Just told I need TKR

[kamarx]

52 year old male. I have been having knee pain for almost 5 years and it has gotten very bad the last few months. Part of the problem is that I have been taking NSAID pain relievers, both over the counter and prescription, for about 5 years now. It was starting to effect my kidneys so my doctor and a kidney specialist told me no more NSAIDs. Tylenol does nothing for the pain, and ice and rest only help a bit. I went to the Ortho doc yesterday and was told I need TKR.
I am a bit scared of the procedure and timing wise, I have an opportunity of a possible new job starting very soon. I would hate to get hired and then have to be off for many weeks.
The part that scares me the most about the procedure would be the post op pain. Doctors these days are very stingy with pain medicine and me not being able to take Advil or Aleve don't want to be in the position where I am told "no more prescription pain meds", when I am still in pain. They don't seem concerned when I tell them now that Tylenol is not helping at all. I know this is something to discuss with the surgeon, but has anyone else had these feelings and thoughts?

If that's the case you should have no problem getting the proper prescription med to help out with that. Try Pain Management Dr.

 

[kamarx]

You have Very Normal concerns.I think about the surgery Alot! But I can tell you as someone who has put the BTKR surgery off for way longer than I should have is that your knee is only gonna to get worse not better.

 

[Titianlady]

I think it was more of the disgusted look on that OS s face when he said that to me. I agree there would probably be tolerance issue. I have those ligament and the tendon issues and boy do they cause grief as im sure you know.In this day nobody should suffer post op whatever the circumstances.

I agree that no one should suffer. Actually, if the surgeon knows you take pre op pain meds, he would know that you need stronger post op pain meds and should be able to do that for you!!

Just because you are tolerant doesn't mean you won't get your pain under control after surgery. I had a horrible time with pain management with my first surgery for two reasons.. The biggest being that I have a genetic propensity to be pain med resistant. Believe it or not ( and you can look this up.) the same genetic component that gives me my red hair also makes my body produce more prostaglandins, and makes me require more or stronger pain meds. The second being I was already on pain meds for months while I waited for my surgery date.

My GP made sure a pain med plan was in place designed around my circumstances, and I actually had a recovery that was surprisingly very comfortable.

I think if your surgeon or better yet your GP knows your history, a plan can be put in place for you so you will be comfortable.

 

[kamarx]

Your right I'll have to bring that up at my next GP appt.in Feb. Even being on these pain meds cold weather sure isn't helping :(

 

[Gettinemdone]

I just had BTKR on Jan 15 and came home from the rehab hospital yesterday. After years of procrastinating, I decided to go ahead and have the procedure. Things have gone very well for me and my range of motion on both knees is approximately 4 - 110 degrees. The PT people are very happy and surprised with my results and I am walking with only a slight limp that I will address with the PT. From what I have been told, I am running well ahead of the normal recovery schedule and I never expected this to be the case. I have worked very hard these first two weeks and will continue to do so. I guess I am writing to provide some encouragement for those considering the procedure and hope you have a similar recovery. My only question at this point is when to begin cutting back on my meds. I currently take the pain killer, dilotted (sp?) about every 4 hours. I am pretty lucid, but still not at 100%. When I feel comfortable and have lost the buzz, I will return to work as a Project Manager, which I can do from home.

Good luck to all and thanks as well as this forum has provided some very worthwhile information that I have used to prepare for my surgery.

 

[Awriterafoot]

I'm also one who developed problems with NSAIDsafter using too many for bad knees, trying to put off the inevitable. Pain management is very sophisticated abs between your surgeon and GP you should be able find good pain relief. OxyContin for a couple of weeks is pretty standard, along with either Percoset or Vicodin. I get headaches from Tramadol so stuck with 1/2 Vicodin + Tylenol toward end of treatment for surgery #1. Now finding plenty of relief from usual regimen for #2.

It is hard to get right back to work, so that would seem to be a larger concern.

The thing is, once you're on the other side, the quality of life is SO much better!

 

[Mike_in_Pain]

Update...
So I did great on my job interview but the company is going through acquisitions and now has a hiring freeze. So again I wait...
My pain keeps getting worse so the doctor gave me Tramadol which didn't really do much. In February I was given a prescription for Percocet. It works great...but... My first prescription was for 120 pills. I took them only as needed so they lasted longer than 30 days. My doctor wrote another script but this time it was 100 pills but that was ok because I can make them last a month.

Normally I would not take them on the weekends and I would just rest. Last weekend again I did not take any pills but this time I suffered withdrawal symptoms. I felt lousy. This was very scary for me as I do not want to be addicted although my reason for taking them is truly for pain. Then I realized that if I now had to continue taking the percs every day to keep from suffering the withdrawal symptoms I am not going to have enough to get through the month.

I took my remaining pills to my doctors office and asked to go back on Tramadol. Even though they didn't work that great they did not seem as addicting. The reality of the situation is that I just have to stop being afraid and go get the TKR done. I cannot wait for a new job and hold off on TKR any longer. I do not understand why I am so fearful of the surgery. A few years ago I had my first colonoscopy and I was terrified of that too. It took me a year to schedule an appointment. In the end(no pun intended), the procedure turned out to be nothing. My fear was baseless.

I think I am worried about the pain afterward the most, but I suffer every day now. I just can't get it through my head.

Thank you everyone for the replies! It is really great having a place like this forum to get so much information and to be involved with discussions with those in the same boat. I wish you all well!

 

[Roy Gardiner]

I think I am worried about the pain afterward the most, but I suffer every day now.

pre-surgery pain is bad, gets worse and is permanent. Recovery pain is bad, gets better and goes away. And that process starts on Day 1.

I was terrified beforehand -- but recovery IS manageable.

 

[vinny]

Have you tried Celebrex? That gave me some relief before surgery and is less habit forming than Percocet.....I had a bilateral and it was easier than the pain before the surgery.....fear is common it just depends on the quality of life you want.....I have a new lease on life and feel years younger and pain free......I would do the surgery again in a heartbeat as it is the best thing I have ever done ..and I was just like you..

Vinny

 

[Mike_in_Pain]

Thank you for the encouragement.

Vinny, I cannot take Celebrex because it is an NSAID. I took too many NSAIDs over the last 5-6 years and it started damaging my kidneys. My creatinine levels climbed to 2.4. I went to a kidney specialist and was told no more NSAIDs. I stopped with the NSAIDs in November 2014 and by January 2015 my levels were down to 1.7, which might be normal for me as I have one kidney that was not fully developed from birth. My next blood test is in a few weeks so hopefully it will show my kidneys have healed even more.

I guess that is another good reason why I need to get this done

 

[vinny]

If you have it done Mike you will never regret it...my recovery was a piece of cake....not all are as good but many people recover very quickly .......I was nervous until the moment they wheeled my in but that was the worst day.

Vinny

 

[Mike_in_Pain]

If you have it done Mike you will never regret it...my recovery was a piece of cake....not all are as good but many people recover very quickly .......I was nervous until the moment they wheeled my in but that was the worst day.

Vinny

Thanks Vinny! I just took the first step...I made an appointment with a surgeon for April 16th. I have done research and have been to a couple other surgeons over the last 7 months but the guy I just made the appointment with does the minimally invasive procedure. Now to start on my list of questions.

 

[icep707]

Wait until you get your actual surgery date ! Than the clock really starts to tick . All the info you need is here on bonesmart. I suppose its not to late to get used to iceing that knee. Remember , its natures pain reliever . And importantly ,you will need to ice alot post op. Along with proper elevation. We dont know what medication protocol your surgeon will prescribe ,but what ever it is ,abide by it religiously. Meds on time ,all the time. Best of luck , Iceman

 

[kneeper]

congratulations on making the appointment with the surgeon. I was kind of worried before my first tkr too, as it was my first major surgery. But they are so good and have such a system I was greatly reassured. And I've been so happy with the results. Heck I even went back for a 2nd knee.

 

[Mike_in_Pain]

Yes, I am a huge fan of using ice for pain relief but for some reason it doesn't do much for my knees. I even bought a bunch of wraps from Dr. Cool Wrap that I keep in the freezer so that I would always have ice available. It seems to help with stiffness in the morning by reducing inflammation, but I get almost no pain relief. I do understand that icing is a must do after surgery.

 

[referee54]

I just took the first step...I made an appointment with a surgeon for April 16th.

That is tremendous!!! That is a big step in reclaiming your life---the life that arthritis has stolen from you!

 

[Mike_in_Pain]

That is tremendous!!! That is a big step in reclaiming your life---the life that arthritis has stolen from you!

Ref, your post is very timely...yesterday when I returned home after work I tried to wash the containers I use to bring my lunch to work. I filled the sink with soapy water, washed and rinsed one container, and then had to sit down as the pain was too much to take. I had a good think about the quality of my life and all of the things I can no longer do around the house. It is not fair to my wife, who also works, to have to do all the housework. She is really understanding about what I am going through.

The appointment date with the surgeon can't come soon enough.

 

[referee54]

That is great---the epiphany is something that many folks do not have---they keep saying, "I am not bad enough, am I?" "I really so not need a TKR yet."

For some, life becomes so dysfunctional that the dysfunctional becomes normal---and it is not until one's life returns to normal---pain-free and without restrictions---that one realizes what one was missing.

You have come to that epiphany--and that is great----you will be amazed at how great you feel---and that normal---pain-free is wonderful---and you will not have to say, "Why did I wait so long?"

 

[Gigi32]

Mike,
Like you, I was terrified of having the TKR and put it off for 10 years because I thought I was too young to have it done. If I had known how much less pain my knee would have after the surgery than what I was experiencing before I would have done it much sooner and could have avoided the "bowing" that occurred because I let it go too long. My doctor was in Indy(I actually drove 2 hours to see him) and does hundreds of these a year. His approach is to rehab the knee 1st to see if you get any improvement since those are the same exercises you do postop anyway. This seemed to help some of the pain I was having while waiting for surgery and I needed very few drugs after surgery. I only needed the narcotics for a couple of weeks, Tramadol for about a month and Tylenol after that. Before surgery I had been on Diclofenac and various other NSAIDS for years - fortunately I haven't had any kidney problems but my Primary doctor has wanted me off them for a long time because of that concern. You are close enough to Indy you may want to get a second consult to see if you have any other options. Good Luck!

 

[Lovestoread]

Seems you've had the "aha" moment! All of us are fearful, but nearly all of us are so very glad we had it done. Good luck to you!


Sent from my iPad using BoneSmart®