Just need some reassurance.

[Kimgrif]

UGH.

I was doing FINE, and still am doing fine, therapy-wise. I'm down to one therapy session per week because my ROM and my extension are coming along just fine. I have therapy on Wednesday, then my PT is suggesting that I come only once very TWO weeks. I'm probably okay with this.

My problem? A week ago yesterday (Saturday, 10/18/09), I *really* overdid it with my knee through a series of events somewhat beyond my control. I knew I overdid it and I knew I was overdoing it at the time, but it couldn't be helped.

I was in quite some pain Saturday night and by Monday was pretty much back to square one. Couldn't bear weight, knee looked like a basketball, etc. Back to the elevating and icing post-op style, rather than the more relaxed elevating and icing I had evolved to since.

The pain has been a deep, achy "bone pain," the likes of which I really haven't felt since about the first 2-3 weeks post-op. The surface pain, of course, came back with a vengeance, as well. I haven't been able to walk without the assistance of a crutch. I'm still getting ROM, still able to do the PT I need to do, but the pain is awful. I'm rationing my painkillers because I *know* my OS will not give me any more, so I only take them at night and only ONE (either Vicodin 5/500 or Percocet 5/325) depending on my pain level. I still take a Percocet before PT sessions, as well. Otherwise, I'm trying to get the pain managed with ibuprofen and Tylenol.

I know I don't have adequate pain relief, but it's six weeks out now and I had to literally FIGHT to get the script of Percocet I have at two weeks out, if you remember right. At six weeks, I should be able to run marathons according to the OS. (Well, not literally, but I should be perfectly healed by now, in his mind.)

This is really messing with my head. Today, 8 days after overdoing it, I was finally able to walk again without the crutch. Still limping, but not the horrid limp that is so hard on the non-surgical leg.

The one thing I cannot get out of my head is that I'm worried about an infection in there. I was being treated for a UTI (that I didn't even knew I had) pre-surgery, but only had 2.5 days of antibiotics pre-surgery. I was instructed to bring the antibiotics to the hospital but the staff ignored them. Could that UTI still be going (I have no symptoms, but never had any to begin with) and that may be wreaking havoc with my knee? Could THAT be causing this pain, perhaps, and then the overuse a week ago exacerbated it?

I know, I really should call the OS, but I just feel I'm going to be brushed off as "narcotic-seeking," which of course, I am not. I already take so many pills I should rattle when I walk and would LOVE to get rid of a few pill bottles!

I think this is all just messing with my head too much.

 

[kimberlyann]

Oh honey, your post is dripping with stress. I am so sorry. First of all, I hate it that you are tempering your feelings of what is going on with your desire not be be viewed as "narcotic seeking". Try, if you can, to put that frame of reference out of your mind. Your knee is swollen and hurting, and you need relief.
Calling your OS is the correct thing to do. I imagine they will want to examine you , and at that time you should say that you need some help with pain relief. Be very honest about what you have been taking, and what you feel you need.

If you cannot get the help you need from the OS, go see a general doctor. Say," I had a knee replacement "x" weeks ago, I have hurt my knee and I cannot function. My OS sees no problem with my knee upon examination, so I need you to help me with a plan of action including pain management."

Please do not feel guilty. You have done nothing wrong at all. Your stress and emotions over dealing with your surgeon's office are awful. Please just take the necessary steps and try to separate your worries from them.

We are here for you, and cannot stand the thought of your pain.

Best wishes for a speedy recovery. Kimberly

 

[Jamie]

Kim, I would say it is unlikely that you have done anything that would hurt your new knee joint. Since you have had problems with your surgeon, I recommend going directly to your family doctor immediately. You need pain relief and you need it now. He can also give you a test for the UTI and see where that is. If nothing else, it will relieve your mind to know that the infection is gone. And if it does remain, it can be treated.

I am pretty sure that the pain you are experiencing is related to whatever it is you did so early in your recovery. (It must be pretty extensive activity, cuz you didn't say WHAT it was!!) You are still VERY new with this knee. Even though your PT says you're doing just fine (and you are), you still must take things easy for a while or you're gonna get pain and swelling. That can take months to subside.

So get on the phone first thing Monday and get yourself an appointment with your primary doc. You'll feel better doing that than just trying to nurse yourself with a few pain meds while you worry about infection.

In the meantime today, put that knee up, ice and elevate. And take some type of pain medication regularly. No activity, okay!! You need to get on top of the pain and swelling.

Please let us know how you get along. We want you back on the road to recovery!!

 

[JudyS]

I agree with everyone. call your primary care doc. I went to see mine for blood pressure issue after having spine surgery. i was in horrible pain. He automatically gave me a prescription for pain meds. he called my spine doc with me present and asked him what the hell he did to me. Joking of course. My spine doc told him he had already given me pain meds. My primary said, well not enough so i'm giving her some too.

You don't need to be worrying about pain relief. you are still so early in recovery from major surgery. Call tomorrow first thing
judy

 

[Josephine]

Badly managed pain can start running wild so if you've overdone it and have some issues with that, not being able to get on top of it right away often means the pain roller-coasters and gets so much worse.

If you don't want to approach your OS for more pain meds, then see your primary care doctor and if he won't help, go to a pain clinic. Most pain meds only work for about 4-6 hrs and then are out of the system so taking them once a day is ineffective. Then once the pain peaks the next dose takes so much longer to work by which time the pain has become too great for it to work. Like this

 

[Kimgrif]

Thanks, everyone. I think I'm just in a funk. The pain was getting so much better until last Saturday and then the slide backwards has been hard to swallow. I just didn't expect it to take quite so long to overcome it.

No great secret as to HOW I overdid it, just...stupidity, I guess. My widowed mother has a 4mo puppy which is her LIFE. The puppy got sick, mom went into a tizzy, and I drove she and the puppy to the vet. In my concern for my mother, I forgot to bring my crutch with me (which I wasn't really using at that point, but had it with me at her house at my husband's insistence, "just in case"). I was also driving my sister's vehicle, so didn't have my handicapped placard with me. So, LOTS of walking, much more than I am used to, and without a crutch which I should have had under those circumstances.

I did have a better night last night, and today seem to be feeling a bit better. I still have that deep ache though and that is what concerns me. The deep ache has been gone (until last week) and now it's back. The swelling has been quite intense this week, as well, which also had been going down VERY well (until last week).

I can go up/down stairs using reciprocal motion (but I must hold onto railings). The quad strength is there now. It's just that deep, deep ache.

I'll call the OS office tomorrow and voice my concerns. I'll ask for a refill of Vicodin for at night, but I highly doubt I'll get it. *sigh*

(Editing to add, the puppy is just fine. )

 

[Jamie]

Kim, do you have a family doctor? If so, just skip the surgeon if you think you'll get grief about the pain meds. GP's for some reason are MUCH more understanding about the need for pain meds when you are in recovery.

 

[Motherofmany]

Hi Kim,

In reading your posts, you and I could be twins. 2 weeks prior to my LTKR, I developed a UTI (maybe from the pool or hot tub?). I finished my 7 days of antibiotic 6 days before surgery. In the hospital, I had the folley/catheter and ran a fever of 102 for the first two days, then a low grade the rest of the week. They gave me heavy antibiotics in the hospital. Spoke with my OS about the possible concern of the continued UTI and had the home health nurse do a urine sample. When I went to the OS for him to fix the area that popped open after the staple removal the next week , I asked about the results. He being cautious, said there was trace elements of bacteria, so back to another round of antibiotics. Cleared it up. Don't forget to eat yogurt to avoid a yeast infection.

Now about the overdoing it. I'm the poster child for that one. I too am experiencing the pain and swelling from that. My OS has me on .5 of percoset. I'm about a week ahead of you. I take the .5 plus 1 aleve for inflamation 3 times a day (about every 8 hours) and sometimes 4 times a day when the pain is bad or I have pt/workout.

My GP and his nurse have been my doctor for about 20 years, and we have a very good relationship. He knows me very well and all I have to do is call Nurse Deanne and she talks with him. When I originally had the UTI, they saw me the same day within an hour. All you have to do is schedule a lab visit. If there is any bacteria, your GP should see you and write out a prescription. Usually they can work you in right away.

Also when my OS was unavailable, my GP- Dr. Lewis gave me a refill on my pain meds. No problem, no questions asked. They know this is a serious surgery and pain management is a key to good recovery. Your OS has issues as I've stated before. Skip him and go see your GP. You aren't seeking drugs, you are needing real relief to heal properly!

As for that deep pain, I find that wet heat helps relieve that. I alternate ice with my rice bag heated in the microwave to get it under control. Also keep up the gentle stretches on your down days. It seems the earlier we are, the longer it takes to overcome the overdo days. I keep a crutch in the trunk of my car, 1 in the van and my cane next to my bed for those days I need a little extra help. No shame, just security and wisdom. This was a huge surgery and from my experience with the first RTKR, I have learned to be cautious and not prideful. When I need the assistance in walking, I use them. Also you can get a second Handicap Placard for $5 from the license plate office. This second round I purchased two and keep one in the car I drive daily and the van for transporting the children. That switching back and forth realy stunk especially when I forgot to switch it. I know you used someone else's car, but maybe keep the spare in your purse?

Hang in there and don't despair! Feel free to pm me and we can discuss this further. Will check later tonight and see if you need encouragement or anything else. Hope your feeling better and are mobile soon without all that pain and swelling.

Blessings,

 

[Kimgrif]

Okay, have an appointment tomorrow (Tuesday) to get xrays, etc. to find out what's going on (if anything) with this knee. I have already been warned that I will not be receiving any more painkillers. *sigh*

 

[kimberlyann]

I am glad you have an appointment, but in my humble opinion, I think telling you before even seeing what is going on with you, that you will not be receiving any pain meds is crazy!
That is not really patient care, that is covering his own behind and you are suffering for it. Let him determine that there is nothing wrong with your leg causing you pain, but get yourself to another doctor who will give you some pain management.
Good grief. Can you imagine someone calling for an appointment for a sore throat and being told before they were examined that they would not be receiving any antibiotics even if it were strep throat? Outrageous.

I do not want to upset you further, I just want you to get some relief. I pray that your leg is not hurt, and that you feel better very soon.

Take care, Kimberly

 

[Jamie]

I agree completely. You may find out there is nothing wrong with the knee, but it's the pain relief that you REALLY need. Is there some reason you don't want to go to your primary physician? You should have an appoint with him/her already scheduled, given the fact that you know your surgeon will not authorize additional pain meds.

But...when you do go to the surgeon, firmly ask WHY he will not prescribe more pain medication when you are hurting so badly. Make him tell you. And if it doesn't make sense, ask more questions. This is crazy for you to be this early in recovery, hurting, and not getting help.

 

[BigRed]

The advice others are giving you is good. My OS gave me a pain med that did not work. It was not as strong as what I was prescribed by the hospital and he would not renew what they gave me that worked. I saw my primary physician and explained the problem. He prescribed the med that worked and he called my OS to tell him this. My OS never said a word to me about it in any future visit but I had the pain relief I needed.

It is not unusual to need pain meds six, eight, or even ten weeks after surgery. I don't understand surgeons. They seem to think that we all follow the same timetable of recovery - but we don't. Talk to a doctor who will listen and you will get the help you need.

 

[Josephine]

It's not unusual to need pain meds 3-4 months after surgery, never mind weeks! I had enough prescribed to last me for the rest of the year!

 

[Kimgrif]

Well, nothing is physically wrong with my knee, he thinks it's just "soft tissue pain." He also said that I shouldn't have needed narcotics after about 3 weeks and he flatly refused to give me anything else. He basically said, "Grin and bear it, it'll get better soon, I'm certain."

I have three tablets of Vicodin left, and 19 tablets of Percocet left. He told me he didn't want me taking ANY more narcotics. I shall now be going "against medical advice" because I do plan to take them. If, when I get close to running out and I am still having this level of pain, I will make an appointment with my GP.

My OS did tell me to "tone it down" a little bit with my daily activity. Um...let's see. I type for a living, so I sit at my computer pretty much all day (knee up, knee down, knee up, knee down). I have to climb 7 steps to get to the restroom, so there's a trip or two to the restroom in a day. I then go to bed.

He also told me that I probably didn't need to go back to PT anymore either, he was perfectly satisfied with my ROM and extension. I'll go tomorrow and see what my therapist has to say about that.

So, nothing is resolved, but nothing is physically wrong either. I guess I can be reassured by that. *sigh*

 

[Josephine]

Well good for you that you're seeing your GP. Those surgeons who say grin and bear it should have the op. I bet they'd be swallowing pills like Smarties!

 

[Kimgrif]

Oh yes, I forgot the best part of today's visit! The skin sensitivity I have (that most of us have) is so painful in and of itself and I told the OS about that too. How the skin feels burned, how I can't stand anything touching my knee (like my pants or the bed sheets), how the incision feels at times like it's gonna split wide open...

His advice? Sit down now, and swallow anything you may have in your mouth before you read any further...



I'm to use a brush on the scar to desensitize it. :shk:

Yeah. Not happening, baby. I'm usually a very compliant patient and will do what the doctor wants me to do or die trying, but I'm SO done with this surgeon and his "advice" and his wonderful, caring, helpful manner.

Bitter? Yup.

 

[Linda2]

I'm so sorry he's such a jerk. I am two months further along than you and I still need my narcotic pain relievers, usually once a day in the evening. He does have a point about desensitizing your incision area. Start with a dry washcloth and gently rub it over the area. Over time it will help.

 

[mtngal67]

Kim,
Your Doc sounds a lot like mine... great surgeon, terrible bedside manner as a Dr.

I sure hope your pain issues settle down soon!
Gale

 

[Pat29627]

Oh, Brother! I can't believe your surgeon! When I quit hydrocodone at 7 weeks, I was in pain that no over the counter drug could help. I got Tramadol (Ultram) prescribed by my OS with no problem probably at 9 weeks.

On the scar, it's too early to be doing stuff to it I'd think. Just gently rub vitamin E or coconut or olive oil into it (something pure without petroleum products). It will get better as time goes on.

 

[tom67]

Hi Kim, Yep sounds like My OS! I fall down the stairs,..........what? maybe 3
weeks post-op, HIS office tells me to come In and when I show up he looks
at me LIKE, What are you doing here?? and after an x-ray I'm shuffled BACK to
the exam Room, he didn't even say Goodbye, OR Tell me I could LEAVE! He left my
PT orders at the desk and he never completed the VISIT!! I sat In the exam room,waiting for him to come back!! I might of stayed till they shut the lights off!!! LOL!!!! Some of
these guys!! (BEDSIDE MANNER??? I HEAR YA'):sct:(sorry I rambled)