Painkillers

[Guest guest]

Dale:

It has its faults, just like any other system-- after all, anything made by us poor mortals isn't likely to be perfect, but at least it works, and, in comparison to some of the complaints I see on this forum and others, it seems to work pretty well.

This wasn't always the case, and over the years, the healthcare system has gone through several series of crises before slowly changing into what it is today.

About your job-related postings...

I don't want to preach, but there are a few things that all of us here who are post-op had to learn: we can't do everything we could before we came down with whatever disease is was that brought us to getting joint replacements, and we have to come to terms with that, like it or not. Many, if not most of us, have had to change jobs, and sometimes careers after rehab.

On a personal level, I've had to deal with retraining and relocating workers after illnesses, both as a production manager, and later, for myself, since I can't spend hours a day on a production floor any more. Here are some ideas for you:

Have you considered the possibility of quality control? If you know how to use a tape measure, caliper and micrometer, you may qualify in your own plant, which would allow you to retain your seniority and pay rating, and maybe even improve on it. There's also the possibility of working in sub-assemblies, where you could work sitting down, at least for part of the day. I've designed a lot of work stations for semi-invalids who had to be able to work either sitting or standing, so I know they exist.

Take it from someone who's been where you are: it's not the end of the world, but there are going to be changes in your life style and physical capabilities. Put your energy into finding an alternative where everybody wins... you, your family and your employer. It's worth it.

RTHR-2003; LTHR-2004

mdavison@...

From: Joint Replacement [mailto:Joint Replacement ] On Behalf Of DaleSent: 19 March, 2007 6:38 PMJoint Replacement Subject: Re: painkillers

that does not sound like a bad system as described.

Dale

RE: painkillers

Margaret...The thing is, perception of pain is so individual that blanket policies arevirtually useless. The first night after each surgery, I was given one (1)additional shot of morphine in the middle of the night, and that was thelast of the painkillers I took. Others operated on at the same time wereindividually counselled on painkillers and those who needed them were givenprescriptions to fill. Doctors here seem to have a handle on the idea ofpain management. This is not to say that there are no butchers andshoemakers among the surgeons here-- there are, but they seem to get weededout pretty quickly.I've also been surprised at the amount of painkillers I've seen people fromthe US talk about, as well as the skinflint attitude towards PT.Apparently, the profit-motivated HMOs in the US find painkillers cheaperthan physiotherapy. It seems to me that many medical decisions describedhere are made more on the basis of cost than on the good/needs of thepatient. Score one for socialized medicine, with all its faults. I justcan not understand how any ethical physician can insist that physiotherapyafter a joint replacement is "unnecessary".It also occurs to me that if so many people are in such severe pain for solong after surgery, then there's something basically wrong, either with themedical profession itself, or with the financial constraints that a fullyprivatized system imposes on the medical profession. The only alternativeto these that I can see is that those in the US who have been relativelypain-free either don't belong or contribute to this forum.The criteria for discharge here (Israel) for TKR and THR patients is thatbefore you leave the hospital/rehab facility, you must be able to cope withcrutches and a flight of stairs, up and down. Average hospital stay is 5days, those who need it can get up to 30 days at a rehab center. No onegoes home with a walker, period. Once home, I received 6 weeks of 3-times aweek home PT visits, and another 6 weeks of outpatient PT at my local healthclinic. Thanks to the socialized medical system, this costs the patientabsolutely zero, other than their regular health insurance premium, which isbased on an income percentage. From the statistics I've been able to find,success rate is around 98%, with half of the failures coming from patientswho disregarded the limitations and physiotherapy.Of the people I'm in contact with on a local joint replacement forum, nonedescribe the kind of nightmares that we see on this board. Believe me,seeing some of the postings on this board has made me count my blessings forliving in a country with a socialized healthcare system that works, evenwith all its problems, and it's made me a lot less critical of the localsystem.Greywolf - RTHR-2003; LTHR-2004mdavisonnetvision (DOT) net.il-----Original Message-----From: Joint Replacement [mailto:Joint Replacement ] On Behalf Of MargaretSent: 18 March, 2007 11:30 AMJoint Replacement Subject: painkillersOne of the things that I, as an aussie, have been surprised about is theamount of painkillers that seem to be given out in other countries,particularly the USA.In Australia, at least at the hospital I attended, patients after hip andknee surgery leave the hospital with panadol (500mg Paracetamol) or panadine(500mg Paracetamol and 8mg Codeine Phosphate). I have never heard of apatient in Australia being given the morphine doses for arthritis. Iactually think Australia undertreats pain in case you were wondering.It's interesting watching how the various cultures form a basis for medicaltreatment. I feel really privilaged to be part of the group that isinternational. Where different countries have different attitudes aboutitems I take it as a cultural rule and decide what I want to do. Wherecountries all seem to maintain a rule I take that as a medical rule and obeyit.Aussie MargaretRTHR 1990 revised 2004

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[Guest guest]

, I don't want to stop going until I can get my bend to an easy 135. I still cannot get the back to go flat either. On my own, I don't have a way to measure this, but they do and it helps encourage me to keep going. Terry

Re: painkillers

Hi Margaret,

I can't remember what kind of medicine I was on but I don't think I ever was given a pill with morphine in it I think after my operations I was given a IV drip where you push the button if you where in Pain, sometimes the way I feel I could use a pill with morphine in it but I don't think they would be good for you . I hope this makes since .Well you take care and have a nice day :-)

Susie

Margaret <zztinau .au> wrote:

One of the things that I, as an aussie, have been surprised about is

the amount of painkillers that seem to be given out in other

countries, particularly the USA.

In Australia, at least at the hospital I attended, patients after hip

and knee surgery leave the hospital with panadol (500mg Paracetamol)

or panadine (500mg Paracetamol and 8mg Codeine Phosphate). I have

never heard of a patient in Australia being given the morphine doses

for arthritis. I actually think Australia undertreats pain in case

you were wondering.

It's interesting watching how the various cultures form a basis for

medical treatment. I feel really privilaged to be part of the group

that is international. Where different countries have different

attitudes about items I take it as a cultural rule and decide what I

want to do. Where countries all seem to maintain a rule I take that

as a medical rule and obey it.

Aussie Margaret

RTHR 1990 revised 2004

AOL now offers free email to everyone. Find out more about what's free from AOL at AOL.com.

[Guest guest]

Susie that sounds like a Morphine IV drip. So I believe you were given Morphine but just didn't know it.

Dale

Re: painkillers

Hi Margaret,

I can't remember what kind of medicine I was on but I don't think I ever was given a pill with morphine in it I think after my operations I was given a IV drip where you push the button if you where in Pain, sometimes the way I feel I could use a pill with morphine in it but I don't think they would be good for you . I hope this makes since .Well you take care and have a nice day :-)

SusieMargaret <zztinau .au> wrote:

One of the things that I, as an aussie, have been surprised about isthe amount of painkillers that seem to be given out in decide what Iwant to do. Where countries all seem to maintain a rule I take thatas a medical rule and obey it.Aussie MargaretRTHR 1990 revised 2004

[Guest guest]

Alan I hope I just misunderstood you and if I did, then I apologize in advance. But an addict looking for a "fix"?? How about someone in so much pain, but needs to continue a job to support a family, because the bills do not give a hoot about our pain, looking for at least a little relief and something to not take away the pain completley, because as far as I know, there is no such a thing, but just to take the edge off enough to make it through a night at work. To continue a job, keep a roof over the family's head, and the bills paid as much as possible. Hard enough having to take a day off here, another day off work there, to play catch up paying the behind bills as a result. I am supposed to be scheduled for my third pain clinic tomorrow, in hopes of them seeing me this week. But the first one injected my joint with steriods, which I have since learned can spread AVN throughout the body to the other joints that were not affected before, then after the third injection they were like "oh, by the way sir, in case we forgot to mention it before, this will actually deteriorate your bone". WHAT!!! Why was I not informed of that fact before they stuck the first needle in me? The second one was intent on giving me a spinal epidural, from everything I read about those, it makes the initial pain worse, and after a couple of weeks, slowly subsides, for only some people, and then in short time, it's as if you never had one and the pain comes back with a vengance. I told them I was not getting an epidural, so they started naming off drugs eventually settling on a low grade muscle relaxer. So the first place actually made the pain worse and possibly could have given me AVN to other joints in the future, the second place gave me a pill that did nothing at all for the pain. I am a little more than aprehensive about trying out a third pain clinic, but I know I have to do something and am runninig out of options. So please Alan, if I misunderstood what you were trying to convey in your post, I apologize in advance.

Dale

Re: painkillers

Hi Aussie Margaret,I don't think it is just a cultural or country related issue so muchas physician. Even in the USA, there are many doctors who don'tbelieve in prescribing much in the use of pain killers. That is why"pain clinics" are popping up all over the place. Only in theseclinics can a patient in chronic pain go and be treated as anythingother than an adict looking for a "fix".Keep stoking,Alan in NJ/USA>> One of the things that I, as an aussie, have been surprised about is> the amount of painkillers that seem to be given out in other> countries, particularly the USA.> > In Australia, at least at the hospital I attended, patients after hip> and knee surgery leave the hospital with panadol (500mg Paracetamol)> or panadine (500mg Paracetamol and 8mg Codeine Phosphate). I have> never heard of a patient in Australia being given the morphine doses> for arthritis. I actually think Australia undertreats pain in case> you were wondering.> > It's interesting watching how the various cultures form a basis for> medical treatment. I feel really privilaged to be part of the group> that is international. Where different countries have different> attitudes about items I take it as a cultural rule and decide what I> want to do. Where countries all seem to maintain a rule I take that> as a medical rule and obey it.> > Aussie Margaret> RTHR 1990 revised 2004>

[Guest guest]

First surgery I had a morphine drip, Oxy, OXY IR,Altram, and Extra

Strength Tylenol.

Second surgery, I requested less and got rid of the Altram, which

helped me not feel so nauseous and sensitive to smells.

Now I take 2 naproxen and 1 tylenol/day. Mostly for muscle pain and

stiffness.

Jackie

[Guest guest]

Micheal thank you for trying to help, but QC is a bid job at my plant. And most of the bidders have 20+ years in, which out ranks me by a longshot. And I do not even see either of the only two we have on nightshift giving up their position anytime soon unless something tragic happens like one of them dies in an auto accidentl. Even still, several others will sign the bid sheet who have 5-10 more years in than myself. And there simply are no sit down jobs in my plant. Believe me, I thought about that too, and there are none. After the terrible experience I had with my doctor yesterday and him just cutting me off meds, and not even shaking my hand as he left, just like an arrogant a-hole turned his head and walked away without so much as a good luck, or see you later, or let me know what you decide comment. Nothing. I am not even focused on saving my job anymore. I understand I need it until I get this hip fixed if I can find a doctor that will touch me. I need the $430 a week temp disability pay for the maximum 26 weeks. I need the health insurance, not just for me, but for my wife and kids also. If I can find someone who will give me a THR, I will worry about another job after I have healed and when that time comes. I am no longer focused on saving my job. I just want a new hip and the pain to end for now.

Thanks for trying to help though,

Dale

RE: painkillers

Margaret...The thing is, perception of pain is so individual that blanket policies arevirtually useless. The first night after each surgery, I was given one (1)additional shot of morphine in the middle of the night, and that was thelast of the painkillers I took. Others operated on at the same time wereindividually counselled on painkillers and those who needed them were givenprescriptions to fill. Doctors here seem to have a handle on the idea ofpain management. This is not to say that there are no butchers andshoemakers among the surgeons here-- there are, but they seem to get weededout pretty quickly.I've also been surprised at the amount of painkillers I've seen people fromthe US talk about, as well as the skinflint attitude towards PT.Apparently, the profit-motivated HMOs in the US find painkillers cheaperthan physiotherapy. It seems to me that many medical decisions describedhere are made more on the basis of cost than on the good/needs of thepatient. Score one for socialized medicine, with all its faults. I justcan not understand how any ethical physician can insist that physiotherapyafter a joint replacement is "unnecessary".It also occurs to me that if so many people are in such severe pain for solong after surgery, then there's something basically wrong, either with themedical profession itself, or with the financial constraints that a fullyprivatized system imposes on the medical profession. The only alternativeto these that I can see is that those in the US who have been relativelypain-free either don't belong or contribute to this forum.The criteria for discharge here (Israel) for TKR and THR patients is thatbefore you leave the hospital/rehab facility, you must be able to cope withcrutches and a flight of stairs, up and down. Average hospital stay is 5days, those who need it can get up to 30 days at a rehab center. No onegoes home with a walker, period. Once home, I received 6 weeks of 3-times aweek home PT visits, and another 6 weeks of outpatient PT at my local healthclinic. Thanks to the socialized medical system, this costs the patientabsolutely zero, other than their regular health insurance premium, which isbased on an income percentage. From the statistics I've been able to find,success rate is around 98%, with half of the failures coming from patientswho disregarded the limitations and physiotherapy.Of the people I'm in contact with on a local joint replacement forum, nonedescribe the kind of nightmares that we see on this board. Believe me,seeing some of the postings on this board has made me count my blessings forliving in a country with a socialized healthcare system that works, evenwith all its problems, and it's made me a lot less critical of the localsystem.Greywolf - RTHR-2003; LTHR-2004mdavisonnetvision (DOT) net.il-----Original Message-----From: Joint Replacement [mailto:Joint Replacement ] On Behalf Of MargaretSent: 18 March, 2007 11:30 AMJoint Replacement Subject: painkillersOne of the things that I, as an aussie, have been surprised about is theamount of painkillers that seem to be given out in other countries,particularly the USA.In Australia, at least at the hospital I attended, patients after hip andknee surgery leave the hospital with panadol (500mg Paracetamol) or panadine(500mg Paracetamol and 8mg Codeine Phosphate). I have never heard of apatient in Australia being given the morphine doses for arthritis. Iactually think Australia undertreats pain in case you were wondering.It's interesting watching how the various cultures form a basis for medicaltreatment. I feel really privilaged to be part of the group that isinternational. Where different countries have different attitudes aboutitems I take it as a cultural rule and decide what I want to do. Wherecountries all seem to maintain a rule I take that as a medical rule and obeyit.Aussie MargaretRTHR 1990 revised 2004

My mailbox is spam-free with ChoiceMail, the leader in personal and corporate anti-spam solutions. Download your free copy of ChoiceMail from www.digiportal.com.

[Guest guest]

,I had THR but when I asked my OS about physical therapy at my consult, he told me that the basic therapy for a hip is walking. He then compared it to knee therapy and said if one doesn't work the knee within the first month properly, one will never get proper range of motion so you are correct. As to pain relief, it is absolutely critical that one not experience pain -- or at least minimal pain for many reasons. Modern medical pain management stresses the need for patients to "get ahead" of the pain and not wait until it hurts.Regards,HelenOn Mar 20, 2007, at 1:23 PM, Risener wrote:'s post made me wonder about something. You see, my PT said that while walking after the TKR is important, you can rebuild strength at any point in the recovery; the flexibility is what must be worked on early on, before the less flexible scar tissue develops. He's got me doing plenty of exercises for flexion and extension, not as much for strenght at this point. I wonder what other people have experienced regarding this matter? By the way, my staples came out today, fifteen days after the surgery. I am still on percocet but my oxycontin dosage has been decreased as of today, and celebrex will be done Friday. I'll go down to vicodin or darvocet after I am out of percocet. But, I'm only taking one percocet once every 6 hours or so. I find myself needing less and less all the time, which is very pleasing to me. He prescribed Ambien for me to help me sleep but cautioned me that it might not work for me. Dr. was very pleased with my range of motion so far. I was encouraged by that. I wish everyone had an OS as nice, competent, and positive as mine!  

[Guest guest]

Your doctor told you this? Man, I need to get that in writing and

take it to my doctor who refused to give me PT the first eight weeks.

I am pretty sure that I have some scar tissue as I have now

developed alot of pain in my leg when I walk.

I am currently looking around to get a total gym for my home, so I

can work that knee out alot on it and see if it will help.

Terry

ps I am so glad that you have a wonderful doctor. That is a real gift.

>

> >

> > 's post made me wonder about something. You see, my PT

said

> > that while walking after the TKR is important, you can rebuild

> > strength at any point in the recovery; the flexibility is what

must

> > be worked on early on, before the less flexible scar tissue

> > develops. He's got me doing plenty of exercises for flexion and

> > extension, not as much for strenght at this point. I wonder what

> > other people have experienced regarding this matter?

> >

> > By the way, my staples came out today, fifteen days after the

> > surgery. I am still on percocet but my oxycontin dosage has been

> > decreased as of today, and celebrex will be done Friday. I'll go

> > down to vicodin or darvocet after I am out of percocet. But, I'm

> > only taking one percocet once every 6 hours or so. I find myself

> > needing less and less all the time, which is very pleasing to

me.

> > He prescribed Ambien for me to help me sleep but cautioned me

that

> > it might not work for me.

> >

> > Dr. was very pleased with my range of motion so far. I was

> > encouraged by that.

> >

> > I wish everyone had an OS as nice, competent, and positive as

mine!

> >

> >

> >

> >

>

[Guest guest]

I use Tylenol.Sent via BlackBerry from T-MobileFrom: "Stefano" Date: Thu, 9 Apr 2009 14:07:56 -0300<samters >Subject: Painkillers For those of you who are allergic to aspirin and let´s say sensitive to  Paracetamol what painkillers do you use?

[Guest guest]

I'm allergic to tylenol and asa so I use Tramadol (prescription) for pain.

Tami

I know I say this everytime....but I did not know I was allergic to tylenol until I took two extra strength at once. This was one of my worst anaphalactic reactions sending me to the ER twice that day. I believe 50% of those with Samters also have an allergy to tylenol so please don't take huge doses unless you have before and you know you aren't allergic.

Painkillers

For those of you who are allergic to aspirin and let´s say sensitive to Paracetamol what painkillers do you use?

[Guest guest]

I second Tami in being careful with Tylenol. My doctor's told me it was better

to take 500mg or LESS every 3-4 hours for pain as opposed to taking 2 together.

They are concerned with me developing an allergy to the Tylenol.

Jennie

>

> I'm allergic to tylenol and asa so I use Tramadol (prescription) for pain.

> Tami

> I know I say this everytime....but I did not know I was allergic to tylenol

until I took two extra strength at once. This was one of my worst anaphalactic

reactions sending me to the ER twice that day. I believe 50% of those with

Samters also have an allergy to tylenol so please don't take huge doses unless

you have before and you know you aren't allergic.

> Painkillers

>

>

> For those of you who are allergic to aspirin and let´s say sensitive to

Paracetamol what painkillers do you use?

>

[Guest guest]

I had a similar reaction to asprin.

Sent via BlackBerry from T-Mobile

Re: Painkillers

I second Tami in being careful with Tylenol. My doctor's told me it was better

to take 500mg or LESS every 3-4 hours for pain as opposed to taking 2 together.

They are concerned with me developing an allergy to the Tylenol.

Jennie

>

> I'm allergic to tylenol and asa so I use Tramadol (prescription) for pain.

> Tami

> I know I say this everytime....but I did not know I was allergic to tylenol

until I took two extra strength at once. This was one of my worst anaphalactic

reactions sending me to the ER twice that day. I believe 50% of those with

Samters also have an allergy to tylenol so please don't take huge doses unless

you have before and you know you aren't allergic.

> Painkillers

>

>

> For those of you who are allergic to aspirin and let´s say sensitive to

Paracetamol what painkillers do you use?

>

------------------------------------

[Guest guest]

I’ve used Codeine before without any problems but aspirin I

react to very badly. Perhaps your GP could prescribe you something that doesn’t

contain either aspirin or paracetamol as just off the top of my head, I’m not

aware of any. I’ve had codeine before without any problems though.

From: Stefano

[mailto:skunkburner@...]

Sent: Thursday, 24 June 2010 12:07 PM

samters

Subject: Painkillers

Guys

I think I asked before but as most of us are allergic to Aspirin and I am also

sensitive to paracetemol what painkillers are available to use. Anyone use

codein? And what else?

[Guest guest]

StefanoBesides aspirin I am allergic to all NSAIDs and to the classical analgesic Analgin known as Algocalmin (active ingredient Metamizole), also a NSAID. In case I really need to take something against aches, pains I take Arcoxia which is a COX-2 inhibitor just like NSAIDs but it is a COX-2 SELECTIVE inhibitor and doesn't give any of the side effects.Arcoxia it is very well tolerated, but can affect the liver if used excessively, so be careful. I personally never had any issues from it.SergiuFrom: Stefano <skunkburner@...>Subject: Painkillerssamters Date: Thursday, June 24, 2010, 5:07 AM

Guys I think I asked before but as most of us are allergic

to Aspirin and I am also sensitive to paracetemol what painkillers are

available to use. Anyone use codein? And what else?

[Guest guest]

Etoricoxib (brand name Arcoxia)From: Stefano <skunkburner@ .co. uk>Subject: Painkillerssamters@groups .comDate: Thursday, June 24, 2010, 5:07 AM

Guys I think I asked before but as most of us are allergic

to Aspirin and I am also sensitive to paracetemol what painkillers are

available to use. Anyone use codein? And what else?

[Guest guest]

Apparently there are six different classes of NSAIDS and most of them will effect us just like aspirin. I've been using the NSAID Nabumetone for about two years with out a problem. The only thing is that if you take the medication in the evening it could effect your ability to fall asleep.

Below is an article which was previously posted on this site.

Tolerability to nabumetone and meloxicam in patients with nonsteroidal anti-inflammatory drug intolerance.

Prieto A, De Barrio M, Martín E, Fernández-Bohórquez M, de Castro FJ, Ruiz FJ, Herrero T, Tornero P, Rubio M.

Allergy Service, Hospital General Universitario Gregorio Marañón, Madrid, Spain. aprieto.hgugm@...BACKGROUND: Because nonsteroidal anti-inflammatory drug (NSAID) intolerance depends on COX-1 inhibition, preferential or selective COX-2 inhibitors have been thought to be well tolerated by these patients. OBJECTIVE: The aim of this study is to evaluate tolerability to nabumetone and meloxicam in patients with NSAID intolerance. METHODS: Seventy patients intolerant to NSAIDs were selected. Thirty subjects were patients with asthma with respiratory (rhinitis-asthma) intolerance to NSAIDs (group A); 40 patients (group had cutaneous-mucous (urticaria-angioedema) NSAID intolerance. Diagnosis was based on clinical histories in all patients, and it was confirmed by positive single-blind placebo-controlled oral challenge test in 36 patients. After written informed consent, a single-blind placebo-controlled oral challenge test with nabumetone in all patients (2 g except for 11 patients who reached 1 g) and meloxicam (15 mg) in 51 patients was performed. RESULTS: Of the total selected, 94.3% tolerated 1 g nabumetone. In those who reached the 2-g dose, the tolerability was 83.6%. With respect to meloxicam, 96.1% of patients, tolerated 15 mg. No significant difference in nabumetone and meloxicam tolerability was observed between groups A and B. CONCLUSION: The results of this study confirm a high percentage of tolerability to the maximum therapeutic dosage of nabumetone and meloxicam in patients with NSAID intolerance, both in those with cutaneous/mucous manifestations and in those with respiratory disease. CLINICAL IMPLICATIONS: Nabumetone and meloxicam are safe alternatives in NSAID-intolerant patients.

-----Original Message-----From: samters [mailto:samters ]On Behalf Of StefanoSent: Wednesday, June 23, 2010 9:07 PMsamters Subject: Painkillers

Guys I think I asked before but as most of us are allergic to Aspirin and I am also sensitive to paracetemol what painkillers are available to use. Anyone use codein? And what else?

[Guest guest]

Hello everyone........

I know not to take codiene with LDN. ..I had been on a occasional codiene mix

for migraine.....

What ACTUALLY HAPPENS when they are mixed - when one takes an occasional

codiene with LDN..

What happens to the body/head....

Regards Ingrid/aus