TKR 4 weeks out

Salsybub

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I'm 4 weeks out and wondering if it's still normal to be needing to take one 5 mg oxycodone before doing my physical therapy? I do it once A-day and I cannot get through it without taking the oxy 1st. My therapist says I'm doing great and I am where I need to be but I'm wondering if it's bad for me to still be depending on the oxy. Tylenol does not cut it for me.
 
Hello @Salsybub and welcome to Bonesmart! :flwrysmile: If you have to take oxycodone before taking PT, then that PT is setting your recovery back. PT should never hurt! It can be uncomfortable but never fall into pain. Also, it's best if you don't medicate before exercising. Doing so masks the pain and that is bad for your knee. You need to feel that pain so you know when to stop. The pain is telling you that your knee isn't ready for what you are doing to it. You are healing, not in training!

Each person is different as is their recovery. Most find that the Bonesmart approach works best for them, but others find that a more aggressive therapy helps them more. It's your recovery and your choice on how you recover. As you read more on other members' recovery threads, you’ll get a better perspective of what to expect. The following are our basic guidelines and should help get you started.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

KNEE RECOVERY 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.

Try out our great new opportunity to improve your gait. It's OneStep. It's free and you will find it to be a huge help to you. Click here: OneStep
 
By the way, which knee did you have replaced and what was the exact date of your surgery and any other joint surgeries you might have had?
 
@Salsybub
I remember taking one or two per day at the 4 week mark. Usually, one during day if I was up a lot and one before bed. My OS always refilled for me. He knew I was tapering off.
Everyone is different. Some can ditch the pain meds quickly, some need them longer. Each knee is different.
You still have a lot of healing to do. Do what helps your pain.
 
I agree that the meds should be managed by how you feel not how long it's been since surgery. Talk with you OS if you need more.

I refused the instruction to take more pain meds before PT for the reason that @sistersinhim mentioned. Pain is a signal to stop doing what you're doing, without that signal, you can push through an activity that your knee is not ready for and do some damage, at worst or prolong your recovery, at best. I don't know why the healthcare team recommends this approach. While my PT did want me to medicate more before a session, my OS did not. He said if hurts while doing it stop. If it hurts a day or 2 later don't do it again for a while.
 
I do it once A-day and I cannot get through it without taking the oxy 1st.

I'm wondering if it's bad for me to still be depending on the oxy. Tylenol does not cut it for me.
It is not bad for you to still be on prescription pain medication, if you still have general healing pain. What is bad is that you are doing exercises that cause you to need it.

Regaining our ROM does not require forceful bending or painful exercises.
Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.
 

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