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Upping My Pain Meds - Good or Bad?

MsHumptyDumptyMMsHumptyDumpty Posts: 1,567
edited 06/11/2012 - 8:53 AM in Pain Management
I had both of my knees replaced at the same time on March 15th.

When I was released from hospital the surgeon said for me to take my normal back pain meds as that should cover my pain from knees.

I am allowed 8 pills a day of oxy 5 mg.from my PM Dr. I usually use 6 a day.

I only used my 8 a day for the first week after my knees were operated on.

Now to my question

Had I used the allowed 8 a day for say 2 to 3 weeks, would I have been able to return to the normal 6 a day to handle my back pain (assuming my knee pain was gone at that point)?

My knee pain was not gone when I dropped back to the 6 a day but I was worried about needing to remain at the 8 a day for back pain relief if I used the 8 a day much longer then the 1 week I did.

I know this is a hind sight question, but I would like to know for future reference.

L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.


  • Actually this is a good question, and one of my favorite topics as far as PM goes. Maybe that sounds bad but I have good reasons. It's just recently that I became aware of what a major role *I* play in my part of this whole PM issue.

    I think you were smart to stop the 8 a day after one week (if possible & if you are concerned w/tolerance), and it's very possible that the longer you stay on a higher dose the harder it will be to control your pain and your own bodies dependence to the higher amounts. You were only taking 5mg at one time, so this probably would not be an issue just spacing your meds out more as opposed to cutting back from 10 to 5 mg again, which can be more difficult.

    Having said that, I am allowed 6 a day (I try to stick to 4 or 5 max), but try to sleep through a dose while seperating out my doses during my waking hours, and it is getting harder to go 10 hours at night without medication, as I keep waking up in pain and even withdrawal.(Say I take my last pill at one am, go to sleep at 4 & wake at 11..we keep late hrs so that is 10 hrs in between, or 6 hrs since I missed a dose).Sorry if that's confusing.

    Tolerance is a huge issue in PM, and our roles play an important part in that. We have to think about how long we are going to be taking these medications and just how much pain relief we expect.

    Sometimes I think I hurt too much (bad days), but other times I'm well aware of how lucky I am to be getting pain relief. Forgive me for going on about this, it's just very important to me and I think it's a very good topic. I never take my medication for granted anymore like I maybe use to, or if not for granted I just didn't understand how difficult treating CP can be. It's a balace, that's for sure, and I can tell from your thread (very good BTW) that you get what I mean.

    Upping My Pain Meds - Good or Bad? Take all things into consideration, ie; your age, pain levels, quality of life, etc. Measure the risks; I always think, You, or *I* don't have to answer to anyone else but just be honest with yourself and you will know if the time has come. It's a very personal thing.
  • Thanks Robin :)

    I agree it's a personal choice.

    I don't just take 5 mg at a time. They are 5 mg pills of which I normally take 2 of at a time but am allowed to take 3 at a time if needed, not to exceed a total of 8 daily. It is up to me how split those 8 pills.

    I guess I am wondering if there is a safe set time frame for a med increase.

    Like in hospital I was on a fentanyl pump - the kind I press when needed pain meds. I expressed my concerns of being given this med as I wear the patch. I did not wear patch in hospital. But was still concerned when I went back to patch at home it would not be as effective as of increased dose in hospital.

    I was fine going back to patch, however I only was on F pump for aprox 30 hrs and I told them to stop it and let me go back to patch & pills.

    I made this request based on my fear of f patch effectiveness at home. As they never did give me the answer I kept asking, which was what was the F pump dosage compared to my normal 75 mcg f patch.

    L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.
  • If you mean safe in the way of side effects, over time the patients will develop tolerance to the respiratory depression, and cognitive changes which include euphoria, normally associated with opioids. Eventually, tolerance also develops to the analgesic effects of the opioid. Depending on the opioid being used, the easiest way to achieve continued pain relief is to titrate the dose until an acceptable level of analgesia is achieved.

  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,730
    I think the answer is yes. In my opinion. A Pharmacist told me that if you are in pain, the meds go to the pain. Now once your out of the extra pain, if the previous dosing was adequate and you drop back down to the old level. You should get the same results. But if the extra pain subsided and you continued to take the extra meds. Then that would be a game changer.
    I think you handled it correctly! But I also think that you could have continued to take the extra meds for the time you were in extra pain
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • Jim, yep you read my question perfectly correct. :)

    Ok that makes a lot of sense and answers my question.

    Oh yeah it was major for real pain! Like put a sheet on my legs too "hard" (yeah I know how dumb that sounds lol) and I would go through the roof.

    My thoughts were I knew no matter how bad the knees hurt that in time it WOULD go away, but my back pain is (short of a miracle) here forever. I really do not want to increase pain meds if/until absolutely needed.

    BUT I will remember this info for future issues.

    Robin - Thanks for the article you sent me, was very helpful :)

    L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.
  • How are you doing with your recovery? I don't know of anyone who has done both knees at the same time, but I'm impressed that you did!
    I got so wrapped up in my own stuff that I failed to remember you were doing this in March.
    I hope your recovery is going well and that you are becoming more mobile. My dad did one knee in January and he has been amazing with his recovery and has never complained. All I know is he has a very high pain tolerance because he didn't complain with shoulder replacement either!
  • Hi Honey :)

    I am doing quite well. It was rough having both done but I have NO regrets. I would not want to have 1 done and then get the other done. I am happy with my choice.

    The first 2 weeks were rough. Not from the knee replacement it's self but he had to remove, cut and then reattach ligaments beside my knee. Those HURT!!!

    Getting mobile again was a bit rough as I did not have a leg to stand on lol ;) So everything I did was hard.

    But I am on the home stretch now. Thanks for asking about me :)
    L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.
  • So happy to hear that your knee replacement surgery went well and you are doing good and feeling less pain in that area!!

    I think you handled things very well....To me...I've been in PM for over 5 years...and only have had to raise my dosage 2 times in those years..so tolerance doesn't develop as quickly as some people think...

    As mentioned...your 'upped' dosage (both in the hospital and at home) worked for the extra pain you were having on your knees...and then easily go back to your previous dosage..

    And I say this being a person who lives with a 5-7 level of pain each day...'some' of our pain is in our heads...and by that I mean that we can train our brain to get used to a certain level of pain...5 years ago...if I had this pain right off the bat..I would have been in agony!...But this is my 'new normal' after all these years..some people when first starting pain management (just speaking in general..not you of course), think a pain medicine should get them back to a 0 on the pain scale...

    I use other tools besides a narcotic to help my pain as well like daily exercise, yoga/stretching, CBT, a muscle relaxer when needed, Ambien to help me sleep which is a God send as this alone has helped reduce my pain level by being well rested...etc..

    So..all of this to say that you did the right thing to make sure you stay on the minimum dosage to be ok with living with your back pain..as for most of us, unfortunately, it's 'chronic' and we want to keep our tolerance low so we have room to go up when needed..

    Again..hope your knees get better each day and that will allow you to be more mobile to enjoy your life!

  • Very well put :)

    I live with a pain level of on average a 5. Unless I am under a general anesthesia lol I don't think I am ever pain free.
    But I am good enough that I can live my life again. Not the same life as before but like you said my new normal.

    I would be snowed BIG time in order to be pain free and then I would be too drugged to live a life lol ;)

    L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.
  • I hear ya!...How amazing that would be to be pain free again...but not in the cards I don't think:(..

    And it's what every chronic pain person goes through with our Drs...is finding that line where you can at least be not in agony and live our lives...but not be so drugged up to not function...

    That is why I save my muscle relaxer for days I'm not going anywhere since it makes me pretty groggy...

    I needed it today after yesterday morning my dog who is 75 pounds...took off running at full speed on his leash because he saw a deer in our yard at 5am...I was looking the other way and half asleep...and my instinct is too hold on TIGHT to the leash...don't know why...lol...

    So I felt like I was beat up today!..I truly blessed it didn't damage my neck which always freaks me out...So it was muscle relaxer and movie day inside today!..

    I hope today was a good day for you!!..

    Take care
  • Hi ya,I just wanted to add that my dad had both of his knee's replaced at once also.I hadn't heard of it done before him either,but obviously they do.He said it was hugely painful as they get you usiing them on a machine straight away.
    All the best for your recovery.Dads op was a huge success,I'm sure you will be up dancing in good time .Mike.
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