THR 3 joint replacements within the past 4 months
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ArthriticWonder
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Hi Josephine ,
1. pain is usually around a 2. When my knee locked up on me it was a 7. Sometimes at night I get nerve zingers that bring it to a 5 but those are intermittent.
2. I take 325 mg Tylenol at 8:30am, 10:30am, 1:00pm, and 4:00pm. Then at night I still need a 5mg pill of Oxycodone. I have a lot of nerve issues at night.
3. I dixie cup ice my knees when I'm done with PT immediately after that session (so about twice a day). I rarely elevate anymore.
4. I elevate if it gets noticeably swollen for 20 minutes about twice an hour for a couple of hours. I also do edema mobilization therapy daily twice a day since my first replacement. Doctors, PT's, and lay people comment on how little swelling I do have.
5. RTKR....flexion 120 extension 0 (5 months out). LTKR...flexion 117 extension 0 (3 months out).
6. I go up and down 16 stairs about 6-10 times a day, I clean the kitchen, cook daily. I dust once a week but still can't vacuum. I work in the yard but need to sit a lot. I grocery shop about twice a week.
7. PT exercises: lying down: heel slides on slide board lying down, ab/adduction on slid board lying down, short arc extensions, long arc extensions, leg straightening stretches, isometric ab/adduction, active ab/adduction with SB, glute squeezes. ALL of these 3/18 twice day. Standing: mini squats, heel/toe raises, single leg flexion, bosu ball mini squats, ab/adduction, forward backward. ALL of these 3/18-20 twice a day. Step (using a 4 inch step...single leg step ups 20 each leg forward and backward). I was biking on the recumbent for 6 minutes but that really bothered my hip and R knee so I have stopped that. (Before my L hip and L knee replacement, I was biking 30 minutes a day with little resistance but have since stopped with all joints being replaced now). I was walking up to 3 miles total a day till last week. PT did introduce new single leg forward lunges on the bosu ball last week....and I believe that is what set me back.
I can tell that my R leg/knee is NOT tracking correctly. It clunks A LOT and I'm getting weird muscle pain from inside of that knee up to my groin. When I sit on my sit bones my R one pops in and out of place.
1. pain is usually around a 2. When my knee locked up on me it was a 7. Sometimes at night I get nerve zingers that bring it to a 5 but those are intermittent.
2. I take 325 mg Tylenol at 8:30am, 10:30am, 1:00pm, and 4:00pm. Then at night I still need a 5mg pill of Oxycodone. I have a lot of nerve issues at night.
3. I dixie cup ice my knees when I'm done with PT immediately after that session (so about twice a day). I rarely elevate anymore.
4. I elevate if it gets noticeably swollen for 20 minutes about twice an hour for a couple of hours. I also do edema mobilization therapy daily twice a day since my first replacement. Doctors, PT's, and lay people comment on how little swelling I do have.
5. RTKR....flexion 120 extension 0 (5 months out). LTKR...flexion 117 extension 0 (3 months out).
6. I go up and down 16 stairs about 6-10 times a day, I clean the kitchen, cook daily. I dust once a week but still can't vacuum. I work in the yard but need to sit a lot. I grocery shop about twice a week.
7. PT exercises: lying down: heel slides on slide board lying down, ab/adduction on slid board lying down, short arc extensions, long arc extensions, leg straightening stretches, isometric ab/adduction, active ab/adduction with SB, glute squeezes. ALL of these 3/18 twice day. Standing: mini squats, heel/toe raises, single leg flexion, bosu ball mini squats, ab/adduction, forward backward. ALL of these 3/18-20 twice a day. Step (using a 4 inch step...single leg step ups 20 each leg forward and backward). I was biking on the recumbent for 6 minutes but that really bothered my hip and R knee so I have stopped that. (Before my L hip and L knee replacement, I was biking 30 minutes a day with little resistance but have since stopped with all joints being replaced now). I was walking up to 3 miles total a day till last week. PT did introduce new single leg forward lunges on the bosu ball last week....and I believe that is what set me back.
I can tell that my R leg/knee is NOT tracking correctly. It clunks A LOT and I'm getting weird muscle pain from inside of that knee up to my groin. When I sit on my sit bones my R one pops in and out of place.
OP
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ArthriticWonder
new member
I just want to add that although I don't have super pain most of the time...my body is NOT recruiting correctly. The nerves are in overdrive and I do feel very un-coordinated and unable to really use my legs that way I want to ...or the way I used to....I feel fake. I don't know if this makes sense...but I feel very mechanical and it's weird!!!
HerbM
senior
Great job on handling so much surgery.
I am only on Surgery #1, a week ago today with BTKR scheduled for Oct 21.
I notice you not only have another hip planned but also a back operation. Sounds like you are still carrying quite a bit of trouble that needs a fixin'.
If your knees only "need to rest" after walking and you weren't doing damage then good on you (I did 30 minutes the 2nd morning after with no issue), and I wouldn't tell you to slow down, but if you ended up there as a RESULT of your physical activity then the answer is going to be obvious -- pull it back or divert that extra energy to something else.
I am trying to find a near by school or group to do yoga right now as unlike most people who see a DRAIN on their energy, my energy has been BOOSTED following the surgery -- need to put it somewhere nurturing to my new hip and body (and my mind.)
So it's not really the sitting itself but the rising from the sitting where you feel the stiffness?
I am getting this, contracture I think from our recent THR I believe -- at least it my case but might be a completely different thing for you. My damaged tissues shrink or draw up while my waist is folded and when standing it has to stretch back out -- for me, not painful, but it feels like it COULD be so I do it slowly and stretch it fully each time I am able.
For me it passes as soon as I straighten up and stretch it slightly. If yours is actually painful or lasting longer than a "warm up stretch" would take then perhaps that is something to investigate with Dr. or PT while you are there anyway.
I don't have 3.5 weeks Anterior THR yet so can't say, but at 1 week (at 1 hour really) there was virtually no pain for me, but YOU CANNOT compare yourself to others.
And if in fact you insist on a comparison you are WAY AHEAD even without counting the knees AND surgeries in the future.
Lot's of people told me at first to "slow down" and you'll get a lot of that too.
Here's the deal, even if I think they over do that advice sometimes, it doesn't mean it is bad advice nor that it isn't absolutely correct SOME (if not most) of the time.
If you are damaging yourself by your behavior, then STOP (or at least modify) it.
On the other hand if you can find a balance that let's you do what is truly important and/or joyful for you then do it with caution and prudence.
This is one week for me today, and I am "back at work" with no problem.
That might not be true NEXT WEEK. Just because it is true one day or one week doesn't make it true EVERY DAY or EVERY WEEK.
The trap is thinking that progress is ALWAYS FORWARD. Sometimes you must backtrack or divert around obstacles.
Good luck -- interested to hear more of your story.
Your recovery is YOUR recovery and no one else's. Do the right thing.
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ArthriticWonder
new member
Herb...or should I do @HerbM ...THANKS for both replies. I completely agree with you that our neurological pathways, muscles, brain have adapted to survival ways of mobility before our replacements and that we need to carefully retrain all of that. It takes time. I'm mindful with my movement and have been doing some "retraining" in my physical therapy and myofascial therapy. I think having had 3 replacements within 4 months has been more of an adjustment than I anticipated-that is what feels fake to me...I feel very mechanical right now...definitely a learning curve. I had another set back today...so I am waiting to see my surgeon on Friday. I wanted to respond to your comments. I appreciate them. Knee replacements are much different and from my experience much more painful than hip replacements. I see you are having bilateral TKR in October. I assume you are prepared for that recovery. It will be completely different from your hip!!!!
ConnieJOS
senior
@ArthriticWonder I totally relate to what you are saying. I have had both hips and one knee replaced since March, and I have that same feeling with walking. I feel like I'm "pretending" to walk normally. I have to make a conscious effort to put my heel down first, then toe, and bend my knee. I'll be glad when that comes naturally again! Best wishes to you @HerbM ! I agree that knees are completely different. I sailed right through recovery for the hips, but this knee has been difficult. And I have to go back for the other knee. I admire those that do both at the same time. It would be nice for both of mine to be recovering now, but I know it would be a difficult process. My doctor didn't recommend it so I really didn't consider trying that.
HerbM
senior
Even with one hip (done), I suspect that we are all talking about the same "fake movement" even though that isn't the first word *I* would have chosen.
You folks have more things to relearn than I do (right now) but yes, it will happen again for me when the knees are done, no matter how much progress I make with the hip in the mean time.
You are both right from everything I have heard or read: Knees are harder than hips, and two knees are tougher.
I could probably have done two hips (the same way, anterior, same surgeon, Exparel) and walked out with MINIMAL differences from what my experiences are now.
After all, there is essentially no pain in my hip or entire upper procedure leg. Both knees hurt and interfere far more than my new hip does. (I still have rehab to do, just that it isn't pain or any significant limitation to simple stuff around the house or getting in/out of car etc.)
Thanks for the warning on the knees -- I am NOT finished preparing for the BTKR YET, but likely my preparation is already more complete than 95% of the people that have ONE knee done. It's a process and a work in progress which includes my knee rehab.
IN fact, most of the rehab for my hip I do is with an eye towards the end of October and my knees.
I am so sorry for your setback and hope the surgeon will be able to offer immediate and practical assistance to help clear that up and get you on track, pointed in the right direction.
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HippyHelen
junior member
Wow! I need all that done too but can't take time from work. You are a strong woman!!
Josephine
NURSE DIRECTOR EMERITA
@ArthriticWonder I will get to your answers soon. I've been trying all day but have now run out of time as it's 1am and I am working tomorrow! So sorry.
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ArthriticWonder
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@Josephine that is ok, no need to follow up on that. @HerbM and @ConnieJOS thanks for your feedback. I apologize if I have messed up the administrative aspect of this. I saw my surgeon yesterday (after being in the ER a last Saturday night). He drained a lot of blood from my knee and gave me a cortisone shot to reduce the swelling. He was hoping the drained fluid would be clear (which would mean conservative measures would remedy that easier because the soft tissue was only being impinged by too much swelling) but since there was A LOT of blood, this means that my soft tissue impingement is bleeding=NOT GOOD. Surgeon sent blood to lab to check on infection (which is highly doubtful). Surgeon was upset to see this much blood because it makes the conservative process to resolve this more difficult. I am to lay low with ROM movements on this knee for the weekend to let the cortisone reduce the swelling. I can do some gentle ROM biking and do normal types of activities. I am supposed to wear my compression sleeve. If my knee locks up again, I am to call him immediately as I would then most likely need surgery to resolve this impingement issue. (Since my post about my ER visit...my knee locked up on me again this past Wednesday while at work....). So, I am bummed out and worried about this. I haven't really had any chance to start using this knee because I went into two other surgeries after this one. Thanks for reading.
HerbM
senior
Wow! I didn't even realize this knee wasn't your most recent surgery.
You are braver than I am; I would have being lying on the floor at the ER demanding to see someone.
Stay with it and stick to the plan so that maybe you can clear this quickly.
Thanks for writing -- I am ENJOYING reading except for you are not 100% comfortable YET.
You are braver than I am; I would have being lying on the floor at the ER demanding to see someone.
Stay with it and stick to the plan so that maybe you can clear this quickly.
Thanks for writing -- I am ENJOYING reading except for you are not 100% comfortable YET.
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ArthriticWonder
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HerbM
senior
And I am glad you NOTICED though it was intended as a message for your unconscious mind to select a target and work towards that 100% comfort and success.
(NLP and Hypnosis language. It actually WORKS, I have seen people do so much good by just turning things around like this. I will take every advantage, wish the same for you, and hope you will be wonderfully healthy as soon as possible and not a moment sooner....
)
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ArthriticWonder
new member
I'm trying to remain positive but my knee locked up on me 5 times last night. NO SLEEP-EXHAUSTED. My surgeon told me if my knee locked up on me after the cortisone, I should call him. I guess I'll be calling on Tuesday. Has anyone experienced soft tissue impingement with bleeding 5 months post TKR? I was doing really well and haven't had any "real" issues with this knee till two-weeks ago. Logically, it doesn't make sense.
Josephine
NURSE DIRECTOR EMERITA
I looked back at your answers and noted what you were doing for exercise:
PT exercises:
ALL of these twice day
heel slides on slide board lying down 18x3
ab/adduction on slide board lying down 18x3
short arc extensions18x3
long arc extensions18x3
leg straightening stretches 18x3
isometric ab/adduction 18x3
active ab/adduction with SB 18x3
glute squeezes 18x3
mini squats 18x3
heel/toe raises 18x3
single leg flexion 18x3
bosu ball mini squats 18x3
ab/adduction, forward backward 18x3
Step - using a 4 inch step, single leg step ups 20 each leg forward and backward
Do you realise that this all adds up to 1,876 exercises per day ?
And I don't suppose you ever took a day of rest in there anywhere, did you?
Have you ever told your surgeon how much you were doing?
This seems to me like a case of acute inflammation created by exercise which has become so intense it's bleeding! It can happen.
PT exercises:
ALL of these twice day
heel slides on slide board lying down 18x3
ab/adduction on slide board lying down 18x3
short arc extensions18x3
long arc extensions18x3
leg straightening stretches 18x3
isometric ab/adduction 18x3
active ab/adduction with SB 18x3
glute squeezes 18x3
mini squats 18x3
heel/toe raises 18x3
single leg flexion 18x3
bosu ball mini squats 18x3
ab/adduction, forward backward 18x3
Step - using a 4 inch step, single leg step ups 20 each leg forward and backward
Do you realise that this all adds up to 1,876 exercises per day ?
And I don't suppose you ever took a day of rest in there anywhere, did you?
Have you ever told your surgeon how much you were doing?
This seems to me like a case of acute inflammation created by exercise which has become so intense it's bleeding! It can happen.
HerbM
senior
I am so sorry for your Knee Pain and trouble and also sorry I know nothing specific to help you.
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OP
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ArthriticWonder
new member
Thanks again for the replies! I guess that is a lot of exercise. However, the lying "exercises" are really just ROM moves for the joint-gentle. I never knew this could actually happen. I was instructed to do the exercises twice a day (and I will admit that sometimes I only did the weight bearing exercises once a day). So, it wasn't quite that much but I do believe the single leg lunges were the straw that broke the camels back.
My PT told me that I do have hamstring bursitis at the origin. And, after sitting my knee is the worse. It almost locked up on me at work yesterday. I called my surgeon yesterday (to inform him that my knee did lock up 5 times after the cortisone injection and to get some guidelines with movement). He told me to lay low over the holiday weekend, which I did. I continue to lay low but my knee continues to get stiffer and stiffer because I'm not moving it much. I see my PT tomorrow and hopefully I will get some guidance.
QUESTION....can soft tissue impingement with bleeding heal without surgery? If so, how long does this process take? My entire R leg is in spasm and I'm limping due to pain.
My PT told me that I do have hamstring bursitis at the origin. And, after sitting my knee is the worse. It almost locked up on me at work yesterday. I called my surgeon yesterday (to inform him that my knee did lock up 5 times after the cortisone injection and to get some guidelines with movement). He told me to lay low over the holiday weekend, which I did. I continue to lay low but my knee continues to get stiffer and stiffer because I'm not moving it much. I see my PT tomorrow and hopefully I will get some guidance.
QUESTION....can soft tissue impingement with bleeding heal without surgery? If so, how long does this process take? My entire R leg is in spasm and I'm limping due to pain.
Let me tag @Josephine to answer your question.
Josephine
NURSE DIRECTOR EMERITA
I doubt that. I think it's more likely the bursitis.
Actually, I'm a little confused by the PT's diagnosis of "hamstring bursitis" as there actually aren't any bursae around the origin of the hamstrings!
I think he meant tendinitis!Of course it can, provided it's not a brisk and persistent bleed. But from what you've said it doesn't appear to be that - like your knee is not swelling up like a huge balloon. If it was, you'd be in extremis (acute pain!). So most small bleeds will ultimately be taken care of in the usual, natural way with clotting, just like it does if you graze your knee or slice your finger with a kitchen knife.
How long it takes is another thing. It depends why it is bleeding. There are many reasons why this might be
1. an inflammatory process which is bleeding because it's so inflamed
2. something is scraping on it but I can't think what. I've never heard of an 'impingement' doing that
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