Pain Meds - Now and Later

[KneedKnees]

I'm having a RTKR on August 5th.

I'm concerned about pain medication - both for pain now, and after the surgery. I currently take Excedrin Migraine for headache and joint pain, as well as for Fibromyalgia. I can't take ibuprofen because I only have one kidney, and I have negative reactions to narcotics (hallucinations :rolleyespink:, which I don't like at all). I have had two major abdominal surgeries for which I took only Tylenol for pain.

According to doctor's orders, I have to stop taking the Excedrin 7 days prior to the surgery. I'm really concerned about this! In addition to the normal, everyday pain, I'm expecting to be more tired and have more pain because we're going to be on vacation for 8 days immediately prior to the surgery! Walking is involved and I don't want to be a hindrance to the rest of my family.

Trying to schedule this surgery has been a nightmare! We made our reservations and got plane tickets for our vacation in January. When I saw my ortho in March and he recommended a knee replacement, I had to wait until the end of school (I'm a teacher). The surgery couldn't be scheduled early enough in the summer for me to be ready to get on a plane on July 27th. So...the next best time was the day after we return - August 5th. Otherwise, I would have had to wait until next summer, and I don't think I could stand another winter of pain like this past year. With the surgery on the 5th, I'll still be missing 2 weeks of school, but I just couldn't figure anything else out.

So...I'm concerned about PAIN!I'm pretty tough, but I've never thought that Tylenol does much for me. Post-op I will probably try some of the narcotics they offer, and see if there are any that are better than ones I've hallucinated from in the past.

But, I'm worried about vacation. I can't even imagine a day without Excedrin! I take it 3-4 times a day now, and sometimes more when in a lot of pain.

I have a pre-op doctor's appointment next week, and I'll ask him if there's anything I can do for the pain. And, we have to talk about my previous blood clot in the right leg - another fly in the ointment.

Lots going on in my mind right now makes it hard to sleep! I really need to "chill" - but it's hard when my to do list includes;
- all lesson plans for all of my classes for 2-3 weeks
- getting my two classrooms ready
- cleaning and preparing the house for post-op
- parents that need care/help
- packing and getting ready for vacation
- exercises
- doctor's appointments

OK - I'll be okay!

Thanks for "listening"!!!

 

[newnee]

I take Tramadol I can only take it at night because it makes me sleepy. I don't know how it reacts with the kidneys though. It is what is helping me get through the pre surgery days.

 

[OKMichele]

I'm right there with you. Up against a hard deadline next week and so many things I have to get done before. I had a similar scheduling situation - working around school, work and vacation schedules so I've been in waiting mode since April.

We just came back from vacation and I understand what you're saying - I survived vacation with Motrin and ice packs and still had a lot of pain. As of yesterday, I can't take any Motrin, so I'm taking Tylenol and otherwise just dealing with it and icing my knee.

I'm also concerned about pain - I'm allergic to codeine and any drugs with synthetic codeine. They are going to do spinal blocks (or something like that) to help for the first few days. I'm sure they will be able to help you and I think you are right to bring it up.

My best advice (I realize you didn't ask :wink1 - breathe. Ask for help and let people help you. Take it one day at a time and it won't be so bad.

Rooting for you from the sidelines,

Michele

 

[jerseychick]

Hi Kneedknees, welcome to BoneSmart. I am not too sure about what you can take, but I was on Percoset, then Vicodin, then Tramadol. You will need some heavy pain meds for a bit, make sure you ask your doctor. You will not get the relief that you need on just Tylenol and Excedrin. Our mother hen and nurse, Jo would be the best to answer your questions about pain meds.

Just curious, when do school start for you? I am also a teacher and had my surgery last June 9th. My OS didn't allow me to go back to work for 8-12 weeks and believe me I wasn't ready to go back before then. I started back to school the first week in Sept and it was still tough. Your plan of going back after only a month or so may be a bit too ambitious. Make sure you read the articles in the library. Lots of good info there.

 

[kneesrus]

Excellent post. As your MD has told you about aspirin products, there are bleeding issues to deal with post-op and possible blood clots. I could not wait to have my second knee done because of the pain in the knee. My MD is very good and very popular. Even being a health provider and exchange patients with him, I had to wait 8 weeks to get on the surgical schedule. I even told their staff if someone cancels at the last minute, I could be their in a hour. So, for 2 months, I did not eat breakfast or lunch just in case they called, it hurt that bad. The procedure went great, I had pain after surgery but it was very different kind. I was up and going because that bone on bone pain was gone.
I will let the Smartie Nurses give you advise of medications. They know a great deal more about that than I do.
Best of luck mate!
David

 

[Josephine]

I've never thought that Tylenol does much for me

Well, the question is how much Tylenol did you take and how often?

 

[KneedKnees]

Hi All,

Thanks for your words of wisdom!

newnee - My doctor gave me a prescription for Tramadol, trying to help with the transition, and I took one last night. NOT GOOD! I am having bad reactions to it, and won't be taking any more. So...back to square one!

OKMichele - I hope you and your doctors figure out what to do for you as far as pain. I don't do well with codiene either. I'm planning on lots of rest and ice packs on vacation! Do you have a surgery date set yet?

jerseychick - Our school starts on Aug. 24. I know I won't be there then, and I have a sub lined up through Sept. 9, but I'm just praying for a speedy recovery so I can get back sooner. I am ready though, to follow doctor's orders as to when I can return!

kneesrus - Thanks for your encouragment - I'm looking forward to a "different kind" of pain!

Josephine - I took whatever dosage of Tylenol the doctor prescribed. I don't recall what it was, as that was many years ago. I just recall that I didn't get relief that I needed.

Everyone - I'll keep you posted on what the doctor says on Wednesday. I'm going armed with my questions about Excedrin and post-op pain relievers. I hope to have some answers that will decrease my stress and anxiety level!

Thank you again for your encouraging words.

KneedKnees:yes 4:

 

[jerseychick]

Good luck with your appointment!

 

[KneedKnees]

I just returned from an appointment with my surgeon, and am feeling relieved about most of my questions, yet a bit puzzled about something else!

First, he gave me the go-ahead to continue taking Excedrin Migraine for pain. Since I get headaches almost daily, and have fibromyalgia, and cannot take anything else (various reasons), I was VERY concerned about what I was going to take for pain between now and the surgery on Aug. 5. If you recall, I am going on a college visit/vacation with my husband and daughter - leaving a week from today, and having the surgery the day after we return. I was envisioning not taking anything for pain the entire time we're gone! The doctor said that I should try to cut back the last couple of days prior to the surgery, but the main result of continuing taking it is that there will be more bruising. So, I feel better knowing that I'll be able to enjoy my vacation, not having to worry about and be in pain the entire trip!

Then, I asked him about pain meds following surgery. He assured me that they would find something that would work. I have a list of the narcotics that I've taken that have caused hallucinations :rolleyespink: and other negative reactions, so that will help them. I feel reassured that all will work out.

My puzzlement came when I told him that my left (better) knee hurts more than the right one (RTKR - Aug. 5). He suggested I could still change my mind and do both! I had pretty much decided that in order to get back to school as soon as possible, I would wait and do the other one sometime later. He said that since I'm relatively "healthy" and "young":wink1:, the recuperation and rehabilitation time wouldn't be that much greater. The biggest reason this sounds good to me, other than having BOTH knees pain-free, is that I would only have to pay the insurance deductible once! I know that's a horrible reason to consider it, but it's also very real and practical, when our deductible is so high. When my expenses for this are going to be astronomical, I don't even want to think about having to pay them AGAIN.

Any thoughts would be appreciated...

KneedKnees
Sally

 

[mkmn]

Hello. I had a LTKR on July 14th - one week ago today.

I have difficulties with narcotic medications also. When I take narcotics, not only do I become very ill, (vomiting, confusion and dizziness), but my BP and respiration drops dramatically. My OS and the nursing staff were excellent in finding a balance that was safe for me.

The anesthesiologist put a nerve block in my leg which helped to control the pain for the first 48 hours. The first 24 hours I was on IV medication but they only used 1/2 dose than the would normally and gave it to me farther apart then normal. They said the problem comes when the medication accumulates in my system so it is not so much one dose, but the cumulative effect of several doses.

After 24 hours we went to Oxycodone orally but instead of two pills every 4 hours, I took one pill every 6-8 hours and supplemented with extra strength tylenol every 6 hours. This managed my pain fairly well. The best thing was that I did not become ill, other than a small drop in BP and a little dizziness, those first three days post-op. That was the most successful pain control I have ever received.

I realize that every person and OS is different. I just thought it would help you to know that it can be done if the treatment team is willing to take it slow and work with you.

I told the anesthesiologist, OS, every nurse that cared for me about my issues and request to take it slow and careful with the pain medications. One nurse told me it was "plastered all over my chart". :th_heehee:

My best advice would be to give the tylenol a try - even if it helps take the edge off of your pain, it is doing something to help you. Also, talk to your treatment team about your past experiences, your fears and what will work best for you. I hope your experience is as good as mine was.

Good luck to you!

 

[KneedKnees]

Karen,

Thank you for your comments about your experience with pain meds following your LTKR. It's encouraging to me!

I think the best advice I can take away from your post is to talk to everyone who cares for me, especially those responsible for administering pain meds, that we need to take it "slow and careful". I'd rather be undermedicated, than sick from too much medicine. (I have Fibromyalgia, so I'm very used to being in pain! I'm just hoping that I'll only have that pain remaining, not the knee pain!)

My surgeon has stickers about my adverse reactions to narcotics all over my charts, and I'll make sure to discuss it with everyone! I will probably also be trying Tylenol - depending on whether or not they have anything else that I can tolerate.

Thanks again ~ Best of luck with your recovery!

KneedKnees
Sally

 

[Jamie]

Yes, Sally.....you must keep that communication going all the time while you are in the hospital.

You might want to consider doing both knees. You would be done with the whole thing and just have one recovery period. Granted, you might not be able to go back to work quite as fast with a BTKR, but you'd be finished with the whole process so much faster.

 

[KneedKnees]

Jamie - I haven't checked my other post yet today, but I have decided to do BOTH knees! Needless to say, I'm a bit nervous, but now that the decision is made, I feel good about it. I think that once I realized that I wasn't going to be at school for the beginning of the year, it was okay to do both knees and have a longer recovery. (The only thing I'm worried about is finding a substitute for my Choir classes!)

I'm still a bit concerned about the pain medications, but I'm confident that I can communicate with everyone about my reactions to various things, and will find the best relief.

My decision was made based on the realization that my "good" knee wasn't good at all, and would have to be replaced soon. As long as I wasn't going to have a good knee to rely on, I thought I should just go ahead: 1 anesthesia, 1 surgery, 1 recovery, 1 deductible/out-of-pocket expense. In essence, two for the price of one! And this way, I'll be done!

Thanks for the encouragement!

KneedKnees
Sally

 

[Jamie]

Sally.....I think you have made an excellent decision. You thought it out logically and came up with the right solution for your particular situation. That's exactly the way to do it!!

 

[referee54]

I teach, as you know, and one reason that I had a BTKR was to get it done at once---"one fell swoop", as Macduff said in the play, Macbeth. I wanted to get both over with ASAP.

Recovery, honestly, was a little bit (OK, at times, a lot) more challenging, but I sure am glad that I had the BTKR; it got my life back in order that much quicker.

Congratulations on your decision to have a BTKR! I believe that it will work out for the best for you---you will get both done and be able to move on with your life and with teaching.

I am also likin' your reasons:

"1 anesthesia, 1 surgery, 1 recovery, 1 deductible/out-of-pocket expense. In essence, two for the price of one! And this way, I'll be done!"


I believe that your "BOGO" will set you on the path of being pain-free and living life and teaching much sooner, and without the angst of going from one surgery and waiting for the other.

If you have any questions or concerns, pleas e do not hesitate to PM me!

 

[KneedKnees]

Referee54

Thank you!

 

[Barstamp]

Pain meds really are an individual thing. Oxycodone made me hallucinate and get very moody. I flushed it away and took Advil. This was for repair of femoral fx that would not heal. Surgeon used the incision that I had for my THR, in 1997. The pain control was not very good when I had the THR done. I know this will be much better.

 

[Josephine]

You flushed oxycodone down the loo? Don't you think that's not a very wise thing to do? It contaminates the water base. Always take unwanted drugs to the pharmacist to be disposed of properly.

 

[kneeper]

Our city water department has a periodic unwanted Rx collection day (with the cops on hand for those narcotics).