TKR DodgyKnee no more<

[DodgyKnee]

Hi everyone. So I had my surgery on Friday 29th July and ended up with TKR despite all the talk of a partial. I'm fine with this.

After the spinal block started to wear off at about 4 hours, on it came. I was put onto a PCA morphine pump for the night, used nearly all 50 mgs and spent yesterday feeling sick and unable to stay awake.

I'm currently on Tramadol and paracetamol (uk) and as long as I don't move, the background noise is just about bearable. When I do move however, it is excruciating due the swelling. I've been up 3 times today, twice with the physio. If I can manage stairs OK tomorrow, I should be allowed home

 

[Pumpkin]

DodgyKnee,
Welcome to the otherside!
Hope they get your nausea under control. The swelling was painful for me after surgery, putting my knee down was agony, fortunately it went away quickly.
Hope you start feeling better soon, and can go home tomorrow.

Please add your surgery date to your signature, hover over your username top right, click on signature, add your information there, Thanks!
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Here is your copy of the recovery article, they are short and will not take long to read.

First is the reading - everybody gets a free copy of the recovery reading!

Here are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock as prescribed
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

Next is a FAQ (Frequently Asked Questions) thread.

And here are some very crucial articles
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs

Myth busting: no pain, no gain
Activity progression for TKRs
Heel slides and how to do them

Extension: how to estimate it and ways to improve it
Elevation is the key
Ice to control pain and swelling

Healing: how long does it take?
Chart representation of TKR recovery
Myth busting: the "window of opportunity" in TKR

Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

 

[kneeper]

The early days are not pleasant, but it sounds like you're doing ok. Hope you get to go home tomorrow.

 

[Josephine]

I'm currently on Tramadol and paracetamol (UK) and as long as I don't move, the background noise is just about bearable.

"background noise"? Do you mean tinnitus?

Given you're only on the second day, it's not to be unexpected that you're not a happy bunny. Most people aren't. But you don't mention icing and you've not told us how much/how often you're taking the Tramadol and paracetamol. I do hope you're actually telling the staff when you're in pain and not just waiting until the drugs come round.

 

[KarriB]

The first 3 days to a week are not fun at all. If you can sleep, do it, it'll be time you're not feeling that surgical pain.

 

[DodgyKnee]

"background noise"? Do you mean tinnitus?

Sorry Josephine, I mean constant background pain by "noise". I am icing, the only one on the ward, because I asked for it.

I'm getting meds 4 times a day, 100 and 1000mg of each at a time. I get the odd oramorph too when I request additional relief.

Thanks for all your replies, good to see I can expect some improvement in pain levels soon.

 

[DodgyKnee]

So, I'm home. Was released on Monday afternoon, got driven home (40 mins), walked upstairs and have set up camp in the spare bedroom. I have no intention of going downstairs within the week - I'm very lucky to have my OH here who will fetch and carry for me.

Just thought I'd let you all know that reading many posts on this forum before my surgery enabled me to be quite assertive during my care at the hospital. Examples, the morning after my surgery the physio came to get me up and go for a walk. However I had spent all night on the PCA morphine thingy and felt very very sick and woozy, so I said no. She tried to persuade me but again I said no at which point she conceded I really didn't look very well.

I also had a bit of a battle over the pressure stocking for the operated leg, it simply increased the pain and restriction, so I removed it. Cue nurse number 1 being less than happy, warning me of dire consequences, and saying 'do you accept it will be your own fault if you get a DVT?' I just answered yes. The next day nurse was just as unhappy as first and asked me to try it again, which I did as visibly, the leg was marginally less swollen. However the impact on pain was the same, so I removed it again. All this whilst never falling out with anyone or being at all aggressive, so thank you BoneSmart.

I'm packing little dog off to her holiday carer for a week today as she likes to get up on a bed with me and settle on my legs! Big dog can stay as he is more respectful - just wanders into the room, gives everything a quick inspection, stays for a head stroke then bimbles off again.

 

[Ellejay]

Hi @DodgyKnee, I'm glad you're at home now and can control your own recovery, stay upstairs as long as you can, as long as you have enough to keep you occupied, and can do some gentle exercise its the best place to be. One tip you may like to consider....I had a cool bag by the side of my bed so that I could replace ice bags throughout the night without disturbing my husband. I also organised it that I had prescriptions from the GP for Tramadol & Paracetamol waiting for me at the pharmacy, so I never ran out. Good luck with your recovery, each day is different, some good some bad. This is a fantastic site to get help and support, so do ask if there is anything we can all help with.

 

[DodgyKnee]

Hi everyone, I need some help please.

I had the worst night of my life last night and really don't think I can face another. My pain was totally uncontrolled by 100 mg tramadol, 1000 mg paracetamol, 400 mg ibuprofen and even in desperation, the addition of 30mg dihydrocodeine. The pain was making me sweat and feel very sick.

I was crying, shaking and moaning for hours. It started about 11 pm, just after I took the Tramadol and paracetamol dose. At 12.20 I threw in the dihydrocodeine and at about 12.45 I passed out until 2am. I very nearly called an ambulance 3 times, the thing that stopped me was I thought they'd just give me morphine which would make me pass out and then be very sick. I remember 5am, when I took 100mg more of Tramadol, but the next I knew was 7am.

The pain generated from my mid thigh down to just above the ankle. Sometimes it was all of this area at once, sometimes just smaller bits of it individually. Eg, at one point it felt like the end of my femur was throbbing violently, at another like red hot nails were being hammered into my kneecap and at yet another like the underside of my skin in the knee area was being bitten repeatedly.

I am now very nearly 5 full days post op. Is this normal? Was it some kind of 'pain crisis' and will it be a one-off? I totally accept that I might be complete wimp, but the pain score was sustained at 10 for hours, despite the meds.

Help!

 

[Celle]

Phone your surgeon. It sounds as if your medication schedule is not working for you.

 

[DodgyKnee]

The hospital have just phoned me for a follow up call. Told them all about it, was told tramadol was a hefty painkiller and there was nothing else they could give me (UK). Was told to give them as ring back in a couple of days if it continued.

Celle, pain levels were within usual bounds yesterday till around 11pm and have been again today, since 7am this morning.

 

[Celle]

I wonder what set the pain off. Any extra activity that day.? You are taking the pain meds on a regular schedule, aren't you? Icing? Elevating?

I'm sure you thought of those.
I have no other ideas, but you do have my sympathy.

 

[DodgyKnee]

Yes Celle, all pain meds being taken to schedule. Very little activity taking place at all, just trips to the bathroom and a few heel slides. The rest of the time it is elevated and very regularly iced.

 

[KarriB]

Tramadol was prescribed for me as a step down med, but did absolutely nothing for me.

 

[Ellejay]

I'm so sorry you have had such pain-are you taking the paracetamol & Tramadol at the same time? There was a very useful 'schedule' on here somewhere, that gave a timetable of timings and dosages for the Tramadol, Paracetamol and Ibuprofen for a 24hour period, it worked really well for me. I'll tag @Josephine , maybe she can help?
I hope you get a better night tonight.

 

[DodgyKnee]

Hi Ellejay, yes I've been following one of Josephine's schedules - the one where you take both together every six hours.

 

[Josephine]

Told them all about it, was told Tramadol was a hefty painkiller and there was nothing else they could give me (UK)

They will say that out of caution but I had such pain storms and rang my GP in desperation one morning, sobbing like a child. To my surprise she was extremely sympathetic and told me that once in a while just once a day, I could take 150mg Tramadol but that on no account was I to make a habit of it.

So I did this about half a dozen times over the next week or so and it got me over the hump. No doctor would normally concede to this for obvious reasons but it is within the daily maximum because what happened to me was that such a dose ended up making me sleep for ages so I missed the next dose! Please be clear - I am NOT recommending this as a routine thing but if you've never had a pain storm then you won't understand how truly awful it is. And if you have had one, you'll also know how desperate you are for a solution. Overall, you just need to ensure you don't exceed the daily maximum of 400mg. So if you want to try it, it's entirely up to you. I'm just telling you what I did, okay?

 

[DodgyKnee]

Okay Josephine, got it. Thanks for reply.

 

[DodgyKnee]

Hello all,
Just thought I'd drop in and let you know that things don't seem to be getting any better. What happened to me Tue night happened again last night and after a few hours in exhausted sleep (that would be the extra meds I took), continued into this morning too.

My leg was so unbelievably painful all day yesterday, all I could do was get up to go to the bathroom when necessary. My thigh, all above my knee, was like a bursting hot water bottle - I guess this is tourniquet pain? It's been a little better today but anytime is not at screaming point, I'm terrified of moving it for fear of setting it off. So that's two days in a row I haven't even attempted a heel slide - ho hum.

Anyway, what I really came on to say was that to those of you who have had a bktr or have had a tkr on their second leg - wow! I really take my hat off to you.

I'm 1 week in today, and if I could turn the clock back to last Friday and not walk into that operating theatre, then I truly would. But of course, I can't - so onwards we must go.

 

[LoveGiants]

Hi @DodgyKnee, I'm sorry you're going through so much pain. The first week and a half for me were very rough and I had some moments, especially in the evening, of severe pain and many tears. Being in the US, I was on Percocet, which is stronger than tramadol and tylenol (paracetamol).

It did get better, but those days were brutal. I hope you feel better soon. You're one week out, and it will get better!