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TKR Five Months Later

I’m so sorry. They really need to figure something out about pain medication. I hope you can get what you need or find an alternative that works for you.
:console2:
 
I have had two conversations with my surgeons physician assistant for refills after Hospital’s one week of meds she prescribed another weeks worth-and now five days more saying that should be it. I have not yet gone for my two week visit as it was postponed last week due to snowstorm. I have swelling and pain and hopefully when I go for visit seeing my knee will change her mind. I have oxycodone 5 mg which helps and tramadol which doesn’t help so much. I have been weaning down from 6 oxycodone now to two or three but still need. Just very frustrating. Will talk to my PCP and see if he would be of help.
 
Ask if you can wean down to Tramadol, which you can combine with Tylenol for effective pain relief.

Josephine has designed a couple of charts to show how to combine the doses.
The first chart is for 4-hourly medication and the second one for 6-hourly:
[Bonesmart.org] Five Months Later


It's important to restrict your Tylenol intake to 4,000 mg in 24 hours from all sources. You will need to check any other medications you take (such as cold cures), to make sure there is no Tylenol (Acetaminophen) in them. If ther is, scale down your other Tylenol doses, so you stay within 4,000 mg in each day.
 
Thank you for your help Celle-much appreciated
 
Three weeks post op today - having a good day! Final visit by home PT had us going outside walking with walker and then with cane. I have not had sneakers on in three weeks or been outside since we had our 4 nor’easters. It felt so great to be in the sunshine even though still cold! Walked up and down driveway and down the block. Next up is a visit from a friend-what more can I ask for! Next outing is Wednesday when I hope to finally make it to the orthopedist for my first visit.
 
That certainly sounds like a day of progress! Walking outside feels so good, doesn't it? It reconnects you to the world in a way. Have a nice visit with your friend. :flwrysmile:
 
Finally made it to the orthopedist for my (due to last week’s snow) three week check up-ortho removed my zip line incision cover-read that it would zip right off-there were a few spots that hurt but all and all I’m sure it was better than getting staples out...my scar looks good and doc said knee doing fine...swelling is normal and will take time to go away. I took walker with me and glad I did as it was a long walk into the office from the parking lot-I am getting better with cane and hope to leave walker behind soon. It was great just to get out of the house! I also took care of the issue with pain meds-PA said she needed to know I am weaning down-I showed her and ortho my cell phone on which I listed every pill taken and at what time in the three weeks since the surgery-that did the trick so I should be good for now. I have my next visit in three weeks by which time I hope for more progress. I start outside PT on Friday-will be sure not to do anything to cause myself pain. I finally feel like I am getting somewhere on this journey!
 
Drives me crazy with all the issues of getting adequate pain meds. Don't they realize that they are prolonging our recovery by not having what is needed for pain relief? I'm sorry you are having the issue also. But it sounds like you are otherwise having a good recovery. Congrats on that
 
Happy Easter to all! What a difference nice weather makes! I was able to walk around and sit outside yesterday and today. I am getting more confident using the cane. Am also not jumping in with Easter dinner but allowing kids and spouse to take care of it. After my outdoor adventure I am now icing and elevating. I had my first outside pt on Friday-not sure about it yet-will give a chance-did let him know I will not be in agony or will be out the door! Had a massage of the leg which though it hurt also felt ok. A few short exercises of the leg, icing and tens. We’ll see. I return there tomorrow although forecast is again for snow!!! Crazy!!
 
Two steps forward one step back-seems to be the story of recovery! I am now 4 1/2 week’s post op and felt like I was making progress and now have had real issues this week sleeping. No matter what time I go to sleep I am up, in pain and restless from 1-4 am. From there I get maybe an hour more. I am still sleeping in the recliner as I know my nighttime issues would wake my husband who had been so patient with me. Any hints to get through this????
 
Are you icing all night. I found that I had to. If you are waking in pain, the ice might help you sleep longer.
 
Oh yes, icing is wonderful if you can manage it. Elevating, also. By keeping down the swelling, both will help reduce the pain. Are you taking meds at night? Even months out, I would take Tylenol before going to sleep, to help with night pain. If you are still using a painkiller, don’t neglect that nighttime dose.
 
I ice throughout the day 20 minutes at a time and before what I hope is bedtime. I use the cyrocooler-when I put it on in middle of the night the weight in the water ‘bag’ becomes too heavy and annoying to make it through 30 minutes. I am also taking Tylenol before bedtime sometimes with one of my few remaining Tramadol or else tramadol when I wake and can’t get back to sleep. I have a lot of swelling in lower thigh, upper calf and a lump on outer thigh. I guess when that ever goes down sleep will return? From what I hear that could be months away? Thank you for letting me vent-reading everyone’s stories gets me through the long nights and gives me hope that the end will come before too long.
 
Yes, sleeplessness can last for a few months, and sometimes more, I'm afraid. :sad: With TKR our whole lives get upended, including our bodies, what with meds and the kind of stress that disrupts our natural rhythms. It takes a while for these things to settle out and allow us to get back to normal. It's a rare person who doesn't have sleep disruption, but it's also a rare person who doesn't get their sleep back. No choice but to stick it out, really.
 
Yesterday went for my six week checkup with my OS. Can’t believe it is already six weeks!

He was very happy with the X-rays and the knee itself-my last PT reached 110 flexion and extension is great.

However, I feel like he feels his work is done! He said I can go back to work in 2 weeks even though I am just getting around house with no cane taking baby steps!! He feels patients who go back sooner get better results.
I had planned to go back at 8 weeks before the surgery but am now hoping to go back at 10 weeks. I have plenty of paid sick time.

I am also not driving yet so need to master that first!

I have a lot of swelling in calf and lower thigh and a really sore muscle on outer thigh-PT works on those areas with massage- they offered deep tissue massage but maximum was way too much so having toned down version which is fine.

I was thrilled last week to finally be able to pedal all the way around on the bike!! Ah for the little successes!!
OS said go to PT until I no longer make any progress and that it is my call. I will go at least a few more weeks for strengthening.

It is also amazing to me that all of a sudden you can start walking again without assistance although I do feel like my one year old grandson!! I am able to do some light things around the house and try to have a project each day to feel ‘useful’ again.

I am still struggling with sleep or rather lack thereof-moved back into my bed after 5 weeks in recliner (no sleep there either). OS said that is not his issue and to take it up with GP-i have used sleep aids in past but don’t want to have to be dependent on it so will keep trying to find that magical sleep position.

My OS also will not give any more pain meds at all and feels Tylenol will cure all-i disagree but have no choice!
Again I understand the caution in overprescribing but for a surgery like this meds are truly needed!! I have weaned way down and will see what happens.

All in all, I have come a long way in six weeks but understand I have very far to go. I see my O S again at 12 weeks and hope at that visit I can say I am glad I had the TKR and would recommend to others!!!
 
Your surgeon clearly has not had a TKR himself. Oh well, most haven't. I think your back to work strategy makes sense; give yourself all the time away from work that 1) you can do without risking your job, and 2) you are comfortable with (some people really must work or they get antsy).

It sounds like you're making great progress! I also liked the massages from PT. Best part of it, really.
 
Yes you will glad you can the surgery, but it is a little early to say that now! I went back to work at 8 weeks , sit and work from home. Have you tried Tylenol pm or melatonin?
 
JG464 said:
My OS also will not give any more pain meds at all and feels Tylenol will cure all-i disagree but have no choice!
Again I understand the caution in overprescribing but for a surgery like this meds are truly needed!! I have weaned way down and will see what happens.
Click to expand...
Tylenol may work, if you take it correctly. It was all I was allowed after the first month.
The correct dose is 1000 mg (2 x 500 mg tablets) 4-6-hourly, to a total of 4,000 mg in each 24 hours. You need to take it on a regular schedule, to keep up the levels in your bloodstream.
Also, do check that there is no Tylenol (Acetaminophen) in any of the other medicines you are taking. If there is, add that amount into your daily calculations and reduce some of your other doses, so you stay within the safe 4,000 mg total.

Some GPs/PCPs will prescribe Tramadol, which is a useful "step-down" pain reliever from the heavy-duty narcotics. You could ask your doctor about that, when you see him/her about sleeplessness. You can take Tramadol in combination with Tylenol.
 
ThAnk you both for meds suggestions-I May try melatonin. I did not know about Tylenol dosing to keep in the bloodstream and was only taking on not so strict regimen. Will also give it a try. I am very grateful for all of the advice and knowledge gained here and hope to guide others through their journey.
 
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