TKR Acute multiple pulmonary emboli

[JoJoP]

Just had my third joint replaced. 1st was left TKR 2½ years ago, followed by a right shoulder 1½ years and then my right TKR 10 days ago. I say this because until yesterday, I thought I knew what to do and how to get through this. My knee didn’t seem to be healing as fast but I put that down to me being impatient and forgetting just how long the first 10 days are!

However yesterday morning (12.49 am) I woke to the most phenomenal chest pains and complete inability to breathe. Long story short and 19 hours in an acute clinical decision unit, I came away with a diagnosis of multiple segmental pulmonary emboli and have started on a course of anticoagulant therapy for 6 months. Otherwise I am extremely healthy - or rather I have good cardio vascular fitness for a person of my age.

But now, I’m scared.

Has anyone out there had this experience? Has it impeded the healing of the knee? How likely is it that I will be permanently affected by the PE?

Any and all sensible advice gratefully received. Trying to limit self guided research on internet. Too many references to sudden death, which makes me feel really really scared.

 

[lovetocookandsew]

I'm so sorry to hear of this and am sending good wishes your way. I've never experienced this, so am tagging our Forum Admin. (and Nurse Director extraordinaire) @Josephine to offer her advice and support. Good luck and please keep us posted.

 

[lovetocookandsew]

Would you please let us know the dates and types of surgery you've had so we may add them to your signature? It helps us when we can see exactly what you've had and when. Thank-you. I'll also leave you our Recovery Guidelines.



Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary

2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.

4. PT or exercise can be useful BUT take note of these
the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy

5. At week 4 and after you should follow this Activity progression for TKRs

6. Access these pages on the website
Oral And Intravenous Pain Medications
Wound Closure

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?

Energy drain for TKRs
Elevation is the key

Ice to control pain and swelling
Heel slides and how to do them properly

Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[RAD]

@JoJoP I had a bilateral PE 4 years ago unrelated to a joint replacement, it basically came out of nowhere. I was on heparin in the hospital and then Zarelto for 9 months. The clots completely cleared and there was no permanent damage. I just had a left TKR on May 15th. The hospital had me see a hematologist as part of pre-op and directed me to be on Coumadin for 5 weeks post op which I just finished and all is well. Now I’m back on my 81mg a day baby aspirin which is what I’ve done ever since I can off Zarelto 3 years ago. I hope you are feeling better, best of luck with your recovery!

 

[Josephine]

Rad is right. It's a singular occurrence and unlikely to affect you in the long run. Be at peace, you're on anti-coagulants so nothing to worry about.

 

[JoJoP]

Thank you both. Last week was rough rough rough coz I was feeling so rotten re TKR and then was feeling rotten re PE and then rotten rotten coz my already replaced left knee is taking too much strain and is HURTING.

This week is much better. Still weak but physically making strides (literally and metaphorically). Managed to walk for a mile yesterday with a cane. Huzzah.

But.... pain in old replaced knee is just getting worse. Xrays from 2 months ago confirm that the button on the back of my kneecap is loose.

Recovery is such a mental game. And at 3.5 weeks, I’m hitting *that wall*. Slightly depressed every morning but I pick up midday.

Again thanks for the support both. The bilateral PE - oh ****!

What no one tells you is that these things are scary even if they are perfectly treatable.

J

 

[JoJoP]

Would you please let us know the dates and types of surgery you've had so we may add them to your signature? It helps us when we can see exactly what you've had and when. Thank-you. I'll also leave you our Recovery Guideline

LTKR = January 2017
Rshoulder = February 2018
RTKR = June 12, 2019

 

[Indygo]

Sounds like you're doing well, despite the rough (and scary!) start. I know what you mean about the 'waking up slightly depressed' feeling. I've been that way the past week or so, and getting on here is one of the things that helps!

 

[bland9]

Hiya jojoP sounds like you got all in control and got good medication to help resolve the DVT - I was in the same boat but unfortunately for me my DVT was not detected until real damage was done -I am very lucky to be here and for myself permanent damage had been done and to this day it has a detrimental effect on my TKR recovery I remember the pain and breathlessness but I continue taking my medication and slowly it got better, just take it easy , today I try to put it to the back of my mind - though future OPs it always being noted and extra care and attention by medical teams is always assured .

 

[JoJoP]

Sounds like you're doing well, despite the rough (and scary!) start. I know what you mean about the 'waking up slightly depressed' feeling. I've been that way the past week or so, and getting on here is one of the things that helps!

It’s such a rollercoaster. This morning I woke up feeling that same old heartsick feeling - I will never be free of pain, I will never be mobile, I will always struggle. Yesterday I woke up and EVERYTHING was possible.

Another thing no one tells you is that body starts to fall apart with all in inactivity! Just before the surgery I was really quite active. I cycled approx 11 miles every other day. Walked my dogs for an hour or so in between. But now with having been so immobile for a month, all my arthritic joints are really killing me (thumbs, feet, shoulder, neck). And I feel awful for being such a MOANER! I feel terrible about the pressure it is putting on my partner.

Ah well, today just isn’t a good day. Tomorrow will be better.

J

 

[Jaycey]

Oh yes, recovery is a roller coaster. Just hang on - the ride will get better. You are at the stage I call the one month slump. Things seem to progress fairly dramatically in the first weeks of recovery. Then suddenly it starts to feel like nothing is happening.

You will be free of pain and you will indeed get back to your active life again. Just a bit of time and a huge dose of patience.

 

[Indygo]

Oh JoJoP, I could have written your last post! The first few weeks after surgery I thought ‘Wow! Somehow this has magically helped all my arthritis!’ But of course, duh, it was the pain medicine that was working on the thumbs, the other knee, etc. Then when I stopped the meds and the inactivity added injury to insult, all the other arthritis pain was back! It was at about one month, and discouraging for sure. It gets better when you can move more!!