Knee Replacement Surgery – PART TWO

medications

Knee replacement surgery is a huge undertaking.  I have already had an MRI, an x-ay of the knee and an ECG.  I am about eleven days out from the surgery and I just had the prescriptions filled. Anyone who knows me knows I don’t take any medication. Zero. Not even aspirin. For this procedure there are seven medications!

 I was tempted to opt out of a few of them.  I considered not taking the prednisone at all.  But a patient who happens to be an anesthesiologist convinced me that that would be a mistake.  He pointed out that most of the dangers are from prolonged use and that the advantages include not being nauseous…. so, I’m in.  That was all he had to say, as the thought of throwing up makes me, well nauseous. I just cannot do it.  It’s also there to control inflammation and helps with itching.  

I also considered opting out of the recommended antibiotic and using oil of oregano instead.  Given that oil of oregano is more powerful than almost any other antibiotic on earth, and it has none of the negative side effects we see with antibiotics, it’s a no brainer.  (In case you’re wondering, one of the negative side effects of antibiotics is that they destroy the good bacteria in the gut.  Who needs that while they’re recovering?)

But when I did the research, oil of oregano acts like a mild blood thinner, so using it before surgery does not make sense.  I will use it after surgery but will take the recommended antibiotic for the recommended two days and also supplement with probiotics to support my gut.  

I am also passing on the oxycodone except for the first night. I rarely if ever take painkillers.  I even made it through a surgery once with no sedation by using self-hypnosis. For this procedure I plan to use over the counter extra-strength Naproxen although I did promise the doctor that I would take one oxycodone the first night.

Here is a breakdown of over the counter pain relievers and what you can expect:

Acetaminophen

It works on the parts of your brain that receive pain messages. It also controls your body temperature.  It can ease pain and lower a fever, but it won’t reduce any swelling and inflammation so it won’t work post-surgery.

Ibuprofen

This medication is a type of nonsteroidal anti-inflammatory drug (NSAID) that reduces fevers, pain, and inflammation.  That is what I need post-surgically.  They work by lowering the amount of hormone-like substances called prostaglandins, which cause the feeling of pain by irritating your nerve endings.  So if you have less prostaglandin floating around, you feel better.  The only downside is that they increase the risk of stroke and heart attack if you take them long term, which I will definitely not be doing.

Naproxen

This is another NSAID that helps with pain. It works similarly to ibuprofen, and it relieves inflammation and fevers as well.  The risk of stomach problems is the same as with other NSAIDs. The difference is that naproxen may be a safer choice than ibuprofen for people at risk of heart disease according to some studies.

Baby Aspirin

Aspirin has been around for a long time, like 2,000 years. Today it belongs in the NSAID class of meds.

It may be a good choice for treating headaches, toothaches, colds and fever.  It has the added benefit of slowing blood clots and preventing heart attacks.  Research conducted from 1989 to 2004 on the effects of a wide range of doses concluded that baby aspirin which contains 81 milligrams of aspirin is just enough to prevent heart attacks while not enough to cause stomach bleeding.

That said, if you take a daily aspirin, wait at least 30 minutes before taking any other NSAIDs (such as ibuprofen or naproxen), since they can make the aspirin less effective when taken together. If you take another NSAID first, wait 8 hours before taking the aspirin.

A couple of questions I have over and above the extensive instructions I have been given are, since I will not be using the oxycodone, and will use an NSAID instead, do I still take the baby aspirin?  If so, should I take the painkiller first or the baby aspirin?   Based upon my research, it is clear that you do not take them together.


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