I agree, some who have an addictive personality can get hooked but for those like me as a chronic pain patient it is what keeps me living a functional life
Thank you for this video. I’ve had chronic pain for at least 6 years. It is aggravating when those with legitimate chronic pain are treated like those with addiction issues. I have one or two more orthopedic surgeries and look forward to a time when I won’t need pain meds. As a side note...congratulations on how your subscribers have increased! Blessings...
Our Ortho Docs Here in Maryland USA give enough narcs to get one to the first two week post op exam. They reassess you, and decide which narc will be best for the next two or three weeks. Tylenol is added too. You cannot get refills here in the USA a new script is necessary. Physical Therapy adds their data to the Doc's as well regarding pain and progress. Thanks guys, another timely video. Stay well!
Great video! I can see how easy it would be for someone to become addicted. I was t-boned by a transport truck and banged up real good. After 7 days in hospital and having hydromorphin at home, when I stopped it was 4 or 5 nights of not sleeping. Then surgery to repair my shoulder from the accident, the doc gave me the script and I said I don't want it and I explained why. He said I get it but you will need it, when the nerve block comes out you will be in a lot of pain. Me thinking I know all didn't take the med before bed, and at 4am just like doc said the nerve block was no longer and I was crying like a baby in pain. My daughter asked me if I was done being silly and did I want my pain med. Answer was yes.
I have been a nurse for 48 years and still practice at the bedside on a pediatric surgery -trauma unit. You have brought up many great points such as using a multi-model approach and understanding how the meds interact for pain management. Also, every person is an individual. You also brought up the great point " post surgical pain should be temporary". Education is the key to help people recognize risks vs benefits of every decision they make concerning their health care. It is a team effort.Great video!
I had my total knee replacement 5 days ago. The doctor sent me home and I've been rehabbing at home. Let's say the exercising and stretching hasn't been pleasant but it's a necessary evil. Praise the Lord my pain is normally at 2. The therapist just keeps reminding me to stay ahead of the pain. Your videos have been so helpful leading up to my surgery. Thank you.
Thank you for this video. Three and 1/2 weeks post op and still in quite a bit of pain. Trying not to use too much pain med but I still need them. I opted for Tylenol 3 as I was given them previously for pain 20 years ago. I don’t’ remember having any problem stopping them. This pain however post surgery is much worse. The most important advice that I took from this video is do not increase. I am recording my use and have gone from 8 per day to 3. It is indeed a fine balance.
Thanks for all the videos you put out as they. are so helpful. You are Canadian doctors so.I believe all the information is good . I am 83 yrs old and share this info with friends as with COVID19 YOU CAN'T GET YOUR DOCTOR FOR INFORMATION. AT MY AGE IS IT OK TO GET BOTH KNEES REPLACED?
Hi Byrute. Very welcome. So age is only part of it. It would depend on the rest of your health but many of our patients are in their 80s. You would likely not get them done at the same time but rather staged. Best of luck. Thanks for watching and subscribing if you did
Having had a hip replacement recently I'm glad that pain meds were made available. That said sound judgement can get easily clouded. I'll be glad when healing is complete.
In my experiences of the times I have been prescribed narcotics is when the pain was bad enough for narcotics, I didn't feel high/woozy/out of it etc. But, when a dose made me feel that way, that's when I knew it was time to focus on other things like acetaminophen, ibuprofen (especially higher than OTC labelling), rest (especially rest!), physical therapy etc. Plus the recognition that "zero pain" is not necessarily the goal post surgery.
Hi Dr.'s, Thank you for the video. I had a total knee replacement here in the U.S. and the Dr. prescribed narcotics, "Percocet" for up to 3 months following that procedure. The Dr. required that I come in on a weekly basis for a refill. 3 months is the maximum amount of time he could write for and after that I would have to go to pain management. Thank you for the video.
Having u come in on a weekly basis is excessive, IMHO. I've heard of pts going on a monthly basis. I hope u didn't pay out of pocket for those visits. I've not heard that an MD couldn't write for more than 3 months. There are lots of "laws" going around that aren't true. My MD told me he couldn't write for more than 3 per day. I asked a pharmacists and he said that wasn't true. When I did finally get in to a pain specialist he increased my dose, but I have health problems that I will die with.
Thanks for enlightening us on how it works where you are Jorge. Very welcome. All the best. Thanks for watching, subscribing and sharing with someone if you did.
I got wrist surgery last year, the surgeon told me that the pain would be terrible but that i dont even bother to ask, no narcotics! He was talking down to me. I went to my PCP afterwards and explained the situation, he rolled his eves and wrote me a prescription for 30 of the 5mg Norco
I've had two spine disk fusion surgeries. The first was a double and I did have to wean off the narcs after recovery. The weaning process was uncomfortable but was a better choice than the post surgery pain. The second fusion was done using "minimally invasive" techniques and the recovery was comparatively a piece of cake.
After my hip surgery I was on oxy for a week or so. The worst part was the constipation these narcotics cause (even with stool softeners, prunes you name it I took it to help). I took Tylenol in between to help get off narcotics.
As an ex smoker I have an addictive tendency. I had surgery two weeks ago and was given narcotics and was fortunate enough not to need any. I am scared to death of addiction. Great video.
Thank you. My biggest fear about my upcoming hip surgery is pain control. I don't take narcotics but have had to take ibupropen for my arthritic hip joint. I look forward to being pain free and drug free asap.
I’m 3 months post operation bilateral knee replacement in Singapore. I did the entire thing without opiates , no morphine after surgery, no hydrocodone after that, just Celebrex… So it can be done, it’s not easy but it’s doable!
Hello… I SERIOUSLY cannot imagine that it’s doable! I applaud you and all the factors that came together for you. I just had my second TKR replacement a week ago. I had a spinal block (the one that lasts for a few hours) as well as the nerve block pack that is supposed to last for about 72 hours AND an IV drip of whatever pain meds they use after surgery, already started before the spinal wears off. I hate the overuse of the words literally and seriously (LOL), especially in all caps,huh‽ But, I seriously and literally thought, I may have a heart attack because of the pain. My blood pressure went up, as well as my pulse, and they really were trying to help. I was so groggy from pain medication that I felt like I might pass out and go to sleep but it did nothing for the pain. I remember telling them “don’t come check on me and assume because I’m passing out, that the pain medication kicked in. Please do something else.” They had given me several things in the IV, including fentanyl, but the pain was winning. Finally, they called anesthesia and the Doctor Who came told me they were going to start a fentanyl pump. I really didn’t think it was going to help, since they already given me fentanyl, but I was wrong. I know exactly how long it took to work because you can only dose with it every 10 minutes and I was quite aware of that little green light, blinking, telling me, “It’s time!“ Within 30 minutes, I had crossed back over into sanity! A few hours (and a lovely nap) later, I asked them to please start the oral pain meds and stop the pump. It was a reluctant request, believe me, not knowing what to expect, but there’s only one way to find out. A couple of nurses suggested letting it go a while longer, but once that door had been closed, I hoped we could nail it shut and go down the more normal path. Thankfully, it worked. Now, a week later and I’m on “regular” pain medication, trying to alternate doses with ibuprofen and tylenol every third or fourth scheduled time, so I can taper off of them asap….I’m nowhere NEAR that right now. Found out with the first knee; I apparently developed a physical dependence on them within 4-5 weeks. Totally unexpected and thought I had Covid or something. My doctors didn’t know and could only treat me for symptoms, which, after many blood tests, showed NOTHING! So, a warning to rehydrate to prevent hospitalization and a script for generic zofran was all I could do at the time. I wonder what different protocols or whatever was used in Singapore. I WOULD say, maybe I’m just a weenie crybaby, but I had the first knee done 4 months ago and it was nothing, compared to this one. If the first one had been like this one, I wouldn’t have EVER gone back for this one. 😊
Thanks for sharing the information. I feel the chronic pain patient is left in a very bad situation, with no end in sight sometimes. My spouse with chronic back pain multiple fusion and then new pain... has done the on - off method to keep dosage down. Its not a fun ride, but it seems to work for him vs the alternative of everyday pain. I hope one day the drug companies can find an alternate solution for pain sufferers. The regulations are cruel and in humane in some cases IMHO. People who are going to be addicted/dependent will just find some other way for pain relief and be addicted to street drugs, a much more dangerous proposition. I know not your guys issues- but should be addressed by the ones who make the arbitrary decisions that affect millions of people in pain.
Didn't request more Hydrocodone when week supply was finished after both hip replacements. Had my friend next door walk me a long block to get bourbon in 8 degree weather. The pain from hip replacement is bad for 3 to 4 weeks and Tylenol won't cut it. I forgot to note that if you are in withdrawal from opioid, Hydroxyzine is one drug that really helps withdrawal. I had to do this years ago after gallbladder surgery.
I have always used the least amount of opoids as I could, but after having to have my knee scar tissue broke so I could bend my knee, I understand what you said in another video, if I am in too much pain I won't do enough PT. I am scheduled for a right total knee replacement surgery in June so I hope to have better results. I am doing my "prehab" already. Thanks for all the information!
hi guys just got my TKR done thank you for all th vidos the TKR related videos they have helped a lot i have cut my oxy meds in quarters much more maneageable .God Bless you both
❤❤.I really appreciate you taking the time to make this video. My dad had a knee replacement about 3 years ago, and he still has problems walking because my mom actually took his medicine away from him before he was even finished with his rehab after surgery. I also have to have my knee replaced soon, and I am allergic to most of the medication you would give for pain, including NSAIDS, but I'm on a blood thinner daily. Basically, I'm going to be stuck with Tylenol and a narcotic. Anyway, thank you again for this video ❤❤
Thank you for this. I didn't think about an addiction. Surgery is coming up and this was good to hear. Taking every step to have a successful surgery and recovery!! I will listen to my dr!
My hips were worn to the point of no head left on the femur. I took 3-4 10-500 Hydrocodone daily plus naproxen. This went on for 3 years. After the bone metastasis was cleared up. I got both hips replaced and after a short recovery period never took another Hydrocodone. Didn’t bother me a bit.
I'm having hip replacement surgery. Could you do a video on taking medications not addictive and what do you about that before a replacement. Again both of you are great. I haven't even talked to my surgeon yet. ❤
Analgesics work in various ways. An analgesic that is good for treating one type of pain has no effect on another area of pain. Perhaps a pain management specialist could be invited to discuss with you the various types of pain, how specific analgesics are used, and why an analgesic which great at relieving pain in one condition is of little benefit in the relief of another type of pain?
We would totally agree David and that is why a multimodal approach is often used nowadays. We have a video on this topic. Thanks for watching and subscribing
Thank you guys for doing videos like these. They give some great information on what ever the subject may be. I know lots of times when people go to see there Doc or specialty Docs, they get a little nervous and forget to ask some things they wanted to ask. Also some people like me forget all that was said during the appointment. So thanks for information, and what to expect with different things you may have done. I am from New Hampshire in the states, but if i was in Canada, i would seek you guys out if i needed my knees replaced. Keep up the great work.
I had a knee replacement and I’m allergy to pain medicines I could take Tylenol . So it was very hard at the beginning after my operation, but with other things I was able to wean very early.
Currently six days post op left hip replacement surgery. I find I had the most pain with the swelling of my left thigh and knee. I took the prescribed Amount of 10 mg Oxycodone every six hours and could take Tramadol 100 mg every six hours the f needed. I definitely took all that was prescribed and how it was prescribed to me for the first four days or so. Very painful. On day five (yesterday), I called my surgeon and said all the Oxycodone is doing is making me high, and I don’t like that feeling at all. I requested a 5 mg Flexeril and he approved that for me. So now I’m taking the Flexeril TID PRN and so far only had one 5 mg Oxycodone since yesterday afternoon. I feel better and I’m not drugged up and nauseous! I would say the narcotic Definitely serves a purpose for post surgical pain with majorly surgery like this. However, once 😊you start feeling a little better and can tolerate the pain more so, get off that crap. I can also use Tylenol and Ibuprofen which NOW a works very well. Just sharing my experience. Sorry for such a long read! 😂
The last time I was in for a procedure the head surgical nurse asked why I was turning down pain meds and my response was im just gutting it out because it was better than risking the unneeded use of narcotics. Pain has always been manageable for me without sketchy drugs.
well i had my operation 4/7/23 still stiff only 2nd out got some pain im doing a few little moves the Dr. had already done 3 TNR so i was his 4th and after i woke up and was standing up the Dr came up to me asked how i was felling, I said ive felt better, so i asked him how did it go, He said 1 word PERFECT and he was gone ,so now the fun part begins i read the 3rd & 4th day are the worst ill keep plugging along .
I appreciate your emphasis on protecting the patient from addiction, use of multi modal management. Opoid addiction is rampant in the USA. I was dismayed at the hospital's near insistance that I have a script for hydrocodone (vicoden) . I had no post operative pain after my hip replacement following a femoral neck fracture. I refused it. For one thing I am very reactive to codein at any level. One tablet leads to a zombie like state and several days of projectile vomiting. They denied that vicoden is codein based. Then they tried to get me to accept tramadol. Again I refused. In 2 months I think I used 4 to 6 500mg tylenol. Once the postural limitations were lifted and I could work on strengthening unused muscles then I had daily need for several weeks of tylenol. Early on when I had some pain in the hip cold packs took care of the hurt. Keep up the good work. At this time as I am working to gain rom, extension, etc heat is helpful to ease the muscle ache.
I always wondered about this topic. I just could not figure out how people get addicted to pain meds. Thank you for talking about this topic. Great video
I have 2 surgeries that I have been needing for 3+ years and have avoided them because last time I had surgery, as a recovering addict, I was extremely under treated and was in so much agony, but the part that was worse was the way they treated me as if I weren't even deserving of consideration and I deserved my pain. Doctors here don't give pain meds for C-sections or open-heart surgery anymore, and it should be a crime and against their path to do no harm.
I survived without a single pill or any other pain killer after ORIF of my radius. I have addictive personality, that's why I choosed not to take anything. The pain was manageble, but still not something I don't want to go through again.
3 weeks out from TKR at a very good center and knee itself is doing great. Had all the multi modal options including ice machine, NSAIDS, Opiates, On Q for 4 days. Essentially no need for opiates for knee pain any longer. However past 2 weeks dramatic episodic neuropathic pain and hyperesthesia from upper thigh to ankle. Anesthesia says this is injury to femoral or saphenous nerve. Not asking you for advice on my case, lots of specialists dealing with it. I cannot be the only one, there must be other people with same complication who are equally worried and confused. How the heck does this kind of thing happen? Any chance you might have a video coming out about this sort of complication? Have you got a Pain Specialist colleague around for another video. Your post TKR pain video does not address this issue. Thank you for all your videos, they prepared me really well for the surgery.
Sorry to hear this. We don’t have a video about this and thankfully it is very uncommon. Sometimes related to the tourniquet if they used one. Other potential cause is pre existing lower back issues and nerve impingement that got aggravated by the procedure. Hang in there. Usually does get better
Great talk guys thanks! For those of us addicts that can be described as having "a genetic predisposition towards consumptive addictive behavior" we can get addicted to anything especially opioids and that has little to do with the doctors or medical laws. The leash is certainly shorter now for understandable reasons... thanks again Florida... In Washington State a total hip and the longest you can milk that for pain meds is about 45 days. For an addict who is on stable ground of being clean they understand it was the abuse of narcotics that was the problem,, not their use so for those in a 12 step program involve your sponsor if your concerned. Plan in advance that your sponsor is going to see you twice a week post surgery and count your pills. To hold you accountable if your concerned that a surgery might send you back "out"...
Thank you so much for taking the time to share Brian and congratulations on your personal success. Thanks for watching, subscribing and sharing with someone if you did.
Thank you, from one who isn't an "addict". Labeling ppl is dangerous when practicing medicine. The day after an abdominal surgery my nurse told the next nurse "she said she's in pain but I think she just likes her meds". I heard her say it and this was b/4 pain pumps and I was being given morphine so I stopped asking for a shot. The night nurse found me awake and asked me why. I told her I was in too much pain that the MS wasn't working, it just knocked me out for about 30 min. Bless her heart, she said "that's better than nothing, it will get u thru the night". She told the surgeon the next morning and he gave me Dilaudid which worked but I promptly had a reaction to. Oxycontin doesn't work on me either as well as Fentanyl. Thank you for not lumping pain patients in the same pot.
Another idea is to have someone in your household be responsible for your pain meds. I used to do home Hospice care, and there were narcotics involved. There were homes where a family member or close friend was an addict, or would steal the drugs. We would have a family member take charge. Sometimes they would only bring over enough for 24 hrs. Other times they stayed at the house and hid the narcotics. We would do daily counts with the designated person to make sure no one was using. In 16+ yrs, we never had any narcs go missing.
@@1packatak When I did home care and we suspected someone else was taking the opioids we would have a lock box installed in the house, screwed to a wall or something and only responsible ppl would have a key.
I did not need anything more than Tylenol for my recent total shoulder replacement and foot fusing surgeries. I had the hydrocodeine, but did not use it (the drug makes me nauseous, so it’s a good incentive to not use it unless I’m really in pain.). Though, i do not expect to be so lucky for my TKR this September. I expect the pain level will be much higher.
So hat is the right time and amount based on your recommendations to start taking Percocet after total knee replacement? I had my partial knee replacement two days ago. I can feel the blocker wearing off. What would you recommend my steps to be to keep the pain down while continuing to get better? Great videos! Thanks
Hi John. Usually once the block wears off you would need something stronger so likely soon. Continue with ice abs your exercises. Take enough medication to be able to do the exercises. Best of luck. Thanks for watching and subscribing if you did
It is all about the protocol. You follow the protocol for the patient's benefit because there're so many unforeseen situations. We all know time is the best healer and time will make you feel better.
good discussion for a very common question and concern. but the biggest addiction risk is through diversion where someone gets ahold of leftover pills with the intent to get high or sell to someone else for that use. taking narcotics in a normal way for short-term post-op pain is really low risk for addiction. the people i know who are concerned about getting addicted don't have a history of narcotic abuse and are very likely to be careful about how they use the pills and it's not something that usually happens accidentally
I was on Tramadol after my neck injury from a car accident, didnt seem to help much, but the Dr wouldnt prescribe anything else...the muscle relaxers wound up helping more, but seem to make me really tired the next day.
Speaking of post op pain control, this was interesting to hear after my PTT surgery. Always have questions about post op surgical wound care. Just had PTT and calcaneal osteotomy surgery. Insicion to fix the tendon went from first Metatarsal to Tibia. Staples used. what is good for helping it heal? ie skin care, scabbing falling off. Leave it all alone or to help it. What to watch for infections etc Thanks for your videos.
Hi JoAnn. Very welcome. Best advice is just to keep it clean and dry. Daily cleanse with saline. Dab dry. Don’t pick the scabs. Be patient. Good luck. Thanks for watching and subscribing if you did
After my TKR I was prescribed 12 hour extended relief oxy 2x/ day for the first week. I also had low dose oxy every 4 hours for the first week. I don't remember the potency. Then no more extended release permitted. I think I was on the low dose for 15 more days. I was never in agony, and did good at therapy. After I stopped the oxy I got night sweats for a few days. Take the pain meds. One will heal faster with less agony. And to add to that, it was easy stopping cold turkey.
The surgery will destroy your life, run or hobble far away from these people ,their is no pain management, they just wont give you any ,2 rods screws all the hardware have taught me they talk a big game before surgery and leave you on your own a year down the road.js
I'm getting my first knee done Feb 20 and I'm nervous about taking the narcotics. Oxy and Hydrocodone make me very sick. I'm talking about vomiting for HOURS after one dose. The surgeon and I talked about this and he's going to give me Dilaudid as he said it's not as likely to cause stomach issues and he's giving me Zofran for nausea. I did have Demerol once and was very sick and the Zofran helped a lot. I will also be getting tramadol for in between if I need it and Celebrex daily. I just hope that all of this works and that I don't have days of having to choose being really sick or being in pain.
Thank you Docs! This is a really good video, they did give me a prescription for Norco and I have been taking 1 a Day for pain or as needed. What else can a person take if they don’t want to take the Norco and cannot take naproxen! Or Tylenol. I would prefer to not take it unless it is needed when I finally do get the surgery on my knee in November. Thanks Docs for this video and all of the other ones! Darlene
Hi Darlene. If you can't take tylenol or NSAIDs you are very limited. Best to talk to your doctor or pharmacist for some specific recommendations. Thanks for watching, subscribing and sharing with someone if you did.
I have a friend whose father is dying and he was in the hospital and one of the relatives denied him pain medication because they said oh my God he’s had it for the last 20 hours he’ll become addicted and I looked at him and literally I was like I don’t think that’s gonna be a problem. He’s actively dying and in pain, it just blew my mind. It really did. I’ve never been so angry in my life that they were going to allow this poor man to suffer. He is so thin he has not an ounce of fat and his all bones. Every touch is painful. it broke my heart not to mention they had to do a procedure on him. They finally allowed him pain medication And that he was sleeping and that drug I said well he’s not in as much pain. That’s why he’s actually sleeping. He still having some because he’s having pain reactions and I said it’s better that he not being in pain and then him being in pain, would you want to lay here in pain for hours and hours and hours and I have kind of pain I can tell you that that’s horrible that’s horrible and it really broke my heart that this family actually was considering not letting this dying man have pain medication in his last days , and it really is absolutely ridiculous “. I had orthopedic surgery for sepsis. I was in a lot of pain and my regular medication wasn’t working. I asked for IV Tylenol, which works pretty good. The hospital actually refused to give it to me because they said it was too expensive.
I'm 71 and recently had pancreas surgery and bleed out 3 times two months after that. I had chronic back pain which no one ever believed which was one vertebrae was fractured and 2 had some other thing. The docs kept refusing any pain relief. Finally they decided to find out they were right all along. With an MRI they saw the injuries and finally allowed me a prescription. Then they didn't fill the prescription for nine days so I tried marijuana and another ovc med. When pain is real and not just a tummy ache then the docs should check and prescribe if there are real injuries. They keep me on a baseline which doesn't take the pain away but it is managable.
After arthrodesis ankle surgery 7 years ago I was prescribed Oxycodene. It worked very well, and was very much needed at least for the first 2 - 3 weeks. And occasional use after if the pain became too much. This year I had knee replacement surgery. Again I was prescribed Oxycodene. This time, unknown to me I had built up a resistance to the drug, the pain was awful, especially at physio. Th bottom line is, I never reached optimum bend in the knee. Because of a fear of becoming addicted to the drug, the dosage was never increased.
Hi Rita. Yes there are many reasons that the response can vary between patients and over time. Sorry you had to suffer. Thanks for watching, subscribing and sharing with someone if you did
Love your videos! Regarding prescribing narcotics from Ortho docs- the biggest issue I see frequently in our area is the amount given to pts after surgery- as you explained, pain should be decreasing with time, so why are some docs still writing out such large amounts of narcotics is beyond me. I have personally found that anti inflammatory meds paired with Tylenol can control a good number of pains- we also need to instruct our patients that pain is expected after surgery- some discomfort is normal and the goal should not be the absence of pain.
Interesting. When I cracked a rib, I was given morphine 25 mg. and after taking two pills, there was no efficacy at all in pain management, so I took them back to the pharmacy and switched to Advil. That did the trick.
Greetings from the Bourbon Capital of the World. In my opinion addiction is a sign of a weak mind. It's because of abuse I can't get what I need for pain. Since I only take it at work I can't go to a pain clinic for help.
Hi Michaels. There are certainly lots of reasons and many are not the patients fault. It is complicated for sure. Are you in Kentucky? Thanks for watching and subscribing
Doctors seem to normalize a certain level of pain. Maybe we need to invent a pain simulator that doctors would wear. When I was a kid, my dentist refused to give me injections saying that they don't work. When I complained, she injected very shallow and it spilled into my mouth and didn't work. I stopped going to dentists, because I had no control, and lost all my teeth. If you didn't finish a prescription, save the pain pills for a bad day. Because you won't be getting any more. They are cracking down on drugs really hard. I still have some codeine in my freezer for more than a year.
Hi Katherine. Unfortunately what we can tell you is that there is no evidence that it works and carries a significant financial risk. Thanks for watching and subscribing if you did
So, if a person has one or two drinks every day their whole life they're NOT considered an alcoholic but someone who takes one or two small doses of a narcotic a day their whole life is considered an addict?
Hi Pauly. No an addict regardless of whether it is alcohol or drugs is someone who has physical and psychological withdrawal symptoms if the drug is not taken and also someone who’s life and relationships are negatively affected by its use. Alcohol is an even bigger problem. Thanks for watching and subscribing
very good point. i have had chronic pain for years and take my narcotic pain meds with great care and caution. That said, although i do not drink, it is very frustrating and aggravating to me to see those who continually abuse alcohol yet consider all those who actually needs pain meds, as addicts. alcohol is the most abused substance really because it is not controlled.
I had surgery that removed a tumor that filled my entire internal cavity which I think is called the Retroperitoneal area, my left kidney, and a whole section of my artery that allowed blood to reach my legs, then had tubes replace the artery and extend from right leg to left leg to avoid amputating them. I am in extreme pain for almost three months from burning sensations of my skin where the incisions where, to stabbing internal pains, pains from gas, bloating, and constipation. For almost three months I've been on constant combination of acetaminophen combined with oxycodone painkillers nonstop with docusate/senna, and miralax for constipation. And now the painkillers hardly have any effect. I don't see an end to this pain.
That is very large surgery for sure and often is associated with prolonged post operative pain. Worth a trip to your doctor for sure though. Wishing you the best of luck. Thanks for watching and subscribing
I live in the USA. A couple of years ago I had gastric bypass surgery. After surgery I was fine other than not being able to sleep at night with RN's coming in checking. I would be asked about my pain level. Between zero to ten, ten being the most what is your pain level? Zero. hahaha, no really. what is your pain level? ZERO !!! This went on for a week. When I was discharged, they gave me a script for pain meds. I didn't want them but was told I had to take the script and fill it on the way home just in case I have pain in the middle of the night. I filled it and it was for 64 oxycodone. What was I supposed to with those I was thinking MAYBE 6-10 tablets at the most. After a few days I had a little pain from moving around too much but looking back I should have just taken a Tylenol. That wasn't the first time I had that happen after surgeries. I've never had a problem with post operative pain, but I'm forced to fill my pain script.
I wish u docs would talk to a pain specialist. I don't know where u young docs get the impression that narcotics don't work for arthritis (3:46). I'm 72 and have several forms of arthritis as well as other autoimmune health conditions that I will die with, and yes, I take an opioid that helps me get out of bed in the morning. I have been on and off opioids for a good portion of my life and was able to stop without a problem as long as I didn't stop abruptly. I'm a retired RN and would never tell a pt that they don't need pain meds or that they are asking for pain meds because "she just likes her narcs", which was said about me by my bedside nurse the day after an abdominal surgery when I was on Morphine which wasn't working. Most legal opioids don't work on me, including the ones being abused. When I met with my pain specialist the first time he told me I wasn't taking enough and I just about fell off the chair. There is so much shaming going on for ppl who do have to use narcotics. Please check with pain specialists b/4 u making such a statement.
Hi Linda. We talk to our pain specialists regularly. Science is where the impression that narcotics don't work for arthritis comes from. It does not mean that some doctors won't prescribe them but it will cause many more problems than it will solve. We use them routinely for post operative pain. Thank you for sharing your perspective. Thanks for watching, subscribing and sharing with someone if you did.
@@TalkingWithDocs It's what gets me out of bed in the morning and sometimes helps me get a decent night's sleep. Scientists who say opioids don't work on pain have never been in constant pain, IMHO. I and thousand more are evidence that they do but they never ask me.
I have a question that would be a great topic. I have severe chronic pain taking "max mme dose" in oregon this is about 90mg mme. How or what can surgeons do to manage pain post op, when already on pain meds. I have yet to get a straight forward answer from my providers, as I have at least 2 surgeries coming up, information would be helpful. If you can create a video on pain management post op, when already taking very high dose pain meds. Some things that may help is, people maxed out on NSAIDS, also gone through any other pain med options for off lable use. The narcotics pain meds im taking is about maxed out. This is not for solely for pain in the surgically place that will be operated on. But getting back to it, how can providers control pain post op, when at the max mme. One of my chronic illness providers, says she's afraid I won't get any pain meds post op, given I'm at the max dose.
I am currently taking Buprenorphine for addiction and pain control for my knee ,neck, and back pain from multiple surgeries over the years , and now I'm about to undergo knee replacement surgery , will there be a problem getting my pain medicine after the surgery ?
Splinting, ice, elevation - basically "we give you some Tylenol and tell you to get over it, you deserve it, you're the screw-up, not us." As usual. That's what they mean when they say "multimodal" l. Tylenol, ice, and trauma.
Yes, agree. Tylenol, really? Doctors should have a little nanobot injected into them durung their edycation/residency that will, without any warning, cause severe pain for weeks at a time. They will have a different attitude or approach when they have sufferred.
Hi Nancy. There are options for pain it is just that narcotics are not the best choice. Thanks for watching, subscribing and sharing with someone if you did.
Hi Mandy. Often patients will have some success with acetaminophen and NSAIDs if you are able to take them. Best to talk to your doctor or pharmacist. Thanks for watching, subscribing and sharing with someone if you did.
Yes Scott. It does not make people feel good for sure. Addiction is often not about feeling good. Thanks for watching, subscribing and sharing with someone if you did.
I had ACL surgery 15 years ago. I remember the first day after surgery I could manage my pain so just threw the narcotics in the garbage. The next few days I was in a lot of pain. I went back to ask them to proscribe me another bottle. They looked at me funny lol Probably thought I swallowed the whole bottle in a couple of days.
I have a question. All narcotic pain killers make me so nauseated that I can’t take them. If I have a hip replacement surgery, how will the pain be managed without narcotics?
Hi D D. Best to discuss with your anesthetist before however usually a combination of acetaminophen, NSAIDs and possibly some nerve agents. Best of luck. Thanks for watching and subscribing if you did
People after surgery should not have to beg a doctor to be out of pain.
We agree Rene. It is different in Canada. Thanks for watching and subscribing
I agree, some who have an addictive personality can get hooked but for those like me as a chronic pain patient it is what keeps me living a functional life
Yes we totally understand Tory. Thanks for watching, subscribing and sharing with someone if you did
Thank you for this video. I’ve had chronic pain for at least 6 years. It is aggravating when those with legitimate chronic pain are treated like those with addiction issues. I have one or two more orthopedic surgeries and look forward to a time when I won’t need pain meds. As a side note...congratulations on how your subscribers have increased! Blessings...
Thanks so much Kay and good luck to you going forward. Thanks for watching and subscribing
Our Ortho Docs Here in Maryland USA give enough narcs to get one to the first two week post op exam. They reassess you, and decide which narc will be best for the next two or three weeks. Tylenol is added too. You cannot get refills here in the USA a new script is necessary. Physical Therapy adds their data to the Doc's as well regarding pain and progress. Thanks guys, another timely video. Stay well!
Thanks so much for sharing the Maryland experience Denise. All the best. Thanks for watching and being a long time subscriber.
Great video! I can see how easy it would be for someone to become addicted. I was t-boned by a transport truck and banged up real good. After 7 days in hospital and having hydromorphin at home, when I stopped it was 4 or 5 nights of not sleeping. Then surgery to repair my shoulder from the accident, the doc gave me the script and I said I don't want it and I explained why. He said I get it but you will need it, when the nerve block comes out you will be in a lot of pain. Me thinking I know all didn't take the med before bed, and at 4am just like doc said the nerve block was no longer and I was crying like a baby in pain. My daughter asked me if I was done being silly and did I want my pain med. Answer was yes.
Hi Ryan. Kids are tough! Glad you are ok. Thanks for watching, subscribing and sharing with someone if you did.
@@TalkingWithDocs just so you are clear, my daughter is an adult, not a 8 year old running around with narcotics. Hahaha!
I have been a nurse for 48 years and still practice at the bedside on a pediatric surgery -trauma unit. You have brought up many great points such as using a multi-model approach and understanding how the meds interact for pain management. Also, every person is an individual. You also brought up the great point " post surgical pain should be temporary". Education is the key to help people recognize risks vs benefits of every decision they make concerning their health care. It is a team effort.Great video!
Thanks so much for your insight and support Theresa. Thanks for watching, subscribing and sharing with someone if you did.
I had my total knee replacement 5 days ago. The doctor sent me home and I've been rehabbing at home. Let's say the exercising and stretching hasn't been pleasant but it's a necessary evil. Praise the Lord my pain is normally at 2. The therapist just keeps reminding me to stay ahead of the pain. Your videos have been so helpful leading up to my surgery. Thank you.
That is awesome W Sue. Congrats on being done one week. All the best. Thanks for watching, subscribing and sharing with someone if you did.
@@TalkingWithDocs I just told a person having hip s in a week to look you up!
Thank you for this video. Three and 1/2 weeks post op and still in quite a bit of pain. Trying not to use too much pain med but I still need them. I opted for Tylenol 3 as I was given them previously for pain 20 years ago. I don’t’ remember having any problem stopping them. This pain however post surgery is much worse. The most important advice that I took from this video is do not increase. I am recording my use and have gone from 8 per day to 3. It is indeed a fine balance.
Another great, informative video. There doc's are doing a great public service! The humor thrown in makes an often dry topic worth listening to
Thanks for all the videos you put out as they. are so helpful. You are Canadian doctors so.I believe all the information is good .
I am 83 yrs old and share this info with friends as with COVID19 YOU CAN'T GET YOUR DOCTOR FOR INFORMATION. AT MY AGE IS IT OK TO GET BOTH KNEES REPLACED?
Thanks so much Chad. Thanks for watching and subscribing if you did
Hi Byrute. Very welcome. So age is only part of it. It would depend on the rest of your health but many of our patients are in their 80s. You would likely not get them done at the same time but rather staged. Best of luck. Thanks for watching and subscribing if you did
Having had a hip replacement recently I'm glad that pain meds were made available. That said sound judgement can get easily clouded. I'll be glad when healing is complete.
Yes Jim. Hang in there. Thanks for watching and subscribing
In my experiences of the times I have been prescribed narcotics is when the pain was bad enough for narcotics, I didn't feel high/woozy/out of it etc. But, when a dose made me feel that way, that's when I knew it was time to focus on other things like acetaminophen, ibuprofen (especially higher than OTC labelling), rest (especially rest!), physical therapy etc. Plus the recognition that "zero pain" is not necessarily the goal post surgery.
All good advice Rebecca. Thanks for watching and subscribing
Hi Dr.'s, Thank you for the video. I had a total knee replacement here in the U.S. and the Dr. prescribed narcotics, "Percocet" for up to 3 months following that procedure. The Dr. required that I come in on a weekly basis for a refill. 3 months is the maximum amount of time he could write for and after that I would have to go to pain management. Thank you for the video.
Having u come in on a weekly basis is excessive, IMHO. I've heard of pts going on a monthly basis. I hope u didn't pay out of pocket for those visits. I've not heard that an MD couldn't write for more than 3 months. There are lots of "laws" going around that aren't true. My MD told me he couldn't write for more than 3 per day. I asked a pharmacists and he said that wasn't true. When I did finally get in to a pain specialist he increased my dose, but I have health problems that I will die with.
Thanks for enlightening us on how it works where you are Jorge. Very welcome. All the best. Thanks for watching, subscribing and sharing with someone if you did.
I got wrist surgery last year, the surgeon told me that the pain would be terrible but that i dont even bother to ask, no narcotics! He was talking down to me. I went to my PCP afterwards and explained the situation, he rolled his eves and wrote me a prescription for 30 of the 5mg Norco
Thanks for your thoughts. I am having a torn rotator cuff repaired in 6 weeks and I find your videos helpful in learning about it.
Glad we could help Chuck. Good luck. Thanks for watching and subscribing if you did
I've had two spine disk fusion surgeries. The first was a double and I did have to wean off the narcs after recovery. The weaning process was uncomfortable but was a better choice than the post surgery pain. The second fusion was done using "minimally invasive" techniques and the recovery was comparatively a piece of cake.
Very nice Greg. Who doesn't like cake? Thanks for watching, subscribing and sharing with someone if you did
After my hip surgery I was on oxy for a week or so. The worst part was the constipation these narcotics cause (even with stool softeners, prunes you name it I took it to help). I took Tylenol in between to help get off narcotics.
Yes constipation can be brutal Dianne. Thanks for watching, subscribing and sharing with someone if you did.
Such an important topic to discuss. Thank you doctors. 👍
Very welcome Eliska. We agree. Thanks for watching and subscribing if you did
Just had my first surgery last Friday from a foot fracture and I’ve been looking for this info exactly. Thank you kindly
Very welcome Maria. Good luck. Thanks for watching and subscribing if you did
Smart, simple, helpful discussion about a difficult issue.
Doing our best to address an important topic. Thanks for watching, subscribing and sharing with someone if you did.
Wish all docs were as great as you guys. Your "actual" patients have lucked out. Love your very frank approach.
Thanks so much hex hex. Doing our best. Thanks for watching and subscribing if you did
Thanks so much Savannah South Beach. We try to keep it light when we can. Thanks for watching and subscribing if you did
Yes those naroctic operative pain can be very addicting after when you start taking them. Very informative video!😊
Glad you liked it Alida. Thanks for watching and subscribing
Thank you for this video! I did not get an adequate explanation after a total knee replacement.
As an ex smoker I have an addictive tendency. I had surgery two weeks ago and was given narcotics and was fortunate enough not to need any. I am scared to death of addiction. Great video.
Glad you are ok huntinbob06. Thanks for watching, subscribing and sharing with someone if you did
Im having surgery in a month or less. I will take pain meds carefully. Liked the multi approach. Thank you❤
Great videos! 8 week since surgery and I use the Oxcy only at night for sleep!
That’s great Dean. Thanks for watching and subscribing if you did
Thank you. My biggest fear about my upcoming hip surgery is pain control. I don't take narcotics but have had to take ibupropen for my arthritic hip joint. I look forward to being pain free and drug free asap.
Good luck Pamela
I’m 3 months post operation bilateral knee replacement in Singapore. I did the entire thing without opiates , no morphine after surgery, no hydrocodone after that, just Celebrex… So it can be done, it’s not easy but it’s doable!
Wow congrats
Hello… I SERIOUSLY cannot imagine that it’s doable! I applaud you and all the factors that came together for you. I just had my second TKR replacement a week ago. I had a spinal block (the one that lasts for a few hours) as well as the nerve block pack that is supposed to last for about 72 hours AND an IV drip of whatever pain meds they use after surgery, already started before the spinal wears off. I hate the overuse of the words literally and seriously (LOL), especially in all caps,huh‽ But, I seriously and literally thought, I may have a heart attack because of the pain. My blood pressure went up, as well as my pulse, and they really were trying to help. I was so groggy from pain medication that I felt like I might pass out and go to sleep but it did nothing for the pain. I remember telling them “don’t come check on me and assume because I’m passing out, that the pain medication kicked in. Please do something else.” They had given me several things in the IV, including fentanyl, but the pain was winning. Finally, they called anesthesia and the Doctor Who came told me they were going to start a fentanyl pump. I really didn’t think it was going to help, since they already given me fentanyl, but I was wrong. I know exactly how long it took to work because you can only dose with it every 10 minutes and I was quite aware of that little green light, blinking, telling me, “It’s time!“ Within 30 minutes, I had crossed back over into sanity! A few hours (and a lovely nap) later, I asked them to please start the oral pain meds and stop the pump. It was a reluctant request, believe me, not knowing what to expect, but there’s only one way to find out. A couple of nurses suggested letting it go a while longer, but once that door had been closed, I hoped we could nail it shut and go down the more normal path. Thankfully, it worked. Now, a week later and I’m on “regular” pain medication, trying to alternate doses with ibuprofen and tylenol every third or fourth scheduled time, so I can taper off of them asap….I’m nowhere NEAR that right now. Found out with the first knee; I apparently developed a physical dependence on them within 4-5 weeks. Totally unexpected and thought I had Covid or something. My doctors didn’t know and could only treat me for symptoms, which, after many blood tests, showed NOTHING! So, a warning to rehydrate to prevent hospitalization and a script for generic zofran was all I could do at the time.
I wonder what different protocols or whatever was used in Singapore. I WOULD say, maybe I’m just a weenie crybaby, but I had the first knee done 4 months ago and it was nothing, compared to this one. If the first one had been like this one, I wouldn’t have EVER gone back for this one. 😊
Thanks for sharing the information. I feel the chronic pain patient is left in a very bad situation, with no end in sight sometimes. My spouse with chronic back pain multiple fusion and then new pain... has done the on - off method to keep dosage down. Its not a fun ride, but it seems to work for him vs the alternative of everyday pain. I hope one day the drug companies can find an alternate solution for pain sufferers. The regulations are cruel and in humane in some cases IMHO. People who are going to be addicted/dependent will just find some other way for pain relief and be addicted to street drugs, a much more dangerous proposition. I know not your guys issues- but should be addressed by the ones who make the arbitrary decisions that affect millions of people in pain.
We would agree it is a very complicated issue and also hope there is a better solution going forward. Thanks for watching and subscribing if you did
Didn't request more Hydrocodone when week supply was finished after both hip replacements. Had my friend next door walk me a long block to get bourbon in 8 degree weather. The pain from hip replacement is bad for 3 to 4 weeks and Tylenol won't cut it. I forgot to note that if you are in withdrawal from opioid, Hydroxyzine is one drug that really helps withdrawal. I had to do this years ago after gallbladder surgery.
Thank you for telling your story El. Thanks for watching, subscribing and sharing with someone if you did.
Lyrica is helpful for withdrawal as well
@@suziecarr1566 Thank you!
I have always used the least amount of opoids as I could, but after having to have my knee scar tissue broke so I could bend my knee, I understand what you said in another video, if I am in too much pain I won't do enough PT. I am scheduled for a right total knee replacement surgery in June so I hope to have better results. I am doing my "prehab" already. Thanks for all the information!
Good call Miss Helen! Best of luck. Thanks for watching and subscribing
hi guys just got my TKR done thank you for all th vidos the TKR related videos they have helped a lot i have cut my oxy meds in quarters much more maneageable .God Bless you both
Thanks so much Roy. Al the best during your recovery. Thanks for watching and subscribing if you did
❤❤.I really appreciate you taking the time to make this video. My dad had a knee replacement about 3 years ago, and he still has problems walking because my mom actually took his medicine away from him before he was even finished with his rehab after surgery. I also have to have my knee replaced soon, and I am allergic to most of the medication you would give for pain, including NSAIDS, but I'm on a blood thinner daily. Basically, I'm going to be stuck with Tylenol and a narcotic. Anyway, thank you again for this video ❤❤
Very welcome Stephanie. Good luck with your tkr!! Thanks for watching and subscribing
Thank you for this. I didn't think about an addiction. Surgery is coming up and this was good to hear. Taking every step to have a successful surgery and recovery!! I will listen to my dr!
Good luck Cheryl. Thanks for watching, subscribing and sharing with someone if you did.
My hips were worn to the point of no head left on the femur. I took 3-4 10-500 Hydrocodone daily plus naproxen. This went on for 3 years. After the bone metastasis was cleared up. I got both hips replaced and after a short recovery period never took another Hydrocodone. Didn’t bother me a bit.
You are so fortunate!
Wow nice Jose. Thanks for watching, subscribing and sharing with someone if you did.
Yes he is Nan '59. Thanks for watching, subscribing and sharing with someone if you did.
How u didn't get a tolerance is beyond me
I'm having hip replacement surgery. Could you do a video on taking medications not addictive and what do you about that before a replacement. Again both of you are great. I haven't even talked to my surgeon yet. ❤
Analgesics work in various ways. An analgesic that is good for treating one type of pain has no effect on another area of pain. Perhaps a pain management specialist could be invited to discuss with you the various types of pain, how specific analgesics are used, and why an analgesic which great at relieving pain in one condition is of little benefit in the relief of another type of pain?
We would totally agree David and that is why a multimodal approach is often used nowadays. We have a video on this topic. Thanks for watching and subscribing
Excellent simple explanation
Thank you guys for doing videos like these. They give some great information on what ever the subject may be. I know lots of times when people go to see there Doc or specialty Docs, they get a little nervous and forget to ask some things they wanted to ask. Also some people like me forget all that was said during the appointment. So thanks for information, and what to expect with different things you may have done. I am from New Hampshire in the states, but if i was in Canada, i would seek you guys out if i needed my knees replaced. Keep up the great work.
Thank you so much travis. All the best in New Hampshire. Thanks for watching, subscribing and sharing with someone if you did
I had a knee replacement and I’m allergy to pain medicines I could take Tylenol . So it was very hard at the beginning after my operation, but with other things I was able to wean very early.
I’m approaching total hip replacement and totally enjoy your channel. Thanks
Glad we could help Jim. Thanks for watching and subscribing if you did
Currently six days post op left hip replacement surgery. I find I had the most pain with the swelling of my left thigh and knee. I took the prescribed
Amount of 10 mg Oxycodone every six hours and could take Tramadol 100 mg every six hours the f needed. I definitely took all that was prescribed and how it was prescribed to me for the first four days or so. Very painful. On day five (yesterday), I called my surgeon and said all the Oxycodone is doing is making me high, and I don’t like that feeling at all. I requested a 5 mg Flexeril and he approved that for me. So now I’m taking the Flexeril TID PRN and so far only had one 5 mg Oxycodone since yesterday afternoon. I feel better and I’m not drugged up and nauseous! I would say the narcotic
Definitely serves a purpose for post surgical pain with majorly surgery like this. However, once 😊you start feeling a little better and can tolerate the pain more so, get off that crap. I can also use Tylenol and Ibuprofen which NOW a works very well. Just sharing my experience. Sorry for such a long read! 😂
Thank you for sharing. It will help others for sure
The last time I was in for a procedure the head surgical nurse asked why I was turning down pain meds and my response was im just gutting it out because it was better than risking the unneeded use of narcotics. Pain has always been manageable for me without sketchy drugs.
You are lucky Old Pete. Thanks for watching and subscribing if you did
These docs are fantastic
well i had my operation 4/7/23 still stiff only 2nd out got some pain im doing a few little moves the Dr. had already done 3 TNR so i was his 4th and after i woke up and was standing up the Dr came up to me asked how i was felling, I said ive felt better, so i asked him how did it go, He said 1 word PERFECT and he was gone ,so now the fun part begins i read the 3rd & 4th day are the worst ill keep plugging along .
Hang in there Leland. You’ve got this!
Nerve blockers for addicts? Great stuff to know. I’m curious, what drugs are used for nerve blockers?
Hi Cathy. Medications like lyrica and gabapentin. Thanks for watching and subscribing if you did
I appreciate your emphasis on protecting the patient from addiction, use of multi modal management. Opoid addiction is rampant in the USA. I was dismayed at the hospital's near insistance that I have a script for hydrocodone (vicoden) . I had no post operative pain after my hip replacement following a femoral neck fracture. I refused it. For one thing I am very reactive to codein at any level. One tablet leads to a zombie like state and several days of projectile vomiting. They denied that vicoden is codein based. Then they tried to get me to accept tramadol. Again I refused. In 2 months I think I used 4 to 6 500mg tylenol. Once the postural limitations were lifted and I could work on strengthening unused muscles then I had daily need for several weeks of tylenol. Early on when I had some pain in the hip cold packs took care of the hurt. Keep up the good work. At this time as I am working to gain rom, extension, etc heat is helpful to ease the muscle ache.
Thanks for sharing trilby. All the best. Thanks for watching and subscribing
Very informative thanks
Very welcome Amrit. Thanks for watching and subscribing if you did
I always wondered about this topic. I just could not figure out how people get addicted to pain meds. Thank you for talking about this topic. Great video
Very welcome Martha. Thanks for watching, subscribing and sharing with someone if you did.
Please cover the topic of shoulder replacement and what recovery from it is like
We will add it to our list Chae. Thanks for watching and subscribing if you did
In Quebec you can prescribe for multiple repeats to a patient who regularly takes pain meds. As well it has to be at the same pharmacy.
Interesting
Great video and presentation! Thank you!
Glad it was helpful!
Titration reduction should focus the taper on dose first and then interval.
I have 2 surgeries that I have been needing for 3+ years and have avoided them because last time I had surgery, as a recovering addict, I was extremely under treated and was in so much agony, but the part that was worse was the way they treated me as if I weren't even deserving of consideration and I deserved my pain. Doctors here don't give pain meds for C-sections or open-heart surgery anymore, and it should be a crime and against their path to do no harm.
Hi Carrie. If you have had addiction issues in the past there just needs to be more planning before surgery with the whole team. Best of luck.
If you have a spinal and femoral nerve block what narcotic and how much is used during surgery? Just curious. Lover your videos!
Best remedy to get off opioids is by going to the gym…and try to go back to your exercise routine slowly. This routine helped me get off the meds..
Good call Dani. Thanks for watching, subscribing and sharing with someone if you did.
What about using buprenorphine for pain management with a history of addiction?
I survived without a single pill or any other pain killer after ORIF of my radius. I have addictive personality, that's why I choosed not to take anything. The pain was manageble, but still not something I don't want to go through again.
Don’t forget the stool softeners while on narcotics! Constipation increases your pain.
Yes Love Dawgs! Thanks for watching, subscribing and sharing with someone if you did.
3 weeks out from TKR at a very good center and knee itself is doing great. Had all the multi modal options including ice machine, NSAIDS, Opiates, On Q for 4 days. Essentially no need for opiates for knee pain any longer. However past 2 weeks dramatic episodic neuropathic pain and hyperesthesia from upper thigh to ankle. Anesthesia says this is injury to femoral or saphenous nerve. Not asking you for advice on my case, lots of specialists dealing with it. I cannot be the only one, there must be other people with same complication who are equally worried and confused. How the heck does this kind of thing happen? Any chance you might have a video coming out about this sort of complication? Have you got a Pain Specialist colleague around for another video. Your post TKR pain video does not address this issue. Thank you for all your videos, they prepared me really well for the surgery.
Sorry to hear this. We don’t have a video about this and thankfully it is very uncommon. Sometimes related to the tourniquet if they used one. Other potential cause is pre existing lower back issues and nerve impingement that got aggravated by the procedure. Hang in there. Usually does get better
@@TalkingWithDocs Thanks much
Great talk guys thanks! For those of us addicts that can be described as having "a genetic predisposition towards consumptive addictive behavior" we can get addicted to anything especially opioids and that has little to do with the doctors or medical laws. The leash is certainly shorter now for understandable reasons... thanks again Florida... In Washington State a total hip and the longest you can milk that for pain meds is about 45 days. For an addict who is on stable ground of being clean they understand it was the abuse of narcotics that was the problem,, not their use so for those in a 12 step program involve your sponsor if your concerned. Plan in advance that your sponsor is going to see you twice a week post surgery and count your pills. To hold you accountable if your concerned that a surgery might send you back "out"...
Thank you so much for taking the time to share Brian and congratulations on your personal success. Thanks for watching, subscribing and sharing with someone if you did.
Thank you, from one who isn't an "addict". Labeling ppl is dangerous when practicing medicine. The day after an abdominal surgery my nurse told the next nurse "she said she's in pain but I think she just likes her meds". I heard her say it and this was b/4 pain pumps and I was being given morphine so I stopped asking for a shot. The night nurse found me awake and asked me why. I told her I was in too much pain that the MS wasn't working, it just knocked me out for about 30 min. Bless her heart, she said "that's better than nothing, it will get u thru the night". She told the surgeon the next morning and he gave me Dilaudid which worked but I promptly had a reaction to. Oxycontin doesn't work on me either as well as Fentanyl. Thank you for not lumping pain patients in the same pot.
Another idea is to have someone in your household be responsible for your pain meds.
I used to do home Hospice care, and there were narcotics involved. There were homes where a family member or close friend was an addict, or would steal the drugs.
We would have a family member take charge. Sometimes they would only bring over enough for 24 hrs. Other times they stayed at the house and hid the narcotics. We would do daily counts with the designated person to make sure no one was using. In 16+ yrs, we never had any narcs go missing.
@@1packatak When I did home care and we suspected someone else was taking the opioids we would have a lock box installed in the house, screwed to a wall or something and only responsible ppl would have a key.
@@susanp102 we did that a couple times too
A touchy subject but great advice…🩺
We agree Mary. Thanks for watching and subscribing if you did
I did not need anything more than Tylenol for my recent total shoulder replacement and foot fusing surgeries. I had the hydrocodeine, but did not use it (the drug makes me nauseous, so it’s a good incentive to not use it unless I’m really in pain.). Though, i do not expect to be so lucky for my TKR this September. I expect the pain level will be much higher.
So hat is the right time and amount based on your recommendations to start taking Percocet after total knee replacement? I had my partial knee replacement two days ago. I can feel the blocker wearing off. What would you recommend my steps to be to keep the pain down while continuing to get better? Great videos! Thanks
Hi John. Usually once the block wears off you would need something stronger so likely soon. Continue with ice abs your exercises. Take enough medication to be able to do the exercises. Best of luck. Thanks for watching and subscribing if you did
It is all about the protocol. You follow the protocol for the patient's benefit because there're so many unforeseen situations. We all know time is the best healer and time will make you feel better.
Yes it often is Walter. Thanks for watching and subscribing
good discussion for a very common question and concern. but the biggest addiction risk is through diversion where someone gets ahold of leftover pills with the intent to get high or sell to someone else for that use. taking narcotics in a normal way for short-term post-op pain is really low risk for addiction. the people i know who are concerned about getting addicted don't have a history of narcotic abuse and are very likely to be careful about how they use the pills and it's not something that usually happens accidentally
We would agree Chris. Thanks for watching, subscribing and sharing with someone if you did
I was on Tramadol after my neck injury from a car accident, didnt seem to help much, but the Dr wouldnt prescribe anything else...the muscle relaxers wound up helping more, but seem to make me really tired the next day.
Hi Thomas. Often it is about the muscle spasm. Thanks for watching, subscribing and sharing with someone if you did.
In my state, we can take our non-used prescription medicine to the police department for them to dispose of in the correct way.
Speaking of post op pain control, this was interesting to hear after my PTT surgery. Always have questions about post op surgical wound care. Just had PTT and calcaneal osteotomy surgery. Insicion to fix the tendon went from first Metatarsal to Tibia. Staples used. what is good for helping it heal? ie skin care, scabbing falling off. Leave it all alone or to help it. What to watch for infections etc Thanks for your videos.
Hi JoAnn. Very welcome. Best advice is just to keep it clean and dry. Daily cleanse with saline. Dab dry. Don’t pick the scabs. Be patient. Good luck. Thanks for watching and subscribing if you did
After my TKR I was prescribed 12 hour extended relief oxy 2x/ day for the first week. I also had low dose oxy every 4 hours for the first week. I don't remember the potency. Then no more extended release permitted. I think I was on the low dose for 15 more days. I was never in agony, and did good at therapy. After I stopped the oxy I got night sweats for a few days. Take the pain meds. One will heal faster with less agony.
And to add to that, it was easy stopping cold turkey.
Thank you for sharing your experience Robert. Thanks for watching, subscribing and sharing with someone if you did.
The surgery will destroy your life, run or hobble far away from these people ,their is no pain management, they just wont give you any ,2 rods screws all the hardware have taught me they talk a big game before surgery and leave you on your own a year down the road.js
How short that period of time 😢
دكتور بول هل تتكلم العربية ؟ ارجوك اخبرني
Thank you 🙏🏻♥️
Very welcome RA. Thanks for watching, subscribing and sharing with someone if you did.
I'm getting my first knee done Feb 20 and I'm nervous about taking the narcotics. Oxy and Hydrocodone make me very sick. I'm talking about vomiting for HOURS after one dose. The surgeon and I talked about this and he's going to give me Dilaudid as he said it's not as likely to cause stomach issues and he's giving me Zofran for nausea. I did have Demerol once and was very sick and the Zofran helped a lot. I will also be getting tramadol for in between if I need it and Celebrex daily. I just hope that all of this works and that I don't have days of having to choose being really sick or being in pain.
Thank you Docs! This is a really good video, they did give me a prescription for Norco and I have been taking 1 a Day for pain or as needed.
What else can a person take if they don’t want to take the Norco and cannot take naproxen! Or Tylenol.
I would prefer to not take it unless it is needed when I finally do get the surgery on my knee in November. Thanks Docs for this video and all of the other ones!
Darlene
Hi Darlene. If you can't take tylenol or NSAIDs you are very limited. Best to talk to your doctor or pharmacist for some specific recommendations. Thanks for watching, subscribing and sharing with someone if you did.
@@TalkingWithDocs Thank you Docs! I will do that! Bless you!
Great explanation 👌👍
Glad you liked it Tory. Thanks for watching, subscribing and sharing with someone if you did.
@@TalkingWithDocs I sure did and your welcome 😊
I have a friend whose father is dying and he was in the hospital and one of the relatives denied him pain medication because they said oh my God he’s had it for the last 20 hours he’ll become addicted and I looked at him and literally I was like I don’t think that’s gonna be a problem. He’s actively dying and in pain, it just blew my mind. It really did. I’ve never been so angry in my life that they were going to allow this poor man to suffer. He is so thin he has not an ounce of fat and his all bones. Every touch is painful. it broke my heart not to mention they had to do a procedure on him. They finally allowed him pain medication And that he was sleeping and that drug I said well he’s not in as much pain. That’s why he’s actually sleeping. He still having some because he’s having pain reactions and I said it’s better that he not being in pain and then him being in pain, would you want to lay here in pain for hours and hours and hours and I have kind of pain I can tell you that that’s horrible that’s horrible and it really broke my heart that this family actually was considering not letting this dying man have pain medication in his last days , and it really is absolutely ridiculous “.
I had orthopedic surgery for sepsis. I was in a lot of pain and my regular medication wasn’t working. I asked for IV Tylenol, which works pretty good. The hospital actually refused to give it to me because they said it was too expensive.
I'm 71 and recently had pancreas surgery and bleed out 3 times two months after that. I had chronic back pain which no one ever believed which was one vertebrae was fractured and 2 had some other thing. The docs kept refusing any pain relief. Finally they decided to find out they were right all along. With an MRI they saw the injuries and finally allowed me a prescription. Then they didn't fill the prescription for nine days so I tried marijuana and another ovc med. When pain is real and not just a tummy ache then the docs should check and prescribe if there are real injuries. They keep me on a baseline which doesn't take the pain away but it is managable.
Agreed Mark. Hope you are ok now. Thanks for watching, subscribing and sharing with someone if you did.
What do you do if a patient has CRPS to help mitigate any retriger of the condition?
Thanks as always!!!
Hi Cindy. That can be complicated and would be addressed by the pain team in advance. Thanks for watching and subscribing if you did
After arthrodesis ankle surgery 7 years ago I was prescribed Oxycodene. It worked very well, and was very much needed at least for the first 2 - 3 weeks. And occasional use after if the pain became too much. This year I had knee replacement surgery. Again I was prescribed Oxycodene. This time, unknown to me I had built up a resistance to the drug, the pain was awful, especially at physio. Th bottom line is, I never reached optimum bend in the knee. Because of a fear of becoming addicted to the drug, the dosage was never increased.
Hi Rita. Yes there are many reasons that the response can vary between patients and over time. Sorry you had to suffer. Thanks for watching, subscribing and sharing with someone if you did
Love your videos! Regarding prescribing narcotics from Ortho docs- the biggest issue I see frequently in our area is the amount given to pts after surgery- as you explained, pain should be decreasing with time, so why are some docs still writing out such large amounts of narcotics is beyond me. I have personally found that anti inflammatory meds paired with Tylenol can control a good number of pains- we also need to instruct our patients that pain is expected after surgery- some discomfort is normal and the goal should not be the absence of pain.
Multi modal for sure.
Interesting. When I cracked a rib, I was given morphine 25 mg. and after taking two pills, there was no efficacy at all in pain management, so I took them back to the pharmacy and switched to Advil. That did the trick.
Greetings from the Bourbon Capital of the World. In my opinion addiction is a sign of a weak mind. It's because of abuse I can't get what I need for pain. Since I only take it at work I can't go to a pain clinic for help.
Hi Michaels. There are certainly lots of reasons and many are not the patients fault. It is complicated for sure. Are you in Kentucky? Thanks for watching and subscribing
@@TalkingWithDocs Yes, but the Bourbon Capital is a certain city.
Doctors seem to normalize a certain level of pain. Maybe we need to invent a pain simulator that doctors would wear. When I was a kid, my dentist refused to give me injections saying that they don't work. When I complained, she injected very shallow and it spilled into my mouth and didn't work. I stopped going to dentists, because I had no control, and lost all my teeth. If you didn't finish a prescription, save the pain pills for a bad day. Because you won't be getting any more. They are cracking down on drugs really hard. I still have some codeine in my freezer for more than a year.
Sorry to hear this. It's a little better in Canada
What can you tell us about cryotherapy (Iovera) for TKR?
Hi Katherine. Unfortunately what we can tell you is that there is no evidence that it works and carries a significant financial risk. Thanks for watching and subscribing if you did
😀😀😀 thank you !!
You're welcome 😊 Jay J. Thanks for watching, subscribing and sharing with someone if you did
So, if a person has one or two drinks every day their whole life they're NOT considered an alcoholic but someone who takes one or two small doses of a narcotic a day their whole life is considered an addict?
Hi Pauly. No an addict regardless of whether it is alcohol or drugs is someone who has physical and psychological withdrawal symptoms if the drug is not taken and also someone who’s life and relationships are negatively affected by its use. Alcohol is an even bigger problem. Thanks for watching and subscribing
very good point. i have had chronic pain for years and take my narcotic pain meds with great care and caution. That said, although i do not drink, it is very frustrating and aggravating to me to see those who continually abuse alcohol yet consider all those who actually needs pain meds, as addicts. alcohol is the most abused substance really because it is not controlled.
I had surgery that removed a tumor that filled my entire internal cavity which I think is called the Retroperitoneal area, my left kidney, and a whole section of my artery that allowed blood to reach my legs, then had tubes replace the artery and extend from right leg to left leg to avoid amputating them. I am in extreme pain for almost three months from burning sensations of my skin where the incisions where, to stabbing internal pains, pains from gas, bloating, and constipation. For almost three months I've been on constant combination of acetaminophen combined with oxycodone painkillers nonstop with docusate/senna, and miralax for constipation. And now the painkillers hardly have any effect. I don't see an end to this pain.
That is very large surgery for sure and often is associated with prolonged post operative pain. Worth a trip to your doctor for sure though. Wishing you the best of luck. Thanks for watching and subscribing
@@TalkingWithDocs thankyou! I’ll need it!
I live in the USA. A couple of years ago I had gastric bypass surgery. After surgery I was fine other than not being able to sleep at night with RN's coming in checking. I would be asked about my pain level. Between zero to ten, ten being the most what is your pain level? Zero. hahaha, no really. what is your pain level? ZERO !!! This went on for a week. When I was discharged, they gave me a script for pain meds. I didn't want them but was told I had to take the script and fill it on the way home just in case I have pain in the middle of the night. I filled it and it was for 64 oxycodone. What was I supposed to with those I was thinking MAYBE 6-10 tablets at the most. After a few days I had a little pain from moving around too much but looking back I should have just taken a Tylenol. That wasn't the first time I had that happen after surgeries. I've never had a problem with post operative pain, but I'm forced to fill my pain script.
I wish u docs would talk to a pain specialist. I don't know where u young docs get the impression that narcotics don't work for arthritis (3:46). I'm 72 and have several forms of arthritis as well as other autoimmune health conditions that I will die with, and yes, I take an opioid that helps me get out of bed in the morning. I have been on and off opioids for a good portion of my life and was able to stop without a problem as long as I didn't stop abruptly. I'm a retired RN and would never tell a pt that they don't need pain meds or that they are asking for pain meds because "she just likes her narcs", which was said about me by my bedside nurse the day after an abdominal surgery when I was on Morphine which wasn't working. Most legal opioids don't work on me, including the ones being abused. When I met with my pain specialist the first time he told me I wasn't taking enough and I just about fell off the chair. There is so much shaming going on for ppl who do have to use narcotics. Please check with pain specialists b/4 u making such a statement.
Hi Linda. We talk to our pain specialists regularly. Science is where the impression that narcotics don't work for arthritis comes from. It does not mean that some doctors won't prescribe them but it will cause many more problems than it will solve. We use them routinely for post operative pain. Thank you for sharing your perspective. Thanks for watching, subscribing and sharing with someone if you did.
Thanks for watching, subscribing and sharing with someone if you did.
@@TalkingWithDocs It's what gets me out of bed in the morning and sometimes helps me get a decent night's sleep. Scientists who say opioids don't work on pain have never been in constant pain, IMHO. I and thousand more are evidence that they do but they never ask me.
I just dont want to be alone at home. With those drugs. Now im not sure if i even want hip surgery. Im from usa. 😢
I have a question that would be a great topic. I have severe chronic pain taking "max mme dose" in oregon this is about 90mg mme. How or what can surgeons do to manage pain post op, when already on pain meds. I have yet to get a straight forward answer from my providers, as I have at least 2 surgeries coming up, information would be helpful. If you can create a video on pain management post op, when already taking very high dose pain meds. Some things that may help is, people maxed out on NSAIDS, also gone through any other pain med options for off lable use. The narcotics pain meds im taking is about maxed out. This is not for solely for pain in the surgically place that will be operated on. But getting back to it, how can providers control pain post op, when at the max mme. One of my chronic illness providers, says she's afraid I won't get any pain meds post op, given I'm at the max dose.
I am currently taking Buprenorphine for addiction and pain control for my knee ,neck, and back pain from multiple surgeries over the years , and now I'm about to undergo knee replacement surgery , will there be a problem getting my pain medicine after the surgery ?
Hi Burton. Best to have a plan before to discuss with your surgeon and your anesthetist. Best of luck. Thanks for watching and subscribing
Splinting, ice, elevation - basically "we give you some Tylenol and tell you to get over it, you deserve it, you're the screw-up, not us." As usual. That's what they mean when they say "multimodal" l. Tylenol, ice, and trauma.
That is not our approach Carrie. Thanks for watching and subscribing
Agree
Yes, agree. Tylenol, really? Doctors should have a little nanobot injected into them durung their edycation/residency that will, without any warning, cause severe pain for weeks at a time. They will have a different attitude or approach when they have sufferred.
My doctor won’t give me any pain medication before surgery which I don’t understand as I was in severe pain! And it Took so long to get into surgery.
Hi Nancy. There are options for pain it is just that narcotics are not the best choice. Thanks for watching, subscribing and sharing with someone if you did.
What helps with arthritis in my knees. I did get injections in both knees. Not working❤️🇨🇦
Hi Mandy. Often patients will have some success with acetaminophen and NSAIDs if you are able to take them. Best to talk to your doctor or pharmacist. Thanks for watching, subscribing and sharing with someone if you did.
@@TalkingWithDocs awww Thxs so much for answering my question. Stay safe. ❤️
I took Oxy after my knee replacement once. That was enough for me. I hated how I felt.
Yes Scott. It does not make people feel good for sure. Addiction is often not about feeling good. Thanks for watching, subscribing and sharing with someone if you did.
So glad your Herpes is better. Thanks for watching, subscribing and sharing with someone if you did.
Are there any evidence of efficacy on use of acupuncture for acute or chronic pain management?
Hi test40323. There is some but not a lot. Worth a try though. Thanks for watching, subscribing and sharing with someone if you did.
No ,for me ,anyway and I was on oxynorm after my op.
Glad to hear it Bernie. Thanks for watching and subscribing if you did
I had ACL surgery 15 years ago. I remember the first day after surgery I could manage my pain so just threw the narcotics in the garbage. The next few days I was in a lot of pain. I went back to ask them to proscribe me another bottle. They looked at me funny lol Probably thought I swallowed the whole bottle in a couple of days.
Yeah it can be tough
I have a question. All narcotic pain killers make me so nauseated that I can’t take them. If I have a hip replacement surgery, how will the pain be managed without narcotics?
Hi D D. Best to discuss with your anesthetist before however usually a combination of acetaminophen, NSAIDs and possibly some nerve agents. Best of luck. Thanks for watching and subscribing if you did