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TKR both knees

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KayeKaye

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I've been told that I will be sent home with 2 weeks of pain meds, most likely oxycotin or tramadoyl. Does that sound doable? I hate pain meds, but since I will be 2 hours away from the surgery facility I want to make sure. My own GP in my town said that she would not participate in pain management because it's not her area.
 

kneeper

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I think many Bonesmarties have had those. With being 2 hours away from your OS, getting refills may need more planning b/c I don't think docs can just call narcotics in any more.
 

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Right. That should be fine, but if you need a refill, call with plenty of time for a written prescription to arrive in the mail. Ask about this process before you leave the hospital and write it down so you know what to expect. Those medications sound like one of the protocols I've read about here.

I got Oxycontin and Hydrocodone. My surgeon was more than willing to refill the Hydrocodone, but will in the hospital, he told me to get off the Oxycontin as soon as I was able, because that was the "nasty stuff." I didn't have any trouble doing that. In your case, I'm pretty sure they'll be willing to refill the Tramadol. In fact, you may see if they'd be willing to give you three or four weeks worth of Tramadol from the start. (I don't know if that's feasible or not.)
 
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KayeKaye

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Thanks! I've had several phone calls from the clinic now to set up everything. One thing I keep asking them about is the pain management once I leave their hospital. They said I will get a two week supply of Oxycodin and Tramadol. I asked how to get another prescription but they seem to think that "just a plain tylenol' will be all I need after that. This is scaring me, am I not being positive enough? From what I have read here most people are on pain meds for much longer. I would love it if I had no need for pain meds after two weeks but it sounds crazy to me.

That's interesting about pain meds prescriptions not being filled except by mail. I think I will call my pharmacy tomorrow and see what they say. I had a foot surgery in 2005 and it was murder. They had me on oxycodin for 12 weeks before I started any PT. I hated oxycodin but really couldn't get by without it. I couldn't wait to get off it.
 

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I didn't mention it in my post, but I had switched over to Extra Strength Tylenol by the end of two weeks. I augmented my night dose with an Aleve for about a week. That is against the BoneSmart recommendations, but I was comfortable with that. You may or may not be.

It's not that the prescriptions are filled by mail. They have to be hand carried to the pharmacy and not called or faxed in. I Thought I understood the hospital was two hours away, so I figured you wouldn't want to run over for a refill. Other people on the site with distant OSes have had refill prescriptions mailed to them to take to their pharmacy.
 
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KayeKaye

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Oh my goodness, that doesn't bode well. I will have to check with the Doctor and pharmacy. I forgot to do it today with all the prep I have been doing. Yes the Mayo Clinic is a two hour drive from St. Paul MN. So there won't be any going back and forth, it's pretty difficult to get appointments. I don't see that working out if I am in pain, ha! So if it takes a day for the message to reach the Dr. and 2 days to be mailed, hoping there is not a weekend involved, it would be at least 3 or 4 days to call in. But how will I know if I will need more. This is so frustrating. I feel so out of touch with this clinic. But they were the only ones that could identify that my knees were shot and needed BTKR, so I am sticking with them. Just odd to feel so disconnected. Ok late night rambling, sorry. I should be sleeping, but the pain has kicked in. I went up and down a few times today doing some laundry.
 

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Here's something to try, and it sounds a little "out there," but it can't hurt. Begin visualizing in your mind for a few minutes every time you think about the potential pain, that you are healing well and the medication you have is more than what you need. Visualize your healing going well (and rest, ice, elevate, and only do gentle movements to ensure it does), and mentally marvel at how pain-free you feel.

Take the prescribed medicine when it's scheduled, set an alarm if necessary. After a week, I was doing well, so I stopped taking my daytime oxycontin with no ill effects (if that doesn't work for you, continue taking it until it's gone). The hydrocodone worked well for me, but I wanted to drive, so I gradually swapped Extra Strength Tylenol for it. Since you're doing a bilateral, you are not likely to be cleared to drive for at least five weeks (safety reasons and all that), so there's no rush to try to get off the Tramadol. You may be able to supplement the Tramadol with Tylenol (as long as you remain under 4000mg in a 24 hour period). If this contradicts anything your doctor or pharmacist tells you, disregard -- I'm sharing what worked for me, and I was off all narcotics within two weeks with no ill-effects (except a little discomfort at 4 am with just Tylenol, and adding one Aleve at bedtime for a week took care of that).

If your OS says two weeks and only two weeks for prescription pain relievers, and your primary care physician will not get involved in that, I don't see any other way than mentally preparing yourself for it to go well pain-wise.

This is not the BoneSmart recommendation, and I hope I haven't strayed into the territory of giving medical advice. I do know your mind can be your most effective ally, so see if you can make it work for you in this instance. You want to be as relaxed and at peace as possible about this process. You have enough on your mind, but give yourself the best possible mental footing for a pain-free recovery.

As an afterthought, ice is your friend. Protect your skin from exposure, but icing should be measured in hours not minutes. Don't forget about the back of your knees.
 
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KayeKaye

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I didn't mention it in my post, but I had switched over to Extra Strength Tylenol by the end of two weeks. I augmented my night dose with an Aleve for about a week. That is against the BoneSmart recommendations, but I was comfortable with that. You may or may not be.
Well I have talked to them three times about the two week Rx for pain meds and they said maybe I will get a bit more since it's bilateral, but it doesn't seem likely to me.

This is really starting to scare me. It's not like I can just go find another doctor to give me narcotics. I asked my own GP and she said no, she doesn't have any experience handling them.
 

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Don't panic yet. The doc may be open to negotiation based on how you're feeling.
 
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KayeKaye

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Thanks for all your advice everyone. I'm sorry if I am writing in two places. But I spent the day in the ER yesterday, them checking for appendicitis. They found nothing, looked for everything. Still have same horrible pain, must be a pulled muscle. Can barely move in bed so that certainly interferes with my knees immobility. Now my dilemma is when I tell Mayo, I foresee a change of operation dates.
 
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KayeKaye

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So it all starts today. I am packing and getting ready for tomorrow's pre op full day. I have to decide if we are leaving tonight and staying at a hotel or if we will get up at 4 am and drive 2 hours for my 7:30 am start. I'm thinking we might as get up, or in my case I will be still up. Not getting any sleep tonight. So nervous.
 

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Right. That should be fine, but if you need a refill, call with plenty of time for a written prescription to arrive in the mail.
I made this mistake after my BTKR. I ran out of Oxycontin, and my OS was out of town. I did not realize that these heavy duty pain meds need a written prescription and I paid the price for it. I received some milder meds that did nothing---I might as well have simply swallowed some M&M's!

As for the two weeks, I was worried about becoming addicted, but my OS told me that I was taking the meds for a reason, and that I would know when I did not need them any more. He was correct.

Another pint is this---I am sure that you have a GP---he can also work in chorus with your OS, so if yo need pain meds, he or she should be able to assist you, as well.
 
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