TKR I’m cold!

[Cathyjbeck]

I’m starting my 5th week. Is it normal to still need meds every 5 to 6 hours? I’m trying to extend the time between pills but I feel like it takes a while to catch back up. I’m fearful my doctor is going to quit giving me them. Do any of you still need pain meds on a regular basis at this time?

I’m a 64 year old woman who had been fairly active until I injured my knee 18 months ago. I had a TKR on my right knee 6/21/22. My flex number was 119 last Friday. I’m sure I’ll be at 120 at tomorrow’s PT appointment. I’m want full recovery. I do have back issues and has an injection in my L3/4 just weeks before my knee replacement. My right quad is very weak. Pain is a 6 by hour 6 after pain meds. I have significant numbness from above my knee down to my shin so much so that I feel like I have a bandage wrapped around my leg with a tight rubber band going straight through the back of my knee. I’m cold most of the time. But I’m going to get over this!

 

[Jockette]

Hi and Welcome!

Yes, many of us need pain meds at 5 weeks, and even longer. However, many doctors don’t want to continue to prescribe them at this point. If your doctor is like this, try Tylenol, if it agrees with you.

The most effective way to take Tylenol is 2 x 500 mg tablets every 6 hours, to a total of 4,000 mg (4 doses) in 24 hours. You need to take it regularly, to keep up the levels in your bloodstream. If you just take the odd dose now and then, it's far less effective.

Check all other medications you're taking, to make sure there is no Tylenol/Acetaminophen/Paracetamol in them. If there is, scale back one or two of your regular Tylenol doses, so you stay within that safe 24 hour limit of 4,000 mg.

I also took ibuprofen 6 hours apart, but alternating with the Tylenol, so that I had something every 3 hours. For example, Tylenol at 6 am, ibuprofen at 9am, Tylenol at noon, ibuprofen at 3pm, etc. This worked well for me to at least downgrade the pain and discomfort.

Please tell us your surgery date and which knee it is and we’ll make a signature for you.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

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​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

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

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

6. Access to these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[Newbai]

I am just one week after surgery and I am down to two oxy pills. Sent a message to doctor for a refill and they told me I should start taking Tylenol and the other pain meds I was prescribed. I told them my pain level is very high and the other meds aren’t doing anything to relieve it… they sent in a refill prescription for oxy.

 

[Jockette]

Often it seems they will refill, even though at first they say they won’t. Prescription pain medications are such a tricky situation these days.

I actually stopped taking mine at 11 days because we thought they were affecting my vision. That’s when I went to ibuprofen and Tylenol. Did they help me a lot at that early stage of recovery? Not really, but they were definitely better than nothing, and much better than the side effects of the dilaudid I was prescribed. I could never even tell if the dilaudud helped, which probably means it didn’t.

 

[Susie-Q]

It's interesting how different surgeries on the same person can have different outcomes. With my first knee I started on Oxycontin, stepped down to Oxycodone then down to Vicodin which I took until 6 weeks post-op. I remember not sleeping too well until I was completely done with all narcotics.

This second surgery I had oxycodone from the outset, added in the Tylenol and Advil (alternating) fairly early on. I started weaning off the oxy at about 3-4 weeks post-op. I didn't seem to have as much trouble sleeping this time.

You should keep taking the oxy if you need it. Some are able to get off of it sooner and others need to take it for longer.

 

[sistersinhim]

I’m fearful my doctor is going to quit giving me them. Do any of you still need pain meds on a regular basis at this time?

Doctors are afraid to prescribe many pain meds because of the abuse of some people. If your OS won't prescribe more you can always ask your PC doctor. Many have found that they will prescribe pain meds with their OS wouldn't.

 

[thneed]

It's interesting how different surgeries on the same person can have different outcomes. With my first knee I started on Oxycontin, stepped down to Oxycodone then down to Vicodin which I took until 6 weeks post-op. I remember not sleeping too well until I was completely done with all narcotics.

This second surgery I had oxycodone from the outset, added in the Tylenol and Advil (alternating) fairly early on. I started weaning off the oxy at about 3-4 weeks post-op. I didn't seem to have as much trouble sleeping this time.

You should keep taking the oxy if you need it. Some are able to get off of it sooner and others need to take it for longer.

I didn't realize Oxycodone was different from Oxycontin, I thought it was just different names or like one was a brand name. I never really looked into it though.

I got Oxycodone and I am down to one every few days, at least for the past week and I'm almost 6 weeks out. Like others said, everyone's pain tolerance is different.

I used to take only Tylenol before the surgery, for the severe pain of the arthritis in both knees. I never felt it worked well, though. And then since the surgery I've taken it more or less every 6 hours and I can tell it helps, I can tell when I'm at the 6 hour point. So like the other person said, keeping it on-board seems to help.

 

[sistersinhim]

Welcome to Bonesmart, @Cathyjbeck! What you are feeling is completely normal at your stage of recovery. Your bend is amazing, way better than normal, which is around 90 degrees at 6 weeks.

 

[kneeper]

It sounds like you're doing well. I was certainly taking pain meds 6 hours apart at 5 weeks. By 8 weeks, though I only took something (prescription) at bedtime and a couple of weeks later it was just tylenol.

Are you icing and elevating quite a bit during the day too? Be sure you're getting some rest as part of your daily "schedule."
Having an area of numbness is normal but most or all of the feeling eventually comes back.

 

[Samsrf]

@Cathyjbeck just to add to the above comments- it may be that you don’t have the correct pain meds for you (we are all different) I took tylenol 2x500mg every 6hours religiously for 10 weeks. I can’t take ibuprofen. OS prescribed a muscle relaxant - the first one made me feel spinny and like I was drunk so I asked for something different. The second one (flexerill) worked and I only took it from 3-6 weeks at night when I had muscle cramps- this they did not want to refill so I tried to make it stretch. If something isn’t working for you, ask your doctor for something else. There are many options for something that can relieve pain.

 

[Cathyjbeck]

I’m currently on Percocet and Meloxicam. They work fine. I only have a few days left of Percocet. I’m trying to spread them out. I can’t imagine using muscle relaxers since the muscles are working properly as it is.

 

[hawk2go]

Hi @Cathyjbeck. My OS only gave me enough oxy for a week at full dose, so I started hoarding them pretty early in. Sleep was a serious challenge for me post surgery since I suffered with pre-surgery insomnia. I used my hoarded oxy when I woke at 2am and that worked so well, my OS prescribed an extra 15 pills with the expectation that they would last 2 weeks or more. I don't recommend this course, rather talk with your OS or PCP to prescribe sufficient meds to cover your pain. It sure is better to stay ahead of the pain by taking meds on schedule then it is to chase the pain after it's out of control.

 

[Cathyjbeck]

So far, they’ve been good about it. I can’t imagine only one weeks worth of Percocet thanks for your comment.

 

[Annie5]

I’m starting my 5th week. Is it normal to still need meds every 5 to 6 hours? I’m trying to extend the time between pills but I feel like it takes a while to catch back up. I’m fearful my doctor is going to quit giving me them. Do any of you still need pain meds on a regular basis at this time?

Hi Cathy, I’m on week 6 and still need frequent pain meds. I’m having a discussion about ongoing treatment on Monday and will be asking to continue pain medication for as long as I’m in pain as much as I am. You have to explain how bad it is. Good luck

 

[Cathyjbeck]

Since surgery 6 weeks ago, I’ve been really cold especially when I’m in pain. After PT or if I’ve walked too much, I can actually shiver I’m so cold. I do warm up with lots of blankets, but it sometimes worries me. I take my temperature to make sure I don’t have a fever because that’s kinda how I feel. Has anyone else experienced that?

 

[WFD]

After my last surgery I caught mono and had alternating fever and chills. Have you measured a fever?

 

[Jockette]

Almost all of us are cold after this surgery. It eventually passes.

By the way, I merged your newest thread with your original recovery thread, as we prefer that members in recovery have only one thread.

This benefits you because all your information is in one place, easy to find, and maintains a nice journal for you.

This also benefits our staff, as your information is all in one place, and we often go back through your thread for previous details, so we know what you‘ve been through which helps us advise you better.

So, please keep all your posts in this thread. If you’d like a new title, let us know what you want, and we’ll change it for you.

Many members bookmark their thread in their computer browser, so they can find it when they log on.
How can I find my threads and posts?

Best wishes on your continuing recovery!

 

[Cathyjbeck]

I am currently at 6 weeks and I too struggle with the best way to do PT. Yesterday my physical therapist said it was time to begin to work on strength. (Perhaps because I told him my leg feels weak). We used a lightweight on two exercises and a band on two exercises. I expected to be sore today but I am way more than sore. I have swelling and quite a bit of pain. He is a good physical therapist and I trust him but I do feel like I step back a step or two after PT. My incision hurts to touch as well but I have been using a medical grade silicone to soften it and it makes my slides even easier to do because the skin feels much more supple. It’s been a few weeks since you originally posted so how are you doing now?

 

[BBBB]

I’m starting my 5th week. Is it normal to still need meds every 5 to 6 hours? I’m trying to extend the time between pills but I feel like it takes a while to catch back up. I’m fearful my doctor is going to quit giving me them. Do any of you still need pain meds on a regular basis at this time?

Its quite normal. I am still (10 weeks) taking pain meds but use it tactically, and not daily. I use pain meds before PT. Other days, I alternate between Ibuprofen and Tylenol. I tried to take lower and lower dose and extend the time gap. For actual hydro or oxy, this was my strategy: just use half a pill for 4 hours and take ibuprofen or tylenol after 4 hours and take another half in 8 hours or so. It works wonder. Like many people mentioned, you know your body and pain. Dr are scared of abusers but you had surgery so its normal.
Fun fact: I had never taken any pain medication until I had knee surgery and I was/still am scared to use too much hydro/oxy because I was having nightmares and stuff. But I have used them tactically now and no longer have side effects. Good luck with recovery.

 

[sistersinhim]

I am currently at 6 weeks and I too struggle with the best way to do PT. Yesterday my physical therapist said it was time to begin to work on strength.

Absolutely not. Weight training should not begin until 3-4 months. Your PT needs to go back for up-to-date training on rehabbing a joint replacement. You don't have a sports injury, you are recovering from a traumatic surgical procedure.

He is a good physical therapist and I trust him but I do feel like I step back a step or two after PT.

Take control of your rehab. Having to recover from PT is setting your surgery recovery back. Say NO to weights at this early stage in your recovery. Using them will just keep your knee angry, swollen, and painful. A swollen knee will have worse ROM. Get that swelling down and the ROM will improve.