Lounge Doctor
Ask the Expert Webinar

TKR The long and winding road - round 2

OP
OP
Rather

Rather

member
Joined
Aug 30, 2014
Messages
123
Age
69
Location
Wisconsin
Country
United States United States
One rant before I turn in for the night.

The craziness of the opioid problem and insurance companies is enough to turn me into an activist. My OS prescribed 42 hydrocodone for the 1st week after surgery with instructions for 1-2 every 4-6 hours. At the end of that week, I requested a refill which he promptly submitted to my local pharmacy through an integrated e-prescription system that allows him to do this without having to use the special paper scripts - this is especially handy since we live an hour away for his office.

But when I called the pharmacy to see if the script had been filled, I was told they hadn't received it. After multiple calls, I discovered that the system was connected to insurance so the insurance company could put a hold on it before it reached the pharmacy. It seems that my insurance company (employer-provided PPO premier plan) was doing that with all opioid refills. The doc could override the system, but then the pharmacy was told that the script was held for review by the insurance company and that it would be at least a week to review it before making a decision. So I asked my pharmacist if I had any other options besides going without pain management for a week. He said that he could fill the script if I was willing to forego the insurance and pay cash - which is what I did.

So in an effort now to appear responsible and accountable with opioids, the insurance company decides to delay prescribed pain meds when they can easily see that the patient just had a knee replacement. And in the end, I got the meds, which had I been part of the abusing community would not help address that problem. But the insurance company folks can pat themselves on the back and show with numbers how they are contributing to reducing the epidemic. Nevermind that some of those numbers come from denying pain meds prescribed by doctors to people who need them.

In the middle of recovering from this surgery, this is not a battle patients should need to fight. Rant off...goodnight.
 

Macknit

graduate
Joined
Jun 2, 2019
Messages
510
Age
67
Location
Oregon
Gender
Female
Country
United States United States
Oh @Rather I completely feel your rant pain!!! I even posted something on my thread about a very similar issue! To address the opioid crisis, the Dr office would only prescribe 7 days at a time and after the first week of 50 pills it immediately dropped to 40 pills (in essence going from 10 mg Oxycodone every 4 hours to 5 mg every 6 hours) and this was happening at a time when I still needed the 10 mg. I did the exact same thing and paid for the prescription, to fill the interim time slot!

It seems rather nefarious to have the insurance company delay filling the Rx just to manipulate their numbers! And you are right....this is not a battle that the patient should have to deal with! I dissolved into tears when I first realized the quantity they gave me for that 2nd week!!

I'm glad you had a different solution. Unfortunately, you were forced to find a work around...eventually it just may be that throughout our nation the Drs will be in the position to sell the pain meds on the side! :sad:

Ultimately, medical clinics or the insurance companies are responding with just a knee jerk reaction (pun intended!) to our nation's opioid crisis and this can't be a true long term solution.
 

luvcats

post-grad
Joined
Jun 7, 2019
Messages
1,072
Age
51
Location
Virginia
Gender
Female
Country
United States United States
I am so right there with you. On my first knee, my surgeon did not address my existing tolerance when he proscribed my pain meds. I was horribly undermedicated the whole time. To make it much worse, I came home from the hospital taking 2 every 3 hours, only to discover that the bottle said 2 every 4-6 and I was running out. When I tried to address this with my surgeons office, they said I couldn't have any more until the 2 weeks the original prescription should have covered was through. So I had to stretch it out and did some not-recommended things to help me get through an awful period.

My second round was managed by my pain specialist, and it was a completely different, and much less horrible, experience.

The law makers are absolutely punishing those of us with a real need because others are abusing the system. But there are ALWAYS people who will abuse various substances. Maybe we should address why that is instead of making life miserable for people with serious problems.
 

luvcats

post-grad
Joined
Jun 7, 2019
Messages
1,072
Age
51
Location
Virginia
Gender
Female
Country
United States United States
Just popped by to see how things are going for you. Is the pain improving?
 
OP
OP
Rather

Rather

member
Joined
Aug 30, 2014
Messages
123
Age
69
Location
Wisconsin
Country
United States United States
@luvcats Sorry to have been so quiet for so long. One reason is that I didn't want to acknowledge what was happening in case I might jinx it. And I confess to some guilt feelings. My healing seems to be happening at a pace I was not at all expecting. Despite much more pain early on, the pain has significantly decreased so that I only need 1 hydrocodone at night and Tylenol during the day. My ROM and flexion are reasonable - at least for me. With yesterday's PT visit I was at 100 and -4 and I was 17 days out from surgery.

Since I'm not drugged all of the time, I was able to work from home this week (another reason for not having much time) and I will be returning to campus next week, working a few hours there each day and the rest at home. I started driving yesterday. This is TOTALLY different from what I experienced with the first knee as I was unable to drastically reduce the hydrocodone for several weeks and was not able to return to work until 5 weeks out from the surgery.

What are the differences? With the first knee I had terrible times with restless leg and an increasingly inflamed IT band. I couldn't sleep more than 1.5-2 hours at a time and was always exhausted. The IT band pain was so difficult that I stopped even realizing that my knee hurt. The swelling spread from my knee to my entire lower leg, lasted for months, and I only got relief from a therapist using kinesiology tape and lymphatic massage weekly for many weeks. None of those things have happened with this knee.

I have been able to sleep for hours at a time. Yes, I sleep like I'm in a coffin - on my back with my legs elevated and ice on my knee - unmoving for hours. But I think my ability to sleep has made such a huge difference in both my healing and my attitude.

I'm not pain-free. I am using a cane to walk. And getting up from sitting is done slowly, especially when a chair doesn't have sturdy arms and I can't use my upper body to help me up. Even after a good night's sleep, I need a nap during the day. And if I push things too much, I get that tight band feeling all around my knee that is only relieved by elevation and my trusty ice machine. But overall, I am beyond amazed so far at the difference this time and crossing my fingers that things will keep moving in this same direction.
 

luvcats

post-grad
Joined
Jun 7, 2019
Messages
1,072
Age
51
Location
Virginia
Gender
Female
Country
United States United States
I confess to some guilt feelings. My healing seems to be happening at a pace I was not at all expecting.
I know exactly where you're coming from. After a fairly horrible first knee, my second knee was almost a breeze. Much less pain, faster improvements. And you come and see so many others posting the usual horror stories, you feel guilty that you're having an easy time.

Don't feel guilty! We are all delighted for you that things are going well and quickly! Take your blessing and run! :running:

I started driving yesterday.
The joys of the left knee over right!

I sleep like I'm in a coffin - on my back with my legs elevated and ice on my knee - unmoving for hours.
:loll::rotfl:
This is exactly me. Just cross my arms over my chest and add a lily. lol

I'm so glad this is going easier. I hope it continues.
 
OP
OP
Rather

Rather

member
Joined
Aug 30, 2014
Messages
123
Age
69
Location
Wisconsin
Country
United States United States
Many days, weeks, months have passed since I last posted. Since we are in a new year, I thought I would share an update. I am almost 9 months out from my new right knee and almost 4 for my left. I could not be happier with the results and their impact on my life.

With the first knee, I had terrible IT band problems that extended my recovery quite a bit. I returned to work at 6 weeks using a cane and a walker at times. I expected a similar experience with the 2nd knee (Oct 7) but that was not the reality. My initial pain in the first few days seemed worse, but my recovery was swift. I went back to work 3 weeks after the surgery and was amazingly mobile.

In December, I went to DC on a business trip and added an extra day for my own agenda. I love Washington and have always enjoyed walking everywhere in that city, visiting museums and galleries, and simply delighting in being "urban". The previous December I was in the city and looking forward to my regular museum visits - I had finally gotten tickets to the Museum of African American History and Culture and was looking forward to going there. Only I couldn't do it. My knees hurt so much that I wasn't able to walk more than a block without needing to take a break. So I gave up, flew home early, and scheduled my first TKR.

Back to this December and my extra day. I set out early and walked from my hotel to the Mall - did the African American Museum, the East Wing of the National Art Gallery, the Botanic Gardens, the National Portrait Gallery, and the Newseum (which was closing at the end of the month). I walked to a bar to meet friends for happy hour, to a restaurant for dinner, and then that evening back to my hotel. My watch recorded just over 19000 steps totaling almost 8.5 miles! I was tired. My legs and ankles were a bit swollen. But my knees did not hurt! Yea me!!!

At that point, I knew I had gotten my life back. I can't believe that I waited so long to have the surgeries - I was frightened by the enormity of TKR - I didn't see how I could take so much time away from work to recover - I kept thinking that postponing it as long as possible was a good thing. Several years ago, I asked my surgeon if it was time to do the surgery. He replied that it would be the right time when I truly believed that my knees were keeping me from the life I wanted to live. He was correct - I wish I had reached that point earlier, but at least I did.

Thanks to everyone on BS who shared their experiences and insights and to the moderators who always knew the right thing to say.
 

Sara61

FORUM ADVISOR
Forum Advisor
Joined
Oct 1, 2019
Messages
1,243
Gender
Female
Country
Portugal Portugal
What a great positive post- light at the end of the tunnel for us all on this recovery journey :)
Wishing you many further pain free adventures xx
 

Benay

graduate
Joined
Apr 13, 2019
Messages
656
Location
SoCal
Gender
Female
Country
United States United States
Just caught up with your thread - so glad for your fast recovery with Round 2. Sending you best wishes!
 

New

Active Antibacterial

BoneSmart #1 Best Blog

Staff online

Forum statistics

Threads
52,558
Messages
1,399,255
BoneSmarties
32,787
Latest member
MetalMickey
Recent bookmarks
2

Top Bottom