Hi Bill, and welcome back although I know that you wish that you were back for other reasons; like to say "hi".

Sounds like you are caught in the ever-growing circle of " true pain patients be dammed, we have addicts around" that are more important. I know that what your doctor is saying is now common for post-op pain; short-term pain Rxs only. Not sure what to suggest. Any chance of you seeing a pain doctor?

Another option that even your current doctor may consider is prescribing Celebrex (or more likely the generic version). I found out the hard way that Celebrex is a very effective post-op pain reliever, even better than standard low-level opiate pain meds. Worth a try. Based on my post-op experience, 400 mg the first day then 2oo mg for a week or two. This was for joint replacement surgery in my foot. The pain was so bad that I could not even let my foot touch the ground. Celebrex totally eliminated the pain overnight when two other opiate-based drugs could not touch it. No idea how your surgery pain level is vs, my joint replacement surgery. I don't see you getting much doctor help with the opiate-type pain meds.

Best of luck Bill!

You need to see a Pain Management Doctor. You might have to see several. before you find one that is the right fit for you.

Are you doing PT? Generally your past the 4 hr dosing at this point after a TKR. Using other meds to help the pains and other therapies to alleviate it are important. Post op pain is not Chronic Pain and you don't need an open ended narcotic script to get through it. Physical Therapy and exercise to keep mobility up are a big part of managing post op pain.

Bill I don't think PM can help with more narcotics. In our state 10 5/325 would be max. Point equivalent. Hydro 1 point for one 5 hydro.. For each 5 mg of Percocet one and a half. One point for each 5 mg of morphine Example 50 points= 10 mg of pecocet and two 15 mg of morphine would put you 5mg over the point system. Here the limit on hydrocodone is 10 5's. Our attorney general Jeff Sessions says 90.
Each state and Doctor chooses different.

It doesn't matter if you have done PT for years or how many injections or nerve burnings or other procedure or if you see a pychcologist or a physiologist or how many other therapies you have had. One thing I will say should you choose PM research carefully. Make sure a doctor only has one office. Not over. Many have as much as 5. This endangers them I believe with DEA in your state. It means times 5 they are prescribing a boatload of drugs and prior to war on drugs have precribed over the limit without patient records.

Good luck and best wishes to find ways to work through pain without more drugs.

hippy

I forgot about your history. You may or may not find a pain management doctor that will prescribe something stronger. The only way to know. is to get an appointment with one. You will probably have to see them a few times before they prescribe anything stronger than what you are taking.

hippyone, who told you the max was ten 5 mg ? If your state has a law. Please provide the link. Thanks.

Just look up Arkansas Health Board. All PM Docs are afraid to go over the 50 limit should they be called before the board and loose license. Doctors started weaning in April to meet requirement .

I don't hear much on this board so I just assumed other states might be going through same or close to same and no one is talking about it.

Doctors in Arkansas can prescribe over 50 mg. But it takes more effort on their part.

https://www.usnews.com/news/best-states/arkansas/articles/2018-07-18/arkansas-oks-rules-for-doctors-prescribing-opioids

I've not heard of this "point system" there is an "equivalent system" but it's a milligram equivalent and its Federal not State based. I know here in NC they go by the Federal 90mg Morphine equivalent rule for Chronic Pain.

As for Post-Op Pain, it's not Chronic Pain, its considered Acute Pain and a Pain Mgmt. Dr. is not going to put someone on a long-term Pain Mgmt. regimen for Post-Op pain, that's how a lot of this over-prescribing crap got started in the first place.

Bill your pain meds aren't as effective because you've been using them for years for Acute Pain and your brain is used to them. So you have to learn other ways to deal with the pain....and there are other ways to do it.

I guess Bill had another knee surgery I was thinking about the one he had last year or the year before. Sorry Bill for the mix-up.

OlderCPer, I have not heard of the point system either. But, this is Arkansas. States in the south tend to do strange things at times.

I hope you get the meds you need as well. It's a shame how all of the doc's are scared to prescribe. It makes me grateful that I can remain on a low dose for now. I have only had one bad pain flare up in 3 months. I have only had to use Methadone once in three months to cover a bad flare. I don't know what happened but I am able to use lower amounts of meds a lot now. Maybe it is because I have my blood thinned to 3.5 and more blood is circulating. I do use more meds on work days though. They beat the hell out of me. Hang in there. I'm glad you got the new knees. I bet you will be running one day lol.

What helped me was taking ibprofen. It's cheap, in every convenience store, and it works I didn't take two pills at a time, like it says on the dosage, I took 4 pills. 800 milligrams is the prescription dose. I amputated a digit and the ibprofen worked far better then the narcotics did so when I ran out of percosts and vicodin, I didn't care because I didn't really need them anyway. Good luck with that Bill

God Bless

bobinmaine, have you tried Aleve (Naproxen)? OTC Naproxen is 220 mg a tablet. Bottle says take one twice daily. But most people take 2 tablets twice a day.. Rx strength is 500 mg a tablet.

Rx ibuprofen is 800 mg. A lot of people take OTC ibuprofen 4-200 mg tablets every 8 hours.

My RX Ibuprofen is 600mg pills and I take 3 a day, with a 4th if needed. I've used Naproxen over the years but it caused nausea, that Ibuprofen didn't and didn't work any better. I've always found that good old Ibuprofen works the best with the least side effects of NSAIDS. Since my Dr. gives me a Prescription I only pay like $5 bucks a month for it, instead of the expensive OTC prices.

I also have Mobic for the OsteoArthritis but it's an LA med.

OlderCPer, Motrin prescription strength comes in 400 mg, 600 mg and 800 mg..There are probably other brands of prescription strength ibuprofen in the same mgs. I am not sure about generics. OTC only comes in 200 mg.