Newbie 7 weeks post OP swollen sore and stiff

[Canada]

Hi Folks GREAT SITE

Well had a LTKR with a complication of a fracture in the femur below the knee
a couple of LONG screws holding things tight. 51 days post OP.
Big problem with pain, swelling and stiff lack of motion. My best is 70 degrees. Starting to get worried and suffering sleep deprivation from pain.
Suggestions and some hope would be GREAT.

Richard
:fdbk:

 

[Canada]

oops

On my Newbie intro THREAD above I mentioned my Femur was fractured let me correct myself here it was my TIBIA.

Still awake past 400 a.m. ,,,,,,,,nursing the pain.

LTKR Oct /3 09
L Knee Surgery @ 10 years old.

 

[Texas]

Hi and welcome well you are still so early in recovery that i would expect swelling etc i still do......but if its hurting that bad are you taking you pain med like you are supposed to .,....do wait till it is really hurting to take the med as Jo has told us stay ahead of the pain its hard one it starts hurting to stop that pain......once the pain is under control you might be able to do more...i wish you the best hope you feel better soon.....sounds like you have been thru alot let in heal..........ok.........post anytime and glad you joined us........)

 

[Josephine]

A little over 7 weeks? Extra complication of the fracture? Yes, you will be exactly as you describe.

But - you haven't told me what you're taking in the way of pain meds, what, how much and how often. Nor if you are elevating and icing your legs lots! It all matters.

Glad to have you here on BoneSmart. I know you'll find support and encouragement by the bucketful here!

 

[Jamie]

Welcome to BoneSmart, Richard! So glad to have you as a member. At this point in recovery, you should be doing serious icing, elevating and pain medication to stay ahead of the pain and swelling. It can really make things more difficult if you don't. I took prescription pain meds for about 3 months and I didn't have the problems initially that you had. And I iced almost constantly for almost 6 months because I had a lot of swelling....internal swelling you really didn't see by just looking at my knee. But it was there and it could really hurt.

Good luck and keep posting to let us know how you're doing.

 

[Canada]

Thanks for the support. The only meds are tylenol 3 ...2 pills every 6 hrs.. I only have been taking them before Physio which is 3 times per week and if I can no longer tolerate the pain. This is usually in the P.M. after I try to get to sleep.

I am starting to forget what sleep is.... especially quality sleep.

I have quite a bit of scar tissue over the knee and it feels like the same thing down the outside of my leg to the foot.... is this normal.......
I massage the daylights out of it to soften it up but a few hours later its back with avengeance. This stops a lot of my range of motion.....sure wish it would go away.......suggestions anyone....

Oh Just to let you know this laptop is new and I can not for the life of
me get the punctuation marks... question marks or commas to work as the keyboard is bilingual and must be turned off English. Talk soon...

 

[Josephine]

Well, you are obviously grossly under-medicated. T3 is 300 mg acetaminophen + 30 mg codeine which is at best a moderate analgesic and nowhere near strong enough for your condition. You should see your GP and tell him those pills aren't cutting it and you need something stronger to enable you to function better and do your PT. Tramadol/Ultram is good. I was prescribed it for my TKR and had 50-150mgs every 4-6 hrs as I wished along with 2 x 500mg paracetamol. Only downside is that 2 Trams can make you feel drowsy but I always felt it was worth it. You're supposed to be resting and recovering anyway!

But you should never be in a situation where you can "no longer tolerate the pain". Pain management is about being proactive, not playing catch up.

Time for my world famous chart again, I think

 

[Canada]

Thanks for the info on the right Meds I will get on that Monday for sure. It makes me think what these Doctors are really all about in Canada. Nights like tonight are sure the worst, and I mean all nights for that matter. I no sooner try to sleep in bed and it all flairs . I have tried everything imaginable to get it to stop to be able to sleep. I lay awake and massage the sore areas that I call the hot zones to get relief. I can ice. and do Ice it for hours each day from above the knee front and back to the ankle to try to get things relieved. I try heat a couple of times each day also.

My range of motion is poor 70 degrees after physio which kills as they push so hard. Thats scary as the screws from the Fractured Fibula and all. I just hope this forcing does not create further probs. Oh! the last report from the surgeon was my bone density is really poor.

 

[Jamie]

"Pushing" is okay to a degree. But you should not be in tremendous pain in therapy. Remember that YOU are the patient and you have control over what they do. If you believe they are pushing too hard, say so. Some therapists tend to get a little overzealous. Not saying that's what's going on with you....just be aware that you are in control.

 

[electric.judge]

Well, you are obviously grossly under-medicated. T3 is 300 mg acetaminophen + 30 mg codeine which is at best a moderate analgesic and nowhere near strong enough for your condition. You should see your GP and tell him those pills aren't cutting it and you need something stronger to enable you to function better and do your PT. Tramadol/Ultram is good. I was prescribed it for my TKR and had 50-150mgs every 4-6 hrs as I wished along with 2 x 500mg paracetamol. Only downside is that 2 Trams can make you feel drowsy but I always felt it was worth it. You're supposed to be resting and recovering anyway!

But you should never be in a situation where you can "no longer tolerate the pain". Pain management is about being proactive, not playing catch up.

Time for my world famous chart again, I think

Josie,
Just read your advice to other Newbie about medication.

I am on (Paracetemol 500mg with 30mg Codeine) X2 every 6 hts and am allowed to take a long acting Oxycontin 10mg at night.

Originally I had Endone to take every 6 hts in the day time, but my GP is worried that these drugs are too addictive.
I don't know much about the Oxycontin and the Endone. Have never taken them before.

Is there something I could ask her for to replace them.
Still in pain if I don't take them.
saw my surgeon and he said it was the GP's job not his.
Was very brief and hurried. Said I was doing Ok and to expect pain.

Lesley

 

[Josephine]

People tend to get paranoid about getting addicted to certain pain meds. Now it's true you can become dependent upon them which is very different, and then you need to come off them slowly over a period of weeks or months but since you'll be needing to reduce them as your pain reduces, that shouldn't be too much of a problem anyway. The really important point is that studies show where there is pain that needs medicating, dependence is less of a problem than with those who take them as recreational drugs. You're not taking them like that - you have really good reason to take them, so as long as you have pain, don't worry about it. You'll find over time that you just naturally reduce them anyway. Also, a person depriving themselves of pain meds, who then gets severe pain, then starts to think the reason they are 'craving' the pills is because they are addicted! Hogwash! You're craving them because you're in pain! Big difference!

Now your meds: Endone/oxycontin is a form of oxycodone/Percocet but a timed release one giving 8-12 hrs pain relief unlike the regular ones which give 4-6 hrs relief. Like any other opioid, they can have issues of dependency in some people if taken over an extended period like 3-5 months.

Paracetamol and codeine (also known as co-codamol) is a pretty good pain reliever for mild to moderate pain but I wouldn't have wanted to be dependent on it for my TKR. I was prescribed Tramadol 50-150mgs which I took in combo with paracetamol 1 gram every 4-6 hrs as I decided I needed.

I mostly took 50mg during the day with ice or 100 if in a lot of pain but I always took a 100mg at night and occasionally 150 if there was a lot of pain. Good thing was, that if I took 100 upon retiring and then found an hour later I was still in pain, I still could take the other 50mg.

This regimen worked well for me and I took them for a full 2 months in these varying doses and as a result had a pretty comortable recovery. However there have been members here who have reported that Tramadol didn't suit them at all, doing nothing for their pain. Must say, however, that they were far exceed by those that seemed to find Tramadol effective.

 

[electric.judge]

Re: Newbie 7 weeks post OP swollen sore and stiff and pain relief advice

Josephine,
Thanks for your very helpful reply.
I received it in my personal mailbox and tried to reply from there.
Heaven only knows where that went.
Will take your advice and see GP again if I feel I need more pain relief.
My OS lives in another town 3 hrs away.
Won't see him again until Jan 1010.

Funnily enough, today wasn't too bad.

Does it show I'm still finding out how to use this site?

Maybe I need a brain replacement!

Lesley

 

[Josephine]

Well if you need any guidance, just give Jamie or me a shout!

 

[Jamie]

Lesley, you're doing fine. And, as Jo said....we're here to help you any time you need it!

If you find your primary doc reluctant about renewing prescriptions when you are still in pain, you may need to get very assertive with him/her. And if that still doesn't work...seek out a pain management clinic for help. You are not going to get addicted as long as you are in pain.

 

[Canada]

8 Weeks OUT going to the OS tomorrow... Thanks for the info on the meds I bumped them up and it helps. Now at least I get some sleep. Talking Physio... it is stiff and sore and they are really pushing things all they want for their satisfaction. Glad I can tell them when enough is enough.
My mind keeps saying this is not working out so well....Stiff, Sore, Loose, Swollen, Clunky and only 45 degrees free movement but when pushed it gets to 70 , 30 mins. later its back to 45.

I will persist. I will, I will

 

[Josephine]

Well, don't let them be too cruel to you. There really is no need. And if your knee is swollen, that's why you can't get a good ROM. It's a mechanical obstruction, not an anatomical one. And remember, pain causes swelling and swelling causes pain.

Treat the pain.

btw, I was wrong in my post - I took that regime of pain meds for 3 months not 2.

 

[Canada]

Thanks Josephine you have been a great help...
I should know tomorrow after the OP visit.

Richard

 

[Jamie]

Good luck tomorrow, Richard. You'll get there...you still are VERY early in recovery and your body will heal at its own pace. Sometimes you just can't hurry it up any.

 

[Canada]

Did not get to see my OS yesterday have to go back on the 21st he was performing emergency surgery. Saw another OS but could not get my meds changed from Tylenol 3 with this OS but she said I could take Advil together and that might help. I am not on anti Inflam. meds since day 4. I find this bazare as there is considerable swelling and my pushed ROM is still 70 and with two people pushing 75. I love it when they tell me what would I do if I had to give birth. My comment was I do..every time you crank down on my leg I have a baby...

Thanks for the support ....take care

Richard

 

[brs0660]

How frustrating. I will be glad when you get to see the YOUR OS. I know that PT stands for Pain and Torture...but if they are have to put that much pressure on your leg to get 75 ROM, I think it is time for your OS and you to have a chat!!
1. Why can I not have something better to control the pain and swelling?
2. I cannot live my life at 75 and in pain...what are we going to do about it...or do I need to find someone who has my well being in mind??

I get a bit bent out of shape when docs don't listen and don't care!