Adequate Post-Op Pain Relief?

Posted by roguesam @roguesam, Apr 5 8:46pm

I had my 4th major lower joint replacement surgery 5 days ago. R hip was my last. My surgeon is obviously feeling major pressure from medical supervision folks from the state of Oregon. He has been cutting back pain meds continually over the 15-year period when I have had my surgeries. On this last one, they shut down any opiates other than Tramadol Post=Op. I even called the morning after my outpatient surgery (when my nerve block had worn off overnight). The refuse to up any pain meds beyond Tramadol 50 mg TID. I have a difficult time being understanding when my thigh is completely black and blue and i am unable to sleep, even with major icing and all ancillary pain control methods. To not provide decent pain meds for the first 3-4 days seems sadistic, IMHO. I have several friends who suggest getting an adequate amount of Kratom and using it at a dosage rate of 1-2 TBSPs/day PRN. I won’t give the docs the satisfaction of doing so. Home health is seeing me for the next 7-10 days, and then I am going back to the surgeon's office for a follow-up. I am ready to blow them off completely. Great surgeon, but bedside care stinks. The office has an in-house PT program that I am going to refuse care from. I can provide my own care protocol at my rural forested property. I will not be complicit in sending the practice any additional money for PT.

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I get what you are saying! Not everyone becomes addicted to the pain meds. Most of us know better BUT do need something to get thru the pain! I had TKR 4 wks ago. I had limited pain med. and would not have been able to do PT without it! I would have just sat there because of the pain. Several people in PT have not progressed as I have because they either refuse to take the pain med. or was not given any. Doctor offered Tramadol but I refused and walked away with nothing. I am not paying for something that does not work for me. Finally Dr. gave me the pain med. I am doing exercises and PT to get this knee back to where I can walk properly. It has changed me, I am not the happy go lucky girl I used to be! I pray that will come back.

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It’s a typical government response to attempt to impact unauthorized/criminal use of materials (medical opiates, firearms, etc) by limiting the access of legitimate people through threatening the loss of a dispensing license. What group receives the most significant impact? Unfortunately, the legitimate consumer. Sad commentary on our current social structure. Why attempt to enforce current laws when you can impose additional controls?

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Although I had concerns of the lack of communication with my health care team for my joint progress after my total knee, the team did provide for me OxyContin with renewal when I asked, for my extended physical therapy time. I ended up getting an MUA ( manipulation under anesthesia), basically starting the recovery/PT pretty much over. I also was on a regimen of Extra Strength Tylenol and Celabrex. Prior to surgery I only took Motrin daily.
This teamwork approach for pain relief is very much needed. I also relied on my ice machine that I used every night- worked better than narcotics.
Now, contemplating another knee- how do I inquire about the pain relief after, without sounding like a drug-seeker. They can look at my life long pharmacy records! This part of care is vital for sure. Knee surgery and recovery is brutal.

PS: yesterday I hiked at a state park +17,000 steps, with over 51 flights of climbing. You can get there!! Sitting here waiting for my Motrin to kick in though. Still very stiff in the morning 11 months later!

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I completely understand your concerns. My first TKA required a MUA, as well. It sounds like your head is in the right place regarding recovery. Keep up the hard work on your journey!
Regarding future surgery & med concerns, I would simply say what you have said here. Point out previous complications and your future desires.

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@roguesam

I completely understand your concerns. My first TKA required a MUA, as well. It sounds like your head is in the right place regarding recovery. Keep up the hard work on your journey!
Regarding future surgery & med concerns, I would simply say what you have said here. Point out previous complications and your future desires.

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You can do it folks! Day 3 of some awesome Hiking in southern Ohio.
Working up bravery to do second knee.

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@cathymw

Although I had concerns of the lack of communication with my health care team for my joint progress after my total knee, the team did provide for me OxyContin with renewal when I asked, for my extended physical therapy time. I ended up getting an MUA ( manipulation under anesthesia), basically starting the recovery/PT pretty much over. I also was on a regimen of Extra Strength Tylenol and Celabrex. Prior to surgery I only took Motrin daily.
This teamwork approach for pain relief is very much needed. I also relied on my ice machine that I used every night- worked better than narcotics.
Now, contemplating another knee- how do I inquire about the pain relief after, without sounding like a drug-seeker. They can look at my life long pharmacy records! This part of care is vital for sure. Knee surgery and recovery is brutal.

PS: yesterday I hiked at a state park +17,000 steps, with over 51 flights of climbing. You can get there!! Sitting here waiting for my Motrin to kick in though. Still very stiff in the morning 11 months later!

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I and a lot of people can not take the anti-inflammatory drugs. I only have 1 kidney. They are wonderful drug.

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@cathymw

You can do it folks! Day 3 of some awesome Hiking in southern Ohio.
Working up bravery to do second knee.

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Keep on working! I am SO relieved that both knees, and to a lesser degree, both hips are finished. I don’t know if I would have another TKA recovery in me….

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@jamesireneedward

I and a lot of people can not take the anti-inflammatory drugs. I only have 1 kidney. They are wonderful drug.

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I cannot fathom no NSAIDs. 200mg starts my day.

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Day 9 post-op R hip replacement. I am walking without a cane and only minor discomfort, in general. Absolutely pleased with the procedure and , to a lesser degree, the recovery. This surgeon does know his stuff!

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@cathymw

I cannot fathom no NSAIDs. 200mg starts my day.

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It ain't easy, but one works with they got. Ibuprofen is a wonderful drug. I was able to take it before kidney removal.

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