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connie1559
@connie1559

Posts: 6
Joined: Nov 11, 2018

How well is pain controlled after total knee replacement?

Posted by @connie1559, 3 days ago

I'm scheduled for a right TKR on 1/21/19.

I own my own small business, and I'm the only one who does the accounting and other functions for a busy retail store.

I will have the surgery on Monday, 1/21, and barring unforeseen problems, will be released from the hospital on either 1/23 or 1/24/19.

I have deadlines on several things for my small business, including getting out W-2s, 1099s, CDTFA payments,and customer store charge account statements, as well as the renewal of my business's liability and work comp insurance. In addition, I will have to do payroll for my employees. I will probably have to work in my office several days between 1/25 and 1/31. I will be having PT appointments as well during that time.

I currently have a pain contract with my GP. I live in a rural area, so my GP is familiar with my ortho and his pain control protocol. My ortho will be handling my pain control, rather than my GP, for a period of time during the TKR process. My GP told me that the ortho will send me home with a few days supply of pain meds and then will "drop the ball on refills". Also, it is my understanding that no refills will be given without an office visit. It is a 3 hour round trip for me to visit my ortho or GP.

I have seen discussions in this joint replacement group when some post TKR patients have said they have extreme pain, and others have said the pain was not as severe as might be expected.

Is it realistic of me to expect that my pain will be well controlled with just OTC products and icing and elevation? I know that most TKR people have said that it's a good idea to stay ahead of the pain before PT with proper use of pain meds to maximize the benefit of PT. I have also seen a lot of posts where people have said the pain impacts their ability to sleep. If I'm going to heal, go to work, and get the most benefit I can out of PT, I'm afraid my pain will be pretty bad if my ortho is lax about refills.

Has anyone had experience with having to carry on a busy schedule after TKR, including the necessary amount of PT, without benefit of prescription pain meds? Am I fretting over nothing? Thanks so much for any answers. Good luck to all of us!

REPLY

Can only comment on recent personal experience. Was discharged from hospital 40 hours after TKR. Ortho physician (who already did several other surgeries on me) allocated 42 Ocycodone pills. This version lets you add Tylenol if necessary. Which I did for a day or so. Final use of opioid pills was 22. I’d describe my general post surgical pain as at least average. Not sure if this helps or not.

@connie1559, I encourage you to do your accounting work and tax form filings prior to your surgery. I say this as a former small business owner who has had two TKRs.

@ellerbracke

Can only comment on recent personal experience. Was discharged from hospital 40 hours after TKR. Ortho physician (who already did several other surgeries on me) allocated 42 Ocycodone pills. This version lets you add Tylenol if necessary. Which I did for a day or so. Final use of opioid pills was 22. I’d describe my general post surgical pain as at least average. Not sure if this helps or not.

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This does help. Thank you.

@capausz

@connie1559, I encourage you to do your accounting work and tax form filings prior to your surgery. I say this as a former small business owner who has had two TKRs.

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You’re right, of course. I plan to do as much as I can beforehand. This next week is a juggling act for me. I know by this time next month I’ll likely be wondering what I was worried about. At least I hope so. 😊 Thanks so much for your input.

@connie1559

You’re right, of course. I plan to do as much as I can beforehand. This next week is a juggling act for me. I know by this time next month I’ll likely be wondering what I was worried about. At least I hope so. 😊 Thanks so much for your input.

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I wish you luck and hope all goes well. Wanted to add that the PT experience can vary tremendously from therapist to therapist (and of course depending on the patient). I had 3 home PT visits, and on day 12 after surgery I went to outpatient PT. I had worked with this particular group before with other rehab, and they trusted me enough to do all that was asked of me. They never tried to force the knee into painful positions, and I usually went there every 7 to 10 days to check on progress, and add progressively harder exercises. In the beginning you can expect to do 3 sets of 20 to 25 minutes of exercises at home, and with 20 minutes of icing afterwards it does take some time. After roughly 8 weeks I reduced it to 2 times daily. Now (4 months) just some stretching, otherwise walking, swimming, recumbent bike etc. As far as sleep and pain is concerned: yes, I will impact you. I found that if I iced the knee just before going to sleep and took 2 Tylenol it let me fall asleep ok. Not always stay asleep, but that happens – sorry!

@ellerbracke

I wish you luck and hope all goes well. Wanted to add that the PT experience can vary tremendously from therapist to therapist (and of course depending on the patient). I had 3 home PT visits, and on day 12 after surgery I went to outpatient PT. I had worked with this particular group before with other rehab, and they trusted me enough to do all that was asked of me. They never tried to force the knee into painful positions, and I usually went there every 7 to 10 days to check on progress, and add progressively harder exercises. In the beginning you can expect to do 3 sets of 20 to 25 minutes of exercises at home, and with 20 minutes of icing afterwards it does take some time. After roughly 8 weeks I reduced it to 2 times daily. Now (4 months) just some stretching, otherwise walking, swimming, recumbent bike etc. As far as sleep and pain is concerned: yes, I will impact you. I found that if I iced the knee just before going to sleep and took 2 Tylenol it let me fall asleep ok. Not always stay asleep, but that happens – sorry!

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Thank you for such a thorough answer! I know I'll be OK and the pain won't last forever.

I have spinal stenosis, plus a Morton's neuroma that is intrusively painful. Add the knee pain (2 surgeries since 2010. The 2nd surgeon recognized the reverse bucket handle meniscus tear the 1st surgeon missed & did his best, but I'm left with a severe deformity that has caused a myriad of skeletal issues). I also have an autoimmune disease which has been flaring up more often as I age.

I'm in a lot of pain already and it impacts me daily. As silly as it sounds, I worry the pain from the TKR is going to overwhelm me.

I'm in my 60s now, and for most of my life I was active, fit and had a good attitude about dealing with pain.

I have been in so much pain the past few years that I feel as if I am not tolerating it at all. It just exhausts me. I'm looking forward to a good result and some relief at last.

Many thanks for your help.

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