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TKR A New Chapter Begins

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crystals5 said:
I have been taking the minimum dose recommended instead of the maximum. I am now going to take the maximum dose. I didnt want to as I know this doc will not prescribe more even if I need it so I must make this dose last.
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Leejaa is correct. Get in touch with your primary care doctor and get him on your side to prescribe what you need when you need it. You can't do this recovery without proper pain meds.
crystals5 said:
The problem is in keeping my knee straight the back really hurts and I stop for awhile.
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Don't struggle to keep you knee dead straight. If it's swollen then you won't be able to anyway. As long as you get up and walk as you are doing, you will be fine. I spent most of my time on my recliner with my knee slightly bent but did extension stretches after things settled down in the pain and swelling department. You can't do it while there is swelling.
crystals5 said:
After yesterday and the way my leg swelled I swore to take today off from physical therapy and I have. I have done some of the breathing,some of the ankle rotations and I think they are called heel slides but very few.
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Bet you still did more than I did! Do keep up with the ankle rotations and foot pumps (see the article on Home PT) as they are important for circulation and preventing clots. As for the heel slides, for now you should be okay with about 5 twice a day. Right now you are not even one week out - don't fuss if you don't do much of anything. My surgeon forbids his patient from doing anything except what I have just outlined for the first three weeks! You need that time to let healing commence and after that you can start in on the other exercises little by little. You will be fine in the end so don't get fraught with anxiety about it!
 
leejaa and Josephine, Thank you so much for your responses. As far as pain control, you are right I will take what I need now and if I need more later I will deal with that when the time comes.

I just met my in home physical therapist. She was great. Very gentle exercises and my homework for the weekend is to do a few of the exercises for circulation and ice and elevate. She wants me to concentrate on icing and elevating paying special attention to the back of the knee.

Thank you both so much for responding to my dilemas. Hopefully, I will pull myself together and become more rational. :thankyou:
 
Honey, it has nothing to do with your needing to 'pull yourself together'. You haven't fallen apart, you're just in a totally alien situation and so far, have no idea what you're supposed to do. Everyone has that moment. We (and your lovely PT) will see you through, don't worry.
 
crystals5 Welcome to the other side. I am sorry to hear that you are at home alone. I couldn't imagine doing this surgery and staying at home alone. You are doing quite well for your situation. The swelling and pain is annoying. I am glad to hear that you like your home PT and she is Bonesmart friendly. We are here for you! Keep us posted on your recovery.

Take care! :flwrysmile:
 
crystals5 -- Im a hip person, but still have to elevate. If I elevate just one leg it hurts, and if I elevate both it feels a lot better.

Will write more tomorrow. I'm just exhausted, and did almost nothing today.

Peace and love to you.
 
Today has been my best day yet and yesterday was my worst. Yesterday I had the biggesi meltdown of all and then I slept all day and night. I sleep (and I'm still at it today only not so bad) anywhere from 10 to 30 minutes then I am up for an hour or more This goes on until elevenish when I will sleep for about 5 hours till I get up. I know this won't last as I am partly an insomniac anyway so its very abnormal for me.

So much sleep but now I really have hope. I think for me the oxcycodone didn't help me much. It kind of made me hallucinate and talk out of my head :shocked: For pain it was great, but I was so nauseaus, light headed and weak it wasn't helping. I had asked my os in the hospital if I could mix some of my vicodin with the oxcy doses to make it last longer and he said absolutely but I never found out how so didn't do it. When the nurse was here she gave me some suggestions which I tried and they are working by just substituting vicodin for an oxcy dose and its working and since I have been hoarding them I have a lot of vicodin. I hope this helps.

Anyway, I know not to get too excited by this but even during my horrifice meltdown yesterday I felt I had turned a corner. Now maybe I can get to the real job of healing physically. I'm ready.
 
The good days start piling up more and we progress. I am glad you found a new mix of meds so that you are not so nauseous and are not hallucinating.
 
The new mix of meds is working really well as far as clearing my head and making me feel physically better but the pain, not so much and I worry that when I see the os on Friday he will not refill the oxycodone. I really don't like what it does to me physically and mentally but I have to say it does a good job with pain and I would really like at least one more script to have on hand for when the pain gets too hard for me to manage.

Last night the pain was pretty bad. I would say a 7 or 8 all night. I took an oxy at maybe midnight and it helped some but I have more or less been trying to get a handle on the pain all night by taking regular doses of vicodin which helped some. Time was so distorted all night long. I would think an hour or more had gone by when in reality only 10 or 15 minutes went by. It was a looonnnnngg night. Icing and elevating constantly.

The physical therapist called and she will be here in a couple of hours so I broke down and took another oxy. I saw her on Friday and to be honest only did the exercises one day as the pain was just too much. My leg seems more swollen if this is normal. One of the med people who came by last week told me the leg would get worse before it gets better. Do any of the veterans think its okay to go a few days without doing the exercises this early on?

No meltdown today. :yay::happydance: For me this is a good sign. Two days in a row........ yessssssssss.
 
I do not know if I am a veteran. I am on my second knee this year. I do not always do my exercises every day - following bonesmart I believe it is more important to keep my pain under control and ice and elevate so my swelling is the least possible. Do some gentle stretches on your own. If I am having an achey day and tired , I minimize how much I do till I feel better or better said - till my knee feels better. The knee rules.
 
leejaa the nurse just left and she basically said what you just did and what I have been reading for months on this forum:headbang: She told me if I am in pain no exercise other than the gentle rotations, stretches, etc, whatever doesn't hurt. AND she told me the probable cause of the two painful nights was Friday was really bad, Saturday really good, Sunday really bad. She said I probably overdid it on the day I felt really good:hissy: I think she hit the nail on the head. I felt so good Saturday I did a lot more than I have been and I guess I didn't connect it because the pain wasn't instant that day. I don't remember if I overdid on Thursday but probably. I know for sure I did a lot lot more on Saturday. She said to be careful of that even if I feel great. and I have been reading this over and over. I can't believe I didn't figure it out.:blush:
Thanks for your input leejaa. It was right on.
 
We all forget when we get excited and we feel better and do more than we should. It seems that is the way we learn eventually.
 
I am still having problems at night. Tons of problems with pain. It was only every couple of nights, now it seems to be every night. I sleep about one or two hours at a time, if that. Time is distorted. I feel like about an hour has gone by but in reality when I check the clock it has only been 15 minutes since I last checked. Then I wake up in a lot of pain. This goes on all night and takes until late morning early afternoon to get the pain under control. I have tried different ways of taking the pain meds but I am stingy with them as I do not believe I will get more. I will have the answer to this tomorrow when I see the doctor.

I feel more swollen but my physical therapist sees numbers are getting better. I don't see how as I do not feel I can bend now as much as I could a week ago. I constantly ice and elevate. I don't do anything much so I don't think I am overdoing. I guess I do read that many posters have these problems at night and otherwise I feel very lucky and blessed.

In reading posts this morning I see I am not the only one who has meltdowns which makes me feel a bit better about them, although I have not had one in days.

I don't have much of an appetite either which doesn't bother me because I could stand to lose some weight, but I have only lost about 1 or 2 lbs.

When does the night time pain subside? Is there anything I can do to minimize it or control it? Thanks for any input you can give me.
 
Hi, any answers or helpful hints to my questions would be appreciated.
I saw my os on Friday. I asked for a refill of the pain meds. He did not want to refill it but he did. He told me this is it, no more refills. This is my first and only refill. He filled 60 oxycodone. I dropped the script off Friday at Walgreens, They wanted to call the doctor. I said I would be back Monday to pick it up. If someone does not stop that script I should have my refill tomorrow. I am going to see my primary doc on the 21st but he does not want to get involved in overriding anything the os says until I am done with the os.

My pain at night is my main problem. On about half the nights I am at a pain level of about 7 or 8 all night and if I don't get a handle on it I have to work till the afternoon the next day to get my pain levels down. Tomorrow will be two weeks since surgery and I seem to be doing a lot of backtracking. I had bend in my knees earlier in the week last week by the end of the week I had almost no bend to them and my os said the dreaded words.... "no pain, no gain". I could not believe it. Anyway, I don't do a whole lot so I doubt I overdo it, although I must say after seeing the os on Friday I did begin to do more, example, take out trash, do a few loads of laundry, a bit more tidying. I would like to begin short walks soon too. The nights are not getting better. The bend in the knee is. I also am taking as few pain meds as possible as I want to save them for outpatient pt later if I need them since I won't be getting any more.

This is my huge concern/question. A few years ago our insurance changed and I lost my primary care doc of 15 years and had to find another who was in the new network. During this time I got a bad case of colitis and was hospitalized. After this I could not find a doc who would prescribe me pain pills for both my knee and the colitis. I must have changed primary care docs 5 times in a year or two and always walking in desperate for pain pills. I was truly like an addict searching for a fix. Anyway, when I finally did find a doc who I liked and would prescribe me pain pills I began to hoard them so I would never have to go through that nightmare again. Sooooo I have been hoarding vicodin. I never needed many but kept the scripts refilled so I would not be without if I needed them.

Now I realize vicodin has tylenol. Because of liver/gallbladder issues I had decades ago I don't do well with tylenol. Its not that I have been asked not to take it but if I buy tylenol I get pains in my liver and gallbladder area. It will happen anytime I take tylenol. I do not get these pains when I take vicodin. I suspect the hydrocodone masks the pain from the tylenol. This is why the docs are now steering me away from tylenol. Anyway, here's the big question: In researching the tylenol and effects in vicodin it appears there is a way to get the tylenol out of the vicodin. Cold Water Extraction (CWE). Does anyone know about this? Does it work? Can it be harmful? (more harmful than tylenol). There were a few medical sites describing this and a lot of sites where it appears drug people are wanting to get the best high. Other than one site mentioning overdose I could not find anything that mentioned any dangers. I will not overdose as I will not prepare more than 2 vicodin at one time.

I tried it yesterday and did get a lot of the "gunk" out (tylenol). I used less pain meds than I have since the TKR and did not feel the woozy feeling pain meds give me In fact I thought I destroyed the pain relieving effects until I realized I only needed 3 doses the entire day!!!!

Does anyone know if this is a bad thing? If this is okay I should have enough pain meds to get me through this recovery. I have no problem mentioning this to my primary care doc on the 21st who will probably think I have lost it and he probably won't be happy that I continued to get refills of vicodin when I wasn't even taking it. . It would just be very reassuring to me to know that the pain meds are there if I should need it. Any input would be appreciated.

I understand that there is a huge drug problem in the US but I really don't see how holding back from patients in real pain helps the matter any. Many of us would be fine if we were not worried we would be cut off of pain meds at any time. I certainly would not be in this predicament. But am sooooo happy I saved some of the meds.
Thanks for any input.
 
Wow. I identify w so much of what you are saying.

I, too, have gotten pain pill refills even after I stopped taking them. I saved them for times when I have needed them. I have chronic back problems and only take rx pain pills when I really need them.

I, too, have had pain and sleeping issues. I am now taking 10 mg Percocet every 6 hrs and I am managing but wake up every night in pain. I don't see my OS until the 22nd and will ask for a refill. Who knows what he will say. He knows me as a knee and that is it. If he doesn't refill I will go to my primary care who knows me well. We will see. I am quite disgusted with the whole medical assembly line attitude of drs these days. Have any of them experienced anywhere near this pain?!?!

I have felt alone medically and completely at their mercy and that sucks!!! So I sympathize totally w you!!!!

I am 5 wk post op.
Maggie May


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Thanks Maggie May,
I am going to try just getting up instead of trying to sleep which might contribute to the problem. Heck, I don't have anywhere to go anyway so it really doesn't matter when I sleep
In one more week I will be off the blood thinners and able to take aleve again which helps me tremendously. This tylenol thing is something that just came up. So, in reality I may just be stressing over something that will never happen anyway. BUT I sure will feel better knowing I have some pain meds on hand if needed.
Good luck with your meds and pain control.:flwrysmile:
 
Oh crystals5 I am so sorry to hear that you are in pain. I wish there was something to tell you to do. Are you icing through the night? I would fall asleep with my cryo machine going. If you have one you can get a few small water bottles and freeze them to fill your cryo machine. It saves so much on time and ice. I had sleeping issues after surgery. It lasted a l o n g time. I got up because it just wasn't worth tossing. The tossing was doing more harm than good.

I had the opposite happen to me with the pain meds and my OS. Every time I go to the OS he asks me if I have enough medication for the pain. :doh: I tell him that I'm okay. Sure I am okay! He prescribed me Vicodin for my arthroscopy in February 2013 that I didn't use, not even one. He prescribed me Dilaudid, Morphine, Norco and Tramadol. Want to come to my pharmacy? :scratch: I only used pain meds for 12 days and sporadically afterwards. Pain meds are wicked to my body! :sick: I hated the way they made me feel, but if I really need it I use it. My blood pressure went way down, I pushed too hard with my home PT because I didn't feel the pain and I hated the poop factor. I'm on Celebrex and it handles the pain I currently have. I have a little stiffness and this site calls stiffness pain, but I don't see it that way.

I hope you start feeling better soon and get some well needed sleep.

Take care :flwrysmile:
 
So sorry you are having pain crystals and especially at night. I will start praying for you tonight that you will have peaceful good sleep.
((HUGS))
 
Thank you for the kind words and prayers knees and daughter stalker.
I actually did way better today. Had a great session with the pt which loosened the knee a lot. Stiffness and swelling I don't like but can live with, pain I don't like at all.

Its funny, knowing I have a new script I took the pain meds all day today and didn't scrimp on them and I feel yucky from them now. I don't think anything will make me happy at this point. Really I am pretty happy right now :) I am going to "rock" on this bike I have and maybe if I loosen the knees a bit that will be a good start.

DS I don't have my cryo machine yet. I ordered it and have it delivered overnight. It should be here tomorrow. I can't wait. This ice thing is outrageous. I can't get enough and I like ice better than the gel packs.

Thank you for the response and keep healing.
 
I am sorry that you have been in so much pain. I am lucky I have a neurologist who is helping me with pain management. I had never heard of cold water extraction but looked it up. It does apparently work. I take vicodin 7.5/325 four times a day. I have gerd and stomach issues and also take prescription strength 30 mg Prevacid. My concern with the extraction is that you are also extracting the buffers and fillers out of the pill. If it were me I would just take the vicodin. Talk to your primary doctor. We all get desperate when we are in pain and I understand your frustration. Feel better - we are here for you.


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