Alternatives to Ibuprophen

[Shadsie]

A lot of the threads and general information I've been reading here recommend Ibuprophen for pain relief for after-care. In contemplating upcoming consultations for getting work, I am wondering just what I should tell or ask a dentist in regard to this because Ibuprophen is a bit dangerous for me.

I had a severe kidney-infection last spring that conflicted with a regular medication for a chronic condition I was taking at the time. I went into second-stage renal failure. I spent eight days in the hospital (getting the bad news for what I'd thought was just a stomach bug... oh, so FUN)! I have mostly recovered since then, but I've been having blood-tests with a kidney specialist every so often. Throughout this ordeal, I've been told to avoid Iburophen, Motrin, Advil - that whole family of things that affect the kidneys. I've been told that I'm at a point where I can take a Ibuprophen every once in a while, but that it's better to stick with Acetominaphen-based products. I'd much rather not take risks - the renal failure and going into shock the night I was admitted into the ER was an apex of pain I'd never felt before (and part of the reason why I'm starting to get brave about dental care again - thinking "If I survived that, I can survive anything).

Back before this happened, when I could take Ibuprophen, it seemed like it worked better for general pain-relief, headache and whatnot and since I see it listed here as a drug of choice so often, my guess is that it is a little bit stronger than your standard Tylenol? If so, what should I ask for or seek out as an alternative for dental pain after a procedure?

 

[comfortdentist]

General guidelines only as you must discuss this with your doctor
All NSAID should be avoided with kidney failure. Unfortunately this is our best class of general pain drugs.
The basic alternatives are acetaminophen and opioids.
So how to manage pain after an invasive procedure:
again general guidelines only
1. Use of long acting local anesthesia such as bupivacaine- If you are numb then it doesn't hurt and wears off slowly so less "shock".
2. Ice packs
3. Comfort and peace and love at home. Yes it matters your mental state!
4. Opioids (hydrocodone, oxycodone, etc) excellent pain relief for SHORT term use.
5. Tylenol for second day forward pain.
Acute pain is completely different than chronic pain which is not dealt with in dental for the most part. The majority of patients having undergone an invasive dental procedure will have acceptable pain relief with 1 day opioid use. Typically after the first night you are okay. There are people who don't them at all, people who shouldn't take them at all and people who need them for three days. We are all different.
personally if I had kidney failure I wouldn't take any NSAID. In fact I seldom take them anyway as I don't want to have kidney problems as I like both of mine.

 

[Shadsie]

The initial damage came from long-term use of lithium carbonate (for bipolar disorder). I was on it for ten years. I had a rather flippant psychaitrist whom I think wasn't reading my bloodwork right and wasn't attune to the danger. I had some thyroid damage due to it - then the infection hit. I have since discontinued the lithium to go on a generic form of depakote, which actually seems to be managing my bipolar symptoms better (but carries a potential liver-danger down the road). - There really is no winning when you have a mental illness. The world wants you normalized and everything that helps with the brain seems to be dangerous for the other organs. Part of what worsened my condition was the copious taking of ibuprophen when I thought all I had was the flu and was trying desperately to reduce fever and headache.

I've been told that my kidneys are recovered (at least to the best point they can be for my age, although I'm only 37). I still want to avoid the whole ibuprophen family - just for safety's sake.

I definitely do not want to go through the failure experience again. I've never had children, so when I see people gauging their dental experiences against childbirth - I've got a different gauge: "Is this going to feel almost as bad as second stage renal failure?" I figure any experience I have at the dentist won't be as prolonged, at least. (And hopefully won't come with the experience of seeing ants on the walls under a high fever). So... yes, any potential further damage to my kidneys is to be avoided.

As an aside, I did have my wisdom teeth out many years ago (when I was in college and on my parents' insurance). I was put under - I do not know if it was conscious sedation or general, all I know is that I got an I.V., I blinked and it was over with. I was given pain pills, but on the second day after the surgery I forgot to take my afternoon dose before going to work (at a fast food place) and had just about the worst headache ever. I was able to manage it with the tylenol in the first aid kit, so... I remember being able to deal with that pretty well. Unpleasant, but I got through it.