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Author Topic: New, confused, what to expect?  (Read 2045 times)

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Offline trdajara

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New, confused, what to expect?
« on: April 14, 2011, 11:59:05 AM »
Hi, I am new, and totally confused, not to mention in pain. I am a 48 year old female and walk loads
Seven months ago I broke my right fib, was in a full NWB cast for 8 weeks. I then used a combination of crutches and a stick, by February this year I could walk more or less OK.
Then the problems began in the left knee, starting with twinges and dull aches, and because it was gradual I guess I didn't think too much about it, until a week ago when I twisted my left knee just walking on grass.  The pain was intense in the inner side of the knee, with shooting pains up the outer thigh too.  The whole knee became swollen and tender and I spent the weekend icing and resting.  On Monday it was a little better,  managed a few simple tasks Monday and Tuesday until the knee twisted again that afternoon. I am sure I dont have to go into detail about excruciating pain that lasted all night.  Got to my GP first thing Wednesday, who specializes in Sports injuries. He seemed to find the site of the pain with eye-watering accuracy, on the inner leg side of the knee cap, just under, makes me feel sick to touch it still.  as there is tenderness and swelling the first step seems to be rest and anti inflammatory tabs. He says it is ligament damage but i did not really hear the details and so have to go back in two weeks to see if I need to be referred.
In the meantime the pain remains intense, can I take paracetamol with ibuprofen? I can barely walk and the leg will not straighten.
What can I dio to ease the pain and will it EVER get better, because I feel it never will.
Thanks for listening

Offline Vickster

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Re: New, confused, what to expect?
« Reply #1 on: April 14, 2011, 12:29:05 PM »
I can't help with the reason for the pain, but yes, you can take paracetamol and ibuprofen happily together.  Just make sure you don't exceed the stated dosages and timings (no more than 2 x 500mg of paracetamol every 4 hours and 1 x 400mg of ibuprofen 3 x a day, every 6 hours).  Also, only ever take the ibuprofen with food.  My GP recommended the 400mg ibuprofen as being more effective than 2 x 200mg (for some reason).  Paracetamol especially has a cumulative effect so take regularly. 

If the pain is severe, you could also add in codeine (but beware the constipation), something like solpadeine (but then reduce the paracetamol so as not to overdose)

Might it be worth considering a support for the knee if you keep twisting it?  The fact you twisted it, it is swollen, painful and you cannot straighten could be suggestive of a meniscus tear, although the doc mentioned ligaments?

Good luck.  Knees are a pain!

« Last Edit: April 15, 2011, 07:51:16 PM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline trdajara

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Re: New, confused, what to expect?
« Reply #2 on: April 14, 2011, 12:38:54 PM »
Thanks.  Have taken some paracetamol now! Yes I wondered about ligament, there was no pop, nothing sudden, but no grinding either. Knees are a pain, I agree.

Offline dm

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Re: New, confused, what to expect?
« Reply #3 on: April 15, 2011, 12:31:44 AM »
When you stretch or snap a ligament, or damage meniscus or both, sometimes the only sign you get when it happens is that your knee "disappears" and down you go! It can vary, it all depends on what angle the knee was at, what direction your foot was facing and what direction the rest of you was going, how much weight was on the knee, etc. Factors like that all come into play to affect exactly what was damaged, and by how much. Sound complicated, because it is, even to someone like me who's had so much go wrong with my knee.

Hope that's as clear as mud for you about how you did what you did to your poor knee. Hope it feels better soon.

Wear a support if you think it helps, the drugstore or sports store has quite a selection that can be had for not too much, while the doc sorts out what's going on. Elevate and ice the knee when you're at home in the evening, it'll help the pain and swelling. keep the knee above heart level when icing, that's what brings the swelling down, to let gravity help move the fluid.

You can do liver damage if you exceed more than 2400mg of ibuprofen or 4000g of parcetamol (acetominophen) in a 24 hour period, so watch the cumulative dosages in all products you take, including cough, cold and allergy remedies. I think you can figure out the divided dosing of that yourself into 3 or four doses. (800mg 3x a day or 1000mg 4x a day) The dosages Vickster listed as written are overdosages so please don't take that much! These amounts come straight from my dr and from listings at the pharmacy... so I trust the info.

You could try an over the counter sports rub on it that doesn't contain aspirin, to see if that relieves some of the ache, when you don't have it wrapped or on ice, as a temporary measure. Can't hurt to try. Worst case is that it does little, or that massaging it in helps some, and the product helps the ache a little too.

I find sometimes that if you take little bits of relief from this and that, you get just enough cumulative relief all together to get by until they get around to doing something about the situation.





multiple arthroscopies 2/00,3/01,6/01,1/03, 12/07,10/10. chondromalacia, severe medial joint space narrowing following 3 partial menisectomies, chronic pain problems, kneecap problems, OCD lesion, failed mfx.

Offline Vickster

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Re: New, confused, what to expect?
« Reply #4 on: April 15, 2011, 08:25:57 AM »
You can do liver damage if you exceed more than 2400mg of ibuprofen or 4000g of parcetamol (acetominophen) in a 24 hour period, so watch the cumulative dosages in all products you take, including cough, cold and allergy remedies. I think you can figure out the divided dosing of that yourself into 3 or four doses. (800mg 3x a day or 1000mg 4x a day) The dosages Vickster listed as written are overdosages so please don't take that much! These amounts come straight from my dr and from listings at the pharmacy... so I trust the info.

This is what my GP has recommended I take - up to 4g of paracetamol a day (2 x 500mg, 4x a day) and 1200mg of ibuprofen, being different classes of drug.  Plus tramadol and codeine as required  ???  I never take that much but could do  ???  I wouldn't take those doses for months without medical advice but certainly my doctor said that it wouldn't harm.  I have also been prescribed diclofenac as a longer acting alternative to ibuprofen but it doesn't agree with me personally. 
I am no pharmacist, just going on my doctor's advice to get my knee pain controlled. I am a failure as I actually under medicate  :)

With your pain as intense as you say it is, I am surprised your doctor didn't discuss pain management with you and indeed prescribe something or give you some actual advice  ???
« Last Edit: April 15, 2011, 08:27:57 AM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline trdajara

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Re: New, confused, what to expect?
« Reply #5 on: April 15, 2011, 10:56:10 AM »
Thanks for advice.  My GP says 600mg ibuprofen 3 times a day, obviously with food. But although swelling slightly better the ibuprofen does little for the pain. I am unable to work as just a few steps are enough.  I think I have learnt my lesson I ignored the pain for 5 weeks, as I just did as much as I could after taking pain killers.
Its a huge learning curve now I realise how debilitating and painful knee conditions are for many people.

Offline Lottiefox

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Re: New, confused, what to expect?
« Reply #6 on: April 15, 2011, 11:17:48 AM »
One thing I find useful is a topical NSAID gel instead of orally taken meds. It reduces the hideous stomach side effects and the demand on the kidneys and liver. Something like Voltarol used as directed over 4 days can really help with hitting the actual part that hurts. DON'T take oral NSAIDs at the same time though. If I'm not on the gel I take celebrex, but it isn't widely prescribed and is a COX-2 NSAID which have some nasty side efects like death/stroke/raised BP in certain people. It suits me though, I'm not dead yet and it really hits my pain but mine is wider spread OA pain in both knees. As Vicks suggested there are also paracetemol/codeine combinations but these should not be taken for longer than 3 days and its probably best to speak with a doctor or pharmacist first. They can be quite effective at hitting acute pain though.

Good luck. Knees, are, indeed a pain.

Lottie

Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline dm

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Re: New, confused, what to expect?
« Reply #7 on: April 16, 2011, 02:52:09 AM »
I have no articular cartilage on the back of my right kneecap, and have had a successful microfracture to my femur for a big chunk of articular cartilage I knocked off of it when I fell last July (op #6 last oct). So, I contend with bone pain nearly daily, the intensity of which fluxuates depending on activity level. I've gone beyond ibuprofen and acetominophen (parcetamol) or codeine for pain control and have gone to judicious use of narcotics. I don't take them every day, but hydrocodone or oxycodone hcl where I'm at. I can thankfully get away with one or two tablets a day when things are bad. I'm going to be in line for a PFJR or PKR within 3 years, I'm thinking, due to the level of kneecap damage, it's just not gonna hold up too much longer.

Bright spot for me, I've recently applied for a new job in field service instead of manufacturing, one that'll be much more knee-friendly, and am in the final stages of job acceptance. Its a big move for me, hoping this'll make my life a lot easier without the daily knee strain the current job has.

Topical NSAIDs can be a good alternative to the oral ones, I agree, worth trying Voltaren if you've a touchy gut.
multiple arthroscopies 2/00,3/01,6/01,1/03, 12/07,10/10. chondromalacia, severe medial joint space narrowing following 3 partial menisectomies, chronic pain problems, kneecap problems, OCD lesion, failed mfx.