TKR Had a difficult time, feeling better<

[Josephine]

Well, it's in my experience so it wasn't difficult! BTW, don't worry about being on gabapentin for a long time.
I know people who've been on it for years! If you need it, you need it. End of!

 

[mamazipp]

So, I had hoped to rest and ice yesterday but granddaughter wanted to spend time with me getting our nails done and mall shopping. She's 15 and so busy that I don't see her much now, so I couldn't give up this opportunity. The mall shopping was a bit tricky but I used every opportunity to find chairs and sit. Returning home I expected a big reaction from my knee but it was ok. Today I spent lying on my bed with my foot elevated all day, watching tv and reading. I decided to add back my mid day Gabapentin, also, at Jo's suggestion. Tonight, however, lying in bed, my knee starts to ache and throb and have those lightning zaps which I normally get a lot down my leg usually early in the morning, the aching knee seems to be a nighttime phenomena. Does anyone know why?
Also, my leg is numb down the inner aspect from mid leg to ankle. My OS says he doesn't know why!
I figure the zaps are due to nerve regeneration in my leg and knee, but the aching in my knee is strange and painful. I have to take Oxycodone 5 mg. for relief. After resting all day it can't be due to overuse or swelling.

I find Bone Smart to be so interesting and informative. Hoping for insights into my strange aches and zaps.

 

[Josephine]

Tonight, however, lying in bed, my knee starts to ache and throb and have those lightning zaps which I normally get a lot down my leg usually early in the morning, the aching knee seems to be a nighttime phenomena. Does anyone know why?

It's likely to be the neuritis.So take your gabapentin!

 

[mamazipp]

I'm taking Gabapentin 3 times a day. I guess I'll be on it for awhile..

 

[Josephine]

Yep, I think so too!

 

[mamazipp]

@Josephine I have some questions. I've not really done any PT at home or pt office for the past two weeks , just alternating between walks, a few excursions, living a tad more of my life, and chilling at home with ice, elevation and TV. I'm at 12-13 weeks. Is there something I ought to be working on? Still tight, still need Oxycodone 1-2 times daily. Still have an extension that doesn't want to stay at zero.

 

[Josephine]

I wouldn't say so. You are only 14 weeks as yet and that's still very early. So you will still be prey to various forms of pain soreness, burning, stabbing, throbbing, aching, swelling and stiffness. So just do what you are doing and be patient. Things will settle down eventually.

However, I would suggest that perhaps you stop the oxycodone and transition to paracetamol/Tylenol 1,000mg 3-4 times a day. Of course if you find nights a problem, then the night time oxy may be good as well.

 

[mamazipp]

Thanks, Josephine, for the suggestions. I didn't get much relief from occasional Tylenol but perhaps a steady regimen will be helpful. I'll try the Tylenol on a regular schedule and see.
Last night when that usual night time stabbing in my kneecap set in, I tried wrapping two ice packs securely on it and did not take the oxy. I was able to fall asleep pain free. The ice did the trick by itself.

So I just have to put up with all of those sensations you so perfectly described! Thankfully they don't all come at once.
I am now obsessed with this site, by the way, and stay up way too late reading everything. It's so full of information and reassurance. Thank you.

 

[Josephine]

I didn't get much relief from occasional Tylenol but perhaps a steady regimen will be helpful.

Oh yes! That kind of medicating is okay for a headache but not for this situation! And remember that each dose is only effective for 4-5 hours so you do need to take it regularly.

 

[mamazipp]

I had a couple of days last week where I lay around the house with ice, elevation, and only Tylenol at Josephine's dosage and experienced no pain for a couple of days. I was elated with the fact that I hadn't needed any Oxycodone and felt like I had turned a corner. I decided to have a very needed shopping trip as I had just about eaten everything edible in the house. I discovered I could get into the car without pain and groaning (it's a small car fairly low to the ground) and I was ready to greet the world. I was able to do a large shop, go to several stores, get gas, and generally felt like I had returned to the land of the living. After getting home and lugging many, many bags into the house, I still felt great but decided to have a quick sandwich and ice, elevate and rest, even though I still was feeling no pain. This wonderful feeling lasted several days, still no need for Oxycodone, and I made sure to ice overnight.
Well, this lovely feeling ended about 3 days later. I woke up with intense pain and stiffness right at the quad/knee area, the place that gave me so much trouble in the beginning when I could barely lift my leg to move or to walk.
It felt like a setback of two months. I've been icing, elevating, resting, can barely walk. When I tried to walk outside I could barely walk and needed to rest on every bench in my neighborhood. I could not wait to get home.
So what is this? I had to take a few Oxycodone which I thought I was done with. Is this a normal part of recovery? I noticed that this morning I did wake up with barely any pain, thank goodness!( I had the ice machine on it all night.) Is this a rebound from all the activity I did a few days ago?
I'm already 15 weeks post op.

 

[Tabbycat]

Really sorry your pain came back with a vengeance. It just goes to show how long this recovery takes. You've had a lot of difficulties along the way too, so don't rush it, go back to what you know helps and take it steady.
Love, Tabby xxx

 

[mamazipp]

Thank you for your support and kind words Tabbycat. I was reading my earlier message where I was feeling a ripping feeling on the side of my knee some weeks ago, and I realized that I don't feel that anymore. That is progress, so I have to remember to keep in mind that things really do progress, albeit at a snail's pace sometime.

 

[Josephine]

Well, you poor thing! You overdid it big time, didn't you? And I am ashamed to note that nobody left you the recovery articles! Shame on us! Here they are anyway, albeit a bit late.

These are the two you should read first as they will explain why this little trip cost you so dearly
Activity progression for TKRs
Energy drain for TKRs


Here 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
Swollen and stiff knee: what causes it?

Myth busting: no pain, no gain
Heel slides and how to do them

Extension: how to estimate it and ways to improve it
Elevation is the key
Ice to control pain and swelling

Healing: how long does it take?
Chart representation of TKR recovery
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?

 

[mamazipp]

Jo, you did send an extensive questionnaire about my recovery issues and that was very, very helpful. I figured the recovery articles were for new surgery people and I was already 3 months out. But no worries, as I read them on other people's posts, so I was familiar with them. I'm happy to have my own copies, however so thank you! They continue to be relevant.
Silly me for thinking that 2 days of no pain meant that I Could resume "normal" activities. I guess it's just so frustrating to think that I must monitor my energy expenditure for a long time. I just want to be pain free, and have to continually remind myself that my recovery is going to be on the longer side.

Another observation. I can negotiate in my apartment without a cane, so tried to see how far I could walk outside without using it, although I did bring it. I found that my back started to ache badly after barely one block, and I had to resume the cane. Guess I will continue to use the cane outside until I'm stronger.

 

[mamazipp]

@Josephine I just re-read the article Healing: How long does it take. It was written just for where I'm at right now. It speaks to all my current concerns! Thanks for sending them. Sometimes you have to be ready for the message.

 

[Josephine]

Bless you!

 

[kneeper]

Yep, you joined the Overdid it Club and noticed the delayed effects of overdoing. I think almost all of us have been there at one time or another.
As you've learned it's often better to do less than you *think* you can and see how it goes the next day before adding more activity. Pacing yourself is needed for quite a long time.

 

[mamazipp]

Well, the Overdid it Club has turned into the club I didn't want to join. Can someone cancel my membership please?
Now I have intense pain localized in my kneecap and that spot in the quad, where it was cut during surgery, just above my knee.
It's so bad I can't lift my leg without pain. I've been taking oxy and icing and neither works.
Is this just overdoing it? There is no sign of infection but the pain is severe.
Any suggestions or ideas? Is this a normal part of recovery?

 

[uva55]

@mamazipp im sorry you are in pain...rest up, ice and I hope you feel better again...part of the problem is that most of us are not used to just doing nothing for soooo long, we feel that we are being lazy and things are not getting done around the house the way we like, so when we have a better day, bam...we over do it. I did it to myself yesterday getting my house ready for my surgery tomorrow....my husband worked really late hours last week so he can take a couple of weeks off after my surgery and he was helping with the chores but not quick enough for my liking....so now I feel that a semi ran over me, the only parts of my body that don't hurt are my head, and my toes, lol

 

[Josephine]

Oh my! What ever did you do?