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Bilateral TKR 4 Months Post BTKR

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15 days post-op BTKR.

Had my post-op appointment with OS this morning. Steri-strips removed and I got the OK to shower without having to saran wrap my knees etc. X-rays looked good. Incisions well healed. All good news. I also got a prescription for 60 tablets of Percocet which I will stretch out over the next 10 days. After that, I will be off of Xarelto (blood thinner) and am allowed to take anti inflammatories such as Advil or Motrin 800 mg 3 times per day. That's what I've learned from this morning's appt. Tomorrow is my first outpatient PT. I will take Percocet before I go so that I can handle the pain of the PT exercises. I will also ice afterwards.

Right now I am managing pain by icing, elevating, and 1 Percocet every 4 to 5 hrs. I am doing OK. The pain woke me up last night a couple of times and instead of trying to sleep, I just logged on to Bonesmart and reading until it was time to take my 1 Percocet and then trying to sleep again. It worked.

I love this Forum. Thank you everyone for all of your advice. I've been told by my inpatient PT to do stairs up and down (full flight) a couple times a day. Also to walk outside around the block using crutches, etc. He also told me to continue to use the walker inside the house. So I am following his suggestions but I let pain be my guide. If it hurts too much, I ease up on my effort and go ice and rest or try to nap.

Night times are much harder than day times with respect to managing the pain. I don't know why.

But I have not wept yet from pain. I am thankful the recovery has been going as well as it has.

By the way I have 2 dogs and 1 cat. And I do allow them near my bed. Sometimes I let one rest next to me in bed. He's on top of the cover and his fur does not come near my incisions at all. I love my pets and having them around cheers me up. I love being home. I am thankful that I did not have to go to rehab after my hospital stay.

Quick question: Does anyone use CICA CARE STRIPs? A PT told me about these strips---they suppose to help prevent scar tissues. Please share what you know/think of these strips. Thank you.
 
Forgive me, @Wellness in Virginia, but since scar tissue develops on the inside, what possible good would those strips do? The scar you can see will not heal any better or be any less visible with or without strips, oils, lotions, or anything else marketed for them, and they are pretty pricey to boot. Of course, if you want to spend money on these things and use them, they won't hurt.
 
Sounds like your recovery is going very well. I too enjoyed the comfort of my pets when healing. Our dog, a Bernese Mountain Dog named Scout, still licks my knees (well healed now) She slept beside my bed for months, and the cat next to me. Hope you continue to do well. Be careful with physical therapy - some are great and some push too hard - be prepared to speak up for yourself. You'll do great!
 
I would start with steps once a day and see how it goes. If that's ok, then you can always add more. But you're very early.
One of the things that sometimes gets people into trouble is cutting back on the pain meds too soon. I'm glad you got a refill.
 
My dogs (a husky and a lab mix) were so excited when I got home, but they were also very careful with me. I think they sensed I needed extra care. There's nothing better than dog love when you're not feeling well. :puppysmooze:

NewkneesNH, my granddog is a Bernese. They are awesome.
 
Since you are just slightly over 2 weeks out, going around the block each day on crutches or even with a walker will most likely be way too much activity. You really don't need to do this, you know. With both my knees, the only walking I did other than around the house was up and down the street in front of my house. And that wasn't until about 4-5 weeks out!
 
Take it easy. The walks around the block can wait.
 
18 days post-op from BTKR. Asking for everyone's opinions/advice:

Should I stop taking prescription pain meds starting today? How best to test whether I can stop taking the narcotics pain meds and switching to Advil Motrin, etc?

Right now I am prescribed 1 to 2 tablets of 5 mg. 325 mg Oxycodone every 3 hours by my OS.

Here is what I am thinking I might do: Take 1 Oxycodone every 6 hours. Then for one dose, take 1 every 7 hours . Then just switch to Advil at that point. Does this sound reasonable?

Please share how soon after your TKR/BTKR when you stop taking the narcotics pain meds. Thank you so much.
 
There is no way I can stop taking my pain meds. yet and I am 10 weeks out....Some people have almost no pain and stop right away. I wish I were one of them but I am not. I' ve tried to slow down cut some out go longer periods of time but I haven't been able to as of yet. Since we are all different in this recovery process, you can experiment by tweaking your meds around and see what works for you.
Good Luck!!!!!! I hope you are one of the ones who can come off the meds and then are not experiencing pain!!!
 
I was taking OxyContin and hydromorphone and tried to stop after week two or three. Bad idea to go off the meds like that as I soon discovered. However, I found that the switch to Tramadol and Tylenol seemed to work. Although a prescription med, Tramadol is not as heavy-duty as the other two, and I do not have nausea and constipation with it. I'm seven weeks out and still take one tablet of Tramadol two or three times a day.
 
Hey Wellness! Welcome to the BTKR Club! Mine was Jan 13th 2014. I can't give much advise because I am still always looking for advise! But please take the pain meds! That advice helped me the most. I was queen of the pity parties too, but then they just stopped! It does get better.
 
Reducing pain meds should be based on your pain, not a schedule you set arbitrarily. If you feel like you don't need the meds every 3 hours, try them every 4 to start. See how that works out for a day or two before reducing further. Remember that stiff, log leg feeling is a form of pain and should be medicated.
 
...and oh yeah, I am still using pain meds! And mine was in Jan! Hydrocone very seldom(maybe 3 a month) at night if I have really over done it and in mucho pain and a tramadol when I wake up because I am so stiff and sore and usually one at night because my knees ache.
 
Kneeper is right. Why are you wanting to reduce your pain meds? Eighteen days out from a BTKR sounds might soon for that! Most people need pain medication of some type for 1-2 months.
 
The constipation is my main reason for wanting to get off the pain meds. Can you all share your tips on how best to manage this terrible side effect? Thank you so much.

Do you take a gentle laxative daily while taking your prescription pain meds?

Or will drinking a lot of water and eating oatmeal and bananas and strawberries etc. be enough to alleviate the constipation problem?

Thank you soooo much for any advice on managing this. I cut way back on the Percocet due to constipation and am suffering for my mistake. Not know what to do now!!!

I cannot sleep from surgical knee pain tonight. Last night I could not sleep due to spending the whole night on the toilet.
 
I started taking stool softeners as soon as I got home. Yes, it was a problem. Drink lots of water. I never took a laxative because I was scared I might not be able to get to the bathroom in time! Couldn't get up or move as fast!!
 
I also took a stool softener and continued to use it after I went off the heavy-duty meds. The Tramadol is less likely to cause constipation, but I am also taking iron pills, which are constipating. I learned that for me it was best to take it at night. If I took the pill in the morning, I had an uncomfortable feeling most of the day. The nighttime pill seemed to work well.

After about a week, I began to take three to four prunes in the morning, and dropped the stool softener. Seems to be working. :fingersx:
 
Stool softeners are your best bet. It is not advisable to take a laxative for any length of time as it can cause problems later when you no longer take it. Be sure and drink lots of water. Eat prunes (the dried candied ones are tasty).

Most people need help with this while taking pain medication. Here is a thread from the BoneSmart Library to give you additional information.

Constipation and Stool Softeners
 
23 days post-op from BTKR.

Thank you for all the advice on managing constipation while on pain meds. It is no longer a problem.

I had my second outpatient PT today. ROM is 0 extension and 120 flexion on both right and left legs. My physical therapist was very pleased with my progress.

I still have that very tight feeling in the quadriceps and around the knees. Very tight. Still cannot sleep well at night. The longest stretch was just 2 hours.

I am taking a total of 8 to 9 Percocets in a 24 hour period and 1 Celebrex. That is it for meds except for 1 Xarelto (a blood thinner). I am on Xarelto for just one more day.

Appetite has returned to normal.

I find that I am in less pain when I get up and move around and I feel the most pain and stiffness after lying in bed or sitting in my recliner for long periods even if properly elevated.

I still ice both of my knees very frequently. I insert the ice packs inside a pillow case and then wrap that around my bare knees. Then I have to put many blankets all around me because I feel soooooooo cold all over not just at the knees. Do you all feel very cold after you've had this surgery? It is 72 degrees in my house. I wear flannel pajamas, long sleeved, and still shiver. I take my temperature and it is 97.3 to 98.3 most of the time. But I feel very cold. I wear socks and sometimes I even wear gloves to bed. Is it the ice packs around my knees that cause me to feel so cold? Please share if you've had this problem before?

Thank you EVERYONE for your continued support.
 
You are doing very well @Wellness in Virginia! As far as being cold. I was told it's because of the blood thinners. I'm not a cold natured person but I find I get cold, especially if I have ice on my knee. Like you I get sleep in two hour stretches. One of my favorite exercises is the leg extension where my heal is on a foam roller and we just let gravity take affect on the knee. But I'm finding that the last few days that with less swelling in my knee I find that that particular stretch now hurts. But my therapist helps by massaging my knee while it's doing that stretch. I also find it interesting that as the swelling goes down I have a few instances where my knee buckles a little. All normal my therapist says as those muscles and tendons relearn how to keep it stable. It's amazing how the body works! As far as the constipation, I use miralax every morning as well as eat prunes. My regular dr said I would probably be doing this for months. He said that if I notice that things are slowing down to take a stimulant like dulcolax (1 tablet in the morning and 1 in the evening) once in awhile. Once again, bravo on your accomplishments!!
 
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