TKR 6 weeks post op and counting

[Kyoung]

Sorry to hear of your difficulties, I can literally share your pain
I plan to go to GP with my husband tomorrow to argue for a period of Tramadol or similar. I don’t understand why they are so reticent to give you a well managed level of pain meds. Maybe this is a UK phenomena.

 

[Homeport]

Hi I am in UK and am post four weeks and using paracetamol as base med and take dihydrocodeine during day and then Tramadol at night it seems to work well would definitely talk to doctor and be insistent because you have enough to deal with without being in pain

 

[SusieShoes]

Remind them you’ve had major surgery and pain is not good for healing. Don’t do your PT and if he asks why, tell him it makes you hurt MORE. In the meantime, ice as often as you can. Ice helps at least a little. So sorry your GP is being difficult.

 

[sistersinhim]

I agree with SusieShoes, don't do any exercises now. You don't need to do them anyway. You are using your knee in your daily living, that is all it needs. Besides, without the proper pain control it's only being angered more.

People here in the states are having a hard time getting enough pain meds, too. Everyone is so worked up about the opinoid epidemic, that the doctors are afraid to prescribe it. It's doing extreme harm to the patients that really need it. Until your pain is diminished you need to just rest, ice and elevate as much as possible!

 

[Celle]

I’m now on Co Codamol and Ibuprofen which seem to be doing nothing to reduce pain.

GP thus far not agreeing to change meds’ recommending more anti inflammatory.
Hope to see a Doctor tomorrow and plead for better pain relief.

You really do need better pain relief and anti-inflammatories are not going to be the answer.
You have surgical pain, caused by having major surgery, not pain due to inflammation. The inflammation is incidental to the trauma of surgery and anti-inflammatories are not very good pain killers.

In addition, the anti-inflammatories (NSAIDS) have a few dangers. They increase your tendency to bleed and can cause severe bleeding from your stomach, so never take them on an empty stomach and stop taking them if yo have any gastric symptoms.
A recent study has show that they also increase your likelihood of developing heart problems:
NSAIDs Diclofenac. ibuprofen increase risk of heart problems: new study

Co-Codamol contains Codeine and Paracetamol (Panadol/Acetaminophen/Tylenol) and Codeine is not very effective at controlling post-op pain.
If your GP won't prescribe Tramadol, I think you would be better off taking Paracetamol 1,000 mg 4 times a day, to a total of 4,000 mg in 24 hours. You need to take it regularly, to keep up the levels in your bloodstream.

 

[Kyoung]

Thankfully I saw a different doctor at my health centre today and he prescribed a short term dosage of Tramadol

 

[sistersinhim]

Yay! I will give you the schedule with Tylenol. Be sure and add up any other Tylenol you might be taking.

The first is for 4-hourly doses and the second for 6-hourly:

 

[Celle]

I'm glad you got a more sympathetic doctor, @Kyoung .

Two small cautions when using the Tramadol/Paracetamol combination:

1. Be careful not to exceed the safe daily total of 4,000 mg of Paracetamol in each 24-hour period,
2. When the time comes, you will need to wean off Tramadol slowly. Coming off it too quickly can give you withdrawal symptoms.

 

[BossK]

Best wishes to you, @Kyoung! I had my left done exactly a year ago today, and my right almost 6 months ago. (Doc wouldn't do both at the same time.) Stay on your medicine routine. It really took about 6 to 8 weeks for each of mine before I stepped down to straight Tylenol. You've got this!


Sent from my iPad using BoneSmart Forum

 

[Kyoung]

Thankyou for your best wishes and encouragement.

 

[Kyoung]

Got my staples out today,wound looks good no sign of infection
Got a few hours sleep last night which was great.
Not quite 2 weeks since surgery but I do feel better everyday,in large part due to my pain being better managed.
Leg is still stiff, bending and straightening is very very difficult. I have excercises to do at home , I don’t go to PT for another 4 weeks and even then it’s just a checkup,no ongoing direct PT input after that.
Its hard to force yourself to bend or straighten when doing so hurts.
That said my knee is obviously feeling and looking better and I’m positive In time it will work as it should...

 

[Celle]

Its hard to force yourself to bend or straighten when doing so hurts.

So don't do it. It's normal for your knee not to bend much at this stage. It's swelling that's stopping it.
Remember this, from the post-op reading we left you:

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.​

 

[Kyoung]

It’s so confusing when the medics depict recovery as a race against time and scar tissue, to regain flexibility.
I am listening to my body and I am stopping when it begins to hurt, I just hope this will be a good strategy in long term.
Thanks again for your support and advice it’s very much appreciated.

 

[Celle]

Yes, it is confusing, but the people telling you there's a race against time have been taught the wrong thing. Bad scar tissue (adhesions) doesn't form quickly and it's actually quite rare. Overdoing exercise early in recovery is one that that can help to cause adhesions - quite the reverse of what they tell you.

There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

 

[Kyoung]

I reread the “window of opportunity.” It realy does make sense.
I have experienced what they describe my knee was bending well in hospital but is now much less flexible.
I find any increase in flexibility following excercise over a day i achieve, is gone the next day.
I will use my cold air ice machine,elevate, rest, do my activities of daily living, and let my knee heal, when I feel ready I will add some gentle exercise.
Thanks again

 

[sistersinhim]

Just walking around your home, going to the bathroom and kitchen, etc., is exercising your knee. Isn't that what it does naturally anyway?

 

[Kyoung]

Yes your right, I noticed my leg muscles have improved getting in and out of bed
I needed to lift my leg onto the bed but can now move my leg independently.
Thanks

 

[sistersinhim]

Yay on lifting your leg! That's a huge step!

 

[Kyoung]

Have to say I was very pleased

 

[kneeper]