Pain meds don't work
Posted , 13 users are following.
I'm wondering if anyone else has had a similar problem getting any pain meds that actually help.
I'm 8 weeks post TKR & progressing very slowly so scheduled for manipulation.
I've tried Oxycodone, Dilautid & morphine (separately of course) with no relief. Apparently I'm unusual in that I have a very high tolerance to pain meds & therefore it's very difficult during PT or my own exercises to get the required flexion.
Has anyone had a similar experience & find any meds that work?
0 likes, 31 replies
clive45466 terri90278
Posted
It seems it changes a lot from country to country, I am in the UK. I was sick with Codeine in hospital, but they still sent me home with it. I did not take it, used Aleve I bought in the USA.
My pain levels were not controlled.
Good healing
CHICO_MARX clive45466
Posted
Shelly54 CHICO_MARX
Posted
I will try to get Percocet I'm allergic to codeine
CHICO_MARX Shelly54
Posted
My wife takes an anti-depressant that has a known major interaction with codeine in one patient out of over 100,000...she's one of them. Hospitalized twice for serotonin poisoning...left for a few days and you die. We learned a lot about these drugs...had to. Avoid anything based on the codeine molecule...not just plain codeine itself.
cynthia89958 terri90278
Posted
Hi terri, I had some simillar experience. I can't take most strong meds since I had digestive illness and other surgery. Also, GP would not prescribe strong stuff once home, so my pain levels were not really controlled but I just got to live with it after a while as it become less agonising. It does however, affect the PT and flexion.
?I ended up having an MUA due to little bend and severe stiffness and swelling. It has helped, sohave no fears about going for it. I have to work hard to maintain it now and it has not been easy but at least I have moved forward. and can work with this. I used the rub on ibuprofen ge on prescription as it is stronger than shop bought. And a range of creams and supplements to take the edge off the pains. Ice and sometimes heat have eased things. I apply organic castor oil on an old cloth then cover with a towel and a warm wheat bag. This seems to help as does light massage but I cannot of course say if this is the right thing to do, but it helped me. I'm now having some sports therapy including deep osscillation and aqua treadmill work and hoping this will make a difference, it seems to be. Good luck in your search and hope it goes well.
terri90278 cynthia89958
Posted
Thanks Cynthia. I never heard of rub on ibuprofen. I'll ask my Dr about it. Luckily my UC has not acted up, so thankful for that. Will also try the castor oil.
Wondering, did you have any issues right after the MUA? I'm supposed to start working (just a few hrs a few days a week) right after the MUA.
cynthia89958 terri90278
Posted
It has been more sore and swollen since the procedure, but certainly more flexible. I cannot say about working as I lost my job and not found another with all the knee stuff going on among other things. I would find it tough as I have been exhausted since the TKR and also still behind in progression with recovery, but I think most people having an MUA are able to return to work within a few days if all else is good. You will need to have time to do intense physio for a while after.
The gel I had was called fenbid, not sure if you are in the UK - that is the name of it here. It does not work for everyone but I found it useful.
martinarvelo terri90278
Posted
The best I could get mty hands on was tramadol, and it didn't do a lot of good. . .I'm afraid there is a great deal of grin and bear it for most people who have had TKR's. You already seem to have had the pretty strong stuff , so I'm not sure what else could work. I only managed to get tramadol until six weeks. . .then I was stuck with paracetamol (acetominiphen). Getting the flexion regardless of what pain medication you are on will for 99 per cent of TKR patients be painful.
terri90278 martinarvelo
Posted
Yes, I'm beginning to realize that I just have to accept that there's going to be pain. I had no idea.
jdftwrth terri90278
Posted
cynthia89958 jdftwrth
Posted
That is a shame, jd. Sorry to hear it.
I've had one TKR and don't feel like any further joint replacements although there is OA in hips and other knee. Here's hoping for some new treatments to become available.
terise78 terri90278
Posted
Yes, I'm exactly the same. Low tolerance for pain but need high doses of stronger meds to get even a small amount of relief. At 8 weeks post op, is your doctor even open to prescribing oxy or hydromorphone at a higher dose?
The first 2 weeks I was taking both 5mg oxycodone and Norco (10mg hydrocodone/325 APAP) plus 5mg diazepam. That's what my surgeon prescribed. (And no, taking opiates and benzos is not dangerous, as long as you are safely home and don't plan to drive anywhere.) I staggered the doses so that I was taking something every 2 hours. Even then the pain was unbearable at times. After a week at home I asked my surgeon for something stronger and was given 2 mg hydromorphone (Dilaudid). Didn't notice any difference. I did ocassionally double my oxy dose and noticed that was the only thing that noticeably helped, but didn't do that very often or I'd obviously run out too soon.
I'm 6 weeks post op and just taking oxy now, trying to cut back as my surgeon will not do any more refills. Tramadol is not an option (very bad side effects) so when I'm out I'll just have to "push through the pain" as my surgeon says.
I've read up to 10% of the population is "resistant" to opiates. Possibly a liver enzyme thing. I need to do more research on that, but I'm pretty sure I'm in that 10%. In the past I was put on a fentanyl patch in the ER and even THAT didn't work. But hey, we're in the 10%. How did we get so lucky?
terri90278 terise78
Posted
I guess I'm lucky in that my Dr. feels strongly that I need to take whatever will get me to be able to handle the PT & exercises. He actually has me deal directly with pain management dept. Taking higher doses of any of the meds just seem to make me sleepy but don't help with the pain when exercising. I don't have much pain in general, except for a bad day sometimes. It's just the exercises that are excruciating, which probably makes me hold back, limiting my progress.
I feel like I need something completely different, like hypnosis or something.
terise78 terri90278
Posted
If the pain is bad only when doing PT and exercises, maybe just try not pushing yourself too hard? Go back to a more basic set of exercises and skip the movements that cause the worst pain. At least for now, until you can hopefully find the right med/doseage that will help? I dunno. That's a tough one. What does your PT say?
terri90278 terise78
Posted
Both the PT & Dr say I have to do the tough exercises. Otherwise the bend won't come & you can develop scar tissue (which I may have already done). Apparently it's a real race against time when it comes to bending. I am making (slow) progress but I had 2-3 weeks of almost no progress & that set me back.