10 days post tkr and pain unbearable

Posted by srm @srm, Jun 20 9:24pm

I am a head and neck cancer group member as well.
Now I have had a tkr 10 days ago. I was not naive going into this new adventure and knew it would be very painful post surgery however, the level of pain I am living with is much greater than expected. I am no stranger to pain (surgery number13). Also, I have a very high pain tolerance. The swelling and bruising is as expected. The incision and staples look good. No indication of infection. The pain is in the knee joint. The dr originally put me on Hydromorphone. It wasn’t even softening the pain a bit. So he now has put me on Tramadol. No difference.
Have been icing and painfully completing all Physio exercises. Basically been doing everything I have been told to do. Movement in joint and leg is as expected etc. I am hardly sleeping and in constant pain. I realize that the first two weeks are supposed to be the worst and then it will slowly improve. I guess my question is what others have experienced in the first few weeks and/or if anyone has any suggestions. Or I am not too proud to hear that I am just being a big wimp and to suck it up. 64 year old male in otherwise good health and not overweight.

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I am 10 weeks tkr. I was taking 10 mg oxycodone every 6 hours and meloxicam once a day. The pain was brutal the first 2 weeks. I sat with my ice machine going on and off throughout the day. That was the only thing that helped. I still have pain after i sit a while and have to stand up. It goes away when I start walking. I only take meloxicam occasionally now. Make sure you go to PT and medicate before hand. Do some exercises at home even if it hurts. All I can say is it does get better. I am told it can take a year to be completely healed and pain free.

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Get pain medicine that works for you and keep a schedule to make sure you take it regularly. You need to be able to rehab and if your surgeon can’t support you in that ask for a referral to pain management. There are too many geniuses out there telling others what your pain should or shouldn’t be. It varies by individual and don’t let anyone judge you. Get help and you’ll be glad you did.

I have two TkR and experienced about the same level of pain with each and now am largely pain free or in the state of no complaints. It took me about 4-5 months with regular pain medicine and PT to achieve this.

So you won’t feel bad, I routinely screamed myself awake without realizing it from the pain. I couldn’t have locals or blocks so I went full into the vicious pain post surgery.

Sadly I had other joints needing replacement as my arthritis came on like gangbusters in every single joint. But I am dealing with those issues one at a time and do my prehab, rehab, and get appropriate pain relief and exercise. I work directly with my doctor on this as I have significant allergies to many medications.

Change doctors if you don’t have a good plan in place before any additional surgery. You need support, understanding and a positive approach to succeed. Don’t listen to all the crazies who drink their pain away and act like Tylenol takes care of everything. It doesn’t always work the same for everyone.

Good luck and get good help! You can get through this.

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I know is hard and painful but believe me you just have to do the exercises even if you have drink your tears.Is imperative that you do them if you want to walk without the help of any devices.This my advice after 8 knee surgeries and just now found out I'm allergic to nickel and vanadium, so #9 and 10 coming next year.So hang in there.

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@heyjoe415

Hi srm,

First of all, you are not a wimp. I had both knees replaced in 2022 when I was 67 y/o. Post-op pain is very real.

A TKR is a vey traumatic procedure, even when everything goes well. You mentioned the swelling and bruising, check. Sounds like the incision looks good (well, you know what I mean) and there isn't any apparent infection.

I had a pain med pump for the first 2 to 3 days. It was a diluted nerve block. That helped me get through the worst of it.

The exercises are hard and certainly do hurt, but as your ROM increases, the trigger point for pain is farther out.

What puzzles me is why you have pain at night, interfering with sleep. I didn't have that. I did elevate my operated leg when lying on my back, and put a memory foam pillow between my knees for side sleeping. And I iced my knee as much as possible. You might want to try this stuff if you're not doing it.

I hope that helps. If you are having severe pain though after one week past surgery, I'd go back to the surgeon to check it out.

All the best friend. FWIW I have been very happy with my new knees. I'm active, in the gym everyday, and best of all, pain free in my knees. I hope you get to that place, but it can take some time.

Joe

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My pain the first 2 weeks was the worst
Had to get a stronger rx. Are you using an ice machine? I used that all day long. It really helped. My insurance covered the rental of it

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Please don't let anyone, particularly your doctor who will only want to make it seem like all is well, make you feel like this is about. Something is not right with that. I would get a second opinion and check on the size of the implant as was previously mentioned. My doctor had deaf ears when I tried to tell him something was wrong with my implant. Lo and behold, upon another opinion, I needed the revision. No one will advocate for you but YOU. Hang in there.

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I feel terrible for all that you are going through right now! I could have written the post three years ago. Like you, the pain that I had with that surgery was truly unbearable! I did all of the “right things”……getting in shape with lots of exercise ahead of time etc but I was NOT prepared for all that came after the surgery! I was allergic to several pain meds……breaking out in a rash, vomiting etc. Also, those medications couldn’t even *touch* the pain! I couldn’t sleep and had no appetite. I felt depressed (had never had feeling in my life) and it was awful! PT would come to my home but I was in such pain, I couldn’t make much progress with the in-home exercises. Once I went to “outside PT”, I got a wonderful therapist who truly understood all that I had gone through. I went twice a week for six months (which is a long time), but little by little, I made progress. I told my orthopedic surgeon that I would *never* have my other knee done! I would rather put up with some pain and stiffness and get a cortisone shot every now and then rather than ever put myself through that again! When I said that to him, his words to me were “Well, total knee replacement is the roughest surgery that anyone can go through”. I am happy for those people who can take the pain meds and are able to get through it with less pain than me. Wishing you continued recovery. The recovery will come, but for some, it just takes longer. Keep icing your knee. Wishing you all the best.

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I am 45 with osteoarthritis in my larger joints and just had a TKR. I am 4 weeks post op with 80 degrees flexion and I have so much pain.
I am doing my best with PT following all the advice but not making much progress. I am praying “something gives”
I really don’t want them to have to go in there again. This is the longest summer ever. I feel like I am obsessed 🤦‍♀️

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Oxycodone every 4 hours for 4 1/2 to 5 weeks got me through the TKR pain. Gotta do it!

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How are you doing? Praying much for you. I'm so sorry this is so painful.

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You are not a wimp! I had terrible pain the first month, terrible sleeplessness due to pain lying down on my back with a straight leg the second month and am now at 2 1/2 months and feeling better. I can finally alternate legs going up and usually, going down stairs. Moaning and whimpering helped me breathe out so I had to take some deep breaths!
I only used oxycodone for a few days. It doesn't do much for me. I 've used icing, meloxicam, half a tramadol at night and about 3,000 mg tylenol during the day to get by. I'm allergic to ibuprofen. Changing positions a lot was the only way to get a tiny bit of relief in the beginning. The DonJoy iceman classic with knee wrap and an elevation pillow helped.

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