Revision TKR Elaine’s slow-as-a-snail revision recovery

my rheumatologist gave me a prescription of Diclofenac cream. He said it has the same medicinal ingredient, only many times more powerful, hence the prescription. I don't know if it it affects the kidneys/liver, if it is used topically.
Well he has it wrong! It's not 'many times more powerful' because topical gels only penetrate about 2 mms into the skin and will never get as deep as the muscles let alone the bone.
And yes, it will get to the kidneys and stomach when used topically.



@eelainea65
I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
 
my rheumatologist gave me a prescription fo Diclofenac cream

@SnowHare Yes, my rheumatologist gave me the same prescription. Alas, I’ve noticed no difference in my pain or inflammation. She assured me it would have very little impact on my kidneys. Thanks for your input!

@Josephine Let’s see what they are! Might need to PM my answers, but go ahead.
 
UPDATE: Well, new ortho doctor (whose residency was at Mayo) had advised I have both patellas resurfaced. He’s also asked for consent to do complete revisions, if he deems it in my best interest at the time of surgery.

I’m trying to wrap my head around the idea of going through this all over again. However, the pain is just too much to deal with on a daily basis. Besides the apparent soft tissue irritation, he believes a good deal of my pain is from bursitis. I am returning next week for cortisone shots. I will need an MRI to determine the condition of my left hip.

Aside from cartilage loss he feels it may have been impacted by my irregular walking due to knee pain and advises PT as well. I’m not a fan of being 50+. The warm, sunny weather is teasing me with the lure of hiking trails. I just want to walk again without pain. Feeling very ungrateful and discouraged right now.
 
@eelainea65 I sometimes wonder if it works or not. My surgeon just gave me a prescription for it. I would be interested in trying some CMD oils. I've heard good things about them. There is a physician in town who used to work at the Bone and Joint Clinic, who dispenses them.

@Josephine If topical medicine can affect your organs, does that mean that some of it is circulating in your body via the bloodstream? Btw, I don't see the rheumetologist anymore, since he kept prescribing an anti-inflamatory over and over again that started to erode my stomach.
 
If topical medicine can affect your organs, does that mean that some of it is circulating in your body via the bloodstream?
Don't see how else it could get to the organs!
 
[QUOTE="eelainea65, I just want to walk again without pain. Feeling very ungrateful and discouraged right now.[/QUOTE]


You’re not alone, I know just how you feel. As for allergy testing, my doctor didn’t recommend it to me, but I’m really glad that I chose to have it done. I’m allergic to most metals and was able to work with my OS to find a replacement that would work for me. Don’t give up, we have to keep pushing to get our lives back.
 
@jboles Thank you for the encouragement. I replied a week ago, but the Bone Smart app lost my reply! ‍ I’m going to have to go back and read your entire thread to learn how the metal allergy manifested itself (symptoms).

Still not 100% confident about proceeding w/ the surgery, though something is CLEARLY wrong. I took my rheumatologist up on her offer of a referral and will be meeting with a very well respected surgeon/instructor at OHSU. My mind will be more at ease once I have his opinion on the matter. Like many things in life, I was told last week that there is no guarantee that the resurfacing or revision will eliminate my discomfort. Still, *something* is causing this inflammation. I hope my visit to OHSU will be a productive one!
Desperate for answers and to know I won’t always feel this way.
TY all for your input and prayers.
 
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I am so sorry that you are having to go through all this pain and frustration. I can’t imagine having both knees done and then facing the possibility of needing to have them both revised again! And what’s so bad is that there is no guarantee that the 2nd surgery will completely eliminate the problem.

As far as the hip pain goes, please post follow ups to that, as I am going through same thing now. Do you also feel a popping sensation in your hip when you walk? My therapist told me last week that she feels like my limping is coming from my hip instead of my knee. And even though I’ve experienced a little pain it before, today it has been really bad throbbing, stabbing type pain.

Best of luck to you and I hope you can get answers soon.
 
Do you also feel a popping sensation in your hip when you walk?

Actually, my hip’s been behaving lately. Might have “popped” once last week. Sore, but no stabbing pains or sense of “giving out.”

Still waiting to be seen by OHSU. Seems to be taking forever to get my medical records transferred. I understand the importance of the doctor reviewing these. But I’m not allowed to make an appointment until he has. Feeling impatient as surgery date gets closer each day.

Has anyone else here experienced neuropathy from knees to toes more than a year after TKR(s)? A feeling like festering/buzzing/tingling/exaggerated tenderness/numbness all at once. Seems worse when lying down! Rolling over in bed is difficult. Extension not so bad, but poor flexion (from the inflammation).

I sure hope his team can figure out what’s wrong with me. These surgeries have definitely been the more difficult physical challenge in my life so far. And the toll these next ones will take on me financially... {shudder}

Okay. I’m rambling nervously now.
I sure wish I had a stronger support system.
Thanks for reading my nonsensical whining,
A very humbled and discouraged Elaine in OR
 
Really sorry to hear about all your problems. I hope your appointment comes through soon and they come up with an effective treatment plan for you. Chronic pain is so debilitating.
 
@eelainea65 I've had mild neuropathy in my feet, which got much worse after surgery. I think the spinal anesthesia is to blame. At six months, it is still bad.
 
Wow. I am so very sorry. I had a terrible recovery from both of my last surgeries. (Never actually recovered.... still having pain and limping). I went through the wringer also. Blood work, pain specialist, injections, RFA, rheumatologist, metal allergy testing... blah blah, no one could ever really figure it all out.
Now, I'm on to a TKR. I am hoping it addresses my pain, but in the back of my mind... I keep wondering, "what if it doesn't??" :shocked:
I truly can empathize with what you are going thru. Just don't give up. Keep on fightin the good fight!
Keep us posted!
HUGS
 
I sure wish I had a stronger support system.
Let Bonesmart be your support system. There are so many of us on here that truly care what happens to you and others going through the same things that we have been through. I am divorced and had no one here to help me or to talk to the majority of the time I was recovering. I spent hours on Bonesmart, day and night. It's nice that someone is always here, 24 hours a day, willing to talk!
 
@Lindylee Thank you! And, yes, it really it.
@rustic It’s maddening!
@Momma-me Yes, and I could have truly written your post myself, especially:
I am hoping it addresses my pain, but in the back of my mind... I keep wondering, "what if it doesn't??" I’ll bet you too found yourself thinking, “Am I imagining this pain?! No, dadgumit. It’s real. It’s relentless. It’s always with me” or “Why is this happening to me when so many people have amazing outcomes?!” {Hug} back. P.S. My right knee revision will be two days after yours. Best wishes!!!
@sistersinhim Thank you so much for that encouragement. And, yes, that’s exactly why I’m here. Ya’ll understand. I feel the few friends/coworkers physically present in my life are sick to death of hearing about it. I can’t blame them. I am, too! I find it incredibly difficult to redirect my focus when the pain is constantly begging for my attention. How does one stop feeling sorry for oneself? Or remain grateful when your quality of life has been so negatively impacted? (Rhetorical questions...mostly)
 
C63FE411-9753-4720-9CDC-85A724C6B431.jpeg
As for that visit to OHSU last week (my 6th “second” opinion), I’m now scheduled to have a revision (including patellar resurfacing) on my right knee at OHSU on May 1st. Wish I could get both knees over with at once, but that was met with a solid, “No, especially not with a revision.”
This was the first doctor to entertain a discussion on metal allergy. While he wasn’t convinced, he did ask if I’d experienced reactions to costume jewelry and assured me he would use a nickle-free knee system. However, I don’t believe my Biomet Vanguard knee components have nickel (see image).
Aside from my reported pain and obvious inflammation, he showed me on my x-rays that there was “overhang.” Components don’t line up perfectly. This could be contributing to the soft tissue irritation. He also said a larger system may have been used than necessary.
I have also been searching to see if my implant has been implicated in any medical device recall.
Aside from the obvious nightmare of undergoing this all over again, this new round of surgeries will put me on disability (60% of my wages) and a few thousand dollars in debt. *sigh* I am not one to rush to judgment (e.g. medical malpractice), but I am highly curious as to whether my original surgeon made the best decisions in my case. Has anyone else considered consulting an attorney as a result of a failed recovery? Honestly, I’m not even sure how this would work or what questions I’d ask were I to seek a legal consultation. Feel free to PM me or direct me to your thread if you’ve been down this road. Much appreciation as always! Elaine
 
I just want to say I’m so very sorry for the nightmare you’ve been through.
I hope this new doctor gets you fixed up and back to having a life.
Very best wishes and prayers!!
 
@eelainea65 if you remotely think a metal allergy is a possibility have the blood allergy test. Doctors only worry about nickel being a problem, and it is the most common problem, but there are other metals to be concerned with. I tested allergic to nickel, cobalt and titanium. My OS said he had never known anyone to be allergic to titanium but we didn’t chance it. I have the Smith and Nephew ceramic femoral component with an all poly tibial component. There’s options out there if you find a surgeon willing to work with you. I feel like there might be a light at the end of my tunnel instead of a train now, hopefully there will be a light for you too.
 
@baker70 Thank you kindly!
@jboles Did you do that $573 test from Orthopedic Analysis? Hoped BCBS might cover it, but no. They call it “investigative.” *sigh* I will take the matter up w/ OHSU. Thanks for the excellent advice. Glad things are looking up for you. I still see the train ahead. =|
 

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