TKR Not a new patient but I need help, lots of it

[KitCat]

@Texaslady Being from the US also, I am aware of these difficulties with medication.

Partly it is a new situation, with new laws about how much docs can prescribe and such having just gone into effect this year. I think no one knows just quite what to do. Many doctors are scared because they are now under many legal restrictions about what they can and can do.

I have gone to my OS twice post op, and did get RXs and that was from the PA. My OS looked at me like why would I still need pain med. I have heard that OS will only prescribe for so long and then you need to be seeing a pain management specialist.

I have called around to various pain management doctors with some weird results. A few (office people, or who ever answered the phone) acted suspicious of me, like I may an addict trying to get meds from more than one doctor. That felt horrible. One place beat around the bush and said they would call me if there was an opening.. One didnt take my insurance. One wasn't accepting new patients. And these places all had multiple docs in the office so alot of docs were eliminated.

So, I finally made an appointment with one which is in a few weeks and hopefully I get somewhere. It took me hours on the phone to work through all that. My primary doc won't touch prescribing pain med.

This is new thing in the US and everyone is trying to figure it out. I hope you find a way! Don't give up!

 

[Fire wolf]

I am in U.S. and am fortunate that my OS was very accomodating with pain meds. I was sent home from hospital with a script for narcotics, had PA write another for me when I got staples out, and she mailed an additional one to me when I emailed her with request. (Where I am, narcotic prescriptions cannot be faxed or called into pharmacy, need actual paper script). I think that some doctors have become too paranoid, or too lazy to prescribe narcotics (they have to go into a database every time they write a script to see if you had soneone else prescribe something as well).
I do hope that you are able to get your pain under control!

 

[Texaslady]

I have not been on the site for a few days, I think the last time I was visiting with you guys I was nearly in a all out battle with my OS over meds.finally I spoke with the PA I told him they needed to get this in order, I could not afford $87.00 every 5 days for pain medication. He talked to the OS next thing I know she had a prescription for 120 which is a pill every 6 hours. Which is ridiculous if you know what I mean I'm sure you guys from what I have read has had basically the same pain pattern as I have, it is now 3 weeks as of tomorrow pain will vary. Day to Day. Today has been absolutely awful the pain is coming about 2 1/2 to 4 hours. I keep doing everything that you guys suggest it seems I get much better information here. I am very grateful for this site and the people that share their experiences and hope. I read from here nearly everyday even when I am quite.
Ice,Elvate,rest and walk!

 

[BamaBelle]

@Texaslady, I'm having the same problem with getting pain meds! Last time I called my OS, his PA told me that I needed to cut back on pain meds ( I was taking 4/day of 5 mg Percocet)! I told her that I wasn't abusing the drug I was just trying to survive this hell I was going through! I still have pain throughout the day and the pain awakens me each morning. When I was so exhausted from lack of sleep, I asked my PA for some Ambien. It helped me to sleep for 5 hours! When I called for a refill (I was given 10 pills first script), I was told that I needed to stop taking Ambien because it was highly addictive! I'm so frustrated and so tired of being in pain!

 

[Texaslady]

To BamaBelle I understand how you feel I am like huge squeaking wheel when it comes to my care, I just don't give up. My surgery was the first of September and this OS has got in her head I guess that TKR people recover faster than they really do. I have my first post op. with her on 10-13 and I have full intention of having a talk with her. One of her nurse tried to give me a lesson over the phone on drug staturation rate of narcotics, I promptly informed her I have a degree in drugs and alcohol that did not need her opinion. I know some think I am a little raw but they have no right to assume I have no knowledge unless they have asked. She was being rude and curt. So like I said I like a huge squeaking wheel. I really hope everything works out for you soon. I can not hardly wait to get off all this stuff but right now I need it so the battle will probably go on. I hate to be treated like a drug addict, I don' drink, do drugs other than prescribed and I don't smoke so until the people that don't know me but treats me that way I will continue being that wheel.

 

[Texaslady]

Good Afternoon All,
Hope everyone is having a good day. I feel every time I post I am complaining about something,today is no different! I am really torn about something and I need you guys sage advice, I am now six weeks out of surgery
for the most of that time I have been going to PT at twice a week. In that time after therapy the day of my knee swells and hurts like crazy. Last week they forced my knee back while bending it, then they laid me on my back and forced my leg flat, I was nearly in tears. That was on a Wednesday that afternoon and the next day my knee swollen and bunches of pain. Today I was suppose to go e there at eleven but I called and lied told them I wa sick, I just couldn’t face it,could I not go to PT and do some less painful exercise and walk and recover on my on? oh yea my flex for bending is 103.

 

[SusieShoes]

Yes, you can blow off PT and do less painful exercising, of your choosing, and have a good recovery. Many people here don't do PT at all and do just fine. Some of us (let me raise my hand) go to PT but never do the home exercises they tell us to do. I also refused exercises at the facility if I thought or knew they would hurt. I never let my therapist force my knee because I was sure that would hurt. It's not necessary anyway. The only bend that matters is the one you can achieve using your own muscles.

Your bend is good for six weeks. It probably would be even better if your knee wasn't always swollen from aggressive exercises.

An exercise program of gentle bends and stretches (your knee might even tell you it likes these sometimes) and walking would get you just as far.

 

[Celle]

I am now six weeks out of surgery
for the most of that time I have been going to PT at twice a week. In that time after therapy the day of my knee swells and hurts like crazy. Last week they forced my knee back while bending it, then they laid me on my back and forced my leg flat, I was nearly in tears. That was on a Wednesday that afternoon and the next day my knee swollen and bunches of pain.

SusieShoes has given you good advice.
You can rehab your knee without going to PT (I did, and have great results) but if you do go, you must set the rules. It is your knee and you are in charge of what happens to it, so don't allow anything that hurts you, at the time, or later.

Remember this, from the BoneSmart advice we gave you?

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.

​

It sounds as if you have been allowing your PT therapists to hurt you and your knee is giving you a message that it doesn't like that. So say STOP to it.
Go back to PT by all means (when your knee has settled down) but you need to set the rules if you are going to continue going there. Say NO to any exercises that hurt, and tell your therapist "Hands off my knee". There is no need for them to touch your knee to help with bend or extension.
Saying no to therapy - am I allowed to?

Your therapist has probably been telling you that there is a limited time to get ROM. That's not true.
There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

 

[Texaslady]

Sorry I have not gotten back I have been busy not up but trying to catch up on reading on this site and reviewing some of the things that on here about TKR recovery, it seems I had not paid close enough attention I
guess! That is on me, just about everything that should not have been done to me at PT was. So this morning I have decided to let my knee recover in gentle kinder way. I fired my PT mainly because of the torture. I have ordered a recumbent bike to use here at . I figure I would start very slowly at first maybe 10 minutes in the morning and 10 in the afternoon see how that works. You guys are so much help. This morning when I told my PT I would not be back she started with all the no pain no gain, you will not heal properly so on and so on. Wish me luck.

 

[Celle]

Good luck!
I did no PT at all for my last TKR and only minimal PT for the previous one, and my knees recovered just fine.

 

[HMZebra]

I am up at 6 again, after getting up at 4 and taking Tylenol, and I wanted to reply just to empathize With your challenges re pain mgmt. (your thread prompted me to update my recovery thread so as to not fill up yours with my issues ).

Re physical therapy - I agree with others, that is inappropriate. If I were in your shoes I would try and find someone else, and barring that, do exercises on my own. I've been really lucky my PT is respectful of my pain levels.

Good luck to you - we are in your corner!!!

 

[kneeper]

I found that once I knew the exercises I could do them on my own just fine. And I was in control of how many and when. Loosening up on the bike is good. You don't have to do much at a time to get a good effect. Are you up to a full rotation or just rocking?

 

[sistersinhim]

I think starting with 10 minutes twice a day on the bike is way too much. Try about 5 minutes once a day and see how you do. If OK, then increase it just a little bit at a time. It is so easy to overdo and not know it until that night or the next day.

I, also, did no PT after any of my 11 knee surgeries. I have recovered just fine!

 

[Texaslady]

Thank you, I could full rotations when in PT but they had me doing 10 mins. Just warm up, after that it really got rough for example they had me do leg presses, and thing you set on and put you legs over cushioned round thing and press back that is just a couple but each one was either timed are 3 rounds of 10. It really got painful. That is why I decided it was to aggressive after an hour of all that My knee would swell and the backside of my knee also would swell for the next day and what was left of that day. I have read a lot on this forum to know that was not right. So I am doing things on my own,believe it are not my knee is already feeling better. I firmly believe the PT set me back. I wish I had done this from the beginning. My OS told me Friday I was not healing as fast so I have to her again in 6 weeks instead of 6 months.

 

[kmak81230]

Glad to hear that you are taking charge of your recovery. I think your knee will thank you for the PT break. Go slow and gentle on the bike -- it's great for stretching if you don't use any resistance. Once you heal up from all of the swelling you will get back on a good recovery track. Hand in there!

 

[Celle]

That is why I decided it was to aggressive after an hour of all that My knee would swell and the backside of my knee also would swell for the next day and what was left of that day. I have read a lot on this forum to know that was not right. So I am doing things on my own,believe it are not my knee is already feeling better. I firmly believe the PT set me back. I wish I had done this from the beginning. My OS told me Friday I was not healing as fast so I have to her again in 6 weeks instead of 6 months.

I'm glad your knee is starting to feel better on the easier regime.

Try not to worry about what the OS said. Your knee is healing on its own schedule, not on her schedule. As long as it's making progress, it is doing OK.

So, be a tortoise if you have to - remember that the tortoise won the race with the hare.

 

[Texaslady]

You guys are great! Here it is 4:00 a.m I woke up at 3:30 in a great deal of pain now I am in my recliner with leg elevated and iced oh well chicken one day feathers te next. Yesterday I slept till 5:00 a.m which is late and the first time since surgery I went to bed at normal hour and slept through for more than 3 hours. Yesterday was a good day, boy this morning is a hum dinger. The first thing after getting set with my ice and stuff this is the first thing I grab my iPad and come to this forum. It really helps. I know this will get better. Slow and easy is all I know darn do. Anyway our guys get my day going. Thanks

 

[kneeper]

Say no to the leg presses--way too strenuous at this stage.

 

[sistersinhim]

What was your OS referring to when he said you weren't healing fast enough? Is it your incision or just the ROM she's concerned with?

 

[Texaslady]

@sistersinhim I have a lot of pain yet, my incision looks great and my motion seems to be okay. I think what has happened was out of stupity on my part, I let PT man handle me for two sessions. I am at 6 weeks an started going to PT the second week after surgery they started out pretty aggressive but nothing like the last week I went, they hurt me every time I went should have listened to you guys. I was not getting better at all. Ever time I went for those 4 weeks 3 days out of every week My knee would swell and get stiff,then the grand final 5he last week they forced by leg all the way back to my thigh and then pressed my leg down I really thought I was going to scream. So think it. As set m back,my husband just was rubbing the back of my knee it was hurting so bad.
I think it is just going to take me taking care of myself.