Bilateral TKR Analysta's BTKR diary

[gaelan01]

Pt is good but too much is not!
I cut back to 2 times a week
One pool and one land!

@Dearjr are you doing specific PT exercises at the terrestrial vs aquatic sessions or are they are the same? Essentially what is one vs the other giving you? Did you have an evaluation process for the aquatic PT, as example how do you simply get in or out of pool? Can't imagine at this point trying to climb a pool ladder

 

[Dearjr]

@gaelan01 the aquatic therapy is in a pool where you get in with steps. They aren't steep. Have a nice railing too!
There is a treadmill too. Walking running marching in it. Doing squats and steps in pool without the resistance of weight
Outside pool machines and strength stuff
How are you doing this week?

 

[gaelan01]

@Dearjr , thanks and appreciated as looking ahead to PT options. Analysta sorry for hijacking your thread.

 

[Dearjr]

@gaelan01 i feel the pool therapy is great

 

[Birdy]

@gaelan01 the pool my PT hospital has is a walk in pool, one short side has a Shallow opening we just walk in. Sorry @analysta don't know how to reply directly to garland,s thread.

 

[analysta]

@Dearjr - no machines (other than the stationary bike) - just things like leg lifts, donkey kicks, steps, and things I don't have a name for working against resistance bands or my own weight.
Lots of eccentric versions of exercises i.e. lowering very slowly. Lots of holds.

@Wanttobebiking - right. active recovery, as you say. I was underestimating its value and figured that activities of daily life would be enough at this point, but no. I'm back doing a gentle routine and already can tell a difference.

 

[Wanttobebiking]

Your post was a good reminder for me to resume my at-home program.

 

[analysta]

@Dearjr - are you saying there's an underwater treadmill? (sounds great)

 

[Dearjr]

Yes a underwater treadmill. I haven't run in 4 years and probably won't on dry ground but I was in heaven when running in the water!

 

[analysta]

I'm at three months! Everything's going great and I'm tapering off the pain medication (Norco), very gradually. My tapering-off schedule will have me drug-free in three more weeks.

I have to say the drugs have surprised me. I wouldn't have traded the "use your meds on schedule to keep ahead of the pain" mantra for any alternative, because it made all the difference for me. But I did develop physical dependence which was made obvious when I tapered too fast. The withdrawal from this drug is AWFUL. Although I didn't experience the whole list of possible symptoms I did get anxiety, aching (knee and otherwise), insomnia, and this horrible thing called Restless Legs Syndrome which is its own kind of torture that is far worse than its name suggests. These symptoms are still there significantly, even with the very gradual tapering I'm doing.

Consequently I joined another forum that's just for hydrocodone withdrawal. As you'd expect it's so helpful to read others' experiences. When I first started experiencing the mental symptoms (anxiety and other stuff) I thought I was falling apart because I hadn't seen any similar experiences on this forum, although I'm seeing quite a few mentions in the last couple weeks. Unfortunately my various caretakers didn't give me any warnings about withdrawal either; they seemed happy to constantly issue me more prescriptions. So I had a rough 24 hours before I put it together than my incipient insanity was my body's flailing reaction to losing its access to a powerful drug.

It's possible that what has happened to me is uncommon and yet I'm putting it in here to keep my story complete. But my GP, who's working with me on the withdrawal, says that physical dependence can take as little as four weeks to develop and he sees this constantly. Again, I do wish the surgeon's office that gave me prescriptions would have been much more up front about what I was going to experience. Again, it wouldn't have changed my use of it during the first few recovery weeks. It just would have saved me a scare.

 

[Dearjr]

Glad your doing so
Well

How's the knee when working. Any stiffness or numbness

Getting off the Med is tough but stick with it by tapering slowly

 

[analysta]

Oh yeah @Dearjr, I'll stick with it. Although there are a lot of people on hydrocodone withdrawal forums who say that tapering prolongs the time period in which you feel the withdrawal effects, and maybe cold turkey is a happier route in the long run (symptoms worse and constant, time period much shorter, versus milder symptoms for only part of the day with tapering).

Regarding my knees ... still some swelling, doesn't bother me. It still swells when overdoing it (duh). There's no stiffness at all, but kind of a muscle twingy-ache in that area that happens with active movement like standing up suddenly, but I'm wondering (based on what the hydrocodone people are experiencing) whether that's related to the withdrawal, since I'm getting aching in other joints also but to a lesser extent. Hope what I'm trying to say is understandable.

The skin on the knees is still numb in places but I think that's improving and some feeling is coming back but I can't tell for sure.

 

[Pumpkin]

anallysta,
Do you have your primary or pain medication Doctor helping you with getting off the narcotics? Having someone with experience can ease the process for you.
The challenge is finding the right person to help you.
Kinda like a knee replacement, it will take awhile, but you will get there.

 

[analysta]

@pumpkin - My GP is helping me, and he tells me he has a ton of "overflow" of his own patients who go have surgery and are put on meds by the surgeon ... and they come back to him for this part of it. So, he's really experienced, thank goodness.

 

[Clipless]

Gosh, after my first TKR I was annoyed by RLS for a couple of weeks (weeks 6 - 8, I think), but only in my surgery leg. I never connected the RLS to opiate withdrawal, probably because I was pretty much done with opiates by the end of the second week. After that I took one tablet maybe once or twice a week before PT. I'm sure I was completely done by week 6. Was my RLS for sure a sign of opiate withdrawal, or could it have been caused by something else?

I am having a little more trouble weaning completely from Percocet after my recent RTKR- going on 3 weeks post op. I've just had a lot more pain this time. I am down to 1/2 tablet q8°, hoping to continue the taper and be done by next week.

 

[analysta]

@Clipless Since I had both knees done at the same time, I can't say whether the surgery location makes a difference in the restless leg syndrome!

And, I don't know how long my symptoms will persist after quitting completely. That's still ahead of me. From what I have read on the hydrocodone forum, symptoms can persist long, long after the last pill. Hydrocodone has a half life of 3.8 hours yet cold turkey withdrawal symptoms (they say, and my doc says) can take 4-5 days and up to two weeks. So I don't know.

I am down to one Norco a couple hours before bedtime and then, if I wake up during the night, another half. This gets me through the night. During the day, work and other things keep me distracted and while I get the anxiety/jumpiness in the evening, I now know what it is and that helps a lot.

 

[Dearjr]

Glad to see that your knees are less swollen
We don't want to be in the overdid it club too many times

 

[kneeper]

Interesting points. I think another example of how everyone reacts differently.

 

[metalheart]

Just wanted to check-in and see how you are doing and it looks as if the hydrocodone has been a challenge. So, I can relate. First TKR, had withdrawal symptoms and it took me a while to find the right tapering for me, but it eventually worked, With this second surgery, I took less Norco anticipating some of the issues I had with the first surgery, but it still took some trial and error before I could taper to a minimum of symptoms (RSL, edginess, blood pressure issues, sleeplessness) and then eventually stop. At least I recognized some of the symptoms second time around and could adjust my tapering when it was too fast. I can see the attraction of just stopping to focus the withdrawal symptoms in a shorter space of time. I am sure you will get past this fine, you have the self-awareness to know what you need to do and you are on the path. Keep up the good work!
John

 

[analysta]

@metalheart thanks! I will!

@kneeper - yes, so true, everybody's different. That's why this forum is important for getting everybody to know about all the possibilities, even the uncommon ones. Being bonesmart is about being prepared and informed! Love it.