TKR Now post-op, surgery on Feb 25, 2020 USA

[Jamie]

Tramadol is a great step-down medication from oxycodone. It isn't as strong, but it works well for many people. You can take 1000mg of Tylenol with it for an extra boost. Just be sure you don't go over the 4000mg for acetaminophen (the active ingredient in Tylenol) in any 24 hour period. Acetaminophen is in an awful lot of over the counter cold and sinus medications as well as some prescription pain meds.

Are you just taking it at night then to help with sleep? None during the day? How is your daytime pain?

 

[TrixieRuby]

@Jamie I just got a script for Tramadol, and so far I have been taking it at night as it has a longer half life than Oxycodon. Right now I have both medications! Last night I took one tramadol and a benydryl at 10:15 pm, and slept well until 4 am. I then took one oxy and two ibuprofen, and slept until 7 am, and just now at 8:15 am took an oxy with two ibuprofen. I have not been trying to taper off, but I think I will try to do so this coming week as my three week post op date is Tuesday and I am psychologically ready to drive and do more. I had such a bad start to this whole thing the first week, but I am doing better now, and my goal is to be as pain free as possible. I am icing 5 x a day or so, just iced this am, and exercising very modestly.

 

[sistersinhim]

I iced and elevated the whole time I was sitting or laying down for the first few months. This helped to keep the swelling and pain down. You can't over-ice as long as you have a thin cloth between your skin and the ice pack. I had a ice machine that circulated ice cold water around my knee. It was heaven!

 

[Jamie]

If you want to try tapering, you can substitute the Tramadol for the Oxycodone doses. Tramadol is not in the same class as Oxycodone and usually doctors aren't as concerned about you being on it for a while after surgery when it's needed.

 

[TrixieRuby]

Good morning! I woke up today with a lot of pain in my knee, particularly on the outside of the knee. My husband brought me a cup of coffee and an ice pack, both essentials at 7:15 am while in pain. My mood is low, and I suspect it is because I took a benadryl last night, and it is lingering and making me feel blah. Yesterday I did two at home PT sessions, about 5 exercises focussing on extension and flexion, and I made a moderate effort. No pain beyond discomfort! Maybe that is why my knee hurts this am. @Jamie I will try the tramadol during the day and see how that goes. The oxy has such a short half life--maybe the tramadol will be better. On a positive note, it is sunny and bright outside, and while we are all on 'lockdown" in the USA, a friend or two is coming by and we have distance visits--works for now!

 

[sistersinhim]

Yesterday I did two at home PT sessions, about 5 exercises focussing on extension and flexion, and I made a moderate effort. No pain beyond discomfort! Maybe that is why my knee hurts this am.

Yes, that is more than likely the cause of your pain. What you did in one day should have been spread out over every two or three days. It's best to do just one exercise, then wait and see how your knee reacts. As many of us have said, you don't even have to do any exercises, just use your knee in your daily living.

 

[kneeper]

I'm glad your pain is being managed well. To be safe, I wouldn't drive while taking tramadol.

 

[Rubyroo]

Sounds like you are coming along pretty good TrixieRuby. You have a good attitude and that is also a blessing. You'll have your ups and your downs along the journey but that is what we are here for to help one another along the way. Your picture of your doggie that goes with your name is adorable. Is it your doggie?

 

[TrixieRuby]

Hi everyone--I am three weeks out from surgery as of today. I had PT yesterday, and today I am so so so sore and my knee is swollen. I don't think I did too much, but instead, as I was learning about the bike, I spun the pedals with my good knee, and omg, the pain in my surgical knee exploded. I almost couldn't breathe. So, today I am resting and icing, but it hurts, and my flexion and extension are worse today. Also, I am trying to decrease my meds, but today I need them. And I heard that NSAIDS inhibit healing as they decrease prostaglandins. I have been taking ibuprofen, so any thougths about this? I am hoping that tomorrow will be a better day. Progress seems to go both forward and back, and sometimes this is just discouraging. @Jamie @sistersinhim

 

[TrixieRuby]

Oh! one more thing: I LOVE my evening tub baths. I cannot really take them right now, but I have improvised a way to do this. I wrap my surgical knee with plastic wrap thoroughly, and then I take a bath and put my knee/calf up on a foot stool that I place in the tub. Warm water covers most of my thigh, and the back of my knee and calf, and the heel of my foot. I luxuriate and relax, and feel eased from discomfort and stress, at least for a while. BUT is this a bad idea? Does it contribute toward swelling in my knee? When I get out and dry off, my knee is 100% dry (the incision) and I feel better, but I wonder if this is setting me back. Thanks!

 

[TrixieRuby]

Oh! one more thing: I LOVE my evening tub baths. I cannot really take them right now, but I have improvised a way to do this. I wrap my surgical knee with plastic wrap thoroughly, and then I take a bath and put my knee/calf up on a foot stool that I place in the tub. Warm water covers most of my thigh, and the back of my knee and calf, and the heel of my foot. I luxuriate and relax, and feel eased from discomfort and stress, at least for a while. BUT is this a bad idea? Does it contribute toward swelling in my knee? When I get out and dry off, my knee is 100% dry (the incision) and I feel better, but I wonder if this is setting me back. Thanks!

@sistersinhim @Jamie Just reposting as I have not heard back as to my concerns about my baths....Thanks!

 

[sistersinhim]

I moved your last 3 posts from Markbet's thread. You need to keep your questions here so you'll know where to find them and so you won't hijack anyone else's thread.

Warm water covers most of my thigh, and the back of my knee and calf, and the heel of my foot. I luxuriate and relax, and feel eased from discomfort and stress, at least for a while. BUT is this a bad idea? Does it contribute toward swelling in my knee?

Yes, warmth causes swelling. You are so soon out of your surgery, it's not a good idea to take the chance of your slipping any opened areas under the water and risking getting an infection.

 

[Jamie]

I must agree that it's not a good idea to do soaking baths until you are cleared to do so by your surgeon. In addition to the warmth potentially increasing the chance of additional swelling, you really don't want to risk getting the incision submerged in water....even for a brief time. Your bath water is much less hygienic than what a shower would be. Sorry to have to cancel out something you enjoy, but it's only temporary. Please stick to showers for a while longer.

 

[TrixieRuby]

Hello everyone! I am wondering if any of you have used the gap-flex gravity device post TKR surgery. Here is a link to the device: gap-flex. Leaving aside the $400 device, I like the idea of using gravity to help with flexion. The heel slides, stair stretch, and baby squats are so painful for me. Just draping my leg off the side of the bed, or creating more angle with a pillow under my butt and my leg draping seems so much more doable and gentle--just let it drape and rest for a few moments. What do you think?

 

[Pumpkin]

I used to lie on my back and bring my hip up and let my leg dangle. You could also support your leg draping it over pillows or the side of the bed as you are doing.

 

[Celle]

Hello everyone! I am wondering if any of you have used the gap-flex gravity device post TKR surgery. Here is a link to the device: gap-flex. Leaving aside the $400 device, I like the idea of using gravity to help with flexion.

You don't need that device. As your knee heals and its swelling goes down, it will start to bend more easily anyway.

 

[Jamie]

Any discomfort you are currently feeling when you are attempting heel slides, stair stretches or baby squats will be felt when you use this device. It's the swelling you have in your knee and its inability to bend very far at this time that's causing your pain. It will still be there with a gravity device like this as well. In fact it could even be even more uncomfortable because you have lost your own ability to control the movement since your leg is just draped over the device.

This device is a passive effort to gain ROM. It's much better for you if you are actively using your own muscles for movement. At $400, it seems very overpriced.

I suggest you continue with what you're currently doing for gentle exercises, but stop pushing so hard that you are in pain. Mild discomfort should not be painful. You are less than a month out of surgery and you have plenty of time to get the swelling down and get your range of motion.

 

[Sara61]

Take a deep breath and relax we are all so much in a hurry to get back to normal and the harder we push ourselves the slower it will be - your knee will heal itself in its own time, once swelling goes down the tight band feeling will ease off and you will one day realize you haven't given any thought to your knee - but keep pushing it and all you are doing is prolonging that day.
Instead of wasting money on something you will use a couple of times - treat yourself to something nice instead xx

 

[TrixieRuby]

I am crying as I read your replies, as I have been so discouraged and so anxious as to my negative progress (my ROM is going down...) and your kind encouragement. I love our reply @Sara61 to treat myself to something nice instead of buying this overpriced device.

Maybe I will take a day or two off from doing any exercises, and just ice, elevate, and rest, and how it goes. Sometimes this is just so hard, and I start worry that I will never have the ROM that will allow me to do yoga (modified even) and sit normally, and be myself. Right now I just feel that I have lost so much, and the future is hard to believe in. xoxo

 

[LD of Michigan]

I would not purchase such a pricey gadget! Start/ continue where you are (heel slides, leg off side of bed, angles and leg draping, etc.). Those are options that improve over time as pain levels recede. I recall this silly metal/ plastic ($80+) floor heel-slide device I considered buying. I didn't.

I found I could do the same foot-slides upon a plastic bag on the floor! Many pricey items are unnecessary. Your bodies natural gravity from everyday basic activities (even those done in bed) are better - more incremental to the paced healing/ recovery usually associated with TKR's.

This is an emotional surgery and emotional times. Rest, and ice. That will help with the swelling.

....$400 device, I like the idea of using gravity to help with flexion. The heel slides, stair stretch, and baby squats are so painful for me. Just draping my leg off the side of the bed, or creating more angle with a pillow under my butt and my leg draping seems so much more doable and gentle--just let it drape and rest for a few moments....