L.I.T
senior
- Joined
- Feb 26, 2016
- Messages
- 353
- Age
- 48
- Location
- Zion National Park
- Country
- United States
- Gender
- Female
First, I want to say THANK YOU for everyone who has contributed, shared, bared their soul, and provided encouragement on this forum. Because my OS and I did not decide on a TKA (vs PKA) until 2 weeks before my surgery, I missed the 'class' on what to expect. And since I am 41y/o, everyone said 'you are young, you'll do great'.... so I truly had no idea of what to expect. THANK YOU for being here, and allowing me to realize that my recovery seems to be pretty 'normal' so far.
My story is this... At 18y/o, my right knee swelled to what I call 'sausage' status (I'm originally from the South, so everything relates to food ). We didn't have insurance, so the quack shack put me on crutches for 6 weeks. The swelling went down, but would periodically come back. At 21 y/o, I had my first MRI and was diagnosed with moderate to severe chondromalacia throughout my knee.
As time went on, in addition to my knee, other joints would hurt - for usually 6weeks to 6 months - then they would be OK again. At 32y/o, I discovered I had Raynaud's. I had the complete rheumatology panel done, and came up normal on everything except a slightly elevated complement c4. None of it made much sense, but life goes on.
I have never played sports or anything cool like that - I was always the geeky type, instead. But 5 years ago, my hubby and I were blessed with an opportunity to move outside of Zion National Park, and I discovered that I LOVED moderate hiking! Nature, taking time to enjoy the serenity of the mountains and listen to the sounds of nature. It was like a blanket for my soul!
Two years ago, after three moderately strenuous hikes in 4 weeks, my right knee finally gave out. Full thickness exposed tibial bone, grade 3OA on the femoral component, and bone marrow edema on both the femoral condyle and tibial surface - all confined to the medial compartment.
After trying PT, a surgical scope, PRP, and BMA (all failed, obviously), it seemed a replacement was my only option. After long talks with the OS, we could not rule out a seronegative inflammatory arthritis (contraindication for a partial), so a total replacement was on.
Fast forward to now.... I am exactly 7 days post op today! It's funny how it feels like it was months ago... Like most people, I seem to have moments where I am OK, and others where I want to cry, lash out, and sock anyone who patronizes me with comments to like 'you worry too much' or 'you just need to get a grip'. (OK, maybe that's just my husband.... The neurologist who sometimes thinks he is an expert in all fields of medicine ).
I have already had an interesting turn of events, as yesterday (while wrapping my leg in saran wrap), my husband used a pocket knife to cut the wrap.... And (you guessed it) grazed my surgical leg with the blade. Luckily, it was very superficial, but it did draw a wee amount of blood. So, per the PA, I am dressing the tiny cut with polystyrene and a bandage and we will see how it looks at my 2.5 week follow up appt.
I have done loads of reading here, and am so thankful to see the many mantras and advice given. I am a person who 'loves to swell', so I have been in sausage mode until about two days ago. I was just then beginning to be able to walk with a little less pain, a little more movement, and without feeling exhausted just by going to the bathroom.
Then enter home health PT yesterday. True to this forum, I didn't do any exercises that hurt much at all (granted, I did take a pain pill beforehand)..... But about an hour after he left, OUCH!!! I was back to sausage status, and feeling like I did on day 3 - ready to cry. So I elevated, iced, took 2 pain pills, and knocked myself out!
I do have one concern. In 2011, I had breast reduction surgery - I ended up developing adhesions (scar to rib cage) on both breasts, afterward. Granted, I had a hyperinflammatory response to the dissolvable sutures, and had to be put on a steroid dose pack.... But clearly, I have a propensity for adhesions.
So now I am somewhat worried about doing the same with my RTKA. The hospital had us aggressively start PT from day one through my release on day 3... My surgeon prescribed the CPM, zero knee pillow, and in home PT. My first visit with the physical therapist was more informative - he told me to not worry about the exercises yet, since I was in the 'pain and swelling' stage. But yesterday's therapist obviously had a different view, having me go through 4 separate exercises (short arc quad, leg lift, extension stretch, heel slide - with pulley, as well as lunge stretches and 5 minutes on a portable cycle). None of them hurt when I did them, but afterward the pain was nuts! I guess I should have expected it, though, as even just using the CPM machine for an hour causes some swelling, but I wasn't expecting swelling to that degree!
So being that my body does have a tendency develop adhesions.... And considering I don't feel much pain when doing the exercises, how should I judge 'how much is too much'? I'm half afraid of not doing enough and getting adhesions... Or doing too much (which was only once) and aggravating the swelling and pain like I did yesterday. Also at the back of my mind is ROM b/c I was 145- neg 5 before my operation.
And just because I know they are pertinent, I'll answer Josephine's standard questions...
1. what are your pain levels right now? Ranging from 1 (rest, little swelling) -8.5 (swollen sausage after PT) with most of time around a 5-6 which is tolerable for me.
2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often? 7.5mg hydrocodone 325 acetaminophen (1 every 6 hrs.... And 1 pill extra if pain is 8.5) and 200mg celecoxib 2 times daily. 1 325 aspirin per day.
3. how swollen is your leg compared to these? Slightly above moderate at rest...huge after PT. B/w moderate and huge after CPM machine for 1hr.
4. What is your ROM - that's flexion (bend) and extension (straightness) - about 90-5 currently
5. are you icing your knee at all? If so, how often and for how long?Icing for 30-45 minutes approx 12-15 times a day (mostly during the day, and the usually twice during the sleep hours) with ice machine
6. are you elevating your leg? If so how often and for how long? Yes - with leg elevator pillow (which I sleep with) - and 95% of the time. If I am not walking to go to the rest room, shower, or to get something from the kitchen (frozen water bottles/food/etc), (or doing the zero knee) I am reclined and elevating.
7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc. Aside from feeding cats, changing litter, getting something from the fridge, shower, restroom, PA..... I am not doing much housework at all. No unnecessary trips out of elevated leg status.
8. what kind of PT exercises and exercises at home are you doing? How much and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)
Exercises done at home: (how many sessions each day)
enter exercise then enter number of reps and sets
etc., etc
CPM machine 1-2 hrs per day
Short 3-5 minute walks in house 10-12 per day (includes shower, bathroom, etc)
Zero knee 10 min 3 times per day
Heel slide 5 reps 2 times per day, light stretch
When PT comes,
Short arc quad 10 reps 5 sec hold
Leg lift 10 reps 5 sec hold
Extensions (roll under heel) 15 rep 10 sec hold
Heel slide with pulley 15 rep 20 sec hold
'gentle' lunge 10 rep 3 sec hold
Cycle 5 min on portable bike
Once again, thanks to everyone for being here. It's like finding a second family! Healing wishes to everyone!!
Liz
My story is this... At 18y/o, my right knee swelled to what I call 'sausage' status (I'm originally from the South, so everything relates to food ). We didn't have insurance, so the quack shack put me on crutches for 6 weeks. The swelling went down, but would periodically come back. At 21 y/o, I had my first MRI and was diagnosed with moderate to severe chondromalacia throughout my knee.
As time went on, in addition to my knee, other joints would hurt - for usually 6weeks to 6 months - then they would be OK again. At 32y/o, I discovered I had Raynaud's. I had the complete rheumatology panel done, and came up normal on everything except a slightly elevated complement c4. None of it made much sense, but life goes on.
I have never played sports or anything cool like that - I was always the geeky type, instead. But 5 years ago, my hubby and I were blessed with an opportunity to move outside of Zion National Park, and I discovered that I LOVED moderate hiking! Nature, taking time to enjoy the serenity of the mountains and listen to the sounds of nature. It was like a blanket for my soul!
Two years ago, after three moderately strenuous hikes in 4 weeks, my right knee finally gave out. Full thickness exposed tibial bone, grade 3OA on the femoral component, and bone marrow edema on both the femoral condyle and tibial surface - all confined to the medial compartment.
After trying PT, a surgical scope, PRP, and BMA (all failed, obviously), it seemed a replacement was my only option. After long talks with the OS, we could not rule out a seronegative inflammatory arthritis (contraindication for a partial), so a total replacement was on.
Fast forward to now.... I am exactly 7 days post op today! It's funny how it feels like it was months ago... Like most people, I seem to have moments where I am OK, and others where I want to cry, lash out, and sock anyone who patronizes me with comments to like 'you worry too much' or 'you just need to get a grip'. (OK, maybe that's just my husband.... The neurologist who sometimes thinks he is an expert in all fields of medicine ).
I have already had an interesting turn of events, as yesterday (while wrapping my leg in saran wrap), my husband used a pocket knife to cut the wrap.... And (you guessed it) grazed my surgical leg with the blade. Luckily, it was very superficial, but it did draw a wee amount of blood. So, per the PA, I am dressing the tiny cut with polystyrene and a bandage and we will see how it looks at my 2.5 week follow up appt.
I have done loads of reading here, and am so thankful to see the many mantras and advice given. I am a person who 'loves to swell', so I have been in sausage mode until about two days ago. I was just then beginning to be able to walk with a little less pain, a little more movement, and without feeling exhausted just by going to the bathroom.
Then enter home health PT yesterday. True to this forum, I didn't do any exercises that hurt much at all (granted, I did take a pain pill beforehand)..... But about an hour after he left, OUCH!!! I was back to sausage status, and feeling like I did on day 3 - ready to cry. So I elevated, iced, took 2 pain pills, and knocked myself out!
I do have one concern. In 2011, I had breast reduction surgery - I ended up developing adhesions (scar to rib cage) on both breasts, afterward. Granted, I had a hyperinflammatory response to the dissolvable sutures, and had to be put on a steroid dose pack.... But clearly, I have a propensity for adhesions.
So now I am somewhat worried about doing the same with my RTKA. The hospital had us aggressively start PT from day one through my release on day 3... My surgeon prescribed the CPM, zero knee pillow, and in home PT. My first visit with the physical therapist was more informative - he told me to not worry about the exercises yet, since I was in the 'pain and swelling' stage. But yesterday's therapist obviously had a different view, having me go through 4 separate exercises (short arc quad, leg lift, extension stretch, heel slide - with pulley, as well as lunge stretches and 5 minutes on a portable cycle). None of them hurt when I did them, but afterward the pain was nuts! I guess I should have expected it, though, as even just using the CPM machine for an hour causes some swelling, but I wasn't expecting swelling to that degree!
So being that my body does have a tendency develop adhesions.... And considering I don't feel much pain when doing the exercises, how should I judge 'how much is too much'? I'm half afraid of not doing enough and getting adhesions... Or doing too much (which was only once) and aggravating the swelling and pain like I did yesterday. Also at the back of my mind is ROM b/c I was 145- neg 5 before my operation.
And just because I know they are pertinent, I'll answer Josephine's standard questions...
1. what are your pain levels right now? Ranging from 1 (rest, little swelling) -8.5 (swollen sausage after PT) with most of time around a 5-6 which is tolerable for me.
2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often? 7.5mg hydrocodone 325 acetaminophen (1 every 6 hrs.... And 1 pill extra if pain is 8.5) and 200mg celecoxib 2 times daily. 1 325 aspirin per day.
3. how swollen is your leg compared to these? Slightly above moderate at rest...huge after PT. B/w moderate and huge after CPM machine for 1hr.
4. What is your ROM - that's flexion (bend) and extension (straightness) - about 90-5 currently
5. are you icing your knee at all? If so, how often and for how long?Icing for 30-45 minutes approx 12-15 times a day (mostly during the day, and the usually twice during the sleep hours) with ice machine
6. are you elevating your leg? If so how often and for how long? Yes - with leg elevator pillow (which I sleep with) - and 95% of the time. If I am not walking to go to the rest room, shower, or to get something from the kitchen (frozen water bottles/food/etc), (or doing the zero knee) I am reclined and elevating.
7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc. Aside from feeding cats, changing litter, getting something from the fridge, shower, restroom, PA..... I am not doing much housework at all. No unnecessary trips out of elevated leg status.
8. what kind of PT exercises and exercises at home are you doing? How much and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)
Exercises done at home: (how many sessions each day)
enter exercise then enter number of reps and sets
etc., etc
CPM machine 1-2 hrs per day
Short 3-5 minute walks in house 10-12 per day (includes shower, bathroom, etc)
Zero knee 10 min 3 times per day
Heel slide 5 reps 2 times per day, light stretch
When PT comes,
Short arc quad 10 reps 5 sec hold
Leg lift 10 reps 5 sec hold
Extensions (roll under heel) 15 rep 10 sec hold
Heel slide with pulley 15 rep 20 sec hold
'gentle' lunge 10 rep 3 sec hold
Cycle 5 min on portable bike
Once again, thanks to everyone for being here. It's like finding a second family! Healing wishes to everyone!!
Liz