TKR Recovering and rehabbing

[marmrf]

Once again, thanks all for the support and encouraging words. They really help/.

 

[marmrf]

Hello all:

I had my first outpatient post-op PT this morning. I am "feeling it" this afternoon!!!! I was able to do a lot in PT (including 98 degrees flexion) but am feeling it now. I am feeling tired and too tight but am resting and icing. Also feel very loopy. Won't be making any big decisions etc. right now.

 

[NetballKnees]

Hi Mary ... Wow you are doing so well with your flexion. I hope the PT wasn't too painful for you. I am gathering you are feeling "loopy" from the pain meds. They can make you feel like your mind is "elsewhere". Also they seem to serve the purpose of making us mellow out and just accept things for a while.

Hope everything continues to go well and your flexion continues to improve. I am so jealous. (I know this is a "sick" emoticon, but it was the only one I could find that was "green" for "envy").

Take Care Mary ...

 

[marmrf]

Hello all and thanks, Netballknees. I needed the humor As expected, I had a rough patch of pain last night. I tried sleeping in bed with a pillow between my knees.....Bad idea I woke up in a lot of pain and with time remaining before I could take more meds. I gave myself the PCM, ice, elevation "treatment" and dozed back off to sleep again. When I woke up, I was feeling better. I seem to doze off a lot. I am not complaining because I guess that I am getting the rest that I need.

Mary

 

[Lovedogs]

HI marmrf, So sorry you woke up in pain! Sending you peace of mind thoughts. Take care,

 

[skigirl]

You are doing really well---but that increased pain is coming from overdoing it. Just take it easy for the first month, lots of rest and icing. Your rom is great, so that is not a worry for you. If the pt is too much, let them know---if the patient does not complain, they assume everything is okay. Rest. Remember the mantras:

First are the mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - 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
- if you won't die if it's not done, don't do it

- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!

 

[marmrf]

Thanks, Skigirl. Thanks for the reminders. I had a PT treatment this a.m., but went prepared. I took two of the pain meds before treatment, which worked well for me and allowed me to go through the exercises with a little discomfort. I find myself struggling with the same issues that others have described in their posts about the pain medications. I am taking Percocet 10/325 of Tylenol of which I can have 2 every four hours. The doc initially prescribed 45 pills with no refill option. We have to go to the doctor's office to pick up a prescription for the medication. I found myself worried about running out of the meds before the weekend is over and being in extreme pain. I know that the thought is outrageous and my panic unnecessary, but I was surprised at how much fear I have associated with not being able to control the pain (one week post op). I have placed a call to my o.s. office requesting that they provide me with a refill that I can pick up before the weekend.

Weird..huh?

 

[skigirl]

Good idea, always call early in case there is a mess up. I never took a med just for pt---pt should not hurt.

 

[marmrf]

Help

I need your help, Bonesmarties..... I am one week post-op and have been able to manage my pain with rest, ice, compression, elevation and generic Percocet. Here is my problem, I am finding that the pain med is not as effective for the four hour period as it was even three days ago. Three hours seems to be the max period ofr me and then I am intense and unrelenting pain. I have tried icing, walking around and taking one pill followed by another pill two hours later.

If I can understand the cause of the pain, what to expect in terms of why it seems more intense and when I might expect this latest cycle to last? I have been resting a lot and not doing very much at all so I don't think that it is a matter of overdoing it.

Any thoughts????
Thanks,
Mary

 

[NetballKnees]

Hi Mary ... so sorry you are having bad pain. I can't advise on pain meds because I would hate to tell you something that was horribly incorrect. Perhaps if I tag Josephine she will be able to help as she has much more experience than I have. Maybe have a really good think too to make sure you are not doing too much. From what I have read, all you should be doing is icing, elevating, basic exercise, NEVER to the point of pain and walking to the bathroom.

All I can do I am afraid is send wishes that your pain is soon controlled and kept under control and you can concentrate on recovering your new knee.

Take Care ...
Ellen

 

[marmrf]

Hello Ellen:
Thanks for responding to my posting. I appreciate your support and concerns.

Mary

 

[skigirl]

If your pain med is not working, your best bet is to call you OS and tell him about it. Perhaps they need to up the script for a week or so.

 

[ema8447]

marmrf...

During my first surgery, the hospital staff got all hot and bothered when my blood sugar spiked and immediately put me on Metformin and one or two insulin injections (I've previously been able to control with just diet and exercise). They sent me home with an Rx for the Metformin. I decided not to take it and see what would happen. Blood sugar dropped dramatically within a few days of being back at home and my PCP said there was no need for the Metformin and that we'd play it by ear. I maintained good levels until a month or two ago, as the stress about the surgery and my frustration with having to be inactive much of the time caused it to start climbing.

Fast forward to a week ago when I went in for my pre-op and my A1C was up a bit. Again, panic. My PCP said to go ahead and take the Metformin until after the surgery and we'll again see how it goes.

It seems that as soon as we're able to increase our activity levels (as PT will do), the blood sugar starts to drop back down and no additional action (in terms of meds, insulin, etc.) is necessary. I certainly hope that will be the case for you.

Good luck as you continue your recovery,

 

[Josephine]

Mary, I have some questions to ask you:

1. what are your pain levels right now?
(remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget that 'pain' also includes soreness, burning, stabbing, throbbing, aching, swelling and stiffness)

2. are you still taking any pain medications, if so, what, how much (in mg please) and how often?

3. are you still icing your knee and if so how often and for how long?

4. are you still elevating your knee and if so how high, how often and for how long?

5. what is the detail of your daily activities? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

6. what kind of PT/exercises are you doing? How much and how often? Details would are required!

I'll be back shortly!

 

[marmrf]

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget that 'pain' also includes soreness, burning, stabbing, throbbing, aching, swelling and stiffness)
2. Yesterday (Thursday) it would be at an 8 or 9 and I would have to pace to be able to tolerate the pain. It is better today and I believe that it is because I have done NOTHING today except to go to PT). I backed off on doing many things for mysekf and explained to my hubby what was happening to me. He immediately stepped up to take care of me.
2. are you still taking any pain medications, if so, what, how much (in mg please) and how often?
3.
I have been taking Perocer 10/375 one to two pills every three hours. I got a refill yesterday and the OS decreased the dose to one to two tabs 7.5/325 eveything four hours. I have been able to go for five hours today and the pain is less intense today.
3. are you still icing your knee and if so how often and for how long?

Yes, I have been icing and elevating my legs whenever I sit down. Sometimes I will leave the ice on for a couple of hours . Again, today (Friday) has been better so I have iced less.
4. are you still elevating your knee and if so how high, how often and for how long?
I sit in a recliner or rest on the couch with the leg elevated either in the CPM machine or on one of the two level wedge pillows designed to keep the feet up the nose.

5. what is the detail of your daily activities? What do you do in the way of housework, cooking, cleaning, shopping, etc., and
Yesterday I would get up and fix a bowl of cereal, make a sandwich and pick up a little around my cocoon zone. I did nothing today except go to PT. I am feeling better this evening.
6. what kind of PT/exercises are you doing? How much and how often? Details would are required!
I am doing only the leg raises, passive ankle exercises. Yesterday I was doing a couple of quad stretches but did not do them today (other than at PT)
I think that I overdid it yesterday and failed to realize my limitations. I really have to put “it in the chair” and make myself rest.
Thanks for the reality check/

 

[marmrf]

Another cry for help-- when the stitches are removed how do you prevent pressure from the TED hose? Also, do you apply any oil or crème to the surgical site after the stitches are removed to reduce the irritation?

Thanks,\
Maru

 

[referee54]

found myself worried about running out of the meds before the weekend is over and being in extreme pain. I know that the thought is outrageous and my panic unnecessary

Actually, that did happen to me! I ran out of my Oxycontin, and my OS was out of town---and the Oxy can only be obtained with a written script---and I had to wait until Monday! The Vicodin that I got was like eating an M&M---it did nothing for the pain.

 

[skigirl]

It is best not to apply any oil or cream to the scar itself. I never did much of anything. If the pressure from the ted hose bothers you---then maybe the ted hose are too tight? I might stick a big bandaid over the scar while wearing them---but, if they are too tight, I would only wear them when you are going to be standing a lot or riding in the car for any length of time. Make life easy for yourself.

 

[referee54]

Also, do you apply any oil or crème to the surgical site after the stitches are removed to reduce the irritation?

I agree with Kelly---it is certainly not advisable to put anything on the incision until it is completely healed.

Like Kelly, I did not put anything on the scars at all.

 

[marmrf]

Hello all: Thanks again for the helpful comments. I am 11 days post op and have been walking without walker or cane since right after I came home from hospital. I have been able to complete the exercises, have had 4 outpatient PT sessions....overall, doing well (except for not sleeping very well). I am still taking 1-2 oxycodone every 4-6 hours. I thought that I had a high pain threshold, but am surprised that I am still requiring that amount of medication (in addition to elevation, icing and resting).

I realize that we are all different, but I am wondering if I am unusual in that 11 post-op days, I still require the amount of pain medication. I have faithfully read everything that bonesmarties have posted and the articles and materials supplied to us, but I have found nothing that gives any type of "norm" for pain meds. I guess that the real question should be why I am concerned at this juncture. However, I have a feeling that I am not the only one plagued with this question?

Please share your pain medication story with me, please???