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Gloria

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I had TKR (right knee) December 15, 2008 with no known surgical complications. I came home rather than going to rehab on the surgeon's advice. Three weeks after the surgery I started PT. Three sessions per week for three weeks. I still had serious pain and saw the surgeon again. He said that I had 'nerve inflamation' which he said he has only seen once in the last 5 years (!!??). He sent me home with prescriptions and prescribed more PT. Three weeks later the only change was even more pain. The pain is up and down my leg. I recently saw him again after the PT and he is 'perplexed'. He suggested that the pain may be due to 'overdoing' the PT or that it is 'non specific' and that I am still 'a babe in the woods'. More but less intense PT was suggested.

I have followed every bit of advice and been true to the program. I am discouraged.

Can anyone compare their experience(s) to mine ??? I really need some unbiased opinions and advice. Thanks very much.
 
So glad you found the forum, Gloria....welcome! Our forum nurse, Josephine, should check in soon and hopefully can provide a medical opinion for you. She has a vast amount of experience in orthopedics!

In my definitely un-medical opinion....if your primary surgeon is "perplexed" and can not offer anything but a wait and see diagnosis, I would find a second (or even third) opinion as fast as possible....someone totally independent of your surgeon.

You don't mention what pain meds you are on....what are you taking?
 
Just finished my second round of prednisone. One round after each doctor visit. Continue to take hydrocodone. One tab every 4-6 hours for pain.
 
Gloria Welcome
I am a hippy so can't help with your knee issues.
But, you do need better pain control. It seems your doc acknowledges your pain, why does he not help you with it?
How many milligrams is your dose of pain meds?
I think it will be asked if you are icing and elevating . It still is early in recovery for you too.
judy
 
I think that means 7.5 hydrocodone and 750 of Tylenol if memory serves correct. However, I stand to be corrected on that.

Sounds to me like it would do you good to see a chiropractor as what you have described is sciatica. A chiro would certainly help to adjust what it is that's causing the symptoms. PT is all well and good but has to be the right kind.

Jamie is right - 2nd and 3rd opinions seem called for as his comments seem to be all over the place! and it's not at all uncommon to have sciatica for several reasons which could include
~ complications from the spinal
~ altered gait and/or weightbearing having had joint deformities corrected by the replacement
~ poor use of crutches or cane
~ bad sitting/lying after the op
~ inappropriate PT
~ a combination of any/all of the above!

Plus, you seem to imply your surgeon has prescribed prednisone for the nerve pain which I find very puzzling. Is there any other reason you are taking it?
 
My new PT regimen is a heating pad for 15 minutes and then a machine for 1/2 hour that delivers a med right into my leg (name ??). After one session I feel significant improvement. Second treatment today. I will ID the med being used.
 
Welcome Gloria! Hope you are now on the right track with your recovery! :)
Good luck!
 
Hi Gloria. I sorry that I don't have any advice for you but I certainly can compare experiences. I too have had complications related to nerve pain, My TKR was on Jan.5 and shortly after I began to have lower back and sciatic pain. I also feel pain which I originally thought was in the bladder but now I just feel a weird feeling of discomfort in that general area. We're not sure whether it's due to the spinal anesthetic or the sciatic block or, as my surgeon thinks, that it's just coincidence that I developed a disc problem that occurred at the same time.

I've been on Ketorolac for inflammation but by the evening nothing helps much. I'm having a CT scan on March 17 to check out the disc issue.

The pain is in my lower back and goes over to my hip and then down my leg. I think everyone is just hoping that it will go away on its own. Meanwhile I'm worried about permanent nerve damage. At this point I would trade back my pre-surgery knee pain to get rid of this awful feeling.

I started PT the week after surgery, twice a week for two hours a session and did all my home exercises. I have a good flex but haven't achieved 0 extension yet because the straightening exercises are too painful for the sciatic nerve. I'm now working at the gym on the stationary bike, elliptical and some of the machines but my sciatic pain is no better and I actually am feeling it more the last few days and am wondering whether I'm overdoing the exercise.

My GP thinks it's nerve inflammation from the spinal anesthetic, as do the doctors in the emergency that my PT advised me to see. I'm seeing my surgeon again tomorrow.

I too, have followed everything I was supposed to do and my hope is that, although I feel like it's been a long time, perhaps it still is quite early and will resolve itself in time.

I'm so sorry to hear that you too are suffering from this complication. We certainly have enough to cope with to deal with the knee alone.

Mag
 
As bad as ever. Couln't do the PT today. Almost addicted to the pain pills. Seeing the surgeon again tomorrow. He now proposes back x-rays.
 
Oh Gloria,,,,,,so sorry to hear that you're still in pain! Hope the doctor gets it all figured out for you!
Keep us posted! Good luck!
 
Gloria and Maggy
Good luck with gettin rid of that back pain. I know how miserble it can be. Let us know what is happening
Judy
 
Gloria, what makes you think you are 'addicted' to the pain pills? How do you know?
 
Addicted is probably an overstatement. But I am finding that I can barely get by without taking them regularly.

My question would be are you taking them regularly because of pain or because you just "need" them. If you're still in pain (and that's entirely possible as you're not THAT far along in recovery), it seems to me you're doing the right thing. If you just feel kind of sick but no pain when you don't take them, then it may be time to start reducing the amount you take slowly.
 
Addicted is probably an overstatement. But I am finding that I can barely get by without taking them regularly.

But you're still in pain, aren't you? That's not being addicted (or, to put it more correctly, dependent) that's being in pain and needing relief.



Why do you guys over there think that 6-12 weeks on painkillers means you should stop them even if you're still in pain? I don't get it.
[Bonesmart.org] 3 months and counting
I know people who have been on prescription drugs for years with intractable conditions like back pain. Pain = needing pain relief.
 

Why do you guys over there think that 6-12 weeks on painkillers means you should stop them even if you're still in pain? I don't get it.
[Bonesmart.org] 3 months and counting
I know people who have been on prescription drugs for years with intractable conditions like back pain. Pain = needing pain relief.

Good question, Jo...but there does seem to be an all-encompassing feeling in the medical community here that taking pain pills for more than a couple of weeks is unnecessary and BAD and leads to addiction which will turn us all into drug-crazed zombies.

Over the years I've been dealing with chronic pain (back, hip and both knees), orthopedic surgeons seem to be the worst with this attitude. Not all...I actually had one I adored before I moved--at every appointment he asked about pain levels and did I need something, and would I like to try something different. He trusted me not to overdo it on the pills, but to take what I needed. Fortunately, I've now found a GP who believes in taking pain meds and isn't worried about addiction at all.

I've heard other opinions on this, the most common one being that a physician can get "in trouble" for prescribing too many narcotics/heavier pain meds. I don't know about this, its just something I've heard...but boy, some of them are sure reluctant to prescribe even Tylenol 3 (all it has is a little codeine added to the acetaminophen, don't know what you call it over there).

Maybe its a byproduct of the "war on drugs"??? Hmmm.....who knows!

Weezy
 
We call it co-codomol. Odd how these names differ!

I see what you mean - but it all seems so unnecessary and unkind. I know a US friend of mine says her doctors are all jumpy because there is a lot of abuse in the way of people getting prescription drugs like Percs just to sell them on the street and that if the drugs are traced back to the doctor, they can get into serious trouble. I can understand that.
 
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