Speaking of discouragement

[missyc]

Dear All,
I have my own story of discouragement today, tho it is nowhere near as dire as what some of you are going thru. But I could use some feedback...

I am 10 weeks post BTKR and saw my OS this morning. He said I'm doing well and gives me an "A" on my progress (I'm at 126 ROM -- with lots of pushing on the left -- and 130 with some pushing on the right. I prefer to "count" what I do on my own which is more like 116 or 117 and maybe 125. I'm also around 0 on my extension). But he said I could lose the extension so I need to keep doing the PT routine for it daily. And, I may not get much more on my ROM. And it will be another 3-4 months before my inflammation really goes down (my knees are like puffy furnaces) and I can truly resume any kind of sports-related activities.
He also said that I should not take the pain meds to be "pain free" but to take them when the pain is so bad as to distract me from doing what I need to do. Except for before I go to PT. He also refuses to give me anything to help me sleep. Doesn't believe in that stuff. Finally, he expects me to be in PT for a few more months.
The last part I don't mind, but am pretty disappointed on the timeline and the sleep and the meds -- much as I want to be off them as much as anyone else, and tend to allow myself to be in low-middle grade pain much of the time, I do notice that when the meds really work, it's such a huge relief and joy to feel no pain whatsoever.
Any advice/comments/feedback/words of encouragement?

Thanks so much! Melissa

 

[DaleMc]

Melissa,

Can't help much with the pain since I did not have any pain to speak of from the day of the surgery to now, which is 17 weeks. I can say that I got off my pain pills about 8 weeks ago and take 2 Tylenol PM to assist in sleeping and they seem to do the trick. Hope this helps and if the OS doesn't help, you might want to try your family doctor for help.

Dale

 

[JenniferG]

If you are not well rested you will not be at your best potential for PT. It's all relevant. I can see trying to at 10 weeks maybe being at a point where during the day you could go without and only Ibuprophen with stronger for PT, but for me (also BTKR) the eve dose was the last to go. Fatigue will only magnify and amplify any pain. Try talking with your primary GP. I'm not a doctor but I did have my bones sawed, hammered and glued like you. Not him. Good luck!

 

[ship4]

Melissa,
I am about 18 weeks out of BTKR. You will find things will start to calm down shortly. I was off my pain medication except for the Celebrex anti-inflammatory medication. I still take that in the AM and PM.
Try taking 2 ~ 600 mg Calcium + D vitamins, along with 2 ~ 250 mg magnesium vitamins at night. They help you sleep and are good for your bones! Two for the price of one!
This is a cure for insomnia....
The Tylenol PM has the opposite affect for me so I can not take it.
Be sure to get your rest and keep working at it!
Best,
Crystal

 

[Kimgrif]

Hi Melissa,

when I was having trouble sleeping and told my OS, he referred me back to my family doctor. I spoke to my family doctor who promptly prescribed Ambien for me. It has been wonderful. I'm on no pain meds now except for ibuprofen and possibly some Tylenol during the day, and usually at night too. If I have a rough day or the weather is changing (OY!!!), I do take Vicodin at night still.

Tylenol PM is simply acetaminophen (Tylenol) with diphenhydramine (Benadryl). It's much cheaper if you buy generic "allergy pills" that are diphenhydramine if you want the same effect as Tylenol PM. Honestly, Tylenol PM is just Tylenol with Benadryl.

Hang in there!

 

[Josephine]

How heartless of him! He obviously has little understanding or care of the psychology and physiology of pain/recovery/healing. How can one possibly give your best to the PT and the rest of life, when you're exhausted from being in pain all the time?

Go see your regular doctor and get him to prescribe you something.

 

[justjuls]

Have you tried using Melatonin I know you can buy it a health food stores. That is what myself and my husband use and it does help quite a bit to get to sleep. However, it doesn't help with pain but it does help you get to sleep.

 

[Gretchendz]

First, your ROM is fabulous...many if us only dream of those numbers. Congrats and keep up the good work.

Are you allowed ibuprofen? I reached a point where I found a couple of them worked faster and maybe better than vicodin for me anyway.

Hang in there, you are doing great and it will get better!

 

[Nursepair]

I used Sleep MD, herbal medication. It helped a lot. So did a body pillow, Good luck

 

[missyc]

Thanks for the support and suggestions. I will definitely try the over the counter stuff (tho Tylenol PM never did anything for me). Otherwise, I normally take between 2 naproxen a day and between 1 and 1 3/4 percocet a day. I take the percocet mainly in the day b/c a) that's when I"m active and feel like I need them and b) they make me wired. But I have to say it sounds like at 10 weeks many people are off the meds altogether during the day. So maybe the doc is right and it's time to wean off?

 

[Gretchendz]

Well I don't know if he's right or not--we all heal differently.

For me, around then I was only on vicodin for PT. However, a couple of 200 mg ibuprofens I was still popping now and then for discomfort 4 months out.

For me the ibuprofen works faster and doesn't make me so loopy

Another possibility on the sleep if you want to try ambien or something like that--call you general practitioner. Many here have found if their OS is not sympathetic sometimes their GP is. (Like several of the other said already!)

 

[AlaskanTKR]

Melissa=
I tried dropping my hydrocodone down a few weeks back and literally took a beating from the OS. This time around the meds have been easily accessed. I am pretty much down to doing the hydrocodone 10s right before pt and/or after depending on how rough pt was. On non pt days I take one before I push at home after school on the knee and the treadmill. I can make it through school on Ibuprofen and ice so that is helping. I downed my last flexirile this am and am not sure how that will go.... I would love to stay off them but they really help relax not just my knee but also the hip and back for all the shoving at pt. I will see how PT goes on Friday and Monday b4 I see the OS on Monday afternoon and discuss it. I fell awful that you can' t get the relief you need. I would prefer not to be taking anything - but at times - when 3 people are shoving against my knee - I don't think I would get through without the meds. I use advil pm and sometimes a hydrocodone if I am really sore - also - rereuns of Law and Order on the DVR seem to put me to sleep quickly! Then... sometimes I can't sleep and just give in and watch tv and by the next night I am exhausted and sleep comes with ICE and the CPM.=

Hang in there - I am right there with you on the sleep - wish I could share my meds!

Marianne

 

[Simon]

Melissa

I have not had much of a problem with pain (I had a BTKR on June 3rd) by mid July I was taking something just before PT and since September I have just used aspirin even though I am still going to PT. I have noticed the knees and hips have been hurting a bit the last few weeks as we push things in PT. I might take one or two and see if it helps in the ROM.

I did have major problems with sleep and I was ready to kill for a good night sleep. My OS gave me Ambian but it did not help, nor did any of the over the counter stuff.

My internist was not available so I called my sleep doctor (I have an unrelated sleep problem). She said that the problem occurs in about 35% of post-op patients and is called learned/conditioned insomnia and it can come on very quickly. Basically your sleep cycle is messed up in the hospital and if you can't get back in sync pretty quickly you start getting anxious about not sleeping which makes things worse and then you start doing things like going to bed earlier, staying in bed later, napping and all of this makes the problem worse.

She prescribed a very low dose (1 to 2 mg) of lorazepam (an antianxiety agent) and told me to get the book No More Sleepless Nights by Peter Hauri. The book is aimed at chronic insomnia but there are some good suggestions on behavior therapy. Well I used about 7 tablets over 10 days along with some of the things in the book and that did it. Within a few days I noticed it was getting easier to fall asleep.

Tell your OS he might want to talk with a sleep specialist.

Good luck