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Revised PKR to TKR 12 months later but can’t find my thread

Hi Josephine. Yes that’s fine. Actually the only time I walk is to test if and how long I can walk as I am supposed to return to work for 8 and 10 hour shifts as a nurse.


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Here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?
[Bonesmart.org] 12 months later but can’t find my thread


4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what 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 you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.
 
Thanks @Josephine.

1. Pain levels right now 6 when sitting. 8 when up and pottering.

2. Pain medications

Tramadol 200mg slow release x1 at night

Mersyndol x 2 - six hourly.
450/30/5 (paracetamol/codeine phosphate/doxyalamine
Meloxicam - prescribed but not taking (stomach issues). 15mg

3. No 3 huge

4. ROM hasn’t been measured but at a guess 90
Extension - 0

5. Icing for an hour at a time when needed throughout day and night, usually four or five times a day

6. Elevating whenever I’m seated for at least an hour

7. Housework / one thing a day. Ie dust one day. Vacuum the next. I can’t do more than that because I overheat and it causes extreme pain. Shopping. Only pick up one or two things at a timely the shop, as I can’t walk for long.

8. Not exercising at all. Surgeon does not want any physiotherapist or exercise at all.

Note: since leaving hospital I get periods of sweating and cold at the same time. Don’t appear to have a temperature. Discussed with GP who said it is probably the medication.




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shelli22 said:
1. Pain levels right now 6 when sitting. 8 when up and pottering.
Click to expand...
Gosh, that's high!
shelli22 said:
2. Pain medications
Tramadol 200mg slow release x1 at night
Mersyndol x 2 - six hourly 450/30/5 paracetamol/codeine phosphate/doxyalamine
I get periods of sweating and cold at the same time
Click to expand...
I've never had much faith in codeine for knees. And extended release can do that. I'd suggest you lower the dose of Tramadol at night or maybe even change it. Ask your doctor if you can have a lower dose 100mgs or better yet, just have regular Tramadol and lose the Mersyndol. If he agrees, don't forget to take 1,000mg paracetamol with every dose which should be 50 or 100mgs every six hours.
shelli22 said:
3. No 3 huge
Click to expand...
Ouch!
shelli22 said:
4. ROM hasn’t been measured but at a guess 90
Extension - 0
Click to expand...
Not bad considering.
shelli22 said:
5. Icing for an hour at a time when needed throughout day and night, usually four or five times a day
6. Elevating whenever I’m seated for at least an hour
Click to expand...
Not bad but could be more.
 
@Josephine thanks for your response. I went to see the surgeon as I am supposed to return to work. However, on hearing my condition during the past month and explanation of the pain, fever/chills and lack of energy he decided to do some investigation. He aspirated fluid from my knee and also sent bloods off again because there was no report from those sent at the time of the arthroscopy. On Thursday I am going back for the results and on Friday going to see their physician and following this determine what the next step will entail.


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Will do [emoji4]


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Hi @Josephine. The result showed blood only, in the aspirate. No infection. The blood test only showed slightly raised ESR. Have appointment with physician tomorrow. The surgeon is not convinced that there is nothing wrong with my knee, either infection or allergy to metal, and is almost convinced that it will need a revision. If or when the physician is happy that my general health is ok the next step will be to do another aspirate to check protein level, another test for infection. Such a long process but I want to get to the bottom of the constant pain and stiffness.

I then had an appointment with the physician. He went through my general health and ordered tests for lupus and rheumatoid arthritis and a urinalysis, however is convinced that the problem is within my knee but he isn’t sure what. Sigh. Next step back to the surgeon.


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Last edited:
Hi Josephine, Celle and Jamie. I have just been back to the surgeon and am probably going to have revision due to low grade infection and possible allergy.

Although tests came back inconclusive I will have another next week. If that is positive then a 2 stage revision. If negative then go in for revision either one stage or two depending on the result of the test they do in theatre.

I’m not looking forward to the possibility of two weeks in hospital then four weeks home then back in to have the new knee put in but I can’t work like this either. Anyway just thought I’d update you four years plus later. Thanks for reading [emoji4]


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How disturbing to hear what you are going through. I pray it's not an infection. An allergy will be must easier to fix. Be sure to keep us informed about what you find out. We care.
 
Oh, Shelli22....I'm so very sorry to hear you're going to need a revision. But it sounds as though you've continued to have problems with this knee so hopefully the revision will give you the good recovery you've hoped for. I'm glad you came back to BoneSmart so that we can provide whatever support you may need as you work through this. You know we'll be here for you! Let us know how things go, please!
 
I hope it’s not an infection too. However, I am hot and cold and have no appetite and extremely tired but can’t sleep. Who know. I hope it is allergy. We shall see I guess
 
@Jamie it’s been a long road of never no pain and lots of issues along the way. I’ve been reading all the posts on infection and metal allergy. It’s just so difficult when none of the tests have come back definitive.

On the positive side, at least I know I don’t have lupus or rheumatoid arthritis. My blood pressure was rather high though I do think that was stress and white coat syndrome as I’ve always had that. At the end of the day I can’t do an eight hour shift until this is fixed. So I’m just going to have to accept that it is what it is and do it. Hopefully third time lucky. Thanks for your reply x
 
Make sure that whatever metal testing you have done is the expanded test. Here in the states it's only done by a lab in Chicago. I'm not sure how metal testing is done in Australia, but I'd ask. Here's the link to the USA website. You want the Orthopedic Panel 2:

https://www.orthopedicanalysis.com/testing/order-testing-panel

Research is finding that some of these allergic sensitivities can be fairly difficult to diagnose, but they can really affect an implant's performance. You want to be able to completely rule this out along with the RA and lupus.
 
I think many of us ought to bookmark this page just in case it is needed in the future. Too bad insurance doesn't pay for it.
 
I have no RA or lupus. Those tests came back clear. Next test is on Thursday - aspirate and check for specific protein to determine if there’s infection. Regardless the surgeon will use a knee that I won’t react to. He will also use cement rather than screws.
 
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shelli22 said:
The surgeon won’t do metal testing. He believes they’re inconclusive.
Click to expand...
It's quite true that the skin testing can be inconclusive, but the full blood testing is not.
Even though the blood testing is not covered by insurance, I think you have a right to have it done. It makes no sense to miss out on testing for one of the possible causes of your knee pain.
 
I will research who does it here in Australia and if it’s the same as those in the US.


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@ Jamie. I’m still waiting for Thursday to be tested for infection. Odd though. To date I have had awful pain that felt like the original bone pain, a constant sickening ache. However, in the last few weeks a new pain has become evident since the last operation. The pain is a shooting pain which comes from any direction and honestly is that bad I jump and catch my breath. Never had that before.

I still have lots of swelling and taking panadol regularly and tramadol as well. The last thing I want to do is have another revision but have accepted I can’t continue to work and live in so much pain and with so much swelling.


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