4 Weeks--??? about pain meds

Status
Not open for further replies.

CG'sknees

member
Joined
Dec 2, 2008
Messages
151
Age
73
Location
Southern California, United States

First, thanks to the board. Along with all of you, I was busy perusing the web prior to my RTKA, and was horrified by most of the boards I read, until I stumbled upon this one. It's truly the most realistic and hopeful one that I came across.

My backstory: I'm 57, have been overweight almost my entire life, and had a mother with arthritis. I made it to age 52 with diagnosis of "mild arthritis" in my knees, and assumed that losing weight would help. I lost about 80 lbs, but various circumstances brought emotional eating and weight re-gain of about 25 lbs. On a trip with hubby to San Francisco, after a couple of months of trying my damnest to get back on track to lose last remaining pounds by going to gym workouts, I made the mistake of thinking I could climb up some funky steps up the side of Telegraph Hill (attempting to get to Coit Tower). There were about 380 steps total. I thought I wrenched my knee near the top of the climb, and ended up with a very sore knee for a few weeks. Although people encouraged me to got to the doc, I refused, assumed I just needed some time, and climbed more steps back at home in LA. WHAT A MISTAKE!! I ended up in urgent care with diagnosis of a torn meniscus in right knee. After reviewing the x-rays of my knees, the PA in attendance exclaimed that I had the knees of a 96 year-old. Gee,thanks guy.

I went to my PCP, who referred me to an OS, who recommended arthroscopic surgery. I was hesitant to do it, since I had looked on-line and had heard that for overweight middle-aged woman this wasn't the best idea. But encouraged by both the PCP and OS, I went ahead with scope in Dec 07. Yes, another mistake. Though I went through months of PT, and was doing my exercises daily, I was not able to get past the pain and recovery that I had attained by the third week after surgery. At a visit to the OS during the summer, I asked about hylaronic acid (sp?) injections. He thought it might be a good idea, could help, but I might be on the road to joint replacement. And oh, BTW, he didn't do those. What a jerk he was! Truly if I had known he was such a limited OS, I would have asked for another referral, etc. I did the shots, to get through a summer trip to Yosemite, but broke down at my PCP's office. She responded by suggesting that I go (finally!!) to the "gold-standard" knee guy in LA; whatever he said I needed would be the gospel truth.

Well, finally, I found someone who had the right idea about my knees, and the treatment I had received so far. He said point blank that an arthritic knee should never have arthro surgery, since it just exacerbates the condition. He would have initially suggested that I just lose weight and heal as best I could until I was ready to contemplate TKA. Well by the time I got to OS-2 I had struggled through 11 months of disability and I was READY!

I had my surgery on Dec 21 (just 4 weeks and one day ago), and I'm so happy I did this. Yes, it hurts, yes, there is still a lot of work to do, but I can tell that this surgery will return me to the life I had before. I could walk for miles before, and ride my bike all around, etc. etc. Now, I was still able to bike up until this surgery, but I didn't push going as far as I could before (about 20 miles in a day sometimes). I hope that by summer I'm able to do that again!

As you can tell, I'm certainly not an athlete, and don't intend to ski or run marathons etc. But to be able to live a healthy and relatively active life as I used to is my goal.

Now, about my pain meds. I was at OS-2 at three weeks for staple removal, and forgot to ask the doc about renewing my Vicodin-ES prescription. I asked the PA on my way out and she said "Oh, you should be weaning off those by now". WHAT???!!!! I hadn't gotten a full night sleep since the second week or so, and that was on the pain meds. Don't give me just Tylenol!

Thankfully I had some lesser strength Vicodin leftover from the arthro surgery last year. I took some of those, along with the Tylenol, for several days. Then just called up the pharmacy and asked for refill on the Vicodin-ES. They had to call the doc, but did get the refill.

My question/s: Is there some strategy, procedure, whatever, to "weaning" off the V? I'm doing pretty well right now with 3 doses of 5/500 V, plus 2 doses of Tylenol ES, doing this daily for past few days. Once the 5/500 are gone I will attempt to replace the Vicodin doses with 1/2 of the 7.5/750 pills. Should I drop down to 2 maybe at some point, then one? I don't want to have some major freak-out once I stop (I think I've been watching too much Celebrity Rehab...).

Well, that's my story. Hope you are all doing well. I starting my outpatient PT next week, after having in-home PT for last few weeks. I'm doing stationery bike also, doing 20 minutes daily. And of course the boring other exercises...

Sorry if I've babbled on too long.
 
Hi
Welcome to bonesmart. I am a hippy (hip replacement on June 6th). I just had a knee scope a few days ago.
As far as the pain meds, I think it is too soon to worry about weaning off them. If you have time there are lots of posts on pain meds, a lot of people take them for months, especially for the physical therapy.
Others will be adding their info for you
Judy
 
Welcome and glad you found posive support here. Strategy to weaning off the pain meds...? Not being in pain anymore. That's the strategy, and that is not going to be at 2 weeks. The dosing may change over weeks and type of drug change but not at 2. Many are still on something at 8 weeks. I was. And usually the bedtime dose is the last to go. Gotta rest to heal.
 
Hi
I am 5 weeks post BTKR. I take a couple of panadine during the day but I take at least one Endone (synthetic opiate) at night. When I left hospital they only gave me one packet of Endone so I went to my local doctor who gave me a new prescription without any hesitation

I also worry a bit about getting "hooked" on the pain meds but for the next few weeks I have no intention of giving up my Endone!
 
CG, I took them for three month solid. The third month, I gradually cut down until I determined that I didn't need them.
My Dr. gave me a re fill for 50 at my last appointment just in case I needed them. I'm coming up on 1 year post op on Jan 17. I had to take one last week at bedtime because of a weather front and having over done it at the gym.
 
CG
I went through the same thing with my OS. He took me off pain meds 1 week after TKR.
After begging him for 3 weeks,I went to my PCP. He was very understanding. At 4-5 weeks I was taking percocet 7.5/325 3 to 4 times a day. Now at 7 weeks I am taking
vicadin 10/325 2 to 3 times a day.
You are way to early to get off pain meds. I suggest talking to your PCP. They know you the best.
In order for you to recover use of your knee you need the meds to exersise and stretch.

chuck
Good luck
 
At four weeks, you probably still need the meds. What I did as my knee healed was to get to the point where I wasn't taking them on any sort of regular basis. PT ahead? Take 'em. Knee being really painful? Take 'em. Soon I was taking them very sporadically and really only "as needed." That was probably around the six week mark. Once my PT stopped at 20 visits (thanks, BCBS! :::sarcasm:::), I found I was often going three or four days in a row without taking any pain meds. I was limited by Coumadin (DVT after surgery) and couldn't take my OTC standby of Advil. At four months, I'd occasionally take a pain pill -- Vicodin ES -- if needed after a hard day. But I probably wasn't averaging more than two a week. My OS never prescribed anything stronger for me, but never blinked when I asked for a refill even at three months out.

Now I'm off my Coumadin and sometimes take a few Advil after a hard day.

Four weeks is way too early for most folks to cut the stronger pain meds totally out, IMO.

--Jackie
LTKR 5/14/08
 
CG

I am a rtkr from July - Tried cutting 10s to 5s after going back to work in August - didnt want to be too stoned. Bad mistake - realy screwed up PT. Went back to 10s for (10/325 hydrocodone and also flexirile for muscle spasm) a total of 4 months. Made it through PT - got to 12 or 125 while still on meds. Went through withdrawl during a flu/bad cold period of a week. Ughhh. But it was a good way to get off the drugs. Used them for the last 3 or so visits to pt and then a couple of bad nights recently b4 I had a hip scoped. The office I deal with is very pro drugs. the watch carefully and will not let me get inappropriately "hooked". I am surprised at the amount he has me on after this scope 2 10/325s every 4 hours until my post op apt on 12/29. We had a power outage last pm and I slept through my 7 am dose - woke at 9 and about cried when I moved. YEOWEEEE. Needless to say I will stay on top of the meds. I really trust my docs and will follow with whatever they say. Pain inhibits progress and progress is so very important!!!!

Hang in there - I do prefer the clear headed feeeling when not on the drugs - but that will come when I can get my life back physically!

Marianne
 
Thanks everyone for all the input. I did hear from a friend that I should check with my PCP, and I remember now that my PCP was willing to put me on vicodin back in the summer when I was complaining about my lack of progress after the arthro last year. So I guess I'll have to check in with her...ughhh...another doctor appt.

I can hardly wait for the day when I can get through a month without a visit to the clinic. (I didn't mention before that I also developed a trigger finger in my left hand from using the cane after arthro surgery, which along with my carpal tunnel, made it necessary for me to visit a whole other OS for my hands. We'll refer to him as OS-Handyman. He was my favorite doctor of all the ones I've had to visit this year.)

Hope everyone has a great holiday season!
 
Well, not much for me to add - others have all said it already! But do make sure you don't stop too early. If you have pain, you need meds and are unlikely to get 'hooked'! As the pain diminishes, so does the need for the drugs. Don't worry about it.
 
Too bad you did not have a competent doc early on. I slipped on the ice a few years ago in January and given a long history of bad knees I figured the swelling (more than usually) would go down. Saw my PCP in April and she was concerned with the swelling but I said it would clear up. When she saw me again at the beginning of June she said they should be checked out by the OS. He took X-rays and did a physical exam and thought it was a torn meniscus and an arthoscopy should clear it up but he wanted an MRI to be sure. One look at the MRI and he said they are so bad (with bone edema) that an arthroscopy would do no good. He said they had to be replaced and call him when I wanted them done.

Pain is a very individual thing so you will figure out what you need. Everyone has given you good advice.

Glad you found a good doc to do the surgery

Simon
 
hi CG being dumb (from the UK) what is vicodin?? I have just started my 4th week and have a very supportive GP who reviewed my pain meds, I'm similar to you as lost loads of weight then regained it again... Also am missing my biking too do you road or mountain bike, I am having a few hicuups so nowhere near jumping back on yet!!
 
It's a mixture of hydrocodone and paracetomol, in other words, a narcotic. About 1-2 steps down from morphine. You can read more about it here which is about as reliable a resource as any other on the net.
 
Hi Gayle,

About bikes, I'm just on a commuter road bike, pedaling around town. We live in Los Angeles suburb that has a lot of bike routes, so on weekends the hubby and I like to pedal around early in the mornings. I like to say that I bike for food...as we always end up at breakfast!

My bike is an Electra Townie 3-speed. As I said in my first post, I'm no athlete. We used to play tennis a lot, but those days are long past. Now it's just gym equipment and bikes.

You got the low-down on vicodin. Here in the US it's thought of as one of the drugs that most easily addictive. Or at least that is the scare-mongering I hear all over the media. Oh, and from friends and mother-in-law. So having the physician's assistant also act like I was a drug fiend for asking about refills made me pretty darned nervous.

To everyone else, thanks again for all the helpful info. This board is a great place!!
 
Sound lovely over in the UK bikes are not very liked by drivers!! Ah seems to be more drug choice in the US I went through the same for the first six months of pain meds afte fracturing my spine and felt like anaddict, but with good support from others I realised I take them for pain, when I need them and it helped me to be able to work rather than stay off sick and claim state benefits...Health professionals really should not be judgemental sorry to hear you felt like they were :(
 
Status
Not open for further replies.
Back
Top Bottom