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patriciad

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5 years on from my TKR - right knee I am now in recovery from a Partial Knee Replacement on my left knee. Surgery was June 29th with an overnight stay.
As long as I keep on top of the pain I do ok but 5 years on the opioid crisis has affected the strength of medication available to me and my strongest is .5 Codeine with 375 Tylenol and that is not doing the trick. I have 50 mg Tramadol but have never found Tramadol particularly effective so for an hour and a half out of every 4 hour cycle I am in major discomfort. The ice machine helps enormously. Any tips or help appreciated. Could I take more Tylenol with the Tramadol safely?
I found this forum invaluable last time and was so delighted to find you again.
 
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Jockette

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Hi and Welcome back to Bonesmart.

I moved your post to the Recovery Forum and started a new thread for you, since it’s been a while since you were here, and this is a different knee. I also edited out the first sentence requesting that we move your post.

I will continue in the next post.
 

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Could I take more Tylenol with the Tramadol safely?
Yes you can, but you must be sure to add in all of the Tylenol that might be in other medications that you take, so that you don’t go over the daily limit of Tylenol, which is 4,000 mg in a 24 hour period. The Tylenol bottle will probably say 3,000 mg, as a precaution, in case people don’t figure in the Tylenol in other medications. Double check with your surgeon and pharmacist.

As you said, ice is a good pain reliever, and so is somewhat limited activity, too much activity, before your new knee is ready for it, including a list of exercises you might have been given, will create more pain. This early in recovery you only need gentle movements and short walks around the house, for mobility.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

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
ice
take your pain meds by prescription schedule (not when pain starts!)​

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

5. At week 4 and after you should follow this

6. Access to these pages on the website

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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 

BBCG

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Welcome back, PatriciaD! This has been my second “rodeo” too! My second was on April 29…

Interestingly, my experience is a bit the opposite: I have major trouble with opioids and found the Tramadol and Tylenol really helped me the most. I said no to the opioids and have recovered much faster!

Because of the state I’m in, medicinal herbal/CBD salve is legal and available and I also used that applied to the achiest areas, along with a magnesium gel for times when I felt those annoying zingers of nerve pain.
I had figured out these ancillary helpful tools while I dealt with the pain while waiting for my surgery. I wore the SERF strap for about a year.

The other pain relieving trick I found worked was elevating my new knee leg every time it began aching! So, for labout 16-20 hours a day for the first couple of weeks I used my recliner as my main perch! I was lucky and have a recliner I got last time.

Hoping your recovery goes really well!
 
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Jaycey

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Could I take more Tylenol with the Tramadol safely?
Here's a handy chart our former nurse director created.

The first is for 4-hourly doses and the second for 6-hourly:


If you use this schedule, do check to make sure you're not taking any other drugs that contain Tylenol (Acetaminophen) You need to stay within the safe limit of no more than 4,000 mg of Tylenol in a 24 hr period. If any other medications you're taking contain Tylenol, add their amount into your daily calculations and reduce another of your doses, so you stay within those limits.
 

Jo Wo

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that clock watching feeling when you are waiting to take a next dose is awful. sometimes just getting up for a little walk helps to bring my pain down during that interval of waiting. Hope you find a strategy that works!
 
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Jaycee has given me a great schedule on Tramadol plus Tylenol doses to follow. I’ll give up the hydocodone and follow this regime and hope to get better management of the pain. I do get up and stretch my legs but once that throbbing takes hold it’s hard to distract yourself.
 
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patriciad

patriciad

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Welcome back, PatriciaD! This has been my second “rodeo” too! My second was on April 29…

Because of the state I’m in, medicinal herbal/CBD salve is legal and available and I also used that applied to the achiest areas, along with a magnesium gel for times when I felt those annoying zingers of nerve pain.
I had figured out these ancillary helpful tools while I dealt with the pain while waiting for my surgery. I wore the SERF strap for about a year.

Hoping your recovery goes really well!
I think I can get CBD oil here in FL too. Did you start to use once your dressing was off? Not heard of Magnesium Gel can you recommend a brand please?
 

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Welcome!
Also try to distract yourself mentally. A compelling book, a great movie, a hobby you can do sitting down (I do genealogy research). It makes the time pass.
Ice and elevate along with medicate.
Hang in there!
 
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That’s a great idea. I’m not quite there yet focus wise but will get some crochet out and see how I get on. Thank you.
 

Jo Wo

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Sometimes the rhythm of a simple crochet pattern lulls me to sleep! I have a baby blanket on the hook and a hat on my knitting needles.
 
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patriciad

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One week out now and have finally got the pain under control. Do not remember having such an issue with my previous surgery but perhaps just the memories are rose colored! I am mainly on Tramadol plus an added 500 or 1000 mg Tylenol at the same time. Also taking an anti nausea once or twice a day is very helpful.
Doing simple exercises 3 to 4 times daily, and icing constantly is helping maintain strength and mobility. In home Physio says I am doing well. My Mood has improved and I am eating better. All in all good progress. I enjoy browsing the posts and articles and its beneficial to go through this surgery and recovery as part of a “group”. The thing that stands out to me is the different recovery experiences no matter what the age or fitness level of the patient. The lesson this has taught me is that comparisons are a waste of time.
Thanks to everyone who are on this journey with me.
 
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Jockette

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The thing that stands out to me is the different recovery experiences no matter what the age or fitness level of the patient. The lesson this has taught me is that comparisons are a waste of time.
Exactly!
 

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Doing simple exercises 3 to 4 times daily, and icing constantly is helping maintain strength and mobility. In home Physio says I am doing well.
Once a day is often enough for doing exercises at this early stage of recovery. Your knee gets exercise while you're walking around the house, too. You may find that your pain decreases a bit if you decrease the amount of exercises you're doing.

The principle about exercise is "Heal first, then strengthen." Your muscles will gradually regain strength as you go about your daily life, but your knee needs to be well on the way with healing before you stress it with formal strengthening exercises. About 3 months post-op is the right time to concentrate on strengthening.

There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your knee has the potential to achieve good ROM right from the start, but it's prevented from doing so by swelling and pain. As it heals and the swelling goes down, your ROM (both flexion and extension) will increase spontaneously, whether you do formal PT or just let your normal Activities of Daily Living (ADLs) be your exercise.
 
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patriciad

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So I had my first outpatient pt a week ago and have had a huge setback as a result of the Therapist overworking the knee. Pain and swelling started that night and I felt I was back to the days immediately following surgery. I had to take my heavy duty meds again and became worried that there was some damage to the implant as I had new pain under the knee radiating down the shin on standing. It is improved now but doesn’t feel as firm and I am not walking as well as before the PT. The worst about this was that I have become overwhelmed and depressed and can’t shake the anxiety. I spoke with my surgeons PA and she says it is very unlikely I have damaged the joint and to stop PT but carry on with the standard exercises in home which I am doing then go back when I feel ready - seriously don’t think that day will come!
 

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Many members here decided against formal PT and did very well. You have suffered a setback, but it is not permanent, and I doubt you did any injury to the implant as they are very strong.
Your soft tissue is angry and now your job is to ice, elevate frequently and medicate as needed. Activities of daily living are enough exercise for now until your knee calms down. Hang in there!
 

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I’m so sorry you were hurt at PT. That is an example of bad PT. You’ll do fine on your own at home. :console2:
 

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I think your PA is giving you good advice. Your knee is just a bit :tantrum: right now.
 
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patriciad

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So have not gone back to Physio on surgeons advice. They called me in to address my concerns on the continued pain and swelling I was anxious about. X-rays showed the prosthetic was fine and everything was aligned correctly so it seemed it was soft tissue inflammation and was advised to baby it, do in home exercises and not to resume Physio as I had good ROM.
So I have followed this advice but my knee continues to swell on walking or standing and I still experience the sharp pain down the inside of my leg that I never had before the disastrous Physio session. I have become very “blue” about the setback. My scar looks OK but is super sensitive. I can’t stand even a light sheet so try to sleep on top of the bed covers with the knee exposed. I am fed up and just venting here because I know fellow bonesmarters will listen and advise.
PS. I hope I’m posting in my own recovery thread. If not sorry and please move.
 

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Yes, you are posting in your own recovery thread. :flwrysmile:

All the things you just described are par for the course for not quite 2 months post op. I experienced the same thing with my partial. Were you thinking you’d be further along in recovery because you had a partial? I sure thought that and after I found Bonesmart, at 4 weeks post op, I learned that the recovery time is fairly similar for both PKR and TKR.

Setbacks can take a while to recover from, especially a disastrous Physio session. (Been there, done that!)

Unfortunately we have to just do the best we can to get comfortable and give our knee the time it needs to sort itself out. :console2:
 

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