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PKR PKR Success - 1 yr out.

Can you take Tramadol? That's a really good step down med. I'll leave you our recommended schedule:

The first is for 4-hourly doses and the second for 6-hourly:
[Bonesmart.org] PKR Success - 1 yr out.


Remember to count all the Tylenol that you are taking in your Norco or anything else that might have it. The combo of Tylenol and Tramadol is a really good pain reliever.
 
You do need to make sure that you don't exceed the safe daily dose of 4,000 mg of Tylenol/Acetaminophen in 24 hours. That's why sistersinhim advised you to count the Tylenol in any other medicines you're taking.

When the time comes to wean off the Tramadol, you do need to do it slowly, to avoid unpleasant withdrawal symptoms.
 
Thanks @sistersinhim for the info. I’m hoping I won’t need any narcotic pain killers after the next few weeks, but if I do, I’ll talk to my OS or PCP about Tramadol.

Because I’ve been on Tylenol regularly since my surgery and I have concerns regarding long term effect and exceeding daily dosage guidelines, I’m more interested in finding an alternate OTC that works on both pain and inflammation that I can take during the day. From what I’ve read so far, it looks like I could take Motrin during the day and use the Norco just at night.

Anyone have thoughts about this approach?

NG
 
Well, just got off the phone with my pharmacist. Turns out using Motrin would be an excellent alternative to Tylenol during the day, especially since it will also address the inflammation issues. The only caution was it also acts as a blood thinner. Luckily I’m not on any blood thinners so minimal risk as far as I’m concerned. She said I can also take a single Motrin within 2-3 hours after taking my bedtime Norco if pain is still keeping me awake.

Going to give it a try tonight and see if any better sleep. I’ll let you know how it goes in the morning.

NG
 
Try the Motrim, but do be aware that it can cause gastric bleeding - sometimes quite bad - so never take it on an empty stomach, and stop taking it if you experience any gastric symptoms, such as nausea or indigestion.

Mortim is the commercial name for Ibuprofen, which is a non-steroidal anti-inflammatory (NSAID).
Apart from the danger of bleeding, there is this potentila risk with NSAIDs:
NSAIDs Diclofenac. ibuprofen increase risk of heart problems: new study

It's not a good idea to take Motrim long-term. Tylenol would be safer.
 
@Celle,

Thanks for the info. I’ve heard taking Motrin long-term is not good, neither is Tylenol from what I understand. My plan was to alternate between the two. A week or so on one, then switch to the other. Gives my system a break?

Maybe I’ll get real lucky and won’t need much of anything after a few weeks (not likely ).
 
Hopefully, as your recovery progresses, you won't need to take anything long-term for pain relief.
 
Well sleep last night not much improved over prior nights, but I’m sure it will get better. I know it’s a normal part of the process. The thing that always seems to get to me and keeps me awake is when the aching around the knee starts to trigger muscle spasms in either my quads or calf’s. I’ll be laying there when either or both will suddenly tighten and then release. No cramping, thank goodness. Has anyone else experienced the same issue? Sometimes I have to get up and walk a bit or grab a cold gel pack to get the ache and spasms to settle down. As a result, it’s been 2 weeks since I last slept in my own bed. My constant moving around disturbs my wife’s sleep, so either my recliner or sofa have become my “go to” for any semblance of sleep.

I have noticed that swelling seems to be improved after being on Motrin for past 24 hours. ROM also improved some once I got loosened up this morning. I find that warmth (especially a hot shower) seems to help loosen up my knee before I do my morning stretches. From my younger athletic days, this makes sense. Heat helps to loosen and relax muscles, tendons, and ligaments. Icing after stretches and anytime spent in activities would help to minimize swelling afterwards. Does anyone else find a little bit of warmth helps get things to move a little easier, especially first thing in the morning?

Thanks. NG
 
Now that you mention it I do remember feeling my leg a bit looser after a shower. I think a shower offers just a little bit of gentle heat that helps, the gentle water on our leg just feels nice.

When I was maybe 4 or 5 months I decided to try one of those heated rice bags on my knee. My knee freaked out with pain! It also didn’t help that I had heated the bag too long and it was too hot, but it took a while for my knee to settle down.

Heat can also encourage swelling, so it’s not a good idea right on the knee. I have no idea what I was thinking the day I tried it right on my knee.

Some people like heat on the thigh or calf, though.
 
I remember the leg moving about. At times mine felt as if the knee just wanted to move - even when I was asleep! I’d just wake up flexing it over and over again! It wasn’t spasms as much as involuntary movements, I just called it unconscious exercise!
 
Prior to my surgery I would normally workout 4 or 5 days a week for 45 mins. Most times my daily routine would be core and upper body strength exercises one day and mild cardio (elliptical or treadmill walk) the next. My knee would not tolerate any impact type exercises and would minimally tolerate leg strength exercises on machines.

Next week will be the beginning of week 4 post op. I’m thinking about possibly starting back up with some very light core and upper body exercises if my knee doesn’t object. These would be exercises that don’t put any stress on the knee and could be done at a weight machine or freeform. I also start PT next week so I also want to be aware not to over do anything. I’ve been sitting around doing much of nothing but resting for 3 weeks now and am going a bit stir crazy. I know this is best for my recovery, but would such light exercises really be detrimental as long as my knee doesn’t hurt or swell?

NG
 
Always let your knee be your guide. If it swells or hurts afterwards, either that night or the next day, then don't do it again for a few weeks. This gives your knee more time to heal before you stress it again.
 
As far as the light upper body excercise I am not a medical proffesional nor did I recently spend the night at a Holiday Inn express. But for me total body conditioning is important to maintain your routine, self confidence, and general state of health. I am not as accomplished an athlete as yourself but it is important to me to work to maintain and improve in some areas as I age. I have had both shoulders replaced a few years back and that has changed my goals and methods but I still do what the replacements can tolerate over the long term. If your workout can be done with no risk to your surgical area I would proceed if I were you. I also make changes gradually to hedge the bet. Begin at a fraction of your normal and see how you feel the next day. You know your body and the difference between potentially a new injury and normal fatigue.
 
@slipjoint ... Thanks. That is exactly the same thoughts I had. A few years back I had major abdominal surgery which meant no exercises for about 3 or 4 months as my core could not tolerate it until it was well healed. I figured the same approach for my leg exercises (maybe longer) but didn’t see any reason why my other routines couldn’t be restarted with moderation.

Thanks. NG
 
do you use pillows between your legs when lying on your side. I find this helps and so far have had no problems sleeping I feel very lucky. Good luck.
 
@VonnieN ... good evening! I have been using a pillow (under my legs when on my back or between my legs when on my side). Doing so definitely helps, but doesn’t seem to provide much relief to my lower left back / hip area. Seems like I have a pinched nerve or something from sitting around so much. That and the muscle twitches drive me crazy. Hoping tonight a bit better.

NG
 
It could be the body has to adjust to the new alignment perhaps use a TENS machine? I use it on my quad to get it going again
 
NavyGunns said:
Because I’ve been on Tylenol regularly since my surgery and I have concerns regarding long term effect and exceeding daily dosage guidelines
Click to expand...
This a problem for US members as the US guidelines differ from everywhere else on the planet! Basically, the maximum per 24hrs is 4,000mg but the FDA, in their wisdom, decided to reduce that to 3,000mgs 'in case' they should also take another medication containing acetaminophen, specially the likes of cold remedies and such! So provided you are not or are at least sensible enough to take the extra into account, 4,000mg per 24hrs is perfectly safe and is not in any way accumulative. Plus it's a rattling good pain med!

I would suggest therefore, that you try a routine of 1,000mg Tylenol every 6 hours which should give you a really good cover.
NavyGunns said:
I’m more interested in finding an alternate OTC that works on both pain and inflammation that I can take during the day.
Click to expand...
I don't know of one, sorry.
NavyGunns said:
Turns out using Motrin would be an excellent alternative to Tylenol during the day. The only caution was it also acts as a blood thinner.
Click to expand...
It's also an NSAID which has some rather unwelcome side effects which as a lot more common than people know and certainly more than the advertisers let on! The blood thinning aspects are always a concern even if you're not on blood thinners. It also has a tendency to inhibit bone growth and healing. A special issue if your implant was uncemented.

Read this Medications: acetaminophen (Tylenol, paracetamol) and NSAIDs, differences and dangers
 
@Josephine
Many thanks for the additional information! While I was aware of the blood thinner and gastro related risks with Motrin, I was not aware of the bone growth/healing concerns. Knowing that the daily limit for Tylenol is higher, I may just switch back. But, I do find it interesting that I’ve noticed a significant reduction in swelling (and increased ROM as a result) over the past couple of days since being on Motrin. Coincidence?

I have my first PT session this afternoon, so that might be a good time to switch back to Tylenol. I’ll give it a try.

NG
 
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