BoneSmart® Hip / Knee Replacement Forum
Knee Replacement & Hip Replacement
Patient Advocacy & Online Community
  1. ATTENTION: Download the new BoneSmart® app today! This FREE app is available for iOS or android phones and tablets and will allow you to connect to the forum on all of your devices. The old Tapatalk app is being discontinued so get the new app now.

    Get The app HERE

    Dismiss Notice

[TKR] No Energy. Passing out couple times

Discussion in 'Knee Replacement Recovery Area' started by drsmagic, Jul 3, 2017.

  1. drsmagic

    drsmagic junior member
    Thread Starter

    Member Since:
    Jul 3, 2017
    Age:
    67
    Messages:
    21
    Gender:
    Male
    Location:
    Irvine, ca
    Country:
    United States United States
    Had a TKR on Monday 6/26/2017. Was given spinal a aesthetic and also had a IV nerve block running all the time. First 2 nights was given OxyContin ER, OxyContin IR, 5 mg oxyhydrocodone, 375 mg aspirin morning and evening, Pepcid AC, 2 x stool softener morning, evening. Days were fine, even enjoyed the meals, but first night no sleep, 2nd night felt high anxiety and claustrophobic. Got the nurse to give me 10 mg Ambien for help with sleep. Also took Miralax powder to help bowel movement
    6/28 Morning wake up go for bowel movement and feel faint and dizzy, aide immediately notices and says that I may be passing out and calls out for nurse. My pressure had fallen to 70/50. They give me some IV, remove the the OxyContin ER and IR. By 5.00 pressure is ok 100/57. They discharge me. Pain has been totally manageable so far.
    6/29- I am on 2 aspirins 375 mg. Percocet 5mg/375 take 1 or 2 as needed. I take 5 in 24 hrs, feel kind of loopy, but pain is ok. PT shows up and is impressed by my recovery
    6/30 take 4 Percocet, feeling very fatigued doing just a little 50 feet walk. BP is ok, but feel like dizzy and need to lay all the time.
    7/1 take 1 Percocet and aspirin am, PT shows up and starts therapy, simple stuff. I tell her I feel dizzy and she gets me to sit and just like that I pass out. My face gets contorted, eyes slant, make snorting sounds, sweating all over. They call 911, EMT measure my BP, is low. I am breathing very hard trying to get air all the time till we reach ER In ER they give me IV fluid, run tests all looks ok, discharged. I decide to reduce dosage of Percocet to 1/2 pill every 6 hrs. Pain is there, but I tolerate.
    7/2 I am still very weak and get of breath with very little activity. BP is ok, but still feel dizzy in head. Increased use of Tylenol. Took 1/2 Percocet 4 times
    7/3. Today was crucial day, PT was nervous, but we took it very slow and though I felt dizzy, stopped enough times to try and recover. Its 5.00 PM and I have taken only 1/2 Percocet. They want me to stop and see if the dizziness disappears. In such case if pain elevates too much they would prescribe something else. Pain is omnipresent but only bad when I try to move knee or do therapy or get out of bed.
    Anybody have this kind of experience, PA feels could be medicine, ER doctor called it a synscope or something to that effect. I have always had low BP, tonite I might take a Tylenol pm to get sleep, forget Percocet. It's strange but I am managing my care
     
  2. skigirl

    skigirl SUPER MODERATOR Moderator

    Member Since:
    May 5, 2009
    Age:
    73
    Messages:
    12,174
    Gender:
    Female
    Location:
    Whitefish, Montana
    Country:
    United States United States
    Wow, that is scary!! Morphine can make some people faint---(syncope). I felt lightheaded and sweaty when I took Percoset myself. You can ask for something like Tramadol which you can take with the Tylenol. It is not as strong and does not have as many side effects, but with Tylenol it is an effective pain med.

    I am going to give you the readings from our library that we recommend to new knee owners!! The articles are all short and easy to read.
    Knee Recovery: The Guidelines. Don’t worry:

    1. 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
    elevate
    ice
    take your pain meds by prescription schedule (not when pain starts!)
    don't overwork.
    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.

     
    • Like Like x 2
  3. Jamie

    Jamie ADMINISTRATOR Administrator

    Member Since:
    Mar 24, 2008
    Age:
    69
    Messages:
    50,751
    Gender:
    Female
    Location:
    Kansas
    Country:
    United States United States
    Kelly is right. There are plenty of other options for pain management. It might be a good idea to let your GP know this has been going on. Sometimes they are a lot more knowledgeable about pain meds and more understanding of potential issues with a particular med.
     
    • Like Like x 3
  4. Lilli215

    Lilli215 member

    Member Since:
    Apr 5, 2017
    Age:
    60
    Messages:
    165
    Gender:
    Female
    Location:
    Scotland
    Country:
    United Kingdom United Kingdom
    First time the physio got me on my feet 3 hours after the op I felt very dizzy and was sick. Next day they got me up again and I only took a couple of steps and felt very faint, was immediately put back into bed and bp had plumetted through my toes, I was told that was quite usual and was as a result of the morphine block in spine I had been given along with spinal aneasthetic leaving my system. Later on that day I asked the doc to stop the morphine based oral med I was getting as I'm super sensitive to narcotic analgesics and was feeling sick and dizzy all the time. After that I was on low dose codeine/paracetamol and naproxen with no more dizziness and sickness. Could be you're sensitive to morphine based meds also.
     
    • Like Like x 3
  5. drsmagic

    drsmagic junior member
    Thread Starter

    Member Since:
    Jul 3, 2017
    Age:
    67
    Messages:
    21
    Gender:
    Male
    Location:
    Irvine, ca
    Country:
    United States United States
    Thanks all, today 7/4. Happy 4th. Last night did not take any Percocet, just 2 325mg tylenols and repeat this morning. Was difficult managing to sleep because of lingering pain. Surgeon did not recommend NSAIDs with Aspirin. Any thoughts on taking OTC Advil 200 mg a with Tylenol. Thank you for suggestion on Tramadol. Will ask dr for prescription. My nephew who is a family practice dr, felt I could have had a mild seizure, because of slant eyes and face contortion while passing out. Definetly feeling more alert without Percocet
     
  6. Celle

    Celle FORUM ADVISOR Forum Advisor

    Member Since:
    Nov 19, 2011
    Age:
    76
    Messages:
    25,309
    Gender:
    Female
    Location:
    New Zealand
    Country:
    New Zealand New Zealand
    No , don't take any NSAIDS. They can cause bleeding and stomach ulcers, and they pre-dispose you to heart problems. NSAIDs Diclofenac. ibuprofen increase risk of heart problems: new study
    They're basically anti-inflammatories and don't work well on the normal inflammation you knee gets after the trauma of a surgery. Besides which, gram for gram they are not very good pain killers. You'll get better results if you take an effective dose of Tylenol - that is 1,000 mg (2 x 500 mg tablets) in 4 doses, 4-6 hourly, to a daily total of 4,000 mg.
     
  7. drsmagic

    drsmagic junior member
    Thread Starter

    Member Since:
    Jul 3, 2017
    Age:
    67
    Messages:
    21
    Gender:
    Male
    Location:
    Irvine, ca
    Country:
    United States United States
    Thank you Celle, wondering if anybody has added Tylenol PM for sleep in the cocktail mix. Sleep is hard to come by when in pain.
     
  8. Wellness in Virginia

    Wellness in Virginia member

    Member Since:
    Mar 28, 2014
    Age:
    57
    Messages:
    130
    Gender:
    Female
    Location:
    Fairfax
    Country:
    United States United States
    Dear drsmagic --- I will pray for your comfort and speedy recovery. If the Tylenol does an adequate job of alleviating your pain then I am happy for you. If you cannot get comfortable enough to sleep at night there are free guided sleep meditation on YouTube that you might like to listen to. It may help to get you relaxed enough to feel less pain. It helped me. My thoughts are with you. Hugs.
     
  9. liam2015

    liam2015 post-grad

    Member Since:
    Apr 10, 2017
    Age:
    67
    Messages:
    1,240
    Gender:
    Female
    Location:
    Toronto
    Country:
    Canada Canada
    i didn't faint but the first time physio came and got me to sit up on the side of the bed, i promptly threw up lots and lots of liquid. luckily there was a sick bowl nearby. they let me be and came back a couple hours later. also a pain nurse came and changed my meds. i'm not even sure what i was on. it's all a blur. hope the new medication regimen helps with your pain and discomfort.
     
  10. KarriB

    KarriB FORUM ADVISOR Forum Advisor

    Member Since:
    Apr 20, 2015
    Age:
    61
    Messages:
    11,206
    Gender:
    Female
    Location:
    Pittsburgh, PA
    Country:
    United States United States
    I added Tylenol PM, but until later in my recovery when I was off oxycodone. It did help me to get back into my normal sleep pattern.
     
  11. knit2tog

    knit2tog senior

    Member Since:
    May 15, 2017
    Age:
    57
    Messages:
    337
    Gender:
    Female
    Location:
    United States
    Country:
    United States United States
    I am hoping you find an effective pain management. I was lightheaded and dizzy the first time PT tried to get me to walk in the hospital. It wasn't until day 2 I was able to walk, but I was not all that steady. I was much better the further out I was from surgery.
     
  12. Celle

    Celle FORUM ADVISOR Forum Advisor

    Member Since:
    Nov 19, 2011
    Age:
    76
    Messages:
    25,309
    Gender:
    Female
    Location:
    New Zealand
    Country:
    New Zealand New Zealand
    I think tha almost everyone has problems with sleep after this surgery. Did you read teh articoe about it tha was left for you?
    Sleep deprivation is pretty much inevitable - but what causes it?

    If you take Tylenol in the dosage I recommended (1,000 mg 4 times a day) your pain should be reasonably well controlled. You do need to stick to a regular schedule, though, to keep up the levels in your blood. You will have reached the maximum safe daily dose, so you shouldn't add the Tylenol PM.
    If you can keep your pain under control, you will be able to rest better.

    Until your normal sleep pattern re-establishes itself, which could take a while, make up for sleep lost at nights by taking daytime naps. Sleep where you can, when you can, and how you can.
     
  13. drsmagic

    drsmagic junior member
    Thread Starter

    Member Since:
    Jul 3, 2017
    Age:
    67
    Messages:
    21
    Gender:
    Male
    Location:
    Irvine, ca
    Country:
    United States United States
    Thanks all, today is my 8 the day, trying to follow yr guidelines. Can walk up to 100 steps before I need to lay down. If I sit for more than 10 minutes I get exhausted. Only laying in bed does not tire me. I try to sit for 5/10 minutes about 4/5 times a day but have to hit the bed each time tired. Is that ok. I do the therapy twice a day.
    I just felt I would be feeling less tired at this stage.
     
  14. Celle

    Celle FORUM ADVISOR Forum Advisor

    Member Since:
    Nov 19, 2011
    Age:
    76
    Messages:
    25,309
    Gender:
    Female
    Location:
    New Zealand
    Country:
    New Zealand New Zealand
    That's just fine. Resting is what your knee needs most at this stage and if lying in bed is the only way that you can rest, then lie in bed by all means. As long as you get up for a short walk about every hours to 90 minutes, that is really all the exercise your knee needs for now.
    If you must do exercises, once a day is enough.

    Your knee has been through a major operation that caused a lot of trauma. It needs gentle treatment, so it can heal.
    My surgeon doesn't allow any formal PT for the first month after a knee replacement and his patients all do well.
     
  15. KarriB

    KarriB FORUM ADVISOR Forum Advisor

    Member Since:
    Apr 20, 2015
    Age:
    61
    Messages:
    11,206
    Gender:
    Female
    Location:
    Pittsburgh, PA
    Country:
    United States United States
    Your body is working hard to recover and heal after this surgery which is part of why you're so tired. This was new to me because I had never had any surgery before. So, the best thing you can do is rest and sleep whenever you can and not push your body to do too much. Go back to the guidelines to see what your activity should look like.
     
  16. kmak81230

    kmak81230 post-grad

    Member Since:
    Jun 15, 2017
    Age:
    60
    Messages:
    1,444
    Gender:
    Female
    Location:
    Colorado
    Country:
    United States United States
    Take advantage of this time to rest rest rest - you are just barely a week out from major trauma to your body. I was very tired like that for at least the first three weeks. Hang in there and keep managing the pain. Wish I could tell you there was a magic formula for sleep - many of us struggle with it for a long time. Naps are a good thing :sleep:
     
    • Like Like x 2
  17. skigirl

    skigirl SUPER MODERATOR Moderator

    Member Since:
    May 5, 2009
    Age:
    73
    Messages:
    12,174
    Gender:
    Female
    Location:
    Whitefish, Montana
    Country:
    United States United States
    Your body is helping you to not do too much!! Right now, rest is what you need the most of, just enjoy this time, you will be busy enough soon. I never did any extra exercises at home---just at PT. They used to laugh when they gave me pages of home exercises to do!!
     
    • Like Like x 2
  18. pdx

    pdx graduate

    Member Since:
    Nov 17, 2012
    Age:
    68
    Messages:
    540
    Gender:
    Female
    Location:
    West Coast
    Country:
    United States United States
    By any chance did they check your red blood count (hemoglobin) when you when to the ER? I had a similar experience after my first replacement, and they discovered I was really anemic. Also, as others have noted, opioids can do all sorts of things.
    So sorry you're having issues.
     
  19. rslobe

    rslobe junior member

    Member Since:
    Jun 20, 2017
    Age:
    63
    Messages:
    22
    Gender:
    Male
    Location:
    Sacramento
    Country:
    United States United States
    I was wondering about Hemoglobin as well. I had dizziness but never felt I was going to pass out. The fear of it, alone on the john (laugh here) made me even more dizzy. Two weeks out there was some puss on the incision so they had me get a blood test. I was anemic. That was predicted because of the surgery itself. Blood! Thankfully no infection. As to pain meds, they all act differently and on each of us differently. I was prescribed oxycodone. My back doc friend said to run from it. I didn't but understand now as it makes (made) me more loopy than Norco. My surgeon's approach is oxy to Tramadol to Tylenol to nothing. A hip doctor friend of mine, when presented with my options, said, "Experiment. Like it was the 70's!"
     
    • Funny Funny x 1
  20. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

    Member Since:
    Dec 4, 2015
    Age:
    66
    Messages:
    11,432
    Gender:
    Female
    Location:
    Virginia
    Country:
    United States United States

Share This Page

Sponsors
Close X