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TKR New Pain one year post op RTKR?

Hello @OUCH! - wanted to check up on you. I'm not a knee candidate (well not so far anyway) but have read your thread and am so sorry you had a tough time with pain. Do hope the ice machine and regular meds will keep things in check. So glad you're all done now which is what you hoped for pre-Christmas.
 
My ice machine became my best friend after my revision. I used a couple of frozen bottles and small picnic boxes that lasted linger than just ice cubes. I also added a little ice. Using that set-up helped my ice machine to stay cold overnight without changing out the ice.
 
Hi All,

It's been so long since I've updated. 2 weeks post op today. In fact right around this time I was getting ready to transfer from recovery to my room.

I'm doing better now, but the first week home was really hellish. I told people that as easy as the hip was, that is how hard the knee has been. My pain was not controlled at all. I think maybe I had built a tolerance to the oxycodone since I used it after hip surgery and was never 100% off it. I didn't use it much, but did use it at night a few times a week before going in for my knee. At the PTs urging, I called the OS last week. She was concerned that I was in so much a pain and really couldn't do any exercises.

First time I have been unhappy with my care. I talked to the receptionist. She asked what I wanted did I want a new med. I told her "I don't know, I want to know what I can do to help with the pain". She put me on hold and then she came back on and said, "well, pain after surgery is to be expected. Take your meds, ice and elevate. You have an appointment Monday. We can figure it out then". I was so upset by this. If I had been myself, I would have let her have it. I was in so much pain and so discouraged that I just hung up and cried. I have had over 2 dozen surgeries before this and have had many orthopedic issues. I know pain and usually handle it well. My husband was bothered too. He is not usually very expressive about things, but he was concerned. I burst in to tears several times through out the day doing simple things like getting dressed. It just hurt so much. Probably an 8 many times and never below a 5. He has seen me through many recoveries and agrees that this was not like me.

Monday, I went to get my staples out. I was all ready doing better pain wise and was starting to wean down a little bit. I wasn't counting the minutes until my next dose was due as I had done the week before. Surgeon was happy with the incision and was happy with the X-rays. He was not happy with how much narcotic I was taking nor with the lack of bend that day. I wasn't concerned with the bend. I had PT that morning and then ridden 30+ minutes to his office and then waited forever to see him. I knew my knee was just swollen and stiff because I had not iced or elevated for hours at that point.

Anyway, he switched me to dilaudid. For the most part, my pain does seem better. I don't know if it was the dilaudid, or if enough time had gone by that the pain was reducing. Either way, I'll take it. Tuesday, I was able to be be up and wrapping presents for a couple hours. I got 2 thirds of the wrapping done. I was also finally with it enough to finish the online shopping. I had organized everything for the kids in spreadsheets etc so my husband could take over, but he has been overwhelmed. I was glad to finally be able to do it. Hopefully everything gets here in time.

My dilaudid prescription is 4mg every 4 hours. I feel like that's a lot. I have gone over a few times today though and now I am in pain and trying to catch up. I won't set an alarm to take it overnight if I sleep through the next dose, but I do think I will try to stay more on schedule tomorrow during the day.

Hope everyone else is doing well.

@jaymo, how is your hip?

@Medfordart, how are you?

@Miss Muffet thanks for checking in on me.
 
Sounds like your starting to get things under control. I think when were down and out the most it's when our dr. or p/t take advantage of the situation. You had, had a busy morning prior to your appt, and a lot of things needed to be taken into account which your O.S. didn't seem very understanding of. Also when you called in you didn't need or deserve to be put off to discuss it more a week later at your appt. And like you said had you felt more like yourself you would have expressed your unhappiness about the situation.
Glad to hear your pain meds may be working better?? Take care.
 
I would suggest that you set your alarm for the overnight dose of pain medication. You could get up and make a bathroom stop then too. That way you won't start your day trying to catch up with your pain. During the day you could then take it as soon as you start to feel more pain even if it's over the 4 hour mark.
 
Wow- you've had a rough time! I would not beat yourself up- you're recovering from major surgery and in pain. If it were me I would take the Dilaudid around the clock for now since you're only 2 weeks out. I've not had a TKR but my sister did her TKR recovery at my house. She's normally stoic but that postop pain was no joke for her and she took her pain meds regularly. Seeing what she went through compared to my THR I definitely consider the knee to be a more difficult recovery.

Hearing about your treatment by the OS and office staff I would not be happy either. I can't believe they made you wait a week to re-evaluate pain control. Not acceptable in my book. Plus you know your body and your pain threshold. It makes me angry to hear when people are treated this way. I'm praying the Dilaudid continues to work for you.

On a more positive note it's great to hear you're ordering gifts and wrapping presents! You are way ahead of me and I haven't just had surgery! I'm impressed.

My hip is doing great. Finally off all dislocation precautions and enjoying that. Walking 2 miles a couple times a week with very little soreness and no limp. Went back to work 4 weeks ago. This week is my first week full time in the office. Without the frequent breaks I took at home the hip gets sore. I set an alarm to get up and walk a little every 2 hours. Doc says all is healing well. Released me to do anything except running jumping or skydiving- haha. I resumed babysitting for my grandson last week and the new hip did great! Just in time cause little man has just started walking and is all over the place. All in all I'm happy with the progress. How is your new hip holding up now that its your main support?

I'll be keeping you in my thoughts and prayers.


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@OUCH! - was bothered when we hadn't heard from you for a while and am so sorry to hear you've had to grapple with so much pain. Slightly relieved to read you feel the beginnings if some improvement on that score. You were determined to get this one ticked off your list pre-Christmas and have seen it through. Good for you - brave girl! Praying things continue along a smoother path for here on. Enjoy your family Chrismas and get the team working for you. You have a much better New Year to embrace now you're all fixed up.
 
I've been worried about you and how your pain was being managed. TKR is very different than most hips. I agree with Marian, take your meds around the clock for now and don't worry about stepping down until your 4-5 weeks because of the slow start. I was 4 weeks before I began forgetting pain medication. Ice, elevate and follow the activity progression chart as much as possible. Keep us updated, @OUCH! .

https://bonesmart.org/forum/threads/activity-progression-for-tkrs.14334/
 
I have been worried. I hope relief comes soon. I am doing well, but not as back, of course, as I would like yet. I think it is a very hard time to be recovering. I feel like I am pushing to try and make Christmas happen.
Thinking of you and sending positive thoughts. Merry Christmas!
 
I hope you're starting to feel a bit better, @OUCH!
I'm sorry your surgeon was so discouraging when you had your clips removed. You will be OK, I'm sure.
 
Merry Christmas to all my Bonesmart friends who celebrate!

Very different Christmas for us this year, but I think it will be good. Its certainly more relaxed than most.

Home PT discharged me yesterday. I start outpatient on Weds. Yesterday with gentle assistance from her my bend was 120 or more. On my own it was 90-100. I'm mostly on top of the pain with the dilaudid although it makes me sleepy. I am going longer between doses but not so long that I end up in major pain. I actually slept for 6 hours straight last night! And I had slept for a few hours before that. That in itself makes me feel better.

Hope all are doing well today. Thank you again for all your care and support!
 
Wow! Six hours sleep! That's quite an accomplishment! Be careful with assistance in measuring ROM, 90-100 is very good for a few weeks out.
 
Yup! I'm jealous of your ROM. Just have to get the pain under control. Best wishes for a peaceful Christmas and a good nights sleep. Everything feels better after a good sleep.
 
Just a note on Monday the bend was only 80 and really didn't count because PT was forcing it too much. In fact I was about to tell her stop when she stopped on her own.

I'm wondering if I can cut the 4mg dilaudid in half? They are so small I'm not sure I will be able to cut them, but they make me so sleepy. I don't want to be in pain, but I don't want to sleep away Christmas.
 
CarolAnn, if I were you I'd stop the PT from pushing on your leg altogether. Does the PT ask if there's pain while she's pushing? I cut my oxycodone in half with a pill cutter my sister got at the pharmacy.
 
Thanks Karri. She wasn't really pushing it except on Monday. It was more passive stretching. But irrelevant because Friday was her last day. I won't let the outpatient push at all.

I will try a pill cutter. My oxycodone had a line down the middle to make cutting easier. The dilaudid are teeny tiny, but I'll try. Thank you!!!
 
Merry Belated Christmas! Glad to hear that your pain is better controlled. I agree with others to not let the outpatient PT push you into pain. If they are paying attention to your facial expression as they manipulate your knee it should be obvious when you are in pain.

Hope things go well next week and your progress goes smoothly.


Sent from my iPad using BoneSmart Forum
 
Merry Belated Christmas to you @jaymo! Luckily from my hip rehab, I know most of the PTs at the outpatient clinic I am going to use, so I can choose to see the ones I trust and that I know I can tell NO.

I'm doing so much better than I did a week ago. We had a lovely 2nd Christmas yesterday with my husband's family. They came to visit us and stayed the entire day. I'm proud to say most of my presurgery prep was very worth it. We had a lovely feast and while it wasn't as good as fresh cooked, most of the food I had frozen ahead was good. My husband was so awesome about preparing it all and getting it on the table. I did make fresh stuffing and jumped in to help get it all coordinated at the end. I probably over did it. My knee was really painful when they left and I was exhausted. I went to bed with my ice machine as soon as they left and seem to be doing fine now. I plan to spend most of today in bed recovering.

Finally sharing a picture of my bend. Hard to see well because of my pj bottoms, but I'd say its pretty good for not quite 3 weeks. I have not done a lot of extra exercises, just bending and straightening through out the day. This bend is just to the point of feeling it. I did not push until it was painful.
 

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That looks like at least a 90* bend! That is wonderful for 3 weeks. You go girl! Keep up the good, no work!!
 

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