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Pain Meds: Post Surgery

post #1 of 29
Thread Starter 
Just out of curiousity, how long did you folks stay on oxycontin/oxycodone post surgery? I keep hearing horror stories about people becoming addicted to them. Fortunately, I have not needed them all that much. Six days post op, I'm averaging no more than two pills a day. Is this normal? Usually, the pain does not start until the evening. Given that I'm such an insomniac anyway, that's when I'll pop a pill. Some people have said that this can lead to chronic insomnia. Any thoughts?
post #2 of 29
Quote:
Originally Posted by Lisamarie
Just out of curiousity, how long did you folks stay on oxycontin/oxycodone post surgery?
I always thought these two were different but now that I am reading more on it I guess they are the same.

hmmmmmmmmmm

So Oxycontin is the same as percocet just at a higher dosage, not cut with anything else, and is a timed release formula.

I took Oxycodone after both knee surgeries.

I didn't have a huge problem after stopping but I wasn't on the Oxcontin variation. I was however taking two percocet every 4 hours for about a month straight after my first ACL surgery. Reattaching an avulsion is extremely painful compared to a normal ACL surgery.

I had multiple bottles of 100 pills.

My sleep schedule was all messed up while on heavy dosage but it got better once I stopped taking them.

I tool very little meds after my second surgery.
post #3 of 29
Can't say.

Only pain meds I was on post Surgery was what they gave via IV and don't recall being on anything there. They kept asking but I kept refusing.

Post OP, It was Aleeve( double dose) for 2 weeks and then single dose after that.

No heavy meds.

Still have all 15 tabs of Vicodin.

Hoping your recovery and rehab are going well. Take care LM.

DC
post #4 of 29
Hi LM-
First of all, forget about the addiction issue. You (and many people) confuse addiction and tolerance. Yes, if you are on an opioid for more than 3-5 days you can become tolerant (you need more drug to get the same effect). It has to do with the opioid receptors in the central nervous system. Addiction, on the other hand, is a psychological phenominon- drug craving and seeking that is independant of need for analgesia- that is a separate problem. The vast majority of people, once the pain is no longer an issue, will simply stop taking the opioid and that is that. If you are on the drug for a prolonged period of time you may need to wean down the dose over a number of days. BUT that is not addiction. Unless you have had problems with recreational drug (or alcohol) addiction in the past this is not something you should be worried about at all.

Your pain med needs sound about right. It is not surprising that after being up and around during the day that you begin to ache in the evening. Problems with chronic sleep disturbance are much more of an issue with benzodiazepines (drugs like valium, ambien, etc) than opioids. I would be very doubtful of any long term sleep issues with oxycodone.

Are you using oxycodone or Oxycontin? The latter is a sustained release version of oxycodone (which has a duration of action of about 4 hours, vs 12 for the sustained release prep). The big advantage of Oxycontin is that you can take one pill and have both a long period of analgesia as well as no "peak and valley" effect on blood level of the drug. That means better pain control as well as fewer side effects. However, if you are only having intermittant pain ( as opposed to continuous pain most of the time) and do not need to be meidicated for longer periods, you should just use the oxycodone when you need it and stop the oxycontin. If you are having both- that is, continuous pain, with episodes of much worse pain- you can take an oxycodone on top of the oxycontin for break-through pain. Percocet is a combination of oxycodone and acetominophen (tylenol). Tylenol is a really good adjunct to opioids- the tow work very well together, and may significantly reduce the amount of oxycodone that you need.
post #5 of 29
LM, When I had shoulder surgery last summer I was told to stay on the medication (Percocet) for at least a week, maybe two. I was given some sort of theory about the pain receptors becoming more sensitive if they weren't dulled during the first few weeks. I had been in such pain prior to surgery that I did what they told me to do, even though I hated the affects of the pills. I don't think the knee is subject to the same long term pain issues at the shoulder, but if there is sny truth to what I was told I would take them as long as you need them.
BTW, regarding my signature below, I am definitely making progress on the "wear out" part!! LewBob
post #6 of 29
I broke my neck in Switzerland a few weeks ago and they gave me Tylenol. I was really impressed by the care I recieved over there. I was helicoptered to the hospital and recieved emergency surgery to stabilize and fuse my C6 and C7 as they had been broken and dislocated. The next day the nurses pulled my IVs and brought me pills 4 times a day. I asked the surgeon what they were giving me and he told me that it was basically Tylenol. The thing was I was messed up and really uncomfortable from my injury and the surgury but not in any real pain. I was impressed that they didn't jump to the conclusion that I needed to be medicated. A week later as I was preparing to be discharged with a very long day of travel ahead of me I asked for something a little stronger or something that would help me sleep on my flights, they gave me some ibuprofin! Now I am home and feeling very fortunate that everything about my accident big and little worked out okay. Ben
post #7 of 29
I took some oxycodone for about a week after I broke my shoulder. Since I didn't want to be drugged during the day (I went to work), I only took them before going to bed so I could get to sleep without the pain keeping me awake. One was not effective, but two did the trick, and I actually enjoyed the buz. When the little vial of pills the emerge doc had prescribed was all gone, I thought about getting some more; I knew I could have gotten another prescription, but decided I really did not need them. Yeah, if you enjoy them you could get hooked, but if you only take them for pain relief you will be fine. Just remember not to take them when you don't need them for pain.

P.S. On a related topic for those of you who like to self-medicate, alcohol and codiene don't mix; it kills your liver, and may even do YOU in in a short time. Nobody told me this until I mentioned it to an M.D. friend years after I had noticed how much better Tylenol 4s worked with a half a dozen ounces of Daniels (a little experiment I conducted after a motorcycle crash).
post #8 of 29
You will be hopelessly addicted. Send all of your pills to me now and save yourself.
post #9 of 29
Thread Starter 
Thanks everyone for your insight and clarification. Even as a "child of the 70s," I managed not to develop any substance addictions, except if you were to call good looking guys "substances." But I digress.

Those of you who have met me in social situations know that I can become completely inebriated on one Cosmo or glass of champagne, even in Utah, for goodness sakes!:

Needless to say, the meds they gave me at the hospital, along with the little oxygen problem I was having, had a strong effect . On the ride back home, I was talking in complete non-sequitors. Mike kept asking me, "What made you think of that?:"

Then again, many people find it difficult to follow the logic of my conversations when I'm not on any drugs.

Seriously speaking, the scary part was getting up on crutches. Twice, on the first night, I got up and became disoriented. The foot of the bad leg briefly touched the ground. OUCH!!!!!!! I was convinced that I had totally destroyed the surgery.: After that, I was determined not to take my meds when nobody was around.

There is, of course, another side to this. This is the third time during my long career as a fitness professional that I needed to take some time off from all physical activity. While you can be prepared for whatever physical pain you'll need to endure, nothing can prepare you for the depression resulting from going from a completely active lifestyle, to a completely sedentary one. All systems seem to go on strike. I have no appetite. I'm experiencing complete writers block. The simple pleasures of life, like washing my hair, have become a challenge. Aside from that, as a social person, spending most of the day without any human element is driving me nuts!

Sometimes I wish I could just sleep through the whole recovery process, and wake up when it's over. This is why I worry about the pills. It would be far too easy to come up with a justification for "zoning out."
post #10 of 29
Quote:
Originally Posted by Bonni
You will be hopelessly addicted. Send all of your pills to me now and save yourself.

Bonni needs a fix since she can't afford the wacky tobacky.
post #11 of 29
Lisa,

After your knee gets a little better, could you use a pool to exercise? A lot of pools in Seattle have a chair that can lower people with injuries into and out of the water. While you're in the water, you could swim with a pull buoy. That way you could exercise without using your knee. I've seen PT people here letting their clients with knee injuries work out in the pool. Just a thought...

Ask your doctor if you can swim.

Get better soon!
post #12 of 29
My skiing partner used 2 ibuprofen and a beer. Waring could be addictive!
post #13 of 29
Thread Starter 
Quote:
Originally Posted by cloudpeak
Lisa,

After your knee gets a little better, could you use a pool to exercise? A lot of pools in Seattle have a chair that can lower people with injuries into and out of the water. While you're in the water, you could swim with a pull buoy. That way you could exercise without using your knee. I've seen PT people here letting their clients with knee injuries work out in the pool. Just a thought...

Ask your doctor if you can swim.

Get better soon!
I thought about that, but with all these weeks of limited activity, I would not be caught dead in public in a bathing suit!: I actually taught aqua fitness for a short time. Never got into it, because I hate chlorine. We do have a pool in the community center at our condo. Perhaps in the day time, I can sneak in when nobody else is around.
Thanks for the suggestion!
post #14 of 29
LM - when I had bad chronic fatigue aqua was the only thing I could do..... we had lots of rehabing people & some very overweight people who could not exercise on land for health reasons (knees etc) ....
I can assure you that a) most of the world don't care anyway
b) leggings & a top go OK in water exercises (yes we had one lady did this every day) - just don't make the top a t-shirt - they float UP
post #15 of 29
Quote:
Originally Posted by Lisamarie
I thought about that, but with all these weeks of limited activity, I would not be caught dead in public in a bathing suit!: I actually taught aqua fitness for a short time. Never got into it, because I hate chlorine. We do have a pool in the community center at our condo. Perhaps in the day time, I can sneak in when nobody else is around.
Thanks for the suggestion!
Smacking LM upside the head! (I need a little smilie guy for that) DO NOT, repeat DO NOT let a little vanity keep you from some exercise that will be good for your knee AND your emotional health. Put the d*mn suit on and get in the water!

I'm sure you are in MUCH better shape than I am, but I swallowed my suit insecurities and let someone here try to teach me to surf last summer! SO you have NOOOOO excuses!!
post #16 of 29
Quote:
Originally Posted by Lisamarie
Just out of curiousity, how long did you folks stay on oxycontin/oxycodone post surgery?
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I used it a bit for a few days. Opiates/narcotics are sooooooo idiosyncratic: some people do well with one and awful with another.
post #17 of 29
You guys are all basically disgusting. I cannot tolerate all the good pain meds. I am left to stuff a rag in it if the pain is to much. Found that out after a good back twisting auto accident.
post #18 of 29
Thread Starter 
Thanks Dr. Frau and disski for bringing me back to reality, and thanks Jim for the laughs.

I found out yesterday why I was not feeling much pain. Turns out, I was keeping my pillow under my knee, when it should be under my foot. Under the knee makes it feel real good, but guess what: It does not help you develop any range of motion. So the bad news is that I have not gained back enough extension in the past week.

After one session of PT, I really needed the meds. : I came home and my lower lip was red from biting it. No way was I going to whine and turn into the equivalent of one of my own worst students! But damn! When I think about how much I used to bench press, and now, to feel so much pain just from straightening the leg, I just want to scream in exasperation!

I mentioned in another thread that for some mysterious reason, my oxygen level is still way too low. They are speculating that it could either be because of my low BP, or due to the fact that I am not accustomned to taking pain meds. Probably a combination of the two. I end up in a catch 22 situation. I need my meds to practice my PT exercises with only a tolerable degree of pain, but the meds may be causing my oxygen to go too low. YIKES!!

BTW, I was thinking of posting a separate thread about the PT process, but I realize that is not the sort of thing that interests most people. To reduce the risk of wasting bandwidth, does anyone else want to hear about this?

Also, send good thoughts to ChuckC. Today, he is having his ACL done on one leg, and his medial meniscus done on the other!:
post #19 of 29
Lisamarie
Be patient. It is only a short time since your surgery. It will get better with time. I never had really strong pain meds (only codine with aspirin) but I saved them for noon time after skiing all morning. Used tylenol,etc after the surgery, but mine was minor compared to your. I am so sorry you cut your season short but you should
be fully healed by next year. And I'm sure you still look great in your swimsuit. (Last week I did a double take on the hill when I skied past what turned out to be a guy in a red and purple jacket.)
post #20 of 29
I just got my script filled for hydrocodone.

I think that the heeling process hurts more then the actual injury when bones and ligaments are involved.

Knee surgeries hurt more after the 2nd or 3rd day. For me at least.
post #21 of 29
BTW Lisa- unless you are really hypoventilating from the opioids (doesn't sound like it to me from what you have written), I would NOT ascribe your oxygen requirement to those drugs. Furthermore, you should be able to increase your saturation by voluntarily breathing faster and deeper (in ambient air, no supplemental O2) if alveolar hypoventilation was the cause. Has anyone gotten a chest xray? I suspect that something else is going on, perhaps atelectasis (collapse of a small segment of lung).
post #22 of 29
Thread Starter 
Oh yes. I seem to recall that they were suspecting some sort of lung collapse. Needless to say, I blocked out the thought. Adds a whole new meaning to the question, "What fresh hell is this?"
post #23 of 29
I never even got my prescription filled. didn't need 'em. my orthopod MD says my pain tolerance is quite high though.
post #24 of 29
It's weird how you can block out injuries. I dislocated my shoulder from a sidekick that glanced off my arm, shoulder and neck once while sparring, and just switched guards and didn't use the right punch. I then forgot all about it, while worrying about my neck, until I tried to wash in the shower and found I couldn't raise my arm.
post #25 of 29
Lisamarie you can increase your BP and oxygen levels by moving back to Boston for recovery.
post #26 of 29
ACL rehab was the most painful and difficult experience I ever endured.

Well, maybe hearing rap music and subwoofers in an adjacent motoring car comes close.

Hang in there.
post #27 of 29
Thread Starter 
Pierre: Seriously, I would rather die! Living near BU means that I would be listening to rap music from subwoofers in cars parked outside my door all hours of the night!
post #28 of 29
Hmmm.....I don't think I wanna go stay and paint now. Nevermind!
post #29 of 29
Thread Starter 
No worries! They're probably on extended Spring Break, either here or at K-Mart.
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