Terrance Heath

I'm Still Tired of Being in Pain

Filed By Terrance Heath | April 14, 2011 4:00 PM | comments

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Well, per the other day's post, yesterday was a better day pain-center.jpgpain-wise. I can't say it was pain free, and may have to start standing up on the bus in order to ensure things don't go downhill before I get to work. But, the day I had yesterday gave me an incentive to get

I visited my primary care doc today, to talk to him about pain medication. I also told him about the day that I had yesterday. Basically, it was too painful to sit at my desk. I spend part of the day sitting on the floor of my office, and most of the rest sitting in the lunchroom with my feet in a chair and a laptop on my lap.

The worst part is, once the pain starts it pretty much stays with me all day. Yesterday, I laid on the couch for several hours after the kids went to bed, before the pain subsided.

The doc told me two things.

  1. He said that opioids are reportedly not all that effective when it comes to joint pain like what I'm experiencing. I found at least one study to back that up. I was worried about the likelihood of becoming dependent, but that's not going to be an issue. If those meds don't work any better than acetaminophen - which does nothing for me and is about as effective as popping jelly beans - then I'm not going to bother taking it.
  2. He seemed to think - given how much pain I'm having, along with its frequency and intensity - that my best option might be surgery.
Surgery.

I'll admit, I tend to want surgery to be my last resort. Mainly because it scares me a little. I've never had any kind of surgery. (Unless getting my wisdom teeth removed counts. I've still got my tonsils and my appendix, though.)

The doc assured me that the surgery wasn't at all traumatic, as it's arthroscopic.

Admittedly, it doesn't look at all bad.

Still, I'm interested in the alternative of euflexxa injection.

Still, it may not work. And even it it does, I'll have to go back for more injections.

So maybe my doc was right. Either way I'm going back to the orthopedist this week.

crossposted at Republic of T. img flickr


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Brad Bailey | April 14, 2011 6:58 PM

Surgery is most likely your best option. I've also heard a lot of good stuff about medical marijuana in addition to or instead of opioids to relieve chronic severe pain. But if you don't live in CA or OR...

DC has medical marijuana but joint pain isn't one of the acceptable reasons to get a card. There are very few diseases that qualify - like MS or cancer.

Rick Sutton | April 15, 2011 11:12 AM

Arthroscopic knee surgery is akin to mild dental surgery, in terms of same-day pain. Managed well with OTC painkillers.

Ice works for the next few days.

If they tell you to take three days off, take off 5-10, and keep it elevated with ice as much as you can. Swelling causes the pain. They'll give you a Kryocuff which keeps cool icewater surrounding your knee.

Post-surgerey results are about 80-90% effective with most folks, depending on your original diagnosis. Be prepared for regular overhauls. It doesn't last forever. Get good insurance. At last count, in a moderate health-cost market, it's a $7000 outpatient procedure. Do the math for your co-pay and deductible.

But do not delay. Waiting too long increases the need for total-knee replacement. Not fun at all.

And enjoyyyyyyyyyyy the drugs. Take an IV morphone hit in post-op cause they won't prescribe anything heavier than Tylenol with codiene (pill). The anesthetic is wonderful. Michael Jackson overused it, God love him, but that instant-sleep feeling could be addictive. It's magnificent.

Pain is the most idiocyntratic of medical conditions; you simply can't tell what will/not work until you try it. I'd strongly advise you to try an opiod, like Vicodin, to see if it works, and at a dose that might offer relief. I've been on that med for about 5 years at the same dose and for me it works remarkably well at taking away the remaining pain from knee replacement and spine surgeries. I readily acknowledge that it does not work for others and/or they have side effects, but for me it simply takes away the pain and that's is, no euphoria, no constipation (except when I was on higher doses immediately following surgery. But the only way you are going to find out is if you try it.

Many docs are reluctant to prescribe opiods becuase of the potential for abuse and the associated paperwork because it is a controlled substance.

I'd offer to do an experiment; take a dose in front of your doc and if it does not provide relief within about an hour, then it isn't going to work for you. No need for a full prescription.