TKR June 30th 2014

[kneeper]

Tell the PT the pumping on the machine irritated your leg if she tries to put you on it again. If you have a hard time with an outright no, maybe say--not today.
I know when the pt tried to have me practice steps on a higher step one day, I tried it but I wasn't quite ready. I said, "no, I don't think I'm ready for one this high" and she just had me use the shorter ones.

 

[martyz4]

I did these stand up sit down exercises yesterday 10 times--times 3. My thighs are killing me today. I am wondering if I will be ok for more tomorrow. Didn't hurt at all when I did it and last night I was fine but today, different story. It takes me a while to walk straight. Maybe in the long run it will help. we'll see.

 

[tiredwife]

@martyz4 maybe not do quite so many to start with, so you don't irritate your poor thigh muscles. Maybe start with 5 - 3 times a day, and add another one every other day. Build up to it. This really isn't a race! You don't want to have a set back. You aren't very far into this recovery yet.

 

[marmora]

@martyz4
Don't know the stand up & sit down exercise, but sounds like a very hard workout especially doing it 3 times per day.
I was given an added exercise on Wednesday by my Physio of just marching on the spot with both legs, but holding on to the back of a chair or counter top for support.

Take care and remember to ice & elevate & relax after exercise.

Cathie

 

[kneeper]

Sounds like you overdid it. I'd say 10 a day would be fine--and don't forget your normal getting up and down from chairs will add to that.

 

[martyz4]

I am going to keep a close eye on how I feel these next few days with no PT. If by Tuesday I am feeling pretty good I need to re-evaluate the PT. I can't get over how much more aggressive she is now compared to 5 years ago. Maybe she thinks she is doing a better job, I don't know. Thanks so much for the encouragement.

 

[marmora]

@martyz4
PT can be a compromise between you and the PT and working out a programme that the main aim and focus is patient centred and hopefully you and your PT will be able to develop a programme without increasing your pain.
Have a good weekend.
Cathie

 

[martyz4]

Last night I stopped taking the Norco at 5pm. I didn't feel the need to take anything for pain. Ended up with that sweaty, chilled, yucky, tired feeling again. Still feel the same way today. Dh made me scrambled eggs and ham and I really had to force it down. Gosh I don't know what's better having pain or feeling miserable. I am torn whether or not to take a pill today.

I have PT tomorrow and will probably need one. It's not like I have zero pain just that it's not too bad and if it's the medication making me feel awful then I can deal with it.

 

[marmora]

@martyz4

Hi, don't know anything about your pain med called Norco and it's side effects - maybe it's not available in Ireland or called a different name here.
Maybe it isn't to be stopped immediately and for a gradual withdrawal. And as I don't know this drug , not certain if nausea is one of the side effects.

Are you on any other pain medication that can ease your pain, but not cause the side effects on Norco ?

Perhaps someone who has more experience with Norco can give you advice.

Take care,
Cathie

 

[kneeper]

Last night I stopped taking the Norco at 5pm. I didn't feel the need to take anything for pain. Ended up with that sweaty, chilled, yucky, tired feeling again. Still feel the same way today. Dh made me scrambled eggs and ham and I really had to force it down. Gosh I don't know what's better having pain or feeling miserable. I am torn whether or not to take a pill today.

I have PT tomorrow and will probably need one. It's not like I have zero pain just that it's not too bad and if it's the medication making me feel awful then I can deal with it.

Possibly your body can't handle the norco but would do better on something else. Do you eat something (crackers or something) with the pills? Have you mentioned your symptoms to your OS or his/her staff? I'll tag @Josephine to see if she has suggestions.

 

[martyz4]

Thanky you @marmora and @kneeper Norco is the same as Vicodin, not as strong as the Percocet. I stopped the Percocet abruptly and had that awful feeling. That is the reason I went to the Norco (hydrocodone) and here I am with the same feelings. I just took a half one to see if it helps my shivers. I sure don't remember this with the last knee replacement.

I also still have this off and on rubbing or clicking against something on the outer side of my knee. The doctor said it's steel against plastic but the PT says it's ligaments or tendons. Anyone had this before. If I put it straight and then bend it I can nearly make it happen.

Hope you are all feeling well today!!

 

[kneeper]

Luckily I did fine with Norco. Maybe the doc will have other ideas.
You really aren't that far out, so the rubbing/clicking is likely to be something that will go away as you heal. Is it painful or just weird? I have a weird tightness on the outside/back of my knee myself--I had it last time and it went away eventually.

 

[martyz4]

Thanks @kneeper I couldn't really say it hurts but it is hindering my walking because I am not sure when it might do it. It jolts me a bit. I was exercising on one of the machines and it started to do it and that was uncomfortable. Sort of like when you are about to crack a knuckle and that feeling just before it cracks.

I can walk quite comfortably around the house with no cane. I don't think with this catching/cracking going on I feel comfortable with nothing outside the house though.

 

[Josephine]

I'm going to ask you some questions and it would be very helpful if you would answer each one individually - numbered as I have done - 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!

)

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.

 

[martyz4]

@Josephine

1. what are your pain levels right now?

Pain is around 3-4 tops

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

I had Percocet 5/325, didn't do much so doc gave me 7/325--tried to cut down and had this chilly-sweaty-feeling. Got Hydrocodon/Norco 5/325, milder worked fine. Decided to stop taking it every 4 hours, stretched it to 8-12 hours...more chills and sweaty feeling the last couple of days. I took 1/2 today then another 1/2 about an hour later. Still feeling sweaty and chilly at the same time.

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

Probably not that much as I have been a lot more vertical these past couple of weeks. I cook when I feel like it, do a bit of laundry, dust that kind of thing. I am not swollen and incision isn't hot. My ankles swell a bit when I am on my feet a lot. I do sit and ice in between for a while and elevate.

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

I am going to say about 3x's a day. Forgot to add 10 minutes of ice at the end.

5. What is your ROM

I can't remember what I was told. I am doing very well, I can bend it better than I did before surgery and probably as much as my right knee. My extension is also doing good at nearly 0 I think they said.

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

Doing everything you mentioned with no problem.

7. what kind of PT/exercises are you doing? How much and how often?

PT 2x's a week for about 2 hours. Heat for 10 minutes. Stretching and pushing down with a ball under knee with little electrical devices on knee. Also leg lifts while unit is on and hold until it stops tingling. Bike, can go full rotation for 10 minutes. Stand on each foot count of 10 seconds, do 3 x's. Arch stretches for count of 30 3x's. Total gym 10 times pushing up for 3 x's. Then this other thing with weights I wrap around my thigh and flex and relax while standing for a count of 30 3x's--I do 20 lbs. Then last week sat on a chair and did leg lifts with weights--5 lbs. Back to the table for more stretching. The the physical therapist then does some rubbing and bending and pushing. Gosh I don't know about you but I'm tired!!!

Last time my ankle was on a pillow to push the knee down more. It hurt and I wasn't happy being in the position for 10 minutes.

 

[Josephine]

Interesting answers, thank you. My only comment would be that that's an awful lot of exercising for 7 weeks out. And a good reason why you still need pain meds. However, you could probably manage with something lesser in the way of pain pills like codeine phosphate 60mg and Tylenol 1,000mg 4 times a day. Speak to your surgeon or GP about it and see if they will let you try it.

 

[martyz4]

I have been cutting down on the pain pills until the day before yesterday I took 1 at 5pm night before then the next day at 1pm--I had a good breakfast but for some reason this pill Norco 5-325, hit me like a tone of bricks. My stomach was so sore I was in SamsClub and had visions of the ambulance coming and taking me away. I was guzzling water and finally found an old Omeprazole in my purse, what a relief.

With that I have decided I will try no more pain meds. I just feel weird on them, they were great when I was in terrible pain but now I think (hope and pray) I am good to go. I went to physical therapy yesterday with 2 tylenol. When I did the exercises I was fine but I was so worried about the manipulations by the physical therapist. When she bent my knee and counted to 10 I had a tear in my eye and she stopped and said OMG Patricia I'm sorry. I was surprised at the compassion she showed, her bark is bigger than her bite lol!! Anyways, she didn't hurt me, I explained the no pain pills and I was so tickled I managed without them for her manipulations that it brought me to tears.

I think they should have a class on getting off pain pills and the depression and anxiety people go through with this surgery. It's not just the surgery, it's the whole mental part that can be just as frustrating to overcome. I think I will contact the nurse that holds a class for people getting hip and knee replacements and mention my thoughts to her.

So I will be 8 weeks Monday and no pain pills so far. Feeling a bit more normal. However for 2 nights I have been tired and can't sleep, wondering if this is part of the pain pill dilemma??

I hope you are all doing well in your recoveries.

 

[tiredwife]

@martyz4 Sadly the sleeplessness, I believe, is a part of coming off narcotics. It hit my hubby hard with his first knee, tried everything to sleep - not napping, zquil (like Nyquil), Benadryl, chamomile tea, bourbon, etc. Finally got a prescription for Ambien. It hits some harder than others hope it doesn't hit you as hard.

 

[martyz4]

oh thank you so much @tiredwife for the feedback. You are so nice, every thread I read you are on it with very good advice. I am recollecting this no sleep business from my last TKR. For some reason I thought it was due to surgery. Now I am quite sure it is due to the pain pills.. Well I will have a couple of glasses of wine tonight and maybe a See's candy or 2 keep my fingers crossed and hope for the best.

We did quite a lot today, Costco, washing and Walmart, did a lot of walking with shopping carts. Came home and elevated and iced for a bit. So far so good. My main goal is to walk comfortable and not have to take those damn pills.

 

[tiredwife]

@martyz4 The forum really helped us prepare for my husband's first surgery and we are very grateful, so I try to 'pay it forward'. Love See's candy, they don't have it around here! Hope the wine helps!