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That is some wonderful sleeping! That is so good for you!
TKR Put the right knee in...and then the left.
- Thread starter gertie
- Start date
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gertie
post-grad
Yes, I'm pleased with progress--and a wee bit impatient of course. But I walked outside today, very briefly, using just a cane (and shadowed by the PT).
Well done! You're going to do well.
Yay, getting outside! That always feels so good after being couped up in the house!
OP
OP
gertie
post-grad
@Celle or @Jamie I'm a little over 2 weeks out from TKR and pain is diminishing significantly so I'm starting to think about slowly getting off the pain meds. I've seen your schedule for doing so but it doesn't work for me since I'm only taking one 2 mg Dilaudid every 6 hours and they'd be hard to cut in half (tiny pill). Any suggestions?
You could either extend the amount of time between doses, or ask your PCP to prescribe Tramadol for to take instead of the Dilaudid.
OP
OP
gertie
post-grad
I really feel you need to still be taking something for pain control. It's so early to be off pain medications. Yes, Tramadol is a step-down medication, and I was thinking you could start by replacing one dose of Dilaudid with the Tramadol, then doing the same for the other dose, a few days later.
Let's see if Jamie has any other suggestions.
Let's see if Jamie has any other suggestions.
It makes some sense to think about a step down medication. Some of us have had docs who made a plan for that. For me, it was oxycodone every 4 hours for the first 3 weeks or so and then hydrocodone. But lots of people have good success with Tramadol. Something to ask your doc about.
But don't feel you need to rush--reducing pain meds happens very naturally for most of us.
But don't feel you need to rush--reducing pain meds happens very naturally for most of us.
It is a bit early to be completely off pain meds and please realize the reason you are thinking that your pain is minimal is simply because you have it properly managed.
Celle is right that the Tramadol can replace the Dilaudid and provide an continuation of the pain relief you're having without having to stay on an opiod pain reliever. You don't have to phase over to the Tramadol; you just stop taking the Dilaudid and start on Tramadol. Once you are on it for a week or so on a set schedule, then you could start gradually reducing that amount and/or replacing it with Tylenol if you feel you really don't have any pain going on. This would be my recommendation assuming your surgeon would allow you to step down your medication.
I suppose you could try replacing a dose of Dilaudid with Tylenol now. I'm not sure how well that would work to taper off but it might. It would not hurt anything to try that, except you may find the pain/stiffness/etc. creeping back in. Likewise you could extend the time between doses of Dilaudid in one-hour intervals to taper off. You would stay at each level for 2-3 days before moving to a longer period between doses.
Just pay close attention to how you feel no matter what you try. What we don't want is for your pain levels to increase as that will negatively impact the wonderful recovery you have going.
Celle is right that the Tramadol can replace the Dilaudid and provide an continuation of the pain relief you're having without having to stay on an opiod pain reliever. You don't have to phase over to the Tramadol; you just stop taking the Dilaudid and start on Tramadol. Once you are on it for a week or so on a set schedule, then you could start gradually reducing that amount and/or replacing it with Tylenol if you feel you really don't have any pain going on. This would be my recommendation assuming your surgeon would allow you to step down your medication.
I suppose you could try replacing a dose of Dilaudid with Tylenol now. I'm not sure how well that would work to taper off but it might. It would not hurt anything to try that, except you may find the pain/stiffness/etc. creeping back in. Likewise you could extend the time between doses of Dilaudid in one-hour intervals to taper off. You would stay at each level for 2-3 days before moving to a longer period between doses.
Just pay close attention to how you feel no matter what you try. What we don't want is for your pain levels to increase as that will negatively impact the wonderful recovery you have going.
OP
OP
gertie
post-grad
Thanks all. Yes, you're right, I don't want to have increased pain. My goal is never zero pain but manageable is nice--and that's what I've got right now. The big reason I'm thinking about this is that I'm due to have the 2nd knee done in early August and, perhaps foolishly, would love to be relatively clear of opiates for at least a few days prior to going back into surgery. No one has told me I need to do that--just me thinking that. Tramadol is not a good drug for me to take at night because it tends to keep me awake--drowsy but not sleeping. So I'll stick with the Dilaudid for now. I just by chance went for 7 hours between doses earlier today (fell asleep) and I felt OK. But I won't do that regularly just yet.
OP
OP
gertie
post-grad
2 1/2 weeks out. Cooking a simple supper--not the first time--I put together some rotisserie chicken, salad, and potatoes earlier in the week--but still it feels like an accomplishment. I've had meals on wheels weekdays and friends have dropped things off for the weekends. I'll do the MOW for one more week then start fending for myself. The MOW food is good--comes from the kitchens of our local university, which has won awards for its food service--but I'm ready for my own food.
A friend stopped by and we went for a short walk outside today, which felt good. Used a cane rather than the walker (with approval of the PT). In the house I find myself forgetting the cane.
I'm part of a small meditation group and they're coming to my house tomorrow morning so I've done some tidying--have a handy long handled dust pan and broom to help in the process.
A friend is coming by in the afternoon to take me for a ride, maybe get some ice cream. We won't go far--but she's the friend with the Toyota Rav, which has great front seat leg room, so I should be fairly comfortable.
Put on jeans today rather than what I think of as my recovery clothes (elastic waist, wide legs that I can easily pull up when someone wants to check the incision, etc.).
I was curious about how the timing of these activities compares with my hip recovery last fall so I checked my thread on the hip side--about the same, with the exception of pain and pain meds--minimal pain with the hip and no opiates once I left the hospital.
A friend stopped by and we went for a short walk outside today, which felt good. Used a cane rather than the walker (with approval of the PT). In the house I find myself forgetting the cane.
I'm part of a small meditation group and they're coming to my house tomorrow morning so I've done some tidying--have a handy long handled dust pan and broom to help in the process.
A friend is coming by in the afternoon to take me for a ride, maybe get some ice cream. We won't go far--but she's the friend with the Toyota Rav, which has great front seat leg room, so I should be fairly comfortable.
Put on jeans today rather than what I think of as my recovery clothes (elastic waist, wide legs that I can easily pull up when someone wants to check the incision, etc.).
I was curious about how the timing of these activities compares with my hip recovery last fall so I checked my thread on the hip side--about the same, with the exception of pain and pain meds--minimal pain with the hip and no opiates once I left the hospital.
There's still plenty of time to reduce your pain medications. Right now, it's important to have your pain controlled adequately.
OP
OP
gertie
post-grad
Not having a great day today emotionally. A long day on my own and I'm bored silly. Still taking some daytime pain meds although I'm stretching out the time between doses but even at the reduced rate they make me sleepy enough that it's hard to engage with books or writing or projects but not sleepy enough to nap. Aaargh. I'm pacing around the house but nervous about going for a walk outside by myself--not sure why--leg is behaving--partly it's those pain meds, which make me a little spacy. Sick of being dependent on others, sick of not driving, just generally fed up with it all. And yes, I've read the article on post op blues--doesn't make them any easier to go through, however.
We understand. It's tough. It will pass, though.
![[Bonesmart.org] Put the right knee in...and then the left.](https://bonesmart.org/forum/attachments/hang-in-there-jpg.58300/ "[Bonesmart.org] Put the right knee in...and then the left.")
OP
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gertie
post-grad
@Celle It does make me reconsider going through this all again in August. I need to find out how long I'd have to wait if I rescheduled. It I could get a new date in September, I'd seriously consider it so I could have some time of feeling a bit more independent but if I have to wait 'til November or December I'll just push on through with August.
becticu
graduate
Hi @gertie, your up's and downs are so normal. From experience I know that doesn't help you much. I feel like my posts may be discouraging for those doing staged knees. Maybe it would help if you know going in that it lengthens everything. I DID absolutely know it but my psyche didn't catch on. That little bit of normality for me because I had a little less than two weeks did me in. I also had a relatively easy (although I didn't know it at the time) first knee and a stubborn one the second time. Also not sure if you are still working or not. I am and worked the day before my first surgery. That's crazy weird being out of work this long. If you want to do it you have the strength. I hope I haven't discouraged.
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Sent from my iPhone using BoneSmart Forum
OP
OP
gertie
post-grad
@becticu Not discouraging at all--it's helpful to hear from folks who have done the staged approach. I know I can dig deep and get through it but...it isn't going to be easy! I am still working and like you worked right up to the first surgery--took the afternoon before surgery off--and I miss being productive and collegial (although I am getting quite fond of lazy, slow start mornings).
The PA I saw for my 2 week check up said I should expect the 2nd surgery to possibly be harder--don't know if he meant physically-that's my sense--or emotionally or both.
The PA I saw for my 2 week check up said I should expect the 2nd surgery to possibly be harder--don't know if he meant physically-that's my sense--or emotionally or both.
