TKR 9 weeks and still using a walker

[kneeper]

For the first several weeks I had some random buckling. I think it was the muscles adjusting and it did go away. I'm wondering if you didn't have it early on b/c you weren't as active then but now are back at work and the muscles around the tkr are not liking it? I'm glad you're following up.

 

[mackd]

Wow! There is such a difference in doctors! I’m in Michigan, in the U.S. Where are you? I agree with all the voices saying get a second opinion. My Dr cleared me for 90 days off and a restricted return to work at 12 weeks. He sent me home with a huge bottle of Percocet, which I used probably at a rate of one a day on most days. At my last visit, (11 weeks) he didn’t take an X-ray, he did at my 2 week post op visit. He also gave me a prescription for Norco as my pain medicine. I hope you can find someone who is more attentive and respectful. This journey is hard enough with you doctor treating your concerns in this way.

 

[Dizzy]

Sorry, but your OS needs an attitude adjustment! He may think he knows but, unless he has actually had a TKR, he doesn't know what we go through. To just minimize your problem is very unprofessional. 6 weeks is very soon to go back to work and him not wanting to give you more time, or pain meds, is just wrong!! I wish you all the best!! You are not alone!!

 

[pholly]

I did get a prescription for tramadol. But it only works if I follow it with Advil. It doesn’t work as well as the Percocet but at least I’m getting some relief.

My co-workers and my boss are very understanding and trying to do what they can to help. My boss ordered me a Vera desk so I could stand while I work. It was $400.00 but she said she didn’t mind if it would help. One of my co-workers installed as soon as it arrived yesterday. So hopefully next week will be better. They are going to install monitor arms in my lab so I can raise my monitors while I’m teaching. That will help also.

As for my knee buckling, I’m not sure why it happens. Yesterday I was in my office after my Vera desk was installed and I was simply standing and contemplating how to rearrange things on my desk to accommodate the desk. Suddenly my knee gave way. Fortunately I was standing near my new desk and I had it in the standing position so I was able to grab it and steady myself. That is the first time I have had my knee give way when I was just standing. It usually gives way when I’m walking.

What really surprises me about my doctor’s decisions about my recovery and his treatment of me is that my cousin has had 2 knee replacements with him and his treatment of her was totally different. With each knee surgery he gave her 9 weeks in home therapy and then assigned 4 weeks out patient PT. He also told her to stay ahead of her pain and take the medication as prescribed and to call him for more whenever she needs it. He told her he did not want her in pain as that would hinder her recovery. She was also taking Percocet. She and I both have severe allergies to hydrocodone and that is why we were prescribed Percocet.

Now granted both of her TKRs were great. She didn’t have any problems at all and was off pain medication by week 6. So I guess he treats his problem free patients better than those who have some problems. He also sees her more often for post op checkups than he does me. He saw her at 2 weeks, 4, 6, 9, 12.... she has appointments on a pretty regular basis. I have only seen him at 2 weeks and at 6 weeks. The next time I see him will be at week 16. I just don’t understand.

My cousin and I are close in age, about the same size, with similar health conditions, high blood pressure and high cholesterol. She is a stay at home wife and she lives closer to the hospital than I do. So I wonder if he thinks he is saving me traveling time by spreading my appointments out. And if he assigns more in home therapy for his patients who don’t work. But why would he be concerned about my traveling time to see him if he is not concerned that I have to travel back and forth to work every day in the freezing cold?

 

[pholly]

Wow! There is such a difference in doctors! I’m in Michigan, in the U.S. Where are you? I agree with all the voices saying get a second opinion. My Dr cleared me for 90 days off and a restricted return to work at 12 weeks.

I’m in the U.S. also, Texas. He didn’t send me back on a restricted return. His note to my HR director said that I was ready to return to regular full-time duties. I called him and askedfor more time and told his nurse that I wasn’t ready. I never get to talk to him, only his nurse. When she called me back she said he said to go back to work and he would see me on my next visit which was 4 days after my return to work. That was my 6 week follow up and that is when he indicated he thought it was all in my head. I haven’t seen him since and will not see him again until March 15th.

 

[pholly]

I my GP today and told her what was going on with the sharp pain in the back of the knee and the giving way. I told her he wasn’t even willing to see me until March 15th because he thinks it is all in my head. She was appalled that he didn’t want to check and take an X-ray to make sure everything was alright. She said if something is wrong,waiting until March 15th is just too long.

I also told her how he only gave me a prescription for 10 day supply of pain medication when I checked out of the hospital. And that 16 days later he gave me another 10 day supply that I made last 3 weeks. I told her I have never been given enough pain meds to them as prescribed. I have had to stretch them out since I got home for the hospital. She said that pain management is necessary to recover from a major surgery like this. She is taking over my pain management and gave me a prescription for Percocet. She gave me a full month supply and not just 10 days like the surgeon had been doing.

She also gave me a referral to my friend who is an orthopedic surgeon so I can go to him and find out what is going on with my knee. My insurance will cover him but it will not pay for any X-rays he orders because the hospital where he works is not on my insurance. But it will be worth it to pay out of pocket to find out if there is something wrong or not.

I cried tears of relief as I left her office today. I’m so happy that I will be getting a second opinion and that my pain is finally being managed correctly. Now maybe my workday won’t be so excruciating and leave me totally exhausted.

Another thing that I thought was weird is that the surgeon said that he could not call in a prescription for Percocet so my husband and I would have to drive the 2 hours to his office to pick up a hand written prescription. Well, today my GP called in the prescription for Percocet and the pharmacy had it ready to pick minutes.

 

[robhunt3]

Hi @pholly, I replied to you on another thread about your knee 'giving way' - it wouldn't take much to make your new knee swollen and muscles/ligaments weaker due to over exertion - by the sounds of it going back to work at six weeks may have been too early for you?

Rest up a bit if you can, elevate and ice and let it settle for a week or two. Forget ROM, that'll come back to better than you had before.

By all means get a 2nd option if you can, but try not to worry, it will resolve itself I'm sure. It probably just needs a bit of TLC and time. Take care.

 

[SusieShoes]

Your GP gets full props for understanding what pain control actually means for TKR. Stretching out pain meds simply doesn’t do it. Now you can relax and know your pain will be addressed, which takes a lot of stress off your body. Your healing will be so much better now.

Calling in opioid prescriptions varies by state. I don’t know what the rule is in Texas, but here in Pennsylvania you have to have a paper script now. It’s possible, too, that Percocet is handled differently in your state than, say, oxycodone. Drug rules can be quite Byzantine.

Can your GP order an x-ray of your knees done at your insured hospital and have it sent to your friend? Or you can hand carry a copy. That way you would not have to pay out of pocket. I too find it odd your OS didn’t at least want to take a look at your knee or x-ray it.

Standing desks are great (so is your boss for ordering one for you). Chances are you won’t be able to stand for long periods just yet, but having the option early on is a good thing because you will find it helps to change position. You should still spend as much time as possible elevating your leg and icing.

Sounds like things are starting to straighten out for you!

 

[sistersinhim]

Your GP sounds wonderful. I am so glad you finally got adequate pain control now! Susie's idea of getting a paper prescription for an xray is a good one.

 

[pholly]

Calling in opioid prescriptions varies by state. I don’t know what the rule is in Texas, but here in Pennsylvania you have to have a paper script now. It’s possible, too, that Percocet is handled differently in your state than, say, oxycodone. Drug rules can be quite Byzantine.

Can your GP order an x-ray of your knees done at your insured hospital and have it sent to your friend? Or you can hand carry a copy. That way you would not have to pay out of pocket. I too find it odd your OS didn’t at least want to take a look at your knee or x-ray it.

My surgeon is in Texas too, so this paper script thing must just be his own rule. Which is very inconvenient when you live 2 hours away from his office.

Unfortunately, my GP and my friend work in the same hospital. But maybe my friend can order one for me at the hospital in another town. There is a town about 30 minutes from me that does accept my insurance. I will ask him when I see him. Thanks for the idea.

 

[Jockette]

Are you able to elevate and ice on your lunch hour? Do you get a whole hour? If not, could you? It sounds like your boss is very caring and willing to help you.

I’m sorry you are forced to go back to work feeling like you do. It is not helping your knee at all.

 

[PolarBear60]

Texas also requires a paper script (at least they did when I had my knees done). Could your GP request an x-ray? Then you could take it to your referral appointment.

 

[pholly]

Well, I’m now in week 13 and I’m still having problems with my knee giving way. Therefore I’m still using the walker to enter the school and to exit it because our school has a very long sidewalk leading to the entrance and no handrails or anything to hold on to if my knee gave way. I’m using the cane inside the building when I have to go a long distance.

I was not able to see my friend who is an orthopedic surgeon because my insurance is refusing to approve my doctors referral. They are insisting that they will only pay for visits with the surgeon who performed my operation. I won’t be able to see him until March 15th.

I have some good days and some bad. On bad days I’m in a lot of pain. I’m am still icing and elevating as often as I can. But this is impossible to do at work, so I do it in the evening when I get home. My range of motion has diminished and I still have a knife stabbing pain in the back of my knee when I bend it.

The weather here is not helping. It has been very cold and raining almost constantly. I’m praying we will get a break from all this rain soon. The temperature has raised the last couple of days. Hopefully it will stay up.

On bad days I go through a lot of regret, anger, depression, crying. I feel like an emotional wreck. Unfortunately I have more bad days than good. But on my good days, pain does subside and all I feel is tightness in my knee. On those days my knee doesn’t give way and I feel stronger. I have only had a few of those days. But those days do raise my hope that in the future I will have more of these good days. I have noticed that even on good days, the knife stabbing pain at the back of my knee is still there if I bend my knee past a 90 degree angle.

I still feel something is wrong but I don’t know how to convince my surgeon that it is not all in my head. Hopefully he will do an X-ray on March 15th when I see him.

 

[Jockette]

Hi, Pholly, the pain is definitely not in your head. But my guess, from personal experience, is that the X-ray will show the implant is fine.

13 weeks is, unfortunately, still very early in recovery and you were forced to go back to work extremely early and I think your leg is just not ready for all the activity it has to handle.

I’m sorry that your surgeon was not more compassionate about your need for more healing before sending you back to work.

I don’t have any suggestions that would be practical for you. In an ideal situation you would benefit from staying home and resting more with your leg elevated so it could heal. But I doubt that is an option for you. If possible do that as much as you can when you are home.

 

[SusieShoes]

Your OS probably will want an x-ray at your appointment. If he does not, you could ask him for one based on your feeling not right and that your knee is giving way while walking. But it might not show anything.

Going back to work early as you did, your knee didn't get a chance to do more healing before being subjected to all of the activity involved with your work. That activity, early and current, could well be at the root of your pain. Rest, ice and elevate all you can. What I don't understand and have no explanation for is why your knee gives out on you.

 

[Celle]

I did get a prescription for tramadol. But it only works if I follow it with Advil.

Have you tried combining Tramadol with Tylenol? That usually works very well.
Here's a couple of charts that Josephine made, that suggest how to use the combination. The first one is for 4-hourly doses and the second one is for 6-hourly doses:

As for my knee buckling, I’m not sure why it happens.

Usually, your knee buckles because your muscles have not yet returned to full strength.


Even though your insurance won't cover a consultation with your friend who is an orthopaedic surgeon, do you think that he would offer you some advice, as a favour?

 

[pholly]

I’m sure my friend would be willing to talk to me but I was hoping to get him to request an MRI. I really feel that something is wrong. I have a sharp pain in the back of my knee. In the picture below it hurts at the 2 spot. I don’t think that the problem is going to show up on an X-ray. I’m pretty sure my surgeon will only do an X-ray when I see him and declare all is well and the rest is in my head. When the pain started you could actually see and feel something in that area stretch out and then pop and release. My physical therapist could see it and put his hand there to feel it while I moved my leg. It worried him and he said that I didn’t need to do any exercises that hurt that area because he feared we were doing more damage to what ever was going on in there. I could not get my surgeon to even look at it much less feel of it. When you feel of it, it feels something like someone stretching out a rubber band and them releasing it.

I did have a couple of good days this week. For the first time since I had my surgery, I felt normal on Tuesday. Nothing else in my knee hurt except that spot in the back. I also had more energy and just felt more energetic and better. The weather has finally warmed up here and it finally stopped raining. So maybe that is helping. My knee feels stronger but it still gives way occasionally.

I do at least feel hopeful that I will more of these good days in my future and that the giving way will eventually subside. So now my only concern is trying to convince my surgeon that there is a real pain at the back of my knee.

Oh and for those couple of good days I only had to take one pain pill for the day. I only started hurting late in the afternoon after being at work all day. I’m praying for more of these good days.

 

[sistersinhim]

Those good days will stay longer and longer as time and your healing goes on. It's a matter of common sense. If your knee hurts afterwards, you need to wait a while before trying it again.

 

[Needhope]

Hi pholly.... I’m praying you’re doing much better now. I just came across your thread because I looked up buckling knee. I’m in my 6th week LTKR and just started knee buckling. It only happened a few times within past week so I’m curious how your knee has progressed in recovery and if you still get the buckling. I hope you well.