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TKR Cflower's recovery

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Day six from surgery. I don't think the hydrocodone is working as we'll as before. So much for getting on top if the pain. I take two 325/5 every four fours and its hurting BEFORE the four hour period ends. Still sleeping ok. I woke up at 2:00 only took one pill and by 5:00 leg hurting maybe a 5/10. By 5:15 I took two pills because I was not staying in pain for another hour.

How much is too much on the cpm machine? I used it about 4 hours yesterday morning then just laid in bed without anything then I iced and elevated for about an hour then repeated same thing in the afternoon.
 
Hi CFlower,

Sorry you are hitting a rough patch. At 6 days post op, you are probably spending too much time in the CPM. I used to do an hour in and then rest a couple, then an hour in. You want it for helping to keep moving in a passive way, but even too much passive motion at this point may not be what is needed. If you think about how it was used in the hospital, that might be a good guide, or call OS office. The ice and elevation is most important, use your compression stocking to help. I cut the foot out mine to make it more comfortable to wear.

I'm sure it's frustrating to get so tired when doing something that seems trivial like making salad. Just remember that all the energy your body has is being directed at healing your knees. It knows where to send the energy and will not share much for non-essential stuff. Not that eating is non-essential but you probably get the picture.

Hang in there and we will be here to guide and support you!

Be well,

Dawn
 
Thanks Dawn. I'm going to try what you suggested with the cpm machine. In the hospital I was using it almost around the clock. The pt there even suggested that I sleep in it but turn the flexion down to 50's. I'm also going to try to not ice so long. My husband made me these great homemade ice bags but the problem was I would leave them on at least an hour then my leg would hurt from being too cold. I'm going to try and keep icing sessions own to under 30 minutes.

I have a question about the MUA he did. This was the second one he did on the right knee. I could tell it definitely helped but I don't want to lose the Rom. I can do heel slides and use my strap to stretch it and maybe sit in the chair and pull it back but I don't think I can physically do all the other exercises I was doing on my left leg. Don't think the right knee will go along with that right now. So, do you think just stretching is god enough for right now?
 
I will be four weeks post op on Monday oct 29. This leg moving much better. The swelling has not been nearly ad bad but does seem like I'm having more pain. Pt measured me at 100 this past week but my left leg hasn't progressed I don't think because the focus has been on the right. I need to start doing stretches more often during day on both legs.

Got a certified letter yesterday saying that injections I had during surgery came from NEEC, the company that had all the problems with meningitis. I'm calling my doctor Monday buy I assume it would be from the June 27 ltkr surgery when the gave me steroid shot in right knee while I was under. Do they normally give a steroid shot as part of the knee replacement surgery? I knew that after the left knee was replaced the right knee might start hurting more so that was why I asked for the steroid.

My RTKR never was as swollen, huge and hard as the left knee but has hurt more. The tightness around right above the knee, all the way around, is a lot worst and I thought maybe it was because all the swelling was not there. After about a week I almost could not tell the difference in size. I gave up walker at about 2 1/2 weeks. I don't use cane at home but do take it out with me.

My 5/325 hydrocodone did not seem to do the trick this time. I had it changed to 10/325. I was taking 2/4 hours but have cut back to one. I think I did that too soon because the pain never fully goes away. This week I had cut out setting my alarm at night and just taking med when I woke up. Not good lady night though because it hurt all night and I tossed and turned all night and ended up taking pills at 12:30 and 4;30.

Pt said I'm doing certain exercises earlier with this right knee than left knee in June. He said I have strong knees/legs and I have more of a problem with the stiffness and tightness than weight bearing pain. I guess that's good. Yesterday when another therapist measured me he said my right knee was only 5 degrees behind my left. I did not ask him the measurement because I knee earlier that week right was 100 and I didn't want to hear that my left knee was only 105. I have not worked that knee enough since the new surgery. I know at one time it was 115. So I'm hoping as everyone here has said I will still get rom in left knee. I've now ad two MUA s on that knee.

Starting to get those depressed never going to get better feelings again even though the knee is doing better than first one did. I guess it's been four months since first and the two knees have blurred into one recovery. Pt said these are normal feelings especially after having second one done soon after first. He said most people start second guessing their decision about now.

My incision already looks almost like my four month old knee.
 
Cflower, I had my knee surgery on Oct 2, 2012 and I need my right knee done as well. My orthopedist will not touch it for three months. So now I want to wait until after February of next year if my knee will let me. I'm going to be a grandmother for the first time and I want to be there for my daughter. Right now I'm only on aleeve twice a day and take motrim pm at night. I'm wondering if a sleeping aid would be more beneficial? I'm uncomfortable in bed not really in pain. I guess this will subside in time. You sound like you are doing okay, keep up the good work. Just my two cents.
 
I'm taking alieve along with my hydrocodone. I try and take 1- 1/2 if them close to bedtime as possible. I'm sleeping but not as we'll as knee in June. Seems like I do more tossing and turning. For the first three weeks of first knee I took 2/ 5/325 hydrocodone around the clock. I would set my alarm and wake up to take it. You must be doing good to only be on alieve. I don't like pain so I'm not ready to give it up at one month. I was still taking at least two hydrocodone for my left knee at three months post op when I went in for second knee. I have four grandsons under four years old and I wanted to get my suffering out of the way. Congratulations on becoming a grandmother.
 
Hang in there, Cflower. I hope the sleep improves for you soon.
 
cflower, everybody handles pain differently . I have three kids, and it's my baby that's having my first grandchild. I can hardly wait. at my office i spoil everyone kids now i wil finally be able to spoil one of my own:happydance:Do what you need to do for your need i listen tomine all the time. The PT gave me a new exercise and it gives me lots of pain, i try to do what i can but if it hurts i stop ,i listen to everyone in here slow and easy wins :yes!:Have a good day and keep up the good work.
 
I'm at week eight on right tkr. Pt say this knee has been ahead of what the left one was doing back in June. He to 105 early then it went back a little. Went to doctor today. He suggested MUA on right (8 week) knee. Since I'm now on Medicare I want to do this before deductibles start over in January. So long story short I'm doing this Monday morning. My left knee was MUA at seven weeks and then again at three months at the time my right knee was replaced. So this will be my one and only ma on right knee

This is not the problem. I have been taking hydrocodone now or five months and the doctor said I need to get off. With the first knee 5/325 seemed to work nth he second one I started taking 10/325. At 8 weeks I'm still taking 4 a day. What I want to know Is what's the best way to get off. He told be I could start taking 2 Advil three times a day with 1 Tylenol at same time. But how do I taper off the hydrocodone, jst quit? I normally take 1-10 mg at 8-12-4-8:00, I have almost a full bottle of 10's and a full bottle of he left over 5's. help auld be appreciated.
 
You might start by spreading them out to every 6 hours. I didn't take those as long as you have, but I just gradually extended the time between doses. and I was taking an anti-inflammatory too in between. Though it does seem like telling you to go off the hydrocodone right when you're going to be having an mua is bad timing. :scratch: Unless he's thinking soon after the mua?
 
I was almost off them before having my right leg done. He told me to treat my remaining pills like gold. I know I have no additional pain with the MUA and ice should handle that. I may try every six hours and taking a 5 mg instead of the ten and adding some Tylenol.
 
Kneeper's advice about stretching out the interval between doses is a good place to start. Next, get a pill-splitter (less chance of the pills scooting away when you cut them than with a knife) and cut your 10s in half. If you have enough 5s do that to them as well. What my OS' PA had me do was do 3 days of one 10 every 6 hrs., then 3 days of one 10 every 8 hrs, then 3 days of half a 10 or one 5 every 6 hrs., then 3 days of 5mg. every 8 hrs., then 3 days of every 12hrs. and finally taking the Norco only before PT (by then, taking the Bonesmart Cocktail--2 ibuprofen and 2 500 mg. acetaminophen--3x/day or two naproxen every 12 hrs and two extended-release acetaminophen at bedtime and upon arising). If the transition from 10 mg. to 5 mg. is too much, you can try 7.5 mg by combining half each of a 10 and a 5. I had expected to need that but was able to halve my dose with no problem. I still have the split 5s so I can sleep if I am not sleepy enough, if my not-yet-operated L knee wakes me up or if, as happened last night, I get awakened by a severe cramp in my shin muscles over my tibial hardware and massaging it doesn't make it go away after 10 minutes.
IMHO, it's easier on your liver & kidneys to take half a 10mg. Norco than a full 5 mg., because both strengths of intact tablets have the same 325 mg. of acetaminophen.
 
D.diva. How long we're you on the pain meds. I had started back in July taking 5 mg I had tapered off to two a day by the time I had done my second knee on oct 1. The 5 mg did not help the pain so they raised it to .75 then 10 which I took 2 every four hours for a couple of weeks then started cutting back to 1 every four hours which is what I was still taking until yesterday. That's probably way too much but I guess I was thinking no pain was better than any pain. So yesterday all the doctor said was that I had taken more drugs than any of his patients in the last five years -- wow now that made me feel bad. He said to treat what I have (pills) as gold. He suggested starting to take two Advil breakfast lunch and dinner along with a Tylenol at each. That is nit tapering off. What would you do. At least I know having the MUA won't require any additional pain. Can't say I get a Hugh off this drug or even a vague feel good feeling. They just take the discomfort away. Maybe I was suppose to be dealing with the pain
 
You need to reduce very slowly, like a week at a time. Reduce the dose or the timing at first but not both.
Substitute some doses for Tylenol, not Advil. Advil (ibuprofen) is actually a very mild analgesic so should be taken later on. Tylenol is about 3-4 times the strength of ibuprofen but you need to take the proper dose which is 1,000mg at a time (to a max of 4,000mg per 24hrs, of course).

Secondly, don't be scared of this. It's not inevitable that you are dependent on hydrocodone and if you read this you will know why I say that Myth busting: on getting addicted to pain meds.
 
Started on June 22. For the first 10 days post-op I was on 2 Norco 10/325 every four hrs. Day 11-16, every 6 hrs. Days 17-19, one and a half pills every 5 hrs; days 20-22, every 5-1/2-6 hrs. Days 23-28, half a 10 or a single 5 every 6 hrs, then the tapering off I described till by Aug. 6 I was down to twice a day; from then on, I took a 5 only before physical therapy, clear up to Sep. 7, when my therapy was over.

Your doctor is unnecessarily judgmental, IMHO. One patient with whom I rode to the PT clinic, who had her surgery a week earlier than I, was still on Dilaudid before PT--she was at roughly week 8.
 
So I was at the hospital at 6 o'clock this morning Yet another MUA. This time it was on the right knee. This knee is. 9 weeks old or new. While in there he did the left knee again. The left knee was first manipulated at seven weeks then again at three months when I was under getting RTKR. The dr told my husband that my adhesions pop pretty easy. He said sometimes he really has to push on legs to get scar tissue to break up. He said he got a few more degrees on my first knee and when I went to pt later that day he got both legs to 120. I just hope I can keep that and not slide back like I always do.

I'm done with the mua s I hope I'm tired of the whole business. I'm going on six months (the end of December) for my first knee. I want my life back and I could care less if I have an artificial knee or two 6" scars. When they are healed I will have, hopefully, two new mechanical knees that don't hurt, burn or grind and pop when I walk. I'm just slow to heal and getting a little impatient.

One other question I have for someone. I was in the middle of weaning off hydrocodone and today he prescribes 50mg tamerol. I don't know whether to stay on my same plan 3 days etc. from above post. Or just wait and take a pill when I have pain instead of the every 4/6/8/12 hr plan.
 
Wow CFlower, so sorry to hear you were back for mua's again. I do hope it helps get you on track. Please do everything you can to control the swelling. That is the key. If you can control the swelling, it will help with your rom. After my revision in August, I iced my knee as often as possible, and tried to get the ice all around the knee at once. I used my Ted hose with the feet cut out to help move the excess fluid out of the legs, and pt did lymphatic massage. I did not do any aggressive pt, none at all. Slow, gentle stretches, and keep moving. I dont have much to offer on the meds issue but perhaps others will be able to help.

Keep us posted and I hope for the best!

Be well,

Dawn
 
How everyone had a merry Christmas. I think tomorrow is my last day of pt. started back with ltkr June 27 a MUA about 7 weeks later then RTKR on oct 1 while under he did ma on the left knee again. Had MUA on right knee about 9 weeks later and again the tweaked both knees bright after that pt was able to get me to 120 rom. Some days I lose some and other days I get it back. I didn't feel as good as I wanted at Christmas with my three kids and their spouses and a 8 mo old 6 mo old 2 and4 year old. Everyone gone home so I need to get back to business f the knees. I think I cod live with the rom whatever it is but I'm tired of the tightness feeling that feels like there's a band tightening around my legs. Dr said that could take up to a year to go away. I'm off hydrocodone as taking one tramadol and two Tylenol pm at bedtime. Guess if tomorrow is my day pt. I need to start hitting the gym.
 
It's been a challenging road for you, so many procedures in such a short period of time. Take it slow and easy, especially ow with the holidays behind us, your knees can get the attention they need. I know this is hard but with time it will resolve.

If there is any way you can get into a warm pool, that might help. I did about 4 weeks of pt in a therapeutic pool which was great in many ways, but most important exercise that was gentle but effective.

Best wishes and keep us posted!

Dawn
 
Thanks dawn. We do have a pool not heating it this time of year but can definitely heat up spa everyday. What type exercises did you do. I do lunges and one where I put a pool noodle under ankle and it pulls leg up to a bend
 
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