TKR SeptemberZen's Bionic Journey

[SeptemberZen]

Clipless- yep, I've got a pill splitter and I've been using it. I initially had percocet in the 10/325 strength but was switched to the 5/325 strength that my doc didn't want to renew. When I ran out of the Perc 5s, I cut my few remaining Perc 10s in half and take them with a 500 mg Tylenol.
So now I'll cut those in half.

Just found out that doctors often suggest taking ibuprofen and acetaminophen together - who knew? May try that.

BananasKnees - Same here. When I wake up most mornings, my knees are killing me but I've noticed there's very little swelling. During the day, I wear the compression sleeve if I know I'll be out for awhile, so there's not much swelling during the day unless I really overdo it.

Legin - "...strength of mind..." I love that!

 

[Jamie]

Here is an article from the BoneSmart Library that may help you if you would like to try a combination of Tylenol and ibuprofen.

Acetaminophen (Tylenol) and ibuprofen cocktail

They do in fact work well together as long as you stay within the 24-hour limitations of each and you have no stomach or bleeding issues.

 

[SeptemberZen]

Thanks! Good to know! We went out to run some errands and before we left, I took one Tylenol (500 mg) and one Advil (200 mg.) Had some pain but not too bad. It appears that I didn't take a high enough dosage, though.

I remember that a couple of weeks ago, I took three 200 mg. Advil which turned out to be a HUGE mistake; my stomach was terribly upset for the rest of the day! I'll try only TWO next time with the Tylenol (and maybe throw some Pepcid in there for good measure).

 

[wberry]

Just got back from PT, aughhhhh.
On the funny recumbent seated looking walker thing. Not exactly a recumbent bike, but boy it pushes the ROM. I had to be able to do 100 to get on it. Up to 105/2 now.

I'm gonna do two extra strength tylenols. Didn't have a med this morning. No pain until the PT added some new stretches.


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[SeptemberZen]

Just read an article in the NY Times stating that acetaminophen is sometimes ineffective for pain.... no kidding. Now that I'm almost off of Percocet, I'm finding that ibuprofen seems to work a little better for me....

Need some input, Bonesmarties: I'm worried. I probably shouldn't be, but the truth is, I am. I'm at 11 weeks and the ongoing stiffness worries me. I can limp around the house without my cane but dare not go in the street without it, because of the following:

If I stand too long in the kitchen cooking, or shopping in stores, my knee stiffens so much, it really hurts to bend it in order to get my leg back into the car. If I'm out for a few hours, I'm usually leaning on the shopping cart using it almost like a walker to get me around the stores which is fine... but eventually my knee begins to stiffen and ache to the point where I have to seriously CONCENTRATE on making it bend.

On most days, just sitting around the apartment, my pain levels are anywhere from 1 - 3 but when my leg stiffens up like this, when I first attempt to bend it, the pain just above the knee and behind it shoots up to about a 5-6 but once the bend is complete, it generally calms right down, although I have residual achiness in my hips and lower back sometimes. I'm reasonably sure that this comes from my gait being off and also just garden variety arthritis.

I get information from a lot of forums, especially this one, and I've read a lot of testimonies from a lot of patients and I know, I know, I know that everyone's recovery is different. But really, is this normal? I worry that I have traded one kind of pain for another -- the bone on bone pain in my left non-op knee for the ongoing stiffness and achiness in my bionic knee. And the odd thing is, I understood that stiffness is generally caused by swelling but I don't have a lot of swelling. When I compare my knees, the bionic one is sometimes just slightly bigger but not by much. Sometimes it is slightly warmer to the touch, but not by much and my OS advised me that this is normal and may actually occur throughout the recovery for up to a year due to all the tissues, nerves, bones, etc., knitting themselves back together.

Is anyone here at 11 weeks or longer experiencing this kind of stiffness?

 

[Homeport]

Yes I have issue at night bend the leg and it is then painful to straighten it's more behind the knee the pain sitting here now I have my legs on one of those exercise balls to try and gently move I feel best after ten mins on static bike it lt loosens everything
Had eighth hydrotherapy today and he did say I had a good bend on the knee but I am in so much pain tonight I wonder if I over did it about to take two paracetamol and two hydrcodiene


20/01/2015

 

[Homeport]

Oh and my knee is warm too


20/01/2015

 

[Spencieca]

SZ..sorry to hear that you are still struggling with the stiffness and pain issue...do you massage the knee? I found that taking a tennis ball or a baseball/softball and rolling it on the area that is really tight helps...Some people retain fluid more than others, which could be part of the problem...the swelling may be on the inside more so than the outside...if I were you I would concentrate on massage the muscles and the scar..it will hurt a bit in the beginning but it does get better...have you talked to your OS or GP about this?

 

[Jamie]

Please let me reassure you that you are very, very normal with your recovery. The problem is that you are ONLY 11 weeks out. That is very early in the recovery process. When your knee stiffens up it means you're pushing yourself too hard and trying to do a bit too much for where you are right now.

It is not good for you to limp anywhere....even around the house. That is hard on your new knee and the rest of your body. Please use whatever walking aid it takes to allow you a normal stride. For example, I used my walker at home for months because with that good support I could take long, strong strides walking from room to room. I could have done without it, but when used in this way, it's an exercise tool. Those long strides work and strengthen leg muscles and allow you to get good extension stretches. Limping or taking small strides does just the opposite and can actually allow muscles to tighten up.

The pain you have indicates swelling in your knee, even though you cannot see it. The knee compartment is very compact and it doesn't take much fluid there to cause pain or stiffness. So don't use the size of your knee as a gauge....the pain indicates inflammation and swelling. It most likely results from being on your feet too much at a time. Try shorter spurts of being up and around for another couple of weeks.

We went out to run some errands and before we left, I took one Tylenol (500 mg) and one Advil (200 mg.) Had some pain but not too bad. It appears that I didn't take a high enough dosage, though.

I remember that a couple of weeks ago, I took three 200 mg. Advil which turned out to be a HUGE mistake; my stomach was terribly upset for the rest of the day! I'll try only TWO next time with the Tylenol (and maybe throw some Pepcid in there for good measure).

Taking 500mg of Tylenol will not work on this pain. When you take it, you need to take 1000mg. Just be sure that you don't take more than 4000mg in a 24 hour period and that you count all sources (sinus meds, cold remedies, and some prescription pain meds contain acetaminophen).

As you found, it's usually not a good idea to double up on doses of NSAIDs. You can combine it with the Tylenol, but do pay attention to the dose and how your stomach reacts.

The article you read about Tylenol being ineffective for pain discussed a study related to pain associated with arthritis. That is very different pain than what you have. Now that you have a TKR, you no longer have arthritis and the Tylenol should be very effective in dealing with pain providing you are far enough along in recovery not to need prescription pain meds.

 

[Maggie94]

Those long strides work and strengthen leg muscles and allow you to get good extension stretches. Limping or taking small strides does just the opposite and can actually allow muscles to tighten up.

@Jamie @SeptemberZen that is what my PT said last week. Ive been out today and purposefully strode for 3600 steps...I sound like a mad woman around the house muttering to myself...big steps, big steps - LOL

 

[wberry]

I have found icing the back of my knee helps a lot, I think @referee54 gave that recommendation. I also take Tylenol with my tramodol if I am only taking one. If my knee is supper stiff I put a warm towel on it the loosen it up, followed by an ice and elevate session.


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[SeptemberZen]

Thanks to all. I've really been spinning lately -- moods are all over the place! I'm thinking it's a combination of extreme boredom, weaning myself off of the Percocets, and the fact that it's been raining for the past three days in my part of the world, with more expected tomorrow. I don't care that scientific studies are inconclusive about whether or not damp weather causes physical ailments: I've always been more achy in wet weather than not; my non-op knee and my lower back are feeling quite creaky lately!

So -- this is going to sound very mean and I'm not a mean person -- but seriously, I have to STOP reading posts on this forum and others like it from people who spring out of their beds at 6 weeks, unassisted, without pain meds, happily driving themselves to work and feeling spiffy! Yeah, yeah, I know: we shouldn't compare our progress to other people's but in the real world, most of us do anyway. I'm all kinds of happy for those who are having an easier recovery than I am, truly, but at the same time, it hits my 'should I worry about this' button like crazy! The stiffness is frustrating to say the least.

I will take ALL of your suggestions:

-- I will take longer strides to work on my gait. I was doing this for awhile; don't know why I stopped.
-- I will try to monitor how much time I can spend on my feet before my knee starts to stiffen up and try to get back to the car or somewhere to sit down before it gets too painful
-- I will try adjusting the meds again to see which cocktail works the best
-- I will try to be patient, which is apparently, very difficult for me to do. I was scheduled to go back to work next week and I was thinking of putting it off, mostly out of fear of not being able to take a daily nap and because of my long commute. I'm thinking now that I should probably tough it out and go. I can't do the gradual thing; most companies want you either there or not there, and are not necessarily amenable to a part-time schedule of the employee's choosing! But if I need to go home early, I won't get much resistance. I'm not at all religious but it's said that "an idle mind is the devil's playground" , so maybe going back to work really is the answer. I'm a very, very busy payroll adminstrator who barely has a chance to breathe at work which will probably be a good distraction!

Here's some good news for a change! Tried the Saran wrap thing last night because the hypersensitivity around my incision has been driving me mad. Even a light touch from the sheets has been extremely irritating.

Had pain during the night as usual so I got up and put on the Saran wrap. The pain was uncomfortable but NOT unbearable so I didn't take a pill. When I awoke this morning, I was achy but not as bad as I have been in the past. When I took off the Saran Wrap, my knee was not as stiff and sore as it usually is. As soon as I started walking to the bathroom, the ache began to subside a little. Yay! A breakthrough! Right when I needed it!

 

[wberry]

Really! Saran Wrap huh, how did I miss that post in here? Well I had to start wearing my hoses at night to help with my stiffness. I will try the Saran Wrap, need to do a search for the post reference.

Are you originally from the Jersey area or are you a transplant like I am from FL.


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[SeptemberZen]

There's a link here somewhere to a You Tube video where this guy shows you how he wraps his knee up at night with Saran wrap. I saw it way before I found this forum and thought the guy was nuts but it helps, it really does! If you can't find it here, just go out and Google "saran wrap knee" and more than likely, his video will pop right up.

I'm actually a native New Yorker, born and raised on the Lower East Side of Manhattan. I love my city -- but rents are cheaper on the other side of the river.

 

[wberry]

I agree there on the rent, my wife use to live in New York, she told me stories about the rent. Okay I will search for the you tube on it.

I forgot to ask, has your sleeping improved any. I am sleeping all night now since getting of the narcotics and getting more ROM.



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[SeptemberZen]

Glad to hear that! Me too -- sleeping is also a little better. I still don't sleep straight through the night, but I don't wake up in screaming pain like I did when I was taking Percocets every 4 hours. When I wake up, I try to adjust my leg into a more comfortable position or get up and go to the kitchen or bathroom. Moving the leg helps. Over the last few days, instead of a Percocet before bed and one in the middle of the night, I take neither OR only the one before bed if I'm uncomfortable.

 

[Clipless]

SZ, I understand. When I was 3 months post op I was in AGONY for real. It was a distinct stage in my recovery that was especially disappointing because I was emotionally expecting to feel better. I remember leaning on shopping carts, thinking I couldn't make it back from short walks, not being able to bend my knee enough to get it in the car, etc.

I stopped reading the amazing recovery stories because they made me feel like a failure, and because they simply lacked relevance for me. I prefer to hear about TKR recicients who had slow but gradually successful outcomes and returned to full function, as that gives me real hope.

Returning to work is just another milestone in your recovery. Expect it to suck at first, and for a while. You won't feel better instantly, but work does tend to make the days go by faster. Bring a few large zip-lok bags, prop your leg up on the desk and ice when you can.

At 5 1/2 months out I am finally starting to feel quite a bit better despite the occasional bad day. I am far from completely recovered, but I'll get there eventually. You will too, SZ! You will get there!

 

[SeptemberZen]

Clipless - THANK YOU. Your response was spot on. As I said in the earlier post, I visit other forums similar to this one and yesterday, as I skimmed through one and saw one of those 'miraculous recovery-I-ran-a-marathon-as-soon-as-they-released-me-from-the-hospital!!!'' posts, I stopped reading immediately. LOL! Emotionally I just don't have it right now and that will have to be OK.

I don't regret having done this but I wish I'd found this forum prior to surgery. I wish all the people at work who said "Oh yeah, my mother in law did it last year and she was so happy, she did the other one last night!!" had told me the real deal or let me speak to the friend/mother/mother-in-law who had a TKR so that they would have told me what to expect. I'm one of those who wants the details, good, bad or ugly. I don't like surprises; never have -- I like to KNOW what's coming.... and all this pain, frustration and slow progress was a surprise.

Glad you are feeling good at your stage of recovery! Best to you!

 

[wberry]

I can relate, no really I can. Let me explain. I had another major surgery about 8-9 years ago, a level 3 services fusion of my upper spine in my neck. This came from premature degenerative disc desease following an accident when I got hit by a falling tree. My Dad always said I was hard headed, well it didn't break my neck. Following the surgery I was on a no drive limited activity order for 4 weeks because I was in a J- collar brace. I hand discussed the recovery with my doctor and he thought I would be good in a month. Instead I suffered incredible pain, setbacks and lack of progress on my neck healing, long weeks with little or no sleep. I was on percocet, Vicodin, and even a pain pump for 3 months. I had to get shared leave from a friend at work because I was out way past what I exspected.

The Doctor only said, it's your recovery and no one else's. Let your body heal itself on its time table and you will be better off in the long run.

Now I can say I didn't truley feel normal for almost a year and a half. I truly know if I hadn't taken what the Doctor told me to heart, I would have hurt myself and my recovery, and the feelings and let downs might have crushed me.

So fast forward to me now. Yea, there are some aspects of this recovery that have gone well, but I have always tried to paint the best light on things. I haven't mentioned that I am currently down with a lot of pain, my knee has swollen up badly and I cancelled PT for the rest of the week because I am in a set back. So I am icing, elevating, resting, and back on my heavy meds until I get through this. I have to slow down and let my body drive the recovery. Even though I have good ROM numbers, I still have muscles and knee motion that is still offline, and the PT is concerned. Most of them are things other patients could do when they left the hospital, and I still can't. I watch one guy the day after surgery, get up stroll around up and down the hall easy pezee and the released him the same day. Me I was there an extra day and could barely walk with my walker when in left.

I personally admire you and your progress, and your comments and those of others have helped me when I look at all the holes in my recovery. So I paint the rosy picture and look to the blossoms in my recovery and take comfort that when it's time the rest of this flower bed will bloom for me. The key is it will happen, that's a better retrospect to me than it will never happen. Like you I wish I had had more information, but my alternative was to continue walking in a brace, when I didn't wear it, every single step hurt and I was in a constant cycle of swelling, pain, and stiffness. At least after the surgery that pain cycle is gone, replaced by a slow recovery cycle. But I take comfort from my last slower recovery and from the fantastic people on this form. It's like we are all in the hole of this giant Viking ship and our operative knee is chained down and sometimes gets reached, hurts, pops, feels better, improves some, then gets hurt again in a new way. But we are all rowing, all moving the ship forward together. Some day we will all get off, the chains will be cut and we will walk away.
Your way ahead of me, just keep moving girl, take your own time and you will finish the race when it's time.

Peace, love, and happiness in all things, thinking of you and praying for you on this very special journey.

 

[SeptemberZen]

Thanks for sharing that, WB! Wow, you have certainly been through it, haven't you??

As an aside...this is one of the things I love about online communication and why I have been doing it for nearly 20 years -- old, young, black, white, male or female, we are all part of the human experience and have so much to share with one another. (In a past life, I was a webmaster and online bulletin board moderator.)

I'm so sorry you've had a setback and boy, can't we ALL relate to that! Frustrating to say the least, but part of the journey, isn't it? Sigh.

Today was a relatively good day, I suppose. I was on my way to the bank this afternoon which is through the apartment complex and around the corner (which seems like a million miles when you have two bum knees) when who should come back from his errands but the Boyfriend. He asked if I wanted a lift and all of me said, "Say no. You need to take this walk because you're going back to work next week," but "YES, thanks!" came out of my mouth because just the half block I walked took SOOO much effort. SOOO tired of this and I just realized that withdrawing from Percs can cause a day or three of depression which is probably part of what I'm dealing with as well. Yes, we WILL get through this, WB. Will we 'look back on this and laugh'? I doubt it! But we will see the other side... and lucky me, I get to do this all over again next year with the other knee! Whoop-de-flipping-do!