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Bilateral TKR 1 year check-in

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Honey, what part of Ice And Elevate All Day until swelling goes down did you not understand? You may be up for a few minutes at a time as needed to get a snack or use the facilities. No cooking, no cleaning, no business as usual until you heal. The world will not end. Your knees will get better. You can't rush this. As of today I have the best ROM on the planet for four weeks out and I am STILL icing and elevating more hours than not. Lots more.

If you don't meet those arbitrary numbers by an arbitrary date, So What???? The Knee Police aren't going to haul you away! Too much activity Too Soon =Sore, Swollen, STIFF knees.
 
I think you're doing fine. You will continue to gain as the swelling goes down. In fact once it does you may jump up quite a bit. I did--and it wasn't from going crazy with PT.
 
6.5 weeks post Btkr and doing alright. My rom is 127/2 (l) and 112/1 (r). I still rest quite a bit and had a huge setback this week when I caught a bug. I have decreased pain meds 5 mg er of opana twice daily to 0 of extended release and take 5 mg opana immediate release as needed. I unable to take any ibuprofen due to gastric ulcers. The medicine (opana) is very hard to find around here so I have to go to the hospital to get it. I have also requested a refill with my is who still has yet to call me back. I have been trying to lay off the need for scheduled meds (I am plagued by family history of abuse-but I have never experienced myself) as I don't seem to have pain during the day. But I woke up at 3 am with pain and couldn't fall back asleep. I took an opana and now I am feeling much better. Im wondering should I still be on some schedule. How do I determine what is right for me?

I am a restless sleeper and do not get any real rest at night. I worry about taking too much medicine but I really don't think I am ready to give it up at only 6.5 weeks. I did try tramadol and it doesn't seem to do anything for me. Any guidance?

Tomorrow I go back to PT after a 5 day hiatus. I hope that I haven't gone backward as I didn't do anything at all while I was sick. The process is slow and I feeling restless lately. I am happy to be this far out as I still have dreams about being in the hospital.

Thanks hope you are all well.




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Tylenol! Two 500mg tabs every six hours, not to exceed 4000mg in 24 hours, make sure that total includes any acetaminophen from any other source, since cold medicines etc. often include it.

The problems you are having with pain right now trump the family history in my opinion. I'd suggest if you still have the tramadol to try it with the Tylenol. I bet it will help. Tylenol makes opiates more effective.
 
Your ROM is great for 6.5 weeks out. Great job!!! I'm sorry though that you've felt such pressure to get to a certain number by a certain date - but regardless, it looks like you made it there! Tramadol seems to work for me, although I would like to get off of it at some point. I don't much pain relief with Tylenol, but it seems to help others. I agree about trying the Tramadol with Tylenol and see how that helps. Honestly, I think 6.5 is early to get off some type of pain meds though if you still need them. I know with your family history you are worried about staying on them too long, but it's still very early in your recovery - and your body needs pain relief to heal. Wishing you the best - keep up the great work!!
 
@Jamie or @Josephine any insights on meds? I feel so uncomfortable at night but the clinic seems dead set on the fact this is a part of the healing process. Also that I may be withdrawing from the opiates hence the uncomfortable feeling. Today on tramadol I don't feel a difference but I sure do feel the stiffness and swelling today. Ugh very discouraging.


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@Shmi47 I'm sorry that you are so uncomfortable at night. That's too bad that they feel you don't need any pain meds anymore so early on. At almost 12 weeks, I still take one hydrocodone many nights. Hope that you can get this worked out so you can be more comfortable.
 
Yes, a lot of us were taking a pain med at least at night for at least 6-8 weeks.
 
Has anyone experienced these as you are coming off your narcotics? I was on 15mg hydromorphone extended releases and 10-15 hydromorphone immediate release. I tapered down off the extended but still taking 10 mg per day for breakthrough. Mostly at night for restlessness. Now coming off I had one and then they wanted me to switch to norco, but only took once yesterday. I am not having pain as much as I am restless, flu like symptoms and just miserable. In convinced I am not sick?
Now when I have pain in my knees I don't want to take it if it comes to this. Anyone?


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It is possible to taper down all narcotics --but I found that I began to "forget to take" my meds when I no longer needed them. A few folks do not feel well when they stop the narcotics abruptly and they taper down. a few days of a tablet, then perhaps 1/2 a tablet, then 1/4 a tablet. Do whatever works best for you.

It is better to take care of your pain since healing happens earlier when you leg is not in pain. Norco is a "step down " drug--it is not as strong as the hydromorphone. Perhaps if you took the Norco as prescribed it would help. I will tag Jo, our forum nurse to give you advice as well. @Josephine
 
@Shmi47 ,
Tapering down has to happen slowly as you heal, most of us are on pain medication for 3 - 4 months. We do not try to taper, we just forget to take our pain meds because we do not need them. You are not even 2 months out and still need your pain medications. Take them as prescribed, only miss them if you forget, you will feel better and heal better that way.
 
I'm so sorry that I somehow missed your tag! I agree that it's way too soon with a BTKR to try and cut back on pain medications. You have pain. You have swelling. These need to be addressed and managed. That requires medication on a set schedule.

So, please tell me exactly what you're taking for your pain....the med, the strength and the dose at what times during the day and night. Then tell me when and for how long you are icing and elevating.

Are you staying away from working or those household chores and errands?

The Tramadol with Acetaminophen (Tylenol) is a good combination, but I'm not sure you're at that "step down" point quite yet. Let's get your pain managed for a day or two and then go from there.
 
You may notice that I have merged your two recovery threads. We like to keep our members' recovery posts all in a single thread. That way it's easy for us to go back and read your history before responding to a question or concern. In addition, the thread becomes a journal of your recovery for those who come along later and want to read about you. So, please post in this thread from now on when you want to give an update or ask a question. If you decide you'd like a different thread title at any point, you can change it by using the Thread Tools button at the top right of your screen or just post what you want here and we'll get it changed for you.
 
I had back to back knee replacements 2 mos apart so was still on narcotics going into the second knee surgery. The third month after my second surgery I was beginning to find less need for full dosages. Even with this natural reduction, I had what I found out from my pt was withdrawal from the narcotics. I had chills then sweats and was not my normal self mentally. My pt assured me that most people are feeling better in a week to 10 days after getting off the narcotic and this was the case for me. My pt also mentioned that anesthetic can cause mental acuity symptoms for months after surgery as it takes the body a long time to process the drugs that are used in general anesthetic . I had generals for each of my surgeries so got a double dose. Hope this helps in finding answers for your situation.
God bless you.



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@Jamie I was taking opana 15mg extended release twice daily and 5 mg opana 3 x as needed up until 1.5 weeks ago. They stepped me down the ER and stayed with IR. I took last 5 mg IR last Thursday. Friday they out me on tramadol. It did nothing so they prescribed norco 5/325 1-2 2x per day. I didn't think I was having pain )just swelling/stiff so I took 1 yesterday. Meanwhile in have had diarrhea since last week and I feel like I am crawling out of my skin. Restless leg at night and even now.

I elevate as much as I can whenever I sit and definitely while laying down.
Ice has been at least 2x day. But today nothing bc I can't tolerate it. (The cold) now I am so upset.

Just spoke with OS nurse and she told me to continue with norco as prescribed. Not to stop. That at 7 weeks to early to stop medications.
My PT today was really rough and I was so stiff when he was helping with heel slides. He just let me rest.

Wow I just feel like crying.




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Btw. I have been picking up stuff around the house. Also tending to kids making dinner (while sitting down). I have a hard time sitting longer than 10 minutes at dinner table so then I go lay down. I sweep my kitchen occasionally.


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The normal dosage for this strength of Norco is as I mentioned: 1-2 tablets every 4-6 hours. So your doctor has only given you half of that. So it may not be adequate to manage your pain. But I suggest you take the maximum prescribed pain dosage you can right now on a set schedule. Since you are only allowed 4 pills in 24 hours, spread them out and take 1 every 6 hours. Wake yourself up at night if need be to get the dose in. The meds only last about 4 hours, so you need to be on the clock with them. Let's see how you feel tomorrow. Try to keep those home chores to the bare minimum. If you can, ice your knees as much as possible.
 
Thanks @Jamie. Thankful you're here.


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You can supplement small doses of prescription meds with Tylenol 1,000mg 3-4 times a day. It's a good way to transition from prescription to otc stuff. Here's a good method of Weaning off pain medication.
 
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