Mako Robotic Arm TKR Day Two

Posted by saeternes @saeternes, Nov 27, 2019

Was discharged before 11AM making my entire stay under 24 hours. Lucky that the roads were clear and we made it home in a bit under 3 hours. However the vibrations from the road threw my knee into pain mode and I had to take the narcotic drugs before the time, by an hour. Interesting effect that I did not anticipate – a national freeway and no bumps I would have thought twice about before. Was able to walk up two flights of stairs, and using walker do a bit of moving around. I now realize how important it is to stay on top of the pain because if you wait to feel something, it will be too late and the pain will spring up like a baby dragon. So it now will be strict schedule for me at least for a week. Anyone else have that experience?

What you say is absolutely true! I think the medical community needs to be much more honest and direct about how painful a TKR is. Or, in my case, a revision of a TKR.

The challenge for me is weaning off the big meds. I'm 6 weeks out and still have pain, though *much* less than during week 1. I can't take narcotics on the days I have PT (I have to drive) and that's when I really need them! My surgeon has refilled my original Rx, but I have a feeling I may need them for some time as I can't sleep w/out them; pain wakes me up.

Best of luck as you move through your recovery!

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Absolutely. For the first few nights at home I had a glass of water on the nightstand and set the alarm clock every 4 hours (assuming I’d sleep). By day/night 5 I let the pain guide me whether or at what interval I set the clock, and after about 8 or 9 days I was able cut way down on oxycodone. 1 around 5 PM, 1 10 PM, 1 at waking, then by ear. Next days at bedtime only. Pretty much quit opioids by about 2 weeks, as soon as I could transition to Aleve. Hate them. Memory may be a little foggy, but scrip was for 42 pills, and I have 12 left over,

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Thanks for the encouragement.@ellerbracke, what's dose were you taking?

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@saeternes

Thanks for the encouragement.@ellerbracke, what's dose were you taking?

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Label says Oxycodone 5 MG tablet RHO, whatever that last letter group means. Please do NOT take me as an “average” example. Most, if not all, people need prescription pain medication longer than I decided to use it. Went pretty fast from every 4 hours to every 6 hours to 2/3 times a day, mostly afternoon and evening. I was able to use ice on knee during the day to keep pain manageable. I am so curious what if any effect the nerve ablation has / will have on your pain. I’m happy that you are pretty mobile, climbing stairs and moving around. Have a Happy Thanksgiving, and let someone else do the cooking this year!

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@ellerbracke

Label says Oxycodone 5 MG tablet RHO, whatever that last letter group means. Please do NOT take me as an “average” example. Most, if not all, people need prescription pain medication longer than I decided to use it. Went pretty fast from every 4 hours to every 6 hours to 2/3 times a day, mostly afternoon and evening. I was able to use ice on knee during the day to keep pain manageable. I am so curious what if any effect the nerve ablation has / will have on your pain. I’m happy that you are pretty mobile, climbing stairs and moving around. Have a Happy Thanksgiving, and let someone else do the cooking this year!

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@ellerbracke,I was on the same drug but 10 mg. I think the reason for that was because they had to start out at 2.5, which did nothing to the initial pain. By the time they got to 10 I said it was fine. I will now try to decrease it to 5, but not to worry, I will go by need — I realize every person is different. Last night I slept like a dead person, exhausted from the 3 hour drive and just in general. I look forward to the time when I can cut down on the Oxycodone, but won't push it. #babette, maybe you can slowly taper the meds just by increasing the time between doses? Day 3 here, somewhat more alert, dull ache still there. Happy Thanksgiving to all!

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@saeternes: I just learned something….. that should have occurred to me after my surgery. You mentioned that they had to go up to 10 mg Oxycodone to control your pain properly. I never questioned the dosage given to me, and since as a result the pain control never got above 75%, even if taken on schedule, I pretty soon said the heck with it. If it doesn’t knock out the pain anyway, might as well get off it. Could have saved myself a lot of wakeful nights, I think, by asking for stronger dosis. However, since I’m determined to do everything alternative-wise before another TKR should become necessary on the other knee, that knowledge will be filed under “so sad, too late”.
PS: in the hospital they added Gabapentin and Tylenol to the Oxycodone, so while there, it worked ok-ish, about 3 hours at a stretch.

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@ellerbracke that's interesting. I can pretty much knock the pain out at 10 and went down to 7.5 today. Will.keep pushing it down but not too aggressively. @babette what dose are you taking, which drug, and how often? I am having a lot of trouble with one of the exercises that it involves tightening the quads and lifting the leg straight up. Leg extension is OK, at or close to zero, and flexion also is beyond 90 deg. Bit this exercise is hard. They didn't measure in the hospital so first actual measurement will be Tuesday.

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Hi @saeternes I take 5-10 mg of oxycodone as needed. I'm not on a schedule. Now that I'm off blood thinners, I can take ibuprofen along with Tylenol and that provides some relief. For the past few nights, I've only taken the Oxy only at night so that pain doesn't wake me up. I know the raising a straight leg exercise; my PT didn't have me do that until a couple of weeks post-op.

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@saeternes : don’t worry about straight leg exercise right now. I had to do them 3 weeks pre-op, so I was used to them. Still challenging, especially when they added ankle weights about 4 weeks after TKR. Play around a little bit with the order in which you do the exercises. I forgot in which succession I did them, but you will find what works for you. Also, I found that putting my palms flat on the floor under my butt took some pressure off my (Sciatica prone) back and made the leg raises easier. Signing off for today – tryptomychin or whatever is in the turkey is starting to make me fade. Hope you had a good holiday.

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@ellerbracke not sure I will be able to tell the effect of the nerve ablation since this is all first time for me. I keep experiencing the dull ache, constipation, and inability to do the leg lifts. I have found some other exercises for "first week" on the web and will try them. I have to use a strap to lift my leg onto the bed and down again. I'll update when there is something more to report.

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@saeternes: you know that the constipation is caused by the Oxycodone. I was told to take OTC laxatives if it becomes bothersome. Check with your doctor’s office if you think you need permission.

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@ellerbracke Yes I did know and I am taking both stool softeners and laxatives that were prescribed. However they don't seem to do much good. I'm down to 5 now for the drugs unless pre-exercise, in which case I may take 7.5 before or 5 before and 2.5 after.

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@saeternes

@ellerbracke Yes I did know and I am taking both stool softeners and laxatives that were prescribed. However they don't seem to do much good. I'm down to 5 now for the drugs unless pre-exercise, in which case I may take 7.5 before or 5 before and 2.5 after.

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Hope the digestive help will work soon. It also doesn’t help, if you are usually an active person, that now you are forced to be more sedentary. For me it was a combination of drugs and sitting. Do you have in-home PT right now? Just asking because you mentioned checking out rehab exercises on the internet.

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Fortunately a bit of bowel action, although the word "action" is not exactly right. I start therapy next Tuesday, no in-home therapy. I am working hard at doing the exercises the therapist in the hospital gave me. I added those from the web only because I cannot do much on the leg raise, so I decided a few more wouldn't hurt. Yes, I have been very active most of my life, working out 4-5 times a week with bike and weights until adding more about 6 weeks before surgery. I also played soccer for years. Extension is not too much of a problem and I can pull my leg back beyond 90 deg flexion but it will not stay there. I have no problem getting my socks on – the hospital therapist told me that many people do not have the flexibility in their lower backs. He also told me to keep using the walker even though I feel I can walk without it, because people give it up too soon and end up subtly favoring the damaged knee, which develops into gait problems. Anyone heard this?

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@saeternes

Fortunately a bit of bowel action, although the word "action" is not exactly right. I start therapy next Tuesday, no in-home therapy. I am working hard at doing the exercises the therapist in the hospital gave me. I added those from the web only because I cannot do much on the leg raise, so I decided a few more wouldn't hurt. Yes, I have been very active most of my life, working out 4-5 times a week with bike and weights until adding more about 6 weeks before surgery. I also played soccer for years. Extension is not too much of a problem and I can pull my leg back beyond 90 deg flexion but it will not stay there. I have no problem getting my socks on – the hospital therapist told me that many people do not have the flexibility in their lower backs. He also told me to keep using the walker even though I feel I can walk without it, because people give it up too soon and end up subtly favoring the damaged knee, which develops into gait problems. Anyone heard this?

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@saeternes : good news on the digestive front. You seem to be doing well, in spite of being without in-home therapy. I gave up walker simply because I did not feel that I needed it for balance, indoors. I had had arthroscopic surgery on that same knee a year prior to TKR, so both pain/rehab was a “been there, done that”. Well, not quite. TKR took longer, hurt more. But the basic exercises all get back to the basics: repetition, and proper form.
As far as the knee’s range of motion at this point – it is good whatever you can do right now. Would you like to hear extremes? Day after surgery the PT measured – after session – 105 degrees. And, to really blow everyone away, I had 0 extension after 4 MONTHS. Hope that gives you something to chuckle about, when grading progress.
Re. Socks: a bother, but not a problem. Glad you figured out the best way to put them on. September here in SC was still quite warm and humid, so my main complaint was the heat generated by the compression socks.

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