TKR Good grief, it's Gort!!

[jetthugger]

Hi all, Toothfairy, I'm on sticks. Took crutches in with me (my friend let me borrow hers) but physio put me straight from a walker to canes on my first trot out of bed. TBH prefer sticks, they make me concentrate on using Gort & bending again as I spent the last few months walking with a straight leg to stop the click grind crunch going on. (not there any more!!!) I just need to know how to space my meds out to cope with nighttime & get myself a cool bag for the wee hours so I can change ice bags without disturbing hubby. Apparently, my knee is a Valiant & is coated, so looks like gold, so will henceforth be Gort the Golden!

 

[Toothfairy]

Good morning Gort the Golden and Alison,
Interesting that you have sticks, another example of how every where does everything slightly differently.

(Jo's edit - please don't advise on meds)

I don't set an alarm for my 2 am meds, I usually waken up sometime between 2 and 3:30 am and I have a glass of water and my tablets by my bedside so it just takes a moment to have them and I usually get straight back to sleep. Twice now I have slept through and missed out this dose. A couple of times I have woken then and read for an hour till the pain meds kick in ( last night)

Hope that gives you some ideas that might help you out. It does get easier.
You are doing really well,
Hugs, Toothfairy x

 

[Josephine]

I'm on tramadol 50 mg four times a day, paracetamol x 500 mg four times a day & ibuprofen 200mg three times a day. I really struggled last night as I tried to take my last meds as late as I could (9,30) but the by 3am was in quite a lot of pain

Who prescribed you all these doses? You are taking half what you could and need to be taking! Or are you going on the usual "take one or two 4-6 every 4-6 hours" instructions on the label? If you are in 'quite a lot of pain' then you need more than this.

First of all, the 50mg of Tramadol - the maximum that should be taken per 24hrs is 400mg so you could take 100mg at night and you could also take a 5th dose somewhere in there if you needed to. I certainly took it 5 times a day and a few times (at GP's suggestion) eventook 150mgs when I was in really bad pain. Just keep a tally of your daily consumption.

The same with paracetamol. One tablet (500mgs) is pointless as it's not a working dose. Here the maximum you can take per 24hrs is 4,000mgs so take 1,000mg four times a day which is what anyone takes routinely even for a headache!

As for the ibuprofen, depending upon how much trouble you actually have with your stomach - that's why you are taking the omeprazole - if you have ever had problems with your stomach, then you shouldn't be taking these regularly anyway. Steer clear of them is my advice. They're okay for occasional use but not regularly. But in reality they are such mild pain killers their side effect risk really isn't worth the little they add to the mix. Did your doctor advise you to take them, by the way? But the recommended dosages are 400-800mgs three times a day.

So what I took (and this is only what I did, I am not 'prescribing' you understand) was the following:
0800: 50mg Tramadol/1,000mg paracetamol
1200: 50mg Tramadol/1,000mg paracetamol
1600: 50mg Tramadol/1,000mg paracetamol
2000: 50mg Tramadol/1,000mg paracetamol
2400: 100mg Tramadol
0400: if necessary, 50mg Tramadol but generally I found I didn't need it!

This regime involves a maximums of 350mg of Tramadol and 4,000mg paracetamol per 24hrs so it gives you a bit of 'wiggle room' with the Tramadol.

Eventually, in 3-4 weeks, you may also find yourself able to let 5 or even 6 hours go between doses during the day which is fine so long as you don't force the issue and end up in pain. Test the waters now and again to see how it's going by all means but not yet. From now until week 7 you are right in the middle of the 'angry tissue' stage and really need good pain management.

 

[Toothfairy]

Josephine apologies, my intention was not to advise, just to state what was working for me but I see how it could have been misconstrued.
Jetthugger I am sure you will find the information in Josephine's post above very helpful.
Hugs, Toothfairy x

 

[jetthugger]

Thanks for that, my doc had prescribed cocodamol & tramadol & the hospital were a little mortified by this, saying one acted against the other, which is why I had so much trouble getting my pain under control the 1st 12 hours. I'm ok on 100mg tramadol (which is what I took when I busted my ribs & had pleurisy) so will experiment with leaving out the ibuprofen & see where we are. I'm getting around ok, slowly & on sticks. Hubby helped me have a shower this morning, which was bliss!!! So resting, elevating & icing now. Gort not as grumpy as I'd thought, given the activity. Still, not going to push it!!thanks again

 

[Fernie]

Good Morning, my drug cocktail sounds similar to yours except I had the Coco's rather than Tramadol. it took me a week or so to work out what to take when, but it all worked out OK in the end, As Jo said, keep a track of what you take when so you can add it up the doses if you need to. The Omezaprole (which i take at 6am on empty stomach) worked wonders allowing me to take the Ibroprofen to help with the swelling and i can really see a difference in that now. PT reckons another 6 weeks before swelling shoudl be all gone and the surface pain has really settled down.

You are good Fab my friend ! I'm sure Gort will have grumpy moments, but enjoy the nice and easy ones when you can.

Still early days but you sound quite cheerful and that is half the battle. Have a nice day. Take care, Fx

 

[Toothfairy]

Hi Jetthugger,
Wise words as usual from Fernie.
Glad you had a lovely shower, it makes such a difference to the way you feel. I think it is good for your spirits as well as keeping you clean and fresh. Hopefully you are now armed with the info to get your pain meds sorted out.
Do take them regularly and don't be in a rush to cut them down. I missed two doses of tramadol yesterday, I slept through the night one and didn't bother to take it later and then decided to miss out the afternoon one to see what happened. I was ok in the afternoon but ended up being awake reading for an hour through the night. Lesson learned. Back on taking them all by the clock again. You have been warned!
Love your positive attitude, it really does help.
Have a great day resting and doing very little, you are officially allowed to do nothing apart from your gentle stretches.
Hugs, Toothfairy x

 

[jetthugger]

Got told off for showering, apparently the dressing is waterproof, but they don't like us taking showers for the 1st five days! Suitably chastised by a lovely gentleman from SWATT team (sort of expected him to rappell in through the window, but hey ho!!) he did go on to show me again how to do those lovely & excruciating exercises! So spent this afternoon in bed cradling Gort in ice & had a nice snooze Otherwise, passed my MOT, my ROM has dropped (was 100 in hospital before I left, but I did squeeze it a bit as they said they wouldn't let me go home if it was less than 90) It is now 78, I'm not bothered by this, after extensive reading on this site, I'm quite blasé about it. Plus I did point out to him that I had been up & active & it had swelled up nice & tight as a result! He did say that as an old hand at arthroscopy recovery, I can decide for myself when I doff the sticks, which I thought was a little premature, I know I walk ok, but Gort is still a newby & getting settled in, so I will keep the sticks. Plus hubby is already asking if I feel better my response was unprintable on this lovely site Got a beautiful huge bouquet of flowers delivered from work today, brought a tear to my eye & booked in on 28th to have staples out, so that will be an adventure! Take care everyone! My PMA is all because of you guys!!

 

[Toothfairy]

5 days
Another example of different practice. I was encouraged to have a shower on day 3 in hospital. Maybe the other patients and staff were complaining.....
I think you definitely need to hang onto those sticks even if you just use them for whacking your husband!
Enjoy your lovely flowers, you really deserve them.
Sounds like you are doing wonderfully well. We cannot take any credit for your PMA, it is all your doing, we just egg you on,
Have a good evening,
Toothfairy x

 

[kneeper]

I was ok to shower by day 4? 5?--after I got home, but told not to get the incision soaking wet. Isn't it great to get that real shower in?

 

[jetthugger]

Can't believe how much I'm sleeping (in the day 2-3 snoozes around half hour to an hour each) not much sleep at night, but I'm ok nodding off again if I can get my pain under control (which I hope to do tonight after the wonderful advice I have received on reassessing my pain meds & timescales) its made me a little more hurty in the day, but I can cope with that for a night of little pain goodnight all, may the sandman sprinkle sleep dust in all of you're eyes tonight my bonesmartie friends!!

 

[kimejen]

So good to hear you're managing well. I know I will be wanting to have a shower asap. Nothing quite like it to make you feel oh so much better. And for me I like my hair clean too, just a huge pick me up. Such simple pleasures. I think I'll be buying lots of cling film/plastic wrap to waterproof the knee. My day is closing in. Last weekend. Our 35th wedding anniversary tomorrow. Then my daughter is getting us all together for a Thai meal at her house on Sunday night, then packing/sorting things out Monday and then D day. Knee is so angry at the moment. Painful and swollen. This might seem like a silly question - but they will still operate on the knee if its swollen and painful? Have a good weekend and take care. Jenny

 

[Toothfairy]

Good morning Alison, I hope you had a better sleep. Snoozing frequently is just what is needed at the moment to let your body heal and recover from the trauma of surgery. It is also normal to have disturbed sleep at first as it is a bit uncomfortable when you move your leg so you need to snooze to catch up.
Hope the sandman kept some of that sleep dust for you.
Another day nearer to recovery. Are you expecting another visit from the SWAT team today?
Have a good day,
Toothfairy x

 

[robynhood]

Yes Jenny Im sure they will still operate if your knee still swollen and angry. My knee was the opposite. Decided to be very 'normal' and behaving itself really well as though to say ' you sure you need an op' confusing me even more. Hope you have a brilliant weekend with your family and get yourself all prepared for Monday.Take Care

 

[Toothfairy]

Hi Jenny kimejen sounds like you are all set for your op.
congratulations on your 35th wedding anniversary tomorrow. Are you doing something special?
As far as your sore swollen knee is concerned my understanding is that as long as it is arthritis pain and swelling you will be ok to proceed with the surgery but if it was sore and swollen for some other reason then that could be a problem. I am not however an expert so you should probably tag Josephine and orthodoc for advice on that.
Have a great weekend,
Toothfairy x

 

[Roy Gardiner]

I really struggled last night as I tried to take my last meds as late as I could (9,30) but the by 3am was in quite a lot of pain, held out till 5.30am & took meds again.

You should take them by the clock. If you have to use an alarm clock to wake you, be thankful, many/most people have sleepless nights after TKR.

I'm in bed now, Baggy snoring gently beside me, Loki will therefore curl up with hubby, so I'm safe from him spring boarding off me for a while!!

What? Oh just a minute, I've read that again...

 

[Toothfairy]

Hello Jetthugger and Gort the Golden. How are you doing today?
How is the pain management going?
Hopefully you will be settling into a relaxed home routine now.
My husband is still bringing me breakfast in bed every day, I will make the most of it while it lasts.
Sleep well my shiny friend,
Hugs Toothfairy x

 

[jetthugger]

Hi Jenny, best of luck for 26th!! It is still very early days for me yet, but I can honestly, hand on heart, say it was absolutely the best decision I made! I hummed & haa'd right up to when they put the spinal block in, wondering how far across the car park I'd get if I changed my mind!! Toothfairy, I'm pleased to say that I'm doing well, had a bit of a cry yesterday when hubby was getting huffy about going to the docs to pick up my sick note - I am not sure he realised up till that point just how fragile we can be and just how big this thing that happens to us is. All he sees is a neat dressing & he keeps asking if the joint pain is gone. I know my sticks aren't weapons (and I'm a pacifist) but........ breakfast in bed is a lovely start to the day isn't it? Yes, routine is coming & my exercises are getting less impossible (I'm not going to say easier because I still can't lift my leg without help!!) I can get the best bend when I'm on the loo I'm calling that one my u-bend!! I'm trying to keep up with everyone's threads, but as Fernie indicated, it's almost impossible (especially at 5am) to know who's on what thread & where!! Let me know how you're getting onTF, I keep eyeing the exercise bike up........

 

[kimejen]

Alison, you poor thing. It is true though, people look at a simple dressing but really don't have the foggiest about what you are feeling inside. Men, they really are from MARS aren't they?? Precious things that they are. They really don't cope too well with their partner's pain. I'm wondering how my sweet man is going to cope. Hang in there, there are so many caring people on this site, giving such words of encouragement, it's a geat place to let off steam. Sounds like you're doing great. Take care. Jenny

 

[jetthugger]

Thanks Jenny, your hubby will do good I promise! You just have to let go of your normal standards & practices & accept that your new knee rules you, & your hubby will rule the other stuff you would normally do, but in his way. every time my hubby makes the "you will be ok in a couple of weeks " remark, I suggest he google the operation & watch more than 12 seconds of it (all he could stand last time) you will both find a way to deal with this new and temporary situation, and you're right, there's more than enough support here to pull us through! Take it easy, it will be over in no time & I will pick up your post op thread & be there with you, on 't'other side!!