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Chronic Knee Pain & Butrans Patches
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Chronic Knee Pain & Butrans Patches

Hi - I am prepping for a knee replacement stemming from an old high school injury and go to a local pain management clinic.  I've been on about every painkiller there is, plus have had 2 pain blocks - most recently I was using the Fentanyl patches and Vicodin as a "kicker" - I was doing okay, spiking with pain because the Vicodin would wear off after 3-4 hours.  My meds have to be changed every so often because they become less effective.  A few months ago, I was put on Butrans 20 mcg and nothing else.  So far as far as pain goes, it is working for the most part.  Now I have a new problem in that both of my legs are swollen, sometimes so much that I can hardly bend my legs.  They are painful to touch at times as well.  Pain clinic sent me to a rheumatologist who did an ultrasound to see if there were any blockages (none) and then just told me to wear the compression stockings and keep off my feet as much as possible...well, I'm only 48 and I have 2 younger children (8 and 10) so it's a bit hard at times.  I'm just wondering if anyone else has the problems I've noted.  I have good days and bad days - some days I wake up feeling fairly decent and can get things done - then I have a couple of days where I'm so lethargic that it's an effort to do anything - today is one of those days.  I have to push myself to do the basic things.  I'm tired a lot, if I sit still, I fall asleep.  I've told the doc all of this...additionally, the patches start to irritate my skin after 3-4 days to the point where I get welts.  He says to just take Benadryl...I just feel like things have got to be better than this, you know?  I certainly could function better when I was taking oral meds.  Any advice anyone can give?  A little more history on me - I've had bariatric surgery, so that's another little struggle (things affect me more intensely because of the rapid digestion, etc.) I can't have my knee surgery until I get my dental work done (another effect of the bariatric surgery - my teeth have disintegrated)...anyway that's my story...help!!
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Hi kikicheri,

Welcome to the Pain Management Forum. I am so sorry to hear about the difficulties you are having with chronic pain and medications.

Sometimes when we find the right medications to treat our pain it comes with side effects. If those side effects are tolerable that's one thing... when they are not we may have to close between the lessor pain relievers vs better pain control. I think that is where you are now. In this instance I would have a long heart to heart with my PMP. Discuss other options and impress upon him how you feel. He's there to treat you... he's a service provider... he doesn't work for free, you pay him...if he doesn't meet your needs it may be time to look else where.

Regarding the swelling of your lower extremities I apologize that I can't offer much. Keep them elevated as much as possible and wear the compression stockings as ordered. There must be a reason for this edema. Are they relating it to the knee pain and inflammation? Is this a circulatory issue? Will a diuretic help? These are all questions I would ask. I might also consider a second opinion.

At 8 & 10 your children are young... but not so young that they can't understand your condition to some degree.  I'd sit them down and give them as many facts as they can absorb. You may be surprised at how much they understand... and how much assistance they can be. They want you love, acceptance and attention... that doesn't mean you have to play kick ball with them.  

My son was just 11 when I had a MVA that ended my life as I knew it. I believe I was still a great mom. The MVA didn't change my love for my children. My son understood I could no longer help with things like coaching Little League or work with him on his baseball skills. But I could still do the things that truly mattered.  He even learned how to help with his laundry. Don't sell your children short. They are smarter then we sometimes give them credit. They still need to be kids... but they can offer support and understanding.

What we can offer is support and understanding. We are all chronic pain patients and face the challenges of that journey everyday. I hope you'll be active in our community... and keep in touch.

Best of Luck to You.
~Tuck

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