@TeriseD Yes. I’m finding it very helpful. Looking at sleep and daily readiness etc. Had a very rough weekend pain wise just absolutely exhausted today,but everything a bit more manageable and worrying looking good. How are you?
TKR TKR with Fibro and Raynauds and RA, anyone else?
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TeriseD
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Making steady progress. Started walking outside over the weekend, about 30 minutes each day. Using my cane only when I leave my apartment but should be able to go totally on my own soon. Had my 2 week check-up today with the orthopedic nurse practitioner. Except for my lymphedema, everything's looking good. Drove myself to get groceries late this afternoon with no issues. Still have moderate pain on the outer side of my knee. Tried stopping the Percocet but pain was intense Sunday night. The NP suggested I continue taking it just prior to sleep, but discontinue the daytime doses, and that sounded perfectly reasonable. PT again tomorrow, and looking forward to more time in the compression pants.
Does the NP know you are driving? Most medical teams warn patients not to drive until you have been off all opioid medications for 2-3 days. Even if you are taking the Percocet only at bedtime, the medication will stay in your system for hours -- even days.
Also, be aware that if you have an accident and are found to be under the influence of an opioid, your insurance company can refuse to cover you.
Please be very careful about this for your own safety.
These cautions about driving when taking opioid medications are good. You don't want to risk being in an accident and having your insurance bail out on you.
Be sure you do get the approval from your doctor's office before driving....remember, most accidents happen within 5 miles of home. Most cities have grocery delivery services available you could use. And there is always Uber or a friend.
You could try switching to Extra Strength Tylenol instead of Percoset if you are able to take acetaminophen. The dose would be 1000mg every 6 hours so that you take no more than the maximum safe dose of 4000mg in any 24 hour period. Just be sure to count any other over-the-counter meds like cold and sinus medications in that daily total.
Be sure you do get the approval from your doctor's office before driving....remember, most accidents happen within 5 miles of home. Most cities have grocery delivery services available you could use. And there is always Uber or a friend.
You could try switching to Extra Strength Tylenol instead of Percoset if you are able to take acetaminophen. The dose would be 1000mg every 6 hours so that you take no more than the maximum safe dose of 4000mg in any 24 hour period. Just be sure to count any other over-the-counter meds like cold and sinus medications in that daily total.
TeriseD
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Appreciate the concern about driving and Percocet. It's certainly a valid point for the majority of people. I'm an ultrarapid metabolizer, meaning most drugs are completely out of my system within a few hours, and opiates in particular have never provided more than an hour or two of semi relief. I can take one Percocet at 10pm, feel slight relief between 11pm-midnight, and then that's it the rest of the night. It's a guarantee that at 8 or 9am I'm feeling zero effects. So no worries there. Over my lifetime I've had nine surgeries, both orthopedic and abdominal, including several where I've awoken from anesthesia screaming in pain, due to insufficient pain medication. It wasn't until 6 years ago that I had gene testing done, at which time I learned of my ultrarapid metabolizer status and all that encompasses. Even the strongest stuff like fentanyl has little effect and only for very short periods. This is why I put off getting my recent TKR for over 5 years. I knew the pain I'd have to go through with very little relief. Also why I purchased a Polar Active Ice machine, which is currently whirring away at my side.
So I have been really exhausted and puffing and blowing up the stairs had a really good day in terms of walking and heel slides. Since the weekend I’ve been feeling very light headed dizzy nauseous but put it down to the loss of energy. I said to my husband I actually think the exhaustion has overtaken the pain in terms of my challenges. Last evening my GP rang and said I was moderately anaemic which explains a great deal.
Had a horrible turn later in the evening and had to g go to bed. Felt so sick and dizzy. Slept well 6 plus hours then an hour later had another two hours. Even now I feel I can hardly keep my eyes open. Slightly less nausea at present.
I’ve got to have a blood test next week for B12 and Ferritin levels but if things don’t get any better by tomorrow I think I’ll ring and say I’m very symptomatic and hopefully they’ll prescribe something in the meantime.
If it’s iron deficiency which seems most likely will it be ferrous fumerate or something? In which case I can get some. It’s a shame cos I really can’t do much until I feel less dizzy.
On an up note I am actually having some pain free periods and have cut a couple of pain meds this week.
Had a horrible turn later in the evening and had to g go to bed. Felt so sick and dizzy. Slept well 6 plus hours then an hour later had another two hours. Even now I feel I can hardly keep my eyes open. Slightly less nausea at present.
I’ve got to have a blood test next week for B12 and Ferritin levels but if things don’t get any better by tomorrow I think I’ll ring and say I’m very symptomatic and hopefully they’ll prescribe something in the meantime.
If it’s iron deficiency which seems most likely will it be ferrous fumerate or something? In which case I can get some. It’s a shame cos I really can’t do much until I feel less dizzy.
On an up note I am actually having some pain free periods and have cut a couple of pain meds this week.
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@beralc oh so sorry, nausea, dizziness is horrid. I felt like that from week 2 to probably week 5. I believe it was shock from surgery, felt so weak with every movement. My ferritin levels were quite low couple months before surgery and again, due to my stomach can only take iron in liquid form. Don't overdo anything until you know what's possibly causing this. If you have any ginger it seems to help the nausea. Let us know how you get on, in the meantime sending hugs
x
xI think it’s also very common to have anaemia post surgery something to do with inflammation and absorption of iron. It’s annoying just when you think you’re moving forward something pops up to hold you back again. Yes I got my husband to get me some ginger biscuits….any excuse@beralc oh so sorry, nausea, dizziness is horrid. I felt like that from week 2 to probably week 5. I believe it was shock from surgery, felt so weak with every movement. My ferritin levels were quite low couple months before surgery and again, due to my stomach can only take iron in liquid form. Don't overdo anything until you know what's possibly causing this. If you have any ginger it seems to help the nausea. Let us know how you get on, in the meantime sending hugs
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@beralc
I'm so sorry this is affecting you so much!
Two key factors with oral iron, because it's hard for our bodies to absorb it effectively:
1) vitamin C helps the absorption, so it's recommended to take a vit. C supplement along with each dose of iron. It doesn't need to be a megadose, just a low dose vit. C will work.
2) calcium greatly interferes with the absorption, so avoid calcium supplements, calcium anti-indigestion chews (Tums in USA), and calcium rich dairy foods for a couple of hours before and after each iron dose.
I'm so sorry this is affecting you so much!
Two key factors with oral iron, because it's hard for our bodies to absorb it effectively:
1) vitamin C helps the absorption, so it's recommended to take a vit. C supplement along with each dose of iron. It doesn't need to be a megadose, just a low dose vit. C will work.
2) calcium greatly interferes with the absorption, so avoid calcium supplements, calcium anti-indigestion chews (Tums in USA), and calcium rich dairy foods for a couple of hours before and after each iron dose.
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Brilliant. Thanks for the advice. I take a good vit c already so that’s one thing ticked.
Just don’t want it to hold me back as I was feeling so proud of what I’d achieved over the last couple of days.
Just don’t want it to hold me back as I was feeling so proud of what I’d achieved over the last couple of days.
TeriseD
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Most women in general, but specifically older women, get nowhere near enough protein in their diet. The current RDAs are way to low. And especially after surgery of any type where blood loss is involved, you MUST increase your protein intake. All sources of protein are great sources of iron, but optimally you need lots of meat and eggs, which are nutritional powerhouses, being they are the most nutritionally dense foods you can eat. Protein will speed your recovery and get you on the path toward faster healing. It's working for me.
@TeriseD Thanks for your info.
Protein is the absolute focus in all our meals. We take way over the recommended intake, the older we get the more protein we eat.
I usually run a fairly high Hb so it’s very unusual for me to be anaemic, but the more I read the more it makes sense given the role that inflammation plays in releasing cytokines that interfere with the absorption of iron.
Given how triggered my auto immune conditions were in the first fortnight after surgery it’s not surprising.
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@TeriseD @beralc
Most Americans are fortunate in that we do get enough protein daily. I think as we age and as we have health challenges it's more about being aware of the need, and current research indicates we rebuild better if the protein is divided among all meals, rather than just at dinner.
Vegetarians have very happily and safely maintained good nutrition and thrived without eggs and meat.
It's crucial to differentiate between high protein foods and high iron foods. It's incorrect to state that all high protein foods are high in iron. Chicken, eggs, and the non-oily fishes either aren't particularly high in iron or have it in forms that are difficult to absorb.
Most Americans are fortunate in that we do get enough protein daily. I think as we age and as we have health challenges it's more about being aware of the need, and current research indicates we rebuild better if the protein is divided among all meals, rather than just at dinner.
Vegetarians have very happily and safely maintained good nutrition and thrived without eggs and meat.
It's crucial to differentiate between high protein foods and high iron foods. It's incorrect to state that all high protein foods are high in iron. Chicken, eggs, and the non-oily fishes either aren't particularly high in iron or have it in forms that are difficult to absorb.
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This is a very important point that many people don't understand.
What's more there are many vegetarian staples that are great sources of iron, including lentils, legumes, spinach, tofu, certain nuts and fortified cereals.
I agree. My husband and I space our protein throughout the day.
We’ve done lots of research since we were in our 30s,when I became unwell, with regards to nutrition and have always been a little ahead of the curve with regards to diet. Looking for ways to help with my conditions.
We look to haem iron foods for their high iron and easily absorbable iron and non haem foods green leafy vegetables, dried fruits, nuts etc.
So no worries with regards to differentiating between the two (between protein and iron sources I mean).
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TeriseD
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Don't know where you're getting this information from but it's incorrect. While beef is certainly the highest in iron, poultry and eggs are excellent sources. This is according to the American Red Cross and many official medical and nutritional sites. All meat is heme iron, which is the most easily absorbed iron. Plants are non heme and more difficult to absorb. Vegans and vegetarians require daily vitamin and mineral supplementation, which is not only unnatural but unnecessary for meat eaters. I'd encourage you to do a bit more research on this.
TeriseD
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Older women do not get enough protein.
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Sorry to hear about your anaemia and how it is making you dizzy
This is one of the best articles I have found on iron and it's absorption.
In addition to @mendogal point about Vitamin C it also says how some things like fizzy drinks and tea can impair absorption.
Hope you get some relief soon.
How low has your Hb dropped?
I would definitely take it easy and be careful getting up/ on stairs to avoid falls risk if you are dizzy.
Good luck. It is a pain the way everything seems to get us when we are down.
