Feeling low

[carolinacooker]

I recently went to my OS for my six week check, he said everything was going well. I assumed after home physical therapy that he would send me to an outpatient facility for more work on ROM. We talked about that and he said due to the extensive prior damage to my knee that my ROM would not get above 110 degrees or so. I had still been doing stretches on my own trying to increase but with no precise way to measure I am unsure where I am at. That kind of suprised me right there that he would say that. Then we discussed pain medication. I had been taking oxycontin for several months prior to surgery and then an even bigger dose after. I told him I wanted to resume driving again and I knew that he would have to change the meds. He switched me to percocet 10 mg and said we could just lower the number of pills month by month until no longer necessary. Since then I have been feeling terrible, I have been hurting more, and feeling very emotional (not in a good way). I am afraid that I am actually having withdrawl symptoms. I also asked again about the incredible muscle tightness and cramps that I have in my calf and once again he had no real idea what was causing that. I would appreciate any advice or words of encouragement. It is nice to know that you people are out there to hear me and offer some kind words.

Thanks, Carolina.

 

[beachcomber]

Carolina,

I am sorry you are feeling down. I had a couple of thoughts I would like to share.
Oxycontin is a time-release medication that releases a more constant stream of oxycodone into your system. The percocet is a fast-release oxycodone pain reliever that puts you on more of a roller-coaster ride. Even if you were still taking the same number of mg of oxycodone in the form of percocet, you won't feel the same. The percocet will start to be less effective as you get closer to your next dose time. Be sure you take them on schedule (every 4 hours) and don't try to cut back yet. At six weeks it is too early to begin to taper off the meds. You are likely feeling PAIN--- not withdrawal and you will NOT recover as well if your pain is not well managed.

Did he NOT write a Rx for outpatient physical therapy for you? I don't care WHAT he thinks your eventual ROM will be--- the PT will help you with all the symptoms you describe and the PTs are the ones who will ride out this recovery with you. The OS's real role is done at this point. If it were me-- I would INSIST on outpatient PT!

And BTW--- don't let his expectations on ROM hold you back. He can't KNOW what your ROM will be at the end unless you DON'T do PT. You can show him up!

I don't mean to sound too pushy--- but you need to advocate for yourself. If your OS doesn't give you the support you need, talk to your primary care doctor. They can help you with pain control and prescribe the PT. Several of us last-year "winter knees" found that worked much better than the OS route for recovery.

Hang in there. You are not alone. We are here for you.

Beach

 

[Troweltalk]

Pick up those spirits girl! You're NOT alone.

I just counted how many oxycodones I have left in the bottle and was wondering how many more the OS will perscribe when these run out in a couple of days. Pain management is just one more thing to, well, manage. Millions of others have done this before us, well make it through too. Talking about it helps.

 

[Simon]

I had knee problems since I was 15 and am now 57 and had 9 major surgeries before BTKR on June 3rd. Before surgery, the OS said that given the extensive damage and all those previous surgeries there was a very good chance we would not gain any ROM post op and might even lose a bit to around 90 to 95 ROM. Well with some great PT (still going once a week till the end of the year for a total of 6 month outpatient, plus 11 days inpatient rehab and a couple of weeks home PT) I now have 120-123 on the left and 115-118 on the right. I ride the bike every day and still exercise

He should let you try PT as he has no way of knowing what will come of it.

Simon

 

[Josephine]

All been said and very well - little more to add.

 

[Linda2]

The tightness and muscle cramps are normal. Everything has been rearranged in there. Most of go in bowlegged and come out slightly knock-kneed(which is actually normal). All those muscles, ligaments, tendons, and fascia are really miffed by these changes. A good physical therapist will work on those tight areas. Call and tell him you want outpatient pt. He doesn't have to pay for it. Lots of surgeons seem to think we can do it on our own--my surgeon is like that. When I insisted, he didn't argue. The surgery, by the way, was wonderfully wrought.

 

[AlaskanTKR]

Carolina -
Hang in there. You will find lots of support here - I certainly did- and still am!
I remeber thinking 4 weeks and all will be fine. Then 6 weeks and then 8 weeks. Burst my bubble! Try 4 months! I wish the OS would have said work hard but expect things to change at 4 months! I know we are all different so 4 months was my high mark. I was exhausted and just a mess at 6 weeks. I tried cutting back on meds so I could drive - UGHHH I basically didnt do my best to take care of myself. I spent 4 months on meds and then got the crud and went through forced withdrawl (the crud was a blessing - I guess). Anyway... seriously... get the OS to prescribe a few weeks of pt. The spirit of success and even just the getting out and working on your knee will help you work even harder.

Dont sell yourself short! you may just surprise your OS- Lots of forum members have had major damage prior to the tkr and have made great gains in ROM.

Hang IN!
Marianne

 

[SportHog]

I agree Marianne! Four months was significant milestone for me as well. Also, 8 and 12 months.
Cheers, Ross

 

[Rowdy66]

If I listened to doctors I would have been in a wheelchair the last twenty-plus years. No one knows what you are capable of doing. He may be a fine surgeon but he cannot see the future and he cannot see into your heart. Maybe your ROM will never be as much as you would like it to be but that doesn't mean it won't improve and who can saya just how much. Do not let anyone tell you what you cannot do, listen to your heart and I bet you can do a whole lot more than anyone realizes, even you.

As for tapering off your pain meds, it is too early for you to be doing that just yet. Proper pain medication is essential to your recovery. I don't think you are having withdrawal from drugs. If you go back and read posts from the last year you will see we all had a period of the blues, you just had a major, major surgery and your body has taken a beating. Let it shed a few tears for itself without guilt, you will feel better for it and your, definitely,will not be alone. Plus this is a difficult time of year for lots of people, me among them. So give yourself a break, you deserve it.

I hope you have a great Christmas and a Happy New Year. Remember you are the only one who can decide when you have reached the point you want to be. And just because your OS didn't prescribe PT doesn't mean you can't do it for yourself and get just as far. Or, if it makes you feel better, call him and insist that he prescribe PT.

Glad you found the forum. It is a great place to recoup as we have all been there done that and can help you. Heck, we want to help you. Good luck, Rowdy

 

[carolinacooker]

Thank you all for your kind words! I will definately talk to my regular doctor to have her authorize physical therapy for my knee.

CC

 

[Gretchendz]

CC....


As to the calf cramping, I had terrible cramping after each of my TKRs. As someone already said, everything had to rearrange. I had been walking in a totally messed up fashion for years.

I used a heating pad on the calf muscles when the cramping became too much. It gave some measure of relief. Perhaps it will help you.

Keep us posted! Things WILL get better.