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TKR greeneyedtattedgirl's recovery

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@greeneyedtattedgirl I am so glad you are feeling better. It usually is quite a roller coaster so don't get down on yourself if you have difficult feelings again. I personally don't consider peoples posts positive or negative. We all deal with different things from day to day.
~~hopefaith
 
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Hello everyone I'm still doing well mentally but I am now suffering severe pain I've recently stopped taking my dilauded long lasting as I was told that it would increase my depression and my panic and anxiety since then I have had severe pain during the day and night I'm trying to manage with Tylenol Extra Strength I'm taking in approximately every 4 hours but I really don't have anything control with that I do have dilauded 2 milligrams and dilauded 4 milligrams on hand. I have so much fear about havingy panic attacks and anxiety again that I have not been taking them last week I was doing well I was even able to go on the recumbent bike and able to do complete rotation I was very proud of that they also put me on a stepper machine but you had to face backwards whether with or the following day which was Friday I assumed it was because of those two new exercises today is Sunday and I'm still having tremendous pain I have been icing almost nonstop and it only feels good when did on it's very hot here yesterday and it's going to be hot here today I'm wondering if this is causing additional swelling and I'm also wondering what you folks would do would you risk taking the dilaudid in order to get the pain under control today as you know in my previous post the effect it has on me I was very positive last week when I was able to do the bike at physio I actually purchased it small like that its electronic and you can set it for speed and various other options I tried it yesterday for approximately three to five minutes I was in a lot of pain and not able to continue. I have also been very dizzy the last few days and I have not slept in 4 days at night due to severe pain I welcome any of your advice the knowledge really really down today I look forward to talking to some of you soon. Tears are flowing today when will this ever be over sincerely sheila

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I am so sorry you are having such a tough time. @Josephine maybe has recommendations concerning your pain meds. I have no medical background but if it was me I would address the pain and try to get that under control. It does make your recovery easier to deal with if you have less pain. Hoping you are able to get some relief soon. ((Hugs))
 
I have been very nauseous for past two days and have been fighting not to throw up but I've just lost that battle do you think because the dilaudid(12mg long lasting) am and pm is coming out of my system this is some sort of detox thing happening ? I'm a total mess today. I can't stop crying need this pain to be over. So embarrassed crying like a two year old when im a 50 year old woman.

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@greeneyedtattedgirl HUGS!!!

I'm so sorry you are having a bad time right now. :console2:

I don't know enough about the drugs to give you any advice, but I hope that @Josephine will be able to help.

As you say that icing helps the pain, why not give yourself a little vacation from physiotherapy for a few days and just concentrate on icing, elevating your leg, and resting? It won't set your recovery back, and you won't be able to do the PT anyway while you are in such pain.
 
@greeneyedtattedgirl If you stopped the Dilaudid cold turkey, those definitely could be withdrawal symptoms. Dilaudid is a very big gun for pain management. I can't imagine going from that amount to Extra strength Tylenol! There is immediate release Dilaudid in smaller doses and there are several other narcotics that may not have such severe side effects. I am not a doc but my opinion is that you need stronger pain meds than Tylenol. More pain management and a lot less activity. Please correct me if I am wrong on this. Earlier you mentioned that your GP was very understanding of what you are experiencing. Can you talk to him about being on another pain med. that isn't quite as strong as the long acting Dilaudid? These are just some of my thoughts. It is no wonder you are very scared of getting back into that place of panic! I also really know that place and it is a very awful place.
Hugs and prayers for you ,
hopefaith
 
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When I spoke to him last he gave me naproxen in the hope I would wean off the long lasting dilauded. I clearly did it too quickly. I have a small amount of 2mg and a reasonable amt of 4mg I broke down and took a 2 mg a few min ago. I will contact GP Wednesday when he returns as its a holiday weekend here in Canada. @hopefaith @Jozilla @Celle
Thank you for your replies and concerns. I value your input sooo very much!!!

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gtg, I have read your thread right through and really feel for your emotional state which appears to have gone completely unaddressed by your medical carers. It seems to that you urgently need some counselling and/or cognitive behavioural therapy. I note someone did mention doing relaxation or breathing exercises but that suggestion was pretty useless without some advice and guidance on how to do it! They almost made it sound a simple process which it is not!

To make best use of these kinds of skills, because yes, they are a skill, you have first to understand the philosophy and manner of obtaining the skill. The first step is never to try and adopt these techniques whilst you are in the middle of a panic attack! You need to study them and practice the techniques while you are reasonably okay so you have the skills on hand when you need them.

I practice a form of self-hypnosis - perhaps better called relaxation techniques as "hypnosis" has such a bad rep! But I learned it from experts and practised it diligently so when I did have a panic attack, it was there for me to use and help me. And it worked!

Secondly, I am disturbed that, overall you appear to view crying as a negative thing - which sadly an awful lot of people do - when it fact it's the most natural and healing thing we humans do. It's out inbuilt pressure valve and when we try to suppress it, feel it's a sign of failure and weakness, we deprive ourselves of a great healing resource. So my message to you here is never allow yourself to indulge in that negativity about crying. It's okay, it's good for us and enables emotional healing. Just like having a good scream will (in an empty house, of course!). Ever heard of the broken link removed: https://www.primaltherapy.com/what-is-primal-therapy.php? it was the 'in thing' amongst the Hollywood set in the 80s and still used when people are sent to anger management classes! Because most of your problem, I think, is caused because of the following:
1. you feel let down by your body needing this surgery
2. you are angry about it - a kind of bereavement about losing your natural knee
3. you feel a failure for needing the surgery
4. you feel trapped by the fact of your recovery, that it necessarily limits your activity
5. you rebel at the pain and the need to use drugs you feel negative about
6. you fear the possible outcomes of the 'what if's' - what if I never get better, whet if I fall down the stairs, what if I get addicted to drugs, what if I never regain my independence - I could go on but I'm sure you get the picture!

There are loads more to add to this list but I'll stop there.

Now I need to help you with your knee problems so I'm going to ask you some questions and it would be very helpful if you would answer each one individually in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't compare this with the bone-on-bone pain you had before surgery!
[Bonesmart.org] greeneyedtattedgirl's recovery
)

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how often are you icing your knee and for how long?

4. are you elevating your leg, how often and for how long?

5. What is your ROM - that's flexion (bend) and extension (straightness)

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. what kind of PT/exercises are you doing? How much and how often? (and detailed details would be appreciated, please! Reps, sets and session and all that)

Note:
If you're not familiar with this, it goes like so:
1 lift of a 500kg bell bar = 1 rep or repetition.
Doing 5 reps and then a brief rest = 1 set of 5.
And doing 5 sets and finishing = a session.
 
We all need to read Josephine's post here. Tears are a good thing! It is healing to cry. I am going to try that primal roar next time I am alone in my house and windows are closed. Seriously.
American culture is so weird about pain,grief, crying.
My grief is real. I know the only way through it is through it. Sorry @greeneyedtattedgirl I will get back on my thread to rant about this.
 
@Josephine Replies to each questions.
#1 during the day with inactivity 2-3 during min activity moving around the house or outside my home in yard for more than 30 min can range from 3-6 since not taking dilauded at night 8-10 all night.

#2 I am currently only taking Extra strength Tylenol 2pm caps aprox every 4 hours during the day. Naproxen 500 mg twice per day. Bromazepam 3mg 3 times per day for anxiety and panic I have only had this med post op. I take Welbutrin xl 150mg 1pm time per day for depression. Now and prior to surgery.

#3 I ice after my home exercises 3 times per day regularly as well as when I am just sitting on sofa or even if im in the car with hubby. Also following PT Lately I am icing more and more due to swelling. I leave ice packs or ice in wet towel until they melt ?? Aprox 30-40 min.

#4 I elevate almost always when home or visiting family. And when I am inactive.

#5 my ROM is 90-95 @ PT last week. My extension was -6 but after Therapist pushed on it for few min it improved but did not tell me the number but after doing so she asked me to bend again and at that point it was difficult to get back to 95° it was 92°.

#6 I am able to do dishes, general tidy ups, laundry. Cooking has been a challenge as I have a hard time standing for long periods. My husband does not know how to cook at all. He will pick up quick items at grocery store easy to prepare. I am not permitted to drive yet so I only get out if hubby or on rare occasion a friend comes by. I spend 14 hrs a day in home alone except on my 2 physio days per week which I get to via a special bus service that I am only permitted to use for medical apptts.

#7 According to my PT and a small booklet that was sent home with me from hospital. Each exercise is to be done 3 times per day. 1 set of 10 sitting leg pulls or slides towards myself on own or with towel to help. Next LG rolled towel under knee , knee is to remain on roll while I lift foot aprox 4-5" 2 sets of 10. Same roll under ankle and I am to push leg onto surface 1 set 10 reps. Sit on edge coach bring knee in as far as I can and slide foreword stretch for 30 seconds 3 times. While in same position straighten out leg press down on knee to stretch.
@ PT I am left alone most of time to do exercises on own ie: arrival heat is applied 10 minutes, bike 10 min simply back n forth holding to feel stretch for 10 min session, last week I was finally able to peddle all way around 10 minutes. Then to pulley system foot placed in straps and I pull pulley 10 min to pull knee back very painful!!! On to stepper machine last two sessions standing backwards 10 minutes. Then leg press 4 wires for 5 minutes this is timed. Thats it at end I get suction tens like machine for 10-15 minutes with ice pack behind knee. Thats it.

Please tell me if you need any further info please forgive any typos using phone and font very small glasses broken. I will re read the beginning of your msg again and respond soon eyes hurt from typing this.
Thank you

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greeneyedtattedgirl said:
when I said I was alone 14 hrs a day that is mon-fri husband home on weekend.
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As far as I am concerned, being home alone is not a problem as I was on my own the entire time! You might like to read the potted version of my recovery to see how I did! Knee recovery - UK style
greeneyedtattedgirl said:
#6 I am able to do dishes, general tidy ups, laundry. Cooking has been a challenge as I have a hard time standing for long periods.
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At 8 weeks this is a little too much. Assuming you have a dishwasher, that bit's okay but cooking, laundry and house cleaning? :no-fin:
greeneyedtattedgirl said:
#7 According to my PT and a small booklet that was sent home with me from hospital.
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Okay - my comments are in bold!

Each exercise is to be done 3 times per day
- sitting leg pulls or slides towards myself on own or with towel to help 1 set of 10 - never do this so hard it hurts
- large rolled towel under knee while I lift foot aprox 4-5" 2 sets of 10 - never do this so it hurts
- roll under ankle and push leg onto surface 1 set 10 rep - never do this so hard it hurts
- sit on edge couch bring knee in as far as I can and slide foreword stretch for 30 seconds 3 times - never do this so hard it hurts
- in same position straighten out leg press down on knee to stretch - never do this so hard it hurts

At PT I am left alone most of time to do exercises on own ie:
on arrival heat is applied 10 minutes,
- bike 10 min simply back and forth holding to feel stretch for 10 min session, last week finally did a full rotation for 10 minutes - very good but go gently

- pulley system: foot placed in straps and pull pulley 10 min to pull knee back very painful!!! - this exercise should never ever hurt you. Never pull on it that hard. All that does is cause swelling and pain which hinders your ROM

- stepper machine two sessions standing backwards 10 minutes - I have NO idea what this is!
- leg press, 4 wires for 5 minutes this is timed - nor this

So what do you do at home?

I think much of your problem and your anxiety is caused by you causing yourself pain. Don't do this. As I said before, it just causes swelling and pain which hinders your progress.
greeneyedtattedgirl said:
#2 I am currently only taking Extra strength Tylenol 2pm caps aprox every 4 hours during the day.
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I also have to tell you that this is too much Tylenol. Only take 1,000mg up to 4 times per 24hrs. That's 6hrly.

I suggest you read these very carefully to learn how to manage your recovery better. And you must take some better pain meds.

First are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock
- 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
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Activity progression for TKRs

Healing: how long does it take?
Chart representation of TKR recovery
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling

Home physio (PT) and activity progress: suggestions
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?

And then some wise words from members who have shared their experiences ...
Where are you in recovery?? (TKR)
Five “P’s” of knee recovery
TKR: work “smarter” and not “harder”
Recovering a knee - from one who knows!
It's never too late to get more ROM!
It's worth the wait for ROM
 
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