Should I have an IOVERA injection before a TKR?

@catheem I too am concerned about the pain medication. Not only am I pretty resistant to it but I also have kidney disease that limits what I can take. My TKR is scheduled for Oct and I am trying to have a good attitude but after 2 years of pain I have come to the point that this IS the choice. Sounds like we have similar circumstances. When is your surgery?

@lindielulu - My surgery is scheduled for November 20 - I have been doing SO many butt exercises to prepare, and my surgeon (as well as the surgeon before him) have stated that I don't have that much damage in my knee (I tore my meniscus 3 years ago and developed OA in the kneecap) to 'warrant' such a brutal surgery. The pain is in my inner knee and the pain is only when I walk...it was controlled with cortisone shots, and they quit working about 5 months ago. I am also losing weight (want to lose about another 15 pounds to get to my 'ideal' weight before then) and I walk daily. The only thing that has me able to do this surgery is if I do Iovera because, honestly, when I had my double spinal fusion in 2009, NOTHING worked to take away my pain. The pain was excruciating and after Dilaudid in heavy doses was finally given, I started to get some relief...I still have a pain specialist, and he can prescribe that..but I just want the area numbed for as long as possible instead since I have such a high tolerance of pain medication.. I keep telling myself that the doctor who is doing the Iovera has been doing it for many years and have to try to trust he won't damage anything...

@catheem I wish you could talk to some of his patients and get some advice from "real" patients but I wouldn't know how to do that. Sounds like you have a lot of determination and I think you will do fine because of that. I wish I had some of that dedication to lose weight. I did try the butt exercises and it helped temporarily, but doctor said mine was severely diseased and I don't have much choice. Sounds weird but when he said that, I felt a little relieved and justified in the awful pain I have been in. I have found it doesn't get better (permanently) which was what I was hoping and praying for with the exercises. Maybe it does for someone that isn't too far gone. I have resigned myself to the inevitable surgery. I am in such pain now with every step, I also don't have much pain when I am not walking but if I move the wrong way it's like lightening! I pray it all works out for you, can't imagine the spinal fusion, ouch! My Dr. told me he would give me a block that would last 48 hours but then his nurse clarified 24-48 hrs, so I guess it's a crapshoot. Let us know about the Iovera. It has been a year since I had it and it is still a little numb and a little pain when I push a certain area but nothing mind-blowing. But it did not numb the area that was painful, it was completely a failure with me but I really have heard of some that did great, I hope you are one of them.

@lindielulu - Again, thank you so much for your kind words of encouragement! When I see the doctor for the Iovera, first, I will be very groggy because I will be taking Ativan beforehand. I was going to ask him how many times the Iovera didn't work for his patients (even though, he may tell me beforehand himself) but since he works with my surgeon..I am hoping it's a much higher number that is successful, rather than not, since they are still using it..plus, the surgeon I was seeing before (he doesn't do robotic, and I want that) said that Iovera is what he is suggesting for his patients, as well, now. Exparel used to be used with most doctors out here (and before that, it was the On-Q nerve block that is a continuous lidocaine type of med that stays on your leg for approximately 3 days). (My husband had that, and then they stopped using it now...not sure why.) And the Exparel was also 'stopped' due to the expense of that block (which could have lasted for up to 5 days)....this is what drives me crazy...how the 'dollar' is what takes over and leaves many people SOL, so to speak, instead of putting the patient's comfort first..! Time usually changes things, since I did not have a nerve block in my back for my double spinal fusion back in 2009, and now they use it (from what I've been told, though, it's only a 2-3 hour block) so I think sometimes it's a crapshoot! All I can do is express how I feel, and ask for what I want, and then hold my breath!!!

@catheem That's good that you are going to ask before he gives it to you, I didn't even think of doing that. I am having my TKR on the 21st of this month. The doctor has a youtube video and he explained how the robot assisted, etc and again, I assumed he used it in every circumstance. I saw one thing that made me question if he used it every time and I called his nurse and she said sometimes he does and sometimes he doesn't. This really upset me because I chose him because he advertised that he did (also my neighbor used him and did fine) I hate that I had to question this, seems like it was a given, but I did and nurse called me back and said he would use robot "if I requested". What???? He never mentioned that it was a choice so my confidence level has been lowered some. What else should I ask that I am assuming? I just know I have to do it and I am tired of having all these questions. I ran errands today and every step was so painful, I am just ready to do something, prayer is what is getting me through. You and I sound very much alike, we try to get the answers but not confident that we got them. And yes, money is such a factor when it shouldn't be. The doctor did tell me about the morphine pump and he said family members would be in with the patient and the moment they groaned a little, someone would reach over and press the button which kept the patient drugged all the time and they didn't get the PT that they needed so I guess that's why they have done away with that. You are in my prayers for success!

@lindielulu - Thank you for your thoughts and prayers! Mine will go out to you, as well..Regarding the morphine pump, that will keep you VERY comfortable! I wish I could just do that, as well, but after SO many surgeries over my lifetime, I am too used to opioids and they hardly work on me. My surgeon is aware of this, which is why I have no choice but to try the Iovera.. BTW, my surgeon said he only does robotic if someone requests it...I really feel that these surgeons who have been doing this for years feel that they are more 'capable' than a robot..it's an ego thing..which I guess I can understand.

@catheem That's very interesting about the robotic assist. I thought the same thing about their ego. I just feel like they shouldn't be advertising it if they expected you to request it, he had a youtube video that showed him using it and didn't say anything about requesting it. I am getting so discouraged about all the different things you find out only after you make the decision to get the surgery. I asked so many questions but never once thought of asking about the robotic surgery. That was just a fluke. I wish I could get the pain pump

@lindielulu Hi there! Did you ever get the surgery? Iovera didn't work for me..:-(. I got through the procedure pretty well, but probably because it didn't do anything!

@lindielulu Hi there! Did you ever get the surgery? Iovera didn't work for me..:-(. I got through the procedure pretty well, but probably because it didn't do anything!

@catheem Hi there! Yes, I had TKR on Oct 21. Pt wants me to walk with walker for 3 weeks before going to cane. I was set back a week due to bathroom issues and did the best pt I could while on the throne. I cannot get to 0 extension but range of motion is better than they expected. Pt only 2x week so I do home exercises 3 times daily. I'm nervous about extension. Glad you got through yours well, let me know how things are going. No, Iovera doesn't work for so many, at least it didn't cause a negative, thank goodness for that. I feel like I am living in a fog although Dr. said everything went well. So glad that part is over but I feel I am not where I should be and hopefully this is my imagination but seems like one leg shorter than other. Looking forward to hearing your details.