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total knee replacement

Posted: Sun Oct 28, 2018 1:14 pm
by jul2873
I am scheduled for a total knee replacement this January. I am wondering if anyone else has had one, and if so how you managed your rls symptoms while waiting for the knee to heal. Currently I am controlling my rls with kratom, but I usually have to walk at least a few minutes after taking it for it to work. My primary care is wonderful, and knows about my kratom use and is fine with it. She is not allowed to prescribe opioids. She said that only pain clinics can in her practice.

So: I'm thinking I'll probably get an opioid prescription for a few days after the surgery. Perhaps my PC could explain the situation to the orthopedist, who might give me a few more days of opioids. I've never taken a DA. Would it work to take a low dose of a DA and then go back to kratom as soon as I can get get around. My ferritin levels have always been high, around 100. When it looked like kratom would be made a schedule 1 drug I tried Gabapentin, but it didn't work for me.

Any advice welcome! Thanks so much.

Re: total knee replacement

Posted: Sun Oct 28, 2018 2:54 pm
by stjohnh
I had shoulder surgery a couple of years ago, before the hysteria of opiods kicked in. They gave me plenty of oxycodone so I didn't have a problem. Of course the shoulder problem didn't keep me from walking, but my RLS was wonderfully controlled for a few weeks.

I now take pramipexole (Mirapex) 0.0625mg (1/2 of a 0.125mg tablet) along with my kratom, THC, gabapentin and dipyridamole. It is remarkable how much a tiny dose of dopamine agonist (pramipexole) works when used in combination with other RLS meds. I'd suggest adding that to your regular kratom dose. There is a good chance it will solve the problem until you can walk again.

Re: total knee replacement

Posted: Sun Oct 28, 2018 6:10 pm
by debbluebird
I had both knees done, 3 weeks apart. They should give you oxycodone that should last a week, then wean down the next week. It should help your RLS at least the first week. I don't remember when I was allowed to ride my recumbent bike. The bike helps me. At first they do give you exercises to do. You will have a walker too at first.
At the time my RLS was out of control because I had augmented with Meripex.
I agree with Holland's suggestions.
Just make sure you do all the exercises so you will get your range of motion back by 6 to 8 weeks.

Re: total knee replacement

Posted: Sun Oct 28, 2018 8:37 pm
by jul2873
Thanks so much, debbluebird and Holland, for your sensible advice. I hadn't really thought of combining kratom with a small dose of a DA, but will recommend it to my PC and I'm sure she will prescribe the DA--so a half a tablet of a .125 Mirapex tablet? And since you managed to get both knees done after augmenting with Mirapex, debbluebird--wow. I feel confident now that I can manage one knee.

I feel really lucky that I've never been on a DA long enough to augment. I went to a sleep specialist neurologist who said he specialized in RLS when mine first started to get bad about eight years ago. He prescribed the neupro patch, but by then I was reading these boards. I asked him about augmentation but he scornfully told me not to read the internet. Thanks heavens I didn't listen to him, but to everyone on here instead. I tried kratom thinking that I had no good options but this seemed like the least bad option, which it has turned out to be for me. So a late, big thank you to everyone.

Re: total knee replacement

Posted: Mon Oct 29, 2018 5:14 pm
by debbluebird
I take my DA every few days. Not daily. I do not want to augment again. Mirapex half tab .125 mg. It seems that's all I need.

Re: total knee replacement

Posted: Sat Nov 10, 2018 5:43 am
by badnights
jul, you probably have already, but check out the three Surgery brochures in the Members section of the Foundation website: Surgery and RLS for the Patient, Hospitalization Checklist for the Patient with RLS, and Surgery and RLS. I found them useful, especially the advice to make sure every member of the surgical team knew about my WED/RLS and the drug triggers for it.