KNEE ARTHRITIS - Total Knee Replacement :

PAIN CONTROL AFTER TKR - - Posted by eau03 (eau03), 27 February 2004

Pain control dominated the first 4 months of my double TKR at age 58. Codiene was the only painkiller that worked for me and others using it may be able to benefit from my experience. NAPROSYN did little for me even after keeping going for 7 days to establish a base level. Neither did paracetamol though I have friends who successfully used both for TKR pain control. My first advice is that you MUST have an electronically controlled bed in hospital, especially for double TKR. DON’T TAKE NO FOR AN ANSWER!
For the first 4 days I had a self-dosing morphine button plus oral codeine and paracetamol. When I went home on day 9 my codiene usage was one 60mg slow release tablet plus one paracetamol every 6 hours for 8-9 weeks. After that I reduced to an ‘as needed’ basis and was pretty well weaned off them by 18 weeks. Inevitably codiene caused constipation and it took me 10 weeks to find a solution. So if you are having codeine problems, try this:
Psyllium fibre in gelatine capsules hourly. Slippery elm bark may do just as well. Ask your GP but I don’t think you can overdose on either of them. Take lactulose syrup and CODALAX FORTE at recommended doses after every meal. Eat fruit every couple of hours. Drink plenty of fluids.
Good luck. Alan

Posted by Joans_kid (Joans_kid), 3 March 2004

Thanks for these details, I'm collecting info for my Mum who has just undergone TKR and feeling pretty lousy.  She suffers really badley from constipation and this been stopping her from taking the stronger painkillers - and guess what , she has lots of pain to put up with.

I passed on some your details and hopefully she will have had a conversation today with her Doctor and mentioned some of the medication to see if he is ok with her using it.

She very much sympathised with your situation and could not imagine going through a double dose of TKR

Posted by hmaxwell (Heather M.), 5 March 2004

Joan,

Tell your mom that dietary changes can help A LOT with constipation that is from surgery and/or painkillers.  Don't want to get crude, but fiber is her friend!  Things that I ate every day, which made the difference between being comfortable or not--canned corn, popcorn, prunes, Fig Newtons, broccoli and cauliflower.  Humus or chickpeas are also very healthy.   Also, cut down on sugar, rice, and bananas.   If worse comes to worse, the doctor can always prescribe her Milk of Magnesia and/or something else that is very mild.  She shouldn't let dietary complaints keep her in excruciating pain.  She's got to keep that knee moving and do her exercises--that is critical to her recovery

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