TKR Almost unbelievable

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i never had any experience with pain meds and didn't know to wean off rather than just stop. the withdrawal was really awful.
Sorry to hear you had to go through withdrawal. Most just forget to take their pain mediations and go off of them naturally as their pain subsides, no withdrawal. Many are on pain medications for 3+ months.
You are less than a month from your TKR, very early in this yearlong or more recovery, if you have pain you need pain medications. Take them according to the instructions on your medication bottle, if they are inadequate call your OS or your GP for something that works.
Here are some articles from the library on the importance of good pain control.
Pain management and the pain chart
Pain management during TKR surgery
Pain management: importance of managing pain after a TKR and the pain chart
Pain management: the multimodal approach
 
@janetg Wow! Is your pain gone already? I was in pain for at least 4 weeks when I went back into the hospital and was still taking oxycodone as prescribed at week 4. I just naturally forgot to take my pain meds as pumklin said. I had no withdrawal at all.
 
hi all who responded! thanks for your input. pain is by no means gone it just ramps up in the evening. i just had such a terrible reaction to eliminating the dilaudid i said to myself 'wow!! this stuff is powerful' i did take the 2mg last night with the advil and when i finally fell asleep it was ok. so tonight i might just try 4mg. or one at around 6pm then one before bed.
i think my expectations are so unrealistic. i can't believe I'm still limping! i know thats crazy!!
everyone here is so nice! thanks again!!
 
Janetg,
Patience is one of the hardest parts of a TKR recovery, you are less than a month and your soft tissues need time to heal. They cut your knee open, pulled apart the tissues to see your knee, held them open (soft tissue does not like this), then pulled them back, sewed, stapled or glued your soft tissue back together. Amputated the ends of your bones, sawed, hammered, screwed, and glued in the prosthesis. There are plenty of knee replacement videos on U tube, if you want a better idea of what happened during your TKR.
Give yourself at least 3 months to start feeling more like yourself, you will continue to improve, complete healing will continue over the next year. Everyone is different, so do not compare yourself to anyone else.
If you are limping you need a cane, walker, or crutches. Walking without a device while limping will only reinforce bad habits.
:ice:
 
Diluded is one of the most powerful pain relievers. There are other that are not as strong and don't have as many side effects. I can't remember if you said that you could not not take Tramadol, but it is a milder pain med. Also, I took Tylenol 3 which has codeine in it for a couple of weeks as well.

I would talk to a nurse or PA at your doctor's office and ask him/her for advice about what pain meds might be the best for you. It is perfectly normal to need some pain meds--especially in the evenings. However, it you are having consistent pain in the evenings, it is also the way that your knee lets you know that you need to slow down and rest more.
 
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@janetg .... You may notice that I have merged your two threads. We like to keep our members' recovery posts all in a single thread. That way it's easy for us to go back and read your history before responding to a question or concern. In addition, the thread becomes a journal of your recovery for those who come along later and want to read about you. So, please post in this thread from now on when you want to give an update or ask a question. If you decide you'd like a different thread title at any point, just post what you want here and we'll get it changed for you.

hi all, gradually coming along to be able to say feeling pretty good. i have a couple of questions. as soon as i came off coumadin i started taking advil which usually works very well for me. well, i never had any experience with pain meds and didn't know to wean off rather than just stop. the withdrawal was really awful. so my question, as i lay here trying to fall off to sleep, advil just doesn't cut it. is it ok to take say 1 dilaudid 2mg at night for pain. seems like a no brainer but feel as I've gotten off the dilaudid, should i take it just at night. thanks
In this post (#37), I'm assuming that you are talking about coming of dilaudid and not coumadin, right? It is a powerful pain medication and your body can become dependent upon it, resulting in some of the withdrawal symptoms you described. A much better route, which you've probably figured out by now, would be to reduce it slowly or go to a step-down medication such as Hydrocodone or Tramadol.

But, you are where you are with pain meds now, so let's just deal with your current pain issues. You are less than one month out from this surgery. It is very, very normal to have pain and need something fairly strong to keep it at bay. Advil isn't a pain medication and it will probably never do the job for you. It's an anti-inflammant. And while you may have some inflammation going on, you also have real pain that needs treatment. If you must go the over-the-counter route, you should be using Extra Strength Tylenol (500mg) taken in 1000mg doses at least 4 hours apart no more than 4 times a day. You can take the Advil along with it on a schedule too. But I really think you're much too early in your recovery for this.

Please talk to your doctor about what options he recommends for your pain. You need to be on something consistently throughout the day and night so that your pain does not "build" by night. When this happens, by the time you take something, you're chasing the pain and you'll actually end up needing more medication than if you just stayed on a schedule. See if your doctor will prescribe some Tramadol that you can take every 4 to 6 hours like this. You will be much more comfortable and your recovery will go more smoothly.

But.....no one can change the fact that you're not going to be healed in a month or so. It takes longer than that and patience is key! You will have good days and bad days. Please go back and reread the recovery articles that were left for you earlier in your thread. I think some of that information will make more sense to you now that you've experienced some of the "joys" of recovery. You'll get through this. And it will be so much easier once you get your pain properly managed.
 
Thank you so much for reeling me back in! My dr suggests staying with the dilaudid but trying smaller doses with Advil for now. So grateful for all the advice!!

And thank you Jamie for straightening out my thread(s)!
 
If you need it, I think that occasionally taking one Dilaudid at night shouldn't do any harm. However, as Jamie said, I think you should discuss your pain management regime with your doctor.
 
When does energy return???? I go about my day, staying busy, but my goodness, everything still wipes me out!!! Also my knee seems to be in constant state of ache. Doesn't seem enough for pain killers but Advil and tylenol don't seem to help that much. Next wed is 5 weeks and I cannot believe my energy level. I started on smoothies with ginger and turmeric for pain and inflammation, we'll see how that goes. Unless i'm simply doing too much every day. ???
 
What are you doing throughout the day?
At week 4 I was only leaving the house to go to PT three times a week and I had just made my first dinner (threw chicken in a crockpot). Standing to cook or do anything else for long periods of time was too much for my knee. My staying busy at week 4 consisted of icing, elevating, resting and watching tv.
I will tell you that I was not able to return to work full time at week 12 because of the energy drain. It took a while to build up my stamina so I could return full time.
You are just a month out and your body is still spending copious amounts of energy healing. I'm not at all surprised the Advil and Tylenol aren't helping your pain. Most TKRS are on prescription pain meds for a month or longer. Have you discussed your pain management with your dr as @Celle suggested?
 
Doesn't seem enough for pain killers but Advil and tylenol don't seem to help that much
You need your prescribed painkillers if advil and tylenol are not touching your pain. Many take pain medications for 3+ months.
TKR's are a very trying experience, your knee needs a lot of patience.
 
Thanks again ladies. I think i stand too long. I'm now embarrassed to admit I'm hairdressing at home and have done 2-3 clients a day for the last couple of weeks, I know!!!!:sad: Another question, I have plenty of Dilaudid left over, should I be moving down to something less strong? Is percoset less strong, vicodin?
 
I have plenty of Dilaudid left over, should I be moving down to something less strong? Is percoset less strong, vicodin?
Percoset and vicodin are not as potent, you should contact your OS or Primary about stepping down.
 
I realize you probably need to be working, and 2-3 clients a day isn't many for you (in a typical regular working day); however, I hope you're spacing them out throughout the day then resting, elevating, and icing between them. Make sure you realize how early you are in your recovery, and this work will take a toll on you. Ensure you compensate in other areas. And yes, you may need a stronger pain medication than over the counter meds, but you may need to plan when you take them to be at your best while you are working. It's quite a balancing act, isn't it?
 
You could ask your OS about tramadol. Some people do well with that as a step down drug.
 
I think a big part of your problem is the standing. I find that walking is still much easier than standing for me. I am at week 14 and still, if I have a large number of veggies to chop for dinner, I sit down with a large cutting board.
 
I am very impressed that you have the stamina to do your job. I am back at work, but I sit with my leg propped up and with my cryocuff icing away. In fact today being a day off I am really tired just from going grocery shopping and doing a few chores around the house. Looking forward to getting back to work so I can take it easy!

We know this will take a while to normalize. We just need to be listening to the knee and take meds if we need them, rest if we need to, and be gentle. We will get there!
 
I realise that economic necessity means that you probably have to do some hairdressing at home, but you are really doing far too much for just over a month out from surgery. Have a look at this:
Activity progression for TKRs

As for feeling wiped out and having no energy, that's completely normal. Most of your body's energy is still going towards healing your knee. Listen to your body, rest as much as you can. It will pay off in the long run. Here's an article that illustrates the energy drain:
Energy drain for TKRs
 
Everyone's responses are so much appreciated. It's a tricky situation with my job because i don't want to take the chance of losing my clientele, so fortunately I can schedule them with rests in between. Also it's a wonderful diversion seeing them! Just went out to Whole Foods and was very surprised my balance and stability is as poor as it is. Dear God a kid jumped in front of me and I nearly hit the floor! I find people looking at me as if they're thinking 'poor thing!' Oh well, rest and ice and nothing much more today. Hope you're all enjoying a relaxing, restful Sunday!! TY!
 
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