Nausea and pain meds

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elcammeno

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I am the one who had to get off the pain med- hydrocodone, having had total knee replacement as it gave me nausea. I had total knee replacement March 2. I am taking extra strength tylenol which is not much help. When the nausea clears up I am to take ibuprofen alternately with the extra strength tylenol. I have a constant burning pain & it feels like something tight wrapped around my knee. I am just miserable. I had my left knee done last yr at this time & went through 3 different meds. I thought this time would be different as I was given a nausea med in case I got this nausea again. Last yr I tooks hydrcodone, then propoxy-n/apap & then tramadol & they all gave me nausea. I haven't eaten anything except crackers mostly & then yesterday my husband got me some V Fusion juice so that I could get some benifit of veg & fruit. I just have no desire for food but worry about getting nutrition so I heal properely. I am so afraid of trying other meds right now for fear of the nausea getting worse than it is. I am taking zofran for nausea. That is a strong med . It helps alittle. Someone wrote about contacting a pain management center. I am from Iowa. Where are they located & how do I contact them? My surgeon & family dr just don't seem like experts on pain management at all. They just tell me to take tylenol & iboprofen. Not much help. I feel so alone in this. Dread P therapy today. Would appreciate hearing from anyone else havng gone through this nausea thing from the meds & how you coped. Also do any of you sleep with a pillow under knee? I find that really helps.

Sharon
 
Poor Sharon! That's a bad state to be in. I also feel like I have a very tight band strapped on my knee. Sometimes it hurts but mostly it doesn't, it just feels a bit constraining and tight! But it's still only one month so early days and plenty of time for things to settle down yet.

I agree your doctors don't seem to be very sympathetic so you should seek out a pain clinic. Have you tried ringing some hospitals and asking them if they know of such a place?

btw I moved your post into a thread of its own as it was a bit off topic in the other thread and besides, I think you need answers to this specific problem.
 
Sharon, Jo's suggestion of contacting the hospital where you were is excellent. They should be able to direct you to a pain management clinic. Unfortunately if you are in a small town, there might not be one available without going to a large city like Des Moines or Cedar Rapids. You can also check the yellow pages or Google (pain management clinic Iowa).
 
This is Sharon again. I went off even extra strenght tylonol now because of the nausea. The nausea had started after one month on hydrocodone. I was given Zofran for nausea but only helps alittle. My stomach is now somewhat better after having nothing for pain. I gave up the extra strength tylenol yesterday as I believe it was giving nausea also. I take an anxiety pill to relax. I use ice packs, helps alittle. I will call a pain management clinic Monday to see what they say. At all times it feels like a very tight band around my knee & then it feels like a burning pain is there also. I am just wondering how long a person feels that very tight band. My total knee surgery was March 2. I sure would appreciate hearing from someone who has been where I am now.
Sharon
 
Both the burning and the tight band are features of the incision and the healing taking place. It's the typical pain most people experience after knee surgery. I certainly did and do. It will all respond pretty well to ice packs but would be better when you can find a 'Sharon-compatible' analgesic!
 
Sharon, that feeling of tightness can last a while. I'm thinking mine held on (sometimes off and on) for at least 4 months. It does lessen with time, though, if you are exercising and treating any swelling that comes up.
 
Sharon,
I have not had my surgery yet but, my surgeon gave me a DVD to watch. He said there is no set rules as to when to stop you pain meds. So I figured I'd have pain awhile. My best friend said hers stopped after 3 months.
There are so many different drugs they can give and should for you to try to see what works for you. I would definitely try something until you find one that works. Your surgery has only been a month. Let me know how you are doing after you call and BTW you can call your family doctor for help too.
Jayne
 
Sharon again. Thank you so much for the reply to my e-mail about meds causing nausea. I have an appt with a family dr at the clinic today. The nurse said I should come in & rule out anything else that could be causing the nausea. She said that after a few days the pain med should be out of my system. I disagree as this is exactly what happened last March after my first total knee surgery & I have no desire to undergo a bunch of other tests to rule out anything else. Yesterday my stomach felt much better after not being on med but awakening this a.m. I ate something before taking extra strength tylenol for severe pain. I am thinking of cancelling that dr appt & call the pain management clinic in Des Moines. Would be a 1 1/2 hr trip. Beings last yr I went through this same ordeal & visited the dr & they really didn't know exactly what to give me that wouldn't cause nausea, it was like up to me to pick whatever drug they had to offer. I don't want to go through that again. Having nausea plus pain is horrible. Thank you again for taking the time to e-mail me your concerns & replys. I just feel that the pain management clinic would have more experience with this sort of thing.
Sharon
Sharon
 
'Fraid not, Sharon. They mostly operate on a 'suck it and see' basis when it comes to things like this.

I have a friend who has had bizarre reactions to all sorts of medications all her life - from spots to fevers, trembles to headaches. Her doctor has declared her to be a 'nightmare' of a patient (how nice!) and that his heart sinks when she walks into his surgery. She's now in her late eighties (still bright and active and has all her own 'parts'!) and after a lifetime of this she can actually, finally laugh about it.
 
Some people get nausea from the tylenol or other extras in such drugs as Lortab. What worked best from me was a combination of extended relief oxycontin--10 mg, and 5 mg of oxycodone caps that I could take 1-3 of per dose/pain episode. The best thing about the oxycodone tabs was that they were pure--no additional stuff in them. For some reason hydrocodone is not administered around her like it used to be. A newer Rx drug that is milder and has less addictive properties is tramadol.

Hope you feel better soon.
 
Hi Sharon,

I'm sure you already know all about TENS machines, but just in case not, mine has been a great blessing. After my THR I got gout, don't like to take the conventional meds because of side effects, so I settled for a minimum of ibuprofen (taken with omeprazole to reduce stomach acid) and used my TENS machine a LOT!!! In the U.K. they're very reasonably priced nowadays - Boots make one - but the replacement pads are not cheap. Worth it, though. It reduced the pain levels dramatically, and continued to do so for quite a while after I'd turned it off. And you can keep using it continuously for as long as you like.

I don't for one moment want to minimise the misery of the pain you're suffering (after a gout attack, believe me, I'm not in favour of pain!!), but I've finally come to see, after 64 years, that these pains I've suffered are part of life, part of me, and life (and me) are wonderful.

I'll do all I can to get rid of pain, and doing that for others is my profession, but bottom line is: I'd rather have the pain than be pain-free in my coffin. And even in the deepest of pain there is still, somewhere, the beauty of life.

Best of luck. May you be pain free SOON.

Enjoy it all,

Nick
 
Nick, according to the booklet with my TENS it shouldn't be used near a metal implant. Have you used yours for your hip?
 
Hi Josephine,

Which booklet is that? I am of course concerned that there is such a warning. The only warnings I've come across are for active implants. As far as I know, the only concern for passive implants (as in knee or hip) is the heating factor, and TENS doesn't go deep enough to cause any problem.

Before I go into more detail, just the obvious point that if Sharon's pain is referred to areas some distance from her implant, then would you still have any concern about using a TENS? (I was using mine on my toe, by the way, but did use it several times on the adductors and ITB in the implant area.)

Here are a couple of samples of info (the first is obviously coming from a biased source, but still fits in with what I've always been led to believe about TENS machines).

This feels like a topic worth more exploration, since if TENS is ok to use the benefits can be huge, but if not . . . .

So, from this site:

https://www.tenscare.co.uk/index.php?action=qa#

Q: Is it safe to use TENS if I have a metal implant?

There is no reference in the medical literature to effects on implants other than pacemakers.

The signal from TENS only penetrates about 1cm below the surface and contains only a tiny amount of energy (just enough to persuade a nerve to send a signal), so we're pretty sure that there would be no ill effects caused by an implant focussing the current.

A Tenscare employee regularly used interferential therapy- designed to penetrate deep into the tissues - across his knee which has steel securing plates with no ill-effects.

Also from this site:
broken link removed: https://www.electrotherapy.org/FAQs.html


(The relevant paragraph is at the end, and I've put it in bold

Electrotherapy with Metal Implants

Metal implants (pins, plates, wires, nails, screws and various arthroplasities - hip and knee most commonly) are widely considered to constitute a contraindication to most, if not all electrotherapy modalities - though in fact, this is not actually the case for many.

IMPORTANT : in the context of this section, only PASSIVE IMPLANTS are considered - any implanted device which is POWERED by a battery (or equivalent) is an ACTIVE IMPLANT and should be considered to be a real contraindication to many forms of electrotherapy.

The major concern is that the applied energy will result in 'significant' heating of the metallic implant, which would have a detrimental effect in the local tissues surrounding that implant, raising the tissue temperature to damaging levels. Whist that would almost certainly be true for some modalities (most especially the high frequency heating modalities - shortwave and microwave in particular), it is not true for many others.

The contraindications grid states that the modalities that generate significant heating in the tissues SHOULD NOT be applied when there are metal implants in the tissues (Shortwave, pulsed shortwave, microwave) and the other heating modalities should be applied with caution (e.g. hotpacks). The heat modalities with the least energy penetration into the tissues (infra red and wax) are not contraindicated by metal implants. (Interestingly, Draper et al recently demonstrated that relatively high powered pulsed shortwave treatments delivered to tissue in which there was a metal implant did not actually have a detrimental effect (Draper et al 2004).

Ultrasound, when used in a PULSED (non thermal) mode is acceptable over metal as a laser therapy when used at therapy doses. Electrical stimulation modalities (TENS, Interferential, NMES etc) are not contraindicated as the amount of energy applied is not sufficient to cause a detrimental heating effect in the tissues sourrounding the implant, though the presence of metal in the tissues will almost certainly distort the pathway taken by the applied current and may therefore generate some unexpected effects in terms of sensation experienced by the patient. Passive meatal implants are NOT therefore a contraindication to the electrical stimulation modalities (ACTIVE implants are though).

I'd very much appreciate any feedback you, Josephine, or anyone else has on this since I do use TENS with people who come to me for pain treatment (and on myself).

Best

Nick
 
Well, Nick - you got me again! Three times in one day! I think I should stop posting until I'm off these pain pills ... the booklet is the one that came with my TENS and it does just say 'implants' which I took to mean all kinds. I must check on that with the 'experts' tomorrow. The info you posted is excellent.

BTW what's your job? Are you engaged in any health profession?
 
Don't even think of stopping !!! :) Yes, I work in the health field, but no special expertise in this area. Just delighted for the chance to keep learning
Enjoy it all,
Nick
 
Tommy... I tried tramadol & it also made me very sick to my stomach. From all the replys I have received I believe I am just going to suffer it out. It can't last forever. My Pharmacist has suggested taking extra strength tylenol alternately with iboproven when the nausea has disappeared. I am almost there. I was able to eat light meals yesterday. I made it through the last tkr with this last yr so I guess I can do it again with the Lord's help. Would appreciate all your prayers. I need to be strong in the Lord. I went to p therapy yesterday & by God's grace it went well. You are all such caring people. Thank you for your e-mails.
Sharon
 
Prayers we can do ... God be with you.
 
Hi Sharon,


I don't for one moment want to minimise the misery of the pain you're suffering (after a gout attack, believe me, I'm not in favour of pain!!), but I've finally come to see, after 64 years, that these pains I've suffered are part of life, part of me, and life (and me) are wonderful.

I'll do all I can to get rid of pain, and doing that for others is my profession, but bottom line is: I'd rather have the pain than be pain-free in my coffin. And even in the deepest of pain there is still, somewhere, the beauty of life.

Best of luck. May you be pain free SOON.

Enjoy it all,

Nick

Thanks for that Nick, I often consider what it will be like when the hip is just there rather than being something Im aware of...in a sense this whole problem (hip and thr) are actually part of who I am and there's a part of me that knows I'm alive simply because of stupid hip syndrome....Im happy to be rid of the issue in one sense, but in another it also is part of who I am and part of my story...The question is.. will I miss it? So many people have said..."just go and get it done" but I actually believe that its much bigger than that ....there's a whole psychology out there about this...I hate to think how people with donated hearts/livers etc cope...at least I don't have to hang around waiting for a joint, ...
Rachel
 
Thanks for that Nick, I often consider what it will be like when the hip is just there rather than being something Im aware of...in a sense this whole problem (hip and thr) are actually part of who I am and there's a part of me that knows I'm alive simply because of stupid hip syndrome....Im happy to be rid of the issue in one sense, but in another it also is part of who I am and part of my story...The question is.. will I miss it? So many people have said..."just go and get it done" but I actually believe that its much bigger than that ....there's a whole psychology out there about this...I hate to think how people with donated hearts/livers etc cope...at least I don't have to hang around waiting for a joint, ...
Rachel

Hi Rachel,
Have you actually had the operation, or is it still in the future (and if so, has your decision been made)?
Nick
 
Ok, I will completely agree with this subject. I found out 7 weeks ago, during the two weeks following my LTHR, that I cannot tolerate Oxycontin. My surgeon had me on 12-hour extended release Oxycontin and Percocet every 4 hours. I was so sick for those two weeks following surgery, I lost 15lbs because I couldn't eat, and couldn't get up to do my exercises! It was horrible!!! My RTHR is scheduled for next week and I told my surgeon, nurses, and everyone involved that I am NOT to have ANY oxycontin put into my body for any reason after surgery! I will NOT go through that again!
 
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