TKR DLR recovery #2

[beachy]

Diane, can your OS prescribe stronger pain meds until you get the pain under control? I know the side effects can be brutal, but the pain is tough this soon after surgery.

 

[DLR]

@beachy my choices are Percocet or Tylenol 3. Percocet gives me a very bad reaction and puts me flat on my back. I am trying T3 again, 2 every 4 to 5 hours. Perhaps my body was still adjusting to reduced meds when I first came home since I was on Tylenol, Celebrex and Dilaudid in hospital. This rollercoaster ride is normal as you know but I agree pain management is crucial.

 

[beachy]

I landed in the ER about 2 weeks post op. Home health nurse suspected clot and OS agreed. Turns out the oxycodone just wasn't helping the pain. No clot, thankfully. Meds changed to Dilaudid and that did the trick. Having uncontrolled pain is miserable. And it seems to spiral. I hope you get relief very soon .

I never liked roller coasters LOL!

 

[DLR]

@Josephine I have an anatomy question.

I am 1 week post TKR and have severe pain (9/10) at LB4 by your diagram.

This started day 2 and they actually did an ultrasound to rule out a clot. It is like a knife piercing me when I bend the knee to any degree. For example, walking with crutch: if I try to make slightest bend in knee rather than peg leg walk, it hits.

I do have extensive bruising down each side of thigh and calf and behind the knee. I originally thought it was the bruising pain which I have as well but have found if I press into LB4 with 2 fingers when bending I can bypass the pain. I have upped meds to max... 2 Tylenol 3 every 5 hours

I know you are the anatomy queen

 

[Josephine]

at LB4 by your diagram

You're not using the chart correctly. LB4 just tells me the column you are pointing to. I need the row as well, so you show me where the column and the row cross - get it?

but have found if I press into LB4 with 2 fingers when bending I can bypass the pain

I don't understand what you mean by this.

I have upped meds to max... 2 Tylenol 3 every 5 hours

Okay, but how much (in mgs) are you taking each time? I would suggest 1,000mg 4 times a day

I know the FDA has ruled that 3,000mg acetaminophen is a safe maximum but that would be assuming that the patient is taking another medication that also contained it and thereby inadvertently take an overdose. Assuming that this is not the case, the maximum safe dosage per 24hrs 4,000mgs.

 

[DLR]

@Josephine sorry
ELB4
If I press with fingers there while bending there is no pain of course I can’t walk that way it was simply a test to see whether there is a trigger
Tylenol 3 in Canada are Rx level containing 300 mg acetaminophen, 15 mg caffeine and 30 mg codeine phosphate tablets

 

[Josephine]

So it's here then?

That would be the lower end of the IT band.

 

[DLR]

@Josephine thank you... looks like a repeat of last knee... These valgus knees play havoc with the IT band once they are straightened and until that band can gain it’s length back

 

[Josephine]

Yep!

 

[DLR]

Happy to have found a good pain management balance using Tylenol3. Sleeping in the recliner but at least sleeping. Zingers have started...
Today will be an ODIC day but sometimes we make those choices eyes open praying for God to give the strength needed because it is important to do this. We are invited to join a family for dinner celebrating the 70th birthday of our dear friend, he is currently losing his 3rd battle with cancer. The drive is 3 hours there and 3 hours back and we have to be back tonight as my husband has church responsibilities tomorrow. I know at under 2 weeks post op this is really pushing it but believe we are supposed to do it.
Tomorrow our daughters are bringing dinner so I can rest ice and elevate.
Enjoy Easter everyone!

 

[DLR]

Well planned trip was a fail... when we were ½ hour from home my leg was in full spasm throwing a temper tantrum. Turned around and came home. Very disappointed. Feel like I wimped out but know it really was too early for that kind of a trip

 

[Softtail]

Dlr I see you're back. Me too. Just got home with new right knee. Fortunately nerve block is still in play so I have pretty much zero pain. Just wish that nerve block could last about 3 weeks lol.

Hope your recovery goes well.
Softtail

 

[DLR]

@Softtail welcome back.... finding this time is different but not as stressful having been through one before. Enjoy the pain free while you can plus the sleep you get ;)

 

[Jockette]

I’m so sorry you missed such a special day, but really, the long ride both ways in one day, and a party, was too much to try this early. Thank the Lord you were only a half hour from home.

 

[DLR]

@Jockette thank you. I did know it was an iffy idea but hoped... ah well I prayed God would show me and the painful spasms made it clear

 

[Celle]

I'm sorry about your friend and that you had to miss the birthday dinner, but really you had no choice. I hope you'll be able to phone her today, and explain.

 

[DLR]

@Celle thanks

 

[Josephine]

Feel like I wimped out but know it really was too early for that kind of a trip

At less than two weeks? You bet it was too early! Did you not read the Recovery Guidelines you were left earlier? Specially this one Activity progression for TKRs? And if you read that, did you not believe it?

 

[DLR]

@Josephine yes I have and I know. I would never have considered even trying for anyone but this dear friend who is losing their battle with cancer. Our chances of seeing each other again this side of heaven are numbered.
The wimping out feeling is only my sorrow speaking.

 

[Josephine]

Oh I missed about your friend. Please do forgive me.