TKR Surgery 16 Feb 2017, wondering about pain

[Celle]

@Crip - it's not a good idea to keep using Ibuprofen for pain control. It's an NSAID and they are very hard on your stomach. They can cause severe gastric bleeding. Also, recent studies have shown that using NSAIDS can pre-dispose you towards heart disease.

When you say that Tylenol doesn't work for you, how much are you taking? The correct, effective dose is 1,000 mg (2 x 500 mg tablets) four to 6 hourly, to a total of no more than 4,000 mg in 24 hours. YOU do need to take the Tylenol on a regular schedule, so that you keep up the level in your bloodstream. If you are taking any other medications that contain Tylenol (Acetaminophen) add that amount into your calculations and reduce one of the other doses.

 

[KarriB]

How kind of you! We are proud, especially because he received a full scholarship and will be in the National Guard while in school. He'lol be married for 2 years this August so he's not alone.

This can be a long recovery and the month 2 can be hard because it's getting old. Try to keep the pain under control, especially at night.

 

[sandi4213]

Hi Crip. Good to have you here with us all. I am in Northern Idaho, so I know what you mean about the rain, we have had a ton of moisture this year. Lots of snow and now lots of rain. I moved here from AZ last June, so I am still enjoying it, though It sounds like you are listening to all the good advice on here. This journey is really a slow marathon. Just keep moving forward. BTW, I can't imagine starting this with a sore, bruised leg...ouch!

 

[Crip]

It's been a few weeks since I posted. I'm still experiencing pain in my bionic knee area. I'm about 3 months out now & have appointment with OS on Wednesday this week. He told me 6 weeks ago to work one third on extension and two thirds on flexion. I haven't really done anything but walk. I've tried little squats and of course don't go down very far. Can't. Still hurts to sit with legs on ground. I have to have a cushion to prop my leg on with it bent a little. It's still tight around my knee. Swelling has gone down a great deal but still there on inside of knee and a little around knee cap.
My calf muscles are getting sore or tight. Have had not so little jolts from knee to inside of calf half way down.
I got a motorized cryo cuff and freezing water bottles to put in it was the ticket It stays colder longer in the cuff as with every air compression cycle it pushes the cold water from unit into the cuff. There are times when the cuff is too heavy or it irritates the incision. I'm using Arnica ointment when muscles are really aching.
I'm seriously thinking about getting a Tens unit since I still have more pain than I can put up with. I'm taking 3 Advil at a time for pain, about 3 times a day. Makes me nervous to be on Advil this long. Hence the tens unit. I read Josephine's notes about them and found the one she recommended to someone else easily. I have a question about ordering extra electrode pads. How many should I order first time and is one brand better than another? Has anyone else had experience with a Tens unit after a TKR?
I'm afraid Dr. Will not be happy with my ROM, but I'm listening to BS people and not pushing into pain. Icing a lot, elevating a lot and getting really bored and impatient with whole recovery. I'm on a shorter fuse for sure. Not getting slammed with total exhaustion anymore, but still not much endurance. Been puttering in garden here and there pulling easy weeds. No long outdoor sessions at all. But, want to be able to get flower boxes and fill with annuals for all summer color.
Not cleared to drive, but have two times on short trips to take my laptop in for repairs and retrieval. I have to drive to my appt this week as hubby is working out of town.
Have also gotten enough tips from places to start a gratitude journal. Hang a sign that says: What Went Well Today? Scientific evidence backs up this approach to getting happier with the life we have. I know for sure that more money does not happiness bring! For me, it created more stress, cost me more to find out how to protect it, invest it.....
When pain is such a constant my mind just goes negative and everything looks bleak. So, I just decided I will try a Tens unit for pain relief and attempt gratitude journal at least in my mind. Does anyone else have a hard time doing what they should to stay healthy? I have ADD, and am finding out the ADD mind is full of conflict, fear, shame, and a host of other things that I thought only went with abuse victims. Anyone else experience inability to organize or stay organized? I've got to get out more and be around people.
We sold our house of 23 years, moved closer to our daughter and grandson. Live in the country and don't know anyone after being here a year. Even people from church I don't know well enough to chat with on regular basis. Then this surgery confines me to my house.....it gets lonely. I've got several projects going, but, unless I feel decent, I can't do them. Sorting old photos and scanning takes more effort than my brain and body can handle at times. I go back and find I put wrong info on a photo, or I've already got 16 copies.of several photos, why am I making more? See, the brain is too tired to Think straight.
I'm going to stop whining for now and order the Tens unit. I can easily order online and then can look forward to a little present Got a nut chopper last week like my first stepmother had and have had finely chopped nuts on yogurt, fruit, ice cream. Little things like that can brighten a whole week
Hope everyone is enjoying spring colors & the return of house flies~
S

 

[KarriB]

Let's tag @Jamie to talk to you about your pain management. She and Josephine agree that Tylenol is a much better pain reliever than Advil and can advise you on the amount you can take for a day. You may not be taking enough Tylenol to impact your pain.

I can tell you that part of your pain is connected to some of your activity, such as squats. They are absolutely brutal on new knees. If you've been doing these since early in your recovery they are responsible for some of your pain.

 

[Crip]

The squats are baby squats, no more than 2 or 3" down. I've tried them maybe 3 times Not real big on routine exercise. I walk mostly, around the house, some outside on sunny days. Nothing strenuous, I'm not into pain at all. I'm glad I had the surgery, it's just such a long haul. I'm lazy, but this recovery takes lazy to the extreme
S

 

[Crip]

I'm pretty sure I'm not taking enough pain meds. The Advil has several nasty side effects and high blood pressure is just of the lesser known one's I worry about as I'm on 2 blood pressure meds now. Tylenol didn't seem to touch the pain, but I'm willing to bet I didn't take enough at one time.
S

 

[KarriB]

You can take up to 4,000mg of Tylenol a day. So if you have 500mg take 2 four times a day 6 hours apart.
I did nothing that even looked like a squat for nearly a year. I did it once and had pain that night, so no more.

 

[jaschembra]

I've had to do a lot of stretching for the back of my leg. The hamstrings and the calves and the area behind the knee. I do it daily. Yes, you're right, a gratitude journal helps me immensely when I'm feeling down. I'm just over 4 months post TKR and I am on 2-3 doses of Tylenol daily. 1,300 mg in the morning and again in the evening - sometimes during the afternoon I take 1,000 mg. I remember having those down feelings pretty heavy around 3 months but it does get better. I still have quite a bit of discomfort when I'm up and walking but I know that I can do more now than I was doing just a month ago so you might think back to what you can do now too. You might try some gentle heal slides to help with your flex. Swelling is still preventing some of my flex (I have a Bakers Cyst behind my knee) and I'm sure internal swelling is there for you as well - it hangs around for a long long time. I wish you well at your appointment. I'm sure Jamie and Josephine will be able to provide some good info for you

 

[Crip]

KarrieB, jaschembra,
Thank you for getting back to me. I started the Tylenol yesterday. I have 500mg caplets, taking 2 at a time. Last night I also took my 3rd to last oxecodone (sp?), slept very well. Just woke up and took more Tylenol, back to warm puppy, bed & ice The sandman and I need a little more time
Later...

 

[flyaway79]

I've had to do a lot of stretching for the back of my leg. The hamstrings and the calves and the area behind the knee. I do it daily.

I'm 7 weeks out and am having a heck of a time with my hamstrings. They tightened up constantly and and I spend all day long stretching them out and then icing them. It makes it harder to walk than the stiffness in my knee. Go figure.

 

[flyaway79]

My PT guy today told me to take a tennis ball and sit in a chair and place the tennis ball under my thigh where the hamstring is tight. I just let my leg hang and it puts pressure on the tight tendon. It feels great when I do this and it seems to loosen it up. You can move it around to different areas of the leg where it's tight.

 

[Crip]

In all fairness, I'm not sure what is tight in my leg except surgical area. Don't know if I've ever had a ham string problem. I get shin splints more than anything and right now, its happening in my good leg! Probably compensating for bionic leg. Will find out tomorrow what Dr. says.

I was reading up on Tramadol that is mentioned on the forum for use with Tylenol, but with other regular meds I take for depression, not sure Tramadol would do well with me. I only know the Tylenol isn't as effective as the Advil, but Advil can be nasty stuff. I'm hoping Dr. can be more helpful with this pain issue I'm having.

Jaschambra,
I look at your sweet horse and think my horse riding days are still a little way into future. My stepmom has a black Tennessee Walker that is out of shape, but is Mr. Personality plus and they are in Louisiana, a little more than a hop, skip and jump away. She had to put down both Posifinos. Never did get to ride them. I like grooming them more than riding, really. That must be the hair designer in me It's calming to brush a huge animal like horses and they love it, too.

I find that my leg actually hurts more when I'm sitting in a chair or on a couch. I get up and it's tight, but then loosens up a bit, like arthritic joints. It doesn't help that my left thumb started hurting and acting like trigger thumb. I'm right handed, so one would think it would be the dominant hand that would develop something. I keep thinking it just maybe got dislocated That's a whole other thread topic. Will return and report Dr. opinion tomorrow evening.
S

 

[Crip]

10 May 2017.
Had my last apt today with the surgeon until next February Says Advil is more productive in the joint than Tylenol, but I could take Tylenol, 4000mg a day for normal days and take Advil if I thought I would be more active. He said they are re-evaluating Tylenol and thinking it should be tapered back to 3000mg a day - FYI.
Told him I had one Oxocodone left and he quipped it was like leaving a fine bottle of wine for a very special occasion - good analogy. Took one yesterday to go to Costco with my daughter and came through that fine, so they do help a lot.
He said extension was good, flexion was good, but continue to work on it even if it takes a year, which it may. Said I won't see progress daily, but monthly maybe and by a year I may still be a little swollen, but the scar on top of my knee should get to where it is white and not very red/purple. Continue with elevating, icing, meds, etc and asked if I really needed the cane anymore. I don't, but getting out of the car gets a little hairy and awkward and the cane helps keep me steady, but once I'm out I don't really need it for anything.
I find it helpful to carry the cane with me to church, because people see it and leave some room for me to pass. It's helpful to keep the little ones from flying into your legs and hugging at knee level too They are so spontaneous, but spontaneous around us crips is unbalancing.

As a side note, on my way into my lane there in all it's sun kissed glory was a pheasant, iridescent blue/green feathers just gleaming in the sun. They are beautiful birds. With the red little side things on their head, whatever those are called - combs? It was nice to see a relaxed bird that wasn't fleeing for it's life from men or dogs or cats

Hope everyone is having a beautiful day soaking in the rays or the thousand shades of green everywhere.
S

 

[hvtx51]

@Crip - I had my RTKR on 13-Feb-2017 so we are the same timeframe and have similar concerns. I still have swelling and the tightness in my knee. I'm still going to PT but have a very gentle PT so don't mind going. I'm not able to take NSAID and felt that was hindering the swelling, but after reading your thread not sure if it would help me or not. Guess we just need to have lots of patience. I too use my cane if I'm going someplace crowded but otherwise don't use it. I cheat at Costco and drive the electric cart! What a hoot.

So nice to find joy in your beautiful surroundings.

 

[Celle]

He said they are re-evaluating Tylenol and thinking it should be tapered back to 3000mg a day - FYI.

Actually, 3,000 mg per day has been the recommendation in the USA for some time. That's because of an excess of caution, with the powers-that-be thinking people will neglect to count the amount of Tylenol in other medications they are taking.

As long as you check all your medications to make sure they contain no Tylenol and, if they do, add their amount to your daily calculations, it is safe to take a maximum of 4,000 mg in 24 hours. You should never take more than 1,000 mg in any one dose. The doses should be taken 4-6 hours apart.

 

[flyaway79]

That's because of an excess of caution, with the powers-that-be thinking people will neglect to count the amount of Tylenol in other medications they are taking.

That makes total sense!

 

[Crip]

hvtx 51, Glad to meet you. I was raised in Texas until I was 15. Angleton. We are on same time line with surgery. I recieved my Tens unit today and using Josephine's instructions used it tonite. It Did take away majority of pain I was feeling. I did 2, 30 minute cycles. We went to restaurant tonite, first time out since surgery at a sit down and take your time eating place, and the knee was on good behavior, until part way home. There must be a a magic angle to have the knee so it doesn't object to being down, or I'm actually getting better. My mind is either going or the Tylenol worked today.

I've read about the active ingredient in Tumeric having anti-inflammatory affects and also fish oil. I bought some and now just have to take them on a regular basis to see if they work on me. I also have Milkweed that I bought for my dog as its cleans the liver gently and with most drugs being metabolized in the liver, I'm thinking I should give it a go down the road.
What the Dr. told me about the pain meds, was to get blood tests done regularly on kidneys and liver to keep track of the side effects of pain meds. Not great news I want to hear! He is correct I'm sure, but isn't my body going through enough already?
At least in tx, it's warm enough for the constant ice to feel good Now, I just need an automatic zero gravity chair. Puts toes above.nose.perfectly, but the patio versions are too hard for.me to push back. ( My tablet is putting periods in where they shouldn't be.) Getting up from couch and all those pillows isn't easy. It sits a little too low. Griping and complaining have become more.normal for me the last 4 weeks as I'm really tired of recovering. Do I hear amens to that?
I'm going to bed now, its easiest thing to do right now given the time.
S

 

[kneeper]

Your knee will continue to stiffen up and you may get swelling after sitting with your leg down for a while still. I tried to get up about every 45 minutes to an hour when I had to be sitting, and just walk around for about 2 or 3 minutes. And of course I elevated (and iced if needed) once I got home.

It is a long recovering and does get old, doesn't it. But think about how far you've come! I tried to do that--and if you have someone whose been following your progress and can point that out periodically, I found it helped a little when I was sick and tired of recovering. Hang in there, it gets better and better!

 

[jaschembra]

Hi crip. I take the turmeric and oil everyday - Turmeric is better absorbed when taken with pepper. Recently I bought some premixed with pepper but when taking the older stuff, I just add a lot of pepper to my eggs lol
Hey, when you write to someone on your thread, use the @ sign right in front of their name and that way we will get alerted, otherwise we are unaware of a post where someone mentions us. . Example: @jaschembra

Awe, my horse. I sure hope the day comes that I will be able to ride again. I hope to try at the end of this month. Too much discomfort to try yet.

Sounds like you're doing well. There is no such thing as over using your cane in my opinion.