TKR Both TKRs July & September 2015

[kneeper]

Sounds like really poor pain management. The first weeks can be tough if not properly medicated. I don't know what planet your doc is on.
Are you icing and elevating?

 

[Julie-Ann]

Thank you everyone! Well day 7 post surgery... I was in bed all ready to write a chirpy, "I feel so much better" post. Then I got up.

Mornings are the worst. I slept 6 hours last night plus 4 naps yesterday - and back on gabapentin. I still want to throw up with the pain and I've been up an hour. But I know this is just the morning stuff, and I'm now realising that it WILL pass, it's just that mornings are so vile. I'm also really low in the mornings.

I'm off to Physio today, and am scheduling a call with my doctor to try to get better meds. Maybe the codeine I was given "for emergencies". I have also decided that an "emergency" is when I am crying with pain and feeling like it will make me throw up. If that's the case then I'll be on a couple of doses a day at least!

Thank you thank you thank you for the support. It is such a relief

 

[Josephine]

the OS was rather unsympathetic about pain! He said most people were fine on paracetamol and ibuprofen/diclofenac after the initial hospital period

Rubbish! I've never known anybody manage on that. He obviously needs some educating!

I'm on ibuprofen 400mg for swelling 3x a day, paracetamol 1000mg a day and Tramadol 100mg 4 x a day.

I think the key here is timing - it's crucial that you even your meds out over the 24hrs. I have this schedule I worked out which worked perfectly for my first knee but not for my second But it would be worth a try.

 

[cairistiona60]

You need the codeine. I tried over the counter meds but they did nothing. Hope you get some relief.

 

[CATSMUM]

@Julie-Ann How did Physio go? Did you get your medication sorted? Codeine is needed atbthisxearly and not just for emergencies. As Josephine said above, your OS needs educating!

 

[Julie-Ann]

I'll post more later, exhausted right now. The doctor placed me on 60mg codeine 4x a day and I feel MUCH better. Everything I had was just going into managing the pain, I was running on empty!

Physio says functionally I am great 0-75 degrees unaided but have to get the pain under control so I start to feel well again.

More soon! Thank you so much everyone!

 

[cairistiona60]

Great to hear this @Julie-Ann. Hang in there.

 

[Julie-Ann]

Really good day thank you everyone. I am now looking at my third dose if codeine shortly, and feeling much better. I ate well for the first time today, sandwiches and cake with tea! I ATE not just nibbled like before. Amazing how much better it us when every bit of energy you gave doesn't go on fighting the pain and just existing!

I'm struggling to find a comfortable position. I must gave "over elevated" because all the back if my lower leg is sensitive to pressure now! So maybe I need to do a bit less. I think I was so happy to be pain free I just melted into the chair with my kegs up and stayed still far too long!

Is it ok to sit with the foot down or does it gave to be raised to some extent (either horizontal or elevated above) at all times? In hospital I had to sit with it up all the time......
Thanks everyone!

 

[kneeper]

Great to hear you're getting more pain control and are actually eating.

It's fine to sit up, but you will get uncomfortable if you do it for very long at a time. It's also ok to get up and walk--to the bathroom, to the kitchen--every now and then. But do spend a lot of your day resting and elevating.

 

[PolarBear60]

Julie-Ann, I'm so pleased you've gotten better pain management, and a physio who concurs not to do the exercises that hurt. What a difference these two things will make for you as you recover!

As for the position on your knee, listen to what it tells you. You'll want to spend a majority of the time resting and elevating at first, but you'll gradually find you need to move more, and that's okay. Find a balance between gentle movement and resting, icing, and elevating.

At nearly 15 weeks, I spend a lot of time with my knee down, but it is more than willing to tell me, "Hey, Lady, put me up for a while!" And I darned well better listen!

 

[cairistiona60]

I'm still finding it difficult to get a position that is comfortable for all my body aches. I just get my knee comfortable when my back hurts, then I get in a spot where my back is ok but my bum goes numb. This sure is an interesting journey. I'm thinking it might be nap time.

 

[Julie-Ann]

hi I am having a spot of bother that is really causing issues. I am experiencing what I can only describe as "pressure pain". It's a feeling at the back of my leg and knee that feels as though my leg is resting on a hard surface. It feels as though there is a hard corner to the pillow or cushion, or even something like a small apple or two under my leg!

Obviously I am trying to do as much elevation as possible, but this is really limiting me because it becomes so painful after even a short period. It's mostly but not exclusively in the back crease of the knee, on the inner aspect of the knee. I'm sure there is a tendon or ligament or something there that is suffering from the surgery. But I get the pain elsewhere too, all along the back of my calf ankle to knee and also the back of the lower part of the thigh.

NOTHING helps - angles of elevation, high pillows, soft pillows, rounded pillows, nothing makes it any easier. Every time we change something it's like "oh yes that's great" and then a minute or two later it's back to square one.

I am guessing I cannot be the first person to experience this! I'm also guessing that it's due to sensitisation of the area by the weight applied to those areas when there is not normally any pressure on them. I would really appreciate any advice as to how to deal with it though, – not only is it painful and annoying, but it's holding me back from elevating as much as I really need. Can anyone suggest anything? For now the only comfortable position is regular sitting, which obviously involves the leg being down, and does nothing for drainage or to prevent clots!

 

[Majic]

@Julie-Ann I had something like this in hospital late one night, the pain behind my knee was under my knee and was a stabbing pain. The doctor elevated my leg and put two ice packs on it. My leg was also numb down the inside from ankle to just under my knee still is. Everyone tells me it is probably a nerve, and it shall ask my Surgeon when I see him next Tuesday. You are 4 days behind me so it is very early days,why don't you tag Josephine and ask her advice, I am sure she would be helpful. It is nice to know that there is someone from my part of the country out there, I will follow you and see how you get on.

 

[Julie-Ann]

Hey thanks! Mine isn't stabling it's dull -exactly as if I had an apple or something under the leg. Talk about the princess and the pea! Ice helps but it's a mare as it makes elevating painful.

I'll follow you too! Local is assuring lol.

Now I just need to check for constipation threads and wait to see what's next by way of problems lol

 

[KarriB]

@Julie-Ann pretty sure a moderator will stop by to merge your threads. BoneSmart wants recovery people to keep everything in one threads for consistency and to make it easier to follow your recovery. Several people have experienced pain while elevating and insure will pop in to advise.

 

[Roy Gardiner]

Julie-Ann, it's just a week since surgery, all sorts of things can happen. Most important, don't worry! Don't do the elevation if it hurts you, it's not essential. The most important thing is just to relax, rest and be as comfortable as possible, don't feel you have to do stuff.

 

[Julie-Ann]

Thanks Karri I just thought as it was a specific symptom a new thread would be best

 

[Majic]

@Julie-Ann I agree with Roy, with my last knee I was in hospital for 10 days and had a splint from ankle to top of thigh, so just lay with it flat on the bed, or sat in a chair with it raised level with the chair. I had the splint on for 5 more days at home. Nobody told me to elevate it, and i couldnt put ice in it. It recovered just the same. Put it into whichever position is comfortable at the moment, and speak to your OS as soon as you can. Just don't worry, rest sleep and a few gentle exercises is all that you need so early on. Where did you have it done, I had mine done at the Nuffield in Cheltenham as we are fortunately insured, so I could fit in with our holiday times.

 

[KarriB]

Just see if you can change the title of your thread. I use an iPad and can't do that so if you tag @Jamie she can change your title for you.
Because you are so early in recovery there will be many different aches and pains due to the trauma of TKR surgery.

 

[Julie-Ann]

Cheltenham is lovely, I was in there twice last year. Perfectly healthy as a rule but have had the worst 18 months....

April 14 emergency appendectomy
September 14 ovary, tube, chunks of uterus removed
November 2014 post op abscess - not from infection in surgical site, from a blocked gland in my lady cave, almost certainly blocked from swelling caused when he went in up there to do some work on the external side of the cervix.
Last bank holiday in all over the holiday with threatened peritonitis - diverticulitis never had it before and I eat high fibre

Now the knee. Knee was done under insurance too but I chose the Spire in Bristol, surgeon is really excellent the staff seemed in awe of him as he has such high standards! The Spire (The Glen) has a zero infection history, which was obviously really important to me.

Just a shame they weren't more pain-sympathetic. I even had a massive telling off from one sister (good cop) who got me written up for oramporph on request 24 hours for breakthrough. Then when I asked for it in the night the evil sister said no because I was on gabapentin. The same witch also said my gabapentin was too high at 300mg 3x a day and was going to ask it to be put down to 100 but I stopped her. I know darn well the starting dose is 300 x 3 a day then it's tittrated up from there so it's a low dose not a high one. Sigh. It's obviously attitude not a hard and fast medical rule when it comes to pain.

I just pity the poor passive patients. The old and the weak and the not in full faculties...