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Bilateral TKR 4 Months Post BTKR

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Josephine said:
Then you still need some pain meds. Pain comes in many forms including soreness, burning, stabbing, throbbing, aching, swelling and stiffness and tightness is indicative of both pain and swelling. You are only 4 weeks out on a bilateral TKR and I find it very difficult to believe you are totally free of all forms of pain.
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Thank you, Josephine. My OS has been very stingy in prescribing pain meds. He only gives me enough for 8 days and then I have to call him and ask for more each time. It's been a struggle each time I asked for more. That's why I have been taking only 1 instead of 2 tablets of Hydrocodone to try to make these last for more days. I supplement with Tylenol etc. But I will take more Hydrocodone in the hopes of feeling better and will keep asking my OS for more when I need more.
Josephine said:
And this indicates you also need to use a cane. Again, it's far too early.
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Thank you, I've listened to you and started using a cane again for more stability.
Josephine said:
Please, please remember that your muscles are not weak, they are injured. The very alst thing they need right now is more exercising! Rather they need the BoneSmart mantra and will need that for at least another 6 weeks. You are rushing ahead too fast and too far. Slow down!
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Thank you for this explanation. I just feel so weak like the leg muscles are not supporting me, like I am going to buckle but I guess this is just the normal healing process. I will feel weak at this stage of recovery. I will slow down. Please keep checking on me and let me know when I should be applying more rigorous effort. I will do what PT tells me to do when I am in my PT sessions. And when I am at home, I will let pain and discomfort be my guide, i.e., don't do things that seem to cause pain and/or swelling.

Thank you, Josephine. Please keep looking over me. I am very grateful for your guidance. You are so wonderfully caring. I've read your own recovery thread and am humbled by how independent you were in taking care of yourself post-op. You're an inspiration.
 
Had a PT session exactly one month post-op BTKR on June 6. Extension is 0 for both legs. Flexion is 128 for both legs. PT thought it interesting that both legs have the exact same measurements. She said usually both legs have different measurements. Anyway, I still feel a lot of tightness around the kneecaps and in the quads.

I do sleep a lit better at night.

I've asked my OS for Tramadol 50 mg, and he prescribed 3 Tramadols per day, taken 8 hours apart for a total of 150 mg of Tramadol each day. Please let me know if I may take Tylenol for more pain relief if the Tramadols don't seem enough to alleviate my pain? I don't know anything about Tramadol. Never took it before. I asked OS for it because I've noted that many of us on Bonesmart are taking Tramadol.

Please share with me any knowledge/advice you have on how best to feel less pain while taking Tramadol.

I am 5 weeks out from BTKR. My BTKR was May 5, 2014.

Thank you and I wish you all a pain-free day!!!
 
Thank you @referee54.

I still have enough Hydrocodone for 3 more days. After that, I will be taking Tramadol 50 mg, 3 tablets per day, 8 hours apart. Since I have not been on Tramadol yet, I don't know if 3 tablets will be adequate for pain control. What do you think? Can Tramadol be taken with Tylenol? If so that may help me keep the pain under control.

Of course I ice and elevate too.
 
Your ROM is very, very good! Sounds like you just need to get the pain and discomfort under control.
 
@Phil75070 -- Thank you. My PT is pleased with my ROM too. I agree with you completely. I, too, would like to get my pain and discomfort under control. Can you share with me what you did for pain management in week 5 through week 8 postop? Thank you!
 
@Wellness in Virginia Pretty much the only pain meds I took were hydrocodone (10/325) and Tylenol. I tried throwing in Advil or Aleve but they didn't seem to have any additional impact. If I recall, by week 6-8 I was pretty much Tylenol during the day, with two of them being at 9:00PM with one hydrocodone. If I awoke in the middle of the night, typically sometime between 2:00 and 3:00 I would take another hydrocodone.

Around week 12 or so I cut the hydrocodone in half but keeping the same 9:00PM and 2-3:00PM schedule. Gradually I found I didn't need the additional medication in the middle of the night and about a week ago I exhausted my supply of hydrocodone and have been Tylenol exclusively.

Keep in mind that this is what worked for me and we all have different recovery rates and tolerances to pain. Josephine keeps referring to the swelling, aching and stiffness, among perhaps other symptoms, as a "form" of pain so it will depend on what "form" of pain you are feeling and what you can tolerate. A lot of people are extolling the benefits of Tramadol. I've never taken it s I can't say from personal experience but from what I have read it is for moderate to severe pain. I hope it works for you. Ice does have a pain receiving effect, too, so make sure you do add that to your regimen if you are not doing much of that.
 
Wellness in Virginia said:
I just feel so weak like the leg muscles are not supporting me, like I am going to buckle but I guess this is just the normal healing process.
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Well, it'spart of teh recovery process, that's for sure!
Wellness in Virginia said:
I've asked my OS for Tramadol 50 mg, and he prescribed 3 Tramadols per day. Please let me know if I may take Tylenol for more pain relief if the Tramadols don't seem enough to alleviate my pain?
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Mean old so-and-so! I bet he does differently when he has his TKR done! I took Tramadol and used a lot more than that - up to 8 a day! This was my regimen for about 12 weeks though not the full amount of course as time went on. As you can see, I took Tylenol (we call it paracetamol) all the time as they make a splendid companion pair. I also found that my pain levels went UP in the 6th week but fortunately my GP was very sympathetic.

[Bonesmart.org] 4 Months Post BTKR


Why don't you see if your GP will be more accommodating?
 
@Josephine Thank you. I am starting Tramadol tomorrow. I will run out of Hydrocodone as of midnight tonight.

Last night, I could not sleep at all all night and it was not due to pain. I just could not fall asleep. I was not worried about anything. Just found myself wide awake. I tried reading posts here on Bonesmart for a couple of hours but still sleep eluded me. Today I allow myself to take naps but naps eluded me too. I hope I will be able to sleep tonight.

38 days since BTKR. I walk slowly. I can do stairs. Progress is slow. I am not complaining.

Wishing everyone a pain free day and a wonderful night sleep.
 
Like Josephine, I was permitted up to eight Tramadol a day. Your OS is being stingy. I am now taking three a day, but I had my surgery on April 1. I take the Tramadol with two extra strength Tylenol. It seems to work better that way.

For what it's worth, I take the meds at 7:00 a.m., 2: p.m., and 9:00 p.m. The evening meds get me through the night, but again I'm almost 2 1/2 months post surgery.
 
I have definitely found that my GP is much more accomodating with pain relief medication. He seemed much more sympathetic to needing to have pain under control, and was happy to prescribe more/different etc etc. whenever I have asked. He also gives lots of repeats so I don't feel like Im 'begging' for pain relief. It sounds like a common theme that surgeons and PT people are keen to get you off of pain meds, and are more stingy. I definitely think it may be worth a GP visit!
 
@msmechanic58 My OS prescribed 3 Tramadols a day, 50 mg each for a total of 150 mg a day. My BTKR was 38 days ago. I am going to supplement the Tramadol with Tylenol up to 3000 mg a day to see how that works out then if it does not work, I will make an appointment with my GP and hope for the best.

I am so glad to be part of this Forum. If not for reading about your experiences on here, I would have wondered if I am a cry baby and am asking for too much pain meds or some such. I am also helping myself by icing and elevating nearly any time I am sitting or lying down. What a relief it is that we don't need a prescription for icing and elevating!!!
 
Thank you for answering. I have tramadol 50 mg as well. I also have Demerol but the pharmacy is having a hard time getting any in stock. I may need to switch to something different. I'm at day 24 though.
 
@Josephine -- 4000 mg of acetaminophen as a rule, do I need to scale back from that number if I am smaller physically? I weigh 123 lbs (56 kilos), therefore, should I try to stay below 3000 mg given my size or am I still allowed to go to 4000 mg? Thank you, Josephine, for your advice.

41 days out from BTKR. I am managing my pain just fine the last couple of days!!! Thrilled. Still don't sleep well but it's not from pain. Truly don't know why I can't seem to falls asleep.

My last PT appointment was 2 days ago, 0 extension and 128 flexion on both knees. My PT was pleased with progress.

I am still feeling weak. Not back to my normal self yet. This is probably due to not getting good sleep. I am looking forward to feeling strong and energetic like my old pre-op self. I am practicing patience. It's not easy.
 
Wellness in Virginia said:
@Josephine -- 4000 mg of acetaminophen as a rule, do I need to scale back from that number if I am smaller physically? I weigh 123 lbs (56 kilos), therefore, should I try to stay below 3000 mg given my size or am I still allowed to go to 4000 mg? Thank you, Josephine, for your advice.
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I'm not Josephine, but I can comment on your question. The dosage of acetaminophen (Tylenol) is not based on body weight. It has to do with how the drug is processed through a person's liver. As long as your liver functions normally and is not compromised by some other condition, you should be fine with the 4000 mg dosage. Because acetaminophen is processed in the liver, this is why the guidelines indicate you should not drink alcohol (which also is processed in the liver) when taking it.
 
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