PKR Pain Meds

[Lsilva]

Hello all. I had my first pkr on my left knee in July 2020 and just had pkr on my right knee on November 30th. My left knee is still healing but strong enough to get the right one done. Of course, like before, I’m in excruciating pain post op. The doc has me taking 1 Percocet every six hours with Motrin in between. Has this been your experience with the meds? Is it possible to get something stronger? Also, when I had my left knee done in July he had me wear the immobilizer for only 2 days, this time he says to wear it for a week. I was so out of it when I left the hospital that I didn’t ask about that. I do hope everyone is healing well out there!! Wishing you all the best for the holiday season.

 

[Sun catcher]

I would call your Doctor and tell him you are in excruciating pain. Do not hold back. I had my right TKR On November 9. I hear you about the pain. It will get better. Meanwhile can you take extra strength Tylenol? Percocet has Tylenol in it so you can take one with it. I had oxycodone (Percocet without Tylenol) and Tramadol 50mg. I took oxycodone 5 mg every 6 hours alternating with tramadol 50 mg so every three hours I was taking something. I took ES Tylenol three times a day. I also am taking Celebrex 200 mg daily. If your doctor is letting you take Motrin you should be able to get Celebrex which is a stronger anti-inflammatory. Just make sure you are taking all with food to protect your stomach and something to keep things moving. I also found near constant icing and elevating helped. I feel your pain and hope you have a better day. I also found it helpful to listen to the experts on here about not doing too much, I am not a person that sits but I felt reading the advice on hear gave me such reassurance. You can always clarify about the immobilizer when you call the Doc, good luck!

 

[sistersinhim]

@Lsilva, would you like to keep this new thread about your last surgery or would you like it combined with your old thread?

I agree you should call your doctor and let him know how much pain you are in. There are meds that will help you and there's no need to be in so much pain.

The following are our basic guidelines and should help get you started. As you read more on other members' recovery threads, you’ll get a better perspective of what to expect and what not to do, especially regarding PT.

Knee Recovery: The Guidelines

1. Don’t worry: 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

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

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.

 

[StandTall]

I had TKR Oct 8 and know how hard it is to have severe pain. I hope you find a solution soon. Talking to your doctor and following their recommendations is a good start. Be very careful adding OTC meds like Tylenol (acetimeniphen). The maximum daily dose used to be 4000 mg, but now their saying 3000 mg max. Check with your doc. Calculate the mg of acetimeniphen in the percocet together with any additional Tylenol you take so as not to exceed the maximum. I took 3000 mg Tylenol daily from day 1 as instructed, and a week later had liver damage (with a healthy liver prior).

 

[Jamie]

Hi, @Lsilva .... so sorry to hear you are having problems with pain. I'd like to comment on some of the posts made in your thread:

Meanwhile can you take extra strength Tylenol? Percocet has Tylenol in it so you can take one with it.

Be very careful adding OTC meds like Tylenol (acetimeniphen). The maximum daily dose used to be 4000 mg, but now their saying 3000 mg max. Check with your doc. Calculate the mg of acetimeniphen in the percocet together with any additional Tylenol you take so as not to exceed the maximum.

It is possible to add Tylenol to your prescription pain medications, but as StandTall indicated, you must be very careful to count everything you might take in the daily total. When you're in recovery, it's never a good idea to self-medicate with anything - even over the counter medications that may seem harmless. You always want to coordinate everything with your surgeon or your GP because there can be interactions with over the counter medications or even herbal products.

That said, there is nothing at all wrong with calling your doctor to let him know you are having high levels of pain. Ask specifically about adding some Tylenol on a schedule. When you're having your conversation, it will help to attach a number to the pain from the 1 to 10 pain scale, be able to detail when the pain comes and describe what things you do that make it better. The maximum dosage for acetaminophen in any 24 hour period is, and always has been 4,000mg. The 3,000mg dose that is publicized now is mostly a US recommendation because our government felt Americans might not count all sources of acetaminophen that they might be taking. Taking more than the recommended 4,000mg per day or taking individual doses above the 1000mg level can put you at risk for liver damage.

I took 3000 mg Tylenol daily from day 1 as instructed, and a week later had liver damage (with a healthy liver prior).

While it's impossible for me to comment about a damaged liver in just one week from taking normal levels of Tylenol except to say I'm so sorry this happened, it is important for our BoneSmarties to know this would be an extremely rare thing to happen. Tylenol is a very effective pain medication when taken as directed and used with the approval of your surgeon or GP.

As I mentioned above, there are many drugs and herbal products that can cause issues for some people who take "normal" doses of acetaminophen over a short period of time. Some may have liver issues they aren't aware of. One thing in particular that presents a risk with acetaminophen is consuming alcohol while taking it. Since both are processed through the liver, this combination can cause problems and it's why the Tylenol bottles all warn about drinking any alcohol when taking the medication. But people should not feel there is a significant danger to your liver when taking Tylenol properly under your doctor's care.