TORADOL (ketorolac) linked to Recurrence Prevention
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Hi Loverly, I'm not sure she has anything on hand. Hoping she does. Can only wait till she responds
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Loverly, can you watch for her. I'm going to go find the pain scale I use.
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took the norco feeling better already thinking it was a good decision thanks ladies gonna try to get some sleep now let you know how it's going in the A
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Good Stephy, Well that was chit. We were working on one thing and forgot the basics. This is a post I wrote years ago.
Rainy and solfeo make sure you read.
Jun 21, 2011 01:22 am sas-schatzi wrote:
This is going to be long, sorry folks. Generic description of how to evaluate pain and what to do.
Try to see if comfort measures will change level of pain. If you have been in one position too long that can cause muscle fatigue which can lead to pain. When appropriate try warming up, mild stretching, or getting up and walk around. In the hospital, after asking what when where why , how long etc to determined what I was dealing with, I'd look to see if something to tight/ restricting etc. If the patient has pushed things too much, too fast pain could be from over use---rest. Bottom line is figure out what we are dealing with first.
Using the pain scale. Research has shown that the worst judges of a patients pain are doctors and nurses. The best judge of the patient pain is there own self description. Everyone's tolerance of pain and response to pain is different.
I know allot of people mock the pain scale, but with adequate explanation it works. The visual smiley frown face scale was developed for children. It accuracy has been proven by research. With adults the visual scale has been proven to be inaccurate. The numerical scale is the method of choice that is more accurate in adults.
Zero is no pain. 1-3 is mild pain, generally tolerated well. There are people that would like relief from this level of pain. Tylenol or NSAIDS like motrin, advil, if tolerated usually work well.
4- 6 is moderate pain. The choice of pain reliever can be individual here too. Many people do not like taking a narcotic because of fear of getting hooked. So using the previously mentioned drugs are okay. Some people don't get relief with these drugs, taking the lowest dose narcotic may be a better choice for this individual. Many of the narcotics are combined with the NSAIDS or Tylenol. For example, Tylenol 325 mg with oxycodone 5mg = percocet, tylenol 500 mg + oyxcodone = Tylox, Hydrocone and tylenol 325mg =Vicodin/Norco etc. Generally, pain prescriptions are written, for example, "Take one to two tabs as necessary for pain every 4-6 hours". I suggest try one pill at lowest dose. If relief is not acceptable, and the doc has said it's okay take the second one---do so.
7-10 is severe pain, if at home this is the range that taking the higher allowed dose versus one is a consideration. Generally, you should expect pain level to decrease below at least a four. If no pain relief call doctor, this is the time to call your doc. Please, don't exceed recommend doses without doctor being aware because it could be an indicator something serious is brewing.
NSAIDS and tylenol are not benign drugs. Taken in doses higher than recommended can cause damage to the liver and the kidney, that may not be reversible. NSAIDS and tylenol should never be taken with alcohol. Damage to the liver can be caused by mixing these drugs and alcohol.
In summary, tyr comfort measures i.e position change, massage, adequate sleep, adequate hydration. Lack of proper hydration will cause the muscles to ache/pain and fatigue faster. Use pain medicine either non-narcotic or narcotic based on pain level. If they're is no response to pain reliever or pain relief isn't acceptable call your doctor.
Edit: Recently have become aware of narcotic affect on immunity in cancer patients. Just mention it as an FYI to discuss with your doc.
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Stephy
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Thanks, Sassy!0
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Stephy, you'll see this in the am. Please, read the pain post above. Pain suggestions and recording chart
Option: Take pain med on a scheduled basis for the first 36-48 hours after sx--that means if it's ordered every four hours take it every four hours. Make a form page. When you take the drug put a line through the time. Then the next time that it's due is visible. When you take the next med put a line through the time. Advantage: You know when you took it, and you know when it's next due. At the end of your chosen scheduled period interrupt your dose to evaluate your underlying pain. If pain is not in acceptable range return to scheduled method for another 24 hours repeat as necessary. for the next few days. Doc should have given you instructions as to when to stop the narcotic and move to a lower drug. (refer to pain scale in above post for suggestions)
Date/time ....... pain scale... drug...... pain scale around 3/4's to one hour after taking oral pain med
9/23_10am______________________________________________________________
9/23__2pm______________________________________________________________
9/23__6pm______________________________________________________________
9/23__10pm___________________________________________________________________
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LOverly, and Hopeful what are you doing up? You gals are always there when I need you.
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Okay we should all go to bed......................HUGS
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lol yes sometimes, slowing down from worrying about Steph. The only positive about this night, is whomever is espousing no narcotics has their head up their ass. We all went through it with her.
For me it was like reliving it. Pain control should be balanced by opioid and nonopioid drugs. Balanced and adjusted as needed
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solfeo, if they show you the smiley face pics for pain description. Those were developed for kids. Kids do remarkably accurate with them. Adults have a hard time. A. Description like I use is for adults. Your welcome
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well I have a hematoma on my right side non cancer side may need to go back into surgery
my hemoglobin is also low at 8 May need a transfusion0 -
no more toradol for me I'm cut off due to the bleeding
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Oh gosh Stephmoen - I'm praying for you to feel better quickly!
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So sorry Steph for the complication.I would think the risk of bleeding with Toradol is higher in those with tissue expander(s) placement ( secondary toforeign objects in the cavity) vs. those without. Any comments on this Dr. Retsky ? Hope you are still with us.
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Stephy, just woke up. Hematoma.Chit. Sorry Steph. Well that deep-sixed.the day. Why can Forget have > 1000 and no bleeding and this doc has one with a hematoma.
What dose did she use preincision? What dose did she give you post op and how long after the first dose? What was the interval between doses? Are you taking your pain med--Norco . Were you wrapped? Did you lift anything? The baby? How long after last dose did you think you had a hematoma? Is the incision together? Did you use that arm to get out of bed? Did you log roll or push off with arm that has hematomaDid you use that arm for toileting? What color is your skin--pale white? What color is your hair?
Your HGB is 8, what was it preop, What is your hematocrit preop. What were your platelets preop, What was your estimated blood loss in surgery? Relevant questions, but obscure too you now.
Are they going to do a repeat Hemaglobin/hematocrit before deciding to do a transfusion? Ask that a platelets be run too.
Is your pain under control?
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I am past all of my surgery except the nipple recon, so I'm not sure this is something I could or should look at. Was this mainly for the cancer surgeries and not recon?
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Homemom, Lost my post. Stick around . That's an answer that is unknown. Theoretically, toradol could prevent existing dormant cells from awakening. When's your surgery.
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I am going to schedule it for next month - third or fourth week
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Stephmoen, I'm so sorry you had such a rough night with pain, and that you are dealing with a hematoma and low hemoglobin. Wish I could help you out in some way, and I really hope I didn't HURT you by jumping on the anti-opiate bandwagon. Hope things start going better for you VERY soon.
For anyone worried about opioids, Sassy is absolutely right, pain management is the number one priority. Opioids are a mixed bag, and there seems to be a movement to minimize them. But in providing pain relief they provide a large benefit. If using them is all that work, your body is still coming out ahead by avoiding the effects of pain. As Sassy mentioned, it's dose dependent, as well. So, low doses of opioids, switched up with other pain relievers aren't going to be harmful.
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yes I'm doing ok now on norco hading pain my drs do say toradolay have played a role but not to dwell on it I will be honest getting through this without opiods is very difficult I am avoiding morphine because that's what must studies are based on but I do need pain meds hemoglobin is at 7.7 hoping it goes up now bleeding stopped and won't need transfusion
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Steph, did you get any other number? Unusual bleeding to be caused this long. Platelets/hematocrit. Your nurse will give you your preop and post op numbers all you have to do is ask. Docs can say it played a roll, but unless a full chart review is done that is laying blame on a drug is an excuse not an answer. Sorry, you are going through this sweetie sassy
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my preop hemoglobin was 12.6 now it's 7.7 they stopped the bleeding so we will see if numbers go up I did not ask about platelets but I will
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they say this is an issue that can occur and not necessarily from the toradol but obviously they do t want to give me something that can cause the bleeding issues to become worse I still am happy I did it pre op like I said this could be an issue for anyone not just from the toradol
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Stephy where exactly is the bleeding? Armpit, breast? Sorry, I know you aren't up to questions, but it's my thing. Detective work. Hoping for a smooth recovery.
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Solfeo, Talk with a Cardiologist. I wouldn't take Toradol. I'm and old Cardiac nurse too. But not well versed in long Q_T syndrome. Can be real trouble. Please, see what a Cardiologist says. Your surgeons a cutter. She has minimal to no knowledge about EKG's. She should have said so. Each doc has a skill. Once they are done with residency, the things they learned about the other specialties during residency rotations fades away.
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around my draining tube I guess the tube was also blocked this is very typical for me to go 2 steps forward and 1 step back had my share of issues neutropenia in hospital after first chemo for a week after 5th infusion my port was infected and I went septic in hospital for a week with that and on antibitics iv for a month now this only good thing my pet scans and ultrasound showed cancer was gone! Can't wait for pathology reports come back
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Stephy, Here I go said I wouldn't question Dying to know preop and post op Platelet counts. Ask her too if they did chemistries? Ask her to just make a list of all abnormalities on CBC and Chemistries.
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norco is starting to upset my tummy and I'm worried about liver I had iv tylenol do you guys think small amount of morphine is ok my only ither option
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Solfeo, Oh my, my nose is bumping things.
https://cardiology.ucsf.edu/care/clinical/inhere/arrhythmia/qt.html
(this is just portions of info taken from this web page)
Diagnosing LQTS can be difficult because individuals with the condition do not always have abnormal EKGs and QT prolongation can be intermittent. In fact, about a quarter of people with LQTS have normal EKGs and those with a long QT interval on one EKG may have normal EKGs at other times.
Since LQTS syndrome is a genetic condition, the family members of someone who has the condition may be at risk of developing the abnormal heart rhythms. Close relatives (parents, siblings, and children) of someone with LQTS should be evaluated for the condition by consulting a cardiologist familiar with LQTS or through genetic testing if the gene mutation associated with the condition in the family has been found.
Electrophysiologists are cardiologists who are experts in abnormal heart rhythms. Appointments can be made with the electrophysiologists at UCSF by calling (415) 353-2554. Electrophysiologists at other hospitals can be located by searching on this website.
Precautions
Individual recommendations should be made with the help of a cardiologist. Individuals with LQTS are often advised to avoid medications that prolong the QT interval. Such medications can bring out arrhythmias and can even cause cardiac arrest. A list of medications to avoid is maintained at www.qtdrugs.org. Additionally, people with LQTS should stay hydrated since dehydration can also provoke abnormal heart rhythms. It is a good idea for people with LQTS to wear a medical alert necklace or bracelet.
Dangerous heart rhythms are sometimes associated with specific triggers in LQTS. There are different types of LQTS and certain event triggers have been associated with the different types. Sometimes individuals with LQTS are advised to avoid certain triggers such as exercise, particularly swimming, sudden loud noise, and extreme emotion depending upon their past symptoms and the type of LQTS they have.
For more information on long QT syndrome:
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