TKR When does the PAIN stop???

[Cannecon]

Jawndo
so sorry you are in pain, but it DOES get easier, but it takes time and patience.Your knee has been through a "car crash". It needs to recover. The pain on standing eases , but not as fast as a week. Follow BS mantras , they work, rest and be kind to your knee. My first pt was 10 days post op and only discussed gentle exercises, second pt a week later was GENTLE exercises emphasis on gentle. Take care and don't be so hard on yourself.
Anne

 

[Wednesday]

I also recommend dropping the machine. At my pre-surgery instruction session, the nurse said that many surgeons now feel that the machine accomplishes nothing, but some still use it. My doctor did, and I was strapped to the darned thing every day in the hospital. It was to be delivered to my home, but I called and cancelled. I'm now almost seven weeks out, and my ROM is approximately 130 in both knees with very little work and much rest.

 

[hopefaith]

I am trying to remember what helped the most with that excruciating pain when I first stood up.... First, allow your strong leg do the work in lifting your fragile surgical leg off the bed by putting it under it. Go SLOW. I wish I had an answer for that first standing up "my leg is going to explode" feeling. I think, once your pain is better managed, it will decrease. Mine decreased gradually, it sure wasn't quick. Use the breakthrough per the doc's orders by the clock. If it is not getting your pain down to tolerable levels, call them, bug them. Between the long acting and the breakthrough your pain should get managed. I had to have my meds increased several times before I was below a 6. I know the "I feel like a baby" feeling. I have never cried so hard from pain and I had two babies one natural...no comparison. For this surgery that saying needs to take a flying leap out the window. Let us know how you are and keep on that doc until your pain is controlled!

 

[hopefaith]

Also, read the myths here that you need to do that 20 on 20 off stuff.

 

[Josephine]

I got up and walked and told pain who was in charge and forced my will upon my body for about 10 minutes then was left in an exhausted pain filled weeping heap for 2 hours

And who won this contest? My money's on Mr KNEE! Mr Knee is always the boss!

Still waiting for pain to become tolerable

After a week of intense torture, it will take another 3-4 weeks to settle down.

On the mscontin, I understand that to be the main sustaining pain prohibitor and the oxy to control breakthrough pain. However until pain is under control mscontin isn't doin the job right?

That's right. So since you are getting constant 'break through pain, take it all the time for at least two weeks. I'm totally mystified about this term "break-through pain". Pain is pain and it's either being medicated properly or it's not. Given what you put yourself though last week, it's most definitely not 'break-through' but constant. I'd get in touch with your GP and ask if he will switch you from MScontyn and oxy to Tramadol. This you can take with Tylenol which makes a terrific combination.

I'm off pt for at least two more days

Try two weeks! And that includes everything, exercises, CPM, everything. You leg appears to be in a serious state of inflammation and 'angry tissue' condition. It's not going to settle down in two days!

Does anyone else experience the sensation of molten hot lead being poured into your leg for about 2-4 minutes after standing up?

That's not at all uncommon. What's happening is that when you are sitting and elevating, the fluid in your leg is draining back down into your system which is what's needed. But when you stand, it fills up again. Think of it like bottles ....

Problem is, your legs being so swollen are already close to capacity so the sudden addition of more fluid can be excruciatingly painful as you have discovered.

My suggestion is that you get some simple support hose - broken link removed: https://www.ebay.co.uk/itm/like/230965760130?limghlpsr=true&hlpv=2&ops=true&viphx=1&hlpht=true&lpid=108&device=c&adtype=pla&crdt=0&ff3=1&ff11=ICEP3.0.0&ff12=67&ff13=80&ff14=108 are a good one - and put them on before you get to your feet. Don't use the TEDS. They are too fiercely strong.

 

[Tamsmom]

BTW you can take the oxycodone every 4-6 hours....no way should you put up with that amount of pain!


4/1/2014 TKR

 

[jawndo]

Hey friends. Well I finally got a call back yesterday from my surgeon and he said there is nothing else he can prescribe me for pain. If I was truly in that much agony I might want to consider checking into a rehab facility for recovery. I was at the max amount for the meds he rx'd which was 10mg oxy every 6 and now 30mg mscontin every 24. When we told him we didn't want "MORE" of anything that wasn't working we wanted to try something different he said there was nothing else he could do. Wow. That was like kicking a downed guy in the face. It took me a while to realize I'm truly on my own now. Still havin a hard time with that ...... Anyho I figured he had me on double morphine for a couple days and I did not feel any less pain, so why keep takin it? The negative effects far outweigh any "benefits" I'm receiving at this point. I decide to take a shower and wash the day off and realize I can't even keep my hands up long enough to wash my hair!!! I nearly fell with exhaustion. I am 6'2" and 225 in excellent physical health, other than a bad R knee, and this type of feeling is totally foreign. So that was the final straw. Left the shower and went to bed at 2:30. Cut my morphine dose to 1/2 rx'd value so now it's 15 mg per day(soon to be cut off completely) and basically slept until 6;30 this morning without getting up. I must say if my beautiful loving wife had not been with me thru this I would have failed many days past. I could not have done it. It is something, like seeing the very worst in me brings out the best in her. What a blessing from Heaven. God's best for me! So as I was saying if it's not working for me why take it. Really this is better. There will be pain. Fact. Drugs aren't helping fact. Why take drugs that don't help me. I know mscontin is great stuff but it is not working for me. My head is already clearer today, (you might question that by my writing!) my outlook is better and I'm now forced to let my knee guide me. It truly has won again. So on with another day. Thanks to everyone with your thoughts and prayers and comments and advise etc etc.

 

[Phil75070]

There isn't anything I can offer in regard to the pain, but with regard to the fatigue I can tell you it was many weeks before I had enough strength to be able to stand at the sink long enough to even brush my teeth. It has only been 8 days since your surgery and almost everybody who has gone through this can attest to the amount of energy that the healing process saps from you.

 

[lori107]

Hi @jawndo, I am so sorry to hear you are suffering so much. I am 8 weeks post op today, and boy! Has it been a long 8 weeks. I have had many major surgeries and this is is definitely up there with the most painful. Keep posting on this fabulous forum and listen only, mostly to your new be friends. I am still taking 10mg oxynorm 3 or even 4 times a day as the pain is so intense sometimes I want to scream. I spent the first 4 weeks basically doing nothing except trips to the bathroom. They don't recommend physio in the UK as soon as you get home from hospital although I did have it every day after the op during the 10 days I was in hospital. I am only on my 3rd session next week with the physio. I have had a 6 week check with my consultant who didn't take any measurements and told me not to expect too much until the 3 month mark approx and then it can take up to 18 months to fully recover. I am still finding out the hard way that my knee is most definitely in charge and it lets me know in no uncertain terms that it is not happy. I showered sitting down for 5 and a half weeks as it was so exhausting and still sit down to dry myself. You must take th is recovery slowly, be really kind to yourself. Don't think about cutting medication unless you really have to or if you are not happy on it and take all the help anyone offers you. I am only 46 and this op has shocked my body to its core. Be prepared for good days and really bad days and rest as much as you possibly can. I went out for a short walk on Sunday and promptly fell asleep when I got home. The energy drain is huge and very real. Take care my friend, Lori x

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[Celle]

@jawndo
Could your primary physician help you with some different pain medication? Sometimes a combination of Tramadol and Tylenol works. There must be something to help - you shouldn't have to "tough it out".

 

[71Beetle]

@jawndo, sorry you are experiencing so much pain. I was on Tramadol and Tylenold and that was not enough for me so my OS prescribed Oxycodone which has at least allowed me to sleep. You should not have to live with so much pain. I do hope you find some answers and relief soon.

 

[hopefaith]

Truth is there are many other combinations of meds. I was never on MS Contin. I was a specialist in pain management as a nurse and I believe what your doc said is not true. BUT that being said I will say my best friend , and I take her everywhere has been ICE! Many thoughts and prayers coming your way. Please be very kind to that knee. No need at all for PT at this point (unless I am missing something). I have done minimal PT, listened and taken guidance here, argued with several people about the way I will treat my knee and 2 days ago received a glowing report on my 6 wk. post op. from OS. We all truly care!

 

[lori107]

Hi @jawndo, just wondering how things are? Hope you have got the pain under control now.

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[Purplegirl]

@jawndo
I had my RTKR, May 2, 2014, so that makes me a month out now and I am still having excruciating pain many days. I do know that I was doing way too much the first 2 weeks. I mean just walking around my house with my walker hoping to make my recovery better. HOW WRONG I was, you must give yourself time to heal. This is the worst for me, I am a on the go type and I am having a hard time with sitting still. This BS site is a life saver and I have realized that each of us is individual in our healing but we still need to protect our recovery with rest, ice elevation and TIME.

I still don't think they have me on the right pain meds. Norco was a big fat NO (allergic to the filler in it) Vicodin only helps slightly but I have been on that for years so used to it. Now I am on Oxycontin 20mg BID (this is the sloe release one) it takes maybe 2 hours before I get a small amount of relief so I am thinking I t doesn't work. Then in between every 4 hours I take 2 Oxycodone 5-325. This seems to give me some relief but not for long. I wake up with a pain level of 9-10 and never get below a level 6 anytime during the day. I have some Tramodol 50mg I may try instead of the long acting Oxycontin that seems useless to me.

I think that everyone responds to pain differently and some of us are hypersensitive and our pain is really BAD. I guess our only hope is all the BS posts that say there is an end to this HOROR we are in now. Thankfully you have an angel wife and I have a angel husband helping me!!

 

[Quasi]

@jawndo

I am coming up on 4 weeks post op this coming Tuesday and am feeling much better. Mainly due to the fact that I went to see my general MD regarding my pain level. Pardon the bad language but the first two weeks were pure h---! I am so sorry to hear that you also are experiencing pain that is not controlled. Please make an appointment with your primary physician regarding pain medication. I am finally getting some relief even though I still have a lot of pain! My wonderful husband has taken care of me around the clock, so I am blessed like you in that area. Please let me know how you are doing. Once I started using ice almost all the time, it is such a relief! Do the mantra and be kind to yourself and rest! Prayers being lifted up!

 

[Jozilla]

I was on the medication you are currently in the hospital and my pain was controlled thankfully. I did take the two oxyy's every three to four hours - my maximum. Yes pain is different for everyone and tramadol might help you more. You didn't mention icing. I iced almost all day and night the first couple of weeks. A lot of the pain comes from the knee being swollen. If you get rid of the swelling your pain will decrease. We can tag @Jamie or @Josephine who can give you more info on your medication and activity. Your knee needs to recover. I think part of the reason my pain was low was because I was lazy and did very little the first 3 weeks. Hoping you feel better!

 

[lori107]

@jawndo, I'm 10 weeks post op now and am only just starting to feel half human again. This op has been the hardest surgery I have ever been through. I spent the first 4 weeks not doing much at all but I'm still taking oxynorm 4 times a day to keep the pain under control. You must listen to the knee, it is telling you exactly what it thinks about any activities you attempt whilst at the crucial stage of healing.

 

[susanlondon]

Jawndo-

After working up the courage to get 'er done, I had ny LTKR on May 14, 2014. (RTKR on Jan. 16, 2012). For Kr #1, I cried every day for five weeks. "What did I do? Why was I in so much pain? When was I ever going to feel better?" You name it, I cried about it. I knew my left knee needed to be replaced, but I wasn't ready until this winter (avid snowshoer). I feel like I've learned from my last TKR how to manage my discomfort better this time. I've also learned that the process, as so many others have said, is out of my control. I can't make my knee heal faster; it's going to take its own sweet time, and TG for that. I'd push to the point of discomfort and my knee would respond with, "Oh, yeah? You think...you're going to tromp around the uneven backyard, walk 4/10's of a mile, etc?" Each overzealous attempt on my part is countered with my knee's reaction: STOP! lEG UP! ICE!

I've learned, from last time to this time, that, as they say in 12 step programs, time takes time. I've learned, from the smarties on BS, to take my meds on time. I've learned, through my own growth and development, that trying to do something to please others (sitting at the dinette table to share a meal that a well meaning friend has prepared and brought over) does me no good. I've had to set boundaries, ask for help (very hard for me, a single and independent woman), and follow what my body suggests is best for the moment.

I started I PT a week after surgery, which was a week before I started with my right knee two + years ago. In some ways, I think it's put me ahead in terms of movement; however, it's also given me more ouch moments for working very tender tissues. One of the hardest parts of this whole process has been the difference of opinions between USA and UK experts. I have to sort out what works for me, but it does cause anxiety.

I hope you're feeling a bit better. The goals are determined by the knee (I am hoping that, like my other KR, that by Week 5, I will have turned a corner on the pain, but I am aware that that might not be true this time.) I really like the graph on BS that shows approximate recovery rate by weeks. It certainly rang true for me.

Keeping you, as I do myself, in white light and in God's hands. Gentle guidance from a benevolent higher power will see us through.

 

[Josephine]

@jawndo so how are you doing now?

 

[hopefaith]

@jawndo Yes. We all hope you are doing okay. Are you?