TKR Di's Recovery Thread

[referee54]

It is important to note that the PT folks work for you---not the other way around. You set the limits and you tell them what is acceptable and what you will not put up with.

Draw the line in the sand, so to speak, and set standards that will not be crossed. IF they do not like them, find a new PT.

 

[ACIM]

Thanks to all for pt advice. Went to a different one today and like her much better.
But exhausted right now...had some scary issues over this past weekend, PTSD episodes resulting from or caused by the pain in my knee. It was a nightmare and I rarely have had any issues with this PTSD.
Anyway, it came, lasted most of the weekend and I used quite a bit of medication trying to get the pain under control-now I go see my os tomorrow and he's not going to be happy to know I'm low on pain meds again.
This is my fourth week tkr post-op and feel like it's my first, like I'm starting all over again.

 

[Pumpkin]

Happy to hear you found a PT you like, never let them push you past the point of discomfort. Be sure to let your OS know how the excessive PT increased your knee pain causing you to have great difficulty getting it under control. You are still very early in recovery, you knee is still inflamed and angry, treat it gently.

 

[ACIM]

Thanks Pumpkin. Getting ready now to go see my OS and your message couldn't have come at a more perfect time.
I'll update after my visit...

 

[ACIM]

Quick update: just got back from my OS appt. He says he wanted me to stick with my original pt guy (the nightmare from hell pt) because he (OS) says I need "aggressive therapy because of scar tissue forming".
He says no more pain med scripts for me and has referred me to pain mgmt. clinic here we in town. Wants to see me back in 2 weeks.
I've got just enough meds for the next two days...tomorrow I will start calling pain clinic to get in asap- cannot go off Delaudid cold-turkey.
Thoughts,

 

[lovetocookandsew]

You're only at 23 days post-op and he won't give you any more pain meds?!!!!!!!!!!!!!I needed them for much longer than that, and as my pain went away I naturally forgot to take them until I didn't need them anymore. This has to be a doctor who never had any surgery, let alone a TKR. I, too, was on Dilaudid. At first I took them by the clock, but as time went on, I took them as needed. I also implore you not to go back to the first PT. Telling you you need aggressive PT is, IMHO, balderdash! I'm not a professional, just someone who's been where you are, but I have been told some people tend to form scar tissue and some don't, just as some of us form keloids and some don't. Aggressive PT will hurt like he**, cause your knee to swell, limiting your movement, causing you more pain and thus taking you longer to heal. My OS never once questioned my need for a refill of the pain meds-he knows patients need it a lot in the beginning and that need tapers off. I'm sure that if I were asking for a lot of refills a year after, he'd question it, and rightly so, but 23 days!!!!!!!!!! Come on. If he won't relent, I suggest you go to your primary doctor and see if he/she will help, if not maybe the pain clinic doctor will have some common sense. Otherwise I'd go to your OS and throw a hissy fit when the meds are gone and you're in terrible pain! Keep us posted.

 

[sistersinhim]

It sounds like to me your OS is a bully and doesn't have a drop of empathy. I, like others here, wish that every one of these surgeons would have to undergo this surgery, then they would understand what a TKR patient has to endure!

 

[Jetmints]

Bless you that can't be right! I'm 5 weeks post THR tomorrow and I'm still on alsorts of meds including a skin patch 35 Micrograms Brupenorphine and Tramadol!! Knee replacements are notorious more painful than hip replacements so if I'm still on prescription drugs you definitely should be!
I live in England so maybe it's different but no doctor whoever they are should allow you to be in pain!!!
I was put on the Transdermal patches for the intense pain before my op but my pain management nurse in the hospital told me not to start reducing under supervision of my GP until I felt I could manage.
I have an appt next week With my GP (week 6) to start reducing meds.
Good luck Hun you'll get there in the end!!
Take Care Jet x

 

[newlybionic]

What an unempathetic person that OS is. He wants you to have aggressively PT which you already know causes a lot more pain at the same time he wants you to stiop them. My former OS was the same tripe of Doctor.. At times you wonder how they can deal with people all day and not truly care. Asking your PCP or GP for help might be a good idea. I personally wouldn't go to that first PT that hurts you so much.

 

[JLP]

I went into my very first outpatient PT session being very adversarial. I explained what I wanted and did not want and was undecided if I would return. They accepted my wishes of no weights or anything that I thought was not to my benefit. Frankly, I thought it was silly anyway. After a couple of times, I knew the routine and just started in on it. They had to ask which exercises I had completed. I never did any exercises between my twice weekly PT sessions. I only did about 7 sessions and my knee has quieted down quite a bit since I have stopped PT. I have good flex (125) and extension (0) and maybe even better now that the swelling has gone down since stopping PT, I am just doing my every day tasks and my knee is much better.

 

[Josephine]

Newbie tkr, would you be very kind to me and change the colour of your font? That red is straining my eyes terribly. I'd be so grateful.

, icing the knee for 10 minutes every hour. But have been told NOT to elevate leg at all.

Popular misconception but wrong!

He says he wanted me to stick with my original pt guy (the nightmare from hell pt) because he (OS) says I need "aggressive therapy because of scar tissue forming".

Well, you just say "fine, okay" and walk out. You don't need him anyway. If you have a serious problem you can go see someone else. Don't let him bully you like that.

He says no more pain med scripts for me and has referred me to pain mgmt. clinic here we in town.

More bulllying. My Lord! You need this guy like a hole in the head!

I'd like to ask you some questions if you don't mind, and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine)

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often? (ignoring your OS's threat to cut you off!)

3. how often are you icing your knee and for how long?

4. are you elevating your leg, how often and for how long?

5. What is your ROM - that's flexion (bend) and extension (straightness)

6. how swollen is your leg?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. what kind of PT exercises and exercises at home are you doing? How much and how often?
This is the most crucial question so please help me by using the format I have left as an example

Exercises done at home: 3 sessions a day
(enter exercise) x (enter reps and sets)
(enter exercise) x (enter reps and sets)
(enter exercise) x (enter reps and sets)

At PT
(enter exercise) x (enter reps and sets)
(enter exercise) x (enter reps and sets)
(enter exercise) x (enter reps and sets)

 

[Josephine]

I only did about 7 sessions and my knee has quieted down quite a bit since I have stopped PT. I have good flex (125) and extension (0) and maybe even better now that the swelling has gone down since stopping PT

@JLP you are a perfect STAR! You made my day!

 

[ACIM]

Josephine and everyone else:
thanks for all your feedback.
Sorry about the hideous red font- not sure how it got like that to begin with but if you can tell me how to change it to another color I will.
Not sure what to say...
Not going back to first pt- I like the one I have now
Will do everything in my power to get more pain meds tomorrow, from somewhere. My GP's office has already told me they won't give them to me, but I can always go to the ER if things get bad.

Josephine: answers to your questions
1. Pain right now about a 2
2. Delaudid- 2mg. He wrote me a script on March 22 for 60 and told me they should last me for fifteen days. Today would have been the 8th day and tomorrow I run out. I took around 18 mg. a day from last Thursday-Sunday after that horrendous pt. session. Since Sunday night gone back down to about 8 mg. per day.
3. Icing knee for 45 minutes 4-5 times a day.
4. Very little elevation other than sitting in my bed.
5. ROM is about 65.
6. Knee moderately swollen.
7. Little to no housework from Sunday to today- nothing but sleeping- (depression?)
8. Starting yesterday- rehab with new pt-
A. Ankle pumps 20 at 2x day
B. Tippie toes- 20 at 2x day
C. Quad sets- 20 at 2x day
D. Heel slides- 20 at 2x day
E. Tighten thigh muscles and hold- 20 at 2x day
F. Lifting operated leg up while lying on back
G. Lifting operated leg while lying on side
H. Same leg while lying on tummy
I. Sitting in chair lifting operated leg up
J. Lying on tummy bending operated knee
K. Sitting in chair while "pulling" knee back towards the underneath of chair

All exercises done 20 times twice a day.
However, my first 3 weeks of recovery I probably did far more work around the house than should have.
Di

 

[kneeper]

Good grief--couldn't the doc just give you something else if he doesn't want you on the dilaudid?
I have to thank goodness for my OS who had a reasonable pain management approach--started on oxycodone then stepped down to hydrocodone and let me go at my own pace, spreading out doses. I was able to be off everything but tylenol by 12 weeks that way. Maybe if you go to pain management they will come up with something like this.

 

[ACIM]

He's never had any bedside manner but I went to him because I heard he was good- he actually did my hip replacement fifteen months ago and that worked out well.
He's upset with me because I think his pride is too strong to ever really be an empathetic surgeon...young, no surgeries that I know of, and even my brother-in-law, who is the trauma director of my hospital, says my OS is arrogant, but good.
Down to 6 pain pills...have to drive to pain clinic tomorrow if I want to remain comfortable on Friday and through the weekend.
Please say a prayer for me.
Di

 

[Celle]

Sorry about the hideous red font- not sure how it got like that to begin with but if you can tell me how to change it to another color I will.

@Newbie tkr
To change the colour of your font, look at the fourth symbol from the left at the top of the box where you write your posts - the one that looks like a capital letter A, with a colour strip under it and a Down arrow beside it. Before you start writing anything, click on the Down arrow and a box containing many colour samples will appear. Select the colour closest to black - because that's easiest to read.

I tried to change the colour of your font in the two posts above, but couldn't do it.

 

[Celle]

Sorry. Duplicate post.

 

[ACIM]

Thanks. Think I've got it...

 

[charmed-life]

Hope the pain clinic can help you - at least that's their specialty and they can monitor better and have more options for you. Orthopedic surgery is one of just a few that are the most competitive to get into, at least is the US. But "bedside manner" is not really part of what they judge on...


Sent from my iPhone using BoneSmart Forum

 

[ACIM]

I understand. Here's the thing...my OS office has just told me that the phones as pain clinic are not working properly and that they're having trouble getting me in to see them today. I asked my OS to write me a script for enough pain meds just to cover me through the weekend, if neccessary- he won't. He has had me on Delaudid and I've got only a few pills left.
Does anyone know what going off Delaudid cold turkey will do to me?
My OS says I should not be having any pain now and said something to one of his staff members about "addiction" issues...needless to say, I'm upset.
Now post op at 26 days.