TKR Update

Are you taking anything for the pain?
 
One of the things that angers me is the surgeon telling before surgery that 2 months out I would be in minimal pain and 4 to 6 months out I would be pain free!!

You know what?
Full recovery takes between 12-18 months, or maybe longer.

I as you was not one of those that had "fast food/drive through recovery"
Much of that thinking is based on what kind of shape you are/were in prior to the surgery.
This is not an easy surgery for the many of us.
For many though it is an easy recovery.
Unfortunately you will not see the majority of them on this board.
Why would they need to come on here to vent, simple they are doing fine.

I am looking at a revision of my 10 year post TKR and am not at all pleased with this possibility.
Never the less, it is what it is.

Have you seen the stats on those?
You sure you want to consider a revision because you're still in pain?
I suggest you do your research before you embark on this.


You might try to wear a compression stocking and connsider see a lymphodema specialist.

I assure you, you are not the only one that is depressed because you are not pain free as of yet and are not what your OS said that you would be.

Some recover quicker than do others.
I've learned that you need to be patient with this and patient with yourself.
 
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Hey Doc, it's been a while, but I'm back to see how you are doing and maybe offer some encouragement. I'm finishing up month 9 and I am finally walking with minimal limp and completely tolerable pain. I still can't walk fast without pain, but at a sufficient pace to get where I need to go. Mind you there are still plenty of "zingers" that come my way and they are NOT FUN, but with the help of my PT, I'm able to keep track of the teeny tiny milestones I keep achieving. My most recent one this weekend is that I was able to come down the stairs foot over foot with something in both hands (lightweight - just towels) without holding the handrail. Slowly, carefully and a bit jerky, but it was a first! I don't think I was descending stairs foot over foot at all at your stage, and until recently was still "cheating" sometimes and coming down backwards when I didn't want to deal with the pain.

So I'm here to encourage you to look really closely at where you were 2 months ago, and compare it to now. Or better yet, think back 3 or 4 months and see if it wasn't quite a bit worse. Because if you are getting better, however slowly, you probably shouldn't be thinking about revision or even a 2nd opinion. Although you might want to consider finding a really good PT. At 5 months I still couldn't pedal the exercise bike around, I was stuck going back and forth. I remember being in tears b/c the lady next to me was only 3 months in and whirling around like a whiz. And now I am doing 2 miles in 10 minutes and can even get my heart rate up to an "exercise" level!

For what it's worth, here's what I've learned works for me in PT (still 2x/week) and what I also am following in rehabbing my skiing. Pain (for me 6+) should be avoided because (at least in my case) it doesn't accomplish anything. For me, progress is made when I "push" to about a 3 - 4 of discomfort. In the beginning (and darn near up to about where you are now, 5-6 months) it was impossible to follow this approach, because there was so little I could do below a 5 or 6 pain level. Often even just sitting or lying down the ache/throb was a solid 6 (just at the point where you can still concentrate enough to hold a conversation.) But about month 7.5 I started to turn the corner, and I was able to actually do some exercises in the 3 - 4 pain range. So by then the kinds of things I could do had increased significantly and the level at which I could do them (with "light" pain) was also increased. This was just about the time I started skiing again so there may have been some rehab synergies going on.

Despite my cheery advice about the slow and long-term nature of recovery (based on my own personal experience as a "bad outcome"), I can totally relate to your anger and resentment when it come to skiing. While I've made the same "baby steps" progress since starting, the level I've achieved is totally unacceptable - and UNEXPECTED! I know a bunch of people my age (61) and older skiing on replacements and they did so like it was nothing. But they were the "good outcome" people and all I can do is be jealous of them, and keep working patiently to rehab and recondition myself on the slopes. My best day so far has been 5 top-to-bottom runs on perfectly groomed snow, followed by one 1/2 run after 6 inches fell the night before. Depressed doesn't begin to describe how I felt that second day, and I still can't ski with anyone else yet. But looking at it objectively (and comparing to my first day out which was 1/2 run on groomer) I have to acknowledge the improvement. WAY TOO SLOW, but still up.

What I'm hoping for you is to see that while it may be unacceptably slow, your progress is still trending up.

Unfortunately I still have considerable pain, and I (now) expect to for many months to come. But I have much, much less of it than before, and I'm still seeing improvement, even if I'm not where I want (and fully expected) to be. At 6 weeks I could barely get to 95 degrees, and that was at 7 - 8 pain. I got to about 120 at the same pain level around 6 months, and now I can do 120 with only discomfort (2 -3). For me the biggest issue is flex under load (think squats, and also descending stairs), although another issue is that while 120 doesn't hurt much at all, 124 hurts a lot. Very few degrees spell the difference, and just moving my foot a bit on the bike pedal has a huge impact on my pain.

So I continue to walk on eggshells, while continuing regular (2x/week) gentle PT and trying to resign myself to my situation. We'll see how I feel after attending a yoga retreat next month, also intended to promote rehab. It's completely disheartening when you can't do the things that are supposed to help... it just feels like total failure. I know, I've been there, but I'm hoping you keep getting to a slightly better place, however slowly.

Sybilla
 
Are you taking anything for the pain?
No because to be honest nothing has been helpful. After surgery I had oxycodone. Took that until it was gone . It made me sleepy, nauseous & did nothing for the pain. After that they gave me tramodol& that did next to nothing for the pain

So what I have come to is I am in pain, still worse then before suy, & will be for some time if not for the rest of my life!!

Containing my anger is almost worse than the pain itself!! I have no patience with anything because I am at the end of my rope when I wake up in the morning!

I saw my GP yesterday for something else & she had me do a survey about depression. At the end it asked if I ever contemplated suicide. I told her yes, pretty much every week! I am either depressed angry or both all the time!!

I also assured her I would never do it as I have kids, grandkids a wife & other family members that I could never do that to

If I had no family, I probably would have called it a day by now. But that is not an acceptable option. So I deal with it best I can. Nothing else to do!!

I will always tell anyone that asks, if you are thinking about a TKR, think long & hard!! As far as I am concerned the odds of ending up like me make it a bad choice!! I believe my doctor just wants to sell as many of these as he can & be on his merry way!! Not likely I will see him again for anything!!
 
Hi Sybilla

Thanks for the encouragement. I honestly have zero faith in this whole thing. 6 months out & WORSE than ore surgery. I can't call this anything but a failure!!

I am going to try a new PT place, waiting to see if my insurance will cover them . If not can't do it. Hope to find out tomorrow

If anyone is considering a TKR, IMHO, if they still have to work for a living & can still walk, DON'T DO IT!!

Just my 2 cents

Thanks
DOC
 
I was surprised at how much 1000 mg of Tylenol, 3 times a day, helped the pain I had, and you know I had a tough recovery. I took it for months. I was always aware of any other medications that might have acetaminophen in it, like cold medication, to be sure I stayed under the daily limit of 3000 a day US, 4000 a day UK.
 
I get your anger and depression, honestly I’ve been feeling more than a little bit of both lately. I’m 41 and had both knees done, so I have to work for quite a few more years. None of the pain meds did much for me except make me spacey and sick. I take 3000mg Tylenol a day, at first I didn’t think it was helping but boy do I notice if I miss a dose. I think it might take a bit to build up in your system as well. Also, ice seems to help when nothing else does, if your not trying that already.
 
I just found a thread on Facebook about TKR stories. I had to stop reading!! There were people with years & years of repeat failed TKR procedures! One guy was 9 years out from his TKR, went to several other doctors who would not touch him & he is now in a wheelchair!! This process seems to have more failure than success!!

I would tell anyone that asked, unless you can not walk, in other words have nothing to lose, don't do it!! I think a good number of these doctors are hacks!!

Yea I am hostile but 6 months of pain, missed work & missed motorcycle riding does that to me. Just my opinion!

My knee is getting worse instead of better. Hoping the new PT next week will be helpful!! Between pain , anger & depression I am spent!!

Just ranting!!

Hope you All are pain free!!

Good night
DOC
 
I hope the new PT will be able to help you reduce your pain. I hope they will be more modality minded than of the opinion that you need a lot of exercises. I’m sure you will set them straight if they give you anything that increases your pain.

I also hope they will be able to help you a bit with your anger and frustration. I’m sure they’ve had others who feel like you do. As I’ve said before, I do understand your feelings, I felt that way for a long while, too. While I still feel that way at times, it’s much less than it used to be.
 
@DOCCUKE I return to your thread all the time because I keep hoping it will get better for you. What a crummy outcome so far. I just have to say that: truly a bad outcome, so far. It seems quite unfair.

As an unbearably optimistic person, I believe most of us will improve over time. I think the statistics suggest that most of us improve. So, while it’s hard to see outside the pain and disgust of the moment, maybe you will find yourself feeling better as time passes. Maybe you’ll be riding one lovely day in May, in relief. I do hope so.
 
Thanks all, I appreciate the encouragement. I will be riding this spring whether in pain or not. At this point I personally believe that the surgeon damaged something, perhaps nerve damage.ice does not help, Tylenol does not help, 800mg ibuprofen does not help, opiates have never been helpful to me for anything other than making me groggy & wanting to vomit. They have never once helped pain for me

So the struggle now is to not be angry 24/7 as it is tiring . Truthfully I go back and forth from angry to depressed. Then vent on here!! :)

I think this is just how it is going to be & I will have to adapt to this pain as"normal"

Hoping the new PT can do something positive

Other than that, just keep pushing on!!
 
Still have good ROM. Doing this doesn't make it hurt any more or less!

Weird
 

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Wow that IS good flexion! I don't think I was that flexible at 22! ...:scaredycat:... LOL!

Out of curiosity I had my PT measure my non-surgical knee and it does not have the greatest flexion.

I like that the my own efforts and PT work towards my TKR knee is helping me get more flexible on both knees. Think SPRING :flwrysmile:
 
Wow that IS good flexion! I don't think I was that flexible at 22!
Me, either!
That is a fantastic bend and you appear to have little or no swelling. Of course, it still could be swelling inside the knee capsule, making it feel stiff.
 
It's just constantly unrelenting pain!! Worst on the part of the knee towards the insiide. Hurts sitting, laying down & when I stand or put weight on it at all, wow!! Hasn't stopped since that person opened me up!!

I think he damaged something but if so I am not convinced it is repairable. Nerve damage sux. I have constant pain in both feet from neuropathy and it is very similar to that. They have not been able to help me with that pain & that is definitely nerve damage

I will see how PT goes this week.

I have no faith whatsoever in my surgeon & not much faith in the medical business as a whole! I never liked the idea of any surgery
that was not mandatory to live & I like it even less now!

The odds of anyone cutting me again if it is not for something life saving are about nil!!

Definitely gotta work on this anger, it is getting tiring!

But it is also tiring when everything I try to do causes massive pain. Just getting out of a chair, getting in & out of a car, hell getting up off the John. All of those basic function of life tasks causes incredible pain that was NOT there prior to surgery!!

It is just infuriating!!

Pointing at where it hurts the most
 

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Wow... YES, please ask the PT specifically why weight bearing remains an issue at this point?

I'm no doctor, and TKR's varies, but weight bearing associated with this surgery should be the least problem. The new hardware should be able to handle it. In my case I had pain/ weakness increasing, in weight-bearing pre-TKR, not after a few weeks post-TKR.

My overall pain came from everything else initially (mostly nearly any movement early on - especially side-to-side positioning of leg in bed) now much reduced.

I may have missed a few posts you've made but did your original surgeon do more Xrays to make sure all the hard-ware is seated properly?
 
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Have you tried Gabapentin for your nerve pain? Many find relief with it. There has to be something out there to help you.
 
Hi Carole4815
I suspect luck is a factor as well. My surgeon has a good reputation, although he is quite young, kind of a Doogie Howser type !! LOL

My wife said the entire procedure was barely 90 minutes. I do not know if that is average, slow or fast.

Probably part of the issue is back to work too soon. While I am working from home at the moment, I am still quite busy and cannot elevate or ice it until I am done for the day!

I think anyone planning this should plan on a few months of just taking care of the knee! I am not in a position to do that unfortunately!! I took one month of, unpaid, it was actually 3.5 weeks, then I started working from home. This coming Monday I will be back in my office.

I may have set myself up for an impossible situation here!! If I could afford to retire I would, but not possible!! REALLY wish I did not do this because so far it is making life much worse than it was!! I am not sure there is any way to improve this

I will start taking it easier on the PT and ice when I can after work

Just really frustrated and angry at this point!!

Thanks for your thoughts and suggestions

DOC

I’ve had the same thoughts. What have I done?
No one really prepares you for this. Most people encouraged me to do it and that I would be so happy I did. They forgot to tell me that recovery is brutal. I’m hoping things get better soon.
 
I have a long sad saga, but wanted to share why I had a total failure of my first knee replacement. I was allergic to the nickel and cobalt in the prosthetic. Had a revision and I am slowly recovering. Have you been tested for a metal allergy?
 

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