TKR Desperately seeking advice

[Xmascarol]

Hello,
I had my 2nd TKR 2/28. I felt rushed out of hospital since I was vomiting as they wheeled me out. Went to ER on Friday because my oxygen was dropping to 72. While there my blood pressure was 165/125 at one point and later I saw labs showing my troponin level was 74 but nothing mentioned. Have not had a blood pressure problem in the past. They sent me home recommending I cut my OxyContin dose by half since I mentioned 10mg was making me kind of delusional. Because I am on xaralto for 30 days, I can’t take any nsaids and am limited. Dr called in Tramadol yesterday but I couldn’t sleep all night. Between the pain and having to pee very often from stool softener. I was desperate I took a gabapenten that I had.
Sorry for rambling but I am so confused and definitely need my sleep.
Thank you!
Carol

 

[MSuki]

Talk to your doctor about the meds, you need to keep letting them know if your pain is not controlled. If the gabapentin helped let them know that. I was taking a Gabapentin only at night before surgery and they didn’t tell me to stop it, so I took throughout along with the hydrocodone. Also I had to take Xarelto because I’m allergic to aspirin but I also had an nsaid prescription with no issues. Your mileage may vary and you may have different reactions to meds so consult your doctor before changing anything. Gabapentin and pain meds can increase the soporific effects of each, but in my case hydrocodone keeps me awake vs making me sleepy.

 

[mendogal]

Welcome back to BoneSmart. I'm sorry you're off to a rough start.

I see you were here in 2018 with a March 6 2018 L TKR. So this was your R TKR on Feb 28 2024.

You are in the very early stages of an average of a yearlong recovery. I will leave you our Recovery Articles that have helped tens of thousands of other knee replacements. We are here to help you through this journey the best we can. The very best thing for your knee right now is to rest, ice, and elevate. Exercises can come later. There is no rush to achieve ROM because it will come naturally as your swelling decreases. Your OS was able to bend your knee while checking for movements during your surgery, so it will be fine. It just takes time.

Each person is different as is their recovery. Most find that the Bonesmart approach works best for them, but others find that a more aggressive therapy helps them more. It's your recovery and your choice on how you recover. As you read more on other members' recovery threads, you’ll get a better perspective of what to expect. The following are our basic guidelines and should help get you started.

KNEE RECOVERY 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.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

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

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

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 a 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 history before providing advice.

 

[mendogal]

Definitely consult with your ortho team about the best medication regimen for you.

Insomnia is a real bummer for many of us in the initial weeks after knee surgery. Definitely sleep whenever (and wherever it's safe and comfy!)

Icing, elevating, napping.... All help, but for some of us it was endangering our mental health. Before it gets there consider some nonprescription remedies....

If you're lactose tolerant, a glass of warm milk! If you're not diabetic, a teeny bit of honey makes it even more comforting... plus milk is high in magnesium! Helps us relax!

If you aren't a milk drinker, or want an easier way to, an evening magnesium supplement has been very helpful for some members.

OTC diphenhydramine is an antihistamine also used as a sleep aid (Benadryl) because it makes you drowsy; it's also included in some cold, flu, etc "nighttime" combination meds.

Low dose melatonin, sustained release - not for long term use but I have used for a week at a time without ill effect. It should be taken an hour to hour and a half before going to bed, and during that time stay in a dimly lit area to allow this hormone to activate.

Valerian root - an herbal remedy, it can be taken in capsule form but that dose might be high compared to my preference, herbal "sleep" blends that include a smaller dose of valerian and make me pleasantly drowsy. Plus the other tea flavorings make it nice tasting! Celestial Seasonings and Traditional Medicinals sell teabags by the box. Their sleep blends without valerian have never ever made me sleepy.

Be aware: even benign herbals and supplements can interact with your routine or post op prescription meds, either making their effects weaker or stronger. If you're on meds you may want to check with your doctor or pharmacist, or even check online for interactions.

 

[Jaycey]

@Xmascarol So sorry you are having a rough start to this recovery. Please do talk to your surgeon's office or your family physician about your medication. One size does not fit all - we all react differently to medication.

Note - I had a major problem with Xaralto during my LTHR recovery. It play havoc with my BP and I eventually fainted. Just not a fit for me. Do mention you symptoms during your discussion. Sounds like you definitely need a medication review.

Hope things ease for you soon!

 

[Layla]

Hello Carol,
It is the one month anniversary of your TKR and we haven't heard from you in about three weeks.
How is your recovery going? You certainly had a rough start and I hope you're feeling much better and making steady progress. Please let us know when you have time. We'd really like to hear from you.
Happy One Month Anniversary!
@Xmascarol