TKR Finally in recovery

Finally

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Had surgery yesterday. The pain is quite intense. The incision doesn't hurt but the back of knee and shin hurt terribly.

No PT yet. Going to try today. Pain was too bad yesterday. Apparently the block to nerves was not done correctly? Was supposed to use a sonigram?? But did not. The oral pain meds not working. The iv diulauded works for a couple of hours but knocks me out.

Woke me up at 3:30 to get in chair, learn to dress, going to PT. Still sitting here in chair. Pain increasing and no meds since 12pm. This is awful.
 
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Why no meds since 12 pm? I hope you keep asking for help with the pain. Also, are you trying to keep your leg straight? If you are, that is likely to be adding to your pain. Your PT and nurses might say otherwise, but it’s probably okay to allow a slight bend. Fully straight is excruciatingly painful for most of us.

oh, I hope you feel some relief soon! Stick with us!
 
Just got the oxy and muscle relaxer. Insisted on moving back to bed. Leg was too straight. Nurse agreed. There was only one nurse to 11 surgery patients last night. He was good, aids were terrible..insisted on keeping leg straight. Plus chair foot rest is too narrow. Foot falls off side and that is very painful.

I will get iv dialudud for PT this morning.

Concerned about pain at home.
 
@Finally Welcome to the other side. It sometimes take awhile to get your pain management cocktail just right. Work with staff to ensure you are covered before you leave the hospital. Ask for ice as well.

Here are your recovery guidelines:
Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary

2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

5. At week 4 and after you should follow this Activity progression for TKRs

6. Access these pages on the website

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 
Sounds very similar to my hospital stay. My nurse on the day of surgery refused to give me the dilaud IV and made me stick to only taking oxy. Thankfully the night nurse said he would have never even bothered with the oral oxy and switched me to the iv dilaudin. Oh man what a difference. But then my nurse, different from the day before, the next day wouldnt let me have the dilaudin and would only give me the oral oxy again. It was early that morning that they had me sit in a chair with my feet on the floor. After about a half an hour I was in excruciating pain and was crying and begging the nurse for more pain meds. The aid tried to joke with me saying ‘hey at least it’s not as bad as child birth’ and I said ‘ oh it’s worse!’ And she said ‘oh I guess you’ve never had kids’ and I said ‘yes I have!’ She was very quiet after that. I finally convinced her to help me back to bed and slowly the extreme pain went down to bearable. I just couldn’t understand why they wouldn’t believe me that I was in excruciating pain and could say no to me when I was just trying to make my pain tolerable. Hang in there! PT is going to be hard but just remember if you can get through it the sooner you can get home and be more in charge of your own comfort. I’m at 6 weeks post op. Things get better I promise!
 
not to defend any actions taken by hospital employees, but we all need to understand the reasons behind the scaling back of opioids. 5 years ago I had major shoulder surgery, on discharge I had a prescription for percocets and OXY 10 mg.... on discharge of my recent PKR, I was prescribed Tylenol 500, and a small quanity of OXY 5mg, with clear instructions to use for break thru pain only....
this doesn’t make us who need Pain relief happy, but the opioid addiction this country has seen , and lawsuits that come from it, make hospitals and caregivers leery, to say the least
 
In my case, it was right after surgery when the nerve block in my leg wore off and the pain went through the roof my doctor had ordered it prior knowing full well I was going to need it once the nerve block wore off.

But I dig where you're coming from, Qdogpa
 
@Finally I hope things are easing for you now. Update when you are feeling up to it.
 
The whole addictive thing is overblown. The odds of becoming addictive while fighting pain in incredibly small. I do understand the doctors caution (Fl limits prescriptions to 3 day supply) then you have to see the DR again. Feel sorry for our friends with limited transportation or those living in rural areas. but for some of us Aleve (etc) is not very effective. Being in pain delays healing.
 
not to defend any actions taken by hospital employees, but we all need to understand the reasons behind the scaling back of opioids. 5 years ago I had major shoulder surgery, on discharge I had a prescription for percocets and OXY 10 mg.... on discharge of my recent PKR, I was prescribed Tylenol 500, and a small quanity of OXY 5mg, with clear instructions to use for break thru pain only....
this doesn’t make us who need Pain relief happy, but the opioid addiction this country has seen , and lawsuits that come from it, make hospitals and caregivers leery, to say the least
Oh I agree the big opioid scare makes it hard for people who are not addicted or do not have an addictive personality to get the pain meds that we need. OP wasn’t even 24 hours out of surgery when they waited more than 4 hours to give her her pain meds. I myself seemed to be labeled a potential addict from the start since they only allowed me 2 doses of iv dilaudin the night of my surgery and when I was in the most pain I had while hospitalized I was refused pain meds. Right before I left the hospital my primary doctor came in who is also the county coroner and gave me a 20 minute lecture about how easy it is to become an addict. That it can happen in 5 days of opioid use and how horrible it is when she had to deal with overdose cases she got quite graphic about it . It was very obvious she was trying to scare me. Thing is I’m 52 years old. I’ve had 4 surgeries in my lifetime and many root canals. I’ve taken opioids many times before. I know what I can handle. I would have had many other chances during harder times in my life to have become an addict. And I’m far from being any type of addict. Yet this opioid scare has made it hard for non addicts to get the pain management they need.
 
I understand the reluctance by medical doctors in prescribing opioids, but it would be pretty obvious if a patient was abusing the drug, wouldn't it?
 
Yeah the concern of opioids is pretty intense and in some case legitimate. I was given Oxy 5M and Tylenol. I was off the Oxy 5M quickly. I never felt 'high' or sick taking them.

For certain not desiring to anything but pain relief I think they helped but my low-dose suggests my pain level was less than some. Also, I had the nerve block cath. but when I went off that I did not have pain spike upwards. That would come later during my early PTs! Tylenol was my around the clock med for the first four weeks. Along with the Robaxin muscle relaxer as needed.

And yes, my nurses insist on the knee NEVER bent. But I had to bend it my in bed sometimes. Doing so helped keep my pain down. Doing so in my case did not cause problems.
 
. Still sitting here in chair.
Plus chair foot rest is too narrow. Foot falls off side and that is very pain.
I’m sorry you were forced to sit in an inappropriate chair. :bignono: I’m glad you insisted on going back to bed. Your leg should always be elevated when sitting, as feet too low is just so painful on the whole leg right now.

They do make a big deal about keeping your leg straight. While you don’t want to bend it a lot (as if you could right now if you wanted to!) but really, a slight bend is ok and will be less painful. As someone else said, once you are home you’ll have full control of what you do. Try to hang in there.:console2:
 
Home and feeling much better! Oral dauladid or however it's spelled! 1 every 4 hours or so is working. Had home PT today and was not too painful. Must say night care was not good at hospital. Daystaff was excellent. The chair thing was wit night staff. Also they disconnected my IV by accident. Was soaking wet. She thought it was from me spilling water pitcher. Nurse came in after I had done my best to dry off. IV was on floor. He cleaned it with a wipe and reattached. My sister was an infection control nurse and is quite upset. Guess this not good infection control. What an adventure! Can be so good and so awful!
 
Glad you’re home & feeling better. I had oral Dilaudid as well, worked well for me.
 
I agree, your night care was appalling. You should mention it to your surgeon at your next follow up.
 
Nurse came in after I had done my best to dry off. IV was on floor. He cleaned it with a wipe and reattached. My sister was an infection control nurse and is quite upset. Guess this not good infection control.
I think you should report this (in writing) to the hospital.
 
Glad you are home and pain is under control. I find the nights are never good in the hospital. Always short of help it seems. I must say this was an advantage to out-patient surgery for me. Much more comfortable in my own home/bed and in control of my meds. Not for everyone but was great for me. Hang in there, it will gets much better after the first couple of weeks for most of us.
 

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