I have suffered bilateral knee pain for over two years, have been through ALL of his suggested treatments and procedures, including radio frequency nerve ablation on both . I am scheduled for the left one in 30 days (🎉😊🎉), and plan on having the other knee done approx 6-8 weeks later. My friend said she hadn’t ever seen anyone looking forward to surgery, and I told her that when it’s your best chance of getting your life back, then it’s pretty exciting ! 🥳
I'd love to know how having both knees done back to back. I'm getting one done tomorrow and the second one in 4 months. Like you I am looking forward to it. I know it will be really painful but I've lived with knee pain for 15+ yrs. Gradually getting worse over the years of course. Several scoops over the years. I'm SO ready. I wondered if 4 months was enough time. Heck I'd have done them at the same time if I could!! I'm ready to get my life back!!
I am 59 and one week Post op for a right knee replacement, and have some discomfort but minimal pain! The swelling and bruising are quite impressive, but I’m working on my exercises, sleeping well, and I have graduated to standing exercises. I have only taken 4 of the 28 OxyCODONE I have been prescribed. Suffice to say, not a cakewalk, but I’m delighted so far
This was very good. Filled in some blanks to what I've already learned and answered some questions as well. Nice to hear the doc is from Akron. About to have lefty knee done at Cleveland Clinic in Bath, Ohio near Akron.
I live in SC and the rules for pain medication are very tight. I had my TKR 2 months ago and my doctor sent me home with only 15 .5 oxycodone pills and would give no more! I have never abused drugs in my life and it is so very unfair for people like me to have to suffer like this! I am going to have my other knee done in about March and I know I will be facing great pain again.
@Ana Kraszewski I did voice my concerns, very loudly. He still wouldn't refill them. It would do me no good to change doctors, they are all like that in SC
Find a doc with a better pain management protocol. One that will meet your pain needs. My doc included, oxy , gabapentin, tylenol, baby aspirin, I had to refill the oxy twice with no problem. I had also left over hydrocodone from a surgery 2 years earlier (disregard exp. dates they are good for years), and i used it as a supplement when my oxy got low or when the pain was a bit less. Do your research, find the doc who has compassion, discuss pain med fears with him or her.
I will be one month post-op January 11, and I am taking Oxi 9AM and 9PM, if I have breakthrough pain in between I will take 2 extra strenght Tylenol during the day. I tried oneOxi but did nit work. Will be glad to get rid of the opioids and the side effects…..is this good or am I relying too much on pain pills? At night is the worse…can’t find a comfortable position and wake up around 5….not getting enough sleep.
I am post op 8 wks and I still have swelling and pain. Akron Ohio is dear to me. My husband went to law school in Akon and went on to be a State Judge . He latter was appointed to the Federal bench by President Clinton. Dr. Jacob is another amazing person that makes Ohio great. Cleveland Clinic is our hospital of choice. Dr.Richard Lang is our doctor at the Clinic. We live in FL. now so I had my leg done here . Not real happy with my results . I am 78 and wonder if ablation would help me. Thank you so much for your expertise.
Hello Marie, I usually give my patients the following timeline: I see patients back at 3 weeks, 6 weeks, 4 months, and 1 year. At 3 weeks most patients hate me and would love to strangle me with the TED hose they are still being forced to wear. At 6 weeks the usually say….meh - it’s not as bad as it was at 3 weeks and it’s not as good as I thought I would be at a month and a half. At 4 months patients first start to see the light at the end of the tunnel and you can expect full recovery at 12-18 months. Your knee will swell on and off during that entire time and it will also feel warm to the touch as compared to the other knee during that time frame. Rapid changes in the barometer will also cause significant changes in your symptoms (usually for the worse). Please know that all the effort and the suffering will come to an end and your symptoms will improve. Don’t give up on your P.T. Your window of time for regaining range of motion is starting to close. Stay positive (glass half full) and this too shall pass! I hope this helped you but if not I am happy to assist any way I can.
I miss Akron, it’s strange in that when you are there you can’t wait to leave and then when you leave you can’t wait to get back. It is truly a special place. Thank you for sharing
I had the pain before surgery so take what the doctor tells to use for pain and move around. It helps. The less you move the more pain before and after. Makes your muscles stronger unless your doctor tells you different.
What are your thoughts on Iovera ? My surgeon has me scheduled and I don't know about the freezing of nerves. It's supposed to reduce your pain to avoid use of narcotics.
I had Iovero injections...I'm actually wondering what my pain would have been without it...I still had lots of pain post op with narcotics and added Tylenol...
I am looking for knee surgeon recommendations in NYC; ones that embrace your multmodal approach for pain management. Ive had 1 cortisone shot and 1 hyaluronic acid injection
Just went over my 2 mouth mark of TKR on R knee. Still in a lot of pain. There is still a lot of swelling, swelling and pain henders my PT alone with no sleep. I just believe that this will be a long tough road.😥😭
I am 2 months PO and yes there is still pain, not like in the 1st 3 weeks, but it is better. Still stiffness amd soreness. The only thing I have found through trial and error to help me to sleep at least 7 hours straight is gabapentin. I only take it at night because it will make you sleepy during the day, although it is used for nerve pain.
I'm 6wks in and it has been very painful. I think the dea has told the doctors how much to give. I have had a lot of surgery so i know. This was a crime against humanity!!!
The ridiculous part is the CDC and DEA are grouping patients with severe pain in with recreational abusers.If acute pain is not managed optimally,the chronic pain is much more likely to set in.Everyone is different.
@@kungfu5561Yes ! It’s just absurd, and people who want recreational drugs will always find them ( like all the bootleg “fentanyl “ mfr. by drug cartels!) , so making post-op patients suffer does nothing to decrease illegal drug trafficking !
I am 8 weeks from my Left TKR. My pain is better that the first couple of weeks, but still have a lot of pain and stiffness. The MD ordered Celebrex, Tramadol, Tylenol, and Oxycodone post op. I felt that the narcotics really didn't stop the pain, so I stopped taking them at 3 weeks. I just stopped the Celebrex because it raised my blood pressure which was very normal pre-op. I had difficulty sleeping before the surgery, not any different except for pain in the knee. Still going to PT. I had less pain before the surgery and wondering if I made a big mistake.
Truly enjoyed this informative discussion. Currently into my 8th week of recovery, seem to be up to par where I should be according to the doctor and therapist. I am now concerned about things just uncovered about misalignment, unseen preop X-rays, and tightness. Thank you for enlightening my needed awareness of conditions and concerns, truly appreciated. Carl Adolphson, baker wv
@@paulb.jacobdo1044 Hi Dr I'm in Sydney Australia saw my specialist today I'm haveing knee replacement December they are sending my mri over to the States and it's comeing back as a 3D MODEL MADE OF BLOCKS HAVE YOU EVER HESRD OF THIS CHEERS DOCTOR
This is 2024, I am having bilateral knee replacement surgery in May of this year. This program has been extremly helpful. I want to have pre op exercise I wonder if insurance covers that. Some friends believe I am crazy to do it together. Since my knees are bone on bone I think it makes sense to do them at the same time. Any thoughts on this_
It is not a good idea to have them both done at the same time. You will be miserable. It’s a roller coaster on pain and emotions. Just do one at a time. You will be glad you did. Good luck to you
I had bilateral total knee replacements 10 months ago. As I said to the surgeon later, if I only had one knee done at a time, I would never go back for the second. I was fit and really put an effort into the 'Pre-hab' exercises for three months prior and put in a big effort into my rehab exercises after the operation. Thank the Lord that I did the Pre-hab because the pain was like nothing I had experienced before (and I have had several significant injuries including broken bones, a gunshot wound, and a high-speed motorcycle accident). Nothing had prepared me for the pain of getting out of bed after the operation. Without post-op oxycodone there would have been no way I could have done my rehab exercises as well as I did. As others have commented, the medical staff do not want you to get addicted and they are very cautious about giving you oxy. Panadol is a poor substitute and I really noticed the pain as they wean you off the oxycodone. That pain at doing simple tasks really knocked me around physically and mentally. (I was thinking there would definitely be a PHD for anyone who looked at post-op depression in Bilateral TKR patients). My advice is to put the effort into your rehab in hospital and continue when you are discharged. Focus on the little indicators of getting better each and every day. Push too hard and you will regret it - push too little and your range on movement in your legs will diminish. Definitely a balancing act. Recognising those little improvements will keep you positive. Good luck with your op.
I wouldn't! You need one to help the other. I just had FKR left in May and FKR right in August. Still in pain from August but can't imagine the pain and lack of mobility doing both at once. Horrible idea :-o).
Very informative a different prospective from Dr. Jacobs. I appreciate his openess with his patients and willing to share much information with patients. Many doctors believe the less infor given, the patients will be more willing to have surgery. Too many details may scare them or become discouraging.
I am certainly of the opinion that you can not make informed decisions without the information. It is often difficult for physicians to discriminate enough information to patients without overwhelming them however I do think it’s possible. Patients are very savvy and very informed these days. Thanks for your feedback.
My surgeon was not like that. A year and half before I had surgery first thing my husband asked the surgeon, so when should she have the surgery done. My surgeon said no, I like to try other things first, so that the patient does not have surgery and regret it. For a year and half I got by with the Hylaronic acid gel shots.
You wanna know how???? Smoke some pot!!!! I had a replacement in 2013 and the best way to cut pain and fall asleep is smoking a big joint and relax.... Try you'll see. Not a joke.
It hurts like hell. Left done in 22, right done on 23. I’ve done everything “right”. Still suffering. I am active in spite of the pain. Pain makes me tired. It is a vicious cycle. I’m still hoping to get some relief.
I had my surgery 6 weeks ago. I STILL have not been able to be able to sleep a full night's sleep. I am in constant pain. My knee is still somewhat stiff. Although I am doing daily movement and have in homr physical therapy. *oh after surgery xrays ended up showing a fracture to my tibia fue to cement expansion. So now 0-20% weight bearing for a while abd use of walker only. What can I do to help the pain? The healing of the fracture? When can I walk unassisted of walker?
This is exceptionally difficult for me to give any advice on as it depends on so many factors. Most will start to see their sleep start to normalize at or before the 3 month mark. As for the weight bearing, it is impossible to advise you here having no knowledge of the surgery, fracture or standard recovery of your surgeon.
I find it incomprehensible why our DEA and CDC have gone overboard treating opioids like street drugs.Interfering with pain control directly impacts surgical outcomes by making therapy intolerable for many TKR patients.
Yes the DEA & CDC should butt out of the controlling of pain. Not everyone becomes an addict. We have more compassion for animals that are in pain than humans.
Often, you have done the days activity and created inflammation throughout the day. Also, cellular mitosis (cell division) primarily occurs at night. Rapid cellular growth is painful (remember growing pains as a child)
@paulb.jacobdo1044 I went from 5'2 to 6'3 in 18 months. Let me tell you about growing pains. I could feel my leg bones stretching at night. Just horrible. I had a thyroid problem(goiter?), they put me on medication and I exploded.
Excellent presentation. My wife is having TKR under Canadian Medicare in three days. Using the VAS pain scale, what number should she expect to be at while taking pain meds? Thanks.
If is difficult to say as each patient handles pain differently. I tell my patients if your pain is 0-3 / 10 then take a non-narcotic pain med like Tylenol and or ibuprofen. If your pain is a 4-7 (most patients) then follow the instructions that come with your pain meds but just take one tablet (not two). If your pain is 7-10 then take the maximum indicated pain meds and supplement with non-narcotic pain medications. Most patients (certainly not all patients) have one or two bad days then they can control their pain nicely. Sleep can be difficult for a few weeks but once bowel movements, sleep, and eating patterns return to normal things get much easier. I wish you and your wife the best of luck!
People as myself have to use pain medication to function daily, I thankfully don't have an addiction gene,, however, I have to beg for extra medication for post op...Really is madness with the pain management and surgeon relaying back and forth while I am suffering.
I completely sunder stand the frustration. In todays environment, most states have imposed maximums on the amount of pain medications you can receive. I’m my cases, physicians hands are tied. There are some strategies that may help. For instance, decreasing your pain medication usage to 50% a minimum of two weeks prior to surgery. The best practice is to work out a plan between you and your surgeon as well as your pain management specialist PRIOR to any surgery. This will help all parties involved feel a bit more comfortable about controlling your pain. This will also Keep your pre-op anxiety in check which will in turn help you control your post op pain much easier.
i now understand how sum folks decide they can't live with pain..im bout 6wks away from procedure date & pain is truly becoming unbearable..& i pride myself on having high tolerance..& o course i can't get anything for pain..if wuz 15yrs ago they'd be more than happy to gimme pain meds,but no i get to suffer.
@@sim7409 I’m in the same boat. My surgery is scheduled 3 months away in June because they are booked. My knees are killing me now. Has been for a year. I have tried everything they suggested; physical therapy, braces, weight loss, walking, swimming, a walker, topical cremes. I take 4,000mg a day of Extra Strength Tylenol. Nothing works! Pain medicine would settle these knees down just enough so I can still function as a human being. Nope, hospital is opposed to opioids. They have gone from one stupid extreme to the other. A Tylenol 4 would settle these knees down enough so I can walk and come downstairs in my own house. I grown to hate doctors and hospitals with a passion because they just don’t care about anybody.
@@MaggieG70 im curious to see what he actually gives me after..sez it's gna be very painful so we'll see..i believe they told me meds only 4-6wks & only 1wk script at a time lol
@@sim7409 That’s crazy, but what can you do. I try to laugh to keep from crying and just accept the fact that doctors in general just don’t care anymore. I had a wonderful doctor for 25 years that retired 15 years ago. Have not had a decent one since I’m sad to say. Thanks for your response.
Yes it does, makes the pain so much worse! I called my nurse practitioner, and they suggested Murillo, can be taken 1 times daily, and of course do not forget your stool softeners ❤️
Joy, am 1- 1/2 weeks in post surgery, I was given 10 exercises to do then following that rehab center provide another five exercises. Important thing is to do them. My recommendation is to switch to heat gel pack before doing. This will help warm muscles and tendons around knee.
Your hospital should supply you with a booklet of exercises. I did them 2X daily 5 weeks before surgery and it really helped after surgery. My surgeon stresses leg raises.
I refuse to get my knee replacement because I am worried that they want treat my pain after surgery, Ibuprofen want cut it my GI doctor says no Ibuprofen at all due to Gastrial Problems Thanks to UNC hospital for feeding them to me for 10 years for osteoarthritis and Arthritis, and I know Doctors want treat your pain with medication no more because today's kids that overdose on them so we all must suffer .. sucks the way today's DRs treat there patients, I'm surprised they don't have their PAs. Doing the surgery that let them do everything else there supposed to do , I have no respect for Dr.s these days as do alot of other people think like I do.
I am sorry you feel this way. I hope that you are able to find a good doctor in your area that you respect. Remember, there are several options besides narcotics to treat hip and knee pain.
I can’t give you medical advice as I have not examined you but I can try and answer your question as a generality. There are no contradictions that I am aware for knee replacement for a 72 y/o or for a patient with fibroid pain. I would consider that patient a candidate for knee replacement if the appropriate criteria was met.
Sadly once again another pain management video that makes no mention of two common post op issues. I know they are common after talking to other TKR patients I’ve talked to in PT, friends who had TKR and involvement in support groups. These have been the worst part of surgery. 1) Not being able to sleep comfortably in bed and living in recliner for many weeks. 2) Night pains: I haven’t heard of one surgeon that is willing to address night pain differently then during the day. During the day your mind is preoccupied with stimulus from the environment around you. At night your brain shuts down and has nothing else to think about and therefore can only think about the pain. In fact it’s common to have pain in a different place at night then during the day. They all expect you to simply grin and bare it. Additionally, no mention of legal Cannabis products such as the role that THC, CBN and CBD edibles, capsules, oils and topicals can play in pain and sleep management. Once I added a topical my night pains disappeared and I was finally able to find a tolerable position in bed. Also keep in mind that many patients are put on blood thinners, which means you cannot take anti-inflammatories which are proven to play a huge role in pain management along with opioids.
Hi Ken, Thank you very much for you input. You are correct that night time pain is difficult to manage For some (but not all) total knee patients. Keep in mind that this was a brief overview and in no way was this meant to be a comprehensive discussion on all aspects of post-op pain control. I love hearing your input on alternative substances for pain control however there is not currently a large body of medical literature investigating these topics so I can’t say that I have much knowledge on those areas. Thanks again for your input.
@@paulb.jacobdo1044 Thank you Dr. Jacob for quick acknowledgment of my post. As we both point out, while not everyone is confined to recliner and/or suffers from night pain, I high percentage do. So odd that I have not found any doctors on YT that mention these issues. Between the surgeons office and the hospital I received stacks of information covering pre and post op care and expectations. Plus I was required to take a one hour class. Nothing and no one mentioned either of those two issues. Something else I’ve experienced is SI joint pain triggered from PT and gout in big toe triggered from surgery. These apparently are also fairly common but never mentioned by anyone. I'm guessing that night pains, sleep only in recliner, SI, Sciatica, or gout probably happen at least as much as commonly mentioned side affects like blood clots, infection and flop foot. Here’s the topical salve I used. fabcbd.com/products/cbd-salve A friend swore that 1/4 square of this edible chocolate bar helped her night pains. 100mg Chocolate bar www.hazeandmain.com/products
Ken Olson: Appreciate your response. I am disappointed with my doctors lack of response to the pain in my knees pre-surgery. It makes me hesitant to have my scheduled surgery in June because they have seen the damage in my knees from MRI and X-ray and just don’t care. I can barely walk, I can’t ascend the stairs in my home to the bathroom and they don’t care. I just need this pain taken down a few notches so I can function until my surgery. I know nothing of alternative topical medicines or oils to help with pain. Could you suggest a couple and direct me to a TH-cam video, blog, or article that could help me learn more about it? Knowledge of an online support group for TKR would be helpful to after my surgery. Thanks so much. I am so close to canceling the whole thing because of the fear of unabated post-surgical pain.
Hi Ken, Although I do not know who your doctor is, I would be willing to bet that he or she is not indifferent to your pain. I think it’s perfectly appropriate to have a discussion with your surgical team about their plan for pre-op and post-op pain control. I think that discuss with your primary care doctor is also appropriate prior to surgery. Over the counter CBD pain creams, CBD oils and other items such as turmeric can be extremely helpful. Prescription NSAIDS are also extremely effective. Nerve ablations (Iovera) and other radio frequency ablation devices (Stryker) may also be very helpful. Physical therapy prior to surgery can not only help to abate pain but some studies show that pre-Hab can also effectively decrease your recovery time. Other things to focus on are diet, and good sleep prior to surgery.
The United States makes up 4.4% of the world's population, and consumes over 80% of the world's opioids. The US consumes approximately 99% percent of the world's hydrocodone. We have a problem and opioids are not the only answer. I feel for you, I really do. The answer is not more opioids. The answer is multimodal pain control. I truly hope you find relief. www.health.state.mn.us/communities/opioids/prevention/painperception.html#:~:text=The%20United%20States%20makes%20up,80%25%20of%20the%20world's%20opioids.
Doctors are too quick to prescribe opioids. I just had a same day knee replacement. I took one oxycodone pill at urging of the medical staff on the first night home. I couldn't stand the feeling, so I switched to tramadol for just one day and then went onto Super Tylenol thereafter. The pain was totally controlled.
I love hearing this. Although it is not the norm we are working toward opioid free post op pain control. Do keep in mind that what may work well for you may not work well for another. Thanks again for your input.
Thay only means it controlled your pain or that you have a high tolerance. I have tremendous amount of pain from disk problems to awful arthritus and it takes alot to control my pain. I guess I have a low tolerance and just cant take alot of pain and I need both knees replaced and that is why I have not done it.
Ice machine 25 min at a time helped me a lot 3 mons out just sore no pain 2 total knee replacements walking good just sore at night ..ice all the time on & off
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I am one month post-op and I love my new knee (left). It feels tight, there still is pain, but it is a good, healing pain.
I have suffered bilateral knee pain for over two years, have been through ALL of his suggested treatments and procedures, including radio frequency nerve ablation on both . I am scheduled for the left one in 30 days (🎉😊🎉), and plan on having the other knee done approx 6-8 weeks later. My friend said she hadn’t ever seen anyone looking forward to surgery, and I told her that when it’s your best chance of getting your life back, then it’s pretty exciting ! 🥳
How are you feeling now? I hope everything is going smoothly. My surgery is in November which feels like torture having to wait so long. 😢😩
@@Shailo911- I'm December. How are you doing?
@@tamianderson123 Still the same, I'm going in for a MRI this week so no surgery yet.
@@Shailo911- Sending good thought for you.
I'd love to know how having both knees done back to back. I'm getting one done tomorrow and the second one in 4 months. Like you I am looking forward to it. I know it will be really painful but I've lived with knee pain for 15+ yrs. Gradually getting worse over the years of course. Several scoops over the years. I'm SO ready. I wondered if 4 months was enough time. Heck I'd have done them at the same time if I could!! I'm ready to get my life back!!
I am 59 and one week Post op for a right knee replacement, and have some discomfort but minimal pain! The swelling and bruising are quite impressive, but I’m working on my exercises, sleeping well, and I have graduated to standing exercises. I have only taken 4 of the 28 OxyCODONE I have been prescribed. Suffice to say, not a cakewalk, but I’m delighted so far
Thank you for sharing this. I'm having surgery Dec 2nd.
This was very good. Filled in some blanks to what I've already learned and answered some questions as well. Nice to hear the doc is from Akron. About to have lefty knee done at Cleveland Clinic in Bath, Ohio near Akron.
Dr Jacob’s explanation is probably the best I’ve heard….Thank you.
I live in SC and the rules for pain medication are very tight. I had my TKR 2 months ago and my doctor sent me home with only 15 .5 oxycodone pills and would give no more! I have never abused drugs in my life and it is so very unfair for people like me to have to suffer like this! I am going to have my other knee done in about March and I know I will be facing great pain again.
@Ana Kraszewski I did voice my concerns, very loudly. He still wouldn't refill them. It would do me no good to change doctors, they are all like that in SC
What's the Dr Name
Find a doc with a better pain management protocol. One that will meet your pain needs. My doc included, oxy , gabapentin, tylenol, baby aspirin, I had to refill the oxy twice with no problem. I had also left over hydrocodone from a surgery 2 years earlier (disregard exp. dates they are good for years), and i used it as a supplement when my oxy got low or when the pain was a bit less. Do your research, find the doc who has compassion, discuss pain med fears with him or her.
@@earnestinehibble5883 Dr. Weiss Atrium Healthcare
@@aliciacowan8111 I don't think there are any in SC and I can't travel...I just don't know what to do
I will be one month post-op January 11, and I am taking Oxi 9AM and 9PM, if I have breakthrough pain in between I will take 2 extra strenght Tylenol during the day. I tried oneOxi but did nit work. Will be glad to get rid of the opioids and the side effects…..is this good or am I relying too much on pain pills? At night is the worse…can’t find a comfortable position and wake up around 5….not getting enough sleep.
I am post op 8 wks and I still have swelling and pain. Akron Ohio is dear to me. My husband went to law school in Akon and went on to be a State Judge . He latter was appointed to the Federal bench by President Clinton. Dr. Jacob is another amazing person that makes Ohio great. Cleveland Clinic is our hospital of choice. Dr.Richard Lang is our doctor at the Clinic. We live in FL. now so I had my leg done here . Not real happy with my results . I am 78 and wonder if ablation would help me. Thank you so much for your expertise.
Hello Marie,
I usually give my patients the following timeline:
I see patients back at 3 weeks, 6 weeks, 4 months, and 1 year. At 3 weeks most patients hate me and would love to strangle me with the TED hose they are still being forced to wear. At 6 weeks the usually say….meh - it’s not as bad as it was at 3 weeks and it’s not as good as I thought I would be at a month and a half. At 4 months patients first start to see the light at the end of the tunnel and you can expect full recovery at 12-18 months. Your knee will swell on and off during that entire time and it will also feel warm to the touch as compared to the other knee during that time frame. Rapid changes in the barometer will also cause significant changes in your symptoms (usually for the worse). Please know that all the effort and the suffering will come to an end and your symptoms will improve. Don’t give up on your P.T. Your window of time for regaining range of motion is starting to close. Stay positive (glass half full) and this too shall pass! I hope this helped you but if not I am happy to assist any way I can.
I miss Akron, it’s strange in that when you are there you can’t wait to leave and then when you leave you can’t wait to get back. It is truly a special place. Thank you for sharing
I had the pain before surgery so take what the doctor tells to use for pain and move around. It helps. The less you move the more pain before and after. Makes your muscles stronger unless your doctor tells you different.
Hi there Darlene I've just been given the ok for knee replacement I'm 53 from Australia how are you going with knee
@@myopinion8062
What are your thoughts on Iovera ? My surgeon has me scheduled and I don't know about the freezing of nerves. It's supposed to reduce your pain to avoid use of narcotics.
I had Iovero injections...I'm actually wondering what my pain would have been without it...I still had lots of pain post op with narcotics and added Tylenol...
My pain dr said he does Genicular nerve knee ablation AND iovera I’ve had both, so far very pleased and my replacement is early August.
Excellent
I am looking for knee surgeon recommendations in NYC; ones that embrace your multmodal approach for pain management.
Ive had 1 cortisone shot and 1 hyaluronic acid injection
Just went over my 2 mouth mark of TKR on R knee. Still in a lot of pain. There is still a lot of swelling, swelling and pain henders my PT alone with no sleep. I just believe that this will be a long tough road.😥😭
I am 2 months PO and yes there is still pain, not like in the 1st 3 weeks, but it is better. Still stiffness amd soreness. The only thing I have found through trial and error to help me to sleep at least 7 hours straight is gabapentin. I only take it at night because it will make you sleepy during the day, although it is used for nerve pain.
I'm 6wks in and it has been very painful. I think the dea has told the doctors how much to give. I have had a lot of surgery so i know. This was a crime against humanity!!!
I'm five weeks out. And im having a lot of pain also. Unbearable:(
I’m scared too death to have it. 😩
The ridiculous part is the CDC and DEA are grouping patients with severe pain in with recreational abusers.If acute pain is not managed optimally,the chronic pain is much more likely to set in.Everyone is different.
@@bridgetlewis2421 ice machine helped me 25 mins at a time had 2 total knee replacements after 3 mon not much pain at all just little sore
@@kungfu5561Yes ! It’s just absurd, and people who want recreational drugs will always find them ( like all the bootleg “fentanyl “ mfr. by drug cartels!) , so making post-op patients suffer does nothing to decrease illegal drug trafficking !
I am 8 weeks from my Left TKR. My pain is better that the first couple of weeks, but still have a lot of pain and stiffness. The MD ordered Celebrex, Tramadol, Tylenol, and Oxycodone post op. I felt that the narcotics really didn't stop the pain, so I stopped taking them at 3 weeks. I just stopped the Celebrex because it raised my blood pressure which was very normal pre-op. I had difficulty sleeping before the surgery, not any different except for pain in the knee. Still going to PT. I had less pain before the surgery and wondering if I made a big mistake.
Truly enjoyed this informative discussion. Currently into my 8th week of recovery, seem to be up to par where I should be according to the doctor and therapist. I am now concerned about things just uncovered about misalignment, unseen preop X-rays, and tightness. Thank you for enlightening my needed awareness of conditions and concerns, truly appreciated. Carl Adolphson, baker wv
Thank you for your kind words
@@paulb.jacobdo1044 Hi Dr I'm in Sydney Australia saw my specialist today I'm haveing knee replacement December they are sending my mri over to the States and it's comeing back as a 3D MODEL MADE OF BLOCKS HAVE YOU EVER HESRD OF THIS CHEERS DOCTOR
@@myopinion8062 I have not heard of this but it sounds very interesting. I wish you the best of luck in your joint replacement journey
This is 2024, I am having bilateral knee replacement surgery in May of this year. This program has been extremly helpful. I want to have pre op exercise I wonder if insurance covers that. Some friends believe I am crazy to do it together. Since my knees are bone on bone I think it makes sense to do them at the same time. Any thoughts on this_
It is not a good idea to have them both done at the same time. You will be miserable. It’s a roller coaster on pain and emotions. Just do one at a time. You will be glad you did. Good luck to you
@@angieadcox195 Thank you.
I had bilateral total knee replacements 10 months ago. As I said to the surgeon later, if I only had one knee done at a time, I would never go back for the second. I was fit and really put an effort into the 'Pre-hab' exercises for three months prior and put in a big effort into my rehab exercises after the operation. Thank the Lord that I did the Pre-hab because the pain was like nothing I had experienced before (and I have had several significant injuries including broken bones, a gunshot wound, and a high-speed motorcycle accident). Nothing had prepared me for the pain of getting out of bed after the operation.
Without post-op oxycodone there would have been no way I could have done my rehab exercises as well as I did. As others have commented, the medical staff do not want you to get addicted and they are very cautious about giving you oxy. Panadol is a poor substitute and I really noticed the pain as they wean you off the oxycodone.
That pain at doing simple tasks really knocked me around physically and mentally. (I was thinking there would definitely be a PHD for anyone who looked at post-op depression in Bilateral TKR patients).
My advice is to put the effort into your rehab in hospital and continue when you are discharged. Focus on the little indicators of getting better each and every day. Push too hard and you will regret it - push too little and your range on movement in your legs will diminish. Definitely a balancing act. Recognising those little improvements will keep you positive. Good luck with your op.
I wouldn't! You need one to help the other. I just had FKR left in May and FKR right in August. Still in pain from August but can't imagine the pain and lack of mobility doing both at once. Horrible idea :-o).
Very informative a different prospective from Dr. Jacobs. I appreciate his openess with his patients and willing to share much information with patients. Many doctors believe the less infor given, the patients will be more willing to have surgery. Too many details may scare them or become discouraging.
I am certainly of the opinion that you can not make informed decisions without the information. It is often difficult for physicians to discriminate enough information to patients without overwhelming them however I do think it’s possible. Patients are very savvy and very informed these days. Thanks for your feedback.
O29000
My surgeon was not like that. A year and half before I had surgery first thing my husband asked the surgeon, so when should she have the surgery done. My surgeon said no, I like to try other things first, so that the patient does not have surgery and regret it. For a year and half I got by with the Hylaronic acid gel shots.
You wanna know how???? Smoke some pot!!!! I had a replacement in 2013 and the best way to cut pain and fall asleep is smoking a big joint and relax.... Try you'll see. Not a joke.
Ya, unfortunately I get tested for my job.
I hated being stoned. The actual pain relief wasn't much more than ibuprofen and barely lasted a few hours.
Dont forget put the joint out before you fall asleep
It hurts like hell. Left done in 22, right done on 23. I’ve done everything “right”. Still suffering. I am active in spite of the pain. Pain makes me tired. It is a vicious cycle. I’m still hoping to get some relief.
I had my surgery 6 weeks ago. I STILL have not been able to be able to sleep a full night's sleep. I am in constant pain. My knee is still somewhat stiff. Although I am doing daily movement and have in homr physical therapy. *oh after surgery xrays ended up showing a fracture to my tibia fue to cement expansion. So now 0-20% weight bearing for a while abd use of walker only.
What can I do to help the pain? The healing of the fracture? When can I walk unassisted of walker?
This is exceptionally difficult for me to give any advice on as it depends on so many factors. Most will start to see their sleep start to normalize at or before the 3 month mark. As for the weight bearing, it is impossible to advise you here having no knowledge of the surgery, fracture or standard recovery of your surgeon.
I have wondered why they needed the hammer
I find it incomprehensible why our DEA and CDC have gone overboard treating opioids like street drugs.Interfering with pain control directly impacts surgical outcomes by making therapy intolerable for many TKR patients.
@@kungfu5561 your 100% right, this is insane.
Yes the DEA & CDC should butt out of the controlling of pain. Not everyone becomes an addict. We have more compassion for animals that are in pain than humans.
I did pre therapy I’ll let you know how I do after. However I am on opioids b4 surgery
how did it go? im doing a lot of pre-hab as well also losing weight, 60lb so far and hope fore 40-50 more b4 I have a tkr
I had a knee replacement 2 years ago it didnt work the pain is very bad wish i never had it done i cant walk without a frame
I hope you have discussed this with your doctor. There are some things that should be ruled out.
Why is pain GREATEST post-op at night in bed? No knee position helps. Sleep is near impossible.
All surgical pain is worse at night in my experience! Your brain is not as busy and you’re more tired I think that has a lot to do with it !
Often, you have done the days activity and created inflammation throughout the day. Also, cellular mitosis (cell division) primarily occurs at night. Rapid cellular growth is painful (remember growing pains as a child)
@paulb.jacobdo1044 I went from 5'2 to 6'3 in 18 months. Let me tell you about growing pains. I could feel my leg bones stretching at night. Just horrible. I had a thyroid problem(goiter?), they put me on medication and I exploded.
@@paulb.jacobdo1044
Excellent presentation. My wife is having TKR under Canadian Medicare in three days. Using the VAS pain scale, what number should she expect to be at while taking pain meds? Thanks.
If is difficult to say as each patient handles pain differently. I tell my patients if your pain is 0-3 / 10 then take a non-narcotic pain med like Tylenol and or ibuprofen. If your pain is a 4-7 (most patients) then follow the instructions that come with your pain meds but just take one tablet (not two). If your pain is 7-10 then take the maximum indicated pain meds and supplement with non-narcotic pain medications. Most patients (certainly not all patients) have one or two bad days then they can control their pain nicely. Sleep can be difficult for a few weeks but once bowel movements, sleep, and eating patterns return to normal things get much easier. I wish you and your wife the best of luck!
@@paulb.jacobdo1044thank you for this scale. I'm having trkr Dec 2nd and am concerned about the pain.
People as myself have to use pain medication to function daily, I thankfully don't have an addiction gene,, however, I have to beg for extra medication for post op...Really is madness with the pain management and surgeon relaying back and forth while I am suffering.
I completely sunder stand the frustration. In todays environment, most states have imposed maximums on the amount of pain medications you can receive. I’m my cases, physicians hands are tied. There are some strategies that may help. For instance, decreasing your pain medication usage to 50% a minimum of two weeks prior to surgery. The best practice is to work out a plan between you and your surgeon as well as your pain management specialist PRIOR to any surgery. This will help all parties involved feel a bit more comfortable about controlling your pain. This will also Keep your pre-op anxiety in check which will in turn help you control your post op pain much easier.
Gvmt.regulators dictating medical post op protocol to doctors.Is this even justifiable?
i now understand how sum folks decide they can't live with pain..im bout 6wks away from procedure date & pain is truly becoming unbearable..& i pride myself on having high tolerance..& o course i can't get anything for pain..if wuz 15yrs ago they'd be more than happy to gimme pain meds,but no i get to suffer.
SIM 740 I'm praying for you, buddy. I have to get my BMI down a little more before I can get the surgery. Good luck, ❤️🙏
@@22lyric
appreciate that...wuz spose be this wk now got pushed to 24th so...🤬
@@sim7409 I’m in the same boat. My surgery is scheduled 3 months away in June because they are booked. My knees are killing me now. Has been for a year. I have tried everything they suggested; physical therapy, braces, weight loss, walking, swimming, a walker, topical cremes. I take 4,000mg a day of Extra Strength Tylenol. Nothing works! Pain medicine would settle these knees down just enough so I can still function as a human being. Nope, hospital is opposed to opioids. They have gone from one stupid extreme to the other. A Tylenol 4 would settle these knees down enough so I can walk and come downstairs in my own house. I grown to hate doctors and hospitals with a passion because they just don’t care about anybody.
@@MaggieG70
im curious to see what he actually gives me after..sez it's gna be very painful so we'll see..i believe they told me meds only 4-6wks & only 1wk script at a time lol
@@sim7409 That’s crazy, but what can you do. I try to laugh to keep from crying and just accept the fact that doctors in general just don’t care anymore. I had a wonderful doctor for 25 years that retired 15 years ago. Have not had a decent one since I’m sad to say. Thanks for your response.
Why does no one mention pain meds are constipating! It adds to the problem.
Yes it does, makes the pain so much worse!
I called my nurse practitioner, and they suggested Murillo, can be taken 1 times daily, and of course do not forget your stool softeners ❤️
Drink your prune juice.
New buzz word by surgeons for not prescribing appropriate opiate pain mgmt post op is multimodal pain mgmt. Run!
What kind of exercise would you recommend before knee replacement
hipknee.aahks.org/exercise-guides/
Joy, am 1- 1/2 weeks in post surgery, I was given 10 exercises to do then following that rehab center provide another five exercises. Important thing is to do them. My recommendation is to switch to heat gel pack before doing. This will help warm muscles and tendons around knee.
Your hospital should supply you with a booklet of exercises. I did them 2X daily 5 weeks before surgery and it really helped after surgery. My surgeon stresses leg raises.
I refuse to get my knee replacement because I am worried that they want treat my pain after surgery, Ibuprofen want cut it my GI doctor says no Ibuprofen at all due to Gastrial Problems
Thanks to UNC hospital for feeding them to me for 10 years for osteoarthritis and
Arthritis, and I know Doctors want treat your pain with medication no more because today's kids that overdose on them so we all must suffer .. sucks the way today's DRs treat there patients, I'm surprised they don't have their PAs.
Doing the surgery that let them do everything else there supposed to do , I have no respect for Dr.s these days as do alot of other people think like I do.
I am sorry you feel this way. I hope that you are able to find a good doctor in your area that you respect. Remember, there are several options besides narcotics to treat hip and knee pain.
What are the options??@@paulb.jacobdo1044
Very painful afterwards .
Should a 72 years women should have gotten knee replacement with Fibroid pain in the body
I can’t give you medical advice as I have not examined you but I can try and answer your question as a generality. There are no contradictions that I am aware for knee replacement for a 72 y/o or for a patient with fibroid pain. I would consider that patient a candidate for knee replacement if the appropriate criteria was met.
Sadly once again another pain management video that makes no mention of two common post op issues. I know they are common after talking to other TKR patients I’ve talked to in PT, friends who had TKR and involvement in support groups.
These have been the worst part of surgery.
1) Not being able to sleep comfortably in bed and living in recliner for many weeks.
2) Night pains: I haven’t heard of one surgeon that is willing to address night pain differently then during the day. During the day your mind is preoccupied with stimulus from the environment around you. At night your brain shuts down and has nothing else to think about and therefore can only think about the pain. In fact it’s common to have pain in a different place at night then during the day. They all expect you to simply grin and bare it.
Additionally, no mention of legal Cannabis products such as the role that THC, CBN and CBD edibles, capsules, oils and topicals can play in pain and sleep management. Once I added a topical my night pains disappeared and I was finally able to find a tolerable position in bed.
Also keep in mind that many patients are put on blood thinners, which means you cannot take anti-inflammatories which are proven to play a huge role in pain management along with opioids.
Hi Ken,
Thank you very much for you input. You are correct that night time pain is difficult to manage For some (but not all) total knee patients. Keep in mind that this was a brief overview and in no way was this meant to be a comprehensive discussion on all aspects of post-op pain control. I love hearing your input on alternative substances for pain control however there is not currently a large body of medical literature investigating these topics so I can’t say that I have much knowledge on those areas. Thanks again for your input.
@@paulb.jacobdo1044 Thank you Dr. Jacob for quick acknowledgment of my post. As we both point out, while not everyone is confined to recliner and/or suffers from night pain, I high percentage do. So odd that I have not found any doctors on YT that mention these issues. Between the surgeons office and the hospital I received stacks of information covering pre and post op care and expectations. Plus I was required to take a one hour class. Nothing and no one mentioned either of those two issues.
Something else I’ve experienced is SI joint pain triggered from PT and gout in big toe triggered from surgery. These apparently are also fairly common but never mentioned by anyone. I'm guessing that night pains, sleep only in recliner, SI, Sciatica, or gout probably happen at least as much as commonly mentioned side affects like blood clots, infection and flop foot.
Here’s the topical salve I used.
fabcbd.com/products/cbd-salve
A friend swore that 1/4 square of this edible chocolate bar helped her night pains.
100mg Chocolate bar
www.hazeandmain.com/products
Ken Olson: Appreciate your response. I am disappointed with my doctors lack of response to the pain in my knees pre-surgery. It makes me hesitant to have my scheduled surgery in June because they have seen the damage in my knees from MRI and X-ray and just don’t care. I can barely walk, I can’t ascend the stairs in my home to the bathroom and they don’t care. I just need this pain taken down a few notches so I can function until my surgery. I know nothing of alternative topical medicines or oils to help with pain. Could you suggest a couple and direct me to a TH-cam video, blog, or article that could help me learn more about it? Knowledge of an online support group for TKR would be helpful to after my surgery. Thanks so much. I am so close to canceling the whole thing because of the fear of unabated post-surgical pain.
Hi Ken,
Although I do not know who your doctor is, I would be willing to bet that he or she is not indifferent to your pain. I think it’s perfectly appropriate to have a discussion with your surgical team about their plan for pre-op and post-op pain control. I think that discuss with your primary care doctor is also appropriate prior to surgery. Over the counter CBD pain creams, CBD oils and other items such as turmeric can be extremely helpful. Prescription NSAIDS are also extremely effective. Nerve ablations (Iovera) and other radio frequency ablation devices (Stryker) may also be very helpful. Physical therapy prior to surgery can not only help to abate pain but some studies show that pre-Hab can also effectively decrease your recovery time. Other things to focus on are diet, and good sleep prior to surgery.
@@paulb.jacobdo1044 I think your last comment was meant for Margie B, rather than me.🙂
Barbaric surgery. Intense pain and now even surgeons are afraid to give adquate pain relief. Sorry but i find your explanation cowardly.
The United States makes up 4.4% of the world's population, and consumes over 80% of the world's opioids. The US consumes approximately 99% percent of the world's hydrocodone. We have a problem and opioids are not the only answer. I feel for you, I really do. The answer is not more opioids. The answer is multimodal pain control. I truly hope you find relief.
www.health.state.mn.us/communities/opioids/prevention/painperception.html#:~:text=The%20United%20States%20makes%20up,80%25%20of%20the%20world's%20opioids.
Doctors are too quick to prescribe opioids. I just had a same day knee replacement. I took one oxycodone pill at urging of the medical staff on the first night home. I couldn't stand the feeling, so I switched to tramadol for just one day and then went onto Super Tylenol thereafter. The pain was totally controlled.
What is Super Tylenol?
I love hearing this. Although it is not the norm we are working toward opioid free post op pain control. Do keep in mind that what may work well for you may not work well for another. Thanks again for your input.
@@wbrandon7456 just extra strength
Thay only means it controlled your pain or that you have a high tolerance. I have tremendous amount of pain from disk problems to awful arthritus and it takes alot to control my pain. I guess I have a low tolerance and just cant take alot of pain and I need both knees replaced and that is why I have not done it.
Ice machine 25 min at a time helped me a lot 3 mons out just sore no pain 2 total knee replacements walking good just sore at night ..ice all the time on & off