Gotten myself into trouble...

[beachcomber]

Hello all---
From reading many of your posts I know others have been in a similar situation I find myself in. I've gotten myself into problems with the pain meds.... or rather the lack of them.....I am so discouraged tonight and rather than just sitting here crying I want to ask for your support.

Back in October when my pain was at its worst and we were waiting for all the test results to come back on my knee and my back--- Vicodin wasn't covering my pain and my PCP started me on extended-release oxycodone at 10-20 mg twice a day. I was able to manage the pain and keep on working while we figured out a plan of treatment. I worried about taking it and trying to keep teaching but I was able to hang in there--- at a level far far below my usual standards. Between the pain and the brain fog from the meds I knew I wasn't doing justice to my students and vowed that I would work my way through the surgeries and recovery and get off the oxy and back to my students ASAP.

I planned to return to school next week so decided it was time to stop the oxy and started tapering off it. (My idea) It's been a week now and I am finding that my pain levels are too high now to be productive in my rehab. I tried just Tylenol and then went back to the Vicodin, but it just isn't working for me and now I am chasing the pain...

I have been working so hard on my knee rehab the past two months and to be patient to allow my back to heal as well and now feel like I am taking a huge step backwards. Sound familiar?

Josephine---or anyone--- could this be withdrawal pain and if I just "tough it out" a couple more days it will let up? Or is it the primary, post-surgical and rehab pain that I need to go back on the oxy for? How can I tell? It is about 40 % knee pain and 60% back pain and the "pain ratings" are higher each of the past few days. When I was taking the oxy I was pretty comfortable and could do my PT, walk 3/4 to 1 1/2 miles a day and often only needed to take a Vicodin in the evening for breakthrough pain.

I am sorry for whining... but I hope you can help me regain some perspective.... I go to see both my knee and back surgeons next week but right now that seems like a very long time away....

Thank you,
Carolyn

 

[SusieSW]

I don't think you're whining at all! This sounds really challenging for you and you need some real solutions. Is there someone you can call at your doctor's office to get some guidance? If you're in this much pain, then you need to treat it with appropriate medication. I want to really encourage you to get some medical advice asap. I've been lucky that my surgeon's primary nurse is very helpful and has really listened to me when I've needed to talk to them about pain management. Is there anyone like that at your doc's office? I think you have an unusually tough situation to be dealing with both back and knee pain, and I wonder how much they interact.

I hope you get some good advice and some relief soon.

Susan

 

[Josephine]

First thing - for anyone thinking of doing such a thing - DON'T!! I know many of you are fretting about getting dependent or addicted, but you won't - trust me. You have pain, you need meds. Short and simple. You stop taking the meds and instead of having a continuous grinding pain, it sky rockets.

I think it is important to understand how pain behaves and how pain control works so I made this chart. You can see how the pain starts at a low level and gradually increases in intensity until it is at its peek. Now obviously, it takes less medication to bring it under control when it is at the lower levels. But when it peaks, it is much, much harder to subdue. So you actually need MORE medication when it is at it's peak. And this is what you have done, Susie. You have let your pain peak big time.

In order to bring it under control again, I suggest you try taking the usual dose every 4 hrs (or what ever the minimum it says on the packet, some are 6hrly) regardless - on the dot of the hour. It will make you drowsy but stick with it. When you are getting down the scale, you can start extending the gap between doses. BUT when you get to that blue arrow point, make sure you take your doses at the break-through point. Don't ever let it peak (red arrow) like that again. It's just isn't worth the agony!

 

[Pattipoo]

AMEN, SISTER JOSEPHINE!

I, too, tried going without. didn't work! I'm back at work and I'm taking my meds VERY early in the morning....so the biggest "funk" has worn off by the time I'm at work.....I also broke a low dose percocet in half and took it at lunch time....it's worked for me. Going cold turkey and without isn't worth it!

good luck!!

 

[beachcomber]

thanks Patti---

I guess it wasn't a very good idea.... and I am not sure how to get out of it yet.... whether to go back to the oxycodone after a week of tapering off them... or to try to manage the pain with Vicodin only.

I have two work-related commitments coming up in the next 10 days and am trying to figure out how to manage the pain and keep those commitments. My high school students are competing in the Oregon State Culinary Championships next Saturday and I must be there with them... and I have a looong day of presentations that only I can do two days later. No idea how I will manage that one yet....

I appreciate your support.
Carolyn

 

[Pattipoo]

Since you're probably not working today.....why don't you "experiment" with the oxy.....take the smallest dose OR break one in half like I do....then, try to put on your presentation.....something will work for you. With those long days....probably on your feet for most of the day, you'll have to have some "chemical" help!!

 

[TitaniumMan]

Just my 2 cents worth: When we come off the opiates such as Percoset or Oxycotin, if we do it too fast we get the Oxy-Flu. It feels like you have the flu for a week or two. And the pain or discomfort comes back. I tapered my dosage off and eventually stopped so I didnt have the quick onset discomfort. Now, I will admit, I take a mild sleeping pill so I can get a good nights sleep and the pill is NON-addictive because its non-narcotic. On a side note here: For the first time since my TKR on 11/20/07 I accidentally twisted and turned my affected leg instead of piviting on it as I was told to do. I was walking down the steps, stepping over my cat gate thats about 3 feet high. GUESS WHAT? No pain, just a real good strech in the quad, calf and patella area with mild discomfort. I think I gave myself a "manipulation" that I really needed. I have a bit more ROM and now, Im not afraid to use the affected leg like I used to be. My point is maybe we need that extra push by the PT or in our daily life activities. Im sure I wont be jogging any time soon, buy I feel more confifent in my metal leg!! Disclaimer: This is just my experience, I wouldnt suggest taking up Ultimate Fighting at our points in recovery!
Respects,
Chuck

 

[TitaniumMan]

Thanks Josephine for your presentation..........You are the Guru and we love u!
Respects,
Chuck

 

[cwalton]

Wow.. it was great to hear about the Oxy-flu - I went cold turkey so I could get back to work and I was so sick.. now I know.. thanks.. Also - I was going down the stairs about week 5 and my knee made a really loud POP.. scared the **** out of me - but.. didn't hurt and my flexation was increased immediately -

 

[JenniferG]

How do you drive, all?

 

[Doug]

You close one eye so you don't see two of everything in front of you. Yell yippie ki yo and go------just kidding. I'm a retired cop so I would recommend you don't drive. If you do, make sure you know the effects of the drugs. Most Dr.'s don't recommend you drive for one month afterwards.

 

[Skeet]

I drive with my pain meds, but only if I feel alert and able. I only take 1 a day at most, usually at night, so I don't think it affects me much. When I was taking more, I didn't drive and medicate at the same time.

As for pain meds and work - I find they have made work more bearable ;) Seriously, I take my pain meds with me everywhere and when I feel the pain increasing, I take one. I have agreements with my kids that if necessary, they will come get me at work and bring me home!

 

[JenniferG]

You do all make me laugh. Laughter is the best medicine. But if you get past the physical limit of 4 weeks to drive (my dr says same) but you are 8 wks postop and still in pain, still taking meds? Or do we just not state the obvious....

 

[JenniferG]

Thats what I thought skeet, by that point mostly used at night. I suppose you build up a level of tolerance and ability to perfom after a while as well. I know the oxys made me so drowsy I could not keep my eyes open. Maybe that was just my reaction when I took them.

 

[Skeet]

I didn't drive until 9 weeks due to my drug use... sounds funny to talk about my drug use...LOL

 

[Doug]

I take one in the early a.m and then at night.
As for humor, you'll definately see it on this forum.

 

[Pattipoo]

I drove at 4 weeks. I had surgery on my right knee. I practiced in our driveway before I got out on the road. I had to make sure I could quickly apply brakes if needed.

 

[Skeet]

I had surgery on my left knee and drive a stick shift... that slowed me down a lot.

 

[beachcomber]

Cabin fever made me drive at about 10 days.... but not far! (left knee/automatic transmission). I found I needed to use my right hand on the steering wheel and my left hand to hold my knee together. It felt like it was falling apart into a million pieces right there in the foot well....

It was also very hard to bend my knee far enough to get into the driver's seat.

So there are several reasons why you don't drive right away! And it is not a good idea.

I did drive myself the two miles to my OS to get my staples out and walked into the office without crutches or cane. It was on sort of a "dare" from my OS. On the day he released me from the hospital he told me another patient had walked in unassisted and she was 10 years older than me--- so of course I had to show him I could too!

 

[cwalton]

That's why I had to get off of the meds.