Update on dependence issue…

I want to start off by thanking my friends and family for helping me over the past few weeks.  Getting off of Norco (an opiode painkiller) has been much more challenging than even the things I’ve researched online.  I tried to go from 8 tablets a day down to 4 and had some bad side effects so I had to start over again.  I finally managed to get down to 2 tablets…and just taking those in the evening.  I noticed that my agitation levels increased the closer it got to the time to take my meds, but I pushed through it.

Last week I took a vacation with some friends and decided about half way through that it was time to cut back to just one pill.  I was worried about ruining my vacation, but I figured I could work through it without anyone noticing.  I had to add 1/2 of a Xanax pill to pull me through the rest of the evening, but I have now been on one Norco for the last 6 nights.  Tonight will be the last night I take Norco if everything goes well.  The only side effects, besides agitation, that I have noticed is severe itching on my head and face.  I tried taking a Benadryl, but that didn’t seem to help.  If the itching doesn’t stop soon, I will go see my doctor.  I’m guessing it is just another withdrawal affect, but it’s actually giving me a headache.  I will keep you posted on my progress.

As for my knee, things are going well.  I did a lot of walking on the beaches in Waikiki and I actually think it helped my knee.  When you walk on sand, especially wet sand, you really have to use a lot of muscles to stabilize yourself.  I would be tired by the end of the day, but not really hurting.  One of my friends with me noticed that I am still limping.  I don’t think it is from pain or range of motion limitations.  I believe it is from so many years of limping that I am going to have to learn how to walk the right way again.  So, I begin practicing.  I do notice that when I take my time and pay attention, my hip is sore.  I think it is from walking normally and the hip flexors aren’t used to working that way.

I still have some popping in the knee, but if I focus on the VMO muscles, I notice less popping.  I’m going to start going back to the gym and use the stationary bike.  I thought I would take a spinning class and just go at my own pace.  Biking is supposedly really good for your knees.  I will let you know how it goes.

I have no regrets doing this surgery.  I am pretty much pain free and almost off all the meds.  I can walk with my dog, go up/down the stairs, and I’m ready to start practicing for my first 5k (walking, not running).  I will keep this blog going for a while longer.  If you have any questions or comments, please feel free to leave them and I will respond as soon as I can.

A problem I didn’t expect to encounter…

I’ve spent a few days trying to decide if I post this for everyone to see or if I was going to keep this private.  After much soul searching and talking with some friends, I decided that this blog was designed to help people get through the TKR (Total Knee Replacement…in case you are just joining in) process.  If I leave out important information because of being afraid of comments, then I am doing nobody a service here.  I will be honest, I don’t even think anyone besides my sister and a few friends are reading this…but even so…one day, someone may read this and know someone who knows someone who needs to see this.

Tomorrow will be nine weeks post-op.  My knee is doing very well.  I am where I need to be physically.  I am full extension along with hyperpextension.  I am up to 125 degree bend.  I’m hoping to get up to 130, but it will take a few more weeks.  I am still dealing with the Baker’s cyst I have behind that knee.  I can now go up AND down stairs.  Down is still a bit challenging, but I am making it easier each time.  My incision has healed nicely.  I still have little feeling on the outside of my knee, but the spot for it is getting smaller.

So, if everything is going fine…you may be wondering what the problem is.  So…whew…here goes.  My knee problems have been going on for years.  The last two years have been the most difficult.  I started taking Vicoden for the pain at night so I could sleep.  That worked for about 6 months and then it was no longer helping.  The doctor’s changed my pain meds to Percocet, but that only lasted for a few months.  They finally put me on Nucynta and that finally did the trick.

We started at 25mg and by the time I had surgery, I was taking 150mg of Nucynta each day.  After surgery they dropped me down to Percocet and then finally down to Vicodin.  Last weekend (not just this past weekend) I decided that since I’m doing everything pretty good, it was finally time to stop taking my pain meds….so I did.  On Monday morning I noticed that I was experiencing a panic attack.  Now, I’ve had panic attacks before…usually due to stress.  I couldn’t figure out what I was stressed about, so I just took half of a Xanax.  That did the trick.  Tuesday I woke up with a panic attack and took another half of Xanax but was still feeling very “off”…just not right.  By Wednesday morning, I was shaking, having heart palpitations, and sweating.  I took my blood pressure, but it was normal.  My heart rate was a bit high, but my machine didn’t note any unusual heartbeat patterns.  I made the decision to go to my primary doctor’s office and I’m very thankful I did.

I explained to her my symptoms and she took a look at my med list (I keep a small card with all my medications and supplements as well as how much and how often I take them.  If you don’t do this yet, you really should.  As someone who has worked in public safety for a while, I know how important this is to medical personnel who may be called to help you.).  She asked me about my pain meds and I told her just what I finished telling you here.  She listened to my heart and lungs and checked for swollen nodes.  She checked out my eyes, ears, and nose as well as my throat.  She finally sat me down and told me that she suspected that I was going through withdrawals.  I told her that there was NO way I could be going through withdrawals because I am not an addict.  She then worked out a plan to wean me off the drugs this time.  I was going to argue with her, but I was mortified. 

Off to the pharmacy I went to get more pain meds.  I sent off an email to one of my friends who is a nurse exposing my dirty secret…well, not much of a secret really.  I should have seen this coming.  Two years on pain meds should have given me a clue.  I’m an intelligent woman who knows a lot of medical information.  He called me and talked me through the differences of addiction and dependence.  He advised that I have dependence and it WILL go away.  I just need to follow the plan my PA (Physician’s Assistant) outlined for me.

I took the first one when I got home and within an hour I notcied a HUGE difference in how I felt.  I felt much better and more in control.  So, I have to admit…I was dependent on the pain meds.  I am now on day six of the process and I’m feeling much better.  The goal is to be completely off the meds by the end of next week.  I have already stepped down once and still feel really good.  I was embarrassed and worried about repercussions from work, but then after reading about drug dependence, I understand more and am now confident that this is an issue that will only be an issue a short while longer. 

The moral of the story is just because you know a lot of things, doesn’t mean you know everything.  Take the time to listen to your body.  If something seems wrong, you should listen to your body and talk to your doctor.  This is your one and only body.  Listen to it and learn.

Til next time!!