HI JH Mithch, That's some of the most rediclous thinking on opiates I have heard. If you have an ortho surgeon doing a TKR that has a flat plolicy to never prescribe anything stronger than Vicodin, I wouldn't let him touch me.
Years before long acting meds were available, when you had major surgery like back surgery or knee or hip replacements you normally wake up from surgery with IV patient controled anelgesia "PCA"
Meaning you press a button every 5-12 minutes depending on how the machine is set and the machine delivers more medication IV, It's a much better system than waiting for a nurse to bring you a pill or shot and then waiting for it to work.
When I was discharged from all 3 back surgeries I came home with 5mg percocet with orders to take 2 every 3-4 hours, That's more than twice the strength of a 7.5 Vicodin.
There is absolutely no reason to come home and suffer after surgery.
If you had been taking 8 10mg percocets a day for several years prior to surgry than the doc sort of has a point but there are still meds stronger. They make a 30 mg Oxycodone tablet without tylenol that could be used or they can prescribe oral morphine. The odds of becomeing addicted to pain meds when your only reason for taking them is pain is about 3%. It's when folks continue to take them for other reasons that problems develop.
One, you won't be able to due the PT required for a TKR without appropriate pain managent.
2 and this is the biggie, under-treated post op pain can lead to conditions like RSD or chronic regional pain syndrome because your nervous system just goes hay wire from untreatd pain and you end up with chronic pain that can barely be managed "Intractable." What is the point of making you suffer because you have been using 2-3 Vicodin a day pre op. That's minimal and absolutely absurd.
People have invasive surgery like TKR's while taking high doses of LA meds, like several hundred mgs of morphine or Oxycodone per day and they can still manage their pain post op. Why is this surgeon so against pain mnagement and using medfs for their intended purpose? Ya know what they call the doc that graduated last in his class.
The Answer is: Doctor
OxyCodone is the opiate in Percocet and OxyContin and many other products. Percocet is the standard orthopedc post op med. Even if you are just having ACL surgery you would likely get pecocet from most docs.Those few Vicodin wouldn't make a bit of difference to most people if even the standard meds are used, but should they need somthing stronger there are plenty to choose from.
Vicodin contains Hydrocodone, Percocet contains oxycodone,oxy is about 50% stronger and available in doses from 5mg to 30 mgs and even higher if he uses long acting version of oxycodone.
They have so much more to choose from now. Any doc that told me I'm going to make you suffer and not prescribe anything stronger than Vicodin after surgery wouldn't be my surgeon.
3 vicodin is minimal tolerance, nothing compared to what peopele on long acting meds take and they have surgery and their pain can be managed. IF some old school doc isn't aware he has options for better post op oral pain control once your home I flat out wouldn't have surgery by a doc that knows less than I do about Pain management.
Find another surgeon, one that says don't wory about those couple vicodin per day, we will use whatever it takes to keep you up and moving post op to do the PT required. Your more likely to end up in a wheel chair if they don't manage your pain properly because you won't be able to get the Knee working in the window you have for PT before the joint and muscles become frozen because it hurts too much to bend.
You got a doozy of a medical team working on you that's seems to be very opiate phobic.
Find a young doc that knocks out hundreds of knees a year and is used to managing pain in all different people, that jusn't just prescribe what he thinks should do the job. If a med is not working you need something stronger and a doc that will listen. What's next, surgery without any pain meds to make a man out of ya, take 2 tylenol and don't complain and do your PT ???
Rheumys are notorious for not treating pain agressively and if the surgeon has the same antiquated views, Post pone the surgery untill you meet a doc that doesn't think 3 vicodin a day makes you extremely tolerant. That's minimal compared to most folks that live with chronic pain.The risk of develping chronic intractable pain from poor post op management is very real and an uneccesary risk with all that's available. You won't be able to manage the PT if you don't have realistic pain management and most surgeons are very aware of this. What a crock.
You start PT within days after a TKR so the muscles don't become frozen, like frozen shoulders, and it's not fun. If they don't get the kneee bending stand retraining the muscles for the poition they are now in you won't be ablt to bend it . Without proper pain management you won't be able to tolerate bending it. It will hurt but nothing is gained by making you suffer.
Did they offer to do the surgery without anesthesia to make a stronger man out of you?
It doesn't make you an addict or doc shopper to find another OS and to realize this guy is a quack and doesn't know what he's talking about, a rheutmey is not a surgeon and never prescribes post op meds, so he's talking out of the wrong cheeks. What part of the country are you in and I'll bet there are some folks that can recomend PM docs and even ortho surgeons that use meds stronger than Vicodin every day of their practice. There really are ortho surgeons that know Vicodin isn't all there is when it comes to post op pain management.
Explain to a new doc that this fear was created by some doc that doesn't seem to be aware there are options stronger than vicodin. Usng something stronger and then tapering back down as you heal won't turn you into a drug addict looking to knock over a pharmacy to get your fix.
MY mom had a TKR last year and came home with 10mg percocet and then slowly stepped down to 10 mg Vicodin and then 5 mg vicodin. That's pretty standard post op care and she never had to resort to robbing pharmacies or buying stronger meds from the street. She used what she needed, when she needed it and hasn't taken a pain pill in months. She didn't become an addict and they had her on more than 3 vicodin per day for several months prior to the TKR because she had a mastectomy 4 months prior.
People have surgery after surgery sometimes and develop tolerance and they simply have to use a stroger med if your not getting relief. Why torture yourself in this day and age.
What they are telling you is flat out ignorant.
Good luck, Dave