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Topic Knee Replacement Surgery soon - concerned about meds at hospital Go to previous topic Go to next topic Go to higher level

By dkleinert On 2009.11.19 01:04
After reading a few of the posts about narcotics and anesthesia reactions with PD's, I am now worried about my PD husband's upcoming knee replacement surgery Dec. 7th. He needs to exercise/walk, and we have tried cortisone and other injections and nothing works - he is in so much pain in his arthritic knee (I have seen xrays - it is bone on bone). His Orthopedic Surgeon has convinced us that knee replacement will be the next thing we have to do so my husband can remain ambilitory. When we went to the Pre-op appt Monday, the intake nurse told us that Joe will have morphine on demand after surgery, then they will gradually switch to pills, etc. I will be there most of the 3-4 days except to go home to sleep. Please help me know what to do here. I am hearing from the posts here that the narcotics and anesthsia are going to be a problem.....I had no idea about this before reading here tonight - thank God for all of you. He will be at Duke Hospital then to a Rehab facility near our home until he can stand, get in and out of bed, go to the restroom and walk alone (or with walker). Then he will come home and our great Home Health OT and PT will begin coming to the house again. Also the Home Health Aide will go back to coming 2 days a week when I am at work. Any input you have will be much appreciated......THANK you for all you have written so far on this subject.

By annwood On 2009.11.19 02:08
I would be very concerned about the narcotics (morphine). In all probability his Ortho Surgeon knows very little about PD. You don't mention whether or not your husband has any cognitive problems going into this. You will have to provide VERY specific instructions regarding his PD meds at the hospital and make sure they are given properly. Duke is a wonderful place so that will help. Make sure his neuro knows ahead of time and ask him questions regarding the pain meds. Good luck

By caregivermary On 2009.11.19 10:36
Ask to speak to the anesthesiologist just prior to the surgery. Tell the person about the parkinson's and the possible-probable interaction of the anesthesia with the PD meds. I did this and it help tremondously with my husb. Also, speak with the surgeon about alternative pain management for post op and beyond. What I mean by that is options to morphine. Push for options. Take care.

By dkleinert On 2009.11.20 22:59
Thanks so much everyone. I will call the Neurologist Monday and see how I can speak with the Anestheologist prior to surgery. I will speak about your suggestions. Hugs to all - so happy you are there!! :))

By lynn On 2009.11.22 14:14
total Knee replacements are generally done with an epidural rather than general anesthesia. this is a good thing and you should make sure an epidural which blocks feeling from the waist down is planned. Second, my husband was in such intense pain before the knee surgery that he had very little pain after the surgery. Right after surgery when my husband was still slightly sedated he kept pushing on the morphine pump without knowing that he was doing it. I asked that the pump be disconnected and pain pills be given orally. He never asked for a pain pill. Make sure you have several copies of your husbands meds with you and the time he takes them. Once he is in his room, tell the nurse you want to go over what they have in their computer regarding his meds. They never seem to get this right. Also, put a copy of his meds and times up on the bulletin board in his room. I've needed to do this for 2 hospitalizations.

By lbellomy On 2009.11.22 16:08
Lynn,
Those are such good ideas!
Lorraine

By annwood On 2009.11.22 17:40
I would add that you should take all of his meds with you to the hospital. Make certain they are in the original bottles. It is easier for the nurse to copy the name and dosage off the bottle. In my husband's case, he was on Clozapine, which the hospital did not have. They used his bottle of med until they could order it in. Stress how important it is that he get his meds on time. He will be on an Ortho floor and I can almost guarantee you that they will know nothing about PD.

By dkleinert On 2009.11.23 00:35
Lynn and Annwood: Thank you so much. I like the idea of the bulletin board. I remember that being in the room from his last hospitalization. I will do that. I already have a typed up schedule of times and dosages for each day that I take to all medical visits. But I will actually take the bottles of medications - never thought they might not have what he needs. Great suggestions. About the epidural. They didn't mention it - only the general anesthesia (1 option), nerve block (2nd option) general anesthesia plus nerve block (3rd option). Is a Nerve Block and an Epidural the same? I only know about an Epidural in relation to my daughter and daughter-in-laws pregnancy deliveries.....guess I am a little behind medically. Again - thanks so much. I will be calling the Ortho tomorrow.

By LOHENGR1N On 2009.11.23 08:27
dkleinert, You might also have to Neuro specify time of dosing with meds. Sometimes our bottles may have a label of take 4x's a day. Which We and our Neuro know is take every 4 hours 4x's a day. The hospital will interpret this as 4x's a day equals every 6 hr's. Take care, best of luck and hang in there.

By annwood On 2009.11.23 09:22
An epidural numbs from the lumbar spine down. A nerve block will just numb the leg.

By dkleinert On 2009.11.23 12:50
Thanks LOHENGR1N and Annwood. I had not thought about the difference between how Joe takes his meds and how the bottle prescribes them. I will indeed make distinction at the hospital!! So the nerve block is much different....thanks again both of you.

By lynn On 2009.11.25 20:05
Try to go with the epidural because of the PD. They like to give the nerve block because it helps with pain afterwards. I say deal with the pain when and if it comes up. Also, great suggestion from annwood about taking the med bottles. During one of my husband's hospital stays, they did not have one of his drugs and I had to come home and get it.


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