Pain medications - help
- Thread starter wordwizard
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KathyH
post-grad
Hey @wordwizard you have absolutely nothing to fear from an MUA. I had my MUA at three and a half months. I was absolutely fine following the procedure (and I am the biggest coward going). It was a doddle compared to the actual TKR. I stayed I hospital overnight (and I was happy about that) and was on the CPM all night - my choice. Okay, I was a little stiff for a couple of days, but then it was uphill all the way. Slowly but surely I got where I am happy. Yes, I would like more bend than I have, but I am not restricted in any way in my life.
Upshot is, so glad I had the TKR followed by the MUA. Hope this is helpful.
Upshot is, so glad I had the TKR followed by the MUA. Hope this is helpful.
sheryl7
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There I think I fixed it.
Very difficult to see and type on phone for me..lol
Makes for some interesting posts tho.lol...
OP
OP
wordwizard
new member
I know we should use our recovery thread over and over but I can't figure out how to find my original one, so I'm sorry for starting a new one. I had my left lateral PKR (yes, a rare one) on 11/11/13 and it's been up and down. I have only read 103 degrees of flexion (with pain) after a lot of PT and an MUA 3 weeks ago. My 24 hrs in the hospital with the MUA was a total nightmare. I had a spinal and had a bad reaction to the lidocaine in the spinal and got radicular irritation which is a fancy word for HORRIBLE back pain radiating down into the back of my thighs and down. I was nearly hysterical after that spinal wore off, to the point they had to hang a morphine PCA pump overnight to stop my pain. On top of that I have been suffering for a few months with an on and off attack of BPPV which is vertigo caused by calcium crystals in the inner ear getting into the semi-circular canals and causing vertigo - and of course I woke up with an attack in the hospital the next morning. I decided to take advantage of the PT visiting me for my knee to have her do one of the simple positioning treatments for vertigo which coaxes the crystal out and back to where they belong. OMG - after 3 repeats of the maneuver (they throw you back and hang your head off the edge of the bed turned to the side of the bad ear, turn you on your side, and then sit you up) my head was in a bucket barfing my guts up from the vertigo induced nausea. It was awful. But I digress.
What I really am worried about now is that I seem to have developed a physical dependence on opiates. I have been taking them for a long time (2 yrs now), but never in an abusive way, always as prescribed and up until my surgery, dispensed by a pain doctor. BUT.... I am now noticing that when the time comes for my next dose, I feel "weird"... Jumpy, strange, I can't describe it, but it goes away when I take my pills. I only take hydrocodone twice a day, morning and night, so every 12 hrs. I have not increased my dose like an addict's behavior, I don't "get high" or anything like that. I have used them for real pain. But now what? I'm scared I am going to have to go through some horrible withdrawal if I stop them. What do I do? After I am released next month from the ortho managing my meds, I can return to the pain clinic. What do I tell them? I'm very nervous and I never intended for this to happen.
What I really am worried about now is that I seem to have developed a physical dependence on opiates. I have been taking them for a long time (2 yrs now), but never in an abusive way, always as prescribed and up until my surgery, dispensed by a pain doctor. BUT.... I am now noticing that when the time comes for my next dose, I feel "weird"... Jumpy, strange, I can't describe it, but it goes away when I take my pills. I only take hydrocodone twice a day, morning and night, so every 12 hrs. I have not increased my dose like an addict's behavior, I don't "get high" or anything like that. I have used them for real pain. But now what? I'm scared I am going to have to go through some horrible withdrawal if I stop them. What do I do? After I am released next month from the ortho managing my meds, I can return to the pain clinic. What do I tell them? I'm very nervous and I never intended for this to happen.
Well, you tell the pain clinic that you have concerns about physical dependence or habituation to your opiate pain medications. If your pain is being controlled by a couple of doses a day I suspect they will not freak out. People can be and are maintained on opiates for a long time.
You WON'T have HORRIBLE withdrawal when and if it's ever time to stop taking opiates, because you can taper the dose down until it's not a big deal. Pain clinic providers should know how to help you with this.
Even cold turkey opiate withdrawal won't kill you should you choose that route. You won't be happy, you won't be comfortable, you might well have some uncomfortable symptoms like a runny nose and weird tactile sensations, muscle cramping and diarrhoea, but you won't die or even be HORRIBLY miserable if you get those symptoms appropriately treated. You won't DIE if you get no treatment, either. I am an old detox and rehab nurse and I can promise you that we never lost a patient and they frankly weren't in anguish while withdrawing because we medicated their symptoms and provided support.
The very worst "withdrawal" symptoms I have ever seen have been folks who actually had a "psuedoaddiction" and were told they would not be getting their accustomed pain medications. They freaked out long before any true physical withdrawal could have begun. And in consequence said and did things which weren't rational and weren't to their benefit, all from justifiable fear of having PAIN that would not be relieved. Which just reinforces my belief that it's not a good idea for anyone to play God with somebody else's pain medicine. There are a lot of misguided policies regarding pain meds that reflect the physician's concern for his or her license more than the physician's concern for patient welfare. The pain clinic would be your best bet because they are geared to deal with PAIN issues appropriately rather than to obsess about whether or not you are an addict at some arbitrary date and level of use.
Finally, I am so sorry you are having so much trouble with your PKR. If I read correctly, we had surgery the same date. Mine was a medial PKR. I have had a really easy time of it so I don't literally feel your pain, I'm afraid. I hope you gain ROM and that your pain decreases with time. Good luck!
You WON'T have HORRIBLE withdrawal when and if it's ever time to stop taking opiates, because you can taper the dose down until it's not a big deal. Pain clinic providers should know how to help you with this.
Even cold turkey opiate withdrawal won't kill you should you choose that route. You won't be happy, you won't be comfortable, you might well have some uncomfortable symptoms like a runny nose and weird tactile sensations, muscle cramping and diarrhoea, but you won't die or even be HORRIBLY miserable if you get those symptoms appropriately treated. You won't DIE if you get no treatment, either. I am an old detox and rehab nurse and I can promise you that we never lost a patient and they frankly weren't in anguish while withdrawing because we medicated their symptoms and provided support.
The very worst "withdrawal" symptoms I have ever seen have been folks who actually had a "psuedoaddiction" and were told they would not be getting their accustomed pain medications. They freaked out long before any true physical withdrawal could have begun. And in consequence said and did things which weren't rational and weren't to their benefit, all from justifiable fear of having PAIN that would not be relieved. Which just reinforces my belief that it's not a good idea for anyone to play God with somebody else's pain medicine. There are a lot of misguided policies regarding pain meds that reflect the physician's concern for his or her license more than the physician's concern for patient welfare. The pain clinic would be your best bet because they are geared to deal with PAIN issues appropriately rather than to obsess about whether or not you are an addict at some arbitrary date and level of use.
Finally, I am so sorry you are having so much trouble with your PKR. If I read correctly, we had surgery the same date. Mine was a medial PKR. I have had a really easy time of it so I don't literally feel your pain, I'm afraid. I hope you gain ROM and that your pain decreases with time. Good luck!
Josephine
NURSE DIRECTOR EMERITA
I merged your threads, @wordwizard
You might also find this article helpful How can I find my threads and posts?
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OP
OP
wordwizard
new member
Well, almost 5 months out. My MUA in January was an utter disaster. Had a bad reaction to the spinal and got something called "transient radicular irritation" which is just medical jargon for unbearable radiating back and leg pain from the lidocaine in the spinal, which happens especially after a manipulation because they are stretching your legs and nerves along with it. Spent the night on a morphine pain pump, it was so bad. The CPM machine was out of the question as it made it worse. Then I woke up with an attack of my benign vertigo so when the PT came to see me, I asked her to perform the maneuver to move the crystals out of the canals in my inner ear, where they don't belong. I got such bad vertigo when she did those maneuvers that I ended up with my head in a bucket barfing up my guts. What a horrible 24 hrs in the hospital, but I DID gain a little extra ROM and can now flex to 120+. A month ago I had surgery to remove a Morton's neuroma in my left foot (same leg as PKR) because that was hurting so bad that I was limping and transferred more pain to my knee. So here I am, can't really say my knee feels right yet. It's numb, I get weird burning pains where the hardware is, and it is still somewhat stiff and sore when I bend it. Can't kneel on it. Basically a so-so result in my mind at this point. I hope time makes it better. I'm physically addicted to pain meds and working on weaning right now through my pain doctor and that's going well but I notice more pain in my knee now, so not sure how I will feel off of them totally. But, I'm all set to enjoy my summer vacation in California doing the zoo with my hubby, kids and grandson and just walk walk walk all day long like I used to. Ha ha... At least that's the hope.
As I weaned off pain meds there were no pain issues. How about your exercise routines? Are you doing anything that might be inflaming your knee?
You're at 5 months, and at 5 months I took a few days' trip and decided I would not do any exercises during that time and just enjoy myself. Well I never went back to the exercises, because the decrease in my pain was significant and so needed. Life will rehab your knee, and as needed, you can always do some PT or whatever.
My husband had a Morton's neuroma operated on and is still suffering. So I feel for you. It really really takes a full year (and then some) for full recovery. And if I count recent improvements after two weeks of snorkeling in the Caribbean, it can be said that full recovery takes years. Which means you have much to look forward to.
You're at 5 months, and at 5 months I took a few days' trip and decided I would not do any exercises during that time and just enjoy myself. Well I never went back to the exercises, because the decrease in my pain was significant and so needed. Life will rehab your knee, and as needed, you can always do some PT or whatever.
My husband had a Morton's neuroma operated on and is still suffering. So I feel for you. It really really takes a full year (and then some) for full recovery. And if I count recent improvements after two weeks of snorkeling in the Caribbean, it can be said that full recovery takes years. Which means you have much to look forward to.
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