Feeling the worst in the morning / lower back pain /pain meds
Posted , 3 users are following.
Hi everyone, This is my first post. I just joined this forum yesterday. So glad I found this group. I read some posts last night and was very encouraged. I am heading into my 8th week post BTKR tomorrow. So far, everything that I had read about recovery from other resources, has not been what I am experiencing.It's been much harder than I had anticipated. I seem to be doing pretty good in some regards. I have very good ROM at 135 right leg and 130 left leg. I've always been limber and it's come in handy in my recovery. My left leg is much much weaker than my right. I walked around for 7 years with severe osteoarthritis and my legs started to lose their muscle strength. My right leg was more dominant and did all the "leg work". Ha ha. So, my left leg is holding back my progress. I am a 61 year old female and do not work. My husband works at home too, so he's been able to take care of me. I am very blessed to be able to have the luxury of recovering at my body's pace. Ok, here's my dilemma: I am on my second percocet refill and will be running out in the next few weeks. I am weaning off of the med because I was told to but I still have pretty severe pain and don't feel ready to not have it. I wake up in the morning feeling so terrible. It's like my entire nervous system is agitated and achy. Also, on top of my knee pain, I'm having really bad lower back pain. Mainly my pelvis, tailbone area and all those bones that make up the pelvis, are so achy. This has been a pre-existing condition for years but now it's much worse with my new alignment. Is anyone else experiencing lower back / pelvis pain? All this laying around on it sure doesn't help. Is anyone else waking up in the mornings feeling their worst? I worry about having effective pain meds to help me through the day now that I am supposed to be weaning off the percocet. It seems a little too soon as I am still in pain. And sometimes I ache all over as if I have the flu but I don't. Any help is greatly appreciated <3
0 likes, 5 replies
CHICO_MARX carri98750
Posted
You already know that your quads, glutes and core are dead, so here's the program to get them back...
https://patient.info/forums/discuss/post-tkr-exercising-565527
...and then stairs...
https://patient.info/forums/discuss/mastering-post-tkr-stairs-552728
Next, ask the doc for some Tramadol (Ultram). It's a step down from the BIG opioids and is used as a transitional drug to just OTC ibuprofen. Talk to the doc about maybe using a muscle relaxer like Flexeril along with the Tramadol. Also try some Voltaren Gel (RX in the US)...GREAT topical anti-inflammatory and pain reliever.
Finally, your lower back pain could be the result of a change in your gait. I had it happen at 5 weeks...bad case of sciatica. My chiropractor realigned me in a few weeks. Pain gone. Think about it...
Got lots more discussions out there. Just click on my name and the "See All Discussions"...good luck.
carri98750 CHICO_MARX
Posted
Thank you for your input Chico, I have been seeing a Chiropractor for a long time and because he's a friend and doesn't charge me, he was also coming to adjust me at my home since I've been recovering. Now I'm going to him at his clinic. I've had a crooked pelvis for years, a painful tailbone along with pudendal nerve pain. I've had many abdominal surgeries when I was younger. So all that has come back to haunt me. I knew it probably would after my new alignment change. But sometimes my pelvis pain is worse than the knee pain. Thanks for the recommendations on the meds. What is the average length of time most BTKR patients are on opiates? I really hate having to take such a strong and additive drug; as I am not fond of drugs but in this case I really need them. But I'm curious how long most have to take the strong stuff. I know they have stricter laws now here in the U.S.that limit refills. What will a muscle relaxer do for me? And why do I feel so bad in the mornings. It's a different kind of pain than throughout the day. Don't quite understand it.
CHICO_MARX carri98750
Posted
First, you bilaterals are our absolute heroes!!! Doing both at once is beyond my comprehension. YOU ROCK!!!!!
Just so you know, people who get #2 done months or years after #1 very frequently have a different experiences...better or worse. I don't think I'd expect both knees to react the same to the surgeries as they are truly independent of each other and you may therefore need pain relief for one longer than the other. That said...
Generally, people are on the heavy duty stuff for less than 90 days. That gets them through the initial "horror show" and then PT. Then they transition to Tramadol and finally to OTC ibuprofen. That's the usual staging protocol which includes titrating off the BIG stuff and onto a lesser pain reliever over a few weeks. It's not like you can stop one immediately so the best way is titration. Work with your doc to move from one med to another while still maintaining a good level of pain relief. Remember...nothing but a coma will ever take ALL the pain away.
Another strategy is to take your mind OFF of the pain. Read a great book, binge watch Netflix, slay zombies on xbox... Here's a great article I found...
https://patient.info/forums/discuss/the-power-of-rest-some-great-strategies-to-try-on-a-tkr-617892
Also: This is NOT a linear recovery. There are advances, setbacks and plateaus...all normal. Post this on your fridge as a reminder...
https://patient.info/forums/discuss/the-reality-of-a-tkr-recovery-in-one-picture-626038
The whole thing takes a year. Accept it...own it!!!!
carri98750 CHICO_MARX
Posted
Ha ha, I've done the marathon Netflix thang! I'm a musician and playing my guitar is a great distraction and pleasure. Maybe I need to jump in on my adult son's video games next
What is titration in dummies terms? Looked it up but still confused. Do you mean wean?
CHICO_MARX carri98750
Posted
I'm a musician too. Started on drums and guitar in 1959 when I was 11. Strictly blues/rock bassist for the past 20 years. At 70, I'm still gigging. Every Christmas, I keep asking Santa for roadies and all I get is socks...
Titration is the method used to either increase or decrease the amount of a medication in your system. For a drug to work properly, you have to maintain a certain amount of it in your bloodstream at all times. This avoids any "roller coaster" effect in your therapy. So if you start a medication, the doc might begin with 30 mg every 4 hours and then after a few weeks, increase it to sixty. This is titrating up. Works the same way for titrating down.
In the case of things like opioids and anti-depressants, titrating down starts with your original dose, let's say 10 mg every 4 hours. For a week or so, you would alternate between 10 mg and 5 mg every four hours and then go to a straight 5 mg every 4 hours. This gradually drops the level of the medication in your bloodstream rather than stopping it "cold turkey". Then, depending on the half-life of the drug, you might take 5 mg every 6 hours then 8 hours...or...take 2.5 mg every 4 hours. Depends on the med.
Talk to your doc, but IMHO, the absolutely BEST person to talk to is your pharmacist. I was married to one for 25 years and they know this stuff cold...better than the docs. Once you have some good pharma info, see your doc. A lot depends on what med you are on (ex: Percocet) and what med you're switching to (ex: Tramadol). Somewhere in the titration schedule, there will be some overlap so as you get less pain relief from the Percocet, the Tramadol starts to pick up the slack.
All of this is very generalized. A lot depends on the meds involved and how you personally react to them. It can be a different experience for one patient vs. another.
Hope this helps...