TKR Nerve pain! please help

Navfed22

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Hi, I was scheduled for LTKR in January, but had it done 2 weeks ago today. Surgery went 4 hours as they had problems getting the old ACL pins out, but for me it was a piece of cake (General plus 2 nerve blocks). However I am now a hurting unit and am not sure where to turn. I have been calling the OS with shooting pains that are excruciating coming from my knee. They happen randomly when i move even the slightest. I literally scream out in pain and my wife and daughters are freaking out. i call them zingers or what i would think electrical pain is like. OS told me last night sounds like nerve pain and to increase my Gabapentin from 400mg/day to 600mg/day. No change so far. I try to walk to get some fluid going through knee but I end up screaming and am worried I am going to fall. I cancelled physical therapy as I cant even get onto the table without screaming. just resting hurts in a different way as my leg/ankle are very sensitive to the touch - i think from taking all the weight of the leg???

I use an ice machine - thank you Lord!
I elevate
I am taking max pain pill (Norco 10mg every 4 hours)
I am an extremely positive person but i obviously can't sleep and now dont know what to do.

sorry for the big long ramble - any suggestions would be greatly appreciated

Graham
 
What was the exact date of your surgery? I need to update your date since you had it earlier than previously scheduled.

Use that ice machine the whole time you are down. You can't over ice, as long as you have a cloth between you and the pack. I iced for hours at a time. This helps to lower the swelling and numb the pain. Also, be sure to elevate, toes above nose.

The following are our basic guidelines and should help get you started. As you read more on other members recovery threads, you’ll get a better perspective of what to expect and what not to do, especially regarding PT.

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. Here is a week-by-week guide for Activity progression for TKRs


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 a 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 history before providing advice.
 
26th December was the day and i am icing and reading - thank you
 
I'm sorry you're having so much pain, @Navfed22 .
Sometimes, it takes a day or two for the increased dose of Gabapentin to take full effect, but if you follow the advice sistersinhim left you, you should start to feel more comfortable soon.

Don't worry about doing exercises for now - just getting out of bed and back in again, as well as walks to and from the bathroom and toilet, will be sufficient until your pain decreases a bit.

I've changed your surgery date in your signature. I've also removed your name from the January Jackpots 2020 surgery list and added it to the December Supernovas 2019 instead.
 
I had neuropathy during my first TKR so am speaking from experience and professional knowledge.
OS told me last night sounds like nerve pain and to increase my Gabapentin from 400mg/day to 600mg/day. No change so far.
I am always amazed how doctors fail to inform their patients how LONG gabapentin can take to kick in. 7-10 days is quite usual.
I try to walk to get some fluid going through knee but I end up screaming and am worried I am going to fall. I cancelled physical therapy as I cant even get onto the table without screaming.
Very wise and the very thing I chose to do during my episode. Despite what some people and PTs will advise, exercise is contra-indicated when you have neuropathy. You might also try warm (not hot) wraps for short periods.
 
Good news - doctor prescribed Lyrica - within a day the nerve pain was gone. feel like I am well on the road to recovery. Thanks to all who helped.

Graham
 
Great result @Navfed22 ! Sometimes it just takes a bit of tweaking the medication. Please keep us updated.
 
Just to close out the issue and give others an idea of how my recovery is going - since starting the Lyrica, I never had another bout of nerve pain. I am just over 4 weeks post-op, tried to wean off all pain meds and what duly put in place by pain during the nighttime. I also quit the Percocet cold turkey and that was a mistake - nausea like nothing i have experienced in the past.

I am having no luck with sleep, but thanks to this forum realize its completely normal. As a former law enforcement officer, i am slightly "type A" to say the least and want everything to happen yesterday, but the recovery is teaching me that one can not control everything.

A huge thank you to all who contribute to this forum it truly is a blessing.
 
I think the nighttime sleeping issues have been the worst part. As a healthcare provider I totally understand the whole Type A thing and how this is a lesson in patience for sure! Hang in there. I am at week 7 and finally getting some longer stretches of sleep.
 
I have no excuse for my Type A personality, but maybe this advice can help?

In the first several weeks, I created some manageable goals that were rarely about how many of something I could do at what effort. Tackling some breathing work, some mobility work (through gentle and modified Tai Chi). Walking, mindful of my gait, not of how much farther I could go than last outing. And, doing upper body and core work, which was more strenuous, but still not too demanding. Maybe that kind of programming of healthy goals could help?

For sleep, I use audiobooks and Great Courses lectures. I usually have to listen to sections a few times to understand them or pick up where I ultimately fell asleep, but who cares?! I’ve got time in the middle of the night. And even if I don’t fall asleep, it’s time well spent.
 
Helizabug - love the idea of the audiobooks, i will give that a try. as far as the goals and my time schedule vs reality - this has been an education. i am learning (slowly) to let my knee rehab take the time it needs. love this forum!! thanks for your encouragement
 

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