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THR How to figure out the optimal medication schedule?

Pink Peony

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I just received my prescriptions noted below, and I am not clear on when to take which to minimize pain.

oxyCODONE 5 mg tabletTake 1-3 tablets (5-15 mg total) by mouth every 4 to 6 hours as needed for pain
aspirin 81 MG EC tabletTake 1 tablet (81 mg total) by mouth 2 times daily
celecoxib 200 mg capsuleTake 1 capsule (200 mg total) by mouth daily
traMADol 50 mg tabletTake 1 tablet (50 mg total) by mouth every 4 to 6 hours as needed

In other words starting at 8:00 am - do I start with all 4 medications, and then take Oxy and Tramdol every 4 to 6 hours. Or do I stagger the start time? Has anyone set up a medication schedule that seemed to work for them?

Finally, I can pick up naxolone in case I overdose, but the pharmacy said it was expensive.

I am happy to set up an excel schedule and share it with the forum, as I plan on having this to ensure I am keeping up with all medications.
 

Chrismcd

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There is an app - medisafe. It figures out when you take what, has some sounds to remind you, and very helpful to keep track.
 

zauberflöte

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Hi @Pink Peony you have a very good question, and excellent answers!
I was prescribed percocet (oxycodone/tylenol 5/325), tylenol, aspirin, and celebrex one hip, meloxicam the other. I took the aspirin and either celebrex or meloxicam as prescribed, but forget what time of day.

I took the percocet at, say, 8:00am, at, say, 2 tabs (that was my max, because percocet is a combination drug). I'd then take my next dose at noon. But that's too much oxycodone for me for the need, so the "only percocet" dosing didn't last long. After that, I did the math regarding maximum tylenol allowed in24 hrs, and took some percocet with perhaps some tylenol every 4 hours. Sometimes I left some tylenol to be taken "in between". Eventually I stretched the dosing out to every 6 hours. Eventually! So my pain cocktail was oxycodone and tylenol. I detest tramadol, and as I have asthma wouldn't want to be taking two types of drug that potentially depress the breathing. After I'd weaned, a half pill at a time, off the percocet and was taking only tylenol, I grinned and bore it until the aspirin and other pill were through (4 weeks I believe), so that I could interleave ibuprofen with my tylenol. Then I weaned off the ibuprofen, leaving me taking (as I have since second hip) extended release "arthritis strength" tylenol for other arthritic joints.

I did it all on paper (in my hip journal) and with my phone alarm. An app is good if it suits, but I need the reinforcement of writing it. I can also easily see where I've come from and where I'm going. If I knew where that journal was, I'd take a photo of a day's pain log for you-- I'm very visual and this method suits me perfectly.

This is just how I did it and is intended as a scheduling example of how it could be done. Your OS will help you understand the meds better.
 

leejaa

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I used a notebook since it was faster and easier to manage the different pills at different times. I did set an alarm on my phone to remind me especially at first when I was more foggy. The funniest part was when I pulled out a steno pad to set up it had my record from the first hip. Use what is comfortable for you and easy to use if brain fogged.
 

CricketHip

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@Pink Peony Discuss your prescriptions with your surgeon at the hospital. Write down what they tell you while you are there.
This is your best advice @ Pink Peony, especially the part about having what they tell you written down clearly for you.
I've found with both of my surgeries that they already have you on a schedule when you leave the hospital and you just continue forward with that. I was lost without my notebook that had the dosages and times listed, it can get confusing without a written record.

You will do just fine, good for you for planning ahead!
 
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Pink Peony

Pink Peony

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Thank you all, I will ask post surgery about the schedule, but wanted to have it charted and printed ahead of time, so I could just check boxes when I take the pills. I am planning on using a notebook, but will put the alarm on my phone.

@zaubflote - are you perhaps German? We think alike. :) I have never had Tramadol before, so appreciate your warning about asthma (although I don't have it).

I go between taking as much pain medicine as was prescribed, but concerned about being foggy and of course constipation.

Thank you all for the helpful replies.
 

Layla

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I had a bit of a different experience with my meds. I had to bring my prescriptions to my surgery site the morning of my THR, handing them over for them to chart and administer. When I picked them up at the pharmacy, the pharmacist explained each one to me :yawn: but I’m a bonehead and feigned listening, thinking “oh c’mon, how difficult can it be?!!”

Thankfully the surgery center sent me home with a spread sheet they had been recording my meds on making it easy for hubs. Due to brain fog from anesthesia I couldn’t remember what I said five minutes prior...for days. :shrug: Several days in my husband made me start recording the meds myself, then checking to make sure I was doing it right.

My guess is they’ll give you something similar upon discharge, but it can’t hurt to ask ahead of time as you seem very organized. If having that info will help you feel more in control / settled going in, please call and inquire before your surgery date.

I’m betting you’ll do great and I know you’re going to love the result.
I’m excited for you! :)
@Pink Peony
 

cstinchcomb

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I think that setting up a spreadsheet beforehand is a great idea. When I got home, I had bag of drugs and the notes that I made in the hospital. It took all of my focus to figure out what to take when.

Please discuss your specifics with your hospital care team; I was prescribed both Oxy and Tramadol but it was suggested that I alternate them. Tramadol was better for me during the day; a little less brain fog, and Oxy at night.

You might end up with more or fewer or different drugs when you actually get home, as they customize your regimen for you.

Eventually I set this up in Google Sheets, as follows:

Top row, drug names and prescribed frequencies, one per column, e.g. Celebrex 2xDay.
2nd row, for each drug in row 1, scheduled drug time of day, e.g., 9am 9pm
Rows 3-9, days of the week, each row tall enough for me to note the time actually taken in the little box, on a printed copy with a pen. I had no short term memory at the beginning, so this thing with the pen was useful.

I put all of the pill bottles together in a box along with a little dish, pen and printed schedule.

Eventually, I adjusted the schedule to take a few pills every 3 hours to minimize the number of pills taken at one time. Too many pills --> nausea, crackers or something recommended. I also set an alarm on my tablet as a reminder.
 
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Pink Peony

Pink Peony

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@zauberflote - my mother was a flute player, so it warms my heart to hear that you play the flute! My mother loved the piccolo and she always had the biggest smile on her face during the Stars and Stripe Forever. :)
 
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Pink Peony

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@cstinchcomb - we are cut from the same cloth. I have my spreadsheet set up, but going to add your suggestions, and that was my intent as well, to have it pre-printed out and on my countertop to check-off (e.g. manual). I will review with the hospital team my options to reduce Oxy, and appreciate your insight versus Tramadol. I am terrified of constipation.

Honestly, I don't know why they don't have these spreadsheet examples ready to go, as they likely prescribe exactly the same medicine for almost everyone. Plus instructions on how to manage 6 pills that need to be taken twice a day (e.g. do you take all at once, or do one every hour, etc.).
 

zauberflöte

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@Pink Peony and I'll bet she knew the Sousa in both keys, too, and could work it up to performance level in about 10 minutes!!

The twice-a-day pills will have instructions as to whether to take with food, before or after food, while standing on your head, it doesn't matter how.... generally if you take them approximately 12 hours apart, following the food guidelines, that could be a good bet. I take a large number of prescription and non-prescription meds, and the twice/day ones end up with breakfast and supper because one of them works best with a solid meal. Opioids also work best for many with some food. I ate a lot of nuts, yogurt, and ice cream while taking them.....
 

Hip4life

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I’ll just throw a couple of things on the pile: you can have respiratory depression with too many narcotics on board no matter your lung status. That is why you and your care team monitor any reaction or negative side effect especially with a new med. I didn’t like Tramadol at first as I wasn’t sure it did much for me but I didn’t like how I felt on the oxycodone even less. So the oxy was used just at first or for more desperate times. My PCP suggested taking the Tramadol with Tylenol and that worked so much better. So you might want to ask your doctor/nurse about that. You’re getting close! I hope you find the right combo that works for you and before you get home.
 

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It's still a few days before your surgery, @Pink Peony and you will have the opportunity to ask how to schedule your medications before you come home from hospital.

Tramadol is a "step-down" pain-relieving medication, not as strong as Oxycodone. You will probably be advised not to take them at the same time, but to use Tramadol when you feel that you don't need anything as strong as Oxycodone.

The Aspirin is an anticoagulant, to "thin" your blood and help prevent blood clots.

Celecoxib is a non-steroidal anti-inflammatory drug. You probably shouldn't take it while you are taking the Aspirin, as it can tend to cause bleeding. Do check with your surgeon about this.
 

cstinchcomb

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Wishing you all the best with your upcoming surgery. I know you're looking forward, like all of us, to those first few pain free steps followed by a return to your normal life :dancy:.

I am just about a month out and just now off the pain meds. For me they were important; I have been really focused on great posture and perfect steps and unlearning a year of bad limpy adaptive habits. A couple notes on the drugs. First hip, I had Tramadol and Tylenol only, worked fine. Second hip (now), my surgeon added Oxy, omg, makes me stoned (I kinda got used to it), but it makes me sleep (on my back even) unbelievably well. Both of these I ended up cutting in half after a few weeks, and also extended the schedule to every 6 hours because every 4 was just too much. YMMV, do what your docs say and what works best for you.

Glad the spreadsheet ideas were useful. I used my every three hour schedule to ensure that I didn't take too many pills at one time, especially during the first week when the concept of a "meal" hmm.

Constipation ... I think that the spinal + sedation puts my normally functional gut to sleep for ... days. I think this does not happen to everyone, and I hope you do not have it. But I suggest that you order up all the laxative type products that you even think you might want so that in the case you want to try one of them, they are on hand.
 

Layla

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Hello...Happy Friday!
Wishing you comfort as you move through the weekend toward your big day on Monday.
We’ll be watching for your first post on the bright side. I look forward to following your journey. All the best to you!
@Pink Peony
 
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Pink Peony

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Thank you @Layla, how nice of you to check in. Work has been so busy, and I have to work over the weekend, which is a bit of a blessing, as I don't have time to worry about Monday.

My lift chair was delivered today, I think we are going to be good friends. :)
 

GrannyC

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It sounds like you are all set. You’re right about working this weekend. It gives you much less time to dwell on the upcoming surgery. I don’t remember being prescribed that many meds - just the oxy with Tylenol. I took as prescribed initially as everyone said not to let the pain get ahead of me but it wasn’t long before I cut back on them and then went to the extra strength Tylenol. I don’t remember the time frame but it doesn’t matter because we are all different. If it were me with several meds to take, I’d take them at different times. I normally take 4 meds once a day daily for non hip related issues so I take 2 of them in the morning and 2 in evening. That works for me. As far as brain fog, mine was more that I couldn’t concentrate on something like reading a book. That continued for about a week before I could finally get into one of the good books I had gotten. Wishing you all the best on the surgery and look forward to hearing from you during your recovery.
 

leejaa

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Best wishes for a successful surgery and a great pain controlled recovery. I hope we see you on the sunny side (recovery) soon when you are able. I am sure you will love your recliner. Have a good week end though busy since you are working.
 

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