TKR Snoots recovery thread<

[Lindylee]

I found the best thing to help 'things move' is 2 tablespoons of golden linseed in Activia yoghurt as recommended by my dietician, beats all the laxatives.

 

[Spex10]

Ooh yes. Activia is great.

 

[catkin69]

@snoots how are you getting on?

 

[snoots]

Better day today. Still nothing ‘moving’ but pain wasn’t so scratchy today. Managed to keep food down. I’ve ordered some linseeds from amazon to add to yoghurt. Not really keen on taking laxatives.
Spoke to doc who has prescribed gabapentin and some liquid laxative. Hoping the gabapentin will stop the scratchy pain and help me settle in the evening. How are u @catkin69 ?

 

[catkin69]

I’m really pleased you had a better day. I hope the laxative helps soon. You will feel better for that. I hope the gabapentin helps too.
I have had a good day probably because I have taken it very easy!!

 

[sistersinhim]

I took an oxycodon at breakfast today for pain and I’ve been nauseous all day.

Be sure to something with protein in it about 20 minutes before you take your pain meds. It helps to coat your tummy, thus helping to keep the nausea down.

For my backed up problem, I found that taking Miralax 3 times a day and eating mixed nuts helped to get things moving again. Also, a lot of water!

 

[Josephine]

Not really keen on taking laxatives.

Ladies, nobody has given you the link to our article on constipation! Constipation and stool softeners

 

[Josephine]

Here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

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 to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?

4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[snoots]

1. pain levels 6

2. pain medications have you been prescribed, how much are you taking (in mg please) and how often?
Paracetamol x6 500mg
Naproxen x2 500mg
Ondansetron x3 4mg
Oxycodon x2 10mg
Gabapentin x3 300mg
Omeprasole x1 20mg

3. Swelling is moderate

4. Flexion 90 Extension 0

5. Icing every hour for 30-40 mins. Using Game Ready machine pretty much all day

6. Elevating on stack of cushions for 5 minutes but not very often

7. Activity level I’m up and down a lot. Find it hard to sit still.

8. Not much as lifting my leg really hurts on medial side.
Foot slides x20 x6 per day
No PT. starting on Monday.

 

[Josephine]

Some additional information please

2. pain medications have you been prescribed, how much are you taking (in mg please) and how often?
Paracetamol x6 500mg
Naproxen x2 500mg
Ondansetron x3 4mg
Oxycodon x2 10mg
Gabapentin x3 300mg
Omeprasole x1 20mg

You never told me how often!

6. Elevating on stack of cushions but not very often

Got that but for how long?

 

[snoots]

The tablets I listed are how many I take each day. I elevate my leg for five mins every hour.

 

[Josephine]

are you trying to tell me you only take each of these medications once each day?

 

[snoots]

Sorry I will clarify.

Paracetamol 500mg 4 times per day
Naproxen 500mg twice a day
Ondansetron 4mg three times a day
Oxycodon 10mg twice a day
Gabapentin 300mg twice a day
Omeprasole 20mg once a day

 

[snoots]

We

 

[snoots]

Natural yoghurt, Linseeds and blue berries . We have movement!

 

[Josephine]

 

[catkin69]

Hooray!! I bet you feel better for that xx

 

[Josephine]

1. pain levels 6

For one week out? That's amazing!

3. Swelling is moderate

Ah - moderate swelling adds 4 points to the pain score so that bumps it up to 10!

Oxycodone 10mg twice a day
Paracetamol 500mg 4 times per day
Gabapentin 300mg twice a day
Naproxen 500mg twice a day
Omeprasole 20mg once a day
Ondansetron 4mg three times a day

I think you should be taking the oxycodone 4 times a day as prescribed but if it's not working for you, I suggest you ask your GP for Tramadol instead which is much MUCH more effective
Paracetamol is being taken correctly but on it's own is in adequate for a knee. You can take it that way with Tramadol as well, btw.
Gabapentin is not usually given as a standard pain killer. It has an entirely different function for nerve pain.
Naproxen is a lot more effective than ibuprofen, is still and NSAID and needs to be taken with caution.
Read these

Omeprasole is what is commonly known as a 'stomach protector' used when taking NSAIDS but why take a second med to cover for another one!
Ondansetron is an anti-emetic or anti sickness medication. You need to figure out what's causing your sickness and stop taking it. I'm not in favour of taking extra meds to prevent to side effects of another one!

4. Flexion 90 Extension 0

Wow! Pretty good. However, don't get depressed if it goes backwards!

5. Icing every hour for 30-40 mins. Using Game Ready machine pretty much all day

Jolly good!

6. Elevating on stack of cushions for 5 minutes but not very often

You need to elevate for at least 40-60mins and more than 4 times a day.

7. Activity level I’m up and down a lot. Find it hard to sit still.

I understand.

8. Not much as lifting my leg really hurts on medial side.
Foot slides x20 x6 per day
No PT. starting on Monday.

I suggest you stop the exercises, such as they are, as you don't need them. And cancel the PT as well because you don't need that either. You're doing excellently well anyway.


In summary:
1. amend your medications as suggested
2. amend your routine of elevation
3. cancel exercises and plans for PT.
It's not the exercising that gets you your ROM, it's time. Time to recover, time for swelling and pain to settle and time to heal. One thing that seems to be missing from all the PT's protocols is that all your ROM is there right from the start, just waiting for all 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. Exercise as in strength training is counter-productive and in the early weeks does more harm than good. Normal activity is the key to success.

If you are concerned about refusing to do therapy, you need to read this Saying no to therapy - am I allowed to?

 

[Spex10]

Such a relief for you @snoots! It's a great moment!

 

[snoots]

I will be honest @Josephine I haven’t been taking the oxycodone since Thursday as I felt so bad after taking it. Shall I ask the doc to change it to Tramadol?