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TKR I have a new knee!

I can't figure out why OS Docs are so different! My first one gave me all the pain meds I asked for. Dr. Maale asked ME if I wanted more pain meds. His nurse said that he had watched me and knew I would never ask for pain meds. I said oh yes if I'm in pain I will. This was the day my leg popped out in his office before surgery. She started to giggle, and handed me the script he had written when he saw me atthe first of the day. :heehee:
 
I'm going to call my OS's NP on Monday. Maybe she'll be more understanding. I also want to ask when i can get a cortisone injection in my left knee. Then I have to call my PCP to check in about the UTI, I'll remind her that she agreed to consider tramadol. My unoperated knee would be ever so happy. I may have to stress that knee with my PCP. Lastly, I'll go to my rheumy who has been there for me all of these painful years. He's give me injections whenever I needed then, and then hold my hand and tell me that replacement was in my future. he doesn't even KNOW that I had my right knee replaced! He can still take care of my left one until that is replaced.
Sonja, it is very, very common in MA for docs to be incredibly conservative about pain meds. I get that, but I still need it at the end of the day and sometimes in the middle of the night.
 
I think my surgeon was very understanding about the pain killers because he himself had a hip replacement. That is why he couldn't understand why I only took Tramadol when I had my hip replacement last Dec. He kept asking me if I wanted more, or something different. With the knee I was very specific on what drugs I would try as I knew some would make me sick and this time it worked.
 
It indeed is crazy how different docs handle things. All of my refills for pain meds have came from my PCP rather than my OS because i'm an hour and a half away from my OS' office. All I have to do is call in and ask for a refill and my PCP takes care of it for me. As for my OS' rules on pain meds, their policy is that they won't do refills after 3 months.

Great to see you are back to work and feeling more like yourself, but I fear you have lost your mind saying you want to do it all over. :thud:
 
Hi Michael!
Hahahaha! When I walk now, my new knee doesn't hurt and my old knee hurts more than ever. I figure if I can convince them to keep me semi comatose for 6 weeks, I can do it!. :rotfl: You have 2 perfectly new knees. I'm only half done. I totally understand after 3 months no more pin meds, but 6 weeks? I'm going to ask my friend (director of palliative care) to find me some good and current pain med research and recommendations for knee replacement. Then I will share it with my PCP. Then maybe my PCP will advocate on my behalf to my OS.
Hi Debbie,
I think that you are right. Your OS must be very compassionate!
 
Wow Nyland, you have a great attitude and sense of humor to top it off! I'm happy to hear that your new knee is treating you well, you deserve it!:thumb: Now if you could get your other knee to quiet down a bit, until you get it replace too, that would be great! Yes 6 weeks and no pain meds IS to early for sure!:skep: Good luck on Monday on getting what you need for pain relief! You don't need the run around for something so serious at that, stick to your guns!

Stay well and stay positive!:friends:
 
Nyland said:
I'm going to call my OS's NP on Monday. Maybe she'll be more understanding. I also want to ask when i can get a cortisone injection in my left knee. Then I have to call my PCP to check in about the UTI, I'll remind her that she agreed to consider tramadol. My unoperated knee would be ever so happy. I may have to stress that knee with my PCP. Lastly, I'll go to my rheumy who has been there for me all of these painful years. He's give me injections whenever I needed then, and then hold my hand and tell me that replacement was in my future. he doesn't even KNOW that I had my right knee replaced! He can still take care of my left one until that is replaced.
Sonja, it is very, very common in MA for docs to be incredibly conservative about pain meds. I get that, but I still need it at the end of the day and sometimes in the middle of the night.
Click to expand...
That is my point Nyland! It is your body, you know how much pain you are in, and how dare them make you suffer! Knees are one of the most painful operations to recover, and for your doc "to think about tramadol" the next time, makes my blood boil. I have quite a few of the Norco's and still have to use one when I do "something silly"! Of course we know that is hypothetical, because inever do anything silly to make my knee hurt! :whistle: :rotfl:
 
Nyland said:
Today's update:
I went to see my PCP about this pesky UTI. ANOTHER round of antibiotics. Just 5 days and then I see her again next week and have another culture done. She gave me 20 days of ambien to sleep. I asked for tramdol. She said that she would consider, but not until we got the UTI under control. She doesn't want to add any new meds to my kidneys. Sounded reasonable to me since I saved 6 percoset. I took one when I got home today, and will use the other 5 judiciously until I can get her to ok the tramadol.
Since my PCP is in the same building as my office, I just stopped in. I worked a full day. I was supposed to begin on Monday, but today was the day. I iced and elevated and walked. It was great to see my old friends. I took a percocet when I got home, went to dinner with my husband, and now I am in this comfy recliner with my ice machine. Today was a good day. I drove, I feel well, but best of all I feel like I got most of me back.
The most amazing thing that happened today is I decided that I'm glad that I did this and I am definitely going to have the other knee done. Can you believe that I am saying that? Yup, and I mean it with my whole heart and soul. I have to wait 6 months, due to the new job, and I have to accumulate 2 weeks sick time....again due to the new job. I'm thinking spring so I can heal in time to enjoy the pool. I have no intention of changing jobs, so this time I will take the full 12 weeks this job's benefits allows. I know that I am lucky that I am feeling well, because 6 weeks is very early, but I didn't have a choice.
So, how's that for an update? Pretty positive, huh? :happydance:
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Dear Nyland,

Sorry to hear that you are still being troubled by the UTI, but also glad to hear that you are doing so well. What a shame that you will have to go all through the process again, but at least you know what to expect this time, and how good the results can be.
Well done you!
 
Besides doctors' personal philosophies about pain control, they are under pressure from governmental authorities spooked by the enormous rise in crime and violence caused by the use of and addiction to opioids by those taking them for reasons other than pain. Oxycodone (straight and in combo) especially, because of its potency and potential for abuse. Unfortunately, much of the illicit supply falls into the wrong hands via theft; and there are bad apple "drug-seekers" who obtain and fill as many prescriptions as they can get, for both recreation and resale. They are spoiling it for the rest of us. Oxycodone drugs are Class II narcotics--they cannot be refilled automatically or phoned in, but must be filled each time with a de novo handwritten (or hand-signed) prescription. Hydrocodone-based drugs are Class III and can be refilled via phone by the patient up to the number of refills authorized by their physicians. Some doctors are not used to dealing with patients in actual constant pain. Others are afraid of putting their licenses in jeopardy. It, uh, vacuums.
 
Thank goodness for my surgeon! He doesn't believe in under medicating pain, we discuss how I'm doing and what I'm taking, and he gives me new prescriptions while reminding me to be mindful of the addictive risks. I don't understand just cutting off drugs after a short time just out of policy and expecting the patient to tough it out.
 
Thank you all for your wonderful support. I had a wonderful day with my husband and grand daughter. We shopped, found our grandson a Patriots snow suit, our little princess found a pair of gold lame sandals with FUR on the toe strap :rotfl:, got our toes and nails painted....well, the girls did, papa took pictures of his princess. We went all day and then went out for Mexican food. I did well on tylenol and advil. Maybe my OS was right???? I'm elevating with my Cryo Cuff now.
Below are the hilarious lame/fur sandals that our little princess found at a consignment store. 3.99 for hours of fun!
 

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Sounds like a very nice outing today for you Nyland. I keep wondering if I should get my toes painted anymore, or is sandal weather about over with.
 
It was 74 here today and we were in Heaven! It is a nice break from the 100+ days we have endured up til now!
 
There's a reason why Josephine suggested the "Bonesmart cocktail:" ibuprofen is an anti-inflammatory, and reducing inflammation also reduces pain; acetaminophen reduces pain in general. Together they are synergistic (the effect of the combo is greater than the sum of its components), just as when either is combined with an opioid (e.g., Percocet or Vicoprofen)--but in this "cocktail," the brain's endorphin centers' "reward response" is unaffected; and alertness is not compromised. AFAIK, people are less likely (if at all) to build up tolerances to its components.
 
Well, it worked. Thank you to Josephine and to you Diva for the explanation.
 
Debbie, Sandal weather may be almost over, but painted toes are just so girly. I wear perfume to bed. :heehee:
 
I take Super Crannactin from health food store and also buffered Vitamen C.
So far, it is working!

Silver
 
Thanks, for the info, Silver!!

UPDATE: First official day back to work. I had to walk from building to building for 3 month mammography ultrasounds...to HR in the bowels of the hospital. I thought that the walking would be good, but I am so stiff tonight. the day was too long. I got in at 8 and didn't leave until 6:30. I had to have my clinical email and apps set up. Tomorrow will be a short day and I think 3 half days is all I can do for a while. Now that my laptop is set up with all of the clinical settings, apps, passwords, I can do a lot of my work from home. Bright side of transitioning from the school to hospital is that I don't have to be available to students. I've been delegating all patient consults to committee members. Now that I am connected from home, i can enter all of the consult notes from home. So, even though it was a tough, long day, I think it was worth it. It is nice to be bck to my life, but in smaller doses than today. :heehee:
 
Well, at least today's long hours got you set up to be able to work shorter hours and do some from home. So sometimes having to overdo pays dividends. If you feel good about what you got done---a stiff knee is a small price to pay---ice and elevate. Small doses of real life are always best when we're lucky enough to have it that way.
[Bonesmart.org] I have a new knee!
Great update!
 
Boy that was a long day, Nyland, by normal standards - but first day after TKR is something else. Relieved to hear that today will be shorter for you and that you can get a lot of work done at home.
 
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