TKR New brand new Knee

[tmwillia]

Big sigh... I am taking the lower dosage of Nocor. Grateful just to have something. But instead of every four hours these are ordered for every 6-8. I'm getting really tired of being good and compliant. I wish I could will whoever made this dosage decision a day or so of horrendous pain. I would then hold up the stupid chart and ask him where he was from 0-10. Then suggest deep breathing through the worst of it.


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[tmwillia]

Gimpy Gal, it's a pleasure to hear from you and know I am not alone in my "low pain threshold". I'm pretty sure I am going to tell my surgeon no to MUA. I had a spectacular massage this past Sunday. She focused on scar tissue release and taught me how to do some or it. I'm going to see her again next weekend because after Sunday was the best I've felt in 4 weeks.
Please stay in touch. I don't know how I'm doing, flexion -wise but I think I'm doing better. The pain is ever present and makes me attack (verbally) all inquiring well wishes.


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[B's Knees]

Sorry you've having so much trouble. I hope that my OS will be kinder than yours. Perhaps he's pushing you so much because he keeps "score" of the results of his surgeries and you don't make the grade in his (stupid) opinion. He probably sees it as a reflection on him.
How long has he been in practice? Not long enough to learn how to treat patients, that's for sure.

 

[tmwillia]

Sorry you've having so much trouble. I hope that my OS will be kinder than yours. Perhaps he's pushing you so much because he keeps "score" of the results of his surgeries and you don't make the grade in his (stupid) opinion. He probably sees it as a reflection on him.
How long has he been in practice? Not long enough to learn how to treat patients, that's for sure.

Thank you for your support. I too hope your surgeon is kinder. I really agree with what you said. The IRONY is that my husband and I moved to this area, sold our house because of all the stairs, bought the house we are in where there are only two stairs to get into it and its a ranch, and purposely went to this OS because he is at a hospital close by. I had met him twice before because he replaced both my father's knees, a few years apart. We thought he was the most down to earth, approachable surgeon we'd ever met. He answered every question in a most compassionate manner. He has a great reputation for joint replacement. At the hospital they treated him like a rock star. But now that I am a patient he is "protected" from conversations with me by his front lines of physician's assistant, nurse practitioner, other nurses and clerical staff. I saw him not at all in the hospital after surgery, just his people. His PA removed my staples at 3weeks post-op and tried to manipulate my leg which was horrible. The doctor poked his head in for three minutes to tell me how badly I was doing and threaten me with MUA. I imagine that he must be in surgery every day all day just looking at a patient outside surgery when he is changing his scrubs.


My issues with pain meds are determined by his staff according to a protocol they have. I truly don't think there is any way to determine who will be a competent surgeon and still have time to see you.

Because I have an HMO I had to change my primary care doctor also, so the doctor I now have has only seen me one time in order to write the referral for the surgery.



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[referee54]

I saw him not at all in the hospital after surgery, just his people.

Wow---I was lucky---my OS came to see me very day in the hospital--sometimes he would pop in afterwards, as well!

The doctor poked his head in for three minutes to tell me how badly I was doing and threaten me with MUA.

This is not a correct example of "the power of positive thinking" by any stretch of the imagination! Remember, everybody heal in their own time and at their own rate.

You are also in charge of your body and what can be done to it---he cannot perform an MUA unless you give him permission to do so!

 

[tmwillia]

Wow---I was lucky---my OS came to see me very day in the hospital--sometimes he would pop in afterwards, as well!


This is not a correct example of "the power of positive thinking" by any stretch of the imagination! Remember, everybody heal in their own time and at their own rate.

You are also in charge of your body and what can be done to it---he cannot perform an MUA unless you give him permission to do so!

I have a lifetime of being compliant and obedient to authorities. But after reading so many different people posting to tell me I can 'just say no' , I am certain I can deal with his disapproval . I guess I may need a MUA at some point but it won't be soon and I think I will be asking for some very persuasive arguments.


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[referee54]

I guess I may need a MUA at some point but it won't be soon and I think I will be asking for some very persuasive arguments.

Who knows? Maybe all you need is time---let that knee heal and see where it takes you. no "kneed" to rush things!

 

[pdx]

Your wording makes me think you're at Kaiser -- OS makes a brief appearance for pre-op visit, then surgery, then if you're lucky, zooms through on his/her way home, rarely or never to be seen again. PAs & RNs do most of the patient care, off a checklist/protocol. It's a crapshoot. Some are great, some just follow directions.
On the plus side, at least Kaiser has good infection control protocols and doesn't waste money on unneeded tests or unnecessary visits.
And no matter where you are, no one can make you undergo surgery!

 

[Mazza]

GimpyGal I had to chuckle when I read what you said about going into hospital with a knee that didn't seem too bad and that you felt pretty fit at the time. I can SO relate to that statement, remembering that I was attending aerobic classes (if with some difficulty) until a couple of days before surgery.

And now this is where I'm at - spending every day with my leg elevated, walking around feeling slightly robotic and impatient about improving. I didn't think this would be a quick fix but nor did I have realistic view of just how debilitating the ordeal would be.

My husband made a comment about "When you have the other one done" this morning and I just mumbled back, "Don't even let me have to think about that". He agreed that he isn't relishing the idea either, but we know it will be another necessary evil if I am to do what I can to delay the aging process of my lower limbs.

I have developed a strong belief in what fellow TKR's contribute to this website as I doubt they would take the time to give advice and support if they weren't all of a similar mindset when it comes to going through the pain and endeavour to make good progress. The fact that we are "watched over" by Monitors who have personal as well as professional experience is a huge bonus.

 

[tmwillia]

I woke up last night with terrible pain in my mid shin . I'm icing it but the new crappier pain pills don't even touch it.
Does anyone have any thoughts what this is about. It's a little bruised still all below my knee to my ankle, fading though as it was apparently from the surgery over a month ago. But this is a deep ache that hurts when I walk or sit still.


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[Jamie]

You may be able to add a little more acetaminophen to your Norco. Tell me how many pills you are taking every 6 hours (one or two) and what the dosage is (I'm guessing 7.5/325). You are taking them on a schedule, aren't you.....not just when you hurt?

 

[Pjmc]

I have to wonder why the Drs. mention MUA so soon. There are other devices to help us gain ROM and break up scar tissue. Ermi,inc. ERMI knee/ankle Flexionater. GetMotion.com. They delivered one for me today . I much rather try this than more surgery . Just wanted to post the info as I had not seen it mentioned anywhere .

 

[Jamie]

A few members have used devices such as these. I must tell you that they've gotten mixed reviews.....so don't be surprised if it doesn't work for you. The issue is usually not scar tissue when ROM is low....it's swelling. So these devices will do nothing to improve movement if swelling is still present. People report they are fairly uncomfortable to wear as well.

But you're right....way too many doctors bring up an MUA too soon. I'm not sure why that is and we can only hope that folks have been here to BoneSmart and have found out that early MUAs aren't all that effective in increasing ROM.

 

[Pjmc]

Thank you for the information @JamieA . I do tend to think my problem is the internal swelling . Also the fact the Dr said in his report my knee does not track well after 90 degrees . I know for myself the surgeon I had will not get another go at my knee for Mua or any other surgery .

 

[Mazza]

tmwillia You mentioned the pain in your mid shin; I've noticed that myself on different occasions and often find myself massaging the area during the evenings. Also a "tight" and sore sensation down the outer side of the shin which I put down to tendons that are sorting themselves out. I also put ice on these areas but the best thing is plenty of deep rubbing into the tissue to promote the circulation. We are bound to get these odd feelings as nerves knit together.
Don't despair; my ROM is improving very slightly every day and I'm really not persisting with the physio. It seems that as swelling subsides, so my TKR moves easier. I still hobble, but without pain, just discomfort!

 

[Dkneeded]

Wow, tm, sitting here in front of computer with watery eyes, just reading your story. I can not fathom of what you are even going through. I have been in the medical field over 25 years and seldom hear of doctors like this anymore, but I know there are the few. I KNOW you don't want to bring discourse and unpleasantness to your physician, but you must!
If you have to, contact your nurse case manager or the Patient Relations nurse at that hospital, and let them know whats going on and how you feel. THIS IS YOUR RECOVERY, not theirs.

By the way... I too have the lower shin pain, from what I've gathered on this website this is probably normal.
The more I read here on this site, the more I realize that I am the most important person in the world right now.

I also am having problems with pain, and pain medications. I thought I had explained this to my physician before surgery. It is fairly well under control, barring any set backs right now. Went to the follow up, and the physician said "well we be curtailing the pain meds here soon, so you'll need to start spacing out dosage times and dosage amounts." I said, "well when did they take you of off pain meds after your TKR?" I don't think so. He just laughed patted me on the shoulder, and said OK. I am now off of the percoset and taking 15mg lortab-narco every 4 hours, whether I need it or not, and I will continue to do so for the next couple days, I will wean myself off the meds, not let the physician do it for me. At this present time I need it, and that's all there is to it, hardly is there a moment when I don't need it - that's just me.

I truly hope things get better for you and I'll be pulling for ya, I'm off to PT right now!

 

[tmwillia]

I have to wonder why the Drs. mention MUA so soon. There are other devices to help us gain ROM and break up scar tissue. Ermi,inc. ERMI knee/ankle Flexionater. GetMotion.com. They delivered one for me today . I much rather try this than more surgery . Just wanted to post the info as I had not seen it mentioned anywhere .

I have a Jazz hinged knee brace that was ordered for me. I'm supposed to wear it three times a day for thirty minutes each time. It straps on at the thigh and calf and has a little crank which allows you to tighten (increase) flexion. It's pretty miserable but I keep trying. I'm at 85 degrees and haven't gotten past that. Depressing.



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[Pjmc]

85 is good for this early in your recovery . Perhaps you were like me going into this thinking I would walk out of hospital , then be running by now .

 

[referee54]

Perhaps you were like me going into this thinking I would walk out of hospital , then be running by now .

I believe that you are correct! None of us thought much of how much trauma would be done surgically to the knee, and we all had less than realistic ideas about how quickly recovery would take place.

 

[tmwillia]

I believe that you are correct! None of us thought much of how much trauma would be done surgically to the knee, and we all had less than realistic ideas about how quickly recovery would take place.

I never thought I'd be running. I attended a class which mainly talked about getting a walker and cane and shower bench. They said "you will have to work hard still PT after replacement." I think I would have remembered discussions of uncontrolled pain, or reaching goals set by the medical staff or you are a failure. I'm disappointed in myself because I feel like I wanted/needed the knee replacement so bad that I wasn't asking or even thinking of questions. I know they said whatever discomfort after the surgery would be nothing compared to the pain we currently all had. Sure sounds great, doesn't it? I'm depressed all the time and I've never felt like this before.


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