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Revision TKR Revision #7

Celle

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I knew Tylenol wasn't but Tramadol Was under the impression it was based on what the resident at hospital told me?
No, Tramadol is not an NSAID. It's a synthetic opioid, but milder than the heavy-duty opioids.

It does work well in combination with Tylenol. We have a couple of charts that suggest how to combine the two drugs to best effect. Let us know if you decide to use Tramadol, and we'll give you those charts.
 
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NFenske

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Well dressing is off NO DRAINAGE!!! As far as pain it feels like ---- ( several 4 letter words will work ). For some letting soft tissue heal before therapy may seem like a good idea but based on the Dr.'s and therapist's I have and continue to deal with I will continue to push. I will not go nuts but when it starts to hurt I stop. At the present yes it hurts and it hurts more then I care to admit but by tomorrow or the day after it will feel better plus when the therapist takes measurements there is improvement.
Asked the nurse about Tramadol she said does not know much about it but advised not taking it while on the Oxycodone. Well its time to call it a day, if the knee could talk it would be yelling.
 

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Good news about the drainage. Sorry for the pain. I hope you find that sweet spot between suffering too much pain and stalling recovery. It seems to be different for people.
 

Jamie

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You've misunderstood me about the Tramadol. It would be a medication you could use when and if you have to stop using the Oxycodone. You never would use the two together. You would take Tramadol with Extra Strength Tylenol on a schedule through the day and night so you keep pain medication in your system helping you 24/7. As long as the Oxycodone works for you and your surgeon will prescribe it for you, I'd say stick with it. I just hate to see you scrimping on pain meds in these early days if you are in pain.
 
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NFenske

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@Jamie My apologies for the misunderstanding. Once I can no longer get Oxycodone then it maybe a good option? As it stands just picked up another script for pain meds. Now I have plenty for the next 2 to 3 weeks. Only thing bad so far driving to get meds a 20mile round trip and now feels pretty blah. Took 1 pain pill along with 1000mg of Tylenol also have an ice wrap so hopefully things will settle down. One thing is definite there is no way you can make the kneel faster it is going to heal at its own pace no matter what another point the more surgeries the longer the recovery time.
Well its Christmas Eve I should be cheerful happy etc but instead just so so. Being in pain over Christmas stinks.
 

Jamie

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Glass have full time.....even though you're in pain, it's post op pain and not what you were experiencing before. You're on the good side of surgery. You have the means to control your pain in hand. These are things to be thankful for on Christmas.
 
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NFenske

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@Jamie Glass half full is still half empty!! Whether I am on the other side or not it still hurts. Yes I had prior to surgery but this is sharper more intense. Yes it will go away given time but being honest with myself this is pretty bad, knee is swollen warm darker in color. Almost reason to think something bad but no fever just lots of pain. I see the surgeon Tuesday hopefully it will settle down
 

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I've had 6 surgeries on my right knee and 5 on my left. Each knee has had it's kneecap removed and not replaced. My right TKR has not left me pain free, but better. I can do things that I hadn't been able to do for over 20 years. If my knee acts up, I rest it the next day or so. I was told I'd never be pain free, but I chose to go for less pain and am glad I did!
It would be nice if my pain level were to get down to a 4 but in my case what are the odds? Just really frustrated.
I completely understand your frustration. But, it's a very good chance that your next surgery will leave you much better.
How can an adult not have a knee cap?
 

sistersinhim

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How can an adult not have a knee cap?
Very easily. I'm living proof. I don't have either one. When they remove the kneecap, they have to shorten the patella tendon to enable a person to be able to straighten their leg. This leaves us weaker in the knees than a normal 'kneecapped' person.

My removals were done in the early 90s. To my knowledge, they aren't done anymore.
 
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NFenske

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@sistersinhim , @ Jamie, @ anyone? Should this be a concern or not? The nurse came by to see how my knee looks after the dressings been off a few days, the color looks good, no fever, pain sucks ( what else is new?? ), the one thing that seemed to somewhat bother her my knee was much warmer then the rest of the leg. Looking at this from my perspective that would makes sense but being paranoid its worrying me. Another thing I have noticed and it maybe its my fault the pain has gotten a little much. The past several days it starts out at a high 5 low 6 by the afternoon its a solid 7. I started taking the pain meds and was doing okay with a total of 3 or 4 during the day none at night now I am taking 4 sometimes 5 ( past couple days 5 so far today 3 ). There is no getting around it I know the pain stinks and I am aware its going to take time how much I have no idea? So one thought well maybe I am doing too much but when you get out of bed and your already hurting odds are not good it going to get any better thru out the day. Christmas or not this is not doing anything for my mood.
 

Jaycey

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@NFenske At the risk of repeating what has already been said on your thread - please take your medication around the clock, as prescribed. You need medication at night to sleep and having just had major surgery you need medication throughout the day. If your pain is flaring you are under medicated.

Ice, elevate, meds and repeat!
 

sistersinhim

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A warmer knee at your stage is completely normal. It's a sign it's healing.
 

Jockette

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So one thought well maybe I am doing too much
At only 2 weeks post op, tomorrow, you should be doing only minimal activity, and this includes any type of PT.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.

For a while, the more you do, the more additional pain you are going to have, beyond the default pain level that this surgery generates.
 
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NFenske

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@Jaycey @sistersinhim Not trying to argue with you on pain meds but the refill I just got 1 every 6 hours so okay when your in pain you fudge the time period I get it. So my question with the exception of past few days pain has been ( at least my version of tolerable yes it hurts but its doable ) okay. Now every day from wake up to laying down at night its pretty crummy. Yes you can say I have been too active or pushed myself too hard in therapy which is a good reason but not entirely comfortable blaming it on that either. If I took pain meds around the clock I would run out sooner plus going by nurses and surgeon's advice If my knee is driving me nuts after 4 hours I am not going to wait another 2 and lets face it getting pain meds is not exactly like it use to be either. Odds are there is nothing out of the ordinary going on with my knee it just seems everytime I go thru this there is always something different during recovery. Really tired of being miserable.
 
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NFenske

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@Jockette I could care less about ROM I am already at 120ish what I have been working on is extension on the 24th I was at -7 the week before -9. All I am working on it stretching and short walks even with a crummy knee it only takes maybe 10 minutes its short. Standing for too long whether its making something to eat taking a shower the longer I stand the worse it gets. Sitting with knee bent is another way to introduce more pain. I agree but disagree with your thoughts on exercise sorry if I were to wait until my knee feels a lot better its going to be that much harder to breakup the scar tissue. Whether you agree or not I cannot argue with the results over the years. With the exception of this forum no one thinks you should wait till after the knee is healed and that is from therapists and surgeons ( not the know it all residents either ). I do appreciate the kind words it helps even more so when your at wits end with knee surgeries etc.
 

Jockette

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ROM is both flexion and straightening and there is no rush to regain either one.

Your flexion is fantastic! :yay:
Standing for too long whether its making something to eat taking a shower the longer I stand the worse it gets. Sitting with knee bent is another way to introduce more pain.
Unfortunately this is par for the course in the early weeks of recovery.
Really tired of being miserable.
I’m sure you are. Life can be so unfair at times. I’m sorry you’ve been through so much. I truly hope this is the final surgery for this knee.
 

Celle

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Whether you agree or not I cannot argue with the results over the years. With the exception of this forum no one thinks you should wait till after the knee is healed and that is from therapists and surgeons ( not the know it all residents either ). I do appreciate the kind words it helps even more so when your at wits end with knee surgeries etc.
@NFenske - No one is saying you shouldn't do exercise at all. What we say is that you don't need to do a lot of exercise, especially in the first few months. Your knee isn't lazy or unfit - it's wounded, having had major surgery. Initially, it needs gentle treatment and it gets sufficient exercise by being used in your normal activities of daily living - and that doesn't include moving heavy objects around. If you throttle back your activities during the first 6 weeks or so, your pain could also decrease.

Different surgeons have different protocols for recovery and not all surgeons agree with the surgeons you have encountered.

For example, my surgeon doesn't allow any formal PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house. The walking is our exercise and we increase it a little each week, until we're walking around the block.

After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home each day.

His patients all do well and achieve good ROM, as I did, and he hasn't had to do a manipulation to help with ROM for the past 4 years. I think that speaks for itself.

The other four surgeons in his practice all follow that protocol.
.
 
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NFenske

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Wish I met your surgeon since all the ones I have seen the many therapists I have had all say the samething. They all agree not to over do it but none think you should wait until your almost healed prior to starting therapy. I have seen the results of those that did nothing till they felt better and it took longer for them to gain mobility back. It's possible the way most look at therapy here is fine but very few of any have been thru what I have surgery wise with this knee. Based on my experience not all surgeons think alike either. Some are exceptional others not so much. Same holds true with therapists right or wrong some therapists that are still in training have never heard of let body heal first. As long as I continue to improve pain or not not going to change. Now before I let that last sentence go no matter what knee is going to hurt my only concession is to not go nuts and cause extreme pain which at this stage it's real easy to over do it.
Once again my apologies it's hard to vent living alone and when my daughter is here she does not understand like most ( mild form autism ) and my mother 80 yrs old does not fully understand like she use to do this forum gives me a chance to vent frustrations out. Wish I knew about this site in 2003 when I had first surgery!
 

Celle

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They all agree not to over do it but none think you should wait until your almost healed prior to starting therapy.
And I never said you should wait until you're almost healed prior to starting therapy.
I said no formal PT for the first month post-op. Since complete healing from a knee replacement or a revision takes a full year, one month is only 1/12th of the way towards being healed. One month post-op is not "almost healed".
 

Jockette

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And I never said you should wait until you're almost healed prior to starting therapy.
And we’re not saying stay on the couch and do nothing all day:
For that month, we rest, ice and elevate our leg, and walk around the house. The walking is our exercise and we increase it a little each week, until we're walking around the block.
Wish I knew about this site in 2003 when I had first surgery!
You don’t have to recover the way you always have in the past. This is a new recovery and you can do things differently. There is more than one way to do this recovery, Bonesmart offers a less painful approach that is very successful.
 

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