TKR Pain meds not working

[ouchie!]

Do you have a non emergency number you can call for advice that isnt 911? We have 111 here in the UK which is open 24/7 and they were the ones who sent me to the emergency room after increased pain and swelling which turned out to be a hematoma (internal bleed) and I was back in hospital for 4 days. It dispersed as they said it would and I’m fine now. I’m no expert but I think you need to be checked out in case of infection?

 

[1ethal]

Agreed. I’m going to follow up today. Thank you!

 

[Layla]

Good Morning,
I hope you slept well last night and you're able to talk to a member of your surgeon's care team this morning.
It can be hard to tell if you have a fever just by guessing. Possibly your body gives the same signals each time you run a fever so you're feeling fairly confident that you are feverish. Consider having a thermometer on hand as its really helpful to have an exact number, so you know whether it's a low grade fever, or serious. Now is a great time to get one with cold / flu...creeping crud season upon us. I hope you have a good day!
Let us know what you hear from your OS's office.
@1ethal

 

[1ethal]

Man! Good thing for this thread. I feel like this has been more helpful than my doctor. I called at 4 am and spoke to the on call doctor. My surgeon called just now. They are calling in an antibiotic and a new pain pill. If that doesn’t get things moving in the right direction by the week then they want me in the office. All offices are closed for the holiday today. Sending wifey to get a thermometer to get an actual reading as well. Dr said they had to do a little extra cutting on me to remove all the osteocytes and arthritic bone growth. Hopefully this helps.

Once again, thank you to everyone for all the help. It’s very reassuring to have a conversation lace to ask questions. I feel like this website should be referred to patients as a part of the surgical process. It’s really helpful. Thank you so much and hopefully I’ll have good news soon.

 

[Layla]

Good Morning!
Such kind and thoughtful words in regard to the forum. It is appreciated, we thank you!
I'm glad you spoke with someone and have a plan in place. It feels good to be proactive, at least I felt that way in those early days / weeks. Hopefully you're feeling like a new person in a few days. No fever, manageable pain.
Dedicate time to the icing, it does help and know that we're always here, lights never go out, so feel free to stop by anytime, day or night. Hope today is a good one!
@1ethal

 

[ouchie!]

It’s a wonderful forum that has helped me no end and everyone is so kind. The advice on here has helped me so much mentally as well as physically and I know when I have the other knee done I will be well armed and ready! So glad 1ethal that you reached out to the on call doctor and got some help. Doesn’t that make you feel powerful? Well done and hope your new meds provide some relief.

 

[1ethal]

It’s been a couple days. This post is probably more therapeutic than anything.

i did get my doctor to change my meds from hydrocodone/acetaminophen to oxycodone/acetaminophen. The pharmacy wouldn’t fill it and said I’m taking too much Tylenol. My doctor call them and they agreed to fill 20 pills no more. I’ve been taking the pills as ordered by my dr but for some reason now it’s a problem. Pain is still out of control because I don’t have enough pills to take and I’m having to ration them out.

I went to the er yesterday, pain was out of control, I had a fever. After all tests, no blood clots, no infections, Dr said my body was shutting down due to the pain response. They gave me morphine to help me stabilize. He prescribed me an nsaid and omeprazole. I had gastric bypass a few years ago and lost 240 lbs, but gastric patients can’t take NSAIDs because they are hard on the belly. We are trying that, along with a 5 mg oxycodone/acetaminophen in the am and one in the pm. So far today, not working well. Fever is coming back, body temp is up and down, I’m sweating and freezing cold at the same time?? I can’t get comfortable and can’t sleep. I have no idea what is going on. My doctor is out of town and I’m going to see a covering Dr tomorrow. I just don’t understand how to function? I’m in so much pain I can’t sit or lay still.

 

[sistersinhim]

I am so sorry to read about your severe pain. Are you icing and elevating, too, while taking your pain meds. We have found that ice is a great pain reducer. I iced the whole time I was sitting or laying down for the first couple of months. As long as you have a cloth between you and your leg, you won't over-ice. Please let us know what you find out from your doctor tomorrow.

 

[1ethal]

Yes I got one of those ice machines that pumps the cold water onto the knee. Absolutely wonderful. The only issue has been with my weird body temperature issues when I’m freezing I have to stop icing because I start shivering so much it’s painful. I use heating pad on hips and back to try and heat up at the same time but the shivering takes over and that becomes painful.

 

[KJ24]

Thank you! Obviously, it was tearing me up. I just don’t understand how there can be so many differences in what to do? I’ve cut back and only bending it when I can and walking every couple it’s calming down and pain is becoming more manageable.

Another question, how long is one suspected to be taking pain meds? I’m currently 8 days out and my doctor seems to wonder why I’m asking for refills??

I’m at nine weeks, I took opioids for the three and a half weeks. My doctor also prescribed Celecoxib for inflammation and I am still on that once a day. The first few weeks work on pain control because it is a bear. It is the most painful surgery I have had in my life.

 

[EalingGran]

I am so sorry you are in such pain. Really glad you went to the ER to check for infection though. I have a congenital kidney issue which makes me prone to infections and I can get those shivering fits when I have one. So good that you had tests for that. Good luck checking in with your surgeon.

 

[Layla]

Glad you stopped by to update. We're all ears, all the time, so feel free to use as as a sounding board and know that we're here...always.
I am sorry your pain was so severe it landed you in the ER. That is awful.
Some do experience a low grade fever (less than 105F) in the early days following surgery as a normal response by the body to the stress of surgery. It is most often caused by inflammatory response to the tissue injury sustained during surgery. It is good you're contacting your physicians colleague for follow up today. I wish you the best for the appointment. Let us know how it goes.

Know that you're not alone in your aversion to ice / icing.
Wondering if a thicker barrier will work? Like a thicker towel between your skin and the ice source. Or maybe shorter sessions of icing? If you want to completely avoid ICE, but miss the positive benefits, what about a cool damp cloth, which won't be as cold, but may still help reduce swelling. Your comfort and safety are a priority so you may have to experiment a bit to see what works best for you. Talk to the OS about this today.
I hope you begin feeling better this week!
@1ethal

 

[WFD]

Fever is coming back, body temp is up and down, I’m sweating and freezing cold at the same time??

This happened to me while recovering from one of my surgeries. I had been bitten by a tick a few weeks before so I went to my doctor to get tested for Lyme disease. She also tested me for mono, and that is what I had. My youngest son apparently brought it home from school, or else I had had it asymptomatically years before and it reappeared due to stress and exhaustion from the surgery.

Did the doctors you saw consider something like this?

 

[sistersinhim]

The only issue has been with my weird body temperature issues when I’m freezing I have to stop icing because I start shivering so much it’s painful.

I had my TKR in June, and it was in the 90s outside, but I still froze inside while icing. Someone on Bonesmart wrote that they had been using a heated throw to help, so I bought one. It worked well, and I was able to ice and have a heated throw in me at the same time. You might give it a try.

 

[1ethal]

Since I went to the er things have been much better. They put me on an nsaid along with Tylenol. I still have a few oxycodone leftover but haven’t been using them as much. Originally, my doctor did not put me on an NSAIDs because I’m also a gastric bypass patient and those can be hard on our belly’s. This we Dr prescribed me omeperazole to go along with it so it won’t hurt my stomach. So I’m getting some pain relief from it as well as anti inflammation, which I wasn’t getting at all before. This has made a world of difference. Finally feel like I’ve turned the corner.

 

[benne68]

Glad to read that your pain is better controlled, @1ethal. I have issues taking NSAIDs too and was advised to always eat something 15-20 minutes before taking them. It definitely made them easier to tolerate.

 

[1ethal]

Tomorrow will be 3 weeks out. Rom is only 58 degrees. My physical therapist is concerned and thinks inpatient therapy would be beneficial. I asked my doctor if I should be concerned annd if inpatient treatment would be helpful and his response via email said, “work hard at outpatient pt.”

I’m currently doing in home physical therapy because I can’t drive yet due to poor rom and my wife has had to take off so much work helping me out. My doctor always seems bothered if I ask him a question and he has really been awful. My recovery has been full of issues that have stemmed from his poor treatment. Stopped prescribing me pain meds week 2, didn’t get pt started until week 3 because he went out of town after my surgery and now he doesnt seem to care about my lack of rom. Should I be concerned?

This forum has been much more helpful than my surgeon!

 

[Jockette]

Tomorrow will be 3 weeks out. Rom is only 58 degrees.

Should I be concerned?

No need to be concerned. You are very early in this year long recovery. Your ROM will improve as your swelling goes down and as you heal.

There is NO Window of Opportunity. My ROM continued to improve even all through my second year.

“work hard at outpatient pt.”

Doing this will keep your knee inflamed and swollen. Instead, spend more time icing and elevating, to help reduce the swelling. Gentle bends for mobility and short walks will give you all the healing movements you need at this early time.

 

[Jockette]

Regaining our ROM does not require forceful bending or painful exercises. That is counterproductive.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.

Lose the Work Ethic While You Are Recovering!

Lose the Work Ethic!!! Article by Referee54 (Tim) Many of us have a tremendous work ethic---and for several reasons. I can still remember, to this day, my father saying to me on the morning of my first day on a “real job”, “Give them nine hours of work in an eight hour day.” I believe that...

bonesmart.org

 

[1ethal]

Wow. Thank you to both of you. This is so opposite of what doctors and physical therapists are saying??? It really seems to make sense though. The body heals itself and everyone heals differently. I’m a cyclist so not being able to get my rom back would be devastating for me! This process is like having a baby. There’s no handbook for it and you have to learn as you go. Thank goodness for others who have been through the process. Def helps ease the anxiety.