Tylenol is a great drug (the image is the chemical structure).  If it didn’t cause liver problems if you take too much it would be the greatest drug of all time.  Relieves pain, non-addictive, does not cause constipation.  I have to say- that’s a great triad.  The problem is that there is a limit to how much you can take.  I am taking 440 mg Alleve twice a day and 650 mg Tylenol every 4 hours while I am awake- approximately 3250 mg a day.  My pain hovers between 3 out of 10 and 5 out of 10.  5 is at the point where i start thinking about taking oxycodone 5 mg.  That’s not a lot of oxycodone but since there are quite a few complications from opioid use I am trying to avoid it.  I may not make it though because tonight I am suspecting an incremental amount of pain as the night comes on which may push me over the edge.  Check back tomorrow for this update.

I exercised a little today and was able to bring my knee to 100° flexion.  I paid dearly for this maneuver as that is when the pain jumped.  I have seen so many patients, though, who did not get past the early fear of movement and I did not want to succumb to that.

I did get a chance to the photographs from inside the operating room and I placed them in sequence in this video.  Not for the squeamish.

It actually is a bit freaky to see your own knee replaced.  Maybe that contributed to my pain today.  Probably not.  The pain is from the operation you see on the video.

Here is a review of the first day after surgery:

Transcription:

Hi, I’m Dr. Kirschenbaum. How are you? I’m set up here first day after surgery actually. This is a pretty good couch setup. I have my iPad here. I have my glasses. I have my incentive spirometer, which I use every hour. I have my cell phone. I also have this foam pillow, which elevates my leg very comfortably. To elevate the knee higher than my heart, I’ve added an extra throw pillow.

I have this device, which I’ve demonstrated to people before called the triple play. It’s a home DVT and combination compressive ice therapy. The gray are sequential compression device sleeves for my calves. This is a knee sleeve that has a pad of gel ice underneath. It compresses periodically, so it sequentially goes from the left foot to the right foot to the compressive device. This is great for DVT, and this is great for comfort as well as healing of the knee and keep the swelling down.

This is a are good setup for post-op day #1. I’m walking with a walker. My pain averages to above 4/10. I’m taking Tylenol and Aleve only of my pain medicines. Have not taken any opioids; I haven’t needed them. Tylenol is holding me nicely with the Aleve; 4/10 is quite good. I’m doing some knee bending and straightening with the knee exerciser. It’s been a pretty good day so far. That’s post-operative day #1.

 Here is a cool knee exerciser I am using: