1. < Joint Replacements

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.

Interested in more discussions like this? Go to the Joint Replacements Support Group.

srm | @srm | Jul 7 7:34am
In reply to @waltscsb "srm - I had a TKR of my left leg on June 11th. I am stunned..." + (show)
@waltscsb

srm - I had a TKR of my left leg on June 11th. I am stunned to find someone else who experienced the intense post surgery pain that pain meds could not control. I was lead to believe that I was the outlier. For the first 48 hours post surgery, no medication would dull my pain. I was on OxyContin, tramadol and dilaudid. Due to the stress on my body, my doctors experimented with a cocktail blend on the third day. My pain relief was marginal. By varying the dosages of the three and frequency of administration, I began to feel some relief. However, my blood pressure tanked and they had to reduce my pain medications to get my blood pressure up. By day 8 in the hospital, I had healed enough that the meds began to have some effect. In retrospect, I wish I had gone to Mayo for my surgery, but I didn’t.
My doctors couldn’t explain why the pain meds would not work on me.
QUESTION : has anyone offered you an explanation why the meds would not work for you ?
I’m on day 24 now and pain is now tolerable.

Jump to this post

No explanation at all on why pain meds don’t work well on me.
They did provide a blend of 3 different medications and on day 26 now. Pain has been tolerable for past couple weeks and improving daily.

REPLY
lenchiksf | @lenchiksf | Jul 7 9:22am
In reply to @waltscsb "Were opiates offered for pain or were just ineffective once given. Opioids gave me very little..." + (show)
@waltscsb

Were opiates offered for pain or were just ineffective once given. Opioids gave me very little pain relief…without an explanation from my doctors.

Jump to this post

Try to stay on meloxicam for at least 30 days or celebrex 7-14 days (as long as you are not taking any blood thinners other than aspirin profilacticly). When there is an advanced OA (ie bone on bone) there is lots of inflamation. Oxy only works to block pain signals in your head and is short term and doesnt address the source of the problem. Work on reducing swelling and pain with elevation and ice. Use ice packs 20 min every hours with a barrier to skin (pillow case) while awake or if you were given ice machine , you can use that one around the clock definetly first 3 days, then just during the day (you can make it colder by higherproportion of ice to water). The machine also comes with barrier pads when you apply to skin.

Our suregons use pain catheters for knees that are good for at least 72 hours with slow delivery of ropivocaine or patients get Exparel injection that also provides contin pain relief for 72 hrs. Patients still expected to take oral pain meds narcotics and anti inflamatory to bridge pain control past 72.
I see you are at about 10 days post op, first two weeks it can be very uncomfortable. Many patients report after 2 weeks they start feeling like pain is becoming more manageble. Continue iceing and elevating. Swelling also contributes to pain. As long as incision looks normal to you (no oozing or redness), the knee is healing. Continue doing gentle heel slides to keep knee joint moving and work with your PT.

All the best !
Lena, PT

REPLY
donnalt | @donnalt | Jul 7 10:33am
In reply to @spinner2 "Thanks for the reply. I am getting an appointment for a second opinion before I decide..." + (show)
@spinner2

Thanks for the reply. I am getting an appointment for a second opinion before I decide what to do. My present surgeon is highly respected with a 5.0 rating in my area. Still, I could make a change .

Jump to this post

You can’t change surgeons after a surgery until a certain amount of time has passed. I can’t remember how long it is three months or something. Good luck. I am seven months out and on two morphine (12-hour release and a fast acting) and two strong muscle relaxers for pain. My third opinion told me I have a long painful road ahead of me.

REPLY
Ann Shrader | @annshrader | Jul 7 5:52pm
In reply to @lauraf1963 "I was prescribed oxycodone 5mg. Did absolutely nothing. I was in the worst pain. My surgery..." + (show)
@lauraf1963

I was prescribed oxycodone 5mg. Did absolutely nothing. I was in the worst pain. My surgery was on a Friday so I had to wait until Monday to get something stronger. I ended up with oxycodone 10mg
It did help except it messed up my stomach
Stayed on them 2 weeks
Then I took meloxicam

Jump to this post

I had a hamstring repair. I was given a script for meloxicam with oxy as well as senna for possible constipation.

I did not use any meds.

Hope you are doing better.

REPLY
View MoreView Less
Please sign in or register to post a reply.