Lortabs and the ortho doc & knee replacement

gak
on 6/29/10 7:08 pm
Revision on 06/21/13
Anyone else take Lortab for pain ? I have this bad knee/ knee injury.. bummer ... I got chewed out by the orthosurgeon today on my intake of Lortab.   My PCP prescribed them for me when I re-injured the knee at my April conference. So anyway, the ortho says my knee is shot, which I knew from my pain levels, and the noises it makes. So it will be replacement time, BUT he wants me OFF Lortab TOTALLY before surgery.

He manipulated the knee so much today, I came home and took more as I could hardly walk afterwards. So frustrating ! I have too much going on for this !  I promised him (not sure I can do it) to stop taking them. But with my pain levels I am not sure  how this will go.

I know others have had knee replacement post DS and I am wondering how your pain level was post-op? Orthodoc says if I am not off the Lortab pre-op that post-op pain will be harder to control and I will be VERY uncomfy and the he WILL NOT prescribe much post-op as he does a spinal with numbing meds that last about 48-72 hours post-op.

Normally I have a high pain tolerance, but after this last fall on the bad knee pain levels have been very high. On a good note there are no fractures in the ankle, but it is badly sprained as well. What a mess !  Any input appreciated.

Ginger<><  
 Revision #2 Dr John Rabkin June 21, 2013; First Revision DS - Dr Maguire
  5-18-09; First DS 7-15-2003 Dr Clark Warden = Third time is the charm   


 



 

Lynne
on 6/29/10 7:41 pm - Macon, GA
I am not post-op but I do understand the pain of a knee replacement.  I had mine 5 years ago due to an accident.  The first week you are going to think it was the worst thing you ever did... then you realize it is the best.  IMO ... doc wants you off Lortab before surgery so that it will be more affective after surgery, since this is the drug that was prescribed for me when I went home.  Try naproxin to get the inflamation down and see if it helps with the pain.  Good luck with the surgery you will be amazed at how well you walk after.

Lynne
Highest 330,    Surgery 297,     Goal 140.     Current 130
First Dr visit - 330 -
BMI 58.4,    Surgery - 297  BMI 52.6
01/24/2011 - 196 BMI 34.7 (ONEderland YEAH!!!),                 ...GeorgiaPink
08/10/2011 Reached GOAL Baby! 140 BMI 24.0                           is my Angel.
08/24/2011
- 139 BMI 23.8 One Year Anniversary 
  
gak
on 6/30/10 7:03 am
Revision on 06/21/13
Thanks Lynne,
Yes I have heard the first few days are awful, but then once you start to walk it is only incisional pain overall and learning to reuse those muscle and tendons. He did state he was concerned about how affective the Lortab would be post-op as I have many allergies and can take few pain killers. I think he thought at first I had been on them long term, but it varies everyday, depending on what I need to accomplish that day. I try not to take too many.  I have been on them since hte last fall in April at the conference.

I cannot take any NSAIDS which makes life a challenge as I am allergic to them.

I am excited that I will be able to walk normally and be able to walk on the sand again afterwards. My walking has not been good for awhile now and I miss the plain old walk in the park and a bike ride, as the knee is too painful now.

Ginger<><  
 Revision #2 Dr John Rabkin June 21, 2013; First Revision DS - Dr Maguire
  5-18-09; First DS 7-15-2003 Dr Clark Warden = Third time is the charm   


 



 

Wenda C.
on 6/29/10 8:22 pm - Combine, TX

Hi Ginger,
  Mine's not knee pain, it's in the hip.  Been going on for almost two years now.  I started out on lortab pills and a high tolerance for pain.  It seems I have also built up a tolerance to pain meds, all kinds.  I would have to take so many pills for them to do any good, I was afraid of hurting my kidney and liver with the extra ibuprofen I would also take in between lortab doses.  My ortho now prescribes me the liquid, and while it may be one of the most foul tasting substances there is, it works quickly and efficiently.  However, I do take more than the prescribed dosage of 20cc, it's more along the lines of 50cc.  I try to take it only once a day when I need it. 
  Having said that, why in the world does he want you completely off of it before your surgery?  Just so your tolerance will be down afterward?  That's crazy girlfriend!  How are you supposed to manage your day to day life without any help?  And as I recall, you aren't one of those stay at home sitting at the computer type of people.
  I'm looking at surgery October 29 myself and I would be mortified if I was told I couldn't have any pain meds leading up to it. 
  I know this hasn't been helpful, and I'm sorry about that.  I'll be thinking about you and sympathizing.  When is the surgery?  Best of luck to you!

 

HW/DOS/Now
300+/273/156
Lap DS  2/3/03
Open Leak Repair  12/5/03

      
gak
on 6/30/10 7:04 am
Revision on 06/21/13
Wenda,
He wants me off pre-op so they are more affective post-op. He is concerned about me building a tolerance to them and then them not working post-op. Surgery is tenative Aug 25th, plus I am on the cancellation list. If a total knee cancels before that they will call me. I begged to be the first one called ! LOL... I told the nurse a few hours notice and I will be there. LOL.. I am tired of the pain.

Yes I do work at home and my work load varies day to day. Somedays I can work from the laptop only (in the lazyboy), but other days I work from the laptop and the desktop (at a desk) at the sametime so I can have a ton of windows at once. It really varies.

I am sorry you have to wait until Oct 29th ! That would be nuts for sure. I am praying there is a cancellation soon for me. They are going to setup all the pre-ops except for the last minute blood work, just in case. The one nurse said people cancel often, soI have high hopes of a cancellation. Maybe I will call my PCP and ask her about this.

Ginger<><  
 Revision #2 Dr John Rabkin June 21, 2013; First Revision DS - Dr Maguire
  5-18-09; First DS 7-15-2003 Dr Clark Warden = Third time is the charm   


 



 

Wenda C.
on 7/1/10 8:04 pm - Combine, TX

Ahh, Ginger.....
  I hope you get your phone call soon!  I understand what you're saying about trusting your doc's skills and not wanting anyone else.  I know things will go well for you.

  I'm having to wait until October because of PTO/Time off issues.  I was hospitalized last October with intussusception, hernia and small bowel obstruction which used all of my available PTO and extended illness time.  I will be going to California in October for a reunion and will have the surgery right after I come back, figured it best just to take all the time at once.  I have to have PTO in my 'bank' so that the transition to use FMLA is easier.  MUCH easier!

Anyway, good luck and keep me posted on how it goes.

Wenda

HW/DOS/Now
300+/273/156
Lap DS  2/3/03
Open Leak Repair  12/5/03

      
Redhaired
on 6/29/10 8:50 pm - Mouseville, FL
DS on 07/13/06 with
I don't know.   I have no experience with this sort of thing but just reading this makes me concerned this guy has his head in the 50's and 60's when it comes to pain management.  I would be looking for a surgeon that would be amenable to effective pain management even if that means calling in a pain doctor.  He sounds pretty set in his ways.

  

 

 

gak
on 6/30/10 7:15 am
Revision on 06/21/13
Hi Red,
Yes he does seem a bit conservative, but I know a lot of people who have been to him. His is a fantastic surgeon. A few years ago DH tore his ACL and he put in a completely artificial ACL and he has done well. You would never know he ever had this done today. I also know others who have had knees done with him. The most recent is a gal at church and she was back at church in 3 weeks walking without a cane or assistance. She was just a little slow getting up and down, and she is in her 70's ! He is the best ortho in our area. I am thinking that I will take some of my own "pain meds" to the hospital and if they do not give me enough, I will take some ! LOL 

But he said he uses a numbing agent in the spinal that lasts for 48-72 hours and he does not want patients on many pain meds as it is not needed since you are numb anyway as he wants you up and moving and starting PT ASAP.

Ginger<><  
 Revision #2 Dr John Rabkin June 21, 2013; First Revision DS - Dr Maguire
  5-18-09; First DS 7-15-2003 Dr Clark Warden = Third time is the charm   


 



 

Redhaired
on 6/30/10 7:35 am, edited 6/30/10 8:27 pm - Mouseville, FL
DS on 07/13/06 with
I get that he thinks he has a good pain management plan for post op -- it is this time before the surgery that would have me concerned.   It is not as if you are a drug addict.  You are in pain!  Also I would not take your own pain meds in the hospital without the doc knowing about it.  The pain medication could have a bad interaction with whatever meds the doc has you on.  If the pain is not well managed post op -- scream loud and long -- do not suffer in silence.  If he will not give you the medication you need post op then insist on seeing a doc that will.

  

 

 

gak
on 6/30/10 5:57 pm
Revision on 06/21/13

Thanks Red ! I agree.. I just want to control the pain and not risk not having pain control post-op.  I have heard you are in less pain a few days after the knee replacement once you get past that  initial surgical pain.

Ginger<><  
 Revision #2 Dr John Rabkin June 21, 2013; First Revision DS - Dr Maguire
  5-18-09; First DS 7-15-2003 Dr Clark Warden = Third time is the charm   


 



 

EastCoastGal
on 6/30/10 4:33 am
Revision on 05/22/10 with
Your ortho surgeon sounds like an ass. Is there another one you can go to? Chronic pain is MUCH different than acute pain and pain control differs depending on what category you fit into. I had bilateral total knee replacements less than a year ago and took Aleve in the AM and PM and Vicodin as needed. Because my knees were so bad, I didn't find the Vicodin helped much and only took about 3-4 pills a week.

The fact is, once your knee is replaced and you get over the acute post-op phase, you won't need ANY pain medication. Right now, you need the pain medication to function on a daily basis and not to get a high. Any rheumatoid specialist will tell you to remain on your pain mmanagement regime until surgery. Start looking for another surgeon.

Stacey      HW 440, SW 245, GW 130             
gak
on 6/30/10 7:20 am
Revision on 06/21/13

Stacy,
There is not another ortho in the area that I would trust to be honest ! He just really scared me with his talk of getting off the Lortabs pre-op. You are right Chronic pain is different from acute pain.  I wish I could take Aleve, but can't as it is an NSAID.

I am looking forward to no pain meds ! Last night I sat in the hot tub and let it massage me. I hurt so bad after he manipulated the bad knee ! Then I came in and took a pain pill and a sleeping pill and headed to bed. Needless to say I slept like a log. I do have less pain this a.m., but I have not done much this a.m. yet as I am sitting here with breakfast.

I am going to see how I do this a..m. without pain meds. I have some clients to take care of and a little laundry to do. If it starts to get bad maybe I will try Tylenol first and see what happens. If it does not work, I can go back to the Lortab and fib to the ortho ! Bad I know..but I need to function on a daily basis !

Ginger<><  
 Revision #2 Dr John Rabkin June 21, 2013; First Revision DS - Dr Maguire
  5-18-09; First DS 7-15-2003 Dr Clark Warden = Third time is the charm   


 



 

EastCoastGal
on 6/30/10 8:21 am
Revision on 05/22/10 with
If he's the ortho you're stuck with, I agree with you. Do what you have to in order to function, tell him what he wants to hear, and let the anesthesiologist know that you've been taking pain medication for X amount of months/years.

Stacey      HW 440, SW 245, GW 130             
gak
on 6/30/10 6:11 pm
Revision on 06/21/13
Good idea on just tell the anesthiologist !  I will be having a spinal, so I will just be given twilight meds.

Ginger<><  
 Revision #2 Dr John Rabkin June 21, 2013; First Revision DS - Dr Maguire
  5-18-09; First DS 7-15-2003 Dr Clark Warden = Third time is the charm