Unbearable Knee Pain

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Waiting for my initial referral apt with consultant. My partner booked an overnight stay in a hotel with a restaurant reservation for a birthday dinner. Just home and my knee is so swollen can't straighten at all can't weight bare and the clunking/clicking is sickening. I only walked about 2 miles at most and rested inbetween. Have kept an ice pack on it this afternoon. Hope I don't have to wait too long for my appointment

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15 Replies

  • Posted

    The best thing to do is rest, ice and elevate until you see the doc.
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  • Posted

    Can you elevate it while icing? That will help too. Good luck.
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  • Posted

    When the knee swells, it means you pushed it too far.  This is an immutable rule...there are no exceptions.  Obviously, 2 miles is a bridge too far.  Get a pedometer or FitBit.  Find your non-swelling limit and then extend your range...slowly.  I once did 8,000+ steps on my FitBit at 5 weeks and paid dearly for my arrogance.  Never made the mistake again.  As Phil said...rest, ice, elevate.  You can also try some Voltaren Gel (RX)...best topical anti-inflammatory on the planet.

    "Initial referral"?  Have you had a scope or TKR yet???  Is all this swelling and pain pre-op?

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    • Posted

      I'm not a doctor but I can provide you with some personal information as well as NIH research plus knowledge that I have accumulated by living for 25 years with my second wife, a professional pharmacist.

      Titration...defined as gradually increasing or decreasing the amount of a drug in your blood stream.  "Cold Turkey"...stopping your meds all at once.  Obviously, it's the latter that you must avoid.  You want to titrate off your current level of pain killers.

      Hydrocodone is a codeine derivative usually mixed with acetaminophen under the brand names Vicodin and Norco (among others).  Can produce constipation side effects unlike Oxycodone (Percocet), the other major opioid pain killer.  Dosage can very low (3/325...3 mg oxycodone, 325 mg acetaminophen), one to two tabs every 4-6-8 hours or high dosage 10/500.  I don't know your dose or schedule.

      The whole point is to gradually reduce the LEVEL of the drug in your blood stream.  The two ways to do it are to take less or spread the dosages farther apart.  Spreading out the doages tends to produce highs and lows in pain relief.  I wouldn't do that.  So...

      Titrating down involves taking less of the drug, thereby gradually lowering the overall med blood level slowly.  Typically, people start with snapping their current med in half, so you're taking half doses on the same schedule.  If that's too fast, alternate a full dose with a half dose until you're on a regular half dose.

      Since this is a TKR, you really don't want to be off pain killers, especially with PT...but you want to be off the opiods as soon as you can.  Gonna need the PKs for 3 maybe 6 months to get past PT and the worst effects of the TKR.  Talk to your doc about an RX for Tramadol (some people hate it...doesn't work on me) or 800mg Ibuprophin TID (RX).  You doc will tell you how to transition off the opioids and onto this lower level of pain killers.  Do NOT go to the store and take four 200mg tabs of Ibuprophin!!!  This method releases all the drug at once, not over time like the RX pill does.

      Not sure about Tramadol but 800mg of Ibuprohin is NOT a long term pain solution...too much potential for stomach problems.  You just really want to get past the 6-month mark where, for most people, the major pain is completely in the past.

      So, talk to your doc, start titrating down off the Hydrocodone, switch to a lower-level pain killer and be completely beyond all of this somewhere in the 6-month timeframe.  Some people get there faster, others take longer...all very individual.  If you're in pain...take your meds.  This is not some kind of contest or race.  Then sleep well...

      http://patient.info/forums/discuss/trouble-sleeping-post-tkr--539591

      Hope this helps.

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    • Posted

      Hi Chico thanks for your advice. Yep this is all pre op. I had arthroscopy back in February doc said 80% chance it wouldn't work and if it did would only last up to 2 years. He trimmed meniscus. I am waiting for my appointment to go back to see him again.

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    • Posted

      Chico, I have had surgeries in the past and I take my meds until I don't feel any pain. Then once the pain isn't as bad, I quit taking my meds. Most of the time, I forget to take them. I was just concerned listening to some of the posts. Thank you for your advice.

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    • Posted

      You never stop taking your meds...you titrate down until you're off them.  As you take the drugs, their accumulated amount (measured by the half-life of the drug) increases in your blood stream to theraputic levels.  Just stopping the meds drop you off a cliff and then you have to battle back to get to the correct blood level to handle your pain.

      If you want to get off the meds gradually, talk to your doc about the proper way to titrate down for both dosing and scheduling.  Cold Turkey is not recommended.  Typically, you want to get off the opioids pretty fast (30-60 days?) and switch to Tramadol, Ibuprophin, etc...the non-narcotics.  Even if it takes you 3-4 months to do it, that's OK...everyone's different.  Just don't stop immediately...titrate...

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    • Posted

      Freestork...  I was in the same boat.  In January, doc refused to do a another scope because there was nothing else he could fix.  Already had two scopes on both sides.  Told me that we could do Synvisc again (worked GREAT for so many years) but it would only put off the inevitable TKR.  I figured that at 68 I was still strong enough to do the recovery...I'm in awe of people that do this at 85!!!  So I got the TKR in March '16.  I'm 7 months out and in no pain, on no meds or aids, 0 / +131 ROM and sleeping great.  Going through it is hell but so worth it in the long run.

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  • Posted

    I do feel for you. Not fun at all. Good luck with your consult and a clear picture of your way forward. I spent the last two years nursing mine and it sounded very similar. Very scary and frustrating. I know have had a TKR and at 6 weeks post op am doing really well and am hopefull for the future again. All the best,

     Jenni.

     

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  • Posted

    Hi!

    I certainly can relate to you about the PAIN!😲 I had five years of increasingly horrific pain prior to my first and then second TKR!

    Today is the first anniversary of my new right knee!🎉📣🙌🎉📣🙌 I now have TWO good knees and wish that all here will eventually arrive at pain-free days and nights.

    Of course there is the surgery, the recovery, the physical therapy, the learning how to walk properly again, but once all that is in the past, you will have your life back again!💟

    Ibuprofen helped me prior to my surgeries. I soldiered on bravely and paid the price for days to come when I went shopping or stood in lines or worked in my yard. It was AWFUL!😵

    I honestly could not WAIT to get my first new knee! After the first surgery THAT KNEE was so much better than the other knee that I scheduled my second surgery at my six week doctor's appointment for my first knee!

    Wishing you fast service in getting your date for surgery! Surgery was my only option, and it sounds like that is true for you, too.

    Sending prayers of strength, calm, and hope to you today!💟

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  • Posted

    Yes i hope you have a appointment soon, maybe they can do a steriod injection to help with some of the swelling  and pain.  But if they decide to to surgery they will not inject the knee.  Good Luck
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