Bilateral TKR Doing beautifully 4.5 months out, then….

[EalingGran]

Day 17- Post surgery. Got a UTI, I was prescribed Keflex

I am prone to UTIs. I was born with a congenital megaureter and that ureter doesn't empty properly.
I had a UTI at about 4 weeks post op. I think it was partly due to being run down but also just so distracted with pain/ tiredness that I didn't manage my usual regime of lots of fluid/ making sure I really try to empty properly by double voiding etc.
Something that really helps me keep my antibiotics use down to a minimum is
d- mannose. I find it much better than cranberry extract. It is a natural remedy but there is lots of evidence in medical journals to support its use for both prophylaxis and treatment of UTIs caused by E Coli ( which cause 90% of UTIs) It is a special kind of natural sugar which humans can't use but passes straight from the gut to the bladder. E Coli bugs can metabolise it though and they detach from the bladder wall and latch on to the d-mannose and are then excreted in the urine. I take it when I have a UTI and sometimes more regularly if I am having a bad spell. I have done really well in recent years to avoid UTIs and I was fed up to get one a few weeks ago. I think this surgery really takes it out of you and I had a spell where it just seemed one thing after another ( colds/ cough/UTI).
Just hope things improve for you.

 

[beachy]

There are otc treatments for uti, too. They don't take it away, but ease the symptoms. They will turn your urine orange temporarily. And you can't take them prior to a urine test. I've used them and they do help.

 

[KateLynn]

Post-Surgery Day 21: went off the Keflex after two days and primary switched me to Macrobid. It seems to be fine and things are improving on that avenue. I’ve had two days of outpatient PT at the center and I thought everything was going well but they keep insisting I’m supposed to be 100 degree flexion by now and I’m only slightly below 90 on each knee. Walked a mile and a half today, 1/2 of it outside and thought that was great but apparently everyone seems disappointed in my progress except me. I am walking with no walker and no cane. I haven’t used either for almost two weeks now. I asked to have my pain medicine reduced to tramadol and Dr is reluctant because he’s worried that I haven’t made enough progress yet and that it will be hard on me without the codeine. I’m having a hard time keeping my head up over this. They keep insisting if I don’t get both knees bending to 110 by five weeks I’m going to have so much scar tissue, I’m going to be in trouble. My extension is at 0 degree on both knees. PT exercises 7 days a week but only 2 in office. All I can do with this point is do my best.

 

[EalingGran]

Sounds to me that you are doing really well. Walking 1 and a 1/2 miles at this stage is amazing. Especially with no cane or walker. I am 14 weeks post pkr and I consider that a good walk and have a rest/ coffee before I walk back!
Don't be bullied over your ROM/ physio. Lots of people here get improvement in ROM much later and more gently than their treating team believe is possible.

 

[sistersinhim]

They keep insisting if I don’t get both knees bending to 110 by five weeks I’m going to have so much scar tissue, I’m going to be in trouble.

You are only three weeks out and are doing amazingly well! You have a right to be pleased with yourself! It is so aggravating to hear that many therapists always put their patients down for their achievements. Also, there is no window of opportunity for ROM. It can happen for years! You have to have scar tissue if you didn't your incision would always be open and all the tissues cut inside your knee wouldn't knit together. What the PT is referring to is adhesion. They are extremely rare. What causes those is overworking tissues causing them to become hot, dry, and sticky. Over-worked knees get inflamed and hot, and hot tissues become drier than normal and more likely to stick together and form adhesions. MUA (Manipulation under Anaesthetic) and Adhesions

You need normal scar tissue. That's what holds your incision together, and it's part of the normal healing process. Without it, you'd always have an open wound.

Pat yourself on the back for a job well done! You are the only person you have to please and tell those pushy therapists that very thing! It's your knee and your recovery. Everyone is different and you happen to be one of those that have a very early improvement. Enjoy it and don't let anyone steal your joy!

 

[beachy]

Honestly, I don't think most PTs know what they're talking about when they start with scar tissue. Mine started up about scar tissue and I nodded my head and changed the subject.
sistersinhim Is absolutely right.
You are having an amazing recovery! Especially for bilateral.
If you are able to walk 1 1/2 miles that's the best PT you can do for now. That alone will get your bend to 110.

 

[beachy]

After my first tkr my first post op appt was at 7 wks. Doc had been on vacation then I got sick.
I was sitting in chair when he came in exam room. He said he didn't need to check my ROM because he could see my knee had great bend. My legs were tucked under chair a bit back.
I had maybe 3-4 PT visits at that point. Very gentle, no threats.
Your bend will happen with gentle PT and walking.

 

[KateLynn]

Thanks for the encouragement! I’m just going to do what I can do and go from there. I find it kind of amusing that my extension is better than it was before surgery in both legs by quite a bit as far as flexion. Not sure I ever measured it, but it isn’t far from where I was and I expect it to get better! Onward and upward!

 

[InkedMarie]

I think you’re doing amazing @KateLynn ! Three weeks, no walker or cane is fantastic! IMO, ignore PT. It’s your body, you set the rules.

Marie

 

[KateLynn]

Can anyone tell me how long the bellyache continues after surgery. I think I’ve mastered the constipation thing, so I’m not sure what’s causing this constant low-grade tummyache with slight nausea.

 

[EalingGran]

I’m not sure what’s causing this constant low-grade tummyache with slight nausea.

Are you taking any non- steroidal anti inflammatory drugs like naproxen? They can give you that low grade tummy pain/ nausea. Especially if you don't take a stomach protector like omeprazole or if you take them on an empty stomach.

 

[benne68]

@KateLynn Most of the time, persistent nausea and stomach discomfort is related to medication. What are you taking? Are you still on antibiotics from the UTI?

 

[beachy]

Ugh. I felt nauseous for weeks after tkr. It was the meds. But, I stayed with them as they were helping the pain. No appetite. Eventually it eased. Ginger ale, saltines were my gourmet meals.
What pain meds are you taking?

 

[KateLynn]

I am still being prescribed oxycodone. I am finished with antibiotics for the UTI, and have no further symptoms with that thankfully! Still having to take medicine for constipation even though I’ve cut way back on the pain meds. Still on baby aspirin twice a day and meloxicam, although that’s going to stop at the end of the week. Hopefully my next pain script will be for some thing like tramadol. Knee flexion is up to 97 on the right and a 101 on the left, I’m still less than four weeks out from surgery, so I guess that’s pretty good. I think I’m just sick and tired of feeling sick and tired. Today is a beautiful day outside so I plan to take a nice long walk. Maybe that will help me. Thanks for all of your input…this has been a great forum for all my Q&A!

 

[benne68]

Knee flexion is up to 97 on the right and a 101 on the left, I’m still less than four weeks out from surgery, so I guess that’s pretty good.

That's excellent! You are doing great.

I do think the nausea will disappear as your medications are reduced. Meanwhile, be sure you take your medications with food.

 

[beachy]

I hear ya on the sick and tired part! My gut just wants to misbehave.
You're doing amazingly well for a bilateral!

 

[Layla]

Hello and Happy One Month Anniversary!
I hope you’re feeling better and your week is off to a good start.
It is still early days in the the entire scheme of things. Lots of healing happening and a brighter days ahead. Hold on, it’s coming!
@KateLynn

 

[KateLynn]

Thank you!

 

[KC Kitty]

You are doing great. I am just ahead of you. I had my bilateral on Jan 9. I am so glad you are doing well and glad the pain in minimizing! Hang in there and try and stay as positive as you can and if you need anything, please don't hesitate to reach out!

 

[KateLynn]

Almost 6 weeks post. Flexion is at 115 and 116 but I feel after exercise like the upper part of my leg stiffens up. Trying to do as well as I can and terrified I’m not doing enough. I might be reaching that panic and for no reason depressive stage. I’m not taking any pain medicine but really just want to take ibuprofen, but I have seen that no one recommends ibuprofen. Any experience on that or opinions? I feel like I need more anti-inflammatory than pain medicine but the meloxicam made me so sick. I don’t know what to do. I couldn’t wait to get 30 days out to stop taking it.