17 days out TKR pain meds cut... in pain and depressed

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I had TKR left knee on October 25, 17 days ago. Under NJ law, doc says he cannot give me any more Percocet 5-325 (got total of 100 at 1 every 4 hours which lasted until today) and he urged me to use Advil or Tylenol. Tylenol doesn't work for me and Advil is hard on my stomach, which is already compromised from gastric surgery. Right now, I am using some 10-325 Vicodin that I have here in my medicine cabinet. I am stretching what I have out to every 8 hours and supplementing with Advil to try to stretch supply. I feel that I need the pain killer for 1.) sleep, which is a nightmare and 2.) before outpatient PT which I start in two days. My doctor keeps telling me how I should be able to handle this with Advil. I found his attitude insulting. His attitude was "it is out of my hands" and "lots of my patients never take pain medication".. which made me feel terrible and weak and depressed. Doc said had to send me to Pain Management but you call them and they are booking appointments three and four weeks out! I don't want to be on Pain meds then!  My in-home PT says I am doing really well. And, as long as I had the pain under control, I was feeling really good and optimistic. Now, facing the prospect of not having any RX pain killers just three weeks in and still in a lot of pain, I am depressed and angry. I would have expected to get at least a 30 day supply of RX pain meds for such major surgery. Had staples out three days ago. Had x-ray. Doc said everything looks good. I ice and elevate almost constantly. Is it normal to still need RX pain killers 17 days in?

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  • Posted

    Wow, your doctor sounds lovely. NOT!! I'm almost 8 weeks and I'm still on painkillers. The ones I got from the hospital ended quickly so I'm taking the ones I need for my arthritis, I've still got it in my left knee. I don't blame you for being angry, you need all the help you can get to get through this.

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    • Posted

      Thanks. Yes, I have heard from other TKR patients that they were able to rely on RX painkillers for at least 4 weeks. Knowing that I am not going to have them for just a couple of days longer is just adding to my stress. Plus, managed to get a UTI on top of everything else... it's regular party here In NJ! smile Thanks for your response.

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  • Posted

    I'd like to know who had a TKR without ANY pain meds?  That's a ridiculous thing to say to a patient and I'm guessing your Dr. has never had major surgery.

    The "new" opioid crisis in the USA is making it very difficult for Dr.s to prescribe proper pain medicine.  I'm so sorry that you are going through this.  The pain WILL ease up in a (hopefully) week or so.  In the meantime, you might look at buying some Kratom.  It's a legal herb that REALLY helps with pain.  You can order it online.

    Good luck!

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  • Posted

    "I found his attitude insulting."  Absolutely right!!!  Welcome to the real world...

    Yes, you will need those pain meds for a while.  YOU are the only judge of that, not the doc.  Everyone's experience is different and he cannot judge your pain based on others.  That's complete crap.  These thoughts may help...

    Percocet is oxycodone with acetaminophen; Vicodin uses hydrocodone.  Equally effective opioid painkillers but not much use if the doc won't prescribe them.  Another option is Tramadol...a lighter-weight opioid that's used as a transition drug between the oxy/hydro and just plain acetaminophen (Tylenol...available in "arthritis strength" of 625mg/capsule).  Advil is an NSAID, like aspirin, ibuprofen, etc. that could be a problem for your stomach.  

    A big majority of people are off the opioids in 30-60 days, titrating down as they go...never stop cold-turkey.  Your doc is a complete a$$ is he doesn't titrate you down to a lower dose, then Tramadol, then Tylenol.  Also, most of us need a painkiller an hour before PT, which can be really intense.  Gotta break down that scar tissue and get your ROM back.  I had some home therapy and started outpatient PT at 3 weeks post-op.  Went from -14 / +84 to 0 / +123 in 10 weeks @ 2X/week plus the work at home.  Takes a while.

    This is for sleep...

    https://patient.info/forums/discuss/trouble-sleeping-post-tkr--539591

    These are for your depression...

    https://patient.info/forums/discuss/tkr-and-post-operative-depression-604195

    https://patient.info/forums/discuss/tkr-and-ptsd-569521

    These are for doing things at home...

    https://patient.info/forums/discuss/tkr-rom-work-at-home-620053

    https://patient.info/forums/discuss/the-power-of-rest-some-great-strategies-to-try-on-a-tkr-617892

    You have a long road ahead; getting past the initial, horrible, unbearable pain is only the first of many obstacles you will face.  I used an icing machine on my knee virtually 24 x 7 the first month for pain and swelling.  Helped but really needed the meds even though I HATE opioids and I need big doses since I have a resistance to them.  But you get past the really bad pain fairly soon, although that's no comfort when you're in the middle of it.  Just remember...

    https://patient.info/forums/discuss/tkr-strong-594566

     

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    • Posted

      Thanks very much for the information the validation and the links! My doctor said his hands are tied by recent NJ state law limits ortho ability to prescribe. I specifically asked for Tramadol and he said he cannot do it. I am going to ask my GP on Wednesday for Tramadol.  I am doing OK for another 7 or 8 days because I have Vicodin that isn't mine that I am using. Not an optimal situation.

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    • Posted

      Screw Jersey.  I grew up in Brooklyn and moved to Joisey in '71 to start my masters at Rutgers.  Lived there until 2010 and now live in Texas.  We have no problem like that down here plus they've just legalized medicinal weed; dispensary opening in Fort Worth in the next 4-6 months.  That'll handle all the pain you'll ever have...ever...  PLUS...the warm climate really, really, really helps!!!  AND...it's one of the cheapest places to live.

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  • Posted

    Unfortunately all this opiate scare is turning docs into rabbits. They are running scared of politicians instead of fighting for the patients rights. I wrote a letter to my rep but I'm sure it's water off a duck s back. One lady on here said her Dr gave a 14 day supply and said she was through. Basically, the Dr s are having to be subject to writing letters on every script If the state requests such documentation. CVS drug has said they were only filling 7 day scripts. That means the doc has to write a new script every week, you have to go pick up the script and personally carry it to the pharmacy. Its a case of a few bad apples, both docs and pharmacies, ruining it for the people that needs the meds. Not much comfort I know, but it reality. Kids stealing drugs from parents and grandparents, docs just writing orders to get rid of mental cases instead of getting them psychriatic help and pharmacies willing to be suppliers to people that use them for. Crutches. Hope you get some e relief. Use ice more frequently, try Aleve if it doesnt bother your stomach.

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  • Posted

    I am at 12 weeks out from my tkr and still have some pain. I am taking Tramadol for my pain. Yea my Doctor said to use Naproxen and it also upsets my stomach that is why the Tramadol.

    ?Your Doctor sounds like a quack Doctor I had couple of years ago. No  bedside manners at all!!

    Ask Doc about Tramadol

    17 days post op you need pain meds not pain management that's my opinion

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  • Posted

    What an awful position to be in. I don't understand why a law has been passed to stop a doctor prescribing more medication that works for you. People recover at different rates so may need the stronger pain killers for longer. I'm in the UK and they are pressurising doctors here on restricting the amount of strong pain killers they prescribe. Tramadol is one of those tablets apparently they can be addictive. I'm taking Tramadol for pain as well as diclofenac I ran out of my first prescription so I asked if I could have some more expecting my doctor to say no but she prescribed me some more......I love my GP X 

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  • Posted

    Hi Laurie!

    Each of us have different pain thresholds. Medications don't always produce the same results for everyone.

    Oxycodone made me LOOPY and offered very little relief. Hydrocodone was better in making me less LOOPY, but it offered little relief. Tramadol made me sick as a dog. Aleve, Motrin, Tylenol, and Advil do NOTHING for me. I can't even tell I have taken anything!

    I switched back to Ibuprofen two weeks post surgery after I was done with my blood thinner shots. Iburofen helps take the edge off my pain. (No knee pain but LOTS of other pain in multiple arthritic joints.)

    I use IcyHot roll-on which acts as a counter-irritant (tricking the brain to notice the HEAT sensation produced rather than the PAIN. ) Pretty nifty technique which works wonders on my arthritic lower back!

    Warmth of a fleece blanket often helps.

    Just moving and shifting around helps with stiffness which can be painful in and of itself.

    My neighbor gets a nerve block. That helps her.

    You just keep trying different things until something works.

    My aunt says a good stiff drink works well!🍸🍹

    I know what you mean about the stomach issues! Meloxicam gave me an ulcer. Been dealing with that which can be frustrating.

    I try to distract myself by doing interesting things. Gardening was a great distraction and fun, too. I am back to scrapbooking since my outside doesn't need me until shovel-the-snow time comes!🌨????

    I hope you find what works for you very soon!?? Maybe you'll come up with some new ideas that we can all try! Keep in touch!

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  • Posted

    I forgot to mention...go to your primary care Dr with your issue. I've found PCP are better at listening and finding a cocktail of meds that will help with pain. That's not Dr shopping, that's dealing with reality. I'm having huge back issues at the moment. They were created by being stupid and picking my wife up off the floor iinstead of calling med act and letting the professionals do it. She is well in the well advanced stages of Parkinson's and fall frequently. Anyway, I'm probably heading back to surgery as pain is unstoppable. I had to take her to our PCP who is an internal med guy. When he looked at 9me and saw the expression of pain on my face, the 1st thing he asked was how my pain meds were holding out and did we need to try anything for relief. Not sure a surgeon would be that easy to work with. Anyway, might be worh a try

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    • Posted

      Yes, I had an appointment set up with my PCP before the surgery. I am hopeful that she will prescribe something like Tramadol that I hopefully use to get me through the night. I dread going to sleep at night.  Thanks for the feedback. Sorry you are having problems with your back. Back pain is awful.  I hope you get some relief.
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  • Posted

    Why not try a TENS machine, I've got one and I've popped the electrodes all around my knee and it does help. It distracts you from the knee pain and creates a sort of fluttering feeling. Just a thought if your doctor can't prescribe you drugs X 

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