Cflower, you are doing really well--I was started on 2 Norco #2s (10/325) every 4 hrs. and didn't start to cut back till 2 wks post-op: 1-1/2 pills every 4, then 5 hrs; 1 pill every 4, then 4.5, then 6 hrs, where I am now. Started taking one 650-mg. extended-release generic Tylenol at bedtime and one after breakfast. I have one Celebrex left--nurse says to start on 2 Aleve at bedtime; take the last Celebrex tomorrow and switch to 1/2 a pill (as much hydrocodone as a #1, the pill you're on, but half the Tylenol) every 6 hrs. for 2 days, then every 8 hrs. for 2 days, and if I can handle it, only at bedtime and breakfast. In other words, I will go from a 10 mg. dose to 5 mg. overnight--my surgeon's office would not prescribe the 7.5mg ones or the 5/325s that are splittable--halving the dose all of a sudden seems really abrupt to me I wish I had enough of the Norco #1 5/325s left that I used to take (half a pill--2.5mg--for sleep) before my surgery, so I could split them and taper off more gradually. But I haven't tried the Aleve yet, which might really help with the pain and stiffness.
What worries me is that last night, only 4 hrs. after taking my one Norco #2 and one 650 mg. Tylenol, my pain actually woke me up for the first time since the first couple of days in rehab. Only it wasn't my operated R knee but my L one! My L one has been bone-on-bone in the medial compartment for a few years now (when I asked abt. replacing it, my previous ortho said "YOU tell ME"), but I'd been coping with an unloader brace and topical NSAID gel & patches. I tore my R lateral meniscus 2 yrs ago and had it scoped--that ortho told me it wasn't ready to be replaced, even after I told him I kept feeling it pop & tear on the lateral side. But by Dec. 2011 I'd just about had it, and went to the top surgeon in town to arrange for a bilateral TKR. He said that at my age & weight (and with 3 antibiotic allergies) it was too risky to do both at once; but he surprised me by saying that the R knee was worse because it had less ROM than the L, it was bone on bone in the lateral compartment, and he suspected I was continuing to reinjure the lateral meniscus. I also had lots of hardware in the R tibia from a bad fracture suffered in a collision with a car, and the tibia was basically a matrix of bone chips and epoxy. Turns out that the tibia had actually begun to re-fracture and my surgeon had to remove twice as many screws as he'd expected--and my rough knee surface had indeed just about shredded what remained of my lat. meniscus. When I began getting into & out of bed in-hospital with the walker, I could feel my L knee grinding, and for the past couple of weeks I could hear it crunch, but the pain was still only in the medial compartment and I figured I could get by with the unloader brace, Aleve, and topical NSAIDs until all my travel and performance commitments were over by mid-Dec.
Unfortunately, the L knee pain is now BOTH the medial twinges AND lateral sharp burning. That's what woke me up--and the medial twinges actually started to feel deeper. I had to apply what was left of my Voltaren gel to my L knee and, when it was 6 hrs. again, take my Norco--still took nearly an hour before the L knee quieted down. I have a call into my surgeon's office for a Voltaren gel scrip (I have enough Flector patches--generic Voltaren, aka diclofenac, but they're pricey and you shouldn't sleep with them on) to get me through till I can schedule the L TKR. I hate to think I'll have to go through this all over again (especially the fear of clots & infections, and the devil of a time they had placing my epidural catheter with my scoliosis....which I'd forgotten I even have), and this time it'll be in winter (unless I completely flush my performing career--and my bandmate's--down the toilet). But we didn't have a bad winter last time, and with this brutally hot summer I haven't gone out much anyway. Found out NW Memorial hospital IS in-plan (just got the much smaller, revised bill) so I needn't wait till my surgeon moves to Evanston Hospital.
Interesting you should mention top-of-foot pain--3 yrs ago I developed it in my L foot. Previous ortho said it was probably a stress fracture, but his partner (a podiatrist) said it was "cuboid syndrome," which happens a lot to dancers and basketball players when they land after jumping. Got custom orthotics (which fit all my shoes) plus that scrip for Voltaren gel. (The Flector patches were for the L knee, back in Dec. 2010 when I wasn't ready to schedule a TKR).
My surgeon doesn't use a CPM machine--and does not prescribe TED hose for obese patients, especially those with spider veins. The cuffs cut into the calf or behind the knee and can actually cause clots. Ironic that you are doing way better than me for pain control, yet my ROM is greater and I haven't even needed to use my cane (exc. for stairs and outside the house) since 14 days post-op! That proves that everyone's recovery is different, and that your body, espec. your knee, calls the shots!
United States
Probably go easy today with all that activity yesterday, though.
