Big Mistake

[WHS]

I am 58 year old male with bilateral TKR in June.. I have been an athlete all of my life and spent considerable time preparing for this event. Thus, I felt well prepared going into surgery. I selected a surgeon with an outstanding reputation for whom replacement rate was well above average. The hospital was rated number one in orthopedic surgery in Pennsylvania.
Bone was worn down on left knee along with scar tissue from previous surgeries made surgery longer than expected. Recovery was very difficult with pain and a very bad reaction to pain meds. I completed all PT as requested and continue with PT. I have 122 degrees of bend in both knees with 0 degrees extension in right knee and 0 degree extension in left knee. Pain continues particularly after being on my feet for any time. Specifically, knees begin to tighten and become stiff with decrease in range of motion. Going down steps and getting up from sitting is a real struggle.
My PT schedule has been two hours nearly every day with an hour plus on the the stationary bike then lifting and stretching. I doubt there is anyone working harder. I am also doing acupuncture and massage therapy.
At six months things should be better. All of this was suppose to improve my quality of life. Instead I am worse off. Doctor has no answers but wants me to see another Dr. in the practice. My doctor has talked about redoing the knees. I'm not seeing many ways out of this but can't imagine living with this the rest of my life.

 

[Rowdy66]

Has it occurred to you that perhaps you overdoing the exercise? I had BTKR on May 13, 08 and have done wonderfully. I am very active and was doing my own cooking, cleaning, laundry plus taking care of my six dogs with in two weeks of the surgery. I only went to PT three times but did exercises on my own at home. Certainly not to the extent that you are going at it. Did you always spend three hours a day exercising? Have you tried backing off on the exercise and seeing if you still have so much pain? I certainly hope you find relief soon as continued pain is so wearing. Were you able to find a pain med you could take without a bad reaction? I have severe back problems and so have continued on the pain meds as I need them for the back and neck pain but I do think that having adequate pain relief is very important and contributes to our getting better more quickly. Hopefully there will be someone else on the forum who can give better suggestions than I have come up with. You must be worn out and very frustrated, as well. Good luck in a speedy recovery. Rowdy

 

[JudyS]

WHS

Welcome to bonesmart. I had a hip replacement in June, first knee scope 2 days ago.
I feel very bad for you having all this pain 6 months out. What does your doc say is the cause of continuing pain?
I am 51 and very athletic and it would really depress me to be going through what you are dealing with.
I would find a doc outside this practice and get their opinion. Actually if I were you I would seek out one of the best on the east coast and get an opinion from him or her. I have travelled across country for a health issue to a great doc which certainly saved me and my sanity.
Jo , our wonderful nurse will certainly respond and help you. Oh and do you have pain meds that work for you?
My thoughts and prayers are with you
Judy

 

[AlaskanTKR]

WHS
I had rtkr in JULY and felt the same way until the middle of November and then I got the stomach crud and a massive cold that totally made me horizontal at home for 5 days - I am a teacher and it takes a lot to keep me from working. Needless to say the pain meds wouldnt stay down and basically I was just totally resting. I hated cancelling PT but there was no way I could even drive to get there (my hubby works away). So basically I was a couch potatoe. I had rom problems and was just making ground when this happened so I was worried about loosing it. I finally got better (Yep broke down and saw the doc for a prescriotion which did the trick) and then went back to my life - weird thing was the knee felt awesome! It took like 2 visits to get the rom back to 120 and then ever so slowly by 12/5 we got to 135. I still swell after work and the weather plays a part in the achieness I have, but.... What a difference. We also found out I had a hip issue so once we figured out how to work around that for rom and exercises at pt things also turned around. Maybe you need a few days to let your body rest - it sure made a big difference for me. Seeing a partner is also a good idea. I ended up having a MUA by my doc partner since he was out of town (agreed to ahead of time). This guy is much younger and more aggressive - he was the one who discivered the hip issues and we just took care o0f that yesterday in hopes of avoiding a hip replacement. I had the scope and am not sure what all he found but he told my hubby that things looked really good when he was done!!

Hang in there. I know how tough this is and I only had one knee - I cant imagine dealing with a bilateral situation!

Thinking of you!
Marianne

 

[Jamie]

After reading your post, my ideas were exactly the same as Rowdy, Judy adn Marianne. Even though you were in excellent physical shape before the surgery, remember that you DID have a MAJOR operation. You are exercising so many hours of the day! Try cutting back for a few weeks and see if the pain is relieved. Also, the idea of a second opinion is great. I'm surprised your doctor didn't tell you to slow down a little. You do need some type of pain meds to help....even if it's just Tylenol or Aleve. Please don't let yourself suffer in pain!! I would certainly do these things before considering any more surgery!!! I know you are frustrated. Please continue to post and you can get plenty of support here.

 

[Josephine]

I'm so sorry you're not getting good results. Personally, my first impression is that with such excellent ROM, why are you still doing so much PT? I honestly think the excess exercise is what's causing your pain and stiffness! To still be doing so much after 6 months, I am at a loss to understand why you feel it's necessary. Additionally, recover can take up to a year so I think talking about revisions at this stage is a bit premature unless there's some factor you haven't mentioned.

 

[WHS]

Has it occurred to you that perhaps you overdoing the exercise? I had BTKR on May 13, 08 and have done wonderfully. I am very active and was doing my own cooking, cleaning, laundry plus taking care of my six dogs with in two weeks of the surgery. I only went to PT three times but did exercises on my own at home. Certainly not to the extent that you are going at it. Did you always spend three hours a day exercising? Have you tried backing off on the exercise and seeing if you still have so much pain? I certainly hope you find relief soon as continued pain is so wearing. Were you able to find a pain med you could take without a bad reaction? I have severe back problems and so have continued on the pain meds as I need them for the back and neck pain but I do think that having adequate pain relief is very important and contributes to our getting better more quickly. Hopefully there will be someone else on the forum who can give better suggestions than I have come up with. You must be worn out and very frustrated, as well. Good luck in a speedy recovery. Rowdy

I have not exercised since Monday and do not see any difference. I stopped exercising this week because I beginning to lose hope. I have always a big exercise person. I stopped all prescription pain meds at the beginning of August because of signs of addiction. First week was hell but so was the first 10 days after surgery. Spent all summer freezing. This has been a fight from the beginning and I no longer have the energy for it.

 

[WHS]

WHS

Welcome to bonesmart. I had a hip replacement in June, first knee scope 2 days ago.
I feel very bad for you having all this pain 6 months out. What does your doc say is the cause of continuing pain?
I am 51 and very athletic and it would really depress me to be going through what you are dealing with.
I would find a doc outside this practice and get their opinion. Actually if I were you I would seek out one of the best on the east coast and get an opinion from him or her. I have travelled across country for a health issue to a great doc which certainly saved me and my sanity.
Jo , our wonderful nurse will certainly respond and help you. Oh and do you have pain meds that work for you?
My thoughts and prayers are with you
Judy

Thank you for the information. Do you have an recommendations for 2nd opinion.

 

[WHS]

WHS
I had rtkr in JULY and felt the same way until the middle of November and then I got the stomach crud and a massive cold that totally made me horizontal at home for 5 days - I am a teacher and it takes a lot to keep me from working. Needless to say the pain meds wouldnt stay down and basically I was just totally resting. I hated cancelling PT but there was no way I could even drive to get there (my hubby works away). So basically I was a couch potatoe. I had rom problems and was just making ground when this happened so I was worried about loosing it. I finally got better (Yep broke down and saw the doc for a prescriotion which did the trick) and then went back to my life - weird thing was the knee felt awesome! It took like 2 visits to get the rom back to 120 and then ever so slowly by 12/5 we got to 135. I still swell after work and the weather plays a part in the achieness I have, but.... What a difference. We also found out I had a hip issue so once we figured out how to work around that for rom and exercises at pt things also turned around. Maybe you need a few days to let your body rest - it sure made a big difference for me. Seeing a partner is also a good idea. I ended up having a MUA by my doc partner since he was out of town (agreed to ahead of time). This guy is much younger and more aggressive - he was the one who discivered the hip issues and we just took care o0f that yesterday in hopes of avoiding a hip replacement. I had the scope and am not sure what all he found but he told my hubby that things looked really good when he was done!!

Hang in there. I know how tough this is and I only had one knee - I cant imagine dealing with a bilateral situation!

Thinking of you!
Marianne

What do I have do to get to 130? Did a NOLS out of Palmer years ago. My goal is do one more trip on the North slope. Thought by getting my knees done I would be able to do another trip. So far I have gone backwards. This is not what I anticipated.

 

[JudyS]

WHS

I reread your thread and saw you researched your hospital and doc. I am in California and don't know of ortho's in the east. Actually, my issue was in endocrinology where I travelled across the country.

I would start with an apt with his partner. Also does he have any reason for re doing your replacement?
Also I am an obsessive exercisor so understand others like me. I would go to evey other day possibly.
What does your pt say about all of your pain?

What made you think you were getting addicted to pain pills. I have now been taking them since last April. Today if it were not friday, I would be calling my docs office to add something as my knee is really really hurting.
Keep us informed and make another apt on monday.
Judy

 

[WHS]

Pain Med addiction: Post bilateral TKR surgery pain was intense. I had an epidural in the recovery room. Pain meds from that point on provided little relief and I spent most of my time not sleeping and hallucinating. Surgery and not sleeping weakened me considerably. I also stopped eating for the first six days and lost 25 lbs. After the first ten days, pain meds seem to provide some peace for about an hour or two. After that, I was miserable. During that time I was constantly cold, wearing a heavy sweatshirt over a long sleeved shirt, sometimes covered with a heating pad. Also, my hands and feet itched to the point where I needed Benadryl to control it. I finally decided to stop all prescription pain meds. The first week was awful but I gradually felt better. During this time I never missed a PT session and completed all activities. Yet, my surgeon wrote a letter to my family doctor indicated there was no reason for my pain and that I seemed to be "mentally overwhelmed." I have endured the pain and being maligned by my surgeon and a family member all along, doing everything that was requested of me and more. The end result is this has been a nightmare with no end in sight. I jokingly suggested to some friends that I would have gladly accepted the idea of someone shooting me in the hospital and had I known the end result, I may have been more serious about it.

 

[marennorge]

If you want to come East to Boston....Dr. James Bono at New England Baptist Hospital. He is considered one of the best in the country. www.dbono.com

 

[JenniferG]

Sounds like you needed a different pain med, not none. Dilauded made me sick as a dog though pain free. I switched and was better. Were you ever referred to pain management specialist?
Dr. John Keggi in CT. I had bi-lat in March and great sucess. Matter of fact just finished shoveling 12+ inches of snow. Last year I stayed inside in tears and pain with fear of slipping at the thought of going out. Might have to start skiing (Ha Ha). He's pretty strict with the pain med regimines so you will be monitored for any addiction concerns.

Pain Med addiction: Post bilateral TKR surgery pain was intense. I had an epidural in the recovery room. Pain meds from that point on provided little relief and I spent most of my time not sleeping and hallucinating. Surgery and not sleeping weakened me considerably. I also stopped eating for the first six days and lost 25 lbs. After the first ten days, pain meds seem to provide some peace for about an hour or two. After that, I was miserable. During that time I was constantly cold, wearing a heavy sweatshirt over a long sleeved shirt, sometimes covered with a heating pad. Also, my hands and feet itched to the point where I needed Benadryl to control it. I finally decided to stop all prescription pain meds. The first week was awful but I gradually felt better. During this time I never missed a PT session and completed all activities. Yet, my surgeon wrote a letter to my family doctor indicated there was no reason for my pain and that I seemed to be "mentally overwhelmed." I have endured the pain and being maligned by my surgeon and a family member all along, doing everything that was requested of me and more. The end result is this has been a nightmare with no end in sight. I jokingly suggested to some friends that I would have gladly accepted the idea of someone shooting me in the hospital and had I known the end result, I may have been more serious about it.

 

[JudyS]

WHS
It doesn't sound like addiction was your problem, bad reaction to whatever you were taking.
Your doc sounds like a piece of work. He needs a bilateral TKR with no pain meds.
There have been many posts on this site of people having difficulty with their surgeons and pain meds. I have been very fortunate as my surgeon knows it is very painful.
I would call my primary care doc and get something that works for you. I am now experiencing lots of pain from my wed. knee scope and know how miserable it can make a person. It is causing me to be totally tense in all my muscles.

After re reading your post. You need to get pain under control. I am glad people are sending you other doctor names. Please set somthing up and see what is going on After you get the pain under control.
What does your pt say the continued pain is from?
Judy

 

[AlaskanTKR]

WHS
Yikes - I hate the pain meds but they really helped as we moved through rehab. We got to 130 in a variety of really strange ways. Once we decided and knew why I couldnt go straight on with the pushing for rom the pt tried something very different. I was on my stomach and he belted my leg around him and stretched it up toward my heqad at a very strange angle. But it worked. Then when we pushed for rom at one point the pt was up front angleing and pushing, the assistant pt was shoving and the office manager was under the table pulling my foor. As long as we held the angle I had very limited pain and we really got it to bend.

I got off the pain meds - for the most part until I had this hip scope. OS was really insistent that this scope was going to be very painful... Did ok til last pm when marcain wore off totally - i guess. Yikes. He gave me more hydrodone 10/325 and dose is 2 very 4 hours so I am very very stoned. But it is making life tolerable. Also running game ready ice thingy as prescribed. 30 on 30 off with compression.

I wish I could help you more - I knowe I feared additiction but after coming off the drugs once I know I can do it again and in the end all this will be worth while.

Thinking of you and hoping the best for you!
Marianne

 

[Josephine]

My goodness! Talk about doing things the hard way! Did nobody advise you of the deleterious effects of uncontrolled pain upon healing? And I think your surgeon needs a sharp lesson in experiential pain management! What a clutz!

As Jennifer and others have said, there are a myriad of other pain meds available and your doctore should have experimented to find the ones that were more suitable to you. Sounds to me like you've had a bad deal all round.

Now as for this present pain, you say it's been no better even though you've done no exercise since Monday ... did you think a pain that has been building up for weeks was going to go away in a few days? Have you taken any pain meds for it? Try Tylenol or an NSAID like ibuprofen - or you could take them both, they act as companion meds extremely well.

 

[Simon]

The itching was a dead give away to an allergic reaction. I had the same thing in the hospital along with hives and turning bright red. Make a note of what you were taking when the itching started and report it as an allergy.

I agree talk to your primary care doctor about a good pain management program. I had 9 previous surgeries as was always worried about addiction so did not take enough pain meds and it was counterproductive. This time I was in the inpatient rehab and the PT requested the med be changed to extended release as they could not line up a drug schedule with PT. That worked great, I took 15 mg MS-Contin in the morning and another 15 mg at night and used hydromorphone 4mg for break through. That worked great and I stopped the MS-Contin in 3 1/2 weeks and by 6 weeks was only using the hydromorphone before PT and stopped all together by the beginning of September (started of month 4)

Knocking out the pain early made all the difference as I really do think recovery went much better when I could function without the pain.

Good luck.

 

[Pa guy]

WHS,
Sorry to hear your having such a rough time, My suggestion is to seek the help of a pain management specialist.
As I have stated in another post that I was concerned about addiction and dependency, but as the pain decreased the need for the pain meds did as well.
Keep your head up and will strong, TKR is a painful struggle but once all is said and done you will be thankful for doing so,
Even though it is the toughest part of the battle, keeping positive is a key part to helping and healing your self!


I was 40 when I had a TKR, very athletic, my work included a lot of manual labor (climbing,lifting, bending, kneeling, ECT...) I have had 6 knee surgeries prior to my TKR.
The first few weeks of recovery and PT were pure HELL to put it bluntly, pain meds were key to dealing with it all.
Your PT and exercise seems to be overly excessive, I was going to PT 3 times a week for about 3 1/2 months,
Also using the CPM machine 2 to 3 times a day for about an hour each time, it had taken me about 7 months to reach almost full ROM.
My daily exercises included nothing more then stretching and walking,
After 6 months I was walking with 2 lb weights on my ankle to help strengthen and regain the muscle loss.
I was also continuing to have pain, clunking along with struggling with stairs, walking for any reasonable length of distance, and border line of knee dislocating.
Went for a few opinions and found a OS here in Pittsburgh who specializes in TKR Revisions and complications (Ari Pressman -OS)
He had ran full battery of testing. and found I am in need of a revision, do to the femur being 5 degrees off, the insert being 4 to 6 mm to small, edema witch may mean loosing, or just from the knee being out of placement (revision will be done Jan 5th just 11 months of my TKR)
He is a very thorough, highly renown and respected for his specialty, works in several areas of Pa I would highly recommend him.
My best wishes and prayers are with you!

 

[WHS]

Thank you for the information. Dr. Pressman is good option for me -I'm about 3 hours east. What hospital(s) does Dr. Pressman perform surgery?

 

[Pa guy]

He has offices in Mt. Lebanon, Belle Vernon, Charleroi and Uniontown.
Not fully sure of what hospitals he works out of, but here is a link i hope it is helpful.

broken link removed: https://www.theorthopedicgroup.com/index.htm