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Bilateral TKR Somewhere over the rainbow...

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Well, I hit a crisis point yesterday. When my brother dropped off all my perscriptions- they noticed that two of the perscriptions were for Oxycotin- not one for Oxcotin and the other for Oxycodone. The doctor called in an emergency three day supply with a mail-in perscription- the drug store didn't have any oxycodone. I wasn't informed till it was late in the day. I hadn't taken any since 9am. I was in so much pain overnight. This morning another chain of drug store was able to get me the emergency amount till the perscription arrives. SIGH- man there is a real difference with movement without it. The drug will arrive to me within the half hour.
I guess there is always something around the corner waiting ....
 
Skigirl- you are so right. I tried to do some of the exercises without the oxycodone and really felt it was a mistake. I am 76 and 0 in my ROM wonder if that is behind the norm.
 
Don't worry about rom right now---the swelling is the problem. A garden hose filled with water will not bend!! The most important thing for the first thee weeks--in my opinion!! is to work on the swelling. So, rest, elevate and ice. Also, take your pain meds on schedule---which was not possible for you--I wonder at the nurses in the office who did not check those scripts!!! Especially when they give you such small amounts that you need new scritps all the time. I finally told my doc that I pay the same co-pay for 20 as I do for 50 and could he please give me one script for 50--which he did do.

Once the swelling is down, the rom moves along quite nicely!! Here is my own plan---I rested for the first three weeks---only did stretching and gentle heel slides in pt. had massage for the swelling. Then, at four weeks, when the swelling was down quite a bit, I was able to begin gentlly moving the leg and think about some strengthening exercises. There is no need to rush---the outcome is about the same for everyone---120-130 seems to be the norm---I was lucky and did get to 150. but remember, I did not worry about rom until I had the swelling under control.
 
Hi, and welcome to the "other side!" I echo the praises of Peapod--it's not just for the homebound. When I'm on the road (as well as in hospital and rehab this time), my family e-mails me the grocery list and I order from wherever I am, even choosing the delivery time! Make sure your home PT knows what you are and aren't willing to do. Establish a "safe word" that indicates you're about to cross over from discomfort into pain, and make sure (s)he honors it. Yes, sometimes in order to make progress we have to endure discomfort (not nec. pain), and taking your meds enough in advance of your therapy will relax you enough that you won't tense up and fear you will go into the pain zone. (Part of therapy is learning what muscles NOT to work--just as in childbirth)! It isn't about being better able to "endure" PT "pain" (which you shouldn't allow to be inflicted). You will know you're going in the right direction when you feel a little suppler with each passing morning upon arising. Don't judge by how you feel w/in the first couple of hours after a session--and make sure you ICE as soon as you're done.
 
Yesterday I had difficulty with the oxycodone. I got sick for a while and ended up with sore abdominal muscles. I will get the hang of it.
Tomorrow, I go for my out-patient evaluation. I'm nervous about the situation. I liked how my in-patient physical therapy went and hope this one works the bonesmart mantra. If they don't- I wil mention it.
Once the first evaluation and meeting with the PT therapist is past- I know I'll feel better.
 
I wonder why what doctors use and do not use vary so very much?? My doctor did not recomend the compression stockings, the CPM machine, the braces or anything. Makes on wonder what truely is helpful or is it based on the all mighty dollar only??? Hey Luisa, It was so nice talking with you yesterday on the phone!:friends: I was up all last night in miserable pain.. I should have emailed you so you could keep me company. Hopefully you slept better than I did.:sad:
 
Today was my first out-patient PT session. I liked the therapist who seemed to "get it" about how to work with me. I'm so happy if it continues this way- just finding a therapist who works well with a patient is a plus.
I have exercises to do and am looking forward to next session.
I'm still have a problem with nausea and pain meds. The Zofran didn't do the job of helping that situation today. I continually felt as if I was going to be sick.
 
Gidem, I saw the brace and will ask my OS when I see her next week if she thinks its a good idea for me. Tomorrow I will have the PT measure my ROM so I have numbers to tell my OS also. The meds were making me sick also Gidem, terrible headaches and nausea. I have switched 3x so far and so far, with the Vicodin its better, but pain is still there. MY pain management Dr mentioned something about an injection for a nerve block given weekly to help with pain. Im wondering if I should take him up on that since i am so so tired of the pain. I felt my OS really just switched me to meds that did nothing for pain (tramadol). I never got to speak to her, it all went through the secretary, so thats when I called the pain management dr I had from before surgery. I really felt like he HEARD me and understood my pain. Maybe you can ocate one in your area and explain your discomfort.

gazelle7777 Nice talking to you as well. I was just telling the hubby how tired I am of being in pain. It never really disappears, a;ways at least nagging, sometimes worse, sometimes when Im busy I can forget, but its always THERE. Its emotionally exhausting. I am asking my Pain Management dr for the shot....I hope it helps...will let everyone know Saturday.
 
Well, I had another crisis this week in terms of meds. On Monday we had trouble getting the oxycodone filled- finally we found a pharmacy that had it. I wasn't able to get it till Tuesday- with a lot of pain built up since Monday morning- I took 3x 5mg of it. I had been given that a few times when going through some pain and prior to pt.
Well, I got so sick this time and the nausea was terrible. I couldn't understand why I was vomiting so much. The next day I took 1 every 6 hours and still felt very unsettled. I took 2 before my pt on Thursday was sick and experienced nausea for the rest of the day. On Friday, I decided something was up and found out that although the doctor wrote the correct amount for the oxycodone- 5mg- the pharmacist wrote 5mg on the jar but gave me a supply of 15 mg. SO- when I took 3x 5 mg- it was really 3x 15mg. I was so upset over this careless mistake.
The first few days after my surgery they gave me too much of certain meds together and I was in Lala land for hours talking about Dorothy and Toto.
I finally have the right dosages, and yet still have to take some Zofran to counter the nausea sometimes felt.
 
Sounds like pharmacist negligence (even if the mistake was on the part of a tech, the pharmacy is still responsible for the errors and omissions of all its employees). You are very lucky that you did not suffer a more serious effect from the overdose. Someone in charge needs to be notified so that it doesn't happen to anyone else!
 
WOWWWW that was a hugggge mistake. So glad you discovered the mistake and hope you are feeling better! I knowall about that nausea you are feeling, so ihope the zofran helps quickly.
 
Yesterday was my second full pt session. I felt it went well, but when I got home- the legs began to really hurt and it was very painful. I took 2 oxycodone and after about an hour the pain slowly left. Thank goodness, today is no pt. I am extremely sore and stiff today. I want to relax and just heal from pt. I have another session on Thursday and then one on Friday. I didn't want two days in a row and the pt therapist didn't want that either- but I have no way to get to the session unless it was Thursday and Friday. I hope Friday isn't too bad due to the fact it is the day after a previous therapy.
I had been on oxycontin twice a day- 12 hours apart. This week, I was told to cut back and take 1 per day. I really notice the difference. I decided to take the morning one believing that it would help me when I take pt along with the 2 oxycodones.
Previously, I had no real difficulty going to sleep at night. I'd fall asleep (after putting on the braces- ugh) and pretty much stay asleep till 5am. I would wake up every few hours, but then immediately fall back to sleep. Well, since cutting back on the nighttime oxycontin- I have had two sleepless nights. The legs are painful in the braces and I just can't find myself being able to maintain sleep.
Has anyone else had to cut back and found new difficulties? Maybe I should take the one allowed at night to help sleep. Hopefullly the oxycodone would be able to alone handle the pt session.
 
Reading this board has been such a godsend to me. It allows me to feel part of a family that knows what each is going through.
I am still a bit concerned over my ROM. I see how well everyone is doing and worry that I am not doing well.
I asked what my ROM was on the day I was evaluated at the out-patient physical therapy session last week. That would have been 17 days post surgery. I was 80 on my own and 85 when pushed for the left knee with a +2 and 80 on my own and 90 when pushed on my right knee with a +5.

I know we are all different and progress at different rates- but seeing how many are 100 and over not long after surgery is amazing.
The only thing that makes me feel positive is that the numbers do continue to improve.
My first numbers were 62, then 75 now in the 80s- all going in the right direction.
I just have to remain positive and say- I, too, will get there....

I haven't been measured since doing the two formal sessions and believe my legs have improved- so I look forward to the next measurement.
 
Gidem, you are moving in the right direction! My flexion was prob only around 90 degrees and extension was at -18. Now at 5 weeks its much better, at abt 115 flexion and -5 extension. It will come, and you need to work on bringing the swelling down by icing and elevating as much as you can.
 
I am finding the night to be the toughest point of the day. I haven't been able to have a full hour sleep at a time. I had enjoyed an ease in falling asleep until this week. Now, I find it difficult and my legs ache and the braces have become painful to use. I wait till morning when I can remove them and hope the time when they lose the stiffness and pain comes quickly.
It is now 3 and a half weeks since surgery and frustration is setting in. I know it is ridiculous, but the feeling of, "I want this all to be over" sometimes overwhelms me. I hope this is a temporary feeling and that my energy returns. I guess the force of going through recovery can take a lot out of a person and then they just have to rejuvenate- I'm in the lull period. For the first time, I have had moments when I cry and let it all out.
Oh well, tomorrow is another day and I'm ready to face the challenge....:yes:
 
Last night, I took a 5 mg of oxcodone an hour before bedtime= it worked. I was able to sleep straight for 6 hours. I feel much better.
What a few hours of sleep will do for you.... nirvana.
 
Hopefully, the heatwave in the northeast is almost over. It has been a brutal week. I wish temps had been more pleasant to allow walks outside.
Last night was one of my "on and off again" experiences. I am still taking one oxycodone 5 mg. fast release in order to get to sleep- it really does allow me to quickly fall asleep within 1 hour of taking it. I wake up around
4am and it is then 3 hours of walking around - lying down- walking around- lying down. lol
I find the hours between 4am and 7am weird- it is another world. Once 7am comes around, I feel as if the world wakes up and I can join it again. I can't wait till I'm back to going to bed and waking up around 7am.
My pain comes and goes- sometimes it is just one big ache from top of thigh to toes. At other times, it is centered around my knees. I try to keep up with pain meds- but am trying to keep their use under 3-4 per day. I take one in the morning, one in the afternoon and one at night.
Tomorrow, is my last oxycontin pill- long lasting. I noticed a diffence when I stopped the nighttime one last week- this morning one will be the end. I hope I can take the drop off. The doctor's office told me to end it with the once per day this week. Last pill- July 22.

I am looking forward to my appointment with the surgeon on August 6. Hopefully, I can get approval to drive. Is there a ROM required to get the driving OK. I wonder what criteria goes into the decision.

Hope all is well with everyone out there- one step at a time.....:angel:
 
Yesterday was the 1 month anniversary of my knee surgery. 4 weeks and counting....

Last night was a good night. I fell asleep aroun 10pm and woke up permanently around 5am. (Yes, I did have to get up a few times- but was always able to go back to sleep- yipeee). The fact that I was able to get back to sleep after getting up a few times was so wonderful.
Today is my first day without any oxycontin. Now, my only pain med is oxycondone -fast acting- which I take as 1 pill- 5 mg about 3 times a day- sometimes 4.

I had PT today and my new measurement is LTKR: 95 on my own and 105 with a little push, RTKR: 95 on my own and 100 with a little push. I am encouraged that every two weeks the numbers continue to rise. I'm hoping to hit 100 on my own by 6 weeks. I know it is behind many others on the board- but it has finally infiltrated my brain- that everyone is diffferent and will get to the point they seek at different speeds. Considering I was stiff and sore before PT today- I was happy with the numbers.
 
Usually, the benchmarks for driving are:
1) You have enough strength in your driving leg to operate the pedals, especially the brake, without pain;
2) You can sit long enough with knees bent;
3) You have sufficient alertness and quick reaction time to be a safe driver. (THE most important criterion).
Usual timetable is 6 wks for a RTKR (or a LTKR if driving with manual transmission) and 4 for a LTKR with automatic transmission.

It's pretty subjective. If you don't feel ready, then you probably aren't, even if enough time has objectively elapsed. My OS' PA put it this way: how would you feel if you got into an accident and caused property damage or bodily harm? And not to be paranoid, what if you got busted after an accident or major moving violation, had to take a blood test (when issued a driver's license, you give "implied consent" to have your breath tested--and if the arresting officer suspects you're impaired even if you blow less than the legal limit, to have your blood drawn to determine levels of alcohol or drugs), and that test disclosed a level of opioid sufficient to raise a presumption of driving under the influence? (OK, so I'm a lawyer and so's my OS' wife, but you get the drift).
 
Sandy, thanks for the wonderful review on the factors that go into the decision on driving. Your point about meds is excellent and is a major part of the decision.
 
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