Bilateral TKR La's new knees (recovery diary)

[Amahoff]

Re: Cutting back on painkillers?

This is interesting to me. Like others, I left the hospital with two pain med prescriptions - Oxycotin extended release and a lesser dose to take every 4-6 hrs. After 3 weeks, the physician assistant suggested that I cut out the extended release, which I did. Then, as he suggested, when I began to run out of the lesser dose of Oxycotin, he switched me to Vicodin. I took it as prescribed for a week, then began to decrease the amount (from 2 to 1 tablet every 6 hours). The Weds. before New Year weekend I realized I would be running out. I called for a refill. No result. I called the pharmacy (who then called the dr.) I called the dr. and left messages, with no results. So - I went off of the meds. I spent a terrible weekend of, I guess withdrawal. Jumpy, wired, couldn't sleep, etc. By Tues. I called my PCP office and talked to him. I didn't want to go back on pain meds if I could help it because of the side effects. He prescribed something to help me sleep and I continued using just Tylenal for pain. Not entirely effective still, but guess I am off the heavy meds now!

 

[karmigirl]

Re: Cutting back on painkillers?

Shutterbug,

I sure will include you in my prayers. We all (TKR's) need to pray for one another.

 

[efoltyn]

Hi La,
I was able to work from home, part time at 8 weeks. I was not ready to be out and at work for a full day (I'm an engineer and work at a desk). I think I started to go to the office at 10 weeks, again part time. Remember that even though you may be feeling pretty good, you are still healing and will be for another couple of months.

I know that it is frustrating, but don't be in a hurry...people our age still have several years to work.

 

[Larosser]

Re: La's new knees (recovery diary) They aren't twins!

Hi, Everyone!

Well, tomorrow is my three week anniversary with these new knees, and I'm still pretty happy with them. I'm walking every day using the cane for stability, but basically walking confidently and with a normal gait for the first time in years. I can't be sad about that. I find that the walks tire me out and a nap is usually in order afterward, but it feels good. I am sore, in my knees and quads as you would expect, but also in my IT bands, lower back and feet, so I am clearly regaining overall condition as well as working my knees.

One thing I am noticing: my knees aren't twins. ROM is returning more easily on the right side than the left - the left knee seems to have more internal swelling. The scar on the right knee is more aggravated than the left, more puckered, a little bit itchly. Some days, I feel that one leg is stronger, and then the next day, I'll change my mind. It's not surprising that people have different rehab experiences - I'm having different experiences from one leg to the other!

I talked to the PT about this today, and he showed McQ how to help me with passive stretches that should help with the ROM on my left knee, and recommended some Mederma scar cream and scar massage for the right knee. We'll see how that helps.

Best,
La

 

[Josephine]

Re: Cutting back on painkillers?

shutterbug, you do have other options. First you could go see your GP and ask for help with pain meds. It's my impression that they tend to be more accommodating than surgeons. You could also use the Tylenol/ibuprofen cocktail which is more effective than just Tylenol alone.

Amahoff, it would be most unusual if you had withdrawal after so short a time. But still, I give you the same recommendation as I gave shutterbug, go see your GP and later, you could make use of the Tylenol/ibuprofen cocktail


And both of you, would you be so kind as to put your surgery dates in your signatures like the rest of us do?
You can find the instructions here How to create a signature.

 

[grabbit97]

Re: Cutting back on painkillers?

I have found that the tylenol/advil cocktail is great... I am almost 6 months out and still need to take the "cocktail" a couple times a day, usually in the morning about 10 am, and then again about 4 pm, and just 2 tylenol at night with my ambien. I couldn't deal with the narcotics, had terrible reactions to them "potty" wise, and it took a long time to get my system back to "normal".
Let your body dictate when you need the meds, but the "cocktail" does work, as Jo said, it's a good combo.

 

[Randi]

Re: Cutting back on painkillers?

.I have a ridiculously high pain threshhold and I HATE meds and so stopped everything early. Should point out I have irritable bowel so for me the side effects really aren't worth whatever relief I get. However after being on the forum for a short time I have realized that there are times when going without is just dumb so I have popped some Tylenol back into my purse and use it when I need it. Everybody really is different but I do agree that there is no reason to be in pain!

 

[Josephine]

One thing I am noticing: my knees aren't twins

A good thing to know! :wink1:

 

[Josephine]

Re: Cutting back on painkillers?

All said, it's a very personal choice. Figure out what works for you and stick with it!

 

[lisabon]

Re: Cutting back on painkillers?

I don't have much more to add to the issue of the pain meds. But I will say that I understand completely what you mean about the constipation issue. I had horrible constipation when I was taking percocets every day during the first six weeks post-op. The only thing that finally relieved it for me was a fleet's enema and glycerin suppositories (not at the same time of course). I have been taking tylenol on an as needed basis now for the past few weeks because I still have tenderness and aching, particularly at the end of the day due to my activity level. But thankfully I'm regular again! :biggrin:

 

[Larosser]

Re: La's new knees (recovery diary) - oops, suture infection

Hi, everyone! Today is Day 23 post op for me, and I'm still pretty pleased with my recovery so far, in spite of a minor set back - superficial infection in the sutures on my right knee. No need to panic, no infection in the implants, or deep in the issues, just a bit on the surface where the staples were.

I didn't really notice a problem with the wound at first, but around last Sunday or so I noticed that I seemed to be getting more tired rather than less. At first I assumed it was just because I was doing more, but then I started feeling kind of sickly and "off", the way you do when you're coming down with the flu or something. I told the visiting nurse, and when she examined me, she was concerned about a bit of peeling and excessive warmth on the right knee. She called my OS, who put in a prescription for an antibiotic. The first couple of doses made me feel sweaty and grumpy (which usually means they are doing their job!) and by the time I saw the doc yesterday, the infection was pretty much gone. He's having me finish out the round of antibiotics, and also recommended that I start using Medema scar gel on my incisions. I am happy with that - I was feeling stretching and prickly pains in the incision when I moved, and applying the scar gel seems to really reduce that. I'm still on track to release from home health care this Friday and start outpatient PT next week. The only downside is that I have to see Evil Chester again tomorrow - he's the evaluation guy for the home health system. Haven't decided what I'm gonna do if he wants a timed sit stand test again - maybe just sit there for thirty seconds and stare at him.

La

 

[bassplayer]

Re: Cutting back on painkillers?

Hi, just wanted to share what has worked for me. A couple of days after getting home from the hospital I simply stopped with the Percoset because I felt that it didn't agree with me.

So then I was using an OTC combination that they had also been giving me in the hospital: Optalgin liquid (3cc) + 1 paracetamol. I like this because it is very fast acting. At first I was taking this combo 3-4 times a day, and over the weeks have been gradually cutting down. But I was never cutting down for its own sake, I just found I didn't need the meds as much.

Now, 6 weeks after the operation, I usually need the meds once a day, in the evening, but sometimes also once during the day if I start to feel pain.

Hope this helps!

 

[Larosser]

Re: Cutting back on painkillers?

I don't have much more to add to the issue of the pain meds. But I will say that I understand completely what you mean about the constipation issue. I had horrible constipation when I was taking percocets every day during the first six weeks post-op. The only thing that finally relieved it for me was a fleet's enema and glycerin suppositories (not at the same time of course). I have been taking tylenol on an as needed basis now for the past few weeks because I still have tenderness and aching, particularly at the end of the day due to my activity level. But thankfully I'm regular again! :biggrin:

Thanks, Lisabon. Glad I'm not alone on this. It's not a problem I'm used to having.

It looks from your picture as if you practice martial arts - what style? I've studied Shotokan for about 25 years, let it drop as my knees got really bad. I'm interested to see if I'll be able to take it back up at some level.

Best
La

 

[Larosser]

Re: Cutting back on painkillers?

Hi, just wanted to share what has worked for me. A couple of days after getting home from the hospital I simply stopped with the Percoset because I felt that it didn't agree with me.

So then I was using an OTC combination that they had also been giving me in the hospital: Optalgin liquid (3cc) + 1 paracetamol. I like this because it is very fast acting. At first I was taking this combo 3-4 times a day, and over the weeks have been gradually cutting down. But I was never cutting down for its own sake, I just found I didn't need the meds as much.

Now, 6 weeks after the operation, I usually need the meds once a day, in the evening, but sometimes also once during the day if I start to feel pain.

Hope this helps!

Thanks, Bassplayer, I appreciate it! You're in Israel, right? I've never heard of Optalgin and I don't think I've seen it in stores here in Texas, but I will check into it!

Glad to hear your need for pain meds is going down. Mine is, too, but I'm definitely not ready to abandon them altogether!

La

 

[Larosser]

WOOT! I am done with in home PT and start outpatient next Wednesday. I'm pretty happy. The outpatient facility has a lot more resources, and I feel like I will make faster progress working there, so this is a positve milestone for me. It does havem two downsides, though. I will miss my in-home therapist (TJ). He's a really great guy. Plus, I had to see Evil Chester the Evaluator again. He's still pretty evil. although he was more subdued with McQ breathing down his neck.

As part of my discharge evaluation, he did strength tests (quad and calf v. good, hamstring a bit weak, darn it!), range of motion, which was a little disappointing because he wanted active ROM (how far can I bent or straighten using my muscles) as opposed to passsive (how far can bend / straighten with assistance) which is what TJ had been measuring, and then that hateful timed sit/stand test. Both TJ and McQ told me I could just refuse to do it, but I decided to try, because I do eventually need to be able to do this. So I tried. And I did it. Fifteen reps in 30 seconds. It hurt like the dickens and I sniveled like a baby. But I did it. And now I'm done, discharged, ready to move on to the next step - which will obviously include increasing my active ROM, strengthening my hamstrings, and figuring out why the HELL it hurts so much to stand up using my quads. Is this normal? Do other people have a lot of pain with that three to four weeks out?

Anyway, on to happier topics, yesterday I got to go on an excursion! McQ took me to the park for a walk, which was a beautiful and welcome change from marching around the block at my house. I'm including a snapshot of the lake with birds and kids. There was a bit of up and down hill walking, which is challenging, but there are plenty of benches to rest when needed. It was fun.

We then went to a cafeteria to eat, and it was nice to be out and about after pretty much being stuck at home. But speaking of stuck...I did not do good reconnaissance of our table before I sat down, and when I went to stand up, I found that I couldn't. Chair was low. No arms. Nothing stable nearby to lever up on. Frustrating! I thought I was going to have to live at Luby's. McQ came around and just bodily lifted me out of the chair I was both grateful and chagrinned. I hadn't been looking forward to explaining to the staff why I couldn't leave when they closed the restaurant, but so much for independence! I guess I'm going to need to keep McQ around as my own personal crane until I get this standing up thing completely sorted out. I'll talk to my outpatient PT folks about it.

Oh, well, onward and upward. I'm off to ice and elevate, and maybe take a nap. Happy Friday, everyone!

La

 

[referee54]

Those little excursions mean so much! It does feel great to get out---it makes one realize that there is a "regular" life out there! Just ice and elevate when you need to---especially after them, as they can bering some swelling and discomfort.

Congrats as well on the completion of the in-home PT. I would not worry about faster progress---progress is the important thing; it may not be fast, and the harder you work (or they try to work you) the slower your progress may be. you are still very early in recovery and these recoveries can take longer than we ould like.

I always hope that the PT's would go through a TKR so they understand how frustratingly slow things can be. Once they realize the issues, they may not be so evil!

As for you quad pain--yes, my quads hurt like the dickens fro a while---they were cut and they tightened up, and the stretching and the strengthening exercises take a great deal out of them, so the will scream at you from time to time.

I remember my recovery from my BTKR quite well, and you are doing fine---these things do take time, so hang in there and do not worry so much about the time---progress is the key---not how quickly the progress takes.

 

[Larosser]

Thanks for the encouragement, Ref. I think I've gotten it stuck in my head that I need to be ready to be back at work full steam in 8 weeks, and I don't think that's really true. My boss is open to options, and I probably need to chill out and not press for that - I've still got a way to go before any decisions have to be made. I should just enjoy the ducks and the rest.

La

 

[Jazyb]

Hi La

You sound like you are doing really well from your report. It is great to get out of the house and feel a little bit normal; it does wonders for your mood. I had an outing this week and I thoroughly enjoyed it but was tired the next day.

My quads are sore and tight but as Tim explains I'm not surprised! I didn't realise they cut and tightened them - it explains the discomfort I feel. I feel for you having to get up and down in a chair with both knees feeling sore.
Have a good weekend.

 

[Roy Gardiner]

...and then that hateful timed sit/stand test. Both TJ and McQ told me I could just refuse to do it, but I decided to try, because I do eventually need to be able to do this. So I tried. And I did it. Fifteen reps in 30 seconds. It hurt like the dickens and I sniveled like a baby.

I would bet my ancestral home* that that exercise did more harm than good, and that it did no good at all.

*(if I had one)

progress is the important thing; it may not be fast, and the harder you work (or they try to work you) the slower your progress may be.

precisely

As for you quad pain--yes, my quads hurt like the dickens fro a while---they were cut and they tightened up, and the stretching and the strengthening exercises take a great deal out of them

My quads are sore and tight but as Tim explains I'm not surprised! I didn't realise they cut and tightened them - it explains the discomfort I feel.

I don't think it's normal to do that is it? Certainly all the pain I've had has been in the knees themselves, not the quads.

Josephine?

I think I've gotten it stuck in my head that I need to be ready to be back at work full steam in 8 weeks, and I don't think that's really true. My boss is open to options, and I probably need to chill out and not press for that -

 

[lisabon]

Re: Cutting back on painkillers?

Thanks, Lisabon. Glad I'm not alone on this. It's not a problem I'm used to having.

It looks from your picture as if you practice martial arts - what style? I've studied Shotokan for about 25 years, let it drop as my knees got really bad. I'm interested to see if I'll be able to take it back up at some level.

Best
La

La, I took up Tae Kwon Do a few years ago. My son has been practicing it for the past 5 years and I was inspired to try it myself and really loved it. Unfortunately, I don't think I'll be able to resume it (at least not at my previous level) for at least another 8 or 9 months. It's not the kicking that is a problem for me, it's more of some of the stances and high impact exercises that are done during class that are a concern for me. I think I just need to wait and let myself fully recover and then I'll have a better idea of what activities I can and cannot resume. But in any event I plan on being active again even if it means doing yoga or pilates instead of martial arts.

Good luck to you on the recovery and continue to keep us posted!

Lisa