TKR BionicManBall's Recovery Thread

BionicManBall

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I am new to this forum. I am not sure the best way to communicate with other people experiencing the same thing or close to the same thing. Some guidance would be appreciated.

I had a TKR done on my left knee August 12, 2020. As of today am a little over 3 weeks post-op. I am walking with a walker and a cane. My pain meds are taken every 6-7 hours and have been increased from every 4 hours. My pain is more of an ache and hurts after exercises (no surprise). I am going to
PT three times a week and can drive myself.

My biggest complaint from the surgery was the pain in the thigh muscles due to the use of a tourniquet. I talked to my surgeon and read the primary medical literature on the use of tourniquets during a TKR. My surgeon said that if I wanted to next time he would use it only minimally to make sure the bone was dry before apply adhesive - that is my plan for my next knee. Other complications included constipation and difficulty urinating right after surgery. I am on the road to recovery.
 
Hello @BionicManBall - and :welome:

You will see that I have moved your post from the August Hotshots thread to start your own recovery thread.

The monthly team threads are primarily to allow you to see who has had surgery the same month as you. Discussion of issues, comments, and questions regarding recovery must be kept in each person's individual recovery thread.

Please post any updates or questions about your recovery in this, your own thread. We will see them there, as someone checks all the new posts every day.
If you need an urgent response to a question, just tag a member of staff.
Tagging other members and answering tags

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

Just in case you couldn't find your thread, 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. Please will you do that?
 
Here are our recovery guidelines, to help you through 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
ice
take your pain meds by prescription schedule (not when pain starts!)​

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. Try to follow this

6. Access to these pages on the website

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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 
Hello and welcome to bonesmart. Congratulations on your new knee. I predict you will love it as much as I love mine and what they enable me to do. It will be interesting to read about your recovery.

There is lots of information in the articles that come in handy throughout recovery. If you have any questions after that please be sure to ask. Have a peaceful night.
 
Welcome to this crazy journey of TKR recovery- it can be a rollercoaster, but honestly, you sound like you are doing great,
I had my left one done in January and 2nd in May, So glad to only have 2 knees.Lol
your right, it is more of an ache, not the previous crippling pain, but it does get tiresome. You are doing everything right! Hang in there!
 
Yes, the surprise tourniquet. I had both knees replaced and wasn't prepared for how my quads would feel after being put in tourniquets. It's impairing my ability to walk (on top of everything else). I've been using a tens unit on my quads off and on and that helps with the pain. Massage helps a little. Seems like only time is going to fix this. I can feel a line in the back of my legs where the fat was crushed. I'm very glad I wasn't awake for that. I might've had something to say about it.
 
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Don't forget tourniquet are excellent in stopping blood squirting onto the surgery ceiling, and are a necessary evil.
In the UK its called a dead leg, mine was painful and very achey, but it doesn't stay around for long.
I'm unclear about the bit about dry bones and adhesive, what's the relevance to a tourniquet which I thought was just a belt which they tightened to restrict blood flow. They put mine on prior to entering surgery, but left it to the anaesthetist to tighten it up, presumably as tight as it needed to control bleeding (I remember him doing it)
Otherwise, everything seems to be going well and as expected.
 
Dear Tykey,

From my reading of the medical literature, a tourniquet is used to help control bleeding (of course) but can also control leakage of other fluids (not sure what kind, lymph fluid?). The exposed bone needs to be completely dry for the glue to work properly. Some surgeons do not use a tourniquet at all have only minor differences that may or may not be clinically significant. My surgeon said he would use it only minimally and this is a compromise I can live with (I hope!).
 
Just thought I’d drop in to say I had my LTKR surgery the same day as you. Will be nice to be on the journey with you - although I’m in the UK so there are definitely differences
 
I am starting to taper off of my pain medications. I am not needing as much relief as I did earlier. I was taking 5 mg oxycodone + Tylenol every 4 hours and then started taking them every 6 hours. Today I am taking tylenol if needed in between doses of oxycodone every 8 hours. So far I am doing well today.
 
By this stage, I had decided to take Tylenol as the routine pain killer, with an opiate only when I needed it, normally just once a day at bedtime for a while then dropped them off entirely after another week or two.
That's the advice the hospital gave me.
 
I am not sure from your post when you stopped taking an opiate. How many weeks post op was it for example? I am at week 5 post op.
 
As far as I can remember, I took my last opiate at about 3 or 4 weeks (one at bedtime). Tylenol were always very effective for me as long as I took them on a regular basis.
 
I was able to walk up the stairs using my surgical knee without pain for the first time in about a year. I am 5 weeks post op and my left TKR is feeling better than my right knee. I am making progress. Thought I would let this board know.
 
Wonderful. Nothing like a bit of normality to give one's spirits a lift. Have a peaceful evening.
 
Opioid Withdrawal Symptoms. I was taking 5mg Oxycodone/325 mg acetaminophen twice a day. I stopped taking this dose about 24 hrs ago. I had a terrible night - restless, some shortness of breath, anxiety, some nausea, some diarrhea. This sure sound like opioid withdrawal to me. I am 6 wks post op and took opioids through this time period.

What have others experienced?

I am going to the ER for a possible pulmonary embolism. I am pretty discouraged. My knee is doing great but I am breathless. I am thinking my symptoms were not withdrawal related. Getting old sucks!
 
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@BionicManBall
Fortunately or unfortunately, my doctor wouldn’t give me enough opioid narcotics (oxy or hydrocodone) for me to ever experience withdrawal. I had to ration what he did give me, so I had enough pills to take when I had bad break through pain. The lack of pain meds seemed criminal to me, but I got through it with Tramadol on a regular schedule, ice and elevation, a heating pad, diclofenac gel, Advil and Tylenol with the stronger opioid for break through pain. After about 5 weeks, the stronger narcotics were all gone, and I had to start rationing the Tramadol - only taking that for break through pain. By 7 weeks, I was off all prescription meds. (I had bilateral TKR on July 6th.)

I’m sorry coming off your pain meds is making you feel awful.
 
I got physically addicted to oxycodone/hydrocodone. I have been taking 5 mg doses. Initially, I took this 4 times a day, then went to 3 times a day and then 2 times a day for the past 6 weeks. Apparently, this is long enough to get physically addicted. I never got high from the drug but it did help with the pain from surgery and PT. Last week (Tuesday) I stopped taking this altogether. Thursday and Friday nights were terrible, slept maybe 3-4 hours each night. I think I was having panic attacks but I did not recognize it. Saturday night around midnight I got a panic attack. I could not catch my breath; I was very anxious. So, I went to the Web to see if opioid withdrawal symptoms include panic attacks – they do. I found a web site that offered 24/7 help. I called them about 1 am. The counselor said that I did not taper off from the drugs in a good way. She suggested that I take 5 mg hydrocodone once a day at bed time for 4-5 days and then take 2.5 mg once a day for another 4-5 days. She said I might need a non-narcotic sleep aid after that for a while. She suggested I talk to my doctor about this and I will do so Tuesday. I took one pill last night and slept for 6 hours in a good sleep – much better than the previous nights.

If you are taking opioid pain killers try and limit the duration you are taking them. I read that people can get physically addicted pretty quickly. If you have to take them for some time be sure to give yourself plenty of time to taper off these meds. Tall to your doctor when you are getting ready to quit.

I will keep you posted on my progress. This is definitely not fun.
 
@BionicManBall the reaction to opioid medication is different for everyone. But yes, a very gradual tapering is more comfortable. I am so sorry you had to experience this major withdrawal. I hope things have calmed for you.

To other members reading this - do check with your OS or pharmacist about tapering of opioid medication.
 
It's important to also recognize, as BionicManBall did, that his body had become dependent upon the pain medication during the 6 weeks that he needed to take it during recovery. This is always a possibility with opioid pain medications, but it is not what is generally referred to as "addiction." Drug addiction is a condition that involves mental dependence as well as the physical. Physical dependence can normally be reduced by a very gradual tapering off (tapering over weeks and not just days) of the medication by the patient and there is no further discomfort or problem.
 

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