TKR Knee pain after 5 months is unbearable

[Nannharwood]

I am worried as well about returning back to my high school classroom. My surgery (a double knee replacement) was December 10, 2013, and I plan on returning on January 21, 2014. I still have a lot of swelling and bruising - did I mention that I'm a redhead? My doctor said we tend to bruise more. I get around the house just fine but still have pain of about 5-7 on the scale (5 on a good day). I still rely heavily on pain medication but of course can't take anything while at school. Any suggestions?

 

[Roy Gardiner]

Hi, Nannharwood, welcome to BoneSmart.

'Of course' you can't take painkillers whilst at school? Why not?

5 weeks IMO is far, far too early to consider going back to work, especially where you have to stand all day. I recommend you try to negotiate an extension to that time, to at least 3 months from your surgery date.

 

[czak57]

My surgery was 10 days after yours (December 20, 2013) and was just one knee, not two. I am also a teacher and I do not know how I would be able to be on my feet for 8 hours every day so soon after surgery. I am returning in April. I agree with Roy Gardiner that you should ask for an extension. Your doctor can help with this. You are entitled to 12 weeks under FMLA. I did not have enough sick leave days so I am am using my husbands (who is also a teacher). Maybe that is an option for you? I totally feel for you as I know just short outings wipe me out. Please keep us informed about your decision and your progress.

 

[Nannharwood]

Thanks for the replies to my post. I forgot to mention that I will have a student teacher who can be my extra set of knees. I plan on keeping ice packs at school in my fridge and taking advantage hopefully of snow days in my school system. I will visit the ortho on January 17 to check on progress so my doctor may tell to stay home longer. I will also get a specified list of do and don't items that will limit my work.

 

[skigirl]

I agree with the others that you are trying to return too early. You will slow down your recovery---but I will let @referee54 Tim talk to you as he is also a teacher.

 

[Jamie]

Hi, Nann....welcome to BoneSmart! Thanks for starting a thread of your own in the recovery forum. You'll notice that I've moved all the responses you received in the other thread here so that we have a chain of information going forward. Please continue to post your updates, questions and concerns here, if you would.

I have to agree with the comments that you may want to reconsider going back to work so soon. Even with help this is going to be a challenge for you. Remember, it's not only the 8+ hours of being at your job, but also the getting ready, driving to and from and getting from your car to the classroom and back. Your body has been through a lot and it tires easily. This is going to be a real push for 6 weeks.

 

[Roy Gardiner]

Remember, it's not only the 8+ hours of being at your job, but also the getting ready, driving to and from and getting from your car to the classroom and back.

:iagree:

You may find - I sure did - that mentally you are not 100% too. No criticism, it's your body taking all possible resources for healing.

 

[1ELISEA]

Hi Nannarwood

I agree with @Roy Gardiner, 5 or 6 weeks is very soon to return to work.

Yikes! I'm not sure what the redhead part means but I am a blonde and it was still swollen and I needed pain medication at 6 weeks; and I had one TKR, you have had two! I returned to work at 12 weeks and that was about the right amount of time off. I still managed at work to keep my leg elevated and had the chemical ice packs as needed.

My suggestion, as you asked, is to take off work for at least 12 weeks. And you will still need the services of the student teacher until April. Do you not have the option of more recuperation time?

 

[Nannharwood]

Unfortunately , I am unable to take off a full 12 weeks for recovery. I do,not have enough sick day and being a teacher, there are so many state assessments that my students are preparing to take. My daughter , thank goodness, has her permit and will drive everywhere. I do not kid when I say that the handicapped parking is less than 200 feet from my classroom. Ice packs will be my friend and I have first period planning so I will ice then and during lunch, which I bring from home and eat in my room. I'm worried about how to manage pain with only Tylenol until I get home. Any ideas anyone ?

 

[crystals5]

I don't know if this is a good or a bad thing and I don't know what your pain meds are but if you have vicodin you might want to "take a bite" in the am. If it does not affect you since your not driving you can do that throughout the day. Sometimes I end up taking that 3 times which equals one pill during the day and my last is usually around noon. It helps me and I told my doctor I do this and he did not say it was not safe to do.

 

[Hitech]

I had Bilateral TKR on 09/10/13 and returned to work three weeks to the day later (including driving 108 miles each way to work each day) and Had no issues and took no pain med's except during my three days in the hospital. My bone on bone pain was gone the day after surgery and the only minor pain was from the bruising on the upper thigh's and stiffness in both knees which is now totally gone .

 

[RimRoc]

@Nannharwood - I am totally sympathetic with your too short period for recovery...nevertheless, it might make sense to find out what options you "could" have (i.e. unpaid time off) to give you an extra week or two to make your return to work sustainable. If it turns out to be too much to get thru a full day, day after day, it might be overwhelming to you and a disservice to the very students about whom you care very much. At least you'd know in advance what your options are.

As for pain management without use of opioids, you can consider alternating doses of acetaminophen 1000mg and an NSAID like ibuprofen 600mg (assuming you have no contraindications). You'd end up taking one med or the other about every 3 hours. You might want to check to see if a near-opioid like tramadol would be an acceptable use while teaching.

As is explained in lots of different places on this site, using opioid pain meds as directed by your provider and for pain management purposes is very unlikely to lead to addiction, so I'll join the chorus of voices that recommend using pain meds to reach reasonable goals: increased ability to participate in therapy, increased ability to obtain restful sleep, increased ability to participate in meaningful activity.

 

[kneeper]

Wow, this sounds like it will be tough. If you can't take off extra weeks (which I can see might be a problem with getting the kids ready for testing, not to mention the sick days)... at the very least do your plan of icing and elevating as best you can twice day at work. See if they can get you a stool or high (stable, not rolling) chair you can sit in for at least some of each hour. Also I'd say once you get home, take your hydrocodone or whatever other pain med the doc gave you, flop out and ice and elevate.

 

[gazelle7777]

I would suggest at least 12 weeks...only part time... and longer( four or five months) if you plan to go back to work full time. I am at 7 months out and just now am starting to feel consistently good. If you go back too soon you will have to do with swelling and stiffness as the healing process is still going on and you are hampering it with a long day.

 

[Celle]

Hi @Nannharwood
I do understand the pressure to get back to work, especially if there is no provision for extended leave.

I have a friend who confounded all my dire warnings and went back to work at only 2 weeks after his knee replacement - and he did it with no ill effects. Why? Because he hired a wheelchair and worked from that.

Perhaps you could consider that? It would certainly take some of the strain off your knees. Does your school have facilities for people in wheelchairs? If so, you could always mention that your surgeon recommends treating the knees gently for a number of months.

My niece, who teaches in a school in a very rough area, broke her leg badly and was in plaster from mid-thigh to mid-foot. When she went back to work in plaster, she found that the naughtiest pupils were often the most helpful, too.

Best wishes, and I hope you find a solution.

 

[icep707]

Wow. And I still think 12 weeks wont be enough for me with 1 knee getting replaced in February. I guess everyone situation is different with work. Fortunately I can take as much time as I need. I have a very physical job and I want to make sure I am ready for the grind. Its auctually hard to imagine going back that soon after a bilateral. I wish you much luck .

 

[1ELISEA]

@Nannharwood
We have something called a Tylenol/Ibuprofen Cocktail you can read about HERE
Also propping up your foot is a must. There are great articles under the Library tab above regarding TKR recovery.

 

[Jamie]

@Nannharwood.....I finally was able to get all the comments from the other thread where you had posted into this one! Thanks for your patience!!!

Now....here are the recovery articles from our BoneSmart Library. They will give you an idea of what is ahead as you begin to heal. Please do take time to read them.

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?

 

[jenn8759]

Hi, I had bilateral done in March, 2013 and was back to work at 9 weeks. I also took the Tylenol/Motrin cocktail over the pain pills and it worked fine. I was not ready to go back, but my disability insurance company shut me off. Thankfully I went back in the middle of the week and was able to go home an hour earlier.... I made it through though and am doing well today at 10 months. I am still stiff in bending my knees or squatting down, but that will come in time....

 

[Riley]

I had Bilateral TKR on 09/10/13 and returned to work three weeks to the day later (including driving 108 miles each way to work each day) and Had no issues and took no pain med's except during my three days in the hospital. My bone on bone pain was gone the day after surgery and the only minor pain was from the bruising on the upper thigh's and stiffness in both knees which is now totally gone .

I'm sorry, but I really don't believe that. You barely got the staples out at that point. I am one year out from bi lateral and still have pain caused by swelling if I walk too much or stand too long. I was walking with a walker at 3 weeks, and could barely get out of bed much less shower, dress, drive 108 miles and work all day. Come on....I know every body is different but 3 weeks ?!?!