TKR with methadone, post op pain?

Hi Lyndsey & welcome to the chronic pain forum. There is a chance you will have difficulty with the post op pain. I do not recommend that you attempt trying to get off the Methadone for post surgical pain. Methadone works different than regular narcotics, works on different pain receptors. Probably the dose you would need on a regular narcotic would be so great no dr would ever rx that amount to a patient. Is there a reason the surgeon will not let you have Methadone & perhaps a little something for break through pain post op? That would be the reasonable thing to do. You may think the 15mg is a small dose but Methadone is a completely different ballgame, which if you have tried getting off of it before you already know this. Most drs do not know enough about it to prescribe it correctly, the half life to it means it stays in the system much longer than a regular narcotic. I think it builds up in the system over time & this is why people go to hell & back several times trying to get off of it. I know of a couple that have not been successful getting off of it. I say once you have recuperated from the TKR then get on a different medication. Understand that even if you were on a different narcotic you would have a hard time handling the post op pain because you already have a med that you body requires. It can be tough.

One of our mods here was on it for years & it took her over a year to get completely off. She was able to reduce her dose over many months but was not able to go completely off. Then after awhile with the help of a good dr she was finally able to transition off to something different. Methadone is cheap & a very good pain reliever for some but it comes with its own set of problems not to mention the stigma attached to it. People automatically think you were someone with a drug problem just by mentioning taking it.

We have a search feature here at the top, if you will type in Methadone you will find many posts here on the subject. We do ask that you not post on those older threads we like to keep them off of the main page.

Keep checking back weekends tend to be slow. Take care.

Hey Lyndsey.Welcome to HW.

I had a TKR on my Rt knee November 9th.I'm 100% satisfied now because my Rt knee was like a bad tooth and a sorce of a great deal of my pain.And it didn't work.I'm sure you can relate to that.

My Pain Management Doctor switched me from Morphine IR 30 mg x 4 to Dilaudid 4 mg x 4 in addition to MSContin ER 30 mg x 2.

When I woke up after Surgery I was hurting,They gave me a Morphine Pump and Norco the 1st day.I was furious.

2nd day they switched me to what my PMD had prescribed and I was OK.

I went from 3 days in the Hospital to 18 days at a Rehab in town.

Rehabbing the knee is the most important thing.Even taking 16 mg of Dilaudid and 60 mg of Morphine ER a day I was in too much pain to do the Physical Therapy.

The increased it to Dilaudid 4 mg x 6 and MSContin ER 30 mg x 2 and I was able to rehab my knee.

My Tolerance was really high when I had my Surgery done,which was a bad thing.Even before the procedure the Surgeon said the hardest thing was going to be getting me out of pain.He was right.

But there is light at the end of the tunnel.I'm 8 months out and my knee feels really good.I'm taking Norco 10 mg x 4 a day now.

It wasn't fun but it was worthwhile and necessary.

Take care and God Bless.

Rick

I have been advised to stay on 15 mg methadone (taken once a day in am) throughout my surgery.

I know nothing about the other meds they give you except that my pain will be harder to control since I am on the methadone. I also take xanax to sleep.

I don't know what "prn" is and I don't know what Narco is, which other people have mentioned. My biggest problem is that I have not got a good pain management doctor...he just gives me meds and has cut my methadone in half because he is afraid of state recommendations...there was no reason he HAD to cut my meds...he just did. I do not trust him to manage my pain post op and I do not want to take methadone at all. It's too late now to switch pain docs and there are none near me anyway. I didn't even know what it was when the doctor put me on it ten years ago and not I can't get off it.

Even it I do manage to get through this surgery, there is still no adequate substance to control arthritis.

Im so scared to take all these other drugs in addition to methadone and xanax, even though it is a lost dose meth and I take 1-2mg xanax to sleep (depending on how bad my day was)...I feel like all these drugs will kill me. They say that many people have surgery on methadone and I am not alone but I feel so alone. I have a very unsympathetic husband who doesn't understand chronic pain and just yells a lot.

I wonder it anyone knows the following: if you are thin, do not have diabetes and in good health, really how difficult is it to recover from knee surgery? I need both knees done. I'm scheduled for 9/26 and hope to be walking by myself by Christmas...I also HATE to exercise.

You are not alone Lyndsey.I've taken 3 mg of Xanax a day for the last 14 years.

Norco is HydroCodone.Used to be called Lortab.It's not very strong but a lot of Doctors prescribe it because it makes them look better.

A TKR takes a couple of months to get through.I was driving to Rehab and walking with a cane at 3 weeks.

After they discharged me from Rehab I've just walked in the morning.

I take something non-narcotic for arthritis.I take 4 Norco 10 mg a day but I need the arthritis med.I stopped taking it for a few days and I could tell.

Take care and keep us posted.

Rick

Post Edited (tidalmouse) : 7/31/2016 6:05:41 AM (GMT-6)

Welcome to HW Crackeryo.You're 100 % right.Most of us suffer in silence because we know family doesn't understand.

This Forum is a lot of things to me.I'm reminded every morning that others here have a lot worse problems than I do and you'd never know it by the positive tone in their Posts.Some very strong Folks here.Much tougher than I am.

If you want you can Post your own Thread."Post New Topic" and tell a little about what got you here.It gives everyone a chance to welcome you.

But,that's entirely up to you.

Again,welcome aboard.

Rick

Lyndsey:
You wrote: "If you are thin, do not have diabetes . . . how long does it take to recovery from knee replacement surgery. And I hate exercise."

Being thin will help your recovery in that your new joint will not have to bear the additional burden of added/excessive weight. Your recovery will be easier than someone who is overweight/obese - all other factors held equal.

You will have to adopt a regular exercise/strengthening and range of motion program after surgery in order to recover well. Knee replacement surgery is not a surgery where you rest and lounge watching DVDs. You will need to partner with a good physical therapist and abide by the exercises to strengthen the musculature that support and stabilize the knee. You will need to be faithful to the range of motion activities to restore functional range of motion.

You do need to put in a bit of effort post operatively in working with your physical therapist as well as following with exercise and ROM at home.

You will not have the arthritis pain "nagging" at you post-operatively. You have post-operative pain but the nagging arthritis pain due to the wearing of the bone/cartilage is gone.

Good luck. You can do this.
- Karen -

You got to embrace life and embrace yourself.You're worth fixing.And a TKR will fix a bad,arthritic knee.A TKR is painful.The Physical Therapy is tough.They get the measuring device and you see how far back you can bend your knee.It's not very far at first.

They usually get you up the day of your Surgery.The Guy told me he was going to get me up and I said "That's what you think".

It was painful but in a few minutes I was sitting in a cushy chair on the other side of the room.

I'm 100% happy that I had mine done.Had it done last November 9th.It's like a new knee compared to my old one.And I think it's something mechanical,so it doesn't like to sit up.So I feel like I'm still rehabbing my knee.

Take care.

Rick

Post Edited (tidalmouse) : 8/3/2016 12:05:27 PM (GMT-6)