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TKR Kate's Knee Knews

SDkate

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I'm not quite a week out yet, so am enjoying reading all of the posts with advice, esp. regarding pain meds. I'm not sure if it was the hydrocodone that messed with my stomach, or just the surgery and anesthesia in general, but when I called my surgeon's office on Friday and said I needed something different for the pain, I guess I was kind of surprised that they switched me so quickly, plus gave me Zofran for the nausea - maybe she could hear me retching into a bag while we were on the phone. Today I kept down 2 snacks and a light dinner. Nights still seem to be tough, with my natural night owl tendencies. Seeing me getting around the house with a cane (up/down stairs to bedroom and bathroom) has my husband stoked and I'm afraid that he's going to start expecting too much of me too soon. Should I be spending more time in bed? Maybe I am up and around too much?
 
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SDkate

SDkate

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I'm 1 week postop and am having a lot of trouble managing the pain of my LTKR. Went home on 3rd postop day, taking hydrocodone, worked okay for the pain but made me so sick that I called OS for something different last Friday. Prescribed Nucynta 50 mg. It's not doing much of anything for the pain - if I take a 500 acetaminophen with it, I can get about 2 hours of okay relief. Tried just taking 1000 acetaminophen but that didn't do anything. Between the pain and thunderstorms rolling through all night, I haven't slept yet. I called the OS earlier today to see what I could do for pain, but they suggested talking to the pharmacist about what I could take with the Nucynta. If 1000 mg acet. doesn't help with the Nucynta, then I'm thinking I need something different than the Nucynta. Does anyone have any suggestions about what I might ask for when I call my OS back in a couple of hours? Going back to bed to try for some sleep.
 
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SDkate

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I got some Zofran last week for the N&V. I'm reluctant to take hydro again, but I'm due to take something now and have PT in a little while. I've been feeling so crummy that I haven't been doing stretches or exercises. Feeling really down, like I'm failing.
 

Slainte

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You are only one week out - you haven't had time to fail yet! And you won't. Keep seeking until you find the correct med mix. And don't work too hard. Rest. Ice. Elevate. You will get your balance back soon. That first week is a doozy. It gets better.
 

PolarBear60

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Slainte speaks words of wisdom.


Jean

LTKR (Stryker Triathlon): 21 April 2015
Right Knee Arthroscopy: 25 July 2006
Left Knee Arthroscopy: 10 February 2005
 
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KarriB

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You need to get your pain under control before you can do anything else. Were you taking the hydrocodome with food? I had to eat something small with each dose of oxycodone to keep from getting sick. When someone brought me my meds, they also brought me crackers or a couple fig newtons, maybe some fruit.
 

Pumpkin

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At one week post op you can skip PT until they have your pain under control. Your OS or GP should be helping you get your pain under control. While it is your Dr's responsibility to find adequate pain control for you, that said, you might get a faster response if you call your pharmacist, they know medications best.

Please add your surgery date to your signature, hover over your username top right, click on signature and add your information there, Thanks.

Here is the post op reading, the articles are short and will not take long to read.

First are the BoneSmart 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!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

Next is a FAQ (Frequently Asked Questions) thread.

And here are some very crucial articles
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?
Activity progression for TKRs

Healing: how long does it take?
Chart representation of TKR recovery
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling

Home physio (PT) and activity progress: suggestions
Myth busting: the "window of opportunity" in TKR
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?

And then some wise words from members who have shared their experiences ...
Where are you in recovery?? (TKR)
Five “P’s” of knee recovery
TKR: work “smarter” and not “harder”
Recovering a knee - from one who knows!
It's never too late to get more ROM!
It's worth the wait for ROM
 

Jamie

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These are all excellent suggestions. It's important to take some small amount of food with every dose of prescription pain medication. The anti-nausea meds do work and you could give them a try. Different meds react differently for everyone, so you might see if he would try you on Percocet or possibly Tylenol 3. Vicodin is another option. Talk to your surgeon and advise him that the Nucynta is not controlling the pain.
 

skigirl

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I will also chime in--I think it is dangerous to take pain meds right before PT. It would be easy to hurt yourself and not even know it until later. It is much better to go to pt with the normal amount of pain meds and no that there should not be any pain during pt.
 
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SDkate

SDkate

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Going to try to get through one more night, see the OS tomorrow for staples out, will discuss pain relief with his face rather than his PA on the phone. A couple of things later today that made me feel like less of a failure - had a totally unassisted BM (off-topic, I know, but still a success for me), and my PT today was very kind, very understanding of not wanting to work through the pain, and he was very happy that I was at 88-90, right where my surgeon feels I should be tomorrow. I haven't done enough reading to know what all the numbers mean, will figure it out more as I go.

So, for tonight, took a Zofran, going to eat a few bites of a cookie, then take the hydrocodone and go to bed.
 

PolarBear60

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A couple of things later today that made me feel like less of a failure - had a totally unassisted BM (off-topic, I know, but still a success for me).
Not off topic at all. A milestone!



Jean

LTKR (Stryker Triathlon): 21 April 2015
Right Knee Arthroscopy: 25 July 2006
Left Knee Arthroscopy: 10 February 2005
 
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SDkate

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Got a decent amount of sleep, only up once. Appt. this a.m., staples out. Incision looks good, X-rays looked good. Dr gave me rx for liquid Tyl #3, also for 100 mg of Nucynta – Have been taking the 50 mg tablets. Was having so much pain in my esophagus from all of the medications, but he suggested trying 100 mg instead of 50. So, took 100 mg of the Nucynta. It hit me really strong, and I can see how someone could get addicted to this feeling. Most importantly though, the pain is so much better. More later ...
 

kneeper

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I'm glad you're getting better pain control. As someone said, always have a little something in your stomach when you take your meds. You're doing great with ROM!
 

referee54

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Please keep us updated as to how you are doing and how the new pain meds are working.

I concur---eating a little bit before taking the meds may be very beneficial.
 
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SDkate

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I'm feeling so much better overall, finally. If I'd known I could have taken 2 of the 50 mg. Nucynta earlier, I could have avoided a whole lot of pain, but I also might have been on my way to becoming a drooling idiot addict to the stuff. But, I also had to learn the hard way to not take a medication and then go to bed right away. Some of the meds were just lying in my esophagus until the next time I sat or stood up, and that was a miserable feeling as well. I think I now have the right dose of a med that does relieve the pain enough to be comfortable. This med does mess with my sense of taste, nothing has much flavor, but that's a side effect I can live with, since I'm hoping to continue losing weight once I'm at the point where I can exercise more. For some reason, I didn't connect my gradual weight gain over the past few years to my increasing knee pain and becoming less and less active.

Now that I'm feeling overall better, I'm anxious to start progressing in my therapy. I have a semi-hard timeline of returning to work at the end of August. I travel around the country doing software training at hospitals and clinics, so while I provide the training sitting down, the physically demanding part is the travel itself, i.e., walking around in airports, getting to rental car agencies, moving about some of the larger hospital campuses, etc. Going to have to just see how things go.

Forgot to ask the OS yesterday about when I could start doing some water exercise, can get a good cardio workout without much weight-bearing. And it's something that I can maintain while traveling since most hotels have a swimming pool.

Okay, my brain is having trouble telling my hands how to type, but my knee isn't hurting anymore :)
 

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