TKR Jan is on the other side

[New England Librarian]

I also found that I couldn't really tell when I did too much because the pain came several hours later, probably at least partly from increased swelling. Even now, at 16 weeks out, I some times feel surprised when pain arrives after what seems like a normal day. I guess normal has a new meaning now, but I want to be active and keep challenging myself because hopefully every day I can do more without hurting.

Your husband sounds very thoughtful and attentive - you are very fortunate

 

[jarabas]

I am going to back off on sitting in chairs and doing exercises.
I hear ya Marian about trauma. I cannot believe the bruises I have! The whopper is on my right thigh
-it goes most of the way around and from my groin halfway down my thigh. Solid purple. The next biggie is my ankle, all the way around the back. It's the color of concord grapes perfectly ripened. I also have a nice shiner on my right forearm where the canula slipped. It's about the size of an egg.

 

[jarabas]

We need support system awards! I know I couldn't do this without my husband's help and my family and friends--including all my new Bonesmart friends- have been so great about reaching out.

 

[jarabas]

I am having some serious breakthrough pain events. They come on rather suddenly and last about 20 minutes. I am moaning, gasping and crying during the worst of it. I take 2 oxycodone when the episodes start and pile on the ice bags. Having 2 to 4 episodes a day, starting in the afternoon and evenings.
Any suggestions?

 

[New England Librarian]

Hi @jarabas I am glad to see a post from you again, but very sorry to hear about the breakthrough pain. It's frustrating to take oral meds for it, because they take a while to work (as you have sadly found out). Ice can certainly be helpful as it is immediate. Can you ask your OS about reducing the interval between your doses? It sounds your meds are wearing off a bit early. You are also in a time period that many here have found the most painful: about 8 to 15 days after surgery. Hope you can hang in there

 

[Celle]

Jan, are you taking your pain meds on a regular schedule, the full dosage prescribed and the frequency prescribed? If not, you need to do so. It's no fun playing catchup with the pain.

That you're getting more episodes of pain in the afternoon and evening says to me that you're doing too much and it's all catching up with you later in the day. It's still only two weeks since your surgery and right now your main job is to rest, elevate, ice and take your pain meds by the clock.

You only need to do a minimum amount of exercise at this stage and I think you're right to put off doing exercises sitting in the chair at this stage. All the exercise you need is just a bit of walking around the house.

My surgeon doesn't allow any formal PT at all for the first four weeks after surgery. He says that's healing time. All his patients do well.

 

[jarabas]

Thanks folks.
I am on a regular schedule for pain meds. I think I am probably doing too much and will cut back. Yesterday I had three visits--the pt, the ot and the nurse and sat up with each for a half hour or so, plus pt exercises, and I took a load of laundry down the stairs, and went upstairs to gather a few books while my husband was at his eye doctor appointment. Didn't think about it at the time, but writing it down, it seems a lot. The day before we tried a short walk to the end of the street and back, and I heated up some soup for myself, and sat up to watch the football game for about an hour. Back to my stack of pillows and ice!

 

[jarabas]

My OS is adding tramadol to my pain meds. Anyone have any experiences, good or bad?

 

[Celle]

Yes, what you did does sound like too much, this early in your recovery. I'm glad you're going to cut back.

I understand about getting books, but laundry? Let that be hubby's job for a few more weeks. Don't go carrying it down the stairs.
My husband claimed he couldn't make the washing machine work. " Really, dear? And you an engineer, too!"
I showed him how and he did laundry for the next month. His planned incompetence didn't work for him.

 

[Celle]

Tramadol is a good "step down" drug from the heavy-duty narcotics. Be careful when you come off it though, because you will need to cut back gradually, to avoid some withdrawal symptoms.

 

[jarabas]

Learned my lesson!
I think the plan is that I will take the tramadol along with my oxycodone/tylenol/celebrex to see if it prevents the breakthrough pain episodes. Thanks.

 

[Timetolive]

I hope you can get some relief!

 

[sleepilu]

Tramadol certainly helps stop the breakthrough pain at night for me. I've found that I don't need it during the day, so can save doses for those most uncomfortable times.


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[referee54]

I think I am probably doing too much and will cut back.

Yesterday I had three visits--the pt, the ot and the nurse and sat up with each for a half hour or so, plus pt exercises, and I took a load of laundry down the stairs, and went upstairs to gather a few books while my husband was at his eye doctor appointment. D

What you think you are doing seems to be rather innocuous----but, in actuality, what you are doing to your new knee is really pushing it waaaaaaaaaaaaaay too far, and it is, as politely and as firmly as possible, telling you that you need to cut back.

You are just about 1/2 month removed from a very traumatic surgery, and you are still in the "Dark Days of Recovery"---it is time to let other people do the mundane tasks---you job right now---your only job, is to rest, to ice, and to elevate.

Think about what was done to your knee---two bones were sawed off, there was filing, pounding, gluing, you had some tourniquets, your leg was man-handled, and then you were closed up. It is much, much too early to be doing all of this at this point in time.

 

[jarabas]

I agree. I am backing wayyyyyy off.

 

[jarabas]

Hey folks, I have a couple of sore spots on my operated leg and I wonder if you have experience with something similar.
I'm going for my post-op on Jan. 13, so I'll ask my OS at that time, but in the meantime, I'd appreciate hearing any similar experiences and any advice you have.
One of the sore spots is right on my greater trochanter. Sometimes it spreads around to the gluteus. This spot is more sore and achy after I do a short walk and when I'm resting. Ice relieves it somewhat.
The other sore spot is the head of my fibula. This spreads around to the biceps femoris and the gastrocnemius.
Again, it is worse after walking and is relieved to some extent by icing.
The pain is worse later in the day. At the worst, the pain gets up to a six and can keep me from sleeping or wake me up from sleep.
Am I doing something wrong? The pt has me taking a short walk each day-about 5 to 10 minutes to the end my block and back. My "assignment" is to take full, heel to toe but slow strides, using my crutches. I'm really enjoying getting outside and nothing hurts while I am doing these strolls. I developed the pain before I began these little walks, while I was just going to the bathroom and the kitchen for a snack.
Today is a rainy day in New England, so I will stay in bed and see if this make a difference.
Thanks all.

 

[newlybionic]

Has your therapist evaluated your gait? I know you were told to do the heel toe walk but I still had problems getting it just right. Before my TKR I wasn't doing heel toe walking because of my limited ROM in the knee. All my muscles in the leg were not used to my new style of walking. I had pains up and down my leg similar to what you describe. In my case it eventually got better.

 

[jarabas]

Hi Marian,
I will ask tomorrow. She did mention that I need to work on my gait as I had been limping for a while before my knee replacement. It's reassuring to hear that you are better. Good luck with your revision--have you a date yet? My best wished to your daughter--when will she get a diagnosis?

 

[newlybionic]

My daughter hopefully will have second MRI this week so we will know as soon as she can get a new appt with her neurologist. I'm thinking I might do my revision in the end of March. It's still up in the air. I'm trying to balance my job, money and when I can have some help at home especially with my dogs.

 

[jarabas]

Good news today. I am officially graduated from home pt and will start outpatient pt!
My range of motion is 0 to 120 with no pain--just stiffness and some soreness in my hip and calf.
Marian, my pt agrees with you. My gait is different (better) now and my itb and the muscles in gluts and calf are adjusting. Thanks everyone, for your suggestions and support. I feel like I am on the right track.