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
helen90430 terise78
Posted
I am only 4 days post op and I am overwhelmed with the pain.
The nights when you are trying to sleep are the worst. The only thing that is working for me and has been prescribed is 2 x30mg cocodamol every 4 hours and 1x50mg Tramadol two hours after. Or 10ml of morphine sulfate if the pain is very bad instead of the Tramadol. I find raising the leg and applying an ice pack ten minutes on and ten minutes off helps to reduce the swelling which I believe is a major factor with the pain
At the end of the day the post op pain for us all is excruciating but it doesn't last forever. Just think at the end of your rehabilitation we will be pain free which is something I personally have not experienced for many years.
Oldfatguy1 helen90430
Posted
Helen, when you realize the damage that has been done and the entire process including tourniquet for blood control, bone chiseling and drilling etc, the damage done to soft tissue, there isn't any part if this that doesn't create pain. Then consider that Drs tell you, if they are honest, its a year before you own the new knee. Now, you are in the 1st week. That will tell you something about the journey ahead. Patience is the key. Slow steady progress. Don't be discouraged. Maybe think about 20 on 20 off for the ice. Push yourself but don't try and beat the process and this is truly a process. Stay ahead of the pain by taking meds as prescribed. Don't let the pain get ahead of you because its too hard to try and catch up. Understand there will be aching and soreness just don't allow anyone including yourself put you I to real pain. Sleep will be the most precious commodity you can find. Rest is necessary for rehab so sleep any time you have a chance...day or night. Don't be impatient and give up...you will recover even if you're sure right now it will never happen. I've recovered from 11 surgeries on the knee and leg including 5 full rehab. I was y5 when I started and now 80. Thinking of you and praying for your well being and recovery. Stay with this group....its a wonderful forum and everyone speaks from their heart and experience.
helen90430 Oldfatguy1
Posted
Thank you for your response. I actually work up on the operating table. Obviously I couldn't feel anything due to the spinal tap. I was horrified initially but found it a sereal moment.
I heard the drilling and metal being hammered and my whole body was being pushed and pulled.
Thanks for your advice
CHICO_MARX helen90430
Posted
Listen to OFG... You are at the worst part of this and, unfortunately, that could last a little while longer. Gotta stay on your med schedule...
https://patient.info/forums/discuss/staying-ahead-of-the-pain-563395
That's one of the things that will help get you past this set of horrible days. They sent me home with an icing machine so I had that wrapped around my knee all the time. There's also a thing called a Cryo Cuff that is manual but also very effective. Used it for knee scopes and shoulder ops years ago.
Sleeping... Some of this may help...
https://patient.info/forums/discuss/trouble-sleeping-post-tkr--539591
Just hang in...it will get better... I'm 15 months post-op and I barely notice it anymore.
Oldfatguy1 helen90430
Posted
I've always had general so can't relate yo spinal. The last 5 or 6 surgeries I've had a femoral drip that stay 24 to 36 hours. Absolutely the greatest thing since the invention of sex. Of course afterwards it's a bit dicey getting the right amt of pain meds. My Dr is a teaching instructor at a university med center and he really has a great feel for pain management. His is more the hands on rather than text book only Approach
Waffalobill Oldfatguy1
Posted
Had a upper endoscopy last week. Doc used fentanyl to put me out . 2 doses. Then verse to make me not remember anything. Also 2 doses. I came home and slept for 3 days. Wife said I talked to the doc after the procedure. Don't remember anything. 3 days of fog. Lol. That was Tuesday morning. Can't remember anything before Friday night.
CHICO_MARX Waffalobill
Posted
All my docs use Propofol ("Jackson Juice"
for anesthesia. I cannot imagine Fentanyl. Just put me in a box and ship me to Tahiti...
Waffalobill CHICO_MARX
Posted
Dude, I couldn't wake up! My wife works nights so I went to bed at like 4 pm day before. Wanted to get up to eat before fasting started at midnight. Layed back down at like 1 am or so. Got back up at 7. Left at 9:45 to be in hospital at 10:30. He was running a little late. Procedure scheduled for 11:30. Didn't get in til 12:45 or so. Only takes about 30 minutes or less. They started IV when I got there. He took me in. Sprayed my throat to numb it. Pushed the fent in. I counted to 125 or so and was out. Remember the nurse and my wife telling me to wake up. Drank some apple juice. Went home. Don't remember the ride home. Couldn't stay awake. Slept rest of the day, all night. Lol. Got up at 7 am next morning. Ate, was up a couple hours, went back to bed. Got up at 3 pm. Couldn't wake up. Sat here trying to watch TV, was back out. I remember nothing til Friday afternoon. Stuff is wild. Been put under 8 times or more. Never had nothing like that. That verse stuff to make you not remember anything worked. Lol. Wife said after I talked to doc and shook his hand. Don't remember that at all.
Oldfatguy1 Waffalobill
Posted
Man, that's a load for anyone. I have only had one scare when it comes to anaesthesia. In the early '80's I had an upper abdominal hernia patched and something went wrong. My potassium got depleted and I hallucinate like crazy for about 24 hrs. Great stuff except it could have been fatal.
CHICO_MARX Waffalobill
Posted
Versed is very effective. Docs need to give me a little extra anesthesia when I have endoscopies, colonoscopies, etc. Been known to come awake in the middle of an endoscopy and pull the camera right out of my throat...not that I actually remember the incidents...just been told about them.
With the Propofol, I'm completely awake after every procedure, getting in the car, going out to eat, and more. Never a problem. After my LLIF fusion in March, I was walking down the hallway, climbing PT stairs and talking to the doc...remember everything. I have to make sure that they never use Fentanyl on me...
Waffalobill CHICO_MARX
Posted
CHICO_MARX Waffalobill
Posted
When I was in extreme pain the first week, I called Warner Brothers and had them send over Wiley Coyote with the 16-ton weight he always tried to drop on the Roadrunner. Good night's sleep...
terise78 CHICO_MARX
Posted
Update on my pain meds.....
Last Friday I ran out of my oxycodone. I took the 7 days worth of pills that my surgeon grudgingly allowed me to get filled and stretched it to last 10 days. I was a wreck over this past weekend. Used Tylenol and ibuprofen but as usual they don't provide any relief. Could only do some of my exercises. Just too painful. This morning I was stiffer than usual and had swelling just below my knee with pain shooting down my shin. Went to my physical therapy appointment and was in tears within the first 5 minutes. Explained my predicament of not being allowed any more pain meds and therapist was livid. She immediately emailed my doc to explain that I wasn't able to do my therapy due to do much pain. She massaged my incision then let me lay on a table with a huge ice wrap for 10 minutes to finish the appointment. Haven't heard anything from the surgeon's?office yet but I'm pretty sure he'll be writing me another prescription very soon.
CHICO_MARX terise78
Posted
Every doc is on edge about prescribing the opioids that TKR patients ABSOLUTELY NEED to get past the first 30 to 60 days. It's a terrible situation. People need to discuss their meds PRE-OP so they know what to expect from the doc. No meds? See a different doc. Yes...there's an epidemic of this crap around but that should NOT apply to TKR patients. We're the ones who need the damn drugs and should not be denied them. Worst case: see if your GP will give you something or see a pain management specialist. It's an absurd situation for people who really need the meds short-term.