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Bilateral TKR I had both knees tkr and am struggling

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Perry

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I had both knees done on May 13th. Went though terrific pain, heavy meds, making me a mental wreck, leading to stomach problems leading to 40 pound weight loss and additional med treatment. Not to mention my doc failed to advise what would happen to my bowels and how to handle it leading to unbelievable distress.

In addition a lower right leg tendon was apparently damaged or twisted in my lower right leg during the surgery which goes insane with pain whenever I put the leg into a sitting 90 degree position. This merry go round of troubles and pain drove me to major distress and thoughts of suicide. Through the grace of God and my loving wife I held on and can now see some improvements and hope for an eventual good out come in the last several days.

My questions at this point ......
I have completely quit ALL the heavy drugs and cleared my mind and gut issues "somewhat" and take nothing except over the counter Motrin and sleeping pills now.

My knees are extremely stiff and burn, I cannot sleep at night because I cannot get into a comfortable position with them, so I am sleep deprived badly. I go to physical therapy 3 times a week. Am I and my complaints normal and in line with others experience?

Can I use heating pads on my knees for relief or does this compound the issue.?
Am I still to use always ice when they hurt and swell ?

I know all people say be patient, but the slow pace of recovery is very demoralizing. I would appreciate some others who are further along with some details of their experience.

Thank You
 

icep707

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@Perry Welcome to bonesmart and congratulations on the new knees, though you are off to a bad start, things are about to turn for the better. Energy drain , sleep deprivation, constipation, pain , depression are all part of the package deal with TKR. I had one knee replace nearly 5 months ago, with excellant results, not one complaint, well , lack of sleep got old , fast!. You have to have a positive attitude . Also it sounds as if you are drastically under medicated. I was sent home with oxycontin, oxycodone, tramadol and celebrex. I didnt like the side effects with both oxys , so after 5 days ,I stopped taking them. And got by excellantly with just tramadol , celebrex and tylenol. However my secret recipe was 16 hours a day of proper elevation and excessive iceing!. My only mistake perhaps was doing to much too soon causing low flexion initially. Someone will send you the mantras and articles, please read them and apply them to your recovery. Read some threads on the recovery side of this forum, there have been a flurry of bilaterals the past couple of months , so you will and are not alone. Best of luck. Iceman
 
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Perry

Perry

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Thank you Iceman.
This was my first ever major surgery and I have never had to take any heavy duty pain meds, so the oxyies
were a huge unpleasant impact on my system.
I have been pushing too hard for a quick recovery and my therapists have told me to slow down and do not try to rush this.
 

warriors42

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Perry, maybe you can ask your doctor about hydrocodone. I took the 7.5/325 acetaminophen along with flexeril. I didn't have much problem with constipation and no adverse side effects of the drugs. Like icep states, ice and elevation along with lots of rest is your best friend. I am six weeks out from RTNR and am doing very well with my recovery, this is after already having four operations on that knee.

You need to take pain meds, the only way you are going to get better is to be some what pain free. Elevate, ice rest, medicate. Repeat, repeat, repeat. Hang in there it will get better. No more thoughts of harming yourself, just imagine what your life will be in a few short months.... absolutely wonderful. Hang tough and remember there are people here that have gone through and are going through exactly what you are. There is support and answers. Were here lean on us...... Joe
 

icep707

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This was my first major surgery as well, however I found bonesmart nearly 3 months before my surgery. I was determined to be prepared and I hit the jackpot with this forum. The day my OS said he would do my surgery was the day I found bonesmart. By far , my best move!. Let me tag a moderator to send you the articles with the mantras @referee54 im sure can assist. He coincidentally had both knees done. Remember not to over do thing. There is no medal for a fast recovery. Best of luck Iceman
 

midwest girl

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@Perry everything you are describing is pretty normal. I had a RTKA on May 13th and I too have had some of the same issues. I was prescribed Percocet which caused vomiting and extremely painful constipation. It did take care of the pain but the side affects weren't worth it so I quit taking that at week 3. Since then I've been using 1000 mg Tylenol + 50 mg tramadol. And I ice a lot to control swelling & it works great for pain control. I still have to use miralax in the morning & prune juice in the evening every day to keep the constipation under control. My biggest problem is still getting a good night of sleep.i don't think I would put heat on your knees at this stage. I think it would cause more swelling. Patience and positive attitude is key to this long recovery. I would rather go at a slower pace and do it correctly for the best results possible. I spent a lot of money on my knee and I want it to last and give me a free from arthritic pain life. In the long run, I know it will be worth it.
 

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@Perry , Welcome to Bonesmart, sorry to hear you are having so many problems, I will tag our forum nurse to advise you, @Josephine .
my therapists have told me to slow down and do not try to rush this.
Your therapists are right, you cannot rush this recovery, your knee is in charge and it will heal at it's own rate. While you cannot speed up the process, you sure can slow it down significantly by doing too much.

Here's a link to some helpful articles, you will need to read all of them, they will answer some of your questions.
TKR recovery article compilation
Constipation and stool softeners
In the meantime we have a three day weekend, slow down and follow the Bonesmart mantra:
Rest, Ice, Elevate, and Medicate on Schedule.

I am at 2 and a half months, and this is how I am going to spend my weekend, you are not alone in having to be patient. The hardest work of this recovery is laying in bed, with ice on your knee, your leg elevated, and taking your pain medications as prescribed.

Hoping your recovery starts to turn around soon,



 

Jamie

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Hi and welcome to the forum! These folks and your therapist are correct. You must fight the temptation to rush your recovery. It takes time! Please do read all the articles that Pumpkln posted for you. It will help you understand more about recovery.

Don't use heat on swollen knees. It will just make things worse. You need ice, elevation and rest. You should be icing every moment you're not standing up....including through the night when sleeping. Just be sure you place a towel between your skin and the ice source so that your skin does not get a freezer burn. This helps with pain.

If you are experiencing any stomach issues, you need to get off the NSAIDs. Motrin is one of them and it's actually not that great a pain killer. Try Extra Strength Tylenol (500mg). You take two tablets (1000mg) as a dose and can do that up to 4 times a day (at least 4 hours apart). The maximum of Tylenol you can take in a 24 hour period is 4000mg, so be sure you count ALL medications you take with acetaminophen (the active ingredient in Tylenol) in them. Our drug companies like to mix it in with cold remedies, sinus medications and a host of other over-the-counter products.

But....at just slightly 2 months out it may be that you still need some prescription pain medication. You might give Tramadol a try along with that Tylenol. It is much milder on your system than the opiates. You still would need to follow the guidelines in the article on constipation, but most people find it helps with pain and doesn't give you that fuzzy-head feeling.

I'm not real clear on what you describe as tendon problems. Are you still getting a lot of pain when you bend your knee?
 

Roy Gardiner

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Hi, Perry, welcome to BoneSmart,
I have been pushing too hard for a quick recovery and my therapists have told me to slow down and do not try to rush this.
As everyone has said, you cannot rush it, any more than you can make a broken leg or a deep cut heal faster. The body does what it does, in its own time. But you can slow it down by doing too much and making the damage worse. Exactly the opposite of what you want, but sorry there it is.

- 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.
- If you won't die if it's not done, don't do it; if you must do it, short and sweet, not hours on your feet.
- Don't stand if you can sit; don't sit if you can lie down, don't stay awake when you can go to sleep
 

Phil75070

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Hi, Perry. I agree with everyone else that says you need to get back on prescription pain killers. That stiffness and burning you feel are two ways pain expresses itself so you need pain relief. At this point you are still very early in the recovery process as it can take a year to be fully recovered. The knee and all the surrounding tendons, ligaments and muscles needs to heal right now. Easy stretching exercises, rest, elevate and ice as much as you can and take your pain meds on schedule! You'll come out of it just fine like so many if us have.
 

referee54

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Welcome!!! I am glad that you have found us!

What the others have said is absolutely correct.

Can I use heating pads on my knees for relief or does this compound the issue.?
Heat on the knees will compound the swelling, as heat brings blood flow and fluids to the inflamed area. You need to ice and elevate for long periods of time at this stage of the recovery process.

Am I still to use always ice when they hurt and swell ?
I was---and I would say almost all of us---were using ice much longer than we thought we were supposed to. If your knees are swollen---even a little bit---you should be icing and elevating and resting---ice will be your best friend for some time, so to speak.

I know all people say be patient, but the slow pace of recovery is very demoralizing.
This recovery from a TKR or a BTKR can be frustratingly slow---but the harder we work, the slower and more frustrating the recovery actually becomes. Patience is needed---you have it; you just have to reach deep down inside of you and find this strength.

You have to resist the urge to outwork the knees---you will slow your recovery even more---keep the knees happy---the gentler your approach, the better the outcome.

Sadly, there is nothing you can really do to speed up the recovery, but everything that you overdo will slow it down---a lot!

Have you had a chance to take a look at the articles in the forum library? They contain wonderful information that may help you understand many of the aspects and issues of a TKR or a BTKR. Here they are for you.

First are the 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!

Next is a FAQ (Frequently Asked Questions) thread.

And then the articles in order of importance .
Group A
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?
Progression of activity for TKRs

Group B
How Long Does Healing Take ......
Chart representation of TKR recovery
Energy drain for TKRs
Elevating your leg to control swelling and pain
Using ice

Group C
Knee Replacement - Where Am I in Recovery?
So What Is It Going to Take? The Five “P’s” of Knee Recovery
Work “Smarter” and not “Harder”
About recovering a knee - from one who knows!
Some suggestions for home physio (PT) and activity progress
Myth busting: The "window of opportunity"

Group D
MUA (manipulation under anaesthetic) and adhesions
It's never too late to get more ROM!
It's Worth the Wait for ROM
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?

I would also agree with the pain meds---you need to get something to help you through this at this time. While six weeks or so seems like a long enough time for recovery, in reality, you are still in the somewhat early stages of recovery---my BTKR took me five months to lose a pesky little limp---six months I was at 80%-85%---and it was at eight months that I was at 90%-95%.

I have to tell you, though, that I was very frustrated at the slowness of recovery---but when you reach your destination of being fully recovered, you will not believe how great you feel!
 
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greeneyedtattedgirl

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Hi Perry
I have had most of what you are going thru and to the same intensity. Please read my recovery. I am now just starting to take a turn for the better. I cant stress enough pain control is the key. I too went off all my heavy medications cold turkey and I suffered terrible, terrible withdrawal for over a week which just increased my anxiety off the charts.

What I have found that works for me is take a medication that controls your pain that you feel comfortable with in my case the maximum dose of Dilauded. I am comfortable with is 2mgs during the day approximately every 4-5 hours. And I take one 4mg Dilaudid at night to help me sleep. I am also currently on 500mgs of naproxen twice per day and 3mgs bromazepam for anxiety/panic 3 times per day evenly spaced 8 hr a part.

I have found for myself when my pain is controlled my anxiety is controlled much better and I'm able to participate more in my physical therapy which we desperately need. Please stay in touch as I really feel your pain as I have been there and continue to work away from it. Wishing you a pain-free happy day today
Sheila

Sent from my SGH-I747M using Tapatalk
 

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Hi @Perry What you are feeling is normal. Your thoughts of harming yourself are probably a result of your feeling like you should be progressing faster but this recovery in difficult. I think you are just feeling a little like you are not going to get better but you will. We all had these feelings and still early in your recovery to have it all healed and moving like normal.

I had never taken any strong medications this was my first surgery other than having my tonsils out and an ingrown toenail surgery and wisdom teeth as well. I thought if I survived the wisdom teeth this could not be any worse than that - boy was I wrong! I am happy that you found us all here at bonesmart . I did not know about this wonderful site until I was 3 weeks into recovery and how much the wonderful people here have made my recovery time and after time after too so much more calm.

I think the problem is that this is major surgery.People who have never had this surgery try to understand but sometimes they dont really know how much was involved to a knee replacement. I didn't till I had mine. Bonesmart friends made me realize and that I was feeling normal told me not to let anyone push to pain and this was happening with pt.

Pt for me was aggressive making you feel like you were not up to par with the requirements set. I think the best way to recover is to surround yourself with positive vibes talk to people who make you feel like you are ok. Visit here lots and tell how you are feeling everyone has been through this surgery and understand because they have done it. More pain in my case then I had expected but now at just over a year al the pain is gone and now love this new knee.

So much information. Josephine and all of the advisors who are wonderful and so many others who are will to listen and who care. Lots of friendly people with the same understanding of the surgery you have just been through. Best wishes and take care keep writing we are all there for you. Holly:):yes::SUNsmile:
 

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@Perry.
Welcome! This site is amazing. What you are going through is so tough. I went through a lot of the depression piece. Under medicating will actually slow your recovery. The folks above gave some great ideas. Keep posting there is always someone (at least I have found this to be true) who has gone through, or, is going through something similar. I believe it will keep getting better.
There are some great recipes for the constipation issue. That cannot be ignored! I think @Pumpkln gave you that info.
We are here always (there is even a thread for middle of the night folks who are having trouble sleeping)
~~hopefaith
 
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kneeper

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Hi Perry--you're getting lots of good responses so I'll just say welcome aboard!
 
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I thank everybody for your comments, suggestions, stories and support. Yes, I agree this is a wonderful site for support with many nice and caring people trying to help. I will be spending some time reading through all the links that have been provided, and have already realized many of the "mis-informations" I have been proceeding under.

From my early days when I could not sleep and could not sit because of the tendon damage where the boot was attached in surgery I walked and walked. Walking was the only escape from the laying horizontal pain and the sitting position tendon pain and the all engrossing fear of ruining my future life forever with this surgery.

I think in my my I thought if I walked long enough and even fast enough I could escape the nightmare. I am talking about walking for hours. I now realize this was only counterproductive.

Presently here is my stats:
*Gut issues and stomach issues resolved ---Yea!
*As leg swelling has gone down knees are becoming extremely tight and burn but are generally bearable - most days are bearable.
*Lower right leg tendon attachment is still very problematic with PT saying the tendon was turned from original position, to new straightened position and will take time to readjust. :(
Using massaging vibrator and cold, and pennsaid to try to make it tolerable.
Not being able to sit in chair or car for long periods does not help

* Still have buyer's remorse of the operation and results(ha ha) but the responses from all of you are helping me tremendously to understand more about what is going on, Thank YOU All !

* I am still terrified of the hard drugs due to stomach issues and the very deep depression they caused. So still undecided as to get on any of them again.

Keep writing and I will keep reading and grasping for the rays of sunshine and hope.......
 

RestAssured

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@Perry,

Even through my long recovery, I never had "buyer's remorse!":heehee: Ok, well there were a few days here and there :groan:but the over all feeling of getting back to life after recovery is better than any amount of pain that I experienced at the time!:happydance:

Hang in there, ice, elevate, and REST, and before long you will be writing and starting on "your own bucket list!":happydance::loveshwr:
 

referee54

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* Still have buyers remorse of the operation and results(ha ha)
Trust me---many of us did---as in "What the heck did I get myself into?"

I think that most of us probably had some type of arthroscopic surgery and bounced back very quickly---and this is totally different.

You have to realize that two bones were sawed off, your implants were pounded and your knee was manhandled, you had several tourniquets on your legs, and they obvioulsy were not gentle with either one of your knees!

I kept asking myself and my PT's---"When will this ever end?"

It did---I just returned from a 35-mile bike ride, and when you are fully recovered, you will be amazed at how great you feel and what you will be able to do---and to enjoy things so much more.

I think in my my I thought if I walked long enough and even fast enough I could escape the nightmare.
Exactly the opposite---"less is more" in this recovery---you have to keep the knees happy---keep them within the envelope, so to speak---and they will slowly begin to get better. Do not work harder; work smarter.

Remember, recovery is like a roller coaster ride---there are some highs and some lows---you just keep focusing on hangin' there---"keep on keepin' on" and you will get to the destination of being fully recovered.

Now that you are a lifetime member of the International BTKR Club, I can teach you the BTKR "Secret Handshake":snork:
 

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Hi Perry!

I Had my LTKR done on the exact same day as yours and have experienced everything you have except the sensitivity to my stomach. The pain, burning, stabbing, can't sleep,etc. oh , and I can completely understand your mind set,, I know that I will have to have my right knee done, but after I got home from the hospital I told my husband I would never, ever do this surgery again!

I have kind of been rescued by this forum! They stay with you thick or thin, and even when you put your true feelings out there for all to see..they do not judge, they continue to support, and most of all someone probably has felt exactly like you!

As far as pain medication goes , I hear your feelings and understand. But in order to progress and heal, you need rest and without some sort of stronger meds, it will be difficult for you. I actually made an appointment with my internist (or GP), as he knows my current medication tolerance and anxiety levels. He gave me some stronger meds for breakthrough pain, stool softener for constipation and also Tramadol to try should I become too depressed. The Tramadol not only helps with the pain, but it has an ingredient in it that helps to increase the serotonin in your brain, which works on your anxiety, and over all well being. It has helped me tremendously and drinking plenty if water helps your bowels. Please think about this, as I do believe, as they teach on this site that we need to stay ahead if the pain.

I had been working with this pain part time at my office since 3 weeks post op and this past Monday started back on regular hours. It is painful but I am too busy to think about it until I get home and then I am exhausted and fall asleep around 10pm. So it is an unexpected slice of heaven as I have not slept more than 4 hours since day one! And one really important thing! I take a cooler full of ice every day to the office. I will have ice as my friend for a long long time!

I just started my outpatient PT on Wednesday, and my PT told me we had to get my pain level down before we ould start on exercises. So he massaged me knee, found around eight knots in my thigh muscle (that hurt like heck) and massaged gently around my tendon near my knee cap, as I have tendonitis in it! He used electrical stimulation which felt oh so good, and ordered me a tens unit. I am so thankful for a PT that understands how hard it is to do the exercises when you Re hurting.

I hope that you continue to keep us posted! I think we all want to see that your pain level has come down.
I hope today you rest, ice and elevate your knee as much as you can and that your pain level comes down,

Praying for you!
 

RestAssured

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Well, so much for trying emoticons from my phone! LOL! :rotfl:

I know that you will figure out what to do. It is so hard when you have been exercising to suddenly realize that you will have to "modify" your expectations for a little while. :sad:

I had been getting ready for the 13.1 Houston Marathon in January, when I broke my foot three weeks ago! They put me in a water cast so I could continue to work on upper body and swim. :swim:

The point is, we all have been where you are; my right knee is a book by itself, but we accept the fact that there will be days that we have to "modify" according to what our body is telling us.:bored:

If we don't listen to our bodies, they will "scream" to be heard! :gaah:Take care of yourself, we care!:console2:
 
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