Post-surgical pain is oftentimes the worst part of a procedure for patients and can lead them to taking strong, potentially addictive painkillers for relief. Now, a single-dose injection given during surgery can take the pain away in the most critical recovery days.
Marilyn Martine of Reeves has been a school bus driver in Allen Parish for 30 years. When the arthritis in her knees became unbearable, she knew she had to do something for herself and her job. "I hurt so bad that they could cut the knee off completely," she said, "and it wouldn't have bothered me any. It would've felt better."
Dr. Nathan Cohen is an orthopaedic surgeon with Orthopaedic Specialists. Marilyn was referred to him after living with the pain in her knees for three years. He immediately ordered a CT scan of Marilyn's leg, then a custom block was made for each knee to replace the worn-out parts with something strong and new. "You pin it in place with two pins in the top, two pins in the bottom and a slot allows us to go ahead and simply remove the arthritis off the femur bone in a very accurate fashion," said Dr. Cohen.
It typically takes several weeks, even months, to bounce back after a knee replacement. But a single dose pain medication called Exparel reduces that time by controlling pain immediately post-op. "It allows the medication to actually be absorbed into the tissues around the knee and it gradually allows the pain to come on over three to four days, as opposed to right after the operation," said Dr. Cohen.
The local analgesic is bupivacaine and studies on the drug show that the pain relief can last as long as 96 hours. "The key is basically to get the pain under control to allow quick rehab and home," said Dr. Cohen. "They're not sick people when they come in with a bad knee or bad hip, they need to get out of the hospital as quickly as possible and get back into their own environment."
It has only been ten days since Marilyn had her second total knee replacement. She says there is some stiffness, but no pain. "For pain, zero. It's a zero. Before it was at least a ten. It was really bad before," she said.
The pain relief is something Marilyn has not felt for nearly four years and it is bringing freedom she is once again ready to enjoy. "I can take off and do the things I did before, just with a little determination," she said.
Patients are still prescribed prescription pain killers, but not as many. Oftentimes, over-the-counter medications like Tylenol or Aleve are sufficient.