TKR Reader's Left TKR Spacer Exchange

You certainly may have something there with the amount of standing time you experienced last week. Good job listening to your body and working to analyze cause and effect.

Your replacement may not have anything to do with this at all. You know, even people with their own knees can overdo things and cause pain and muscle weakness. It is possible (even 4 years after your knee replacement) that your legs were not ready for that much work all at once.

Before you worked the 4 days straight with lots of standing and walking, what were your days like? It may be you just pushed yourself too hard. If you continue to feel better today, that may be the case. Since you aren’t too keen on trying to talk with the surgeon’s office, you could see your GP and request some physical therapy to get you going on targeted strength training.

If you continue to have the pain, though, even seeing the PA would be good. You could find out whether you had the patellar button and, if not, talk about the possibility that arthritis has moved to your kneecap. You could have an x-ray and possibly even get an MRI to look at your soft tissue. Those are all valuable tools and things that a PA can handle just fine. In fact, that may be a better choice as surgeons sometimes only think in “surgical” terms….yes….I do know surgeons. :heehee:
 
Hi Reader,
I hope you got some sleep last night and your pain is under control. We look forward to hearing from you once you are resting comfortably at home.

I will link your knee thread to keep your THR and TKR journeys separate, hopefully making it easier for you.
You can receive support for your current recovery on your 2021 TKR thread (below) since it's a continuation of the story. Also, we can change the thread title to something like - Reader's Left TKR Spacer Exchange...or whatever you prefer for a title, just let us know.

Wishing you comfort as you begin healing and looking forward to supporting you. Safe travels home!
Link to knee thread -> HERE

@Reader525
 
@Layla I am sure I will refer to what you just said about links many times, lol. I've always been a little flummoxed by the forum's posts, sorry!!

Yesterday was such a long day. I had to be there at 11 am, and my son took me because my husband had a MELO back procedure done the day before. Yes it was planned, don't ask. Lol

We got taken back right away and I was prepped. When the anesthesiologist came in he was very interested in my history of anesthesia. I told him about how terrible I felt after my THR and he asked if I'd had Propophol before and I had for a colonoscopy. He said then it has to be the Versed. When his assistant came in to give me the spinal he was going to add the Versed to my IV but the anesthesiologist said, she gets sick with Versed. So I got nothing. I didn't mind the spinal too much, hurts but quick. So I was completely alert as they took me to the OR and aware of the arm boards and then the mask over my face and they took it off and told me they were going to give me the Propophol now and then I woke up. I was very confused for a few seconds, I thought I was waking up at home and couldn't understand all the bright lights. But aside from such a dry mouth I was okay.

They took me back to my cubicle and my son came in. They offered me something to eat from a menu and I said just soup. So chicken noodle soup and coffee, it was perfect. The PT came in and we walked to the bathroom. Then I was given a Hydrocodone, because I said Oxycodone makes me sick.
We got home about 7 o'clock and I had a protein drink and a muffin. Went to sleep with another Hydrocodone and rested well. Pain was minimal.

Today though, the numbing they did that lasts about 18 hours has worn off and I feel like they slammed my knee with a sledge hammer. I'm fine if I don't move, but if I do...ouch. I had thought I would take the Hydrocodone just to sleep, but it's now 5 o'clock and I took one about a half hour ago.

I have some exercises to do and I'm walking around every hour. I think all the positions they put my leg in to make sure my spacer was appropriate plus removing my scar tissue and lifting my knee cap is the cause of the pain.

Day by day? I'm just so grateful I didn't get the Versed.
 
Wow...you and hubby both recovering.
Sorry the pain has ramped up, Reader. I hope you're able to keep it under control well enough to rest / sleep. Glad you're in your own space. There's no place like home! :thumb:
Keep us posted, we're here for you!
@Reader525
 
Well happy to hear you are home and now you can start your recovery . I hear knee surgery recovery can be challenging in the early days.
I hope you find right combo of meds to assist in your pain. And I’m guessing you can use ice as well?
All my best.
 
@myglasshalffull Thank you for your well wishes. I'd say the reality has hit the fan. I'm in serious pain and evidently the numbing they did of the joint during surgery has worn off. It feels like the most intense toothache in my knee. I have started taking Hydrocodone every 4 hours and it definitely blunts the pain. I can't tolerate Oxycodone, and wish I could because I know it's a little bit stronger. But I'm very grateful for the bunting! I am icing too, and it helps. Interestingly enough, the PT at the hospital said to ice for 20 minutes and then stop for 20 minutes. I haven't done that, I've just been leaving it on because it helps so much with pain. I'm thinking perhaps, the process of icing and removing it, and then adding it again 20 minutes later is more effective because you get the added benefit of the initial jolt of ice. I'm not sure, and it may be my Hydrocodone brain trying to understand the whys. I'm someone who can handle most things IF I know the reason. So I am handling this level of pain because I know the numbing agent they used during surgery has worn off.
There's not a lot of information out there on a spacer replacement, but the nurse did indicate they had to lift my kneecap out of the way and manipulate my leg in different ways to make sure they had the right size spacer. That makes sense to me as to why I am in such pain. I've read days 2-4 are the worst. Is day 1 surgery day or the day after.
 
Is day 1 surgery day or the day after.
We don't count the day of surgery. So today is Day Two.
I'm sorry you're dealing with such heavy pain. Thankfully the meds and icing are providing some relief.

In regard to icing -
Icing for up to twenty minutes only several times a day is what most of us have been advised to do following an injury. Ice is a critical part of pain management and should be used not only on the joint, but any surrounding areas of discomfort. Always place a towel between your skin and the ice source to prevent freezer burn and ice as much as you like. Icing helps bring relief from the soft tissue trauma and internal swelling. Icing is a great natural pain reliever and best of all, it's free. While some care providers do put a maximum time on icing, others suggest you ice as often as you see fit. Icing after therapy, exercises, or prolonged activity that challenge ROM and endurance should help ease any discomfort, or may keep pain at bay. You can find relief through icing for weeks to months post op.

I hope the pain eases enough so you're able rest comfortably this weekend, Reader.
Healing hugs! :friends:
 
For the first couple of months, I iced continually the whole time I was sitting or lying down. I had an ice water circulating machine which really helped with the keeping down the pain and swelling. I was addicted to ice!
 
I’ve always found ice to be a very effective relief from pain.
Here’s hoping you feel better with each passing day.
Never had knee surgery, only had meniscus tear years ago and ice and rest then were my best friends.
 
Here’s a refresher course for you, pay special attention to this part:

Control discomfort:
rest
elevate

*****ice

take your pain meds by prescription schedule (not when pain starts!)
don't overwork.

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.
(Administrative Note: For those reading this post, please be aware that these links are a premium service and only available to Insiders Club Members. To learn about membership, click here ).

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
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork your new knee.

3. Do what you want to do BUT
If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you.
If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.

4. Good Nutrition is essential for successful recovery:
Dietary Tips for Recovery
Nutrition Basics

4. PT or exercise can be useful BUT take note of these
BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy
**and please also read the Recovery myths below.

5. At week 4 and after you should follow this:
Activity progression for TKRs

7. If you want to use something to assist with incision healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

8. Still need recovery aids? The BoneSmart Recovery Shop offers BoneSmarties best-loved recovery products at great prices.

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?

**Recovery myths:
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.
 
I am kind of stunned by the level of pain I'm in. I can't believe how no one prepared me for this, I was told how it was going to be nothing like a TKR, and yet here I am really in severe pain. Last night I switched from Hydrocodone to Oxycodone, the Hydrocodone wasn't touching the pain. I wish it were a weekday and I could call the surgeon's office for some guidance. This seems worse than the TKR to me. I really can't put weight on the operative leg. Why don't they tell us?
I've always felt Tylenol did nothing, but they prescribed it for me. Did anyone see any help from it?
I feel so alone.
 
I'm really sorry you're having such a rough time, Reader. :console2: You're never alone here. Lights on 24/7. There may be slower response times given the time of day, but we're here when you're in need of encouragement or support.

I'm not sure who told you any post op pain after the spacer exchange would be less than the discomfort after a total knee replacement. There's likely some deep joint pain, along with the irritation and inflammation of the surrounding soft tissues, ligaments and muscles, especially with movement. This should gradually improve over the coming weeks.

Regarding meds and pain relief....You can try your surgeon's office and speak with whoever is on call this weekend, which may be a surgeon, doubtful though, more likely a nurse or PA. PA's can prescribe meds, in some states, so at least give calling your OS's office a try. Worse case is you'll have to call back tomorrow.

I was prescribed Extra Strength Tylenol at 1000 mg, every six hours, but no more than 4000 mg in any 24 hr period. I did find this to be effective and don't normally use / favor Tylenol as a pain reliever. Regular strength is 325 mg of Acetaminophen and Extra Strength Tylenol is 500 mg of Acetaminophen, so more pain relief per tab.

You must also calculate anything else containing Acetaminophen into the 4000 mg so you're not exceeding that amount. You may find more relief on this schedule in addition to the Oxy temporarily, but that is something that needs your surgeon's approval. You want to be safe and manage pain without risking liver damage, so you do need to make contact with his office.

I hope you're able to speak with someone today and I'm wishing you a big dose of comfort along with a hug. Don't forget to ice on a regular basis also, for the inflammation, pain and stiffness. :ice:

Good luck!
@Reader525
 
I’m so sorry @Reader525 to read all this. @Layla is spot on with her advice.
The usual bonesmart advice is to take pain meds regularly and on time, rather than waiting for the pain to overtake you. This includes the Tylenol spaced out throughout the 24 hrs.
To begin with I set alarms to take mine on schedule through the night, until the sleep disturbance after the alarm became worse than the pain.
I also used lots of ice, day and night, tapering the ice off at 4.5 months.
I hope you can reach someone to help today.
 
I'm reluctant to call the surgeon's office because I am doing everything possible to help myself. I was told to take 1000 mg. Tylenol 3 times a day along side of the Oxycodone. So far I have done the following...

First 2 days I took Hydrocodone because I foolishly felt it was an easier medication and it would be enough pain relief, because how did I know I was going to be in severe pain. Then last night at 9 pm, I took a Hydrocodone and felt just awful. There were a few jolts of nerve pain in the mix as well. As I lay in the dark, I thought, it's time for bigger guns. I waited for the 4 hours to pass, dozing on and off. Then at 1:15 am, instead of the Hydrocodone, I took a Oxycodone. It might have brought my pain from a 10 to a 9. Then at 6:30 am, I took another Oxycodone. I plan on taking another one at 10:45 am. I took my first dose of 1000 mg. Tylenol about an hour ago, at 9 am. I will take another 1000 mg. at 3 pm.

I think the Oxycodone and Tylenol need to be consistently taken and then perhaps I'll see some effect. At this point I would take a level 7 pain as a win.

Thank you for being here with me. As Emily Dickinson said...Pain has an element of blank.
 
You can try your pharmacist for now, until your able to reach your surgeons office tomorrow. A pharmacist should be able to advise, with the knowledge of what you're working with. Consider that option, Reader. They won't steer you into the danger zone in regard to safe dosages.
A schedule of Oxy and EXTRA Srength Tylenol may be your best bet because with a quick online search Oxycodone, which is what you're taking, does not contain Acetaminophen, but some other Oxy formulations do.
@Reader525
 
Please definitely ring, no medical professional wants or expects their patients to be in this much pain, and it’s part of their job. There’s no stars for being brave, and it may potentially even slow recovery. Adequate pain relief is essential post op. The pharmacist is a good call, if you’re not calling the clinic on call. They have on call staff for a reason too. Thinking of you.
 
I don’t have any other advice to add but wanted to say I am so sorry you are having such a tough time with the pain after everything you have been through and I hope that you are able to get some relief soon.
Also thinking of you.
 
The only thing I can add is for you to ice continually. As long as you have a thin cloth between your leg and the ice pack, you can ice 24/7. I did, and it really helped with reducing the pain level.
 
How did the overnight go, Reader?
Hopefully by now you've talked with someone form your OS's office and have a plan for successful pain relief.
Please let us know, we want you to be comfortably mobile. Happy Monday...I hope it's a good one.
@Reader525
 
Good morning, I am trudging along, or maybe limping would be a better word. I am doing the Oxycodone 5 mg. every 4 hours and set up alerts on my phone so I don't miss any doses. In addition to that am taking 1000 mg. Tylenol 3 times a day. I'm on top of the pain. I think now if a forum member is having a spacer exchange, we can safely say it's like having a knee replacement again. I don't know why doctors aren't more honest with us, I have never been adequately prepared for any of the pain in my 3 orthopedic procedures.
Be that as it may, I am doing what I can, ice, ice, icing all the time. Yesterday I took a shower, blow dried my hair, put on some lipstick and fragrance and a clean nightgown. It was a crumbling facade, but it sure helped my morale.
The doctor's office was reassuring about my pain being typical, it seems that while they didn't cut through my bones this time, the did lift and move my knee cap and muscles, removed scar tissue and generally inflamed the entire region.
Day by day.
The only thing that helps in this case is letting time pass. The great healer that it is.
Thanks everyone.
Just one question...why don't they prepare us?
 

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