Nope, 2000mg of Tylenol 4xday for a total of 8000mg a day. 800 mg 4xday of Advil for a total of 3200mg a day.
At first for about a week I was on regular dose per bottle instructions along with 5 mg of Valium before bed. Was not helping at all, but getting worse. That is when my oral surgeon upped it to present doses and added the steroid and additional Advil/Tylenol and I started PT (where I get heat treatment, ultrasound and manual massage and given mouth stretching exercise regimen.) This is an extremely painful condition. I can just now brush behind my teeth but getting toothbrush out of my mouth is still excruciating. I have been basically living on McDonald shakes to have something in my stomach to protect it from the adverse effects of the Tylenol/Advil. I also only take the Valium at night when I need to be driving during the day. Finally feel like I am turning the corner and was able to eat small bits of fried calamari when I was out for dinner Friday night (with my fingers as fork to painful) and MAC and cheese when out for dinner Sarurday night in which I could slip penne on fork prong and suck into my mouth. It was a huge portion so I had it for left overs Sunday and yesterday. I tried to eat some cherry tomatoes last night but too painful to even pop in my mouth so I had to take wee bite to get inside squished into my mouth.
All three of my kids have a mild bleeding disorder and can’t take ibuprofen at all. So I’m dreading my daughter’s upcoming wisdom tooth removal. Her brother’s face swelled up like a chipmunk and we couldn’t do anything about it.
@MaineLonghorn I saw elsewhere on CC today the recommendation that the kids sit upright in a comfy chair, rather than lay horizontal to keep the inflamation down. I don’t know why it’s supposed to help, just passing this along.
Acetaminophen dosage over 4000mg per day is considered risky in terms of liver damage, and some suggest keeping it down to 3000mg per day to have a larger margin of safety.
This regimen shouldn’t have to last much longer so I can’t be worried about long term damage; but while muscle is still inflamed and in spasm there is no other choice, but it is definitely now improving each day. Stretching the mouth as much as possible is extremely important but cannot be done without pain control. Not doing the stretching would make condition worse and last even longer! To stretch you must put your tongue on soft palette at back of mouth - open as wide as possible with no pain for 5 seconds in 20 reps. I have to do this 4 times a day, too.
Dental trismus usually resolves in approx two weeks but I seem to have a more serious case than most.
Meanwhile, permanent crown is supposed to be put on the 16th but has been postponed indefinitely. And I was suppose to have regular cleaning on Nov 1st but had to cancel that too.
Emilybee, please verify there hasn’t been an error and check with your primary care provider, or another doctor you trust. Maybe the pharmacy made a mistake, maybe the surgeon wrote the prescription wrong. People make mistakes, I would always verify and never trust something that sounds wrong.
I would think they would be checking your liver periodically to make sure it is not damaged. And God forbid you had an alcoholic drink!
There is no prescription for Tylenol/Advil. I have written instructions from my oral surgeon on dosages and times.
While uncommon, oral surgeons deal with this condition and understand how to treat it. It’s more common with wisdom teeth removal than the work I had, but usually it occurs from work done on lower teeth and where the Novocain needs to be injected for work there.
I have complete trust in my oral surgeon.
No alcohol but a lot of milk which I hate with a passion.
@emilybee I feel your pain. I had jaw surgery about a decade ago and had to be wired shut for a couple weeks afterwards. Sucking Ensure and soup broth through the gaps between my teeth wasn’t fun at all!
But the funniest/saddest part was the day I got the wires out. I was all excited to eat solid food so I stopped by Boston Market on the way home and got a large mashed potatoes and gravy. Got home, sat down with my fork, dug in… then realized I couldn’t open my jaw more than a tiny crack! Imagine every movie scene where there’s a closeup of someone experiencing a tragedy and that was my face!
I had to spend the next 4 weeks stretching out my jaw to get back my normal range of motion. About 3-4 days before I could eat those mashed potatoes, but I did get to them! I think I lost about 10-15 pounds during the whole ordeal.
I’m assuming that he must have also cautioned you that he was giving you a potentially lethal dose, and how to recognize the beginning stages of liver failure in case it happened to you.
I was starving the other night near bedtime and all I could eat was a big bowl of sour cream -which was an improvement from the milk shakes I was drinking several times a day when all I could do was sip something.I made two batches of chocolate pudding yesterday to have on hand for late night hunger pains.
I am definitely not losing weight. McD’s shakes are a gazillion calories!
I mainly drank Ensure - not many calories and somewhat more nutritionally balanced than milkshakes, although not nearly as yummy
And just to keep this on-topic, I did have a prescription for codeine but only took a single dose. I wasn’t in too much pain anyway and it gave me such wicked hallucinations at night that I never touched it again!
Broke my ankle in two places in Europe; ankle was swollen by several inches. Surgery required. Had two long flights home 4 days afterwards. Meds were only alternating Tylenol and Advil equivalents. My high pain threshold, coupled with an aversion to strong meds helped. US Dr said that’s how its done In Europe.
Had a follow-up surgery to reduce pain secondary to first surgery complications 6 months later at home; told to keep opioids on board for a week, minimum. There was pain, but I DCed all pain meds and analgesics in 3 days. Hated the tired feeling and was uncomfortable with or without it. Bet less addiction when it isn’t routine to get 60 pills post-op. That said, sometimes it is necessary. Have to help folks self-assess over time.
Many years ago, like nearly 20, I had a serious knee surgery, medial plication, very painful with a long recover. I was treated by a team physician for the USA alpine ski team. He managed pain initially with a nerve block and then with a alternating schedule ibuprofen/acetaminophen/naproxen. The key was to stay on top of the pain and to never let is run away from you by missing a dose.
About 10 years ago. I had ACL surgery on the other knee, in combination with a fractured ankle and tibial plateau, also very painful. This time treated by a team physician for the Houston Texans. His key to pain management without opiods/narcotics…also a nerve block and then Ambien to sleep through the first few days of intense pain and then again an alternating schedule of ibuprofen/acetaminophen with ice, lots of ice.
Daughter had shoulder surgery for a Bankhart tear a few years ago. She had a nerve block, was given (3) tylenol with codeine enough for 24 hours and then again instructed to follow an alternating schedule of over the counter meds. She was given compozine to help with nausea and to encourage sleep through the worst of the pain.
There are ways to manage pain without narcotics/opiods. In every instance these MDs said to follow a strict schedule, to wean off even the over the counter meds a quickly as possibly and not be afraid if pain, yes it is going to hurt but fear, just makes it worse. You have to stay on top of the pain and keep it at a manageable consistent level, but to not expect no pain, sleep as much as possible at first.
IME of the USA dr’s are just plain irresponsible handing out drugs. Having been used to a UHC system that might have given you 3 tablets or some such management protocol, to get given 60 for your 11 yr old post knee op was just irritating. I gave him 1. My DH had 2 shoulder ops, same 60 opiods per op. He maybe took 3 before going onto OTC stuff. Docs give this out for dental work. That is horrifying for most situations. Pts need to be their own advocate, it is collusion in many cases really. I was just handed a percocet with no explanation after a c section so I learned quickly to take nothing until I knew what it was. Nurses were not giving out any info. This is all very well for educated consumers but the fact that barley literate people will be given those meds with zero education is a real problem. There is a real case for conspiracy theories here.
So much depends on the individuals tendency to respond to the opiates. Some of us are give the heavy pain meds for a few days, then the aspirin/Tylenol rotations. We do fine. When given the heavy meds, we are so out of it, just wanting to sleep, that we don’t feel any high. The rotation schedule minimizes the damage to our kidneys and liver.
Personally, I do fine post surgery on Tylenol codeine4, but took Percocet once and hallucinated. Never again. Others cannot handle anything with codeine. I vomit almost most pain meds ( I mean over several hours), so I really talk to the anesthesiologist pre surgery.
I’m another who cannot take aspirin or NSAIDs. Tylenol alone is not effective for me post-op or when I have severe pain that wakes me up at night. My PCP has written a Rx for pain meds (30 pills) for me about once a year for quite some time. That way they’re available when needed and I don’t have to spend half a day (or night) in an urgent care clinic waiting to see a strange doctor or, even worse, wait weeks to see my orthopedic surgeon only to go through the same conversation about not being able to do cortisone injections or take NSAIDs. Some years I’ve needed the entire supply and other times they’ve lasted 18 - 24 months. I dread my doctor’s retirement.
One of my kids has a chronic medical condition that causes extreme pain at times. Tylenol is contraindicated due to an already damaged liver and NSAIDs can’t be taken either.
Some of our doctors are concerned about whether they will be permitted to provide appropriate pain relief for patients who require opiates even if it’s only occasionally.
All this is complicated and how you tolerate can start with your overall health. What’s effective similarly depends on what’s going on. It can be premature to assume a few doses or a few days of a narcotic will lead to addiction, in legit cases, for stable folks. Or even that 10 days or so, post surgery or in certain circumstances, is worse than being immobilized by pain and how the latter affects the body, brain, and healing.
Good news this morning - woke up for first time in 3 weeks being able to open my mouth with no real pain just stiffness. I’m going to celebrate trying to eat a piece of toast!
