Work out - An honest discussion of a slippery show

by Nancy Leasman of Long Prairie

It was a slippery slope. No, not the ice out on the road nor in the woods. It was inside... me. The slippery slope of pain killer dependence.

Everyone who has joint replacement surgery is familiar with the need for pain control. Research has shown that healing occurs more quickly when pain is managed properly. To that end, there are dosage limitations, spacing of doses, and term limits.

Fearing any potential dependence on my prescribed medication after my knee replacement, I tried to cut back right away, to find the lowest effective dose, to switch to a non-narcotic medication. Being aware didn’t change anything. I always took the prescribed dose but found myself metaphorically (though not literally) pacing the floor for hours, waiting for the next dose to control the pain in my knee. Once a nurse, always a nurse, so I charted each medication dose.

I was aware of a gentle euphoria when I took the pills. Then dreaming; then sleep. Yes, the dreaming came before the sleep. The sleep was deep; for two to four hours. Then I was awake and waiting for the next dose. I spent hours of sleepless nights watching dance videos on my phone. Sometimes they put me back to sleep, but usually I ended up doom scrolling, even if it was for more dance videos. I also did some rather brilliant free-hand late-night dish towel embroidery.

I renewed the prescription twice after talking with my health care provider. She said it was okay, they could taper me down to lower dose opioids.

On day 18 after my surgery, I hadn’t taken pain medication for 12 hours. The pain wasn’t bad. But I couldn’t sleep. Couldn’t go to sleep or stay asleep if I managed to doze off. That’s when it hit me: was this rebound insomnia from not having the pain pills?

I did an online search and found that concern for dependence rises after seven to 10 days of regular use. I was beyond that and my current prescription was running out. I called my healthcare provider and received a prescription for a lower strength medication.

But two things bothered me, beside not being able to sleep. I’d seen a report on opioid dependence in which a family member talked about their mother, a successful professional, who after a surgical procedure had become addicted and died of an overdose. The other thought was that if I tapered off the pain medications, I would likely be taking them for several more days/weeks while dealing with the insomnia and the intestinal side effects.

That 12-hour window in which I hadn’t taken any pain medication was open and I opted to jump through it.

I was still awake at 3 a.m. the next morning. Luckily, no one was depending on me for anything. I had the luxury of recuperation on my terms. Eventually sleep would return. Pain would lessen. Life would resume its normal pace. And there was plain old Tylenol, though I was careful to not take more than my liver could tolerate.

Six weeks out my knee is stiff but it doesn’t cause much pain. I still have trouble sleeping at times, but after I was able to change my sleep positions from just on my back to front and sides, that was better, too. Over-the-counter medications, ice packs, and elevation help on achy days.

I feel fortunate to have recognized the bullet of potential addiction and dodged it. And I am back to managing just the slippery slopes of snowy December in Minnesota (though not in the woods, yet).