Lithium and NSAIDS

[gizmo]

I have a question, one that I admit I'm a bit freaked out about. I'm having knee surgery on 12/14, and having had two knee surgeries (one the same knee) before, I know there is massive swelling involved. I also know that the faster you get the swelling down, the less pain you feel, and the faster you heal. And the easier PT goes.

I have an ice machine that circulates cool water around my knee to help with the swelling, but I know I will need to be on NSAIDs, lots of them. And I take lithium.

I've taken NSAIDs before with lithium, but the circumstances were a lot different, with both the lith and the NSAID. What am I going to need to do? Cut the lith dose down way far? Get off of it (scary thought, scary thought) while I heal? Something else?

I didn't ask my ortho about the lith because I was stupid and stressed out, and now I go see my pdoc, and I'm gonna ask him - but he's leaving the practice and I have to see a new pdoc, so I don't know how much weight his word will hold. I have a pre-op appointment on 12/1, but it will be with the nurse, and not the ortho. I can ask about what meds to stop taking, and I know they can tell me what meds I will be given post surgery, but I doubt they will be knowledgeable on lithium-NSAID interaction.

[Silver]

Actually, I believe the thinking now re: ligamentous injury/repair and NSAIDs may be shifting. So talk to ortho.

You'll be getting a lithium level pre-op, and you'll be probably getting one post op.

[eta: striking the range by which NSAIDs increase serum lithium. It varies too much by drug and person.]

So discuss with psychiatrist, discuss with ortho, and ask if ortho can check into it. Not that big a deal.