LTKR scheduled for 7/14/16

[Diane LTKR]

Thanks for your comments and suggestions. I just called my OS office and spoke to his PA. She said his policy is to wait to see how the oral meds already prescribed are working and then deal with it later if it is not working. I asked if this would be handled while I am still in the hospital and she assured me it would be. She said he normally prescribes a muscle relaxer and anti inflammatory along with the Percocet. However, I am very limited in the amount of anti inflammatory drugs I can take because I only have one kidney. I have an appointment with my PC prior to surgery - I think I will run all this by her and see what her advice would be. I know that after my last surgery I was able to take anti inflammatories on a limited basis - and they did help. Hopefully, as long as my kidney is functioning well (which I will find out at my PC visit) I will be able to do the same.

@Celle I expect to be in the hospital 2-3 days - however, after my last TKR they kept me an additional day because I spiked a fever. The OS said that the nerve block will wear off within 24 to 48 hours. So, this should give us time to make sure pain is managed. I don't have the unrealistic expectation of being painfree - just want it managed better than the previous one.

@turtle68 Dorothy - looks like you and I are close to the same surgery schedules. My first TKR was in April of 2013 and now we are scheduled 5 days apart!

 

[Celle]

I think it's a very good idea to talk to your PCP before your surgery. With only one kidney, it could be advisable to not take anti-inflammatories at all, but that's up to your doctor.
I have a medical condition that means I can never take anti-inflammatories, and yet I've had three successful recoveries from knee replacements.

 

[mamazipp]

I am not able to take anti-inflammatories due to being on a blood thinner. I did have pain, and the OS prescribed MS Contin 30 mg. morning and evening, besides oxycodone q 4 hours. The MS contin is a long acting marcotic and the oxy is short acting. Good luck with your surgery coming up.

 

[Diane LTKR]

@mamazip thanks for your info. Did the MS Contin 30mg work well for you for pain control?

@Celle. Could you tell me what meds you did take for pain management? I just want to have some options I could suggest to my OS if needed. Thanks.

 

[Celle]

I was prescribed Oxycodone and Oxycontin for the first two weeks and then a combination of Tramadol and Paracetamol/Panadol (Tylenol/Acetaminophen), which I took on a schedule very similar to the one that Josephine recommends, which is this:

NSAIDS are primarily anti-inflammatories, not pain relievers. That they do relieve some pain is incidental, as they are less than 45% as effective as regular pain medications. They also have many dangers associated with their use. As well as being likely to cause gastric bleeding, they can adversely affect other organs:
NSAIDs Diclofenac. ibuprofen increase risk of heart problems: new study

 

[Diane LTKR]

Well, nine days and counting till surgery date. Feeling a mixture of dread, excitement, anxiety, and hope. Guess that's all normal. Trying to get everything tied up at work so that I won't be worried about things while I'm off.

Wondering if someone can tell me how to move my thread to the recovery forum? Not ready to do it just yet but would like to have it ready for me after surgery (July 14th.) Thanks!

 

[newlybionic]

You will need to start a new thread in the post op side. You can start it before your surgery so you won't have to figure it out afterwards.

I'm glad you are finally close to your surgery date. I did well with a muscle relaxer and Oxycodone 5,325 mg 1-2 every four hours. My OS also prescribes Celebrex starting four days before surgery and continuing for a total of 1 month. This combo worked well for me. I also needed Zofran for nausea. Make sure you also have ready some stool softeners and miralax for an extra help if needed.

 

[mamazipp]

Diane, MS Contin twice a day, along with adequate Oxycodone on a 4 hour schedule, worked for me. Luckily I tolerate them well, no nausea. everyone on this site has had such different responses to meds, it's pretty amazing. I suppose you will have to see what works for you.

 

[Diane LTKR]

@mamazipp Thanks. I have been prescribed Percoset 5-325 (I think). I am hopeful that will be adequate. I know I had Oxycodone with my previous TKR and did fairly well with that. I think I would like to talk more to my OS about something in addition to the Percoset if I need it though. I can remember some extremely painful days and nights with just the Oxycodone - especially during those first two weeks.

The anesthetist just called me from the hospital for some pre surgery info. She thought she was being extremely helpful in telling me to make sure I ask for pain meds before PT - because it WILL HURT. I just smiled and agreed - she doesn't know I will be following the Bonesmart way and will nicely tell the PT that I won't be doing ANYTHING that hurts my knee. This isn't my first rodeo and I know from my previous TKR that the Bonesmart way is the only way to go.

 

[uva55]

@Diane LTKR I believe percocet is the same as oxycodone-acetaminophen 5/325, that's what they gave me to take every 4-6 hrs, I took it every 4, Tramadol every 8 hrs and extra extrengh Tylenol every 6 hours for the first 2 weeks, and my pain was under control, also ice ice, ice and elevate, it really helps with swelling and pain, I still ice most of the time I'm sitting down and NEVER SKIP taking your pain pills, I made that mistake and paid for it ddearly.

You will do great and you have all of us here to cheer you on

 

[Diane LTKR]

@uva55 did you take 1 or 2 oxycodone every 4 hours? My prescription actually says to take one every 6 hours. I think I will ask my OS about that. I am hoping he will prescribe tramadol also to take in conjunction with the percoset. Gosh, I will be so happy to get this surgery over and start healing. The waiting part is awful. Thanks for your help.

 

[uva55]

@Diane LTKR the first two weeks I needed them every 4 hours.

 

[Diane LTKR]

I have a question....my OS told me he recommends a sapheous nerve block. Have any of you had experience with this? For my last TKR he used a femoral nerve block but states that he feels this new one is much more effective. I had good results from the femoral block- hope this gives me the same results.

 

[Celle]

I think the saphenous nerve is part of the femoral nerve, but situated a bit lower down your leg. I don't know much about a nerve block there, so I'll ask @Josephine for her advice.

 

[Josephine]

Celle has it right. I've added a bit to this article explaining it
Anaesthetics - spinals, femoral blocks, GAs and everything else

 

[Diane LTKR]

@Celle and @Josephine Thanks to both of you for the information. I read the information Josephine referred to in the link above and it was very informative. Just trying to be as informed as I can possible be! One week from today at this time I will be in my hospital room and the surgery will be over!

 

[Josephine]

Oh we have a veritable encyclopaedia of information in our Forum Library!

 

[newlybionic]

The final countdown is starting. I was originally prescribed 1-2 tabs o 5 mg of Oxycodone every 6 hours in the hospital but it wasn't doing the trick to it was changes to every four with tramadol every 6 hours for breakthrough pain. My OS also prescribed a muscle relaxer and something for nausea( Zofran).

 

[Mazza]

@Diane LTKR Wondering what happened after your talk wth OS?

 

[Diane LTKR]

@Mazza I spoke to my OS about my Percoset dosage and he said I am to start out taking one every 4-6 hours. If that is not working, we will discuss another plan before I leave the hospital. I know that's probably the best way to handle this - start out with minimum and work up if needed - I just want to be sure this is worked out prior to going home. My OS is good and I have confidence in him - it's some of his staff that I had issues with the last time. As many have said - folks do not know the levels of pain this can create if they have not been through it themselves. I am hopeful that this will be an uneventful, managed pain recovery. Just want to make sure I take all the steps necessary to ensure that. I don't think I am being unrealistic - I know that some pain and discomfort is part of the recovery - I just want it managed. 6 days and counting till surgery!