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TKR Moriah's Leg Cramps

Moriah

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So my surgery was Tuesday, home Weds AM.
Surgery went without a hitch and was surprisingly easy. robot assisted.

I was very surprised and pleased that my knee/leg is no longer pigeon toed; toes now go parallel to the other foot.
Bruising is almost unbelievably light for the surgery.

Surgery started an hour and half late so I wasn't to the overnight room until close to 4.

With recovery, I got behind on sleeping, maybe 3 hours the first night, dozing.

The PT came over on Weds early afternoon, had made sure I had taken my meds an hour before. Going down the stairs with PT had significant pain.

Nerve block must have been wearing off and despite taking meds as prescribed by 7 pm my pain was at 9 1/2. We called the on call and they redid the meds, the top amount per day of ibuprofen and top amount per day of Tylenol (Tylenol has never done anything for me). I have been prescribed oxy but the script said every 4-6 hours and I was prescribed 30 tabs. The nurses used my prescription of oxy overnight on Tues.
On call told me to take it every 3 hours instead of 4.

Pain didn't settle down until 3 am so another night of little sleep. I have an ice machine and compression and was using elevation the whole time.

Thurs, in a complete zone. Friday talked to my PA because I was worried that I would run out of oxy over the weekend.
She had me count them and told me that I could be waiting to take them every 4 or 5 or 6 hours to get me through the weekend.

Friday some walking in addition to bathroom. During the day, Friday pain was 3-4 and Saturday 1-2 with shower and more around the house walking.

The problem is nighttime. I am awake every couple of hours and the pain is 8-9. Meds don't really help with it, I'm taking oxy every 3 hours at night and am watching the clock to take it. My husband has to lift my leg even to get a pillow in because I'm in so much pain. Once I get up in the morning and walking some, pain goes down again.

My husband is up throughout the night putting the ice machine on, frozen bottles of water behind my knee, helping me elevate. As of right now, I have 5 oxy left, last one was early am and I take them every 3 hours overnight so I would have to make sure I take only one during the day today to have enough overnight.

I'm going to have to call tomorrow especially if tonight has the same pain as the other nights. PA says ibuprofen and Tylenol are enough to take before PT and seems to think that I have had more than enough pain meds to get me through. Any suggestions on overnights? my guess is that I am swollen due to day time activity yet I'm not overdoing it in any way.

Things that have helped me: I take Miralax one to two times per day in addition to 2 Sennas a day. This has made me as regular as normal even with oxy. I drink Gatorade also which I think helps with some pain too. I can tell I am much more steady walking than being pigeon toed so looking forward to the future!
 

Celle

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:welome: to recovery @Moriah .

I've moved your post-op post from your pre-op thread and started this recovery thread for you.
Please continue to post on this thread from now on.

I think a lot of your overnight pain is because you are doing too much during the daytime. All those little walks around the house are enough PT for such a new knee. You don't need PT on top of those right now. I suggest you stop the PT for a while.

In any case, it's never a good idea to take medication so you can cope with PT. PT should never be painful. If you experience pain during PT, that's a warning sign that you're doing too much for your new knee. Taking drugs to mask that pain means you could unwittingly miss that warning sign and do too much or too advanced an exercise for your new knee.

It's not exercising that gets you your Range of Motion (ROM) - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your knee has the potential to achieve good ROM right from the start, but it's prevented from doing so by swelling and pain. As it heals and the swelling goes down, your ROM (both flexion and extension) will increase naturally, whether you do formal exercises or just let you Activities of Daily Living be your exercise..

Now the weekend is over, please call your surgeon and explain that the prescribed medication hasn't been controlling your pain. Ask for a review of the medication regime.

Don't forget to elevate and ice your knee - both of those also help to relieve pain and swelling. Instructors on how to best to do those are in the recovery guidelines, which I'll give you in my next post.
 

Celle

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And here are the promised recovery guidelines:
Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

5. Try to follow this

6. Access to these pages on the website

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 

Tykey

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Just be aware that bruising might come in a few days, we get some weird and wonderful black and blue designs.
If they appear, just show them off to all and sundry, but don't worry, they are quite normal.
 
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Moriah

Moriah

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So I am now officially one week after returning home from tkr. I have had leg spasms that feel like those awful leg cramps one gets with too much exercise in my surgical leg every night since last Wednesday. Wednesday Last week my nerve block wore off which was excruciating and I had to call on call to get my meds adjusted. After that, Each night I wake up about an hour to an hour and a half after falling asleep with Cramps/pain. I rate it as a good 7 on a 10 point scale and I’m basically awake until early morning when they go away. I had oxy and then the PA changed me to tramadol (Just enough to get me through the evening to morning) and neither of those stop the pain.

Every night my husband is helping me out with the ice machine and elevating and I’m doing that the whole night. So I contacted the PA again today, the nurse called yesterday and I broke down crying... Today the PA said, “I’m going to prescribe a muscle relaxer”. So my husband picked up the prescription and it’s Hydroxyzine. I have looked on the internet and see nothing about any form of muscle relaxation and it’s not in any list of muscle relaxer categories. As far as I can tell it’s prescription strength Benadryl or “anxiety PRN medication”. I called the pharmacist and he said it’s sometimes prescribed for post-surgery muscle spasms. Just wondering if my crying about lack of sleep yesterday put me on the “nut job list”. Does anyone have any input regarding Hydroxyzine as a muscle relaxer? I see way back in 2017 someone on this forum described the same muscle cramps and said she took Flexeril and it was very effective which is what I thought I would be getting. On a positive note this morning when I got up I was so tired and dizzy, eating crackers, I fell asleep for 2 hours and I had no muscle cramps. It was wonderful!
 

_Annie_

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I‘m sorry about the rough night times you are having. I had right TKR on August 11th, so I’m a few weeks ahead of you. Sometimes I sleep in bed and sometimes I’m on the recliner. Wherever I can sleep, is where I’m at. I’ve been taking Hydroxyzine for years to help me get a good night’s sleep. And it does help me with muscle cramps. Hang in there, it will get better. I think we all have our struggles in one way or another with these knee replacements.
 

leejaa

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I had a muscle spasm with my first knee in the hospital and was put on a muscle relaxer (Flexeril) and was sent home with it. I am sorry you had to go through the spasm with no relief for that long. I felt it was a worse pain than the knee surgery. I am glad you had some sleep. Naps are the best.
 
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Moriah

Moriah

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Just wanted to post this for others to be aware. I had tkr the end of August and was discharged with prescription for pain meds, Celebrex, Tylenol etc I began having leg cramps the first night I was home. Similar to the lactic acid leg cramps one has when exercising too hard. They would start an hour after falling asleep and go on until morning. It would start in my ankles and move to my calves and all the way up my leg. Some nights both legs. A clue is that it was consistent every night. I tried everything I could find on the internet, tonic water, Gatorade, potassium. Epsom salts, magnesium and yes even pickle juice. I tried walking several times through the night and bought a calf massager (which I recommend, it’s lovely !). My PA was stumped as to what to do. She thought it was inflammation so I elevated and used my ice machine constantly. Nothing was really effective even pain meds only turned it down a couple notches, I asked PA for a muscle relaxer which also helped somewhat.
During my daily googling leg cramps, I came across an article saying that Celebrex can cause leg cramps. I stopped Celebrex that day (it’s one pill a day) and the first night the cramps were gone. That night I woke up around 4 am and realized “no leg cramps!” I’m sure you could imagine my relief. My prescription is for 40 days so I’m no longer taking it. Googling side effects for Celebrex says that leg cramps Is uncommon, 1 in a 1000 patients get them. I’m sure Celebrex is really helpful for most people, I had googled it before surgery and the studies say it’s helpful for pain reduction so I’m not in any way discouraging people from Celebrex. I just wanted to post this and hope it’s helpful for others who are having leg cramps to see if this could be the culprit and not to just chalk it up as part of the tkr pain. The first night home (first dose of Celebrex that day) was so Excruciatingly painful we had to call the on call that night and I’m sure it would have been different w/o the leg cramps. Once I stopped the Celebrex, pain meds and Tylenol has been very effective. I’m hoping this will save someone from having 2 + weeks of leg cramps on top of regular pain.
I’m almost a month out and doing well, really amazing that I can walk on a straight leg !
Positive thoughts for everyone out there, hoping you all have a smooth journey !
 

Pumpkln

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@Moriah
You'll notice that I have merged your newest thread with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:
  • That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
  • If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
  • Having only one thread will act as a diary of your progress that you can look back on.
So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.

Many members bookmark their thread in their computer browser, so they can find it when they log on.
 

Pumpkln

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Thanks for the information about Celebrex and your leg cramps. From time to time we have members with leg cramps and asking them about Celebrex may be helpful.

Glad you figured out what was going on and were able to resolve your cramps with doing more, but doing less.
 

Jockette

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I’m so glad you found the cause of your leg cramps!
 

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