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Bilateral TKR Journey Continuing June 4th, 2012

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RestAssured said:
Oh, I love PT! I look at it as good for mind and body! :wink: Maybe my mind has gone crazy, because I don't take any drugs except at night! LOL :rotfl:
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Well of course it's fun for you! You get to go in the water and walk while in a bouncy seat! Who wouldn't have fun with that!! Lol! Ask any one year old! :)
 
This is a lot of tedious detail about medications, so it really needs to go to Josephine; or Jamie; for direction. Boring warning for everyone else, although happy if anyone has personal experience to share!

I'm having an ultimatum with my drugs, as in, something has to give. I seem to be feeling worse as I go along. So I'm doing a little experimenting today. I got up and walked around about 8:30, to see how my pain level was, 10 hours after the last oxycontin, and 13 hours after the last percocet. No real knee pain as much as thigh and calf pain and general achiness. So I substituted 2 extra strength Tylenol for 2 percocet. I still felt queezy though, so maybe it's the oxycontin. Two hours later, I walked around again to see how the Tylenol was doing. Not much change from before the Tylenol, but other than the thigh and calf pain, not bad. Then I took the oxycontin and Celebrex to see how much that helped. Also, still feeling queezy, I took the Zofran, but tried the two pill dose rather than the one I had been taking. Of course, that just knocked me out, and I was feeling lousy as well from intestinal issues. Just yuck, yuck, yuck! After a yucky nap, and two hours after the oxy and celebrex, I walked around to see how I was doing pain wise. Much better, other than a calf pain from PT yesterday. Thinking I shouldn't ditch the percocet altogether, four hours after the tylenol and two hours after the oxy and celebrex, I took one percocet and one extra strength tylenol. An hour later, walking around, I feel about the same as before I took them. At this point in the day I feel alert and not sick, however.

So, I understand how to faze out the percocet, and I've read advise about that here, but what about the oxycontin? I was advised to give up the daytime dose first, so the nighttime dose might help me sleep, but when do I do that, and what do I give up first? The oxycontin or the percocet? How do I know it's time to give up the oxycontin? Can I back off the percocet, filling in with the extra tylenol during the day, and then will I need to step it up again when I stop the oxycontin? I'm on Celebrex, so I can't go with the ibuprophen/tylenol cocktail unless I give that up, and I'd rather take one celebrex than a bunch of Advil if I can. I have some tramadol I came home with but was never given. I wondered if that would be better than the percocet for the nausea, but seems it can have the same problem for someone with a queezy stomach and motion sickness like myself. I'll be four weeks from surgery on Monday, and other than head/stomach/intestinal isues, I'm having a very good recovery.
 
Janet, it's fine that you are doing a little experimenting to see how you feel with a little less medication. But the fact that you still have pain tells me that you need to not hurry up to switch to over the counter meds. Four weeks out is still very early for you.

When it does come time to phase out, I would start with the oxycontin. At first, phasing out the daytime dose may mean you need to up your Percosets to the maximum prescribed dosage for a few days to a week. The next step would be to drop the nighttime dose of the oxycontin and just rely on the percosets.

Have you asked your GP for something for your nausea? There are medications that can help with that. If it continues, you probably do need to have a discussion with your GP about your pain management. You could try the tramadol instead of the percoset. But I think you should wait until you are off the oxycontin before adding in another drug.

I do want you to be careful combining these meds. It's easy to lose track of what you're taking when if you are experimenting. It's better to work on reducing just one at a time.
 
Hi Janet,
I can't help with your drug regime, but I do have some experience with that horrible nausea and sickness while taking pain-killers. It's not fun, is it?

Zofran is great, but this also worked for me : Metoclopropamide, known her in NZ as Maxalon. I took it regularly while I was on the pain-killers, and it really did help. I think you have to keep taking the anti-nausea drugs on a regular basis while taking the pain-killers.

Hoping you soon get this sorted out.

Celle
 
Thanks Jamie! I have an app on my iPad with which I keep track of every dose of everything I take, and I can look back to see exactly how much I took and when over the last 30 days, broken down by day. It's been very helpful so that I don't lose track of anything. The pain is in my muscles rather than my knees which is why I'm questioning how much I need the pills, especially on days I'm not going to PT. I am on an anti-nausea drug already, the Zofran. I'm sure it helps, but isn't eliminating the issue. It's the queeziness, lightheadedness and constant struggle with avoiding constipation that is causing me the most distress. It's probably the oxycontin giving me the most pain relief based on my experimenting today. My knees are doing great! My stomach, not so much.
 
Janet,

You might want to contact your Dr. (whois giving you the meds) and tell them that the Zofran doesn't seem to be doing the job and they may switch you to another one. I took Phenagran (sp?) for nausea and it worked pronto.
 
Janet2012 said:
Well of course it's fun for you! You get to go in the water and walk while in a bouncy seat! Who wouldn't have fun with that!! Lol! Ask any one year old! :)
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No I am on an anti gravity treadmill but it is not in water. :wink:

Of course, I might identify myself with one year olds some times :rotfl:
 
My only advice about stopping pain meds is "softlee softlee catche monkee"!

In other words, whatever adjustment you make, take it for at least a weak before you make another adjustment. Trying to do it a day at a time is not a good idea.
 
Josephine said:
My only advice about stopping pain meds is "softlee softlee catche monkee"!

In other words, whatever adjustment you make, take it for at least a weak before you make another adjustment. Trying to do it a day at a time is not a good idea.
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Ughh! That means several weeks anyway you cut it. But I do think that's valid advice. I probably need them more than I realize because they are doing such a good job! It's just the side effects that I could do without. Thanks!
 
Janet,

Boy do I understand where you are.....

Here is what I know about myself.....the OxyContin gave me a sense of well being that went beyond pain control and left me sort of depressed when I stopped it. The oxycodone made no significant improvement in pain after about week 2 . Nerontin withdrawal is reported to cause nausea in some folks. When you are nauseous you don't eat ...which can cause ketosis ...that can cause more nausea. Be sure to eat carbs and drink plenty of fluids or risk a miserable number of days of dehydration, dry heaves and possibly an ER visit. If you get to the point where you need IVs you will be glad there are places like ERs and people like ER nurses and doctors.

Guavascon liquid anti acid helped w/ nausea and loosened up my BMs. Zofran helped but not completely.

It took well over 10 days after I stopped the narcotics and the neurontin before I stopped throwing up. I now look back at what happened and understand that my brain's neurotransmitters were slammed and slammed hard by....anesthesia, stress, narcotics and adjunctive pain meds. I quit the narcotics and the neurontin cold...I didn't have any more discomfort with out the meds. This past 3 weeks have been a battle not with pain as with nausea, vomiting , sleeplessness and the blues.

I don't think anyone could ever convince me to use OxyContin ever again. Same for neurontin and oxycodone.

I have been doing ok pain wise w/ ibuprofen 400 mg. I have also found that the heat in my knees improves w/ 2 regular Tylenol. If I could glue the ice bags to my knees I would. I have played around w/ lasix to try to encourage more rapid fluid loss from my legs w/ minimal to no luck. It seems that my legs will stop swelling when they want to period. I think my little exercise bike might be helping some.

Josephine rightly cautions not to stop pain meds cold turkey. For me that was the only way I was able to undo the mess I made of my brain from OR and narcotics.

I have lost 25 lbs post op due to this issue. I learned to recognize an odor of plastic coming from myself as me spilling ketones. When I detect that odor I try really hard to drink more and eat some carbs...bannanas and yogert seem to stay down best.

Also if you do start feeling better take it easy for a little while longer (3-4 days) No alchohol! I absolutely was craving a margarita several days ago. I had a med lime margarita on the rocks w/ a meal of shrimp fahitas. OMG Montezuma's ghost almost killed Mel that night!

This too shall pass, I hope you recover your tummy ASAP.

Chris
 
Chris, that is some scary stuff! My discomfort from the meds is at a low level at this point. I'm eating, even though I don't have a big appetite. I'm doing better than a couple weeks back. But as someone who was on no prescription drugs until I went on Celebrex in recent months, I'm concerned about being on these drugs and having to get off of them. I hopefully will have a better experience than you! My, my! But thank you for sharing your experience as that will help me understand what might be happening as I go through it. All the more reason I did both at the same time. Only have to do the meds once! What is the neurontin and how did that fit in with your oxycontin and oxycodone?
 
Neurontin is an anti seizure med that has been shown to help control neuropathic (angry or damaged nerve) pain. I was started on it in hospital to help control the burning sensation pain I had post op. It did help w/ this type of discomfort. I don't have that sort of pain now.


My real issues w pain are the deep bone ache from cutting the bone ends off and the tight muscular band or teathered feeling at the top of my knee. That teathered pulls and hurts like .... ( insert 4 letter words of choice) ...... This pain is particularly exquisite when first standing. No amount of stretching seems to prevent the pain, it eases up after about 4-6 steps. Basically I hurt when I walk and I'm ok when I rest. This is exactly the same situation that I was in pre op. I'm about even w/ my old self right now, no better, maybe a little worse because of the sleep/ nausea issues.

Take care, I think you will be able to come off meds w/ease. When you don't need them you will find yourself forgetting to take them. Next thing you know you'll realize you don't want to take them.

Chris
 
Janet thanks for bringing up the pain med issue!:friends:I am dealing with the same thing, that yucky feeling! I appreciate reading all the feed back you got. And on we go for another ride down the recovery slide!:thankyou:
 
The med challenge continues. Up today, walking around, then on the bed doing some exercises, including those to ease those knees into flexing just a little more than is comfortable. Walking around. I'm not in pain and I haven't had any pain meds for 12 hours. Just a little stiff and achy, but not really in the knees. Walk it out, it goes away. I don't want to load up with the big gun meds if I don't need to. So today I skipped the daytime dose of oxycontin for the first time and took the Celebrex and 2 percocets, which I'll take regularly today and see how I feel. I did take the 1 zofran as well. So it's been three hours now since I took those meds, and for what ever reason, at this moment, I'm feeling much better than yesterday. We'll see how it goes.
 
I hope this works for you. fingers crossed (((Janet)))
 
I'm just now trying to sleep on my side which is definitely better than on my back. But oh how I wish to sleep with my knees bent or flexed! I don't think I'm supposed to sleep like that but it certainly helps me sleep better. :puppysmooze:
 
Janet, I wish you well on the pain med changes. My asthma really is kicking my butt, so as of two days ago I quit all prescription pain meds and am doing ibuprofen and Tylenol. I did experience withdrawals such as restless leg syndrome and a low dose of depression, which I don't normally get. Today, mid day, I seem to be going back to my old self, don't take "old" too seriously, LOL!. We'll see what tonight and tomorrow brings! This morning I was ready to go to the ER for the asthma, but that passed!
I hope your life gets back to more normal! That yucky feeling from those meds doesn't make recovery any better! Good luck kiddo! :friends:
 
DL, I really think that if you are having NO problem with extension- and if even this early it's 0--then I can't think of a really good reason that you can't sleep with your knees flexed a little. However, you will find that you will probably wake in the night to find them aching a bit and wanting you to straighten them out for a while. I always sleep with the bottom leg pretty much straight and the top leg flexed. And I change sides during the night. this is sort of the best of both worlds.
[Bonesmart.org] Journey Continuing June 4th, 2012
Dog Lover;
 
Jacky, I'm sorry your asthma is being problematic and caused you to have to abruptly stop all those other meds! I hope the withdrawal is short or over, and that the cocktail is sufficient to keep you comfortable. Gosh, as if it isn't enough to just deal with this! I had such a better day today, even with the percocet. I think I'll take the oxycontin at night and just skip the daytime dose, and then maybe take it every other night, etc. Then I'll see if I need the percocet or can start eliminating that also.
 
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