5 weeks on from my total knee replacement

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5 weeks ago I had a total knee replacement, operation went well and was discharged after 3 days. Given lots of information before procedure and what to expect after surgery. I had been prescribed Codeine x2 and Paracetamol x2 x4 times a day and liquid morphine for night time if needed. I stopped the liquid morphine almost immediatley as appeared to be hallucinating. I received a call from the hospital asking how I was and if I had any worries just ring the ward, which i did a couple of times. I did have trouble getting more medication and was in a position of nearly running out. The medication wasnt on my usual list so had to make numerous calls to the ward, doctors and chemist. I cut down on one Codeine and appeared to be doing well. District nurse came out after 2 weeks to take out the staples and had to wait another 3 weeks for physio. I felt quite confident with my new knee and after 3 weeks walked comfortabley around the house with no crutches and no pain in the actual knee cap. i took the steps to walking around the block again with no crutches. I did the exercises as often as I could and was pleased with how I was doing. The Physio suggested i cut out the codeine and use ice packs instead. i tried this and after missing 2 tablets I was so uncomfortable and stiff I had to go back on to it. I am wondering how long I will have to take the medication, I am doing everything I can to help myself but I seem to have hit a Platue......I know its a long process and I have to be patient but sometimes feel once surgery is over one has to look after themselves and left to their own devices, did anyone else feel the same....

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  • Posted

    after 5 weeks you should not need pain meds anymore maybe you should take 1/2 of the codeine for a week and then 1/2 every other day and quit its easy for some people to get addicted to this stuff and my knees are still stiff its something i just got used too but thats just my point of view

  • Posted

    "I stopped the liquid morphine almost immediately as I appeared to be hallucinating." DUH!!!

    There is no correct way to address your issues in that they are all very common yet very individual. Everything you discussed is incredibly normal but each patient goes through different combinations of these reactions (and more). Your particular set is all about you. For example, we all have the challenge of breaking down the forming scar tissue to achieve a target ROM but each person's DNA controls how much or how little scar tissue forms. It's just that we all know we have to break it down, no matter how much we generate.

    Click on my name, Discussions and then See All. I have about 30 of them out there on all sorts of topics from physical to mental to emotional. This recovery is all about getting rid of expectations, working hard and having patience. A full recovery (almost all pain gone, no drugs, feeling more like your old self, getting back to work, doing stairs up and down normally again, and more) takes about a year. Even then, there might be some residual stiffness.

    This is a LIFETIME recovery in that you must keep the knee active or it will stiffen up even years later. Post this on your fridge...

    Reality

    ...and remember your oars for the boat part. Good luck.

  • Posted

    Hi Alice, I too had full knee replacement , 5 weeks ago today - I wasn't given orimorph , only the Co-Codamol 30/500 which i was on prior to surgery for Arthritis - I previously took them at bedtime , but since surgery have been trying to cut down to x3 times a day . I found the first 2-3 weeks sheer hell ( was prepared for it to be painful , but oh boy !!) Having never being able to sleep on my back didn't help , getting about 2 hours sleep a night. I saw the physio back at the hospital at three weeks for a review, told that i was progressing well. ( 23 staples out at 2 weeks) . Got my 6 week ? final review in 10 days when ? will be discharged. I don't really feel i have really progressed any more really , no way can i walk downstairs yet without doing one step at a time . I know exactly what you mean , but understand it really does take time . You sound you can walk much better/ further than I - it's not easy is it .

    Do you have a 6 week review too . Sending big hugs and best wishes, let me know how your are , Mechele x

    • Posted

      Hi Mechele, thank you for replying. I have a 6 week review on 1st November. The consultant did warn me it was painful and I thought I was ready for it but its more severe than what I imagined. Sometimes its not pain its like a bad bout of irritable leg but just in your knee area. I was worried I wouldnt have confidence in my new knee so I made a point of walking confidently without aid. I felt very vunerable at first but soon got the hang of walking without limping. I have been told everyone is different and heal at a different pace.....good to have someone who understands what we are going through. have you started using bio oil around the scar.....sending best wishes to you too, x

    • Posted

      Think i maybe 'got into the habit of limping' , as was limping prior to surgery due to pain . Had all inside of knee shaved due to osteophytes ( probably not spelt that right !) Walking around house with no aid but feel vulnerable outside in busy areas in case someone knocks me over. No, not tried bio oil , do you find it helpful ? Don't suppose there's anything in it to react with all other medication ( on several things for grade 3 BC 3 years ago , then kidney out 2 years ago , ?? due to radiotherapy damage) - decided NOT having anything else now ha ha when recovered from this .

      Best wishes and hopefully a good nights sleep zzzz

    • Posted

      Have you tried some Voltaren Gel (RX in the US, generic diclofenac elsewhere)? Excellent topical anti-inflammatory. Check for interactions with your current meds first.

      The "habit of limping"...

      Other Pain Post-TKR

      Normal but you have to overcome it by rebuilding all the surrounding musculature that has atrophied with non-use. Do the rebuild, lose the pain...

      Muscle Rebuild

      Start slowly and increase gradually. This takes gritty determination and months of strength work. However, the payoff is HUGE. At 14 months, I was climbing stairs TWO AT A TIME without holding onto anything. Gotta do the work to get the results. Start NOW!!!

    • Posted

      i rang the hospital to see if I could use Voltarol and they said no because it will bring all the blood to the would and it would be more painfull. I will try again after 6 weeks. I am using Bio Oil in the surrounding area...

    • Posted

      In the early days of recovery (actually the first three months), each of us goes nutz trying to find some relief from the pain and sensitivity in the leg. Everyone does the ice/elevate thing but beyond that we each have to find what works FOR US as individuals. Voltaren Gel worked great for me but you have to wait until the incision heals to put it directly on the scar. There are many, many posts on here about using all sorts of gels, oils, creams, etc. It's a trial and error game...but by the time you figure it out, you are past the major pain window and into the muscle rebuild phase. The pain is always real but expectations make it worse.

  • Posted

    Are you taking paracetemol still? I took mine religiously every 6 hours and found that along with icing for 40+ minutes 4 times a day was usually enough with the occasional application of voltarol gel. Occasionally I swapped the paracetemol for the lowest strength cocodamol (8mg codiene with 500mg paracetemol). If that's not enough for you maybe you could try reducing the codeine gradually by taking alternate 1 and 2 tablets and gradually weaning yourself off them or switching to cocodamol.

    Everyone is different and some people are able to do without painkillers earlier than others and some have an easier and faster recovery. If your pain warrants painkillers for a little longer to enable you to function so be it. I have days when I need some paracetemol still if I've done a lot and I'm 9 months post TKR.

    • Posted

      taking your advice about halving the codeine to 15 mg......using the ice packs more often and trying to be a little bit kinder to myself ,,,,

    • Posted

      Everyone's different (like you haven't heard that already) but everyone needs to get off the heavy-duty opioids as soon as they can anywhere between 3 and 12 weeks. Very personal.

      The method is "titration"...the gradual decrease in a medication in the bloodstream. A lot of this depends on the drug and its "half-life" (time it takes for 50% of the drug to leave your system). You cannot stop "cold turkey"...gotta ease on down.

      Your doc can help with a titration schedule but a pharmacist is even better. Consult with an R.Ph. about all your meds and how to do it.

    • Posted

      i rang the Pharmacy at the doctors today and they are going to work with me regarding winding down on the codeine...thanks for your advice...

    • Posted

      I was married to a pharmacist for 25 years. I got to know this stuff really well. Been married to the love of my life for almost 10 years now...she spent 30 years as a certified psychiatric nurse. I said something one day early in our relationship...her response...

      Sage: "Well that was very passive-aggressive!"

      Me: "Really? It's genetic. I'm a Sicilian from "Mafialand" in Brooklyn. Wanna hear more?"

      Yeah, she tried tried to change me. I must say that she's been fairly successful in getting me to recognize the trait. Better for the relationship. Hard to be that way to the kind, gentle soul she is.

  • Posted

    hi Lynda, Yes still need the paracetamol, i did cut out 1 codeine after 2 weeks and tried to cut down last night but it was bad through the night. I will wait until I have seen the Consultant next Friday and see what he says. so pleased when i walk there is no pain in the knee cap just surrounding muscle etc....must be the healing process

    • Posted

      Yes, I think they should prepare us more for how much the surrounding tissue is affected. I was told it would be a painful and lengthy recovery, but hadn't anticipated how much the surrounding tissue would hurt, although maybe if I'd thought more about what they had to cut through to get to the bones, plus how everything had to adjust to a straight leg, I would have been better prepared. I got the impression from my surgeon's registrar that once the surgery was done, because of the expected long recovery, the post-op check was really just to check the wound had healed and there was little point in looking at anything else until the year was up. I guess they expect us to contact them if we have any serious concerns, but it's all the niggles that we're unsure of that make forums such as this a boon.

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