day, I know I could used something else or add something. I am 86 yrs old, I have not idea what to add ; but thank


maybe

When you day you take 1 and a quarter pramipexole, do you know how many milligrams each tablet is?

And, how much did you originally start taking? What I want to know is how much have you had to increase the dose over time. If you have not had to increase it much, it's not likely you've had any augmentation, at least up until now.

The best thing you could do may be to see if you can use an opioid or similar acting drug - a mild one - such as Tramadol. This would be good to add.

[badnights]

Can you get Tylenol 3's or something that has codeine in it over the counter where you are?

You probbaly need to see your GP and make it clear to her that your symptoms have become very bad and prevent sleep or rest. Then you need to get her to recommend a potential solution. This might be a referral to a neurologist, or a prescription to a different med. It would help if you printed for her the the pamphlet on augmentation (first link below my name at the bottom of this post). Read it yourself and try to decide first, after reading it, if you might be augmenting. If you think so, tell her that's what you think. Ask her to read the pamphlet and advise you what to do to relieve the worsened symptoms.

Be aware that stopping Mirapex or Requip will usually lead to WORSE symptoms but this is temporary. Nevertheless it can be dreadful and is unnecessary torture - a prescription of opioids will relieve the worst of it. The pamphlet is not terribly clear on that point, but there is another paper (more complicated) that is, it can be found by following the second link after my name, it is the Buchfuhrer 2012 paper.

[maybe]

The doctor gave me hydrocodone,acetaminophen for pain. Can I try to take less Mirapex and take the hydrocodone would that helpI also have some tramadol would any one of these help me cut back on Mirapex
maybe

[ViewsAskew]

The doctor gave me hydrocodone,acetaminophen for pain. Can I try to take less Mirapex and take the hydrocodone would that helpI also have some tramadol would any one of these help me cut back on Mirapex
maybe

Maybe, how much pramipexole were you first prescribed, and when was that? For example, a .25 mg tablet once a day in 2010. Tell us the milligrams of the tablets, if you remember it. That's important.

Then, how much pramipexole are you taking now? Again, tell us how many milligrams, how many times a day.

We can better help if we know that.

[maybe]

I have been taking 2mg a day of pramipexold

[ViewsAskew]

I have been taking 2mg a day of pramipexold

That is much too high. When they first started using these drugs, they did not know that higher doses would cause augmentation. Now we know that. The specialists such as Dr Allen, Buchfurher, and Earley, are saying that we should not use more than .25 mg at a time of pramipexole.

It's very likely you are augmented, and if not, you will become so at that dose.

Getting your doctor to take you off of this may or may not be easy, however.

The only way to stop this is to take a moderate or strong opioid, stop the pramipexole, and in 2 to 4 weeks, your doctor can assess what to do next.