TKR 28th August 09

[Lubbock58]

I had my surgery on the 28th of August. Hospital stay was not the greatest. Pain management was and still is an issue. I am on a med that I used just to function before I had the surgery, so I think I have a tolerance. My first post op dr visit is on the 10th. My rom is about 90, nine days out from suregery, but I get depressed and seem to cry a lot. Anyone have that same problem? I get dressing changed daily and home PT daily, but that may change after my appt on the 10th. It really helps to have care at home. My husband is staying home with me for the first three weeks or so, or longer, if need be. I talked to lots of folks who have had TKR and they ALL assure me that they would do it again. At this point, I wouldn't and question daily if I did the right thing.
I use a CPM machine and it has been great, but yesterday it started to really hurt at about 93 so I am backing off. Anyone have that problem too? The PT says that it can aggrevate the knee. It is encouraging to read other's experiences> I do know that folks who have both done at once are truly superhuman.

 

[Josephine]

Hi, Lubbock and welcome to BoneSmart. I moved your post into a thread of it's own so you would get your own responses and also wouldn't derail the other member's thread.

First off, we all had times when we questioned our sanity! Usually about that time as well. First couple of weeks are the worst and the most painful.

What meds are you taking and how often? It's important to take them on the dot of the four hour periods else you start playing catch up with the pain management. And you need to organise them so you get a dose about half an hour before your PT session. But what you are taking is just as important. Do tell me that.

90 degrees is pretty good at this stage. You'll get more and time goes on. Don't try to do it all at once.

Everyone gets depressed and feels like it was the worst thing they ever did but that wears off eventually. It's not only the effort of getting throught the day, it's also the pain and the pain meds. They make you feel low as well.

Remember a couple of things: you've just had MAJOR surgery and your body's had quite a battering; you're in early days and bound to feel low.

Don't judge things by how you feel now. In 2-3 weeks you'll feel completely different.

But I do want to know about those pain meds ......

 

[Josephine]

By the way, I am envious of you living in Lubbock - I am a great and life long fan of Lubbock's #1 son, Buddy Holly!

 

[cotton1958]

Hi. I got the boohoos several days after surgery, after I got into the rehab. I think it's very normal. A neurophsychologist that made rounds said the depression rate is 70%. After I had by crying bouts, I felt better. Also, even without surgery, depression rates are high just with osteoarthritis and the pain.

Just wanted to let you know you are not alone.

Hope you feel better soon.

_________________________

BTKR 8/25/09

 

[FrogFeathers]

After two weeks in the hospital (rehab was in the hospital for me), I spent two weeks at my parents fully-handicapped accessible house. My mother was suffering through some serious health problems of her own and incidentally, on the same pain meds I was (but in higher doses).

We used to have tandem crying jags- usually late at night when our pain would keep us awake.

It wasn't till I was about three months out that I stopped questioning my sanity. And looking back at my past six months, I can say that it hasn't all been fun and games (except that morphine shot that one time in the hospital), but I'd do it again- IF I HAD TO!

As for ROM, at five full weeks out, I was barely bending to 60 degrees... so to me, anyone telling me they're going to 90 is excellent.

 

[Sticker Lady]

Hi Lubbock and welcome!

I had some crying spells in the early days and again about 2 months out. You just get tired of dealing with pain and stiffness and not being able to do what you want, when you want. It seems to be very common and a normal part of recovery.

I had my surgery on a Monday and spent 3 days in the hospital and then 5 in rehab. My hubby stayed home with me for the remainder of the second week and then he went back to work.

I had home pt until I was able to drive at 4 weeks and then went to outpatient pt until mid August when I went back to my part-time job.

Recovery is a process that takes longer than we want it too but most of us end up happy that we chose to have this surgery. I am not superhuman but I'm glad that I did both knees at once. It's really hard but it will be over when I finish this recovery--I would not want to look at repeating it any time soon.

You seem to be on track for a good recovery once you get the pain meds sorted out. Jo will give you great advice if you respond to her questions.

Keep in touch and be kind to yourself!

Blessings,
Irene

 

[Texas]

Hi Lubbock, I cried alot to I think alot of us did....Hang in there it does get better i didnt think so either but it does............I think you are doing fine hang in there........You are not alone we have all been thru it and understand post anythime...........)

 

[Lubbock58]

Thanks for responding Josephine and all you nice folks who answered my post as well. All this support does make it easier to cope.

You asked about my meds and I am taking two 500MG Lortab substitutes (Hydrocodone) every four to six hours. I took this medication for a couple of months prior to my surgery and I think I have a tolerance. I am also taking Tramadol 50 MG. I have been out for several days and I await for the doctor to renew the prescription. But In the hospital I had expected a pain pump but didn't get it, but thought it was because I take bloodthinners (I was off them for two weeks prior to surgery). As it turned out, when I complained about pain, they did give me doses of morphine on occasion.

I plan to ask my doctor tomorrow during first followup after surgery about any possible pain med options that might be better. The CPM machine has become my enemy, so I am spending a little less time in it. That will be another question for my OS. The PT said my swelling is still a little much, so I keep ice on it when I am sitting or lying down. That is it pretty much it.

If I could have more than one hour out of every four with a pain number of 2-3, I would be a happy patient.

Since you are a Buddy Holly fan, you can stream through your computer, the local am radio station KDAV Lubbock. They play all the real golden oldies from downtown Lubbock including all of Buddy's songs. Virgil Johnson is a DJ and he had a group during the fifties too. Virgil went on to be a high school principal and referee for basketball games when our two kids played in the early 90's. The website is www.kdav.com. Thanks for your dedication to all of us needy orthopaedic patients! My office window looks out over Buddy Holly Avenue and the radio station is just down the street.

 

[Judles]

Welcome, Lubbock! Well. Looks like you're over the worst! Just talking about it helps Wishing you better days!! (0)!

 

[loggon]

Hi Lubbock and welcome.

Texas (Kim) and I are both from Texas (around Austin)

I guess I was in the 30% because I did not have the crying. I know most here did so just let that crying out.
I think it will make you feel better.

Your rom is great for just the little time you are out from the surgery. Don't worry about the rom, just do the PT and it will come and you don't have to be aggressive either.

I got rid of the CPM machine. I had it in the hospital and had no choice. But a week after I was home I called and had it picked up. I did not like it because it hurt and it is
a passive exercise anyway.

Good luck and post when you can and I hope the doctor gives you some pain medicine that will work better for you.

 

[hubbieoftheladywithPKR]

Hi Lubbock,
Get your hubbie to read this blog to help him help you! My wife's OS said to send the CPM home when she got to 95 so you are almost there! Hope you have an iceman machine with which your hubbie will get alot of interaction. Stay in the day. Week to week you see a slight difference. At wk 5 my wife is just entering a new good phase, at least today!

 

[Doug]

It was winter time. I was taking those blood thinner shots. I would get chills and sit in my chair with this laptop talking with my BoneSmart buddies.
I just stayed stoned most of the first month...worked for me!!!

 

[Oldie]

In regard to the CPM, it was making my knee hurt too much, so today when I went in for my 2-wk post op. my OS just told me to stop using it,

 

[ship4]

[Hi. I got the boohoos several days after surgery, after I got into the rehab. I think it's very normal. A neurophsychologist that made rounds said the depression rate is 70%. After I had by crying bouts, I felt better. Also, even without surgery, depression rates are high just with osteoarthritis and the pain.

Just wanted to let you know you are not alone.

Hope you feel better soon.]

And they say crying does not help.....
I always told my Dad when he asked why I was crying, that "it made me feel better!" I think it is necessary to release all that pent up feeling at the moment.
Hope things are going better for all of you!

 

[cindy88fan]

Welcome! I too went through the crying spells. I did it even before my surgery. I had a CPM just when I was in the hospital. Didn't have to have one at home. My Dr. thinks it can tend to make you lazy. I don't know that for a fact because I wasn't given the chance. You are taking the same pain me that I was. If you don't think it's enough, call your OS. Pain is so normal after such a major surgery.

P.S. I'm not superhuman...just didn't want to go through it 2x.

Good Luck! Feel free to post anytime. Every body is here to help each other!:thmb:

 

[Texas]

Our own lil Texas group going......wow i cant believe you didnt have a pain pump how did you do that.........sorry that makes me hurt now. yep mine was at 5-6 weeks then a big difference.............keep us posted hang in there it does gets better........promise...............

 

[Josephine]

It was winter time. I was taking those blood thinner shots. I would get chills and sit in my chair with this laptop talking with my BoneSmart buddies.
I just stayed stoned most of the first month...worked for me!!!

And didn't we know it! I almost gave this forum the subtitle "welcome to the asylum"!

Thanks for responding Josephine and all you nice folks who answered my post as well. All this support does make it easier to cope.

You asked about my meds and I am taking two 500MG Lortab substitutes (Hydrocodone) every four to six hours. I took this medication for a couple of months prior to my surgery and I think I have a tolerance. I am also taking Tramadol 50 MG. I have been out for several days and I await for the doctor to renew the prescription. But In the hospital I had expected a pain pump but didn't get it, but thought it was because I take bloodthinners (I was off them for two weeks prior to surgery). As it turned out, when I complained about pain, they did give me doses of morphine on occasion.

I plan to ask my doctor tomorrow during first followup after surgery about any possible pain med options that might be better. The CPM machine has become my enemy, so I am spending a little less time in it. That will be another question for my OS. The PT said my swelling is still a little much, so I keep ice on it when I am sitting or lying down. That is it pretty much it.

If I could have more than one hour out of every four with a pain number of 2-3, I would be a happy patient.

Actually, though I jest about Doug, he is right on the button. You say you take them every 4-6 hours. I would take them every four hours no matter what. There's two issues you need to bear in mind:

1. swelling causes pain and is caused by pain. A nice, effective vicious circle.
2. you need to understand the cycle of how pain meds work and how to get the most effectiveness from them. I think my chart might help

So you see how essential it is that you take the next pill on the dot of the four hours and to not wait until the pain breaks through.

However, if, after a day of applying this, the meds just aren't working, then you need something else.

I've noticed that over in the States, it doesn't seem very common to use drugs in tandem. When I had my knee done, I was prescribed Tramadol 150 or 100mgs with 1gram of paracetamol (acetophenamin) four hourly! It worked a treat. As time went on, I could just take various amounts of the Tram and/or paracetamol as I wished. At first it was the 150mgs, then 100 and finally 50. But I'd switch about as I felt the need.

In recovery in the OR, for post op analgeisa we would often give a cocktail of 50mgs diclofenac, 30mgs codeine phosphate and 1gram of paracetamol! It worked a charm and was most effective for day case patients who really didn't want to be doped up when they had to go home. I'm telling you all this just to show that there are other options that if one pain med doesn't work, maybe using it in combination with another, milder one might make the difference.

As for the CPM, I have my doubts about their efficacy. They are, by defnition, a passive method of getting flexion and since much of the flexion is obtained by the muscles, it's necessary for them to be toned up which a CPM won't do. Very few surgeons in the UK use them for that very reason. But that's just the UK opinion!

Since you are a Buddy Holly fan, you can stream through your computer, the local am radio station KDAV Lubbock. They play all the real golden oldies from downtown Lubbock including all of Buddy's songs. Virgil Johnson is a DJ and he had a group during the fifties too. Virgil went on to be a high school principal and referee for basketball games when our two kids played in the early 90's. The website is www.kdav.com. Thanks for your dedication to all of us needy orthopaedic patients! My office window looks out over Buddy Holly Avenue and the radio station is just down the street.

Thanks for that info, I'll check it out. I have a broken link removed: https://buddyonline.org/forum.html on Buddy but the archive is undergoing a revamp at the moment. My claim to fame is that I saw him live in 1958! The theatre tickets of which historic event (in my life!) are on display in Liverpool museum right now!

Is that street still called Buddy Holly Avenue? I heard that the widow had required some ridiculous kick-back from Lubbock for the use of his name which she has copyrighted! I'm so delighted to hear it's not happened.

 

[Lubbock58]

Thanks Josephine. I went to my post op doctor visit yesterday and had my staples removed. I also got my prescription for out patient PT. I found a place here in town that has underwater therapy and have experience in TKR rehab, so I am encouraged and looking forward to starting next week. I talked to the doc about pain meds, but he really didn't seen very simpathetic. I did mention that I had been on Celebrex before the hospital and they had told me when I was released to not take that anymore. He said that I should continue with it, so I am hoping that it will add some more pain relief. The PT was here one last time today and worked with me on the use of cane. My ROM is about 92-95, so I am encouraged. Had the CPM machine picked up yesterday. The doctor told me that it was up to me whether I thought I was getting any use from it. I did at first, but it was annoying me the last couple of days. I actually got out of the house yesterday after the doctor visit and had a nice time taking a drive with my daughter. It also gave my husband a break from being constant caregiver. I saw my xray and didn't see that button you all have talked about in blogs recently. I hope that doesn't become an issue for me in the future.
With staples out, I can now get the surgery site wet, so bathing will not be such an ordeal.
I will keep updating on my progress and will continue to read about everyone's unique experiences with TKR.
Lubbock58

 

[Judles]

They're doing "underwater" therapy now? Seriously, aquatherapy is the BEST!!! Just make sure your incisionhealed enough before you start!!! (0)

 

[Josephine]

It seems to me that the surgeons just don't seem to want to have anything to do with the post-op pain management, almost like it's not their business! I'd make a visit to you personal doctor. I've observed that they often seem a lot more sympathetic and pro-active than the surgeons.

As for the button, less than 50% of patients get patellar buttons because they just don't need them!