Paralyzing pain with knee effusion (+fractured tibial plateau)

@subu Hello and welcome to Connect. You have a tough injury that happened not long ago. I understand the concern of not wanting to risk infection. Have you called your surgeon about this? One thing that comes to my mind is the risk of blood clots after an injury and surgery. A clot could be adding to swelling. They can do an ultrasound to find a clot. Clots also happen to people who don't walk. My elderly mom who uses a wheelchair has had some issues with clots and is on a blood thinner to prevent them. It took about 6 weeks if I remember right for the clot to dissipate. I remember at the beginning, her doctor had her use aspirin as a blood thinner before she was referred to a vascular specialist and put on Eloquis. Has your surgeon offered you a prescription for pain management?

I understand considering warnings about Tylenol and liver damage. That might be something to ask your surgeon about too. They would have information about how much of a risk it is for someone in your age group, and it also depends on how many other prescriptions you take regularly, and if you smoke or drink. Because the liver has to detoxify everything, including normal waste products from living, it has a big job to do. A trained medical professional will understand how those risks would relate to you personally, or if there is an alternative that is less toxic over a long period. Your doctor needs to help you decide what is best. You could ask about using a supplement call N- Acetyl Cysteine. It is a precursor that your body uses to make glutathione which is a master antioxidant that your body makes for detoxification. NAC is used in emergency rooms for detoxing Tylenol overdoses. A professional needs to say if and how much of that should be used.

I understand how painful fractures can be. I fractured my ankle badly 2 and half year sago, and it was very painful and a long recovery. I don't like to take pain medication either, and some really nauseates me, but having a fractured ankle swelling inside a hard fiberglass cast was pure torture. I had to use pain meds to get through it all, and I elevated my foot all the time above my heart and just lived on the couch. I minimized using pain drugs as best I could and used ice packs to help with pain. I found that using a half dose of pain meds containing codeine worked well enough and I was less nauseous.

Would you please share what your surgeon advises? Has anyone looked for possible blood clots?

Thank you, Jennifer! I read your bio and don’t mind sharing that my fracture is the result of a beautiful Belgian Malinois we were fostering who chasing our puppy and accidentally hit me in the knee. ( Great success with the foster as a lovely young woman who owns her own dog training business and owns a Malinois adopted her. 🥰)

Surgery was not required, but I have been checked for blood clots and am taking baby aspirin.

I forgot to mention that two weeks prior to my fracture I was diagnosed with a compression fracture in my L-5 vertebrae, which made crutches very risky.

Since I had hydrocodone prescribed twice in a short amount of time, the treating PA said I would be flagged and he would be flagged if he wrote another prescription—even though each prescription only had five pills. Nonetheless, I declined. Thanks for suggesting N- Acetyl Cysteine! I will inquire about that.

Your recovery sounds miserable. You are very kind to offer assistance to others. 🌷

I’ve attached a photo of our foster dog with her new family. She is on the right.

@subu Thank you! Oh my, you also have a compression fracture of the spine? Did that happen from an injury or event, or was that spontaneous? A spontaneous spine fracture can happen to a person with osteoporosis, and that happened to my elderly mom. What have your doctors said about the spine fracture? Have you been checked for osteoporosis?

It's good that you didn't require surgery for you tibia fracture. I had 3 surgeries on mine. The first placed an external cage on my ankle to stabilize it, and cleaned the wound because it was a compound fracture and the fibula was snapped and sticking out. The surgeon debrided the wound. I was on vacation and this happened from a horse back riding accident when a loose dog on the trail chased the horse and she bolted.

My first experience at Mayo was for cervical spine surgery, and I asked my surgeon for a recommendation for an orthopedic surgeon for my ankle. That second surgery fixed the ankle fracture with titanium plates. The plates bothered me, and I had chronic hives, so after a year and a half, I came back to Mayo and had them removed. It has been a long process, and my ankle is still temperamental. I am still recovering and slowly building strength. I lost some joint cartilage with the injury, so it won't be perfect.

I do enjoy helping here on Connect because my first experience of spine surgery at Mayo far exceeded my expectations, and it was an extraordinary journey. I learned so much and found new strengths from facing my fears and finding a path to recovery. Thank you for your kind words. How nice that you are helping foster rescued dogs! That must make you feel good to know you are helping unfortunate animals. I have 3 shelter cats.