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TKR Struggling managing Pain

Corvetteman2021

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I just had a knee replacement on my left knee November 11th, 2021, using the conformist style.
Back in 2018, I had my Right Knee Replaced and although functional, it has been sore ever since. Spin the clock forward, different knee, different style, different hospital, and different doctor, and hopefully different results!
Its only been a week, sore as can be. I was giving a coolant box that regulates a constant flow of water through a pad, much better than the old frozen strapped on ice packs, mine just happen to spring a leak, but the problem has been corrected.
 

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Jockette

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Hi and Welcome!

Do you want all but the knee photo deleted?

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​


4. PT or exercise can be useful BUT take note of these

5. At week 4 and after you should follow this

6. Access to these pages on the website

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 

Jockette

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I’m glad that we’ve been a good support for you! That’s what we’re here for.

Best wishes as you go through this second recovery!
 

Sara61

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Congratulations on your 2nd new knee :yes!: wishing you a good recovery. There is a large group of 2nd timers all having surgery in November & December xx
 
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Corvetteman2021

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It is good to be a part of this community, this website gave me an opportunity to better understand what I was experiencing along with thoughts and considerations I might not have brought into the mix!
No one can fully understand what you are experiencing unless they have experienced it! In one of the articles giving to new members, it was mentioned that regardless of the Physical Therapist good intentions and time frames, we have to be the judge and jury of wether we follow it, I am not saying that we shouldn’t push ourselves, and that we cannot experience any pain, that is not reality, but do so with clear expectations and goals!
Today is day 7th since my operation, still extremely sore, swelling is starting to reside, movemement is stiff but I am able to walk, get on and off the couch, take showers, etc. I am scheduled today for my second PT, I didn’t progress hardly any on my exercises, but see that improving. Sleep is almost non existent, I dread the nights. I truly expect having gone through this before, that every day should show some better quality of life!
 

lovetocookandsew

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Lack of sleep is a part of this recovery for many/most people. But, that too will pass. We recommend patients sleep whenever they can, as sleep often eludes them at night.

I agree, we make the decisions on how we choose to recover. There's no perfect path for recovery; each of us goes through it on our own timetable (although your knee has more to say about that timetable than we'd sometimes like to accept) Friends, family, doctors, PTs, and so on, may all give advice, but only you can choose the advice you take, or ignore. Only you get to make the decision, no one else can do it for you.

Each day brings you closer to the goal of a good knee and a life you've taken back, but it does take time and patience to reach that goal. As your knee recovers, the tissues will begin to settle down, the swelling will recede and your knee will move and bend much more than it does today. As long as there's swelling, whether it's external and visible, or internal and can't be seen, your knee won't bend as well as it will in later days. Listen to your knee, it will tell you what it's ready for and what it's not ready for, and will do so quite loudly at times. Allow it the time it needs to heal and you'll be glad you didn't force it to do what it wasn't ready to do.

As time goes on you'll find yourself naturally doing more, and resting less, until the day comes where you hardly think about your knee at all. Then you'll know the surgery was a success and you have taken back your life!
 
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Corvetteman2021

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I had my second TKR on November 11th. It’s been 12 days, I am able to move around and do basic functions, handling cane easily. Swelling is considerably less although still there. I have had two PT, and am scheduled for my third tomorrow along with my first doctors appointment a couple of hours later. My scar is looking good and I am suppose to get my staples out at that appointment.
I am struggling with the pain! What seems like pretty minor standing and walking, and heaven forsake I have PT, I can’t seem to manage the medication and also afraid that I am using more than I should. I am on Oxycodone and I should be taken 2-4 tablets every 4-6 hours, I find that I am averaging 1 tablet every 3 hours which keeps it barely manageable and my knee is stiff!
 

Jockette

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I am on Oxycodone and I should be taken 2-4 tablets every 4-6 hours, I find that I am averaging 1 tablet every 3 hours which keeps it barely manageable
Make sure you tell your surgeon how you’re taking the medication. He may make an adjustment.

I am struggling with the pain! What seems like pretty minor standing and walking, and heaven forsake I have PT,
Pain with standing and walking is common at 12 days post op.

Be careful at PT when they work on ROM. Don’t let them push your knee into a bend, or push down to straighten it, as that can cause pain if they push you past what you can do yourself. Also, any exercise that causes pain is counterproductive, especially this early, so say no to certain things if you want to.
Saying no to therapy - am I allowed to?

and my knee is stiff!
Stiffness is par for the course and will be with you for a while. Stiffness/Tightness is a normal occurrence after this kind of major surgery. Your surgeon did major carpentry work and disturbed every millimeter of soft tissue in this area. You aren't tight because your muscle is underused and needs to be stretched and rehabbed. You're tight because your tissue is healing...and full healing takes a full year or more.

By the way, I merged your newest thread with your original recovery thread, as we prefer that members in recovery have only one thread.

This benefits you because all your information is in one place, easy to find, and maintains a nice journal for you.

This also benefits our staff, as your information is all in one place, and we often go back through your thread for previous details, so we know what you‘ve been through which helps us advise you better.

So, please keep all your posts in this thread. If you’d like a new title, let us know what you want, and we’ll change it for you.

Many members bookmark their thread in their computer browser, so they can find it when they log on.
How can I find my threads and posts?

Best wishes on your continuing recovery! :flwrysmile:
 

Susie-Q

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I am on Oxycodone and I should be taken 2-4 tablets every 4-6 hours, I find that I am averaging 1 tablet every 3 hours which keeps it barely manageable and my knee is stiff!
Please talk to your surgeon's office. They should be able to guide you on taking more oxy. I was taking 2 oxy every 3 hours at this point in my recovery and had instructions to take more if I needed. You can't recover well if your pain isn't managed. You won't be taking this much forever and right now you really need it.
 
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Corvetteman2021

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I will be meeting my surgeon in about an hour, and will definitely talk to him about this. This being my second TKR, I am not afraid to do the exercise, but as you mentioned, if you are hurting, the mind and body doesn’t want to proceed. I think that if I can feel comfortable, I will be more aggressive and will have a win-win situation. With the approach you were allowed, I take it that you had good success? Thanks
 

Jockette

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I think that if I can feel comfortable, I will be more aggressive and will have a win-win situation.
There is no need to be aggressive, especially this early in recovery.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for 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. Normal activity is the key to success.
 

BarabooProud

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I can’t seem to manage the medication and also afraid that I am using more than I should. I am on Oxycodone and I should be taken 2-4 tablets every 4-6 hours, I find that I am averaging 1 tablet every 3 hours which keeps it barely manageable and my knee is stiff!
Definitely talk to your surgeon about your pain. I put up with way too much pain, I believe. I was prescribed one oxy every four hours (said this on the bottle) and in fine print on a pain management page in my informational binder it said one could take two if needed. I felt like that should be done very few and far between because of this. A friend of mine who had a replacement was told she could take oxy 1-2 every 3 hours at first. I would've been so much better off if I had done this!
 
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Corvetteman2021

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I feel the same way, although I have kept to the guidelines, I believe I have paid a price for this by missing that extra tablet and being in so much more pain. Since my visit yesterday with the surgeon, he has said to do the extra occasionally when needed. He says your knee has been through hell and keeping the pain down is more important and that I should not fear that I will get addicted under these circumstances.
 

BarabooProud

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I feel the same way, although I have kept to the guidelines, I believe I have paid a price for this by missing that extra tablet and being in so much more pain. Since my visit yesterday with the surgeon, he has said to do the extra occasionally when needed. He says your knee has been through hell and keeping the pain down is more important and that I should not fear that I will get addicted under these circumstances.
My communication was "occasionally", too. However, my pain was so bad that there wouldn't have been an "occasionally" situation. I would've needed 2 pills every 3 hours for the first couple of weeks, I think.
 
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Corvetteman2021

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It’s been 16 days since my TKR, basic routine procedures and moving about is generally good. I seem to be better able to control my pain, currently taking 1 Oxycodone every 3 hours and if I am having PT, then I might do 2 tablets every 3 hours for a little while.
ROM still limited to about 90 degrees and my gap behind the knee is still there. The swelling is still there also, but my knee looks like a knee and the swelling has gone down about 90%. Sleep seems to be getting a little better also, dozing off 1 1/2 to 2 hours a couple times during the night.
My current goals are to continue to keep pain under control, work on exercising a little more to increase ROM.
 

Jockette

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At only 16 days post op it’s too early to worry about working to increase ROM, if your intention is to exercise more. Instead, the way to increase it now, is to focus on “working” to get your swelling down, and give your knee time to heal, which will increase ROM, by default.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for 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. Normal activity is the key to success.
 

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