S'up Slut?

[Alex2507]

FWIW tramadol is weak, I'm glad you got relief from it. As for wired, I found after the initial doses all opiates will pick you up as long as you don't take too much more than prescribed. I had synthetic morphine (Demerol) after the acl replacement and spinal fusion and I could watch a whole movie and not remember one bit of it.

Weak ?!? That's the one I hold in reserve for when I know the going gets rough. Your circumstances require more relief than mine. Inside my head is nobody's bargain but I can't have much more of not being in my right mind.

 

[TechHDS]

I'm never gonna run on this leg unless the police are chasing me and even then it's gonna have to be more than one cop and probably a dog. I'd take my chances with just about anybody one on one. I'm looking forward to being able to walk the nearly 3 miles round trip to the local red box. I use to do that when I needed to not be 282.2 f^%&ing pounds. Can you imagine? I'm currently 30 pounds less but still porky.



30 years? Congratulations!

Wish you the best with your rehab Alex2507!
Yeah the 30 years replacement was the first of its kind when i had it done in 2012.

Mike

 

[KEW]

Does it hurt to watch this?

That's what I thought!

 

[TheWarrior]

I'm finally developing the vocabulary to talk about this. De-gloved though? You mean .... ? Oh no ... That can't be good.

They had me taking baby asprin and Celobrex and now for the first time ever, my BP is high. Gotta go see my Primary Care guy today about that. I'm nearly at the stage where I might be able to not take anything for pain. Stretching and exercise make it feel great but a cooled off, slept on knee is sure to wake me after a few hours. It's tough but I'm almost there and past the worst of it intensity wise. Now it's gonna be weeks of no ice cream and lots of work.

Don't try this at home.

I never cared for pain killers myself, they make me feel awful in ways the pain does not!

Has hanging off the bed, just above your knee cap, been recommended to you? That is one of my favorite stretches that I have never stopped doing since my ACL surgery like 15 years ago. If the doc says its ok, try that and stretch your legs out before bed!

Take the Therapy Exercises seriously, there's a couple that I've never stopped doing any time my knee feels weak.

Yes, I figured the descriptive 'de-gloved' would render the necessary image. Car cut over on me to make an illegal u-turn. I think the damage to my knee was from where it hit the car (that hip is impinged as well - I wear a 3/4" lift in my shoe to compensate) and the rest of me flew over the hood and landed on my head.

 

[Alex2507]

Yeah the 30 years replacement was the first of its kind when i had it done in 2012.

Mike

Oh, you mean that model is rated for 30 years. I spoke to a person that had one knee done 6 years ago and the other knee done 3 years ago. She said the 3 year old knee was a better model that performed better. I'll ask my 2 week post-op check-up doc about models.

Alex,
Sorry to hear you are in such pain, unless that is what you are into (NTTAWWT).

One thing I would mention on pain relief is to consider it from the standpoint of aiding sleep. YMMV, but if you are running a cumulative sleep deficit (due to pain),you might consider taking a nap whenever the pain meds you are taking kick in. Your body won't be its best at healing if you are sleep deprived. Also proteins are the building blocks, so I'd do high protein diet. You're not a kid anymore, so it makes sense to give your body any advantage you can to allow it to heal efficiently! (A nutritionist once told me that around 25 is when your body starts rotting faster than it is growing - before that you can eat crap like cheap frozen pizza three time a day and your body will largely make it work!)

Instead of my knee-jerk (sorry!) "eat protein", here are some intelligent people talking about diet for joint healing:
http://www.mills-peninsula.org/orthopedics/joint-replacement/patient/nutrition-tips/
https://www.livestrong.com/article/323807-foods-that-help-healing-after-knee-surgery/
https://bonesmart.org/forum/threads/healing-phases-nutrition.21918/
http://www.homecuresthatwork.com/15519/8-healing-remedies-to-repair-joints/

Hopefully your doctor has a comprehensive approach and has provided this type of information; however, I see too many otherwise smart doctors who look at joint replacement as being isolated to the surgery process with little thought about the subsequent role your body plays in aiding/accelerating your recovery aka healing.

I'm currently in the middle of the 3rd article. My motivation to do PT got a huge boost from that. Thanks for posting those.

WTF do you mean I'm not a kid any more? 53 is the new 13.

My nsaid seems to be responsible for a 150/100 BP or something close and actually temporarily higher so that's out of the picture now. It went to 135/91 at my doc's office the day after my nurse had raised the alarm. I miss that nsaid already. My surgeon told me to do protein and vitamin D and even talked about meditation and hot yoga. Their team has actually been compared I guess nationally and come up as above average in not having long term readmissions or something like that. I'm forced to wonder why you see "too many" doc's doing surgery. It's a telling statement that doesn't tell quite enough for people w/ way too much time on their hands (me).

My primary care guy said that it was likely the other nsaids would affect me the same way so we're dropping the nsaid to remove the BP concern as opposed to treating the BP and waiting for that round of side effects. So my anti inflammation path is going to be more closely tied to ice/elevation/diet. Like, I'll do all this. I think I'm down to 2 or 3 days worth of oxy. I think I'm going to have to keep eating healthy. Once the oxy is gone I won't really have a way to deal with inflammation related pain. I don't know much about it so I'll ask the doc's about a steroid based anti inflammatory because I NEED a way to keep pizza on the menu. BTW I did eat pizza for a couple of days last week and was in agony the following day or two.

Back to the articles. Just wanted to say thanks.

 

[everettT]

Hopefully your still off the smokes, as that slows recovery big time. As for BP I'm normally 135/90 when I wake and dont go much lower. Pain itself will cause a rise in BP.

 

[Alex2507]

I never cared for pain killers myself, they make me feel awful in ways the pain does not!

Has hanging off the bed, just above your knee cap, been recommended to you? That is one of my favorite stretches that I have never stopped doing since my ACL surgery like 15 years ago. If the doc says its ok, try that and stretch your legs out before bed!

Take the Therapy Exercises seriously, there's a couple that I've never stopped doing any time my knee feels weak.

Yes, I figured the descriptive 'de-gloved' would render the necessary image. Car cut over on me to make an illegal u-turn. I think the damage to my knee was from where it hit the car (that hip is impinged as well - I wear a 3/4" lift in my shoe to compensate) and the rest of me flew over the hood and landed on my head.

I just mentioned that Kurt's links motivated me to work the PT thing with very serious intent. I do that leg dangle thing and something called long arc quads from that position in addition to something else where I use my other foot to help bend the knee. Plus about 20 thousand other uncomfortable things I'm doing to it with dedicated repetition. I've never been good at leaving well enough alone and now I have something to f^%& with constantly. More Winning.

 

[Swerd]

Wow, reading all this has made me feel damn lucky. I had knee surgery 43 years ago (1975) to remove a torn meniscus, a skiing injury. I was young (26), and even though it was before arthroscopic surgery was common (I was in a hospital for 2 weeks after surgery), I recovered quickly and have rarely had trouble again with that knee. I read all those knee problems here, and I feel like I got off easy.

Alex, if your blood pressure got up to 150/100, what was it before? Mine used to be nice and low when I was younger. But I'm no longer young, and prolonged prednisone has raised it significantly. I couldn't stop the prednisone, and my primary care doc said I was at the borderline of needing BP lowering medication. Instead, she suggested I buy one of those automatic blood pressure cuffs you can use at home. Practice using it every day, keep a log of my BP before and after exercise (2-3 mile walks), and see if I can regularly get lower BP readings. I found that using it everyday let me get much lower readings than I had in the doc's office. Apparently I wasn't relaxed at the doc's office – something known as white coat syndrome. I learned to relax before taking my BP, and significantly lowered the reading. It's not unlike people who do yoga or meditation.

I'm not trying to say that will work for you, it could very well be due to the nsaids. But I am suggesting it's worth a try. I bought an inexpensive automatic BP monitor at Amazon for about $30 or $40. Get the kind that wraps around your upper arm. It's more like the cuffs the docs have in their office. The monitors that go around your wrist give very different reading than the upper arm cuffs. If you do get one and monitor your BP daily, bring it with you the next time you see your primary care doc. Compare it's readings with what the doc has in the office.

Keep doing that PT! It's the key to recovery.

 

[TechHDS]

Oh, you mean that model is rated for 30 years. I spoke to a person that had one knee done 6 years ago and the other knee done 3 years ago. She said the 3 year old knee was a better model that performed better. I'll ask my 2 week post-op check-up doc about models.


I'm currently in the middle of the 3rd article. My motivation to do PT got a huge boost from that. Thanks for posting those.

WTF do you mean I'm not a kid any more? 53 is the new 13.

My nsaid seems to be responsible for a 150/100 BP or something close and actually temporarily higher so that's out of the picture now. It went to 135/91 at my doc's office the day after my nurse had raised the alarm. I miss that nsaid already. My surgeon told me to do protein and vitamin D and even talked about meditation and hot yoga. Their team has actually been compared I guess nationally and come up as above average in not having long term readmissions or something like that. I'm forced to wonder why you see "too many" doc's doing surgery. It's a telling statement that doesn't tell quite enough for people w/ way too much time on their hands (me).

My primary care guy said that it was likely the other nsaids would affect me the same way so we're dropping the nsaid to remove the BP concern as opposed to treating the BP and waiting for that round of side effects. So my anti inflammation path is going to be more closely tied to ice/elevation/diet. Like, I'll do all this. I think I'm down to 2 or 3 days worth of oxy. I think I'm going to have to keep eating healthy. Once the oxy is gone I won't really have a way to deal with inflammation related pain. I don't know much about it so I'll ask the doc's about a steroid based anti inflammatory because I NEED a way to keep pizza on the menu. BTW I did eat pizza for a couple of days last week and was in agony the following day or two.

Back to the articles. Just wanted to say thanks.

Alex2507, yes it is a 30 year knee at least that’s what my surgeon said. He even had to go to a seminar with other orthopedic surgeons cause he told me it was made of titanium one that he and other surgeons hadn’t performed before and cause of my age at time of 53. The 2nd time I tore the meniscus was worse than the first time ended up bone on bone. The rehab even with the meds was excruciating pain Doc did say that I may not get to bend my leg all the way back. I can almost get it to bend back to where my cafe touches my hamstring. Still to this day I have to do exercises to relieve swelling if I stand or sit too long. As for pain meds I hate those anyone who says they like pain meds needs rehab lol. Yes I did get hooked on pain meds ask my Doc to take me off of them took me about 6 months to where I felt like myself again. Took a year after the replacement before there was no pain with the replacement. The one thing they don’t tell you is how very painful the rehab will be. After all said and done glad I did it it does get better towards the middle end of the rehab. I live about 98% pain free, Doc did say no running, jumping, no walking on uneven ground watch my weight. I should go to back to rehab just to keep me knee, muscles around the knee tuned up but I just get on the floor take a long belt loop it around the ankle and pull my leg back for about 3 minutes sets that’s about a half an hour of that. Best of luck with your rehab!

Mike

 

[Alex2507]

Hopefully your still off the smokes, as that slows recovery big time. As for BP I'm normally 135/90 when I wake and dont go much lower. Pain itself will cause a rise in BP.

I'm normally lower. My guy says if I was at 135/90 steady, we would start considering ways to keep it lower for the long term. But right now all we know is that 150 or 170 are not happening without Celobrex. Smokes are still greatly missed. I have smoked 4 cigars in the decade or so since quitting cigarettes. Each one was a distinct and singular pleasure. I don't know when the next one will be either. I like for it to be a matter of the situation presenting itself

 

[KEW]

I'm forced to wonder why you see "too many" doc's doing surgery. It's a telling statement that doesn't tell quite enough for people w/ way too much time on their hands (me).

I did not word that very well. What I meant is there are too many surgeons (including their support staff) that view treatment like changing the shocks on a car - it is all about the mechanical task of the surgery. Problem being if they don't allow consideration of how best to help you help the body heal, they are missing an opportunity to improve their outcome statistics. It sounds like your doctor at least addressed some of the biggest points of diet. Things have probably changed over the years - now that PT is an included part of treatment that alone helps reinforce the importance of your active post-surgery participation in regaining knee function!

While effective, PT sucks! I entertain the theory that the people who go into it are just natural sadists! Hopefully you have a good looking therapist who at least fakes a sympathetic face as she is gleefully exploring your limits of pain/endurance (while not letting you escape into unconsciousness)! I'm not sure if they will be happy or sad that you are backing off the pain meds. On the one hand, that helps ensure you feel the maximum amount of pain. On the other, they may be disappointed that you consciously chose more pain over drugs (seems a sadist would feel a bit impotent with the revelation that pain is not the most dominant influence over you)!
...just sayin'

 

[KEW]

My primary care guy said that it was likely the other nsaids would affect me the same way so we're dropping the nsaid to remove the BP concern as opposed to treating the BP and waiting for that round of side effects. So my anti inflammation path is going to be more closely tied to ice/elevation/diet. Like, I'll do all this. I think I'm down to 2 or 3 days worth of oxy. I think I'm going to have to keep eating healthy. Once the oxy is gone I won't really have a way to deal with inflammation related pain. I don't know much about it so I'll ask the doc's about a steroid based anti inflammatory because I NEED a way to keep pizza on the menu. BTW I did eat pizza for a couple of days last week and was in agony the following day or two.

Back to the articles. Just wanted to say thanks.

This may be a blessing in disguise!
The fourth article I linked says:

There is an irony in the vicious cycle of pain and damage to joints: the very drugs prescribed for arthritis actually prevent you from repairing the joint. It turns out that the NSAIDs, including aspirin, ibuprofen, naproxen, COX2 inhibitors (Celebrex, Mobic) and so forth, inhibit prostaglandins that cause inflammation, which in turn decreases the pain, redness, and swelling that comes from injuries to the tissues.

However, these anti-inflammatory drugs also prevent increased blood flow that brings healing oxygen and cells to the tissues, as well as prevent the formation of collagen, the strong protein that is required for healing fibrous tissue like bones, tendons and joints.(3) It doesn’t matter whether you take a little or a lot – even the smallest dose in the study prevented healing.

The take-away message here is to avoid any of the anti-inflammatory drugs!

This is at odds with the conventional prescription of NSAID's, so that always leave one wondering what to believe, but your BP situation makes a moot point of it! Your body made the call for you!

 

[TechHDS]

I did not word that very well. What I meant is there are too many surgeons (including their support staff) that view treatment like changing the shocks on a car - it is all about the mechanical task of the surgery. Problem being if they don't allow consideration of how best to help you help the body heal, they are missing an opportunity to improve their outcome statistics. It sounds like your doctor at least addressed some of the biggest points of diet. Things have probably changed over the years - now that PT is an included part of treatment that alone helps reinforce the importance of your active post-surgery participation in regaining knee function!

While effective, PT sucks! I entertain the theory that the people who go into it are just natural sadists! Hopefully you have a good looking therapist who at least fakes a sympathetic face as she is gleefully exploring your limits of pain/endurance (while not letting you escape into unconsciousness)! I'm not sure if they will be happy or sad that you are backing off the pain meds. On the one hand, that helps ensure you feel the maximum amount of pain. On the other, they may be disappointed that you consciously chose more pain over drugs (seems a sadist would feel a bit impotent with the revelation that pain is not the most dominant influence over you)!
...just sayin'

KEW, You pretty much nailed it with your post,
the guy who was helping me with my rehab didn’t care how much pain I was in, almost changed Rehab clinics. But than again it’s his or hers job to get you to maximum mobility today I’m glad he took no mercy on me. Yeah rehab sucks big time but the alternative would have left me in pain for life or a wheelchair. I’m at about 125% on the bend thing that not all the way back good enough for me at 60.

Mike

 

[Alex2507]

Wow, reading all this has made me feel damn lucky. I had knee surgery 43 years ago (1975) to remove a torn meniscus, a skiing injury. I was young (26), and even though it was before arthroscopic surgery was common (I was in a hospital for 2 weeks after surgery), I recovered quickly and have rarely had trouble again with that knee. I read all those knee problems here, and I feel like I got off easy.

Alex, if your blood pressure got up to 150/100, what was it before? Mine used to be nice and low when I was younger. But I'm no longer young, and prolonged prednisone has raised it significantly. I couldn't stop the prednisone, and my primary care doc said I was at the borderline of needing BP lowering medication. Instead, she suggested I buy one of those automatic blood pressure cuffs you can use at home. Practice using it every day, keep a log of my BP before and after exercise (2-3 mile walks), and see if I can regularly get lower BP readings. I found that using it everyday let me get much lower readings than I had in the doc's office. Apparently I wasn't relaxed at the doc's office – something known as white coat syndrome. I learned to relax before taking my BP, and significantly lowered the reading. It's not unlike people who do yoga or meditation.

I'm not trying to say that will work for you, it could very well be due to the nsaids. But I am suggesting it's worth a try. I bought an inexpensive
automatic BP monitor at Amazon for about $30 or $40. Get the kind that wraps around your upper arm. It's more like the cuffs the docs have in their office. The monitors that go around your wrist give very different reading than the upper arm cuffs. If you do get one and monitor your BP daily, bring it with you the next time you see your primary care doc. Compare it's readings with what the doc has in the office.

Keep doing that PT! It's the key to recovery.

My BP has recently been as low as 120/80 -ish. I tried the relaxing business and affected a small change with the nurse doing the readings like 5 minutes apart. I'm no Zen Master. These guys come around for another week and then the staples come out and I start going to PT instead of it coming to me. I think that's how it works anyway. Going to the doc's yesterday after a solid hour of torturing myself was more than I was really interested in doing and it hurt later but my # was good at his office and so long as the # is good tomorrow (will post) I should be able to go back to being unconcerned about BP.

This may be a blessing in disguise!
The fourth article I linked says:


This is at odds with the conventional prescription of NSAID's, so that always leave one wondering what to believe, but your BP situation makes a moot point of it! Your body made the call for you!

I still haven't completed the 3rd and 4th articles but I did read a little about prostaglandins in that Zone Diet book. Also this being my 3rd time @ PT I have heard the rhetoric for nsaids and pain relievers in PT. Having the joint imobilized by pain results in not doing the PT which is way worse than taking nsaids and/or pain relievers. Asprin knocks out some good prostaglandins as well but the risk posed is much lower than the risk posed by blood clots. I'm pretty sure that it's as simple as that. The Zone talks about the increased circulation associated with keeping blood sugar/insulin levels from spiking and the anti inflammatory properties offered by that same diet plan. It's a good go to plan considering my current situation.

It's wild that Richard was in a hospital for 2 weeks for a meniscus tear. I mean, what a baby! On my second night after a full joint replacement, I cracked one off so hard it broke the wheel on my office chair. (stolen line)

 

[Alex2507]

(seems a sadist would feel a bit impotent with the revelation that pain is not the most dominant influence over you)!
...just sayin'

I'm so glad you never started talking about S&M at Richards.

 

[Swerd]

It's wild that Richard was in a hospital for 2 weeks for a meniscus tear. I mean, what a baby!

Two reasons for the 2 week hospital stay. I was in the Navy at the time. The standard hospital stay in a military hospital for knee surgery was 1 week if you were married and 2 weeks if you were single. They also gave me 2 more weeks off for convalescence. At the time, I had about 3 months left before I got out for good. If powers much higher than my pay grade wanted to give me one month off, who was I to argue?

This was non-arthroscopic surgery done when hospital stays were much less expensive than now. They opened up your knee to look for damage and take out the torn stuff. The incision left a 3" long scar. My leg was immobilized from the hip down for about 3 days, but I could get around in a wheel chair. After 3 or 4 days, I graduated to crutches. I went to PT twice a day after surgery. I had to wheel myself to PT in that wheel chair, and later hobble to PT on crutches. The switch to arthroscopic surgery made for much less surgical trauma. Knee surgery became a simple out-patient thing. You went home the same day as surgery. And recovery was usually much easier. I did like the time off from a really boring job where the hours left me jet-lagged most of the time, but the knee surgery and the subsequent recovery back then was a much bigger deal than it is today. But with knee replacement, you've gotten a good taste of how much fun it can be.

 

[Alex2507]

Two reasons for the 2 week hospital stay. I was in the Navy at the time. The standard hospital stay in a military hospital for knee surgery was 1 week if you were married and 2 weeks if you were single. They also gave me 2 more weeks off for convalescence. At the time, I had about 3 months left before I got out for good. If powers much higher than my pay grade wanted to give me one month off, who was I to argue?

This was non-arthroscopic surgery done when hospital stays were much less expensive than now. They opened up your knee to look for damage and take out the torn stuff. The incision left a 3" long scar. My leg was immobilized from the hip down for about 3 days, but I could get around in a wheel chair. After 3 or 4 days, I graduated to crutches. I went to PT twice a day after surgery. I had to wheel myself to PT in that wheel chair, and later hobble to PT on crutches. The switch to arthroscopic surgery made for much less surgical trauma. Knee surgery became a simple out-patient thing. You went home the same day as surgery. And recovery was usually much easier. I did like the time off from a really boring job where the hours left me jet-lagged most of the time, but the knee surgery and the subsequent recovery back then was a much bigger deal than it is today. But with knee replacement, you've gotten a good taste of how much fun it can be.

Fun fun fun ... ugh. PT dude walked me for 12 minutes on the crutches and I felt like I could walk another 12 but I don't feel like that now. Oh yeah, this feels great now. (sarcasm) I gave it a 5 upon waking from a nap. I was overdue for the oxy too by then and now ... ice, Tylenol in an hour but maybe now would be smarter. Light stretch to loosen up. Box of tissues for all my issues.

I didn't measure my scar. I saw your scar. Mine's bigger.

It is amazing how efficient and really how good these guys are at this. I've had 2 arthroscopic surgeries. I wouldn't call it simple. It's all sh!t. Pain puts you in the OR. More post op pain. PT pain. The pain that didn't go away. Further deterioration until you go into an OR AGAIN !!! My last 5 years in a nutshell. BP was at 145/95 today. Close to 135/90 from yesterday at the doc's. Maybe I'm conditioned to get ready for action upon seeing PT in front of me. I might be getting a BP monitor after all. You're right about the scope being a faster recovery.

*rough night*

That PT guy is not my friend. I am plotting my revenge.

 

[Swerd]

Fun fun fun ... ugh. PT dude walked me for 12 minutes on the crutches and I felt like I could walk another 12 but I don't feel like that now.

The good PT dudes are like coaches. They push you harder than you would push yourself and they don't care if you like them.

One of the things I actually liked about being in a military hospital was that I was in a large ward with about 40 other guys – no private rooms. Most all had orthopedic or other surgery of some kind, but were otherwise in good health. We cheered each other up. We all cursed the PT dudes up & down. And we all cheered when the pain meds guy showed up around 5 pm. I realized I was better off than some other guys there. It helped that no one there had some dreadful disease with an even more dreadful treatment.

Box of tissues for all my issues.

I didn't measure my scar. I saw your scar. Mine's bigger.

Yeah? Mine's older. It's a vintage scar.

 

[TechHDS]

The most pain I have ever felt in my life was when they strap me down stomach down than strapped my leg to this arm attached to this machine that would rotate my leg back towards my back it would hold my leg there for 30 seconds till I would turn red in the face! No amount of pain meds would help. Did that for five sets than the last one 3 minutes. Swerd your right PT could care less how much pain I was in. One day this old dude in his 70’s was put on that torture machine he didn’t know what he was in for as soon as that arm came back he started screaming crying his wife older than he was, was about to beat that PT guy down! She started screaming at the PT guy take my husband off that machine now! Poor ole guy never came back to rehab after that. My anesthesiologist told me that’s one of the most painful surgeries you can have Knee replacement cause of all the Nerves around Knee. Now I fully understand when I see a NFL player on the field rolling around on the ground after he just tore up his knee crying like a baby.

Mike

 

[ParadigmDawg]

Weak ?!? That's the one I hold in reserve for when I know the going gets rough. Your circumstances require more relief than mine. Inside my head is nobody's bargain but I can't have much more of not being in my right mind.

Tram, even after 6 whiskies does absolutely nothing for me.....