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[TKR] Barometric Pressure?<

A New Knee

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Update, I've had my second knee done on Monday 12/17/18. This go round, the pain is intense and so was given Norco 10/325, Tramadol 50 and Phenergan to take home. How do I take these please? I took a Tramadol at 3pm & a Phenergan at 345pm. May I take a Norco now or how should I space them apart?
Thanks in advance!
April
 

sistersinhim

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I am going to tag @Josephine, our forum director and nurse to address your concerns.

I will leave you our recovery articles. Following these will help you to have a less painful recovery.

Knee Recovery: The Guidelines


1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now; they are almost certainly temporary
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these
5. Here is a week-by-week guide for Activity progression for TKRs


The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?

Energy drain for TKRs

Elevation is the key

Ice to control pain and swelling

Heel slides and how to do them properly

Chart representation of TKR recovery

Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 

Celle

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@A New Knee
Until Josephine replies:
You should have been given instructions about your pain medication regime before leaving the hospital. Since you apparently have not, have you considered asking your surgeon, or phoning the pharmacy that dispensed the medications?
The instructions should also be written on the medication labels.
 

Josephine

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was given Norco 10/325, Tramadol 50 and Phenergan to take home. How do I take these please?
I would suggest you ask your doctor for this advice. Sometimes when they prescribed so many they have a particular routine in mind. I think I know what this routine might be but it would be ill-advised for me to meddle.


However, I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
 
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A New Knee

A New Knee

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Hello @Josephine
I believe I have it under control. I called the hospital and spoke with my nurse.
The question was, if I didn't have my Norco by the time I came home, and took a Tramadol, how long should I have waited to take the Norco?

They said wait & take it every six hours, so that's what I did. I started the Norco once my husband came home with it and I did wait until the sixth hour after. I have also set an alarm clock for every six hours.

Thank you so much!
 
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A New Knee

A New Knee

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Hello All,
Here I am heading into my 3rd week of recovery and in such pain still. This one is very different from my left side done a year and a half ago, during the "dry summer!"

I spoke with my PT as I have not had my follow up from surgery with my surgeon as of yet. He seems to think the pain is the crazy weather here in California, one day hot one day cold and overcast... Says it has to do with the barometric pressure in the air causing pressure within my joint, thus causing pain.
What do think here my friends? Any advice at all? I can't seem to get comfortable, the leg hurts from hip to ankle. I want to stretch and "pop" the joints as if that would relieve them somehow. I am icing as much as possible and still taking my tramadol 50 @ q5hrs (the bottle says q4-6hrs, so I chose q5hrs.)
Thanks for being here!
Chat soon! April
 

CAdesgirl

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Hi, April
I'm just down the road from you (well, about an 45 minutes east) and my bad knee has been really bad for the past week. I'm still waiting for surgery but I'm convinced that the crazy weather has made my knee worse.
 

Celle

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Hi @A New Knee
You'll notice that I have merged your newest thread with your original recovery thread.
For several reasons, we prefer that you only have one recovery thread:
  • That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
  • If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
  • Having only one thread will act as a diary of your progress that you can look back on.
So please post any updates, questions or concerns about your recovery here - even if it's a new question.
Don't worry that we won't see your question because, between us, the staff read all new posts every day.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

If you prefer a different thread title, just post what you want and we'll get it changed for you.

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.
 

Celle

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Yes, barometric pressure does affect some new knees, but not all.

Another reason for still being uncomfortable could be the exercise you're doing. At this very early stage, you don't need to do much.

I'm going to ask @Josephine to advise you.
 
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A New Knee

A New Knee

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Hi @Celle
Thank you for combining my threads, I wasn't sure how to proceed with that. My apologies for starting a new thread.
Thanks also for the advice on the exercise, I didn't do much yesterday wondering if that was the issue. But, I woke at 4:30am in excruciating pain at the back of my knee. I have taken my Tramadol, it was six hours since my last dose, and this darn is causing my to hold my breathe!
It's 37°F and 49% humidity here and I'm feeling it!
Please, how can I help this feeling?!
April
 

Josephine

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I did ask you this earlier but haven't seen you respond yet
However, I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
 

Denny39

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@A New Knee
I am 1 day short of 3 weeks today. A few days ago, I was concerned that all of a sudden there was significantly more pain in my knee than the day before. My therapist, who came that day, told me that none of her knee patients were having a good day. A storm front was moving in and the barometer was dropping like crazy. Vulnerable knees pay a price when that happens, and right after the trauma of major surgery, they are very vulnerable. That made sense to me when I read an explanation of the structure of the knee. Basically, there just isn’t much room in there to begin with for expansion and contraction. With the resultant swelling from surgery, there is even less. So, barometric pressure changes become an even bigger deal than normal. We’re still having fluctuating weather, and I still have fluctuating levels of pain and discomfort. But all other signs and indicators remain stable. I strongly recommend reading the articles recommended by the Forum advisors. They are thorough, easy to understand, and very reassuring.
 
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A New Knee

A New Knee

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@Josephine I am an open book and am willing to answer any questions you may have.
Ask away!
Thank you, in advance, for your help!
April
 

Josephine

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Here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?
ai63.tinypic.com_eta39s.jpg


4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.
 
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A New Knee

A New Knee

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@Josephine Alrighty then:
1. Pain level steady at 4-5. Throbbing, general soreness. If I rub it, it feels slightly better...

2. Norco 5/325 - stopped after week 1 due to nausea.
Tramadol 50mg 1-2 q4-6hrs - currently taking 1q5hrs as I'm running low. I see my surgeon on 1/2/19.

3. moderately swollen.

4. Flexion beyond 90° Extension almost straight.

5. Icing every hour for 20minutes during the day. At night I've been wearing the ice machine all night.

6. Trying to elevate, uncomfortable, I will try harder. I will try the pillow stacking technique here today.

7. No extraneous activity. I walk with my walker around my home a few times a day. I walk to the freezer in my kitchen to get the next ice bag and to my restroom when necessary.

8. Exercises done at home:
Extension & flexion, feet on the floor, sitting in a chair
Reps x10 times a day
Three sets x20 per set.

Exercises done at PT: 2-3 sessions per week
Extension & flexion, feet on the floor, sitting in a chair x5 times a session, several sets
Standing Balance balls, five to eight minutes x1
Swaying while standing on a cushion pad, 5-8 minutes.
 
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Josephine

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Tramadol 50mg 1-2 q4-6hrs - currently taking 1q5hrs
Sorry I don't understand all these 'q' things. Just want to know the hours

8. Exercises done at home:
Extension & flexion, feet on the floor, sitting in a chair
Reps x10 times a day
Three sets x20 per set.

Exercises done at PT: 2-3 sessions per week
Extension & flexion, feet on the floor, sitting in a chair x5 times a session, several sets
Standing Balance balls, five to eight minutes x1
Swaying while standing on a cushion pad, 5-8 minutes.
I don't understand these. I just need them described like this - heel slides x10 3 sets
Can you do that for me, please?


Trying to elevate, uncomfortable
Have you been told to elevate with your knee straight like this?
elevating angles.jpg


That's why it hurts. Because it's unnatural to lie with your leg straight. Somewhere along the line, some nurses and PTs got the idea that this would make your knee 'set' and be permanently stiff and straight. This is completely untrue. It's unnatural to do that, you need a bit of a bend though not a huge amount like this

elevate 4.jpg


The best ways are like these

elevate 2-horz-horz.jpg
 
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A New Knee

A New Knee

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@Josephine
So sorry; the "q" standing for "quaque" (every) and the "h" indicating the number of hours.
I take 1-2 Tramadol 50 milligram tablets every 4-6 hours.

You have it, heel slides, yes. X10 20 sets.

And yes, I follow the pillow stack technique as demonstrated in this forum as I found that last year in June 2017. You are very correct as when I was hospital, they locked my bed flat and took away pillows, told me to keep my leg flat with toes raised.

** I'm so curious about the barometric pressure I hear some suggest? Do you have any ideas about that please?

Thank you for your time! April
 

Josephine

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Yes, some people do get affected by the weather. It is believed to cause an increase in pressure in any swelling that might be present.
 

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