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[TKR] Painful Recovery So Far

kneeper

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Yeah, I'd skip that step up backwards one. My PT had me try that one too. I didn't do it at home. I think they give us some of these before we're ready for them.

I can tell you virtually no one is happy with their tkr at 7-8 weeks because it seems like the recovery will never end. But as you're learning, recovery is a bit of a trial and error process--how much activity or exercise is too much? It takes a lot of listening to your body. Testing your limits but also not being afraid to back off when you need to.
Sometimes I'd try something and had to say to myself "not quite yet" or "that's enough for today." That didn't mean I wouldn't try again the next day or a few days later and so on.

Try to ice on your breaks at work. Every little bit helps.
 

Sybilla

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Hi DOC - I'm new here on week 23 of a right TKR (surgery date 4/30/19) and it was your headline that caught me - PAIN has been my near-constant companion starting with a constant, traumatic level as soon as the block wore off (at home). BTW I saw your photo and we have the same leg physique even though I'm female - bowed legs, but with one straight one to go with the scar. And like you my original knee is round (and swollen) while the surgery knee is long and flat.

My pain experience was traumatic because my doc believed in "taper from day 1" for Oxy, so I got 40 (5mg) pills to ration for the week, plus Tylenol (which is a joke that early, unless it's on top of opioids). They used Dilaudid in the hospital (plus I had the block) and then discharged me day 2 with a fictitious "pain under control with oral meds". What I had in the hospital was good function with Dilaudid and the block (stairs, bathroom, etc.) and I wanted to return home because what did I know? I'm detailing this saga to drive my point home: pain begets more pain, and once it is entrenched, it can be EXTREMELY difficult to banish.

I share your frustration with the opposing messages of "it has to hurt to rehab effectively" vs. "if it hurts don't do it because you'll only make it worse". I am still in PT twice a week after almost 6 months, but I now have a responsible PT who is very diligent about stopping short of "seeing stars" (which in my case is "interrupts my concentration so much that I can't keep talking"). Home PT was a DISASTER and I believe this (plus the lack of pain management initially) is what got me where I am now (and my PT is in agreement).

So listen to the smart folks on this board, and do NOT do anything that hurts "too much". You know the difference between a "productive" stretch and a "painful" stretch? That is where you need to be - in the "sweet spot" of knowing you're doing something, without inducing pain (trauma) to tissues that need to heal (and will for quite a while to come). The only exceptions I make for pain are stairs: foot over foot hurts a lot without the railing going down, but it is important enough to me that I keep trying.

If like me you've had terrible spasms (thigh and calf) post-op, you might find some relief with massage, your own or from the PT or using a (soft) roller. I came to this remedy late (3 months?), and it seemed to really help me turn a corner. Like you I returned to work too early (end of week 5), which also contributed to my issues I'm sure, and I can completely relate to feeling like you would NEVER do this again. My thinking at this point is "be sure and use a different surgeon" but if I'm still unhappy after a full year, I'll have to rethink that too.

Hang in there and it will get better. I have ROM at 115, but only got the recent 15 in the past month or so, so whatever you've heard about time limits is garbage. I can finally sleep well and know exactly what you mean about heading to bed b/c it's the only place you can find relief. The constant, no-relief pain WILL subside, but perhaps so slowly you won't appreciate it. Here's hoping yours disappears faster than mine!

Sybilla
Right TKR 4/30/2019
bone-on-bone left knee up next
 
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DOCCUKE

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Hi Sybilla
I am back to working from home as of yesterday. Fortunately my manager actually gives a dam about my health. On a conference call Thursday he asked how I was doing & I told him not great. He immediately said go home!! He told me to work from home as long as necessary! So I am very fortunate in that regard.

I also had stopped my Tylenol because I had an issue passing blood when I had a BM. I have that under control now so I am back on 2 X 500 mg Tylenol every 8 hours. That and working from home seems to be helping..

Still not inclined to let anyone touch my right leg as long as I can walk & have to work. But at a minimum I need to get this one working before anything else. Still very unhappy & not at all convinced I chose the right place to get this done. If I ever do get my right knee done it will probably be a surgeon in Boston & not the guy that did this knee in NH

Anyhow, thanks for your post, & best of luck to you in your recovery! Please keep me updated on your progress & I will do the same here!

Have a great evening
DOC
 
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DOCCUKE

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Just a quick update. Wednesday was 9 weeks since my TKR. Still regret it, still believe it is one of the worst decisions I ever made, still in far more pain then I was before!
The medical business is just that a business!!

Excuse my rant, bad aggravating day
Have a great evening all

DOC
 

Jockette

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I’m sorry your having a bad day. I do hope in time you will end up happy with your knee.
Still regret it, still believe it is one of the worst decisions I ever made, still in far more pain then I was before!
I’m 2.5 years post op and I have to say, I feel the same way about my partial. I no longer have the pain I had in early recovery, but I still have a lot of discomfort and more limitations now than I did before the surgery.

However, I do still continue to see improvements, even this far from my surgery date. I hope that you will, too.

9 weeks is early days. Try to believe that where you are now is not where you will end up. You are still experiencing the surgical pain. It should diminish over time. But you do need to help that along by resting, icing and elevating as much as you can. I know you had to go back to work, but you really have to find time when you’re not at work to invest in your recovery.

Can you elevate your legs overnight while you sleep? I still do that.

Are you taking any pain relievers? At 9 weeks I was not taking any prescription pain medication. Instead, I was alternating Tylenol and ibuprofen. I took 1000 mg of Tylenol every 6 hours, which means I also took a dose during the night, for a total of 4 doses in a 24 hour period.

My doctor said I could also take ibuprofen, so I took 800 mg of that every 6 hours. By alternating those two medications, I was taking a pain reliever every 3 hours, and yes I had to keep track in a little notebook.

For example, I’d take Tylenol at 6 am, ibuprofen at 9 am, Tylenol at noon, ibuprofen at 3 pm, etc. Each medication itself was 6 hours apart. I didn’t set an alarm for the middle of the night dose, I took it whenever I woke up, as long as it was at least 6 hours from the previous one. Then I’d start the 6 hour spacing from that time. (So it varried a little from day to day, depending on what time I happened to wake up during the night.

I made sure I didn’t take more than a total of 4000 mg of Tylenol in a 24 hour period, as that is the safe daily limit. If I took any other medication that had Tylenol in it, like some cold medicines, for example, I would adjust my Tylenol dose.

This combination worked very well for me. Actually I was surprised it did, as Tylenol had never done much for me before. But keeping this amount in my system regularly really did help me a lot. I wasn’t pain free, but I was better.

Come here and vent any time you want. We’ll be here for you.
 
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DOCCUKE

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Hi Jockette
Yes I take extra strength Tylenol, 2 X 500 mg every 8 hours. I was told 3000 mg max per 24 hours. I have prescription 800 mg ibuprofen for my shoulder but for some reason my doctor specifically did not want me to use ibuprofen for my knee

It seems that trying to work for a living & do everything I need to fo for this knee requires more hours than I have in a day! I really don't think getting this surgery is a good plan for anyone that has to work, which honestly is most folks!

Today my disgust & anger with my knee was trumped! I am far more concerned with my wife's issue!

She had a needle biopsy on a lump on her throat the other day. What came back from that was potentially very bad!!

It may be an aggressive form of thyroid cancer called Hurthle cell cancer

If it is Hurthle cell cancer & they get it before it spreads to the lymph nodes there is a 75% survival rate beyond 10 years

It will be a couple of weeks before we get results from the dna tests they are doing

If it is that, & it got to her lymph nodes the survival rate drops

There is still a possibility it will be benign, which we are of course hoping & praying for!

So all of a sudden, my knee pain is of much less concern for me!!

I have had enough of this day!

Hope you all are pain free

DOC
 
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luvcats

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How frightening and stressful when you're already dealing with your knee. I hope the biopsy comes back favorable and they don't take too long.
 

Jockette

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I’m so sorry to hear about your wife.

And as if going to work with a new knee isn’t hard enough, I found emotional stress made my knee feel worse.

I took the 4000 of Tylenol because I wasn’t taking any other medication that had Tylenol in it. The reason they are now saying 3000 is in case people don’t know to check their other medications for it.

Interesting how different doctors’ opinions vary. Mine was fine with including ibuprofen. It did wonders for my arthritis in my other knee, spine and neck. I took it more for that reason.
 

kneeper

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Hi Jockette
Yes I take extra strength Tylenol, 2 500 mg every 8 hours. I was told 3000 mg max per 24 hours. I have prescription 800 mg ibuprofen for my shoulder but for some reason my doctor specifically did not want me to use ibuprofen for my knee
You really shouldn't take more than 1,000 mg in a dose. I think you'd do better taking 1,000 mg 3 times a day. The tylenol only works for about 5-6 hours. I take tylenol along those lines (for my shoulder and other issues. I can't take NSAIDs) and it keeps the pain well controlled most of the time.

Wishing the best for your wife.
 
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DOCCUKE

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Hi Kneeper
Yes , like I said, taking 1000 mg 3 times a day. Does help somewhat

Thanks, I am hoping & praying for my wife!!
 

Jamie

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@DOCCUKE .... I am so sorry to hear about your wife. I hope you receive the best news possible and that she can get treatment going right away, if needed. Of course, hearing it's benign would be THE BEST!

I think Kneeper must have misread your post. I almost did the same thing because when the 2 500mg is so close together, it can look like 2500mg.

Years ago the FDA decided they couldn't trust Americans to count up all the Acetaminophen they were taking in various products. It's added to a TON of over-the-counter medications for everything from pain to sinus problems. So, they dropped the recommended dosage guidelines that manufacturers had to put on products like Tylenol from 4,000mg to 3.000 in a 24 hour period. The rest of the world is still at 4,000mg per day. You can do that safely as well, as long as you are counting every other medication you're taking with acetaminophen in it. Just read the labels and you'll be fine.
 

kneeper

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Hi Kneeper
Yes , like I said, taking 1000 mg 3 times a day. Does help somewhat

Thanks, I am hoping & praying for my wife!!
Oh, I see. I misread your post.
 
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DOCCUKE

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Hi Kneeper
Yea I figured, I should have spaced that better. Yikes 2500 mg 3 times a day would be a bit much!! Lol

Have a great evening
 
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DOCCUKE

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Good evening
Today's knee fun!! Went to PT and as the young lady was doing a deep tissue massage on my knee she noticed a small scab on my incision that began to leak blood & pus!

I saw my surgeon's PA and he found it was just a stitch that did not dissolve. He squeezed it out along with the pus, cleaned it up & put a bandaid on it

He suggested I back off PT for a while when I described the pain I am still having in my knee. He felt that at 10 weeks stairs should not be bad by now. My right knee which is completely bone on bone hurts far less then my surgical knee

I get 130 degrees ROM & straightening it I get to 2 degrees. He doesn't believe I will lose anything by not doing PT

I have no idea at this point. I will try no specific knee PT, continue to walk my dog & use the recumbent bike

Have I mentioned I really wish I had not done this?? :)

Hope you all have a pain free evening

DOC
 

Celle

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I think Kneeper must have misread your post. I almost did the same thing because when the 2 500mg is so close together, it can look like 2500mg.
I've edited a couple of posts, so that the dose taken is written like this: "2 X 500 mg". That way, there's less chance of confusion.
 
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DOCCUKE

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[/QUOTE]
I've edited a couple of posts, so that the e fosadose taken is written like this: "2 X 500 mg". That way, there's less chance of confusion.
[/QUOTE]

Yes that is definitely a clearer way to communicate the dosage. Thanks
 

Jockette

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I get 130 degrees ROM & straightening it I get to 2 degrees. He doesn't believe I will lose anything by not doing PT
Very often when a person is back to work they are getting plenty of natural exercise for their new knee. So, listen to your PA.

Your numbers are great, now it will just be continued healing to have the function that matches that number. Stairs can take a while. Going up comfortably usually happens first, going down sometimes much longer.

Walking your dog is very good for your knee, just don’t walk for miles yet. Generally how long, timewise, do you walk him/her?

The recumbent bike is also good, but keep the sessions short. 10 minutes or less, at this stage of your recovery.

Having the stitch issue you had is common. I bet it scared you, though.

Many members at your stage still regret doing this surgery and as they heal they change their mind. I hope that happens for you. You are still in the early part of recovery. Where you are now is not where you will end up.
 
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DOCCUKE

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Hi Jockette

I hope it improves, because I am very discouraged at the moment.

Yes when I thought there may have been an infection in the joint I was very concerned. Glad it was nothing much

I walk the dog about 1/3 if a mile 2 to 3 times a day. Usually do the recumbent bike half an hour a couple times a day. Maybe dial that back a bit

I realize 10 weeks is relatively early, but for it to be this painful still is just not thrilling me. I am still at the point of getting up off of the John is intensely painful every time!

The fact that my right knee with no cartilage left has far less pain is disturbing also

I am just hoping they did not somehow do something wrong or that I have a defective joint

Oh well, back to work

Keep on smilin

DOC
 

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@DOCCUKE , I'm so sorry about your wife's health scare on top of this whole knee adjustment!! I hope all the tests come back quickly and most advantageous!

I'm still working also (14.5 months to retirement!) I returned last week for 4 hour days, however I am a desk jockey and can ice and do a mini elevate, while on the computer. It is the driving that irritates my knee, calf, shin, quads and hamstrings, I have a ROM of 112 and it has just stayed there since my activity has increased (extension is at 0)

I am a few weeks behind you with my TKR, I am finding I have to consciously take my negative self-talk and turn it around!! A good friend shared with me "I GET to go to work and if it goes south today, in just a couple of hours I GET to go home!" I've started applying that to every frustration I have with my knee recovery! It truly does help in these early months! We all have different rates of healing (as you know) and different triggers that set off our knees.... I find I can't stand too much yet, but it is better than 6 weeks ago!

Hang in there on your recovery and many prayers and blessings for your wife in this journey!
 

Jockette

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Usually do the recumbent bike half an hour a couple times a day. Maybe dial that back a bit
You are 10 weeks post op tomorrow. This is far too much for 10 weeks. Seriously. Try dialing it back to 10 minutes, and only once a day. And maybe not even every day if you’ve had a busy day up on your feet a lot. And no resistance on the bike. You are surgically injured, not out of shape. What you are doing is training, and it’s way too early for that. No wonder you’re in so much pain!
 

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