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TKR DodgyKnee no more<

Have you talked to your OS? Tramadol did nothing for my pain. He can prescribe something different for you.
 
I'm so sorry you are in so much pain, the first few days are rough, can you ask/before your OS for stronger meds??? I can't believe they can't prescribe stronger meds. I don't think I could have survived the first 2-3 weeks on Tramadol and Tylenol.

I hope you feel some relief soon!!!
 
Im so sorry for what you are going thru. I dont know if its helping me to know what I may expect, or scaring me into finding a way to NOT go . But I will. I just hope you start seeing some improvement and can start to move forward in your progress.
 
@DodgyKnee , I'm so sorry you are still in such pain, as @LoveGiants says, the first week or two is really painful, and I think, if we're honest, most of us on here regretted having the op at some point during that time. It IS worth it, I went from hardly managing to walk 200yards and that with a stick, before my two TKRs, to climbing Helvellyn a couple of months ago, so give it time. Can you speak to your GP on the phone? Or can you phone the hospital ward? There may be something else that you can take if they realise that your pain is not controlled.
 
I'm wondering whom you spoke to in the hospital? Was it the office staff? The OS? His nurse or his assistant?
Initially I was given high doses of morphine but it bottomed out my blood pressure so severely that I couldn't get out of bed. Finally switched to Oxycodone about mid first week, 1-3 5 mg tablets as needed every 4 hours and it worked much better and my blood pressure normalized. Oh, and OxyContin every 12 hours too. You need to talk either to your surgeon, his nurse, or your GP and get some pain control.
 
I agree about contacting your doctor about better pain control. For thigh pain I also used a heating pad set fairly low (away from the knee itself).
 
My OH rang the hospital yesterday morning because I was in such a state. Nurse said TKRs are very painful and everyone always rings up because the are worried about the amount of pain they are in. She reiterated there was nothing stronger than tramadol to be prescribed and suggested splitting the tradamodol dose to once every 3 hours, instead of 2 every 6 hours (as 2 on schedule when it's really bad don't touch it, I can't really see how that's going to help).

We then rang the GP surgery to get a further prescription for tramadol as hospital had only discharged me with a week's worth. OH went to pick it up from chemist today - GP had issued 30 tabs and had changed dosage from 8 per day to 4!

So, I'd say the chances of getting anything stronger are nil.
 
Oh my goodness, how horrid, to be told how painful somethig is but being denied proper meds. Is there some appeal process? @Josephine , is this normal in UK?

I would be screaming my bloody head off non stop to get proper pain management. That is just not right.
 
There is nothing stronger than Tramadol and a proper dose should be more than adequate. However, taking 50mgs every 3 hours would be a better approach as it does work differently.

I take it from what you are saying that you are only taking 50mg at a time, yes? You need to take 100mg and 2 paracetamol as well, every 6 hours. You also need to have words with your doctor and tell him/her that 50mgs is not cutting the mustard.

You also need to ensure you are icing and elevating a LOT and not doing too much. For instance, are you exercising at all?
 
Josephine said:
There is nothing stronger than Tramadol
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really? are you saying tramadol is stronger than oxycodone? I just cant imagine that. I have had various surgeries that tramadol would not touch, but oxy (percoset) relieved it, markedly better. Do they not rx oxy in the UK?
 
30 tabs? That's not going to last long. The nurse sounds very blasé about pain with TKRs. Yes they are painful. Yes that's what pain medication is for. I'm so outraged that those who need narcotics for genuine pain are denied them because of the "opioids addiction problem". Rant for today.
 
dianehelen said:
really? are you saying tramadol is stronger than oxycodone?
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Not stronger, just the same as. But as with all these drugs, they don't always suit everybody the same. Oxycodone did absolutely nothing for me except make me nauseous!
 
So is it possible Tramadol is doing nothing for @DodgyKnee as it did for me or as oxycodone did for you, @Josephine ? If that's the case why won't the OS give her something different?
 
Josephine said:
I take it from what you are saying that you are only taking 50mg at a time, yes? You need to take 100mg and 2 paracetamol as well, every 6 hours.

You also need to ensure you are icing and elevating a LOT and not doing too much. For instance, are you exercising at all?
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@Josephine I am CURRENTLY taking 100g and 2 paracetamol every 6 hours, but the GP has now prescribed 50mg every 6 hours with paracetamol.

It was the hospitals who suggested the 400 mg a day be split to one 50mg every 3 hours, but now of course I only have enough for 200 mg a day.

I am doing NOTHING but icing, elevating and going to the loo. I simply can't do anything else due to the pain. I haven't even done a heel slide for days for fear of setting it off worse. When I walk to the loo, it has no give or bend in it at all. Today, Sunday, is 9 days out.

I didn't know "Oxycodone" was available in UK as I've never heard of it. Yet you say it is no stronger?
 
DodgyKnee said:
I haven't even done a heel slide for days for fear of setting it off worse.
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That's okay. Don't bother about them anyway. You'll be fine without and you're quite correct to avoid doing any exercises in your present situation.
DodgyKnee said:
I didn't know "Oxycodone" was available in UK as I've never heard of it. Yet you say it is no stronger?
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I didn't say it was stronger than Tramadol. I said it was about the same. And it tends to be a medication that is only used in hospitals.

I also suggested you talk to your GP about your pain management needs.
 
@DodgyKnee
I do feel for you so much. It doesn't seem right to put people through this surgery when pain relief afterwards is sometimes so hit and miss. Uncontrolled pain of this severity is hard to bear, you can tell these doctors and nurses have never had a TKR. I was similar to you, in that I got discharged from hospital with a prescription for paracetamol on the advice of the hospital doctor, having reacted with extreme nausea to everything stronger including Tramadol. it was very rough for the first few weeks. I agree with what KarriB just said, they have to try everything available. I read on the forum that someone tried a Butrans patch or Fentanyl,maybe with anti nausea meds. Keep looking for a solution, and try to stay strong.
All my best wishes,
Tabby xxx
 
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Thanks Tabby and Josephine, I'll try with the GPs tomorrow. Although if they can halve my dosage of tramadol after 1 week when the full dosage wasn't covering it, it doesn't look hopeful.

I've been trying to find some NICE guidelines about post operative pain management to quote to them, but not having any success.
 
Hi again,
I agree, there's a bit of a dearth of choices on www.nice.org regarding post op pain management. The sufentanil sublingual tablet system looked promising but I discovered it's only for use in the hospital setting. But the fentanyl transdermal system might be worth a try, if you can tolerate the side effects. You just need something to get you over the next couple of weeks. Best of luck, we are here to support you.
Tabby xxx
 
DodgyKnee said:
Although if they can halve my dosage of tramadol after 1 week when the full dosage wasn't covering it, it doesn't look hopeful.
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But have you actually had a conversation with them about it not helping you?
 
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