Pain meds

tarajenni

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I’m having PKR this Friday. In the last week I’ve started having constant, terrible pain in my knee. Doc wants me off NSAIDS prior to surgery so called me in Tramadol 50mg. I took my first last night around 9pm. Here it is 5.30pm the following day and I’m still feeling foggy headed and weak.

I know I’m a lightweight when it comes to pain meds but this one has me worried about post-op pain control. Don’t get me wrong, it worked with regards to the pain but I feel like ****. I also was incredibly itchy all night which I know is a side effect but drives me crazy and kept me up most of the night.

Anyone have any luck with non-opioids?

Thanks!
 
I am also a lightweight when it comes to pain medication. I have tried Tramadol. It made me anxious and dizzy. It kept me awake all night. The pharamasist said it may interupt sleep patterns. My brother used it for a few months and it worked well for him. I unfortunately had to use the opioid route.
 
Glad to know it isn’t just me. I’ll have to ask my doc for other options I guess.
 
Tramadol is a synthetic opioid. It is not as potent as the heavy-duty opioids, so for some people it is a useful drug when stepping down from the heavier narcotics.

Some people do experience withdrawal symptoms if they come off it too quickly.

@tarajenni , since it is not long until your surgery, have you considered icing your nee to reduce the pain. Ice is good for that, before and after surgery.
Ice to control pain and swelling

What date is your surgery, and which knee? If you tell us that, we can make a signature for you.
 
Thanks. I’ll try the ice for now.
Surgery is on right knee on 8-10.
 
Ice, ice, ice. It is the best pain reliever and you don't have the side effects that come with the various medications. Ice, ice, ice, and more ice. Plan on using a lot of it after your surgery and good luck!
 
Thank you for posting your surgery date @tarajenni . I've done you signature now.

I'm glad to see you've already joined the 2018 August Hot Shots group.
 
Good to know your reaction to Tramadol now. Be sure to mention it to your OS so he/she has the info when prescribing post op.
Tylenol and ice are probably the way to go for the week or so you have left.
 
There is no effective pain med for arthritic pain. I often said - whoever manages to develop such a drug will be in line for a Nobel Prize for services to humanity!
 
All went well. I’ve been up three times. He’s got me on Dilaudid and hydrocodone. He also injected a lot of anesthetic into the knee during surgery. My fear is the pain when that wears off. But right now, all ok.
 
Interesting topic. I'm curious as to to what moderators/others might have to say about the approach this (yes, my) hospital is using:

https://www.southcountyhealth.org/a...way-non-narcotic-approach-to-pain-management-

I thought this was interesting and wondered if this was now the standard everywhere:

“We never used to start treating before the surgery happens. Part of the theory behind this is that we reduce any inflammatory processes that occur by treating it before it actually happens,”
 
That's interesting.
@Josephine and @Jamie - what do you think of the approach that rhodyrhody's hospital is using? THe link is in his post, above.

Recently, @lovetocookandsew has had a narcotic-free recovery, because she reacts so badly to narcotics. She will be able to tell you more, but I know that she was discharged from hospital with a small pump loaded with pain killers that went directly into her knee.
Some surgeons are also putting a pain-killing medication into the knee joint during surgery. That seems pretty effective, too.
 
@Celle
My surgeon injected anesthetics in and around my knee during surgery. Said it would last about 18 hours. It did but now it’s wearing off. Definitely helped with the immediate pain.
 
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@Celle Along with my OS injecting a lot local stuff into my knee during the surgery (which he said only lasts a short time), I also had an epidural in the hospital for approx 5 days, then some kind of local was injected directly into my knee, that may have lasted one day, I forget. I don't think it worked that well, either, if I'm remembering correctly.

But the next day an anesthesiologist inserted a catheter into my upper thigh which was connected to a pain ball, which contained non-narcotic medicine that goes directly to the knee area only, and blocks pain in the knee, whereas the epidural blocked everything from the waist down. The medicine slowly dispersed into my knee over approx. 3 days, then they removed that pain ball and gave me another one, which stayed in until it was empty.

At that point I was two weeks post op and had no more pain relief of any kind. Miraculously, I also had very little, to no pain, at that point, so I had a narcotic free recovery. The only time I had pain was after the first pain ball emptied, and before the second one was attached; and that pain was excruciating, but as soon as the next pain ball was attached, and took effect in a short time, I was pain free again.

Narcotic pain meds and I are not compatible as my reactions from them have gotten worse each time I've needed them, to the point where my OS was worried they would kill me this time around, as he felt they almost killed me after my 2016 surgery. So he had to work on ways to handle my pain without using narcotics. His plan was a resounding success and I was able to have my pain controlled safely. I didn't have to ask for, or wait for, more pain relief every two to four hours, nor did I have the ups and downs of pain relief you get with IV pain meds and pills that take a while to get into your system and slowly wear off.

I had pain relief 24/7 and it was consistently controlled at whichever level it was set. And to top all that off, I had none of the foggy head, constipation, nausea and vomiting, sleeplessness, and the rest of the side effects usual with opioids. Maybe one day they'll be able to do something like the epidural or pain ball that lasts a long time and will allow patients to be home the entire time. I was in the hospital a full week, then got to go home the day after they inserted the pain ball catheter. It would have been wonderful to do it all at home as I was wide awake every day, had no side effects at all, and could have gone home except that they don't allow patients with epidurals to go home.
 
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what do you think of the approach that rhodyrhody's hospital is using?
Looks interesting and has promise. However, I'm afraid I don't have time to read it thoroughly at the moment but I will later.
My surgeon injected (local) anesthetics in and around my knee during surgery.
Mine did that for my second nee. It was bliss!
 
So, as part of the opioid-sparing pathway and pre-op, I'll be getting Meloxicam, Gabapentin, Acetaminophen, Prilosec, Tranexamic acid. Not sure when I start taking it, sounds like a lot. Any comments on this as a pre-op approach?
 

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