Pain meds

Posted by robinredmond @robinredmond, Jan 31 7:51pm

I had a total knee replacement a little over 2 weeks ago. I'm only taking pain meds at night, but I'm really struggling with the pain of physical therapy. I know the Doctors don't want us to take pain meds if not needed. Is everyone else taking them every 6 hrs at this stage?

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@gravity3

I was told, stay ahead of the pain and have pain meds onboard prior to pt. Doesn't payoff not to use the pain meds prescribed.
Are you doing the required home exercises? I really had to push myself to do them but it paid off. Good luck to you

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They were very vague on the pain pills. At my 2 week checkup yesterday my Doctor said you need to be on pain pills while doing physical therapy. I guess I should have called earlier and asked. Thanks for your help!

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@heyjoe415

Good point. The exercises they give you to do at home are extremely important to a successful TKR. Do then 3x day followed by ice and elevation. It might help to take pain meds an hour or so before doing the exercises.

I'm generalizing, but most people who don't recover well from TKR simply don't do the required post-op work. The surgery is the easy part. And I'd say the first month immediately after surgery is the most important.

Please understand that extreme or sharp pain means something is wrong, or being done incorrectly, and should be stopped immediately. With bending and straightening the knee, expect some discomfort/pain and back off when that point is reached. Try to go a little farther each time.

As the swelling comes down, flexion and extension will improve. Stick with it as it's worth every second.

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Thank you!

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@robinredmond

They were very vague on the pain pills. At my 2 week checkup yesterday my Doctor said you need to be on pain pills while doing physical therapy. I guess I should have called earlier and asked. Thanks for your help!

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Take care and heal well

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@rainerhans

My TKR is 2 months ago now and I had to take pain medication up to 4 weeks at night and special one hour in front of PT.
My doctor, nurse and PT advised me to take it, otherwise you can’t do all the exercises correctly or sleep at night.
I always tried to take a little less to adjust, but if I was in more pain I took what was needed.

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Good points. There's the pain of rehab/PT, and then there's just the pain of recovering from a major surgery.

A TKR is a common but traumatic surgery. The incision is around 8" long and cuts are made first into the skin and then the knee capsule. There is a small incision made into the quadriceps to release the patella so the surgeon can move it aside. The metal prostheses are set in place with taps from a surgical hammer.

I don't mean to be so graphic, but this is what usually happens. Once the work is done and the incision closed, and any nerve blocks wear off, it's gonna hurt. That's why it's best to take pain medication before the nerve block wears off. In some cases, the anesthesiologist will attach a unit that pumps a diluted nerve block for a few days.

Then there is the pain - discomfort really - of the rehab/PT. You're gonna bend and flex your knee and walk each day, multiple times a day. That pain is best described as soreness. It's gonna be worse the first few days but should start to get better, especially as swelling starts to increase. Again, you can take pain meds before rehab/PT to lessen the soreness during exercise.

But please be diligent. It is so very important with a TKR to do the exercises prescribed early and often (3x/day).

(One other thing I wasn't told - a tight tourniquet is applied around your thigh during surgery to reduce bleeding. This is removed before you wake up. It will most likely leave a large and intimidating-looking bruise in the days after surgery. Just be ready for it. It doesn't hurt much. Also, always look for the signs of infection, although that is rare.)

All the best to you rainer, and to all who get a TKR, or two, like me.

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@heyjoe415

Good points. There's the pain of rehab/PT, and then there's just the pain of recovering from a major surgery.

A TKR is a common but traumatic surgery. The incision is around 8" long and cuts are made first into the skin and then the knee capsule. There is a small incision made into the quadriceps to release the patella so the surgeon can move it aside. The metal prostheses are set in place with taps from a surgical hammer.

I don't mean to be so graphic, but this is what usually happens. Once the work is done and the incision closed, and any nerve blocks wear off, it's gonna hurt. That's why it's best to take pain medication before the nerve block wears off. In some cases, the anesthesiologist will attach a unit that pumps a diluted nerve block for a few days.

Then there is the pain - discomfort really - of the rehab/PT. You're gonna bend and flex your knee and walk each day, multiple times a day. That pain is best described as soreness. It's gonna be worse the first few days but should start to get better, especially as swelling starts to increase. Again, you can take pain meds before rehab/PT to lessen the soreness during exercise.

But please be diligent. It is so very important with a TKR to do the exercises prescribed early and often (3x/day).

(One other thing I wasn't told - a tight tourniquet is applied around your thigh during surgery to reduce bleeding. This is removed before you wake up. It will most likely leave a large and intimidating-looking bruise in the days after surgery. Just be ready for it. It doesn't hurt much. Also, always look for the signs of infection, although that is rare.)

All the best to you rainer, and to all who get a TKR, or two, like me.

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Also, find the surgeon who has the lowest rate of infection. I don't think of this pre surgery bot I lucked out and learned circuitously that he had the lowest rate of infection in his patients
Again...stay ahead of the pain. Once you are in pain it is hard to manage it.

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@robinredmond

Thanks for the help. I'm going to get back on my pain meds and if it still feels like torture, I'll talk to my therapist

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I'd talk to them. No reason to hesitate. It is their jobs to make sure you have plenty of support. They work for you

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@gravity3

I'd talk to them. No reason to hesitate. It is their jobs to make sure you have plenty of support. They work for you

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I talked to my Doctor and she said I need to be on pain meds as long as I'm in physical therapy to increase the bend. Thank you all so much for your help. I am feeling so much better now and my therapy at home and at the clinic is going much better!

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