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Old 05-03-2013, 12:54 PM   #1
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TKR 11 days out

Hi everyone,

I'm new here, but have read many posts. My story: I am a 43 yr old male. Both knees were bone on bone due to football and a car accident. I had prior surgeries, ACL and MCL repairs back in the late 90s. Those were horrible and I was laid up for months and on crutches my whole senior year of high school. Since my job requires that I am on my feet all day, up and down ladders and scaffolding, they just continued to deteriorate. I eventually ended up with a pain mgmt doctor who put me on Vicodin. Eventually, that wasn't doing it and they wanted to move me up to OxyContin. I had heard the withdrawal from that was horrid so I denied it and began looking to TKR.

I found a great doctor 5 years ago and he couldn't believe how bad they were especially for my age. Said they were the knees of a 70 year old and wondered how I got out of bed every day. He recommended replacements for both ASAP but I couldn't afford to be off work then. Fast forward to today, I am 11 days out of getting my right one done and the left one is due to be done on the 13th. Today, I am pretty sure I will cancel that one. I am not emotionally ready to go through this again. The pain is killing me. I feel as if I am going to crawl out of my skin! I am bored terribly and it is messing with my mind.

I had this done at the doctor's surgical center, they do not dispense meds so I had to get the scripts first. There was no drip or pump, just Percocet, Vicodin, and OxyCodone. It wasn't enough, especially after years of taking meds. They could only give what was prescribed and I was miserable. Three days ago, I dropped the Percocet and the oxys. I have been miserable. I hate to admit it but I have been crying and just feel so claustrophobic. I cannot even stand to have my leg in the CPM machine. When I do, I get up to 90%, I might go further but the home health nurse said not to push it until I get the staples out tomorrow. I have PT coming a couple times a week. She comes today. I do all my exercises every day, I walk outside a bunch of times a day and I constantly ice it. I just want this done.

I wonder if anyone has not gone through the second one after the first one. I just don't think I want to do it. But, I also feel like I should just get it over with. My wife is supportive of whatever I choose but I feel like a big baby. She also thinks I dropped the pain meds too soon. I do still take the Vicodin and I cannot wait to get off those too. I know that I might have to go to rehab to get off them and that scares me too.

Comments? Advice? Thanks for reading.

 
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Old 05-04-2013, 12:20 AM   #2
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Thumbs up Re: TKR 11 days out

Hi KayJaylv

First of all, I am sorry to hear you are suffering so much but you are most definitely NOT a big baby! It's very early days for you. I had my first TKR last September and for quite a while, I was so depressed, in awful pain, so tearful that I felt like taking all my meds. I also swore that I would never have the other knee done - it too needs replacing. I am surprised you didn't have a pump and the proper pain relief afterwards because, as we who have had this surgery know, you definitely need it. I was warned beforehand that I would have "some discomfort" for a week or so but that had to be the understatement of the year! You have had major surgery - the knee joint is the biggest in the body. Also you have had an active life and it is a phychological as well as a physical blow to go through this and be in enormous pain and so restricted. I'm in the UK and a 56 year old female by the way but both my knees needed replacing ten years ago. The docs would not proceed as I was "too young" though I had the knees of a "woman in her 80's" Doctors thought they had got the wrong notes! All I can say is hang in there and it WILL get better. You must get your meds sorted out - there is no way you will be able to do your physiotherapy without them and being in such pain will not help your recovery. You may have some responses saying how folk have gotten through this without the pain you are obviously in but we are all different so don't beat yourself up. Let us know how things go and I wish you a good recovery but - I have to be honest - it will take time. Good luck.

 
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Old 05-04-2013, 05:45 AM   #3
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Re: TKR 11 days out

Hello KayJaylv,

So very sorry to hear of the hell you are going through, like Kamboyo said, it is going to take time. A LOT more time than your OS suggested. Like you I (or was) pretty active and was told that I would see some 'normalcy' after a couple of weeks. I thought and was led to believe that I would be back on the golf course in three weeks or so, well, that was so wrong, so very wrong. I had to have a special 'session' with my OS (who is also a friend of mine), and I let him know that he should not build up the expectations of his patients and should be more honest with them.

I am now in my 13th week and while my knee is more comfortable to be with, some days are still quite uncomfortable and requires meds. In your case, I can well appreciate what you are going through and I know it is living hell. As Kamboyo pointed out, the psychological pain coupled with the physical makes it just about unbearable. I found that I had to try to occupy my mind as much as I could and not think too much about the pain I was feeling, that was accomplished by icing, exercising and meds. You will not get 'addicted' to the meds if you are using it to control pain.

When I first got home I went directly to PT skipping Rehab, bad decision, PT was too much too soon. Lesson learnt was that you MUST take it easy for as long as it takes before feeling that you can do 'normal' everyday things for which PT prepares you. After the staples are out (I could not believe the pain in taking them out, take a couple meds B4 taking them out), you must go slowly. Remember that the scabs which appear on the outside are also on the inside (scar tissue) and must be dissolved by your body. The only way that happens is to keep the joint moving (sans CPM machine), icing, and ROM exercises. Use the meds to accomplish this.

Wish I could tell you that you will be pain free but that probably wont happen until you are in your 10th to 12th week. I know everyone's different and recovery differently but I think that 12 weeks is the base for most people. It will get better and you must get used to the idea that your activities will be curtailed for some time. TRY to relax and enjoy the inactivity case if you don't, and you push it, recovery will only take longer.

I wish you the best and just remember it will get better.

dj

 
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Old 05-04-2013, 01:19 PM   #4
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Re: TKR 11 days out

Thank you both for you responses. I appreciate them and the words of encouragement. As it stands now, I feel as if I was lied to by other people and the professionals. I even think the pt people blow smoke when they tell me that I am so advanced. I don't feel advanced. Every part of my body hurts from sitting or laying, I can't get comfortable at all.

At this point, I don't see myself getting the second one done and I must admit, I am disappointed about that.

As far as meds go, they are the biggest reason as to why I wanted this done. Iam tired of taking them and I am addicted to them. Add that to everything else and this whole process just has me in the dumps.

I hate feeling this way and look forward to better days! Thank you for you honesty as far as how long that will take. Doesn't make me happy that I now know how long this will take, but at least I feel it's the real truth.

 
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Old 05-04-2013, 04:49 PM   #5
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Re: TKR 11 days out

To all of you who have posted on this thread, I commend you for your candor and thoughtful comments. I don't want to repeat the things that have already been said, but I will emphasize a few points. One is that it seems rather strange to me that you did not have meds provided to you at the time of surgery. With this type of surgery, it is absolutely necessary to control pain before, during, and immediately after the surgery in order to minimize (as much as possible, which varies from person to person) subsequent pain. I would definitely question your doctor, and go so far as to suggest that you change doctors, in order to get your pain situation under control, and to avoid a repeat should you decide to have the other knee done.

I am a 60 year old female. I had almost no movement in my left knee by the time I had it replaced at the age of 45. The problems began when I was 20, playing basketball, and I totally blew out my knee. The doctor thought I was dislocating my patella. It took years to get a doctor to consider the fact that a female actually is more likely to hurt her knees playing sports than a male. Anyway, fast forward after many intermediate surgeries to my knee replacement. In my case, the pain went down pretty much immediately after my surgery. The replacement did resolve many problems with my knee. I can't remember when or how often I needed pain meds back then, but I'm sure it was not for long. Rehab, though, in those days was forced bending of my knee by the therapist. I laid on my stomach and he forced my knee to bend. Let me tell you that THAT was painful. In the end, though, I recovered much faster than expected.

Three years ago, I had my right knee replaced. Now that was a different story. Sure, I was older, but things just did not go as smoothly, beginning with a hematoma that sent me back to surgery. I took more pain meds than the first time around. My rehab took longer than the first time around. But I am walking fairly well, although I have other issues that contribute to the right knee not working as well as the left.

I have explained all of this to say that I, too, had a severe problem when I had my first knee replacement. It is in fact true for some people that the recovery goes quickly. The doctor was not entirely wrong. And for the same people, another replacement might end up going quite differently.

The thing about recovering from orthopedic surgeries is that (and believe me when I say that I have had many of them) you need to think past your present condition. You need to say to yourself, "In two weeks, this will be a bad dream and I will be feeling better." And after those two weeks, you tell yourself, "In another two weeks, I will be able to do even more than I am doing today." And so on. You cannot get stuck in the muck of your misery. You have to think beyond it. Focus forward, not down.

As for having the other knee done, kayjaylv, my suggestion to you is to wait until you are feeling a bit better to make any decision, but definitely put it off for now. I would also suggest that you see a pain management specialist who can help you sort out your situation with pain meds. He can steer you towards the best route for you to take. Don't assume you should not take your pain meds, because that is obviously not working. On the other hand, you are right to be concerned since you have had issues with them in the past. But seek the help of a professional rather than deciding on your own.

I commend your wife for her support, and I wish you well. Please continue to converse with us so that we can help you through this as much as possible. Good luck!
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Old 05-05-2013, 12:33 PM   #6
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Re: TKR 11 days out

Thank you for your response. I do need to think forward...good advice!

Let me clear up the pain med thing...I am with a pain mgmt dr who prescribes me the Vicodin every month. Unfortunately, I did not manage it well as I was taking too many of them at once. I would run out before my script was due for refill and then I would go through withdrawals. I know it was stupid, especially when I went for the surgery as I think I was immune to the dosage they gave me. This caused me to be in terrible pain. My fault. I did tell my OS so he was aware.

What they do at the surgical center is after the surgery they take the IV out and you have just the meds you filled before the surgery. No chance of getting anything stronger, such as morphine or dilaudid. I am jealous of those who were able to get that on the first night. They prescribed me some oxy, 5mg...10 of them, some Percocet and my Vicodin. They dispense them as prescribed. They also prescribe ambien, which I had at home and didn't know to bring, so I couldn't get those for the first night, that really stunk. I live an hour away so my wife went and got them for the second night, that definitely helped.

I don't know if that was confusing...but at any rate, my goal is to get off these meds completely. I have a love hate relationship with them!

I feel ok physically, I mean there is definitely pain, but I'm dealing with that and down to one Vicodin every 4-6 hrs. Staples came out yesterday. Couple of them hurt, but not terrible and I'm glad they are out...one more forward step! I am doing the CPM and I get it up to 107 and-2. I walk every hour, not using the assistive devices anymore, and I do my PT exercises.

Mentally, I feel a wreck. I am trying to fight that and I think that's harder than the physical part.

Today I am thinking I will go forward with the left TKR. (This could change in an hour...). I just think that I want to get it over with and move forward instead of having this hang over my head for how ever long it takes me to decide to do it again...if ever!

Moving forward.....��

Last edited by Kayjaylv; 05-05-2013 at 12:40 PM. Reason: Added info

 
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Old 05-05-2013, 12:34 PM   #7
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Re: TKR 11 days out

I don't know why this double posted....sorry....

Have a great day!

Last edited by Kayjaylv; 05-05-2013 at 12:37 PM. Reason: Erased double post

 
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Old 05-05-2013, 02:23 PM   #8
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Thumbs up Re: TKR 11 days out

It definitely sounds as if your head is in a better place than when you started this thread. Whether that is because you got a chance to air some of your concerns, you have your pain situation under control, or you can really start to see progress in your recovery, I don't know. Chances are that it's a little of all of those.

Thanks for clearing up the pain med situation. I understand all of it other than that you are going to a surgical center rather than a hospital unless a surgical center IS a hospital in your area. Around here where I live, that term means outpatient surgeries and tests only. But it sounds as if your facility is perhaps out- and in-patient. I hope I have that part right.

I still don't get the part about you having to bring your own meds, though, unless that is another feature of your surgical center. I certainly never have to provide my own pain meds, or any meds for that matter, except for my migraine medication which the hospital does not carry in their pharmacy.

In any case, I am very pleased to learn that you are making steady progress. Fifteen years ago, I used a CPM machine, but not 3 years ago. CPM machines are rarely used around here any more, except under certain situations such as when the patient is unable to get out of bed for conventional PT. I still think they are very valuable, even for the mobile patient, because it can be used at any time of the day between regular PT sessions. I imagine that it boils down to costs. It sounds as if, in your case, you are making very good use of it given your range of motion. That will set you on a very good course. Make sure to maintain that range of motion while you are recovering from your other knee replacement, though.

It sounds as if you are making a sage decision to go forward with the other TKR. Get it over with and be done. I think that's how I would feel if I were you. Make sure you get plenty of rest leading up to the second surgery, because your body will still be recovering from the first round when you go in for round two. I guess that would be my key advice at this stage. Except, of course, to continue to remain positive, even if you have a minor setback from time to time, and keep your mind looking toward the horizon and not the discomfort you are feeling at the moment. Before long, it will all be behind you.

Great job! Keep up the good work!!!
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Old 05-06-2013, 12:08 PM   #9
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zimmerTKR HB UserzimmerTKR HB User
Re: TKR 11 days out

Kayjaylv - sounds to me like you're progressing just fine based on your surgery date. 2 degrees extension and 107 degrees flexion is about where I was a 2 weeks. It's good you understand your Narcotic dilemma, but I wouldn't stress on it at the moment. Doing the prescribed exercises everyday and keeping a positive mental attitude are top priority right now.

When it comes to the left knee you might want to think of it as your gateway to eliminating Narcotics from your life. With two fresh implants, the need to treat pain should be gone in a couple of months.

Take care,
Chuck

 
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Old 05-07-2013, 10:11 AM   #10
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Re: TKR 11 days out

OMG I cannot imagine going without pain meds! I am post surgery Day 8. Feeling frustrated of taking them every 3-5 hours, but cannot imagine NOT taking them! I am 47, with a knee of a 70 yo also. Take your meds! I don't have anyone coming to my house nor do I go to PT center. I heard so many stories about a woman similar age walking around her block a week post surgery and others saying they were literally pain free...bogus! Take them and slowly reduce your time,dosage. Can't imagine doing it again so soon, I think I would wait. Best wishes. Hang in there and continue to reach out.

 
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Old 05-07-2013, 08:38 PM   #11
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Re: TKR 11 days out

Fleafly, the surgical center is the surgeon's baby. He has his own operating rooms and staff and then you go to recovery suites. It's very nice and I am impressed but the med thing is a downfall. I didn't realize that until I was going through it. They have their own PT staff and nurses. It is very personal and only people with hip, knees and shoulder issues.

Thanks for all the encouragement, it really does help. My jitters come and go. Today I drove! That was a definite forward move! The PT came today and said the doc should be happy with my progress, so that's a good thing. She did some exercises with a band today...it hurt but I know they will be uncomfortable.

I still am very afraid of the next surgery, but I'm going to do it. I hate the confined feeling and the pain.

I am surprised about the CPM machine, I thought everyone used them.

Thanks again!

 
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Old 05-15-2013, 11:43 AM   #12
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Re: TKR 11 days out

Hi there, KJ! Glad to hear from you. The surgery center sounds cozy, apart from the pain med situation.

Although I am very happy that you are feeling pretty good, I am surprised that you are already driving. I presume you mean that you are driving with your right leg, correct? The thing about that is that you might feel just fine for regular driving, but what about a sudden stop? Or a situation where you need to brake and accelerate to get out of a jam? I just urge you to not take any unnecessary risks, for safety's sake. I think I was perhaps 4-5 weeks out before I drove, either time.

In regards to the CPM, I am gonna guess that the key is the "passive." While there are benefits to keeping the knee moving (i.e. it is less inclined to get stiff, it's doing SOMETHING during those hours between PT sessions, and it's generally painless), it is a passive method so that the rest of the leg is not making any effort. It's much better to make the quads and everything else work to move the knee, even if they might not get your knee bending and flexing as smoothly or as far as the CPM. After all, the CPM machine is not going to walk us across the room. Our leg is. So, I'm thinking that too many people get lazy with the CPMs and don't do enough therapy for the whole leg and end up needing PT for a longer period of time, thereby costing the insurances more money. Just a guess.

Do you have a date for the left knee surgery yet? Let us know how things are going. Keep up the good work.
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Old 05-15-2013, 12:24 PM   #13
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Re: TKR 11 days out

Kayjaylv - sounds like you're progressing well. That first drive is definitely liberating!

FWIW on the CPM Machine: They sent one home with me for a couple of weeks. I used it the first couple of days, but after that I spent most of my time doing exercises my Outpatient Therapist laid out for me. They didn't want me to use the CPM beyond 90 degrees flexion, and by day 1 at home I was already able to comfortably obtain that on my own. Now at 3 months Post-Op, I see my Insurance Company (Blue Shield) is fighting the charges for the in home CPM Machine. The Insurance Company claims there's no substantive proof that a CPM at home positively affects the recovery outcome of a TKR. After having gone through my recovery I would agree with the Insurance Company on this point. I do know that everyone heals a little bit differently, but the most important thing for me was dedication to doing the exercises laid out by my Therapist (everyday!!!) and to not sit around on the couch too much.

Take care,
Chuck

 
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