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Worried about pain control

Discussion in 'Knee Replacement Pre-Op Area' started by ThumperJB, Mar 18, 2018.

  1. ThumperJB

    ThumperJB new member
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    My knee replacement is scheduled for next Wednesday. A few days ago I had pain from a superficial Clot (varicose veins). My doc in the box gave me oxycodone 5mg and it made me sick as a dog. I already knew I couldn't take codeine as it has that effect on me. Now I am worried that pain control is going to be a big problem for me. I know the nerve block will help for the first 2-3 days but what about after that?

    Anyone else who can't take pain medicine without getting violently sick?
     
  2. Celle

    Celle FORUM ADVISOR Forum Advisor

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    Yes, that would be me! All those drugs make me vomit.

    Tell your surgeon and anaesthetist that the drugs have that effect on you and ask to have an anti-emetic prescribed, to take along with the narcotics. I found that Zofran worked well for me, but there are other anti-nausea drugs as well.

    Another little tip - never take the narcotics on an empty stomach. Always have a cracker or something similar, and eat that with the medications. Have a store of nibbles by your sleeping place, so they are easy to access when you take the pills.
     
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  3. ThumperJB

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    Thanks for the advise. I guess the upside is neither of us is likely to become addicted. Fortuntally I have always had a high tolerance for pain, but I realize this will be very different. Thanks for the incouraging words.
     
  4. Mutti3

    Mutti3 senior

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    I had a prescription for Zofran ( anti emetic). It helped tremendously with nausea. If you have it post op, ask your dr if you can have a prescription at discharge. Don’t worry about addiction. The goal is pain relief. You will be fine!
     
  5. lovetocookandsew

    lovetocookandsew supremo

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    @ThumperJB I am one who fully understands as my body is the mother of all bad reactions! There are no narcotic pain meds I can tolerate at all, and most of them also set off violent, uncontrolled, nonstop vomiting. So, before surgery they give me an anti-nausea patch behind my ear, which lasts three days before being replaced; then they load me up with everything they have so I wake from surgery without the violent vomiting of the past. Then, after surgery they keep the patch going, plus I am given IV anti-nausea meds before any pain meds. Sometimes one of the anti-nausea meds doesn't work so they try the next one. And sometimes I end up getting two at a time. Long story short, most of the time they can keep my nausea and vomiting to a minimum, or even totally gone, with extra care and awareness. Speak directly to your anesthesiologist directly just before surgery and let him/her know your concerns so they can address the problem before it happens. Good luck Wednesday!
     
  6. celynda

    celynda member

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    Talk with the docs about having a spinal instead of general anesthesia. Then about the PCA nerve catheter which should last for 72 hours. For pain control, try the Tramadol/Tylenol scheme as recommended by Josephine.

    This should help you avoid Oxy. Regardless of what you choose, ask for the anti nausea drugs as well. This is not the time to be brave. You deserve to be as comfortable as modern medicine can provide.

    Good Lick
     
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  7. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    Me! I can't take any narcotics. I do ask for anti-nausea medication before and after the procedure. Work with staff to get your pain management cocktail just right before you leave the hospital. There are plenty of options available.
     
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  8. NDSunshine

    NDSunshine junior member

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    When I had my scopes last Nov, I was throwing up when I got home, and for the rest of the day. Last surgery I had was around 20 years ago, no nausea. 20 years bf that, had General anaesthesia, woke up sick as a dog. So no idea what causes it. Guessing all the drugs on an empty stomach, bc narcotics don't normally make me ill. I will be asking for antinausea meds bf surgery. I also get anti-anxiety meds, bc I stress.
     
  9. pdx

    pdx graduate

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    Lots of options other than Oxy, thank goodness. I had hallucinations & refused to take it again, but I found that (in my case) hydrocodone, AKA Norco, worked fine.
     
  10. NDSunshine

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    I had tramadol at some point during surgery, and they sent me home with Norco, which works well for me.

    Curious-how do we find out everything they give us before surgery, during, and while in The Twilight Zone afterwards?

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  11. Jajakio

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    I knew some drugs were going to be a problem for me going in. I had had a c section several years ago and vomited 12 hours straight afterwards. I remember taking 4 different shots before the vomitting stopped. Things were so much better with the knee surgery.
    At the preop check about 10 days before surgery , we had a discussion on what I could and couldnt take. My surgery was at a large orthopedic surgery center ( st thomas in nashville) and i have to say they were really good. Everyone paid attention to what meds hadn't worked for me, gave me preop anti nausea meds plus a scopolomine patch behind my ear, more anti nausea meds in the iv bag in the hospital and anti nausea pills to take home. I honestly wasn't even queasy once. I was able to toletate one opiate for a few weeks with the help of anti nausea drugs

    What impressed me the most was how careful they were to answer all my questions and be transparent. Just before surgery, the nurse came along with a big handful of pills. Of course, being me, I wanted to know what they were giving me. The nurse pointed to each pill, named it and explained why they were giving it. No eye rolling or snarkiness or just take your pills which I've experienced at other places. They did the same with what was in the IV bag. My surgeons office called after I was home a couple of days to see how pain control was working and if I needed any changes. If you have good people,it is possible to get through this in spite of prior drug issues. Wishing you the best.
     
  12. HappyCatTX

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    In a scale of 0 to 10, my worst pain was a 7 one time. A month after surgery is less than 1. It has been on average a 2 to 3. They gave me oxys, up to 2 every 4 hours (as needed), but I cut the frequency and amount of taking these. After a month, I may take half of one in the morning, and another half some evenings. Pain was not as bad as I was afraid. I never had nausea, and as far as anesthesia, I don't remember anything.
     
  13. NDSunshine

    NDSunshine junior member

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    Jajakio, thanks. I had a bilateral scope in November, and awful nausea that entire day. I know it wasn't the Tramadol or the Norco, so maybe the general anaesthesia?

    I am today, 10 days before a RTKR, and still no pre-op class. They've screwed up on scheduling all appts related, and I just got approved with my insurance 2 days ago, and that, only because I rode their butts. I had to call my insurance to see what the holdup was, and the admins at the doc HADN'T EVEN SUBMITTED THE REQUEST.

    So the lady that called to tell me I was approved, tells me, "Oh, the insurance was holding us up"... I interrupted her before she finished and corrected her. No they didn't, I've been riding your admin butts this entire time to get this done.

    If I wasn't so confident in this surgeon, I would so cancel and look elsewhere. But anyway, my current struggle is getting to the class. I may skip that, because I don't think I really need that. I've been my scope already, Ive done intensive research, including watching surgeries on Youtube, and I have the book from the class. I think I'm ready :)

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  14. Jajakio

    Jajakio senior

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    Not getting the pre-op class isn't the end of the world. Mine was mostly hospital protocol like where to park and what door to come in and what to expect. I'd done a lot of reading and watching my surgeon perform a realtime surgery on you tube, so I pretty much knew most of that. There was a short section on what home aids might be useful post op but I had all my stuff already anyway.

    What was more important , to me anyway, was to preop checkup. It was at the same hospital, same day as the joint class. That's where we talked medical history, prior issues with pain meds, etc. It wasnt done by any of my surgical team but the PA wrote out a plan to deal with pain that day and it was part of my chart and referred to pre and post surgery. The presurgery nurse went over it with me again half an hour before surgery when she gave me the big handful of presurgery pills and put the scopolomine patch behind my ear. They were very with it, but the preop discussion on pain management was very important. Best of luck, Thumper and Sunshine.
     
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  15. NDSunshine

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    Jajakio, Thanks for the nausea patch mention. Im putting that on my list to ask for.

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  16. Chillimac

    Chillimac junior member

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    I've had far less pain with my recent TKR than I had with the Uni I had some years ago on the other knee. I spoke to the ward sister before I went to theatre regarding medication and she told me what they'd prescribe which consisted of Oxycodone 5mg every 4 hours, if needed, anti nausea pills and Oxycontin 5mg twice per day as well as Ibuprofen 2x 400mg every 4 hours.

    I took the two opiods for 7 days then found I no longer needed them. I'd been given 7 days supply anyway but didn't want to take them any more than that if I could help it. After finishing those two I used paracetamol 2x500mg every 6 hours and found I was good with those. I hardly took any ibuprofen, 4 or 5 doses at most, the anti nausea only while I was taking the opioid and luckily haven't had any problems, I only take paracetamol now when I have a physio session and before I go to bed. With my other surgery I was on co-codamol 2x500mg 4 times a day for around 4 weeks before I was comfortable enough to drop down to paracetamol after finishing my prescribed opiods.

    I'm not entirely sure why I've had less pain and discomfort with this surgery compared to the other but I'd much rather not need the medication. Everyone is different of course, some meds play havoc with some and work for others just fine.
     
  17. NDSunshine

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    Jakakio, just got done with the class. It was a snore. Most of it I already knew, but I tried to be interested. Once, when she was talking to the hip people, I asked a question, and she was, "Are you in the hip group?" She knows Im not, but I wasn't interrupting, and I was genuinely interested. Yesterday, a nurse gave me a pee test, and I've always done it a certain way, but I wanted to make sure I was doing it correctly, so I asked. She said, and I quote, "Are you kidding me??" I heard a couple registration girls chatting about snooty nurses, and I was like, yeah. Are all hospitals this way, and what's a good way to cut comments like this short? I don't need the stress.

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  18. Mutti3

    Mutti3 senior

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    Those preop classes can be a big waste of time. When I had my required class, I sat there with “1/2 an ear” thinking to my self, are you kidding me! This old instructor was prancing around telling tall tales and boring stories .
     
  19. NDSunshine

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    Rofl!! Tall stories, lol!! This chick was burned out or something. She talked with one guy, but ignored me. She said some hospitals will cancel surgery if you dont go. She basically told us it would hurt (no :O), we would get drugs for pain, and how to navigate stairs. Zzzzzz....THEN she was telling me some mush about someone who could go into details, but they would use a lot of jargon "I might not understand". Really. I read ALL my lab results. I diagnosed my own UTI. The doc missed it, the clinic missed it, the nurses missed it. IM the one who pushed for insurance approval. But your comment was funny, lol..

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  20. NDSunshine

    NDSunshine junior member

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    I will most likely be doing my other knee, and I WON'T be doing that class.

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