Total Knee Replacement

Bobw235 said:
Thanks Sue. The Oxycodone does is 5mg, but she's allowed to take one to three tablets every four hours. She's been primarily on one tablet and doesn't need them at night. Because she's having so much pain/stiffness right now, the nurse suggested she take two or even three tablets before her sessions with the PT. She's going to try two for her session this morning and see if that gets her through the pain. She was stretching this morning and I thought she made some progress, but the knee is still swollen after two weeks post-surgery. The nurse yesterday also told her to start taking an anti-inflammatory to help with the tissues. Staples come out this morning. That may also help.

We're fighting through this, but have come to realize that this is going to be a protracted process. I think it's good that the nurse was so blunt with her yesterday.

Appreciate your words of advice.
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Hi Bob,yes, when the staples come out,your wife will feel better,I know I did. Another suggestion my surgeon mentioned,buying coconut cream and putting it on the knee scar.I did it twice a day for awhile,helped with the healing process. Sue
 

moviequeen1 said:
Hi Bob,yes, when the staples come out,your wife will feel better,I know I did. Another suggestion my surgeon mentioned,buying coconut cream and putting it on the knee scar.I did it twice a day for awhile,helped with the healing process. Sue
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She made some progress today, getting her leg bend to about 65%, but the other day she was only at 20%. I went outside when the PT was here, and I'm glad I did. My wife told me she was pretty vocal during the session. I worked with my wife this afternoon and I know she was hurting, but she wants me to do this with her and I know it's important. If she doesn't get the flexibility back, she'll have longer term problems. Going to get her on the recumbent bike tonight and rock the knee back and forth.

I'll pass along the suggestion about the coconut cream. Good idea. Thanks.
 
Bobw235 said:
I think this is what's so difficult about the recovery, conflicting advice. Online advice from Bonesmart.org seems to suggest what you and Warri have said, namely that it shouldn't hurt this much. Then she had a call from the orthopedics nurse today that left her in tears. The nurse essentially told her to increase her pain meds as a way to fight through the pain of rehab, stressing that it's crucial for the knee to not develop adhesions. The nurse told her she needs to fight through the pain, and that the Oxycodone is there for that reason. This is nothing like her spine surgery two years ago.
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I got that "don't be a hero" about the meds lecture from my doc at one point, too. He flatly told me that he had prescribed the doses of the meds he had prescribed because I needed them, and he expected me to be taking them as directed, and that the body doesn't heal as fast if it is fighting intense pain all the time. He was very big on getting ahead of the pain so your body can heal.

I hear all the time about opioid addiction, but all those meds didn't make me feel good in any way except by relieving pain and I felt no need or desire at all to keep taking them after I no longer needed them. I guess everyone reacts differently to the meds -- except for being pain-free, all they made me feel was sleepy.
 
jujube said:
Bob, watch out for one of the side effects of Oxycodone. My mother got very constipated while on it...."opioid-induced constipation". Miralax helped her a lot.
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Way ahead of you on this one. :) We were warned after she had her spine surgery about this, and now there are even commercials on TV about it. You should see our kitchen table; it's a myriad of pill containers, one of which is stool softener (2x per day) and a bottle of generic Miralax from Costco, used in the morning. Really helps she says. The first few days after the surgery were really difficult constipation-wise. Much better now.
 
deesierra said:
My knees are not a dependable part of my body any more. But questioning if replacement is a good decision.
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In my wife's case, this was a nearly two year decision after trying to find answers for why she was having pain in her right leg from the knee and down into the calf. We invested a small fortune in co-pays for doctor visits, first to her original spine surgeon (who assured us that the spine was no longer an issue) to a "pain specialist" who spent months trying to diagnose the cause of the pain. Then there was physical therapy. Then there was acupuncture (not covered by insurance, so $75/visit!). Finally she started looking into surgery when the first sports medicine doctor told her that the right knee was pretty much bone on bone. My wife did a TON of reading, watched a number of YouTube videos about knee replacement surgery, visited three surgeons, investigated each potential hospital and finally decided it was time to do it.

So I know we're in the early stages of her recovery, but I can tell you that the original pain she was having where the arthritis was present, that pain is no longer there. My wife can now be on her feet for more than 10 minutes without having to sit to relieve the discomfort. I'll take that as a good sign.
 
Butterfly said:
I got that "don't be a hero" about the meds lecture from my doc at one point, too. He flatly told me that he had prescribed the doses of the meds he had prescribed because I needed them, and he expected me to be taking them as directed, and that the body doesn't heal as fast if it is fighting intense pain all the time. He was very big on getting ahead of the pain so your body can heal.

I hear all the time about opioid addiction, but all those meds didn't make me feel good in any way except by relieving pain and I felt no need or desire at all to keep taking them after I no longer needed them. I guess everyone reacts differently to the meds -- except for being pain-free, all they made me feel was sleepy.
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My wife feels the same way as you do. It seems she really just needs them during the day, but not at night. This will be an aid to get her through the difficult part of the rehab, but she is not craving these by any stretch. As you said, it just makes her feel sleepy and lethargic. After her spine surgery, she never needed them beyond the first week, then switched to Tylenol.

She just took them at breakfast so I can start working with her this morning on getting that flexibility back.
 
I do not have any experience with knee replacement but am obviously interested in the subject. I do have a few comments that may or may not be appropriate and they are based on having had severe knee pain and are related to how to deal with the pain, other than the pain killer aspect. It is about some of the techniques of how I dealt with the pain while it was subsiding over a period of weeks/months.

I found that I was most comfortable during the day when sitting in my recliner. No other combination that I tried compared with that. I think a big part of that was in how it fit me; particularly that my heels extended past the foot rest and weight was distributed along my calf. Now there is only so long you can remain like that without discomfort on the calves but it is a pretty long time.

And during the day at times icing and/or heat treatment helped with the pain. I mostly used icing. I still had a contraption designed for holding gel packs around my knee from when I had my knee scoped years back. It's light weight, has pockets to hold a couple of gel packs, and Velcro to hold it in place on both sides of the knee cap. The gel packs can be either frozen in the freezer or heated in the microwave.

At night I found two things. It was my right knee. When laying in the bed on my back having my heel extent off the bed helped at times. I bought a new mattress and then added two inches of mushy insulation to that after a few weeks. I used one of those specifically contoured pillows that you place between you legs just above your knees when I laid on my right side. I used a body pillow (for pregnant women?) when I laid on my left side and draped my right knee over that while hugging that 54 inch long body pillow.
 
Some encouraging news today following the latest PT appointment. Range of motion went from 65% on Friday to 74% today! Not having to take much pain medication, only before a PT session, but otherwise not in discomfort. My wife sees the surgeon next Thursday, then it's probably on to outside PT treatment instead of here in the home. The therapist today was really pleased.

On a related note, the PR firm representing the hospital where she had the surgery came to our home today for a photo shoot. They're putting my wife in some ads in magazines and maybe on social media as well. Took several hundred photos. The photographer has an impressive background and even did a cover for Time Magazine at one point. Looking forward to see what he chooses for the final shots for the ads. He took several of both of us, just to say thanks for our time.
 
Great to hear your wife is doing better Bob, and WILD to hear they came in for a big photo shoot! Would love to see one of the ads they make! :cool2:
 
Hi Bob,thanks for keeping us posted about your wife's recovery. It reminds me what I went thru,each week my knee felt better,knowing I was getting my flexibility back certainly boosted my spirits.In the beginning,I had to remind myself to walk at a slower pace than what I was use to. I continue to say nightly prayers for you Sue
 
Butterfly said:
I got that "don't be a hero" about the meds lecture from my doc at one point, too. He flatly told me that he had prescribed the doses of the meds he had prescribed because I needed them, and he expected me to be taking them as directed, and that the body doesn't heal as fast if it is fighting intense pain all the time. He was very big on getting ahead of the pain so your body can heal.

I hear all the time about opioid addiction, but all those meds didn't make me feel good in any way except by relieving pain and I felt no need or desire at all to keep taking them after I no longer needed them. I guess everyone reacts differently to the meds -- except for being pain-free, all they made me feel was sleepy.
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My goodness Butterfly, this is music to my ears. I never knew extended pain inhibited healing!

When I broke my wrist resulting in surgery with hardware, I was prescribed Oxycodone. Everyone and family members told me to watch out- try not to take it, you'll become addicted , etc.

So, instead I took NSAIDS like Ibuprofin, Motrin, Alleve and even aspirin, in quantities I needed for the pain. Which, for my small body ended up being too much and caused internal bleeding requiring surgery. That amount of Tylenol would have damaged my liver. It was a complete nightmare.

I'd foolishly ignored my doctor's instructions and even more foolishly tried to self medicate because of this "opiate thing" going on these past several years and the uninformed "advice" from others.

Truthfully, as far as feeling "sleepy", that only lasts less than a week. Or so I've found after extensive oral surgery recently.

That said, I hope Bob, your wife heals quickly!
 
So, in the continuing saga of her recovery, today marked a new "first" since the surgery in that I took her to the grocery store. She liked the fact that the cart made her feel more stable on her new knee. Also took her to the library so we could pick out books for the grandkids, which we're still recording and posting on YouTube for them. We're over 100 stories now and still going strong.

The good news about today was that as long as my wife was on her feet, she had none of the pre-surgery pain that was so constant after just a few minutes. The thing we're looking out for now is the knee feeling like it's going to buckle, which makes her tense the muscles suddenly and thus causing an instant burst of pain. Has to get the quad stronger in order to build stability for the knee. I worked with her earlier today on the massage table, bending the knee a little bit more than the day before.

Thanks again for the best wishes.
 
The mention of the shopping cart reminded me that it is vital to avoid a fall. A stick is helpful for maintaining stability but a wheelie walker is ideal for walking on uneven ground. Mine has a nice wide seat which is great and a place where I can stow my handbag to keep my hands free. I don't need it now but it only cost $149 new and it has been well worth the cost.
 
Warrigal said:
The mention of the shopping cart reminded me that it is vital to avoid a fall. A stick is helpful for maintaining stability but a wheelie walker is ideal for walking on uneven ground. Mine has a nice wide seat which is great and a place where I can stow my handbag to keep my hands free. I don't need it now but it only cost $149 new and it has been well worth the cost.
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We left the hospital with a walker (wheels on front) and a cane. She's been encouraged to wean herself off the walker by her PT and use the cane. I think the walker is close to being retired.
 
How has OP's wife come along with the TKR...I have a nasty knee and doing all I can to NOT do a TKR and some days I wonder if I really ought to do one.

I had a nasty hip replacement in 2010 and I so fear another replacement surgery. I use a walker now as I've been thru some issues including a staph infection which was a major setback for me, and I can bend my knee but the pain when I start to walk.

Any thoughts...I know we are the only ones to make the decision. Thanks.
 
After looking back and reading the previous posts it appears that your wife is headed in the right direction. I'm happy for both of you. I think in a month or two she will say it was all worth it. It is good not to get to dependent on a walker. I did that when I dislocated my knee. My balance was off for quite awhile.
 

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