whats realistic to expect from pain management

Status
Not open for further replies.

bumleg

junior member
Joined
Apr 8, 2008
Messages
64
Location
United States
Hi again, surgery is looming in the near future. Tomorrow morning and again I have more questions. I have been limping a long time and have R knee,hip and back pain because of it. With a new knee will these extra pains go away on their own? I have loss some ROM in the hip. I exercise daily and do ROM exercises to help speed recovery. I started doing leg raises with a 3 lb ankle wt because that is how much the new knee will weigh. I hope it gives me the head start I'm aiming for. I will be getting an epidural and sleep medicine for surgery so I should be fairly comfortable for a good while afterward. I intend on making full use of pain management. If later on I find I need to take narcotics before PT, I have no problem with that. I already have a small stash from other recent procedures. Fortunately my GP and other docs know me from working with me in the past so if I need any more than OS is comfortable prescribing it shouldn't be a problem. In the past I have found that I put up with more pain than necessary. Usually after I've taken narcs for pain that I realize how bad it was. The other thing is in the past I haven't needed to take narcs for more than a few days, thats why I have the stash. I have never had major surgery either so this may be different. I'm not sure what to expect with pain management. Is it realistic to expect meds to completly get rid of the pain? Lortab cuts the pain but does not totally do away with it. Should I expect the new knee not to hurt with weight bearing? I know that once the epidural wears off I will have post surgical pain. When I get back home I will take my meds every 4-6 hours when I feel the pain starting to return. Its harder to get pain relief than to prevent if its allowed to become to strong. I am going to let my body tell me when to wean off the hard stuff providing I find its not taking forever. How do I tell if I have a good physical therapist? I have never had PT before. I am concerned I won't do well because when I had the partial meniscectomy I had a more difficult time than what it seems most people have with the same thing. I just had it last Dec. My OS that did the surgery didn't order PT and I was hoping that I could get by with just home exercises. The limp and accompaning pain never went away. Even Lortabs don't help that knee. Anti inflammatories took care of the pain in my back and R hip and R knee. Of course now both ankles and feet hurt in addition to sharp pain down the front of my L shin with wt bearing. I don't know how I could cope with this if my surgery was further away. My old pleasant self has been gone a long time and I miss her. I'm too young to be this cranky.
 
I'm sure some of the others will chip in here with the voice of first hand experience which is by far the best but in the meantime, I'll give you my take on all this.

Is it realistic to expect meds to completly get rid of the pain?

At rest, it should control pain completely. But will not suppress it in activity.

I'll show you my pain chart which demonstrates the most useful way to plan your medication. The aim is to take the meds BEFORE the pain totally breaks through, i.e., when it's a moderate discomfort or ache. That way the meds can take control fairly quickly whereas, if you leave it till you are in real pain, there is so much more for the meds to get on top of.

[Bonesmart.org] whats realistic to expect from pain management


Should I expect the new knee not to hurt with weight bearing?

Here you have to differentiate between the weight bearing on the bones and the control of balance by the ligaments and muscles. You should not expect too much pain from the former but you will get quite a lot from the latter.

How do I tell if I have a good physical therapist?

Various pointers are
- do you get along with her, (or him!), feel comfortable with her, talk easily with her - in other words is there a rapport?
- does she hurt you excessively, force your leg into various positions or exercises without explanation?
- overall, do you feel you are progressing with her regime of treatment


And we're used to cranky in here! Crank all you want!
 
#1---I was never in any pain in the hosptial---PT yes, but all other times, no pain. When I came home, if I took my pain meds faithfully, i had limited discomfort---I would take them an hour before PT---that hurt like an son of a gun...no luse lying about that.

Your PT should be passionate and compassionate---they will work with you as you battle your way back to normalcy. A good PT will be honest with you and tell when it is going to hurt, when you are working too hard, and when you are not working hard enough.

Bets of luck to you!

Tim C.
 
At risk of sounding reptitious. The recovery pain is NOTHING like the bad knee pain, and it changes and reduces where as the pre-surg only got worse. Weight bearing initially hurts, but ot is tolerable and the drugs do a good job. Like Ref, in the hospital my 1 to 10 scale for pain was almost always a 1. At home it did hurt more, but insert drug regimen here, and plenty of ice rest and elevate. Pay attention to Jo's pain graph. Take meds on schedule, not when it hurts. My biggest fear of this whole process was the pain. Some may think me crazy (be quiet you guys) but I would do this again if I had to. PT, like what has been said. tells you honestly when it will hurt, tells you to guage based on your pain tolerance and doesn't force things. Recovery is not a race. And dare i say, results. I have faith in where I went for PT because of the results. I went before surgery as well as after and I worked hard but they also did right by me. I progressed quickly.
 
Thanks you guys. Jo, I like your pain chart. Your answers are very helpful. Thanks again. I'll probably be crankin some more when I get back. Its nice to know people here understand and some having been through it can really give the low down on their experiences. I feel better too knowing that theres an experienced ortho nurse who can give information from the professional side too. Jo, you do a wonderful job as do the rest of you. I'm going before I ramble on.
Soon to be member of the new knee club. woo hoo!!!
 
Bumleg, unlike Jen and Ref, I had considerable pain in the hosp but basicly at night. I wasn't keen on all the drugs and I removed my nerve block early. I used the pain drip when necessary and accepted the percocets only if I had pain. I was told that I had so much pain because I waited so long to have the TKR. I had several blood effusions into my knee where the pain was off the charts and I was scheduled and then resched as an emergency, I couldn't even walk any longer. 2 mos before my surgery is when it all went downhill. The surgery is to give you a knee that functions and is not painfull.

I have pain mgm't for my back and it can help imediately or you might have to try a few thngs to get the right protocol...even a new doc. But pain can be managed. My new doc realizes now that I am a gym person despite my arthritis...he's a physiatrist....so he is working w/me on all the different exercises I can and cannot do.....my next surgery will be a major shoulder redo. Many docs will write you off when you develop all of these challenges. My doc is inspired to help me because I refuse to go down. That's the goal. To find a great doc. Good Luck...Peace out......Ms Weezl
 
Hi....Josephine's chart is fabulous, and I wish I had seen it and had all of this information before my LTKR was done on 4/30.

So now that you know all of this--PLEASE listen to it!! Even when I found this group two weeks after my surgery and started to get an idea about the amount of pain I needed to deal with, I kept trying to cut down and not take pain meds. BIG MISTAKE!

And here's the funny part--once I really gave myself permission to take drugs when I needed them (after a lecture from my GP), within a week I found myself naturally forgetting to take a pill! And now I'm down to pretty much just taking meds before PT sessions.

Weezy
 
I Think You Can Control The Pain Better If You Listen To Josephine. I Was Familiar With How Pain Meds Work For Me Prior To Surgery As I Have Been On Pain Meds For Years For My Back So I Knew To Take The Pain Meds Before The Pain Got Out Of Control. I Have Even Discovered Since My Btkr That If I Really Listen To My Body I Am Able To Cut Back On What I Take For Pain Relief Which Is Absolutely Wonderful You Sound Like You Have The Kind Of Spirit That Most Of Us Have Here And You Are Going To Do Fine. I Think It Takes A Certain Type Of Personality To Have Joint Replacement Surgery. It Is Like Saying I Refuse To Be Stopped I Am Going To Do It. I Refer To Myself As The Little Engine That Could, I Know That Sounds Ridiculous But Thinking I Could Got Me Through A Lot Of My Life And Let's Face It Some Of Us Seem To Have More Pain Than Others. I Will Keep You In My Prayers And Know You Will Be Fine. This Forum Is A Wonderful Place To Find Info And Support. Rowdy
 
Status
Not open for further replies.
Back
Top Bottom