Medications

Pain management is the first protocol that actually matters. This page tracks what I take, in what order, and how I step down off it.

The hardest rule first: no NSAIDs

All NSAIDs (ibuprofen, Advil) stop seven days before surgery and stay out through the first eight weeks: bleeding risk and slower bone healing. Last time I caved for one emergency week; this time I’m toughing it out. The full eulogy’s in the journal.

OxyContin first, then oxycodone

The opioid plan runs in two stages, and they’re the same drug wearing different clothes. OxyContin is the extended-release formulation: one dose holds for about 12 hours, so it lays down a steady baseline through the worst of the 96-hour rebound window. Oxycodone is the immediate-release version of that exact same molecule: it hits faster but only lasts about 4 hours, making it the as-needed tool for pain spikes once the round-the-clock need eases. Start on the -contin, step down to the -codone. The why is in the journal.

Hydroxyzine: the Doublemint gum drug

Double your pleasure, double your fun: hydroxyzine is one drug with two jobs. Taken with the opioids, it “gives it a boost” (my doctor’s words), tuning the pain relief to 11 without adding more opioid. Taken alone, it works like prescription-strength Benadryl, which matters when the post-surgical itchfest kicks in a week or so after surgery and the incisions, the wraps, and the leg itself all start screaming at once. If your surgeon offers it, take the script. The itchfest is in the journal.