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TKR Need Help and Encouragement, please...

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Oh my gosh! I wish I could give you a hug and some in home full time help! I was also misled to believe I'd have to "work hard" the first 3 weeks and then I'd be fine. What a joke! But you have found this site and your life will be forever better for it! Read all the materials, try to follow the mantra, and be oh so good to yourself - anything less will not make you better. There is pain and swelling and stiffness for a long time - but I promise you it gets better, it really gets better! I thought I was down for the count with this surgery, but with help from this site I learned patience and how to get better by taking it easier - not pushing! And, I still need reminders! We are all here, so come see us any time! I stalked this site for a while because it was the only place that actually gave me understanding! ox:angel:
 
Thank you all again and again! I AM so happy to have found you! I am waiting for my GP to call back, explained all of it to his nurse. I saw him about 2 weeks ago and explained what was going on and he told me to call if I needed him. He was not at all pleased with what was going on. The low dose Vicodin has really done not much of anything but my Advil at least helps a little. All I have felt is a upset stomach. Terrible night with little sleep. I am concerned how I am going to get through therapy today.:boohoo:
I hope my GP will handle my pain management from now on if that is possible. I also would like a referral for another surgeon for a second opinion. I am keeping my fingers crossed that he will not let me down. I have only been in the area for a little over a year and he was the best doctor every time I have seen him. I am praying hard.
I am waiting for the shuttle to take me to outpatient therapy. I agreed to outpatient because I did not want the therapist that was taking care of me in house. She was terrible, never even looked at my knee, never touched me, just went by the book. Well, I have seen this new therapist twice and she is truly wonderful. She is appalled to what I have been going through and I do believe I have someone on my side. She was shocked to hear that they did not want to see me for another three months when my ROM is only 50. Since I have been with her, she massages, and does coax not to pain but to push it a little harder. After two weeks I was up to 60 but I swear it goes right back down when it swells. Anyway, I am happy with her and see her again this afternoon.
I am hoping to come back here with some good news of some kind. Thanks again so much for listening, I do not feel so alone anymore.
 
Glad to hear you have a good GP and PT in your corner. Makes all the difference. And you have us! :kittykiss:
 
I am so very sorry to hear how badly you have been treated. I am new here but you have many others with great advice. I will keep you in my prayers and please know you are not alone. :kittykiss:
 
Went to therapy this afternoon and unfortunately my ROM is still 60. My therapist said that is actually good since it is not going backwards. I really like her as she always tries to find the positive. She agreed that I need to find another doctor. I am going to start my search tomorrow. I did contact my GP and was not able to talk with him but his nurse called and said he wrote out a prescription for Percoset and I could stop by to pick it up. Unfortunately it was written for "one every six hours."<big sigh> It is the low dose and I was taking two every six hours and sometimes four after therapy. Is it just me? Should I not be having this pain? I am adding Advil but only one every six hours is not working at all. I am discouraged. My therapist and home nurse thought the amount I was taking was OK considering my swelling and ROM. I surely don't want to be over doing the meds. This pain is so much more than anything I have ever experienced.
Someone mentioned depression at five weeks. I am sure that is a factor in my recovery. Soon it was to be our 42 anniversary and I have a birthday this coming Saturday. With the holidays, being shut in, and feeling helpless along with my pain...I am sure no amount of pain meds would totally help.
I am reading all I can and having feedback means so much to me. It makes feel so much better to know I am not the only one ....with night pain, difficulty sleeping etc.... I have always been the strong one of the family and always question when I feel I am not being strong enough. I hope that makes sense! :flwrysmile:
 
Hi,
I'm sorry you are still having a hard time.

Your pain relief medicine is still inadequate and you need to push for more effective treatment. No, it isn't just you. This is a big operation and it needs proper pain control.

Please don't worry so much about your ROM. It doesn't need to be measured every time. It's just a number and it really cannot improve until you get rid of the swelling. Some physical therapists get hung up about ROM - that's their problem, not yours. Sometimes I think it is just so they can justify their existence - they need to show progress on a piece of paper.

Also, there is no such thing as a magic "window of opportunity", within which you have to get a good ROM, or all is lost. Many of us can tell you that ROM continues to improve for at least a year.

Try to think of your knee as being like a hosepipe that is filled with water - it really can't bend well until the water has gone. The water keeps it stiff, just as swelling keeps your knee stiff. Keeping on working hard at trying to bend that knee can't help and it may even slow your progress - the more you work at it, the more the tissues get irritated and then they swell more.

For what it's worth, I think you should stop all your physical therapy for a while and just concentrate on reducing that swelling. Just do gentle bending and straightening at home, combined with ankle pumps. People in the UK recover from a TKR by dong just that. They have very little formal physiotherapy and their end results are just as good.

Resume the PT once the swelling is down - and make sure that your therapist never pushes you until it hurts, or to the point where you get swelling after PT.

Best wishes, my dear. You are over the worst. Be kind to yourself, and insist that others are kind to you.

Caryl
 
Hi I've been thinking about what you have been going through and my heart aches for you. I know what it feels like to be the strong one this surgery is very humbling as it certainly has pointed out to me I am not invincible and I need help and support which I am not use to asking for. I am struggling with rom and getting about I have very hard days when I am depressed, agitated , hopeless I guess you name it I've had that emotion. Could you make an appt. with your GP and see him in person it might very well make a difference. You are certainly not alone in your feelings and you have so much more on your plate emotionally the loss of your husband of so many yrs the holidays yes you have nothing to feel bad about you are going through a hell of a lot right now. I am about 9 weeks out and still struggling as I said but I do have a support system and yet I still feel very alone sometimes so I won't pretend to know how YOU must feel. Like I suggested maybe if you could see him in person and he can see for himself what you are going through it may very well make a difference not that you should have to go through all of this geez like I said you can bet your bottom dollar they have not exp this surgery or they would be ashamed of themselves. I know it's not much but we are here for you and vent away cry, scream :gaah: :headbang: :tantrum: :hairpulling: :hissy: :yikes: but let it out it helps! I hope you can find an answer soon I will be praying for you! Paula
 
At this moment I am totally devastated. I put all my hopes in my GP , although I have only been with him for a year since I have moved here, and he just let me down totally. I did see him a few weeks ago and explained what was happening and he said he was upset with doctors that treat everyone the same and if I needed his help to call on him. I did just that. I have not talked to him, spoke with his office, and he did prescribe me the one every six hour percoset. I called today and asked if I could take it in a shorter time period or is there anything I can add...etc, that one every 6 hours was not working.
I just got a call from his office. He is not comfortable giving me any other medication and I should go back to my surgeon and work with him or get a referral from him for a pain management clinic. A total...I can't help you...
Wow...I am just...I don't know what to say...
 
Hi BEG,
I am so sorry that you are going through this.
I encourage you to read the Library links as posted for you by Judy.
At this stage in your recovery, LESS is MORE. You simply cannot bend and angry, swollen and painful knee.

Some thoughts from my experience from my 1st TKR, as I had a similar exerience to you. In fact, I checked your location because your OS could have been my OS!

--As long as the PT is doing gentle massage and ROM stretches, that is good. NEVER let anyone push on your knee!!!
--Call your PCP and tell him/her that 1percocet every 6 hours is NOT cutting it. You need at least 2 Percocets every 4 hours, or a similar dose of Dilaudid. You MUST have pain control to be successful with this recovery.
--Call your OS office and insist that you be seen. Tell them you think that something is wrong and then describe your pain in detail, your ROM and your swelling/bruising. Don't accept the "this is normal noncense" Tell them you are 62, and you know YOUR body and insist this is NOT NORMAL.

Make a pest of yourself. The squeeky wheel gets the oil. Keep calling until you have an appointment. Document the calls.
***Once you have your pain under control ( and have found another OS)-
THEN:
Refer back to your thread, and write a letter of complaint to the CEO of the Hospital AND the PA Board of Registration in Medicine. It may get you nowhere at the hospital, but the Board takes these complaints very seriously and the OS must respond in writing to the complaint. It will be helpful to your emotional healing from this traumatic event.

I do hope that your PCP is empathetic and gives you enough pain meds to get by.
Just stay here and we can help you get through this hurdle (and some more to come).
Best,
Sandy
 
Just read your post as we were posting at the same time!
Call your PCP back as he has to do the Pain Management referral.
Call the OS and get seen ASAP.
The other (not great) option is to go to the ER. Again, tell them something is wrong and you have been unsuccessful with seeing your OS and your PCP.
Hugs,
Sandy
 
Unbelievable and what is your surgeon saying? It is crazy how different drs are I am on oxycodone and tramadol I just call and they mail it out actually I told them that I would like to cut back oxycodone they told me to soon I also had a manipulation does your surgeon just do knees I find that they understand more my surgeon does just knees and hips that's it and they assure me I still need pain meds and are not stingy. I cannot believe what you are going through when is last time you talked with surgeon? Sorry I actually feel your anger and hurt I wish I had some answers it must be frustrating to be told to keep trying but I guess it may be your only hope to keep calling or go to ER you may get someone who knows what the heck your dealing with! Paula
 
My PCP said that the surgeon must make the pain management referral...I left a message with the OS yesterday that my PCP was taking over the pain management, which I thought he would since he gave me a prescription. Maybe one talked to the other? Gosh, this is such a nightmare I can't believe is happening. All I wanted was to stay on the Percoset another few weeks to work with my physical therapy and pain. I have never seen my OS since BEFORE surgery and when I saw his assistant he said the knee should come around with time. If not, in three months they will consider a MUA and wrote me a proper prescription for the percoset for a week. All was well until a week later I asked for another prescription and was told, no more Percoset after a month. Then it all hit the fan. I left a message with my OS office regarding a pain management referral. Totally have to eat crow now that my PCP left me out in the cold. Wow....did I do anything wrong?
 
No.
And Docs Rarely speak to each other. This is the biggest issue. You are the little badmitton thingy, and your Os and PC are on opposite sides of the net, and they are swatting you over it back and forth....
So sad.
Call the OS, and tell them the PCP declines to manage your pain. You need to be seen, IMO. I think that this is the best option, since your PCP didn't actually operate on you. Docs here are all batty about addiction. Believe me, I went through all the issues. I ultimately ended up in Pain Management where I am still today (long story).
Eat the Crow Pie, as long as you get a side of Percocet to eat it with.
Good Luck!
xx
Sandy
 
I'm so sorry you are having such a tough time! Unfortunately, few doctors are willing to take on another doctors patients and pick up the slack. Some professional respect for other doctors toes, I think. Elevation and icing cannot be over emphasized, especially in view of the lack of proper pain management. When it's hard to endure the moment, it's little consolation to be told that it will get better with time, but it's true. At five weeks, you will soon be approaching a turning point, so hang in there! You are really in a jam all round, and I'm so sorry for this. I know 2013 has just started, but your 2014 will be so much better. Keep your eye on the ball. I've looked forward to 2013 since I scheduled my June surgery last March, and by golly it's here and it's good.
 
I was just thinking the same thing - ice the back and front of your knee as often as you can and stay elevated...without pain pills you will have to do this. I can't imagine being told no for pain meds...I wonder if they would be more willing to give you hydrocodone...the 10/500 every four hours might work for you and might not freak out the Dr. so much. Ugh - I hope you get help today and I know it may seem daunting - but try to follow the advise above from the Forum Advisors...good luck and you have a ton of sympathy!
 
Big hugs to you! I have had 15 operations on varying parts of my body, abdomin, liver, kidney, neck etc. And I will tell you the tkr was the most painful and has the longest recovery of them all. You need to be adequately medicated. Definetly push hard for a pain mgmt referral. You need to get that pain addressed. Hugs!
 
You MUST be your own advocate and just keep hounding the hell out of them until you get the results you need. I have 3 or 4 different meds of different strengths (all narcotics) that will last me 3 to 4 months. This is just completely inexcusable unless you are on some other meds for other conditions which you haven't mentioned. Regardless there are still medicines available to work around any other conditions.

By the way, interestingly I was reading an article recently about how frequently doctors are prescribing anti-depression meds for people who are suffering from the loss of a loved one so it is possible you could also ask about a low dose anti-depressant which will help to relax you and the muscles or even ask for sleeping pills.

Hang in there.
 
Okay, if you can't get the doctors to do it properly then you need to work something out for yourself. You said you have the lowest dose of Percocet which is 2.5mgm oxycodone with 325mg acetaminophen (Tylenol) which means that if you are only taking one Percoset at a time, you could take two regular 325mg Tylenol at the same time but make sure you don't exceed 4,000mg per 24hrs.

Also you could take 800mgs ibuprofen three times a day as well. But do be careful with this - you need to read this to learn why Tylenol/ibuprofen cocktail. Perhaps you should also ask your GP for some Lansaprazole (Omeprazole) to protect your stomach during this.
 
A long day. Finally talked to my OS office and they knew about me talking to my GP. They said my GP did not want to be involved and my OS did not want him involved so I think there was some talking between offices. Something has happened because they insisting that the doctor does not want to hold back medication, it was just difficult with the holidays etc. That is a total like but if they are willing to work with me for now I will listen. She said she will be talking to the doctor tomorrow. The amount of lies and back tracking is unbelievable but if I can turn someone around it is worth it. I think my insurance advocate got into the middle of it because she was pretty upset. Right now I do have some percoset, with directions of one every six hours. I am taking them as needed. I told my OS nurse that too and she wanted to know how many I got from my GS etc. in which I told her. My in home nurse is so happy that I have spoken up as she said this has happened to so many. Right now I am"icing" taking my motrin and percoset as I need it. I am supposed to hear from the OS nurse tomorrow. I asked that if he does not want to help me with my pain management I will got to a pain management clinic.
It has been such a emotional day and such a emotional experience from the start. I am taking a mild anti depressent that was prescribed when my husband passed. All doctors know about that medication and say there is no issue. I was taking Meloxicam per my GP for the knee pain before the surgery but stopped that several weeks before the surgery. That is it for now....big sigh...thanks again everyone. :thankyou:
 
BrnEydGrl - not sure why I thought you were in UK but I see you are in PA. Work through all the **** they feed you and stand your ground to get what you need. I still can't for the life of me understand how they think a low dose every six hours is sufficient. That aside, I'm happy to hear that you have the mild anti-depressant as it will help you get through the emotional days as you get yourself taken care of. Usually you can split them in half as well if you find you need a little something to take that edge off night or day.

Keep fighting the good fight and before you know it your knee will be where it should be by mere passage of time - which is not a bad thing either but I would still make sure you have plenty of meds to carry you through for the next few months (at least they need to assure you they will not stonewall you when you need a refill.

One thing you could always do is tell them you will tell all your friends who not to go to in the future. Nothing worse than bad opinions from patients - he may start whisteling (sp) a new tune in no time.
 
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