TKR 17 Days Ago. Need pain medication advice.
Posted , 10 users are following.
Hello everyone! I'm brand new to the forum and looking for advice about pain meds. I'm in the US, medium sized city in the Midwest. Surgery done at a top notch hospital. Stayed 2 nights with no complications other than severe pain. While in the hospital I was on a regimin of Norco 10/325 and 5mg oxycodone, staggered every 3 hours. Upon discharge, surgeon wrote prescriptions for 2 weeks of the same strengths of both Norco and oxycodone, each to be taken every 4 hours. I scheduled them so I'd be taking one or the other every 2 hours. For the most part this has worked well. There were only a couple times when I took two oxys at the same time after physical therapy. The pain was almost unbearable.
I had my 2 week post-op visit and staples removed earlier this week. Saw my surgeon very briefly and I asked for a refill of both meds. He looked at me with a scowl on his face and told me "we don't prescribe narcotics beyond 14 days". I explained I was having trouble sleeping due to waking up in pain. Most nights I'm lucky to get 4 hours of sleep. I mentioned how much pain physical therapy was causing, including the obvious fact that pain was keeping me from being able to do specific exercises.
To make a long story short, surgeon grudgingly agreed to one more week of just the oxycodone. In my opinion, it's gonna take a week just to taper off the oxy. I've started trying to go 6 hours between doses but it's not going well. Pain is not going away anytime soon. I ice and elevate at least 30 minutes every 2 hours.
Please don't suggest I talk to my PCP. He is so anti pain medication that upon meeting him the first time several years ago, the VERY first words out of his? mouth were "We don't prescribe narcotics here".
1 like, 49 replies
Julia-NewKnee terise78
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Wow Terise, that is highly unusual protocol to cut off the pain meds by 14 days. It's MAJOR surgery with cutting and drilling of the bones..I would consult with pain management if you have too. I'm in Tulsa Ok. Went thru Tulsa Bone& Joint. They tell you up front they will prescribe the pain meds up to 3 months then taper you down. I tried the Norco for 24 hours in hospital. Just did not work for me. Then they switched me to percocet 10/325. I personally needed the Oxy all 12 weeks of PT!
Follow what all have said to ice and elevate!
I know you're not having fun even to get out to a Dr appt and PT. But look into seeing a pain management Doc if your bone Dr won't offer you help..
terise78 Julia-NewKnee
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I'm in a catch 22 situation. As long as I'm under the care of my ortho surgeon, neither my PCP nor my pain management doc will prescribe anything for pain. Even more absurd is that neither my PCP nor my pain doc will prescribe any pain meds that are schedule 2 or 3, for ANY condition. So I'm screwed.
leta99341 terise78
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So sorry your pain is not adequately being taken care of. I'm going on my 10th wk out & my Ortho or IM makes sure I have pain meds.
I was also put on Neurontin 100mg @ bedtime for nerve pain. Helps somewhat don't feel like knives in my knee in the middle of the night.
Every surgeon is different. Mine believes in pain management for healing & rest.
I believe pain management should be a discussion for all pts before surgery. We're not taught to ask those questions
Good luck!
martinarvelo terise78
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Another pain in the ass surgeon! I just hope . . I really do . . that this man needsa TKR some time in the future, and that he finds himself with a surgeon who is a carbon copy of himself. of course, HE will be able to bend the rules and get himself all the pain control he needs. I wonder why gabapentin? that's for nerve pain, surely . . .Turned me into a raving lunatic, but I can take Lyrica, wich is very similar, with no problems. Only advice I can give is to use a combination of acetominiphen and ibuprofen, which are availalble without prescription, and to start reducing the opioids immediately, or it's going to be hell to go cold turkey! (voice of experience!) . . or find a friendlier doctor of course.
leta99341 martinarvelo
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Pretty sure they have special training for surgeons to before careless Jerks!
They started me on Neurontin because I was having so much pain at night because I wasn't tolerating the narcos. It does help the sleep & some of the nerve pain.
No good remedies if you don't tolerate pain meds
martinarvelo leta99341
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I had terrible nerve pain in the thigh , and always at night! . . that's when I started on Lyrica, but to tell the truth I didn't notice any difference. it certainly helps me sleep though! Also got polyneuritis, so supposed to be good for that.
jenny80029 terise78
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terise78 jenny80029
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Thanks Jenny. I've used a TENS machine in the past for a different area. Although it didn't work back then I'm going to inquire about trying it for my knee. And icing more for sure. I generally ice at least 30 minutes every 2 hours, and always before and after PT, making sure to rotate from front to back and side to side. I was just reading a few articles online last night that were basically saying doctors and PT are pushing TKR patients too hard AND too soon. I'm going to do some more digging online today.
jenny80029 terise78
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Oldfatguy1 terise78
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A lot of the "too hard" is evident. As far as too soon, it would depend on what your mindset of PT happens to be. The idea of getting up and walking the next day is still P T and has to be done. Shooting for a 90° bend for everyone before they can leave the hospital is probably too much for most. I read some who are forced to work hard 3 times a day. After having 11 surgeries and 5 complete rehabs I consider for personal well being that to be complete and utter nonsense. One solid work out a day has always been good. M y pt told me on my time around "15% of healing is in me, 85% is on you" and he worked me hard twice a week. 9 years later when I had to have a revision, the sessions were more gentle and types if routine modified. The one principle that now seems to be the standard, push your self up to the point of pain but not into pain. Know the difference between just aching and hurting and real pain. I learned to change the routine. One group of exercises one day and another group the next. You can t do any of them to full benefit if you are doing them wrong. One simple example, walking. Go very slowly stride correctly touching your heel, ball and toe then give it as full of a bend as possible. Sounds like a no brainer, right? Unfortunately most of us are tired and in a hurry to get somewhere and we do it wrong. My wife is in advanced stages of Parkinson's so not only am I a recovering 11 time surgical vet but I am her nearly complete care giver.....always hurrying. But when I go to the store I fortify myself with a cart and stand up straight moving slowly and correctly. As a matter of fact I deliberately make more, shorter trips to the supermarket just for that experience. Don't beat up on yourself trying to make a therapist or Dr look like the genius the want everyone to be believe they are. You are exactly what you are....a one of a kind. Love and be kind to yourself, the rest will fall in place.
BTW, if you ever get up to Frankfort, my ex daughter in law has a neat little resort hotel there.
terise78 jenny80029
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jenny80029 terise78
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terise78 jenny80029
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Thanks Jenny! I did use quotation marks but still got 389 hits. I'll check out your wordpress blog.
CHICO_MARX jenny80029
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"...God manages to work..."... but only if we are awake and aware enough to notice the reply.
Starting on your blog...very interesting. I've got almost 20 Discussions out here on the forum; people tell me that I should put them all in a blog...hmmmmmm....
I like your thoughts on patience, waiting and taking action. There's this "joke"...
Following a shipwreck, this man is on a raft in the middle of the ocean dying of hunger and thirst. He prays to God: "Oh Lord, if you love me, please send a helicopter to rescue me."
Later on, a boat passes by. He hears a voice calling: "Do you need help?". The man replies: "No, that's OK. God will hear my prayer and send a helicopter."
The next day, so much weaker, he sees another boat pass by and hears a voice: "Do you need help?". The man again replies: "No, that's OK. God will hear my prayer and send a helicopter."
The following day, the man dies. When he gets to heaven, he finally gets to meet God face to face and asks him: "Lord, I prayed to you to rescue me. Why didn't you send the helicopter?"
God replied: "I SENT TWO FREAKING BOATS, YOU IDIOT!!!"
It's so important to be awake as we walk our path...to see what God and The Universe offer us along the way. Looking forward to my continued reading...
jenny80029 CHICO_MARX
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That is very funny! 😁
CHICO_MARX jenny80029
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terise78 jenny80029
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Strange that my previous reply to you is waiting moderation. I simply said that I did use quotation marks when searching for your blog but I would go to your wordpress blog and read your story there.
Is this because I'm a newbie and am not to be trusted yet?
Oldfatguy1 CHICO_MARX
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Oldfatguy1 terise78
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I used to use a s series of dots to seperate or emphasize a though within a thought and suddenly was being sent to moderator hell. Also would throw in an occasional mild profanity and got the same reaction. Retrained my less than well educated brain ( in my case not sure if I should use either of those words , educated /brain much less in combination) and have been able to get by without the visual hand slap. Even Chico, with the new Jersey, Sicilian hand waving has mastered moderator free verbiage. BTW, its 5 a.m. and I've had little sleep due to my wife's bad night with some Parkinson's issues plus the fact I just washed my hands and can't do a thing controlling my fingers so its hard telling what's coming out of my finger tips. Back to bed for awhilr
jenny80029 terise78
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