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TKR ACIM

Hi ACIM,
Nice to hear from you. I'm sorry you're feeling depressed, please know that you're not alone, many can relate. Six weeks can feel like a long time, especially when your body is not keeping up with your expectations. Remember, you are very early into your recovery. You just experienced major surgery and your body is still working overtime to heal. What you're dealing with now may feel frustrating, but it's normal. Be patient with yourself. Even if you can't do everything yet...you've come a long way. The cumulative small wins will get you to where you want to be.
Hang in there :thumb: and have a lovely weekend!
@ACIM
 
ACIM said:
One woman wrote asking if anyone who had a tkr over 10 years ago had had to have a revision done. I answered her as I had my first knee replaced in 2014 and it is still working great
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The risk is that on Internet fora that posts are skewed towards the bad ones- as people who are doing fine are less likely to post. It is easy then to freak out and think that all TKRs are problematic.
The good thing about BoneSmart that we have a huge range of experiences- so although there is still some bias ( as recovering posters drop out); the early weeks cover the full range of recovery experiences. Also the moderators know that most people do well in the end and only a very small minority need revision.
 
@EalingGran
Hi. Thanks for your response. I agree about the internet; one has to be very careful in terms of information given. I hit a slump a couple of days ago and knee is hurting a little bit today. I'm going to have to force myself to take it easy. Hope you are having a good weekend.
 
@Layla
Hello dear. Thank you for your response and always grateful for the emotional support. Since the surgery I often don't feel like the Diana I knew before the surgery, LOL. Indeed the last three nights I've not really slept and I've become irritable again. The knee is bothering me today and I have to take my kitty into the Vet. Thank God I have a nephew that is going to carry his cage to and from for me. In the meantime I will get my simple chores done and try to take it easy, so hard when I've become antsy and impatient. Will apprise you accordingly Layla. Hugs.
 
Hi. Question for you all:
I've been having severe discomfort for the last 3 days. Yesterday in particular I just ended up staying in bed all day as I did not want to move. My knee and leg were very tired and I could feel the nerves on the back of my calf spasming. But the top part of my leg, from the knee up through the thigh was feeling uncomfortable muscle wise. The top of my knee where the bone was shaved was really bothering me. And then the inside of the knee itself had some sharp stabbing pain. I am feeling a little better this morning but really hesitate to do anything today. I did not do my PT yesterday. I don't know if I should call into the on-call doctor for my OS office and either ask for some Gabapentin or a muscle relaxer, or neither. Thoughts? Thanks so much. I really am at the point where I am suffering from some depression.
 
Plus, it feels like the lower part of the back of my calf keeps giving out.
 
I am sorry to read this, recovery is never a straight line. Layla has this wonderful picture of a squiggly arrow she posts often. I send my support and I’m sure the admin team will be along soon with some of their excellent advice.
 
ACIM said:
I've been having severe discomfort for the last 3 days. Yesterday in particular I just ended up staying in bed all day as I did not want to move. My knee and leg were very tired and I could feel the nerves on the back of my calf spasming
Click to expand...
I think if it is a new pain that is severe and
not settling; I would call in to at least discuss it with your surgical team. Especially if you can't think of anything you might have done to trigger it.
Is it similar to any previous pain you have had? Did gabapentin help before?
 
Good Morning.
I am sorry you're hurting. It sounds like you overdid it, without allowing enough recovery / rest time in between activity. Personally, I avoid prescription meds, so I'd opt for backing off activity and PT, then slowly proceed again, once you've bounced back. Reduce the walking, stair climbing, long car rides without breaks, and focus on gentle movement / stretches and icing. It certainly won't hurt to touch base with your care team since you used the word "severe" to describe your pain. I think the fact that you're feeling better this morning is a good sign, rather than feeling worse. With the right movement and rest, I believe you can turn this around.

I will leave the image that, Legseleven, referenced in her post to you. It is a reminder that recovery isn't linear, there will be ups and downs and in the whole scheme of things, it's still early into the process for you as your body continues to heal from the controlled trauma of major surgery.
I hope you feel better soon! :)
@ACIM


[Bonesmart.org] ACIM
 
Yes, Gabapentin helped before. I called my on-call doctor but was told that I could not get any more prescriptions. Kind of weird, huh? And no I have never had these symptoms before, not after the surgery. All I want to do is go back to sleep because I don't like what I am feeling at all. I've asked my brother-in-law to call me in a prescription for Gabapentin, hopefully that will help. And I do have my final post-op appointment this coming Friday. I feel like giving them hell because I can't get medications from them.
 
Is your surgeon concerned about lack of effectiveness, side effects, like kidney function issues,
misuse / dependency concerns, or what? Have they given you a reason why they will no longer prescribe?

I'd avoid muscle relaxers since they're a central nervous system depressant and my make the depression you mentioned worse. Possible side effects of Gabapentin are mood changes and depression.
Again, try some gentle stretches, calf massage, heat or cold, breathing / relaxation techniques so you're able to remain clear headed and not overly fatigued. Hopefully with some of these measures, and more rest, you'll feel better soon!
@ACIM
 
Thank you Layla. Not sure what the concerns are with my OS and the medications. I know that Pennsylvania, and I have learned this the hard way, is more stringent than most other states with its controlled substances. Initially, up to about 3 weeks after surgery, I switched back and forth from Oxycodone to the hydrocodone because I wasn't sure which one was helping me more. There was some confusion with the os office on this and it wouldn't surprise me if they thought I was taking more than I should. I explained to my, OS prior to surgery, that I had PTSD and that I had a very low tolerance for pain. I also explained to him my four previous joint surgeries, with one of them being a revision, and how that simply added to the trauma of going through with this particular surgery. So after the confusion on the pain meds they said that they were not going to give me any more but had no real reason for not doing so. I don't get it. I don't want to be on the pain medication or the Gabapentin or a muscle relaxer. I want all this out of my system. But the fact that I called them today to ask for a non-controlled substance and they told me that they don't prescribe after 2 weeks is not right, I think. Amazingly, I just got up and did a couple of chores and the leg felt better. If I knew what was going on I could fix it or at least help it. But I don't have a clue as to what's going on and I'm now ready to go back to sleep as the symptoms are appearing again and I just want to be free of the pain. If you can make any sense of this that would be great.
 
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Also, the bottom part of my back calf keeps giving out and I have never had that issue before. My doctor, after the surgery, did prescribe me one 5 mg oxycodone every four six hours which would have been fine for most everybody but not me, for all the reasons I explained above. Starting the second week he prescribed one oxycodone, 5 mg, every 6 hours. Then when I switched to the hydrocodone, which I know is less potent than the oxycodone, he prescribed one every 6 hours, go figure. I had to call the office to remind them that the hydrocodone is less potent and therefore I would be wanting one to two every four to six hours. After 2 weeks I went back to the oxycodone. At the end of the third week they would not give me any more prescriptions.
 
Hopefully you can make it to Friday and get some advice from your OS at your last post op visit. :fingersx:
Try to take it easy for the next 6 days.
@ACIM
 
Sometimes it’s all in how you present your case to a doctor. If you go in demanding drugs or specific doses of a drug he’s prescribed, a red flag will immediately go up and it’s possible your file will be marked as someone who has the potential for problems with drug usage. Instead, try to speak calmly with your medical team about your specific pain and ask what can be done about it. Seek help, not necessarily drugs. Let the medical professional decide what medications will or will not be prescribed. If he has a policy of no prescriptions after a certain period of time, ask what he recommends to help with your pain.

As you found today, sometimes pain like you describe can be helped by some gentle moving about coupled with rest and ice. I suggest you keep up with that and avoid a lot of stair climbing and errands until your appointment with the surgeon on Friday. Keep a log of the pain you’re experiencing during those days along with your activity levels so you can better talk with the surgeon about his recommendations. It will be counterproductive if you just lie around in bed, so fight the urge to do that. Your body and especially your new joint needs consistent gentle movements like walking around your apartment every couple of hours.

You really need to get a GP. This is the person who will deal with any issues once you are released from your surgeon this coming Friday. Orthopedic surgeons are not typically involved in continuing pain management. He also will likely not be well versed in the various aspects of PTSD. You may need to see someone in a pain management clinic or other clinics, which would be ordered by your GP. GP’s are the ones with the broad knowledge to know what specialists may be helpful for whatever you are experiencing.
 
Thank you all so much. I just woke up after sleeping for a couple more hours and my leg does feel a little better. I'm starting to think I did overdo it. I hate the thought of sitting here in my bedroom for the rest of the day but I'm going to try to do it in peace. I'll check back in and no, I don't want any more meds. Blessings.
 
I appreciate the feedback, I really do. I don't know what the deal is with my OS and the medications. The fact of the matter is I am only going to see his PA for the Post stop on Friday. Perhaps I should cancel and wait until I can see my doctor. On Friday they were going to get X-rays done but I am not crazy about just going to see the PA and she is not a particularly hospitable person. I am totally helpless here and I have done a little bit of very light activity today but the majority of my time has been spent in bed. I just thought I'd be a little further along by this time. Fyi, I have never never asked my doctor for any specific medication or any specific dosage or anything like that. Indeed, I went down on the potency of the Oxycodone to the hydrocodone, all voluntarily. I actually do, on paper, have a GP but I have only seen him once and that was when I first moved up here almost a year ago. Should I change my appointment with the PA and wait until I can see my Ortho doctor instead?
 
Also, somewhat concerned about the bottom of my back calf in terms of it just giving out. I've never had that experience before.
 
Hey ACIM,
Since your last post op visit is coming up on Friday, it might be a good idea to jot down any questions or concerns you've had during your recovery so far from pain levels to mobility...anything you're unsure about. Sometimes those appointments feel rushed and this way you won't forget anything and hopefully fully understand all that's discussed as you wrap up this very early phase of your recovery.
A peaceful evening and Sunday to you!
@ACIM
 
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