TKR Its been 1 year!!

[gooseisland1]

I am three weeks out on my left knee replacement. All is going great, doing my own PT at home. Ice and elevation is keeping the swelling down and I am getting great bend of the knee (approx, 105 ROM).
I am taking (2) aspirin per day:( 2) 500 mg tylenol every 8 hours; (1) 50 mg tramadol every 6 hours.
Also use (1) oxycodone during the night if pain stops sleeping.
I want to start reducing the Tramadol, should I cut the pill in half or extend time to 8 hours?
How are others doing this?

 

[eliza61nyc]

Can I ask why you are trying to reduce your pain medicine?? I think unfortunately because of the horrible opiod addiction currently happening folks are petrified that they will get addicted.

Now if you are no longer experiencing pain then by all means stop taking the tramadol. I am 6 weeks out and find that I still need to take one especially in the morning when I'm stiff and in pain.

Personally I would extend the time before I cut the pill in half. I'm 6 weeks out today and again I still take a tramadol especially before pt and I still take an oxycodone before bed especially if I do a lot of walking.

lol, sorry for the long winded answer.

 

[Sara61]

to BoneSmart. Please read the guidelines, then we're ready for specific questions

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these
the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy
5. At week 4 and after you should follow this
Activity progression for TKRs
6. Access these pages on the website
Oral And Intravenous Pain Medications
Wound Care In Hospital


The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds


We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[Sara61]

I will ask @Jaycey to advise you about tapering off any medication.

 

[Jaycey]

@gooseisland1 Don't be in a rush to taper off just yet. Three weeks out is still very early days.

You can do one of two things to begin reducing the amount of drug you are taking:

1. Begin spreading out the times when you take the drug. If you are currently taking it every 4 hours, for a couple of days make it every 5 hours, then 6 for a few days and so forth until you reduce to one pill a day (usually at bedtime, cuz that's when we seem to need the pain relief most). Then at that point, you can start taking half a pill for a while and then no pill. At that point (no pill), you would take them only periodically when you have pain that over-the-counter medication won't take care of.

2. You can stay on the same schedule (like every 4 hours) and cut back on the amount of the narcotic with each dose. That can be done by asking your doctor for a lower-strength medicine or by cutting pills in half. Only reduce the amount by 1/2 pill at a time if you are staying on the same schedule - not a whole pill. Then when you get to the point that you're taking a half pill at each dose time (that's about as small a dose as you can get), start spreading out the time between doses. This approach works if you need the pain medicine during the day for PT appointments or other activity where over-the-counter meds won't work.

As you're cutting back, expect that you may have to use NSAIDS to fill in the gaps for pain.... Aleve, Advil, Motrin or use Tylenol.

Just be sure you don't try to cut back too fast. You'll feel it if you do and will need to make adjustments accordingly to slow the taper. The whole process can take several weeks, so be patient and make sure you are stable for a day or so at each level before you make another reduction.

Or....you can contact your doctor and ask what schedule THEY prefer you do. But I believe a person will do just as well taking care of this yourself. Only YOU know how you feel at any given time. You want to cut back just enough so the over-the-counter meds work and not so much that you get those flu-like symptoms or have pain.

 

[Cjackso21]

Couldn't open the article above. I tried to quite Tramadol cold turkey once and was sick for a week. So I did lots of research and found the way that most said is to take them at the same time intervals (mine was every 6 hrs) but to decrease the amount by 10% each day. I did that a few years ago by making an exact solution with crushed pills. With this last surgery I just had on 2/7, I used 1/4 pills using a pill splitter I bought from Amazon. I had a little more headaches and aches but it worked fine. I found if I just tried to increase the time, I would get a headache and feel worse. Tramadol is a bit different than other pain relievers in that it has 2 ingredients, an opioid and a serotonin–norepinephrine reuptake inhibitor and both have withdrawal side effects. if you look up the wikipedia on Tramadol it has some good info. Can also google how to taper off of Tramadol. Good luck!

 

[Jaycey]

@Cjackso21 the article content is now in my post above. There really is no right way to taper off meds as everyone is different.

If in doubt check with your surgeon or family doctor.

 

[NewToMe]

@gooseisland1 remember, as you feel better, you WILL do more (or to much). I stopped tramadol during day at 12 weeks, but kept taking it at night because I had to go back to work.

I spaced out time between doses, which worked well for me.

I stopped taking Tylenol regularly around 16 to 20 weeks.

Follow forum guidelines, they WORK and WORK well. Hopefully this isn't your OS pushing you off meds!

 

[gooseisland1]

Thanks for all the suggestions.
At this point my pain is well under control. As my ortho office is reluctant to prescribe narcotic meds after the 4th week I thinks this is a good time to taper my dosage.

 

[gooseisland1]

Just want to give an update. I am now in the middle of week 6, as of today I am not taking any Tramadol. I do continue 3000 Mg of tylenol daily. Add in an occasional Advil and also 1 Advil PM at bedtime. These meds and a bit of icing controls my pain well.
My swelling has pretty much gone away so my ROM is great (not doing PT so I guess 110 deg +).
I can do stairs foot over foot going up, starting to do down the same "carefully".
I have worked hard at icing and doing home PT which has really paid off.
Have been back to work 2 weeks (desk job).

 

[sistersinhim]

What a good update! It sounds like you're doing things just right for your recovery. It's amazing how much ice helps with the pain and swelling. I was addicted to ice for the first couple of months. I'd get up and do something and then immediately ice and elevate afterwards.

Working at a desk can painful, too. Be sure and get up and walk every hour or so.

 

[gooseisland1]

More like taking a walk ever 30 minutes. I am lucky as i have the freedom to do this at my job.

 

[sistersinhim]

Great!

 

[pamsknees]

Way to go Gooseisland1! That’s a great report

 

[gooseisland1]

Thank you all.

 

[gooseisland1]

I just wanted to give an update on my progress. I have now been able to stop all the pain meds.
Ocassionally will do a series of Tylenol when i have over done! I still have some oxi in reserve if I totally over do during the day (grandson and I stacked a cord of fire wood last weekend), needed that night.
I will be eight weeks this Monday, I still seem to improve each day, it is great not to have the pain in the knee. I have a 2 month doctor visit on next wednesday, i am interested in what he has to say.

 

[sistersinhim]

It sounds like you are doing quite well for less than 2 months! Stacking firewood is hard work. No wonder you needed a pain med that night!

 

[gooseisland1]

I have not been on here in quite a while. I am one year out on a left knee replacement. I just want everone to know it was a great improvement, at one year I can do anything I want and at most times I forget that I had a replacement.
I am most certainly looking at doing the other knee and will not hesitate when the time comes.

 

[Jaycey]

@gooseisland1 Great update. So glad that new knee is behaving for you.

I merged your latest post into your recovery thread so that your whole story is in one place. A good read for someone making the decision to have TKR.

 

[pamsknees]

@gooseisland1 - happy knee anniversary! I’m so glad that you’re doing well