Kiwigirl62
member
Heaps of prunes finally worked for me if you can stomach them
TKR Scruffy’s recovery journey
- Thread starter scruffydog
- Start date
Larryhg3
senior
At this early stage it is very important to stay ahead of the pain. Keeping the same number of pills and slowly extending the frequency seems to work best. However as you have realized, that introduces constipation and sometime nausea. For me I use Senna, Miralax (takes an entire minute to mix into juice) fresh prunes and coffee. Amazingly my nausea eased after my constipation eased.
I would suggest you tell your husband to keep his hands off your Lounge Doctor. Having an effective method to elevate is so important.
I would suggest you tell your husband to keep his hands off your Lounge Doctor. Having an effective method to elevate is so important.
Hi Scruffy, you're two days ahead of me (my RTKR was last Wed 10/31). I'm sorry you're hurting and having to fight for what you need. My hubby leaves me alone a lot to fend for myself. I'm able to walk without the walker and I've just had 1 shower so far. Best wishes!
scruffydog
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Trip to ER for IV fluids, check for clots, and an enema. Fun was had by all. Was there all day and night. No clots found, and other missions accomplished.
No more oxycodone for me. Ever.
Pain tolerable with ibuprofen & Tylenol and ice. I feel it, but would trade knee pain with how horrible I felt. Nauseous, dizzy, clammy, weak, lightheaded, pins & needles in face, and trouble forming and saying sentences. Out of breath after any exertion, and nearly passed out several times.
Am now walking w a cane / crutch, had a shower and am home on my own couch. Resting. Moving frequently. Drinking water. And remembering to eat. Even though not hungry at all. Yuck.
Thanks to those who replied. Nice to have support here as well as in real world. Hope all newbies are doing well.
No more oxycodone for me. Ever.
Pain tolerable with ibuprofen & Tylenol and ice. I feel it, but would trade knee pain with how horrible I felt. Nauseous, dizzy, clammy, weak, lightheaded, pins & needles in face, and trouble forming and saying sentences. Out of breath after any exertion, and nearly passed out several times.
Am now walking w a cane / crutch, had a shower and am home on my own couch. Resting. Moving frequently. Drinking water. And remembering to eat. Even though not hungry at all. Yuck.
Thanks to those who replied. Nice to have support here as well as in real world. Hope all newbies are doing well.
Try to eat as much protein as you can. Your body can use it for healing.
scruffydog
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Follow up.
“Tolerable”is a fluid word.
Question, please:
What other pain relief options are there, other than opiates (oxycodone) and just alternating/overlapping Tylenol/Motrin?
Some people tolerate pain differently than others. Half my well wishers who have had TKR say not to be a hero, and to stay ahead of the pain. Half say they were on Tylenol and Motrin a week out, and were doing fine.
I kept ahead of the pain, but ended up having a horrible experience. (It was stupid not to stay on top of fluid intake, since I knew that. And had full glasses of water everywhere ... that I felt to queasy to drink)
I don’t want to now have the pain get out of control. It is tolerable - I mean the knee hurt before surgery, I can take pain. But if does hurt. A good amount. Right now there is a burning. And the swelling above the joint makes it painful to (try to) bend much.
And so I was wondering what other suggestions for my pain arsenal I might be able to discuss with my doctor ?
At least I have Lounge Doctor and ice !
“Tolerable”is a fluid word.
Question, please:
What other pain relief options are there, other than opiates (oxycodone) and just alternating/overlapping Tylenol/Motrin?
Some people tolerate pain differently than others. Half my well wishers who have had TKR say not to be a hero, and to stay ahead of the pain. Half say they were on Tylenol and Motrin a week out, and were doing fine.
I kept ahead of the pain, but ended up having a horrible experience. (It was stupid not to stay on top of fluid intake, since I knew that. And had full glasses of water everywhere ... that I felt to queasy to drink)
I don’t want to now have the pain get out of control. It is tolerable - I mean the knee hurt before surgery, I can take pain. But if does hurt. A good amount. Right now there is a burning. And the swelling above the joint makes it painful to (try to) bend much.
And so I was wondering what other suggestions for my pain arsenal I might be able to discuss with my doctor ?
At least I have Lounge Doctor and ice !
Softtail
senior
Josephine might be able to help you there . At just over a week out there is no doubt you are dealing with pain , so don’t think there is something wrong with your knee. You will have pain jump around ,tightness can show up anywhere on knee and restricts your knee bend. All normal. If you definitely feel your pain cocktail is not sufficient , get back to your doctor.
Rockgirl4
Former BoneSmart staff member
@scruffydog Have you heard of Movantik? It is a prescription medication to help fight the battle of opioid-induced constipation and worked wonders for me.I used to see the ads in magazine all the time a few years back.
I had a major knee surgery in 2015 that left me in severe pain for 3-4 weeks, requiring 2 oxycodone pills every 4 hrs. Even with stool softeners, I was miserable by Day 15-16, as my few trips to the bathroom weren't very productive. I had that same nausea, clamminess, and no apatite. My surgeon gave me a few tips on getting things moving finally, but I didn't want it to happen again, knowing the pain meds were necessary for weeks to come.
Once I started the Movantik, I was good to go (literally!!!!), though I kept taking the stool softerners just to be safe. It's a common medication in the USA, so I think it would be easy to request. It would let you use the oxycodone for better pain control, and NOT get backed up.
My surgeon told me that after my TKR in December, if I need the Movantik again, don't be afraid to ask him.
I had a major knee surgery in 2015 that left me in severe pain for 3-4 weeks, requiring 2 oxycodone pills every 4 hrs. Even with stool softeners, I was miserable by Day 15-16, as my few trips to the bathroom weren't very productive. I had that same nausea, clamminess, and no apatite. My surgeon gave me a few tips on getting things moving finally, but I didn't want it to happen again, knowing the pain meds were necessary for weeks to come.
Once I started the Movantik, I was good to go (literally!!!!), though I kept taking the stool softerners just to be safe. It's a common medication in the USA, so I think it would be easy to request. It would let you use the oxycodone for better pain control, and NOT get backed up.
My surgeon told me that after my TKR in December, if I need the Movantik again, don't be afraid to ask him.
You might ask your doctor to prescribe Tramadol. It's a synthetic opioid that is weaker than the heavy-duty narcotics and it's a useful "step-down" drug from them. You can combine it with Tylenol for increased pain relief.
You should also ask to have an aperient prescribed for you - to combat constipation. All those pain medications make me very constipated and I had to take an aperient every day, to ward it off.
You should also ask to have an aperient prescribed for you - to combat constipation. All those pain medications make me very constipated and I had to take an aperient every day, to ward it off.
scruffydog
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Thank you !
@Rockgirl4 I will remember that info in case I ever need to get the "good" knee done. I have been ok since the trip to the ER got everything hydrated and "in order."
And thank you @Softtail & celle -
I got the rx of tramadol, but I am afraid to take it after what happened with the oxycodone. If it is weaker than the oxycodone, that is a good start.
I am not sure if there is a difference between oxycodone and hydrocodone, but I know I can handle lortab. So I might see if I can talk to my doctor about that. I am also a bit *anxious* so may try some ativan for therapy because I was really wired from anxiety on Friday. I don't know.
I will be two weeks out tomorrow, and haven't had anything stronger than tylelol & motrin for a week now. I do think I could get a little more flexion at PT with something stronger, and the past couple nights its taken a little while to fall asleep, so I think it would help with that, but other than that, the pain really hasn't been that bad. But I am resting and elevating alot. And icing some, but need to do that more. I love ice.
My activity level has varied over the past few days. I probably overdid it on Friday, so I've been really resting up this weekend. Using a cane or one crutch, and getting much more (for me) bend in my walk. Friday, was not able to do a revolution on the bike, but wasn't expected to. The stationary bike was just a nice way to stretch it some. Went to my kids' back to school conferences on Friday, but only made 2 of the 10 minute sessions because I had to get home and make sure the house was tidy for a brief business meeting. No heavy lifting, but more walking and bending than I would have liked. Have managed a couple loads of laundry, but admit to washing a load a second time to avoid unloading it. Not a big fan. It really is time to teach my teen boys about the joys of laundry.
I have a couple more questions:
(1) from all the sitting and laying around, I am getting the beginning of piriformis / sciatica pain. Does anyone have any suggestions on what to do for that ? I will ask the PTs tomorrow, but it is really helpful hearing from other patients.
(2) would love suggestions on how to gently remind family members that the healing process is a PROCESS ?
I've been asked to iron, make dinner, drive to the airport. I've politely declined most requests, and can and will continue to do so when I need to, but am afraid that I will start getting really annoyed that my loved ones think I am fine and back to normal already, or that I might start doing too much because it's easier.
(3) lower thigh pain
When I try for flexion, it is the lower inside of the quad that is hard as a rock and swollen and sore, and prevents me from getting all that much. I am not stressing about it, because I am trying to gently stretch it every day and it is improving, but I was just wondering if that is normal, and if anything in addition to rest, ice, gentle stretching might help it calm down ? My PTs have really been great, and said not to worry if the doctor fusses at me at the 2 week appointment tomorrow about the flexion not being that great. I think they want ~90, but since I've read all the posts here, I am not overly concerned and do not want to rush it, especially if it continues to feel looser every day. They also said not to obsess over the #s, which was also nice to hear.
(4) Adhesions
If I am going to get them, would they be here now, between 1 & 2 weeks out ? What exactly is an adhesion, and is there any way to avoid or fix them ?
Thanks !
@Rockgirl4 I will remember that info in case I ever need to get the "good" knee done. I have been ok since the trip to the ER got everything hydrated and "in order."
And thank you @Softtail & celle -
I got the rx of tramadol, but I am afraid to take it after what happened with the oxycodone. If it is weaker than the oxycodone, that is a good start.
I am not sure if there is a difference between oxycodone and hydrocodone, but I know I can handle lortab. So I might see if I can talk to my doctor about that. I am also a bit *anxious* so may try some ativan for therapy because I was really wired from anxiety on Friday. I don't know.
I will be two weeks out tomorrow, and haven't had anything stronger than tylelol & motrin for a week now. I do think I could get a little more flexion at PT with something stronger, and the past couple nights its taken a little while to fall asleep, so I think it would help with that, but other than that, the pain really hasn't been that bad. But I am resting and elevating alot. And icing some, but need to do that more. I love ice.
My activity level has varied over the past few days. I probably overdid it on Friday, so I've been really resting up this weekend. Using a cane or one crutch, and getting much more (for me) bend in my walk. Friday, was not able to do a revolution on the bike, but wasn't expected to. The stationary bike was just a nice way to stretch it some. Went to my kids' back to school conferences on Friday, but only made 2 of the 10 minute sessions because I had to get home and make sure the house was tidy for a brief business meeting. No heavy lifting, but more walking and bending than I would have liked. Have managed a couple loads of laundry, but admit to washing a load a second time to avoid unloading it. Not a big fan. It really is time to teach my teen boys about the joys of laundry.
I have a couple more questions:
(1) from all the sitting and laying around, I am getting the beginning of piriformis / sciatica pain. Does anyone have any suggestions on what to do for that ? I will ask the PTs tomorrow, but it is really helpful hearing from other patients.
(2) would love suggestions on how to gently remind family members that the healing process is a PROCESS ?
I've been asked to iron, make dinner, drive to the airport. I've politely declined most requests, and can and will continue to do so when I need to, but am afraid that I will start getting really annoyed that my loved ones think I am fine and back to normal already, or that I might start doing too much because it's easier.
(3) lower thigh pain
When I try for flexion, it is the lower inside of the quad that is hard as a rock and swollen and sore, and prevents me from getting all that much. I am not stressing about it, because I am trying to gently stretch it every day and it is improving, but I was just wondering if that is normal, and if anything in addition to rest, ice, gentle stretching might help it calm down ? My PTs have really been great, and said not to worry if the doctor fusses at me at the 2 week appointment tomorrow about the flexion not being that great. I think they want ~90, but since I've read all the posts here, I am not overly concerned and do not want to rush it, especially if it continues to feel looser every day. They also said not to obsess over the #s, which was also nice to hear.
(4) Adhesions
If I am going to get them, would they be here now, between 1 & 2 weeks out ? What exactly is an adhesion, and is there any way to avoid or fix them ?
Thanks !
Last edited:
BeesKnees!
junior member
Hi Scuffydog,
I had my LTKR on Oct 29th too. Came home from the hospital on the 30th also. It Sunday November 11 now. I had my RTKR on June 11.
I know I cannot compare knees and I was hoping the second knee would be better, because I have experience. But last time I hardly had any swelling at all, and had ROM 120 within two weeks. This time my whole leg is swollen, and I have a very sore calf muscle that’s inhibiting my movement.
I wouldn’t be able to meet my Mom for lunch 4 days out and sit in a dining chair.
I was on Oxycodone first, now on Hydrocodone 5mg 325. Trying to figure my dosage out. Too much makes me dizzy, and headachy. Too little, I’m in pain.
We are almost 2 weeks out now. Patients is a virtue.
I had my LTKR on Oct 29th too. Came home from the hospital on the 30th also. It Sunday November 11 now. I had my RTKR on June 11.
I know I cannot compare knees and I was hoping the second knee would be better, because I have experience. But last time I hardly had any swelling at all, and had ROM 120 within two weeks. This time my whole leg is swollen, and I have a very sore calf muscle that’s inhibiting my movement.
I wouldn’t be able to meet my Mom for lunch 4 days out and sit in a dining chair.
I was on Oxycodone first, now on Hydrocodone 5mg 325. Trying to figure my dosage out. Too much makes me dizzy, and headachy. Too little, I’m in pain.
We are almost 2 weeks out now. Patients is a virtue.
BeesKnees!
junior member
Scuffydog,
I have been having lower back, hip pain from sitting and laying around. I ordered a tube of Tiger Balm neck &shoulder rub pain relieving cream on Amazon.
I carefully rub it into my hip and lower back giving myself a good massage. It’s really helped me with that deep back and hip pain for me.
I know it’s says neck and shoulder, but it can be used on back legs ect. Has good reviews on Amazon
I have been having lower back, hip pain from sitting and laying around. I ordered a tube of Tiger Balm neck &shoulder rub pain relieving cream on Amazon.
I carefully rub it into my hip and lower back giving myself a good massage. It’s really helped me with that deep back and hip pain for me.
I know it’s says neck and shoulder, but it can be used on back legs ect. Has good reviews on Amazon
Show them a real-time video of a knee replacement on YouTube. They should be a little more understanding after watching that!
It's very normal to still have tight areas and pain in all sorts of places so early in recovery. They will all sot themselves out, given time.
Don't worry at all about your flexion. Most surgeons don't expect 90 degrees until about 6 weeks. Your knee can;t bend more right now because it's still traumatised and swollen from the surgery.
In any case, there's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR
It's most unlikely that you will get adhesions. In spite of the fuss people make about them, they are actually quite rare. You certainly won't have them this early in recovery and they aren't sitting there,waiting to pounce if you don't exercise enough.
Adhesions may form during the “hot” phase of tissue recovery, when the tissues of the knee are angry and inflamed from the trauma of surgery. These angry inflamed tissues become quite hot, with the result of sometimes also being dry, which can lead to tissues that should just slide over each other instead “sticking” together and forming adhesions. One cause of hot, inflamed soft tissue is aggressive, inappropriate PT that aggravates an already angry knee. Doing so just extends the inflammatory phase —and that’s one reason why BoneSmart advocates for a gentler approach to movement and exercise. Once the soft tissues are no longer inflamed, they no longer produce the response that leads to adhesions. And that’s why we emphasize elevating and icing, to cool down the knee and calm (and eventually get rid of) the inflammation.
scruffydog
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Thanks for all the information & input!
@BeesKnees! - love your name! And, happy 2 week anniversary to us . I hope this second knee feels better soon !!
I had a good 2 week appt, and a really good PT session.
At the appt, which was first, I had about 85 flexion and full extension and was able to really discuss pain options. I got an rx for lortab because I have taken it before and am not afraid of it. The dr said ultram was “weaker,” but after the oxycodone fiasco I am afraid to try new things. As I walk and do a bit more, it is a little more painful at night, so I won’t be afraid to take that. I may first try the PM version of an anti inflammatory as he also recommended. But for now, I am really doing ok on just Advil & Tylenol. Some amount of pain is to be expected.
I saw the x rays and doc looked at them and the scar and said that the knee looked good, and my flexion was in the average range for 2 weeks out. I’ll take average !! I asked him about activity level /possible unreal expectations of my family. He told me to tell them I had at least 6 weeks before return to modified duty, and I had to take it easy until then. I like the idea of showing the YouTube clip of the surgery!!
PT were pleased too and I think I ultimately got a bit more than 90. Thanks to this forum, I am not caught up in numbers, but just glad to be gradually improving. They gave me heat for my back, eliminated the straight leg lifts, and modified a couple other stretches to prevent putting strain on my back. I made an agreement w my therapist - last time she tried to manually “stretch”/ move the knee I fought it by pushing against her. (Nothing wrong with quad muscles!!) I told her I would relax if she promised to go slowly and stop when I said. She did, and I did, and it was not bad at all. Go figure. I will not need pain meds for PT. ((Flashbacks to my ACL rehab in the late 1980s when the new ligament was tied in too tightly ... serial casting, mua, strong pain meds for visits, and towels to bite for pain with the forced flexion & extension)
My gait is getting pretty good w cane. I don’t always use it at home, and when I really concentrate I can walk well in PT without it, but I am in no rush to be untethered. I want to keep an aid until I can walk normally for an extended period of time.
And, my PT told me to drive go ahead and try driving home, and I did, and it was great ! But I am not driving anyone to the airport in rush hour yet !
I walked too far yesterday - went with my sister and dog on wooded path, then walked all around my Mom’s assisted living place, and managed to sit for lunch. But iced and elevated it a lot at home.
All in all I feel good about where I am at 2 weeks out.
Thanks Celle for all the great info on adhesions. I do like to understand what all these terms mean, and have an idea of how things work.
@BeesKnees! - love your name! And, happy 2 week anniversary to us . I hope this second knee feels better soon !!
I had a good 2 week appt, and a really good PT session.
At the appt, which was first, I had about 85 flexion and full extension and was able to really discuss pain options. I got an rx for lortab because I have taken it before and am not afraid of it. The dr said ultram was “weaker,” but after the oxycodone fiasco I am afraid to try new things. As I walk and do a bit more, it is a little more painful at night, so I won’t be afraid to take that. I may first try the PM version of an anti inflammatory as he also recommended. But for now, I am really doing ok on just Advil & Tylenol. Some amount of pain is to be expected.
I saw the x rays and doc looked at them and the scar and said that the knee looked good, and my flexion was in the average range for 2 weeks out. I’ll take average !! I asked him about activity level /possible unreal expectations of my family. He told me to tell them I had at least 6 weeks before return to modified duty, and I had to take it easy until then. I like the idea of showing the YouTube clip of the surgery!!
PT were pleased too and I think I ultimately got a bit more than 90. Thanks to this forum, I am not caught up in numbers, but just glad to be gradually improving. They gave me heat for my back, eliminated the straight leg lifts, and modified a couple other stretches to prevent putting strain on my back. I made an agreement w my therapist - last time she tried to manually “stretch”/ move the knee I fought it by pushing against her. (Nothing wrong with quad muscles!!) I told her I would relax if she promised to go slowly and stop when I said. She did, and I did, and it was not bad at all. Go figure. I will not need pain meds for PT. ((Flashbacks to my ACL rehab in the late 1980s when the new ligament was tied in too tightly ... serial casting, mua, strong pain meds for visits, and towels to bite for pain with the forced flexion & extension)
My gait is getting pretty good w cane. I don’t always use it at home, and when I really concentrate I can walk well in PT without it, but I am in no rush to be untethered. I want to keep an aid until I can walk normally for an extended period of time.
And, my PT told me to drive go ahead and try driving home, and I did, and it was great ! But I am not driving anyone to the airport in rush hour yet !
I walked too far yesterday - went with my sister and dog on wooded path, then walked all around my Mom’s assisted living place, and managed to sit for lunch. But iced and elevated it a lot at home.
All in all I feel good about where I am at 2 weeks out.
Thanks Celle for all the great info on adhesions. I do like to understand what all these terms mean, and have an idea of how things work.
BeesKnees!
junior member
Wow! Scruffydog, you sound like you are doing great. I can only hope to be walking in the woods at 4 weeks out. I’m struggling with my entire leg hurting. I’ve had very bad pain in my calf that feels like a constant Charlie horse when I put weight on my leg.
It’s getting better slowly. I see my doctor tomorrow, or probably the PA. I’m going to try walking around my cul de sac this afternoon. It’s been beautiful sunny fall weather here in the Willamette valley, Portland , Oregon.
Then I see my PT Thursday.
I’ve had a hard time with this left leg. My RTKR was a breeze compared to this left knee/ leg.
Keep up the good work.
It’s getting better slowly. I see my doctor tomorrow, or probably the PA. I’m going to try walking around my cul de sac this afternoon. It’s been beautiful sunny fall weather here in the Willamette valley, Portland , Oregon.
Then I see my PT Thursday.
I’ve had a hard time with this left leg. My RTKR was a breeze compared to this left knee/ leg.
Keep up the good work.
SusieShoes
Former BoneSmart staff member
It's so good to read your report and know you're doing wonderfully. For two weeks out, you're in the sweet spot. That you made that deal with your therapist is brilliant. I rather did the same with mine: I would try new exercises and he would accept my decisions about whether or not to continue them. Having an understanding means you can go to PT without stress, just knowing you will get some benefit from it. Benefits are good.
Do keep the cane around for a bit longer. I found mine quite useful on daily walks, even if I only kept it in hand for the whole time. It was available to knock branches out of my way, or warn people I might need a little leeway in lieu of a bump.
Do keep the cane around for a bit longer. I found mine quite useful on daily walks, even if I only kept it in hand for the whole time. It was available to knock branches out of my way, or warn people I might need a little leeway in lieu of a bump.
