Revision TKR 3 years out - Injury?worked

[kneeper]

I got so mad when she said he wasn't going to give me any more narcotics, (2wks out now), that I decided to not ask anymore. Thank God I had an entire bottle of tramadol 100mgs in the medicine cabinet from my PCP prior to my surgery.

Which is exactly what we shouldn't be doing! If they actually would prescribe for us they wouldn't have people scrounging for leftovers in the medicine cabinet.

I'm not surprised you're not finding the tylenol 4 very effective @HookEm613 . I never found pain meds with codeine particularly good. And one every 6 hours? I didn't go down to every six hours for at least 4 weeks and that was with vicodin. Boo on your doc.

 

[HookEm613]

I went to PT on Friday and right away the therapist noticed how stiff my knee was. I measured at only 55, but by the time PT was over and I was warmed up, it was back up to 77. Our goal is to hit 90 by next week, but the swelling is horrendous. I am really working to reduce my time on my feet, and add more time icing and elevating. Yesterday I was basically only up to do the dishes and cook dinner. Today I just did laundry and cleaned the master, and I've been sitting with elevation and ice otherwise. I am so bored lol!!

I learned my lesson the hard way about over doing it last week. We went to Home Depot and hobby lobby, and it felt so good to walk with my cane. It was the best I felt since my surgery! Well, the next day I woke up and paid for it 10 times over. I won't make that mistake again!

My doctor said that once I get to 90, I can get back on the gym and at least do the bike and upper body. The movement worked wonders for me after my last knee surgery in terms of stiffness and swelling. I need to get there again, so when I get to 90, we are going to try it in therapy first...even just 5-10 minutes to start.

My doctor has been wanting me to stop taking my pain pills unless I absolutely need it. I'm taking one Tylenol4 every 4-6 hours, but I will take 2 before therapy. The pain has increased a bit but it's manageable. I had no idea that they would want me to stop taking medicine so soon. Two weeks out seems so hard to believe. It's odd that I asked for Tramadol and they said that it's not strong enough, then turned around and told me to only take my medicine if I absolutely need it.

Anyhow, I am frustrated but I can't complain. Things are going pretty well so I just remind myself to keep looking forward.


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[sistersinhim]

I'm sure you've read before, but you should never take pain meds before therapy. It just masks the pain that you're really causing and you will pay for it later. You're swelling because you're not letting your knee heal by doing too much. I found this that Josephine had posted. Look at all these layers of stitching you have!

Wounds are closed in 'layers' each with several stitches meaning
1. the joint capsule is closed then
2. the muscle
3. the fascia - which is a white, fibrous outside layer of the muscle
4. the fat
5. the sub-dermal layer of the skin - meaning the 2-3mm immediately below the skin
6. and finally the outside skin

As a recap:
2, 3 are the main anchors that holds the wound closed
5 is the one that holds the skin closed.
6 is mostly cosmetic, probably unnecessary, and may either be further closed with staples or Steristrips.
1-4 are closed with absorbable sutures
5 is closed with a single long stitch that runs the length of the wound called either subdermal or subcuticul

 

[newlybionic]

Make sure you are elevating the correct way. Knee above your hip and foot above your knee. Having your leg parallel to the floor will not help you decrease your swelling. Keep ice on it as much as possible. That will bring your swelling down and increase your ROM. I agree with sistersinhim that you shouldn't take any extra pain meds before PT. You don't want to do anything in PT that hurts but only to the point of discomfort and that's it.

 

[HookEm613]

Good point, I didn't think of that at all.


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[LFitz]

I stopped PT about a week after I joined bonesmart, my last appointment my therapist had me on the floor kneeling on my good knee holding onto a parallel bar and trying to bend into my tkr knee. My knee had so little bend I could barely hold the bar and I was bawling in pain , and then she had me stop that and sit back from that position to straighten the leg (I'm still crying feeling totally defeated and embarrassed that I am crying) and while she was kind to me these were her words. "Did you take you pains meds an hour before you came?" I responded yes I always do. She said you probably should double up so we can do these things. That was my last appointment. I remembered reading on here that you should never have to increase pain meds to get through a therapy session because then you are masking pain that could be injuring your knee.


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[HookEm613]

Oh wow!! That is horrible! That woman is going to hurt someone! My therapist has been very gentle, so I should be fine without the meds but I am interested to see how it will be without them. The PT assistant at the same clinic was horrible, she made me so mad. I cancelled all sessions with her.


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[LFitz]

If it is gentle than it shouldn't be any worse that your pain level during your daily living at this point. I'm glad you cancelled all those appts with the assistant. Smart lady!


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[Suz]

My first Home PT left me in tears when without notice she shoved my knee in for a better flexion number. I figure any PT that hurts you to the point of tears is in the wrong calling. I ended Home PT after that. The more PT I did during my early days of recovery the more swelling my knee gave back. And of course swelling gives back poor ROM! Hopefully BoneSmart is the beginning of a new revolution in the recovery of knee & hip joints!

 

[amab]

"I learned my lesson the hard way about over doing it last week"

Something all or at least many of us have learned in the healing process.....sometimes you have to go slow to go fast...chalk last week up to experience .

Keep looking forward!!

(Almost became a longhorn fan while living in Austin and attending a number of games.....but have always been and will always be an Alabama Crimson Tide football fan...."Roll Tide")

 

[Gigi32]

I know I've said this before but you are doing way, way, way too much activity at this point and the swelling in your knee is a result of that. You're not even 4 weeks out yet and fixing dinner, cleaning up, Hobby Lobby, Home Depot, and going to PT 2 or 3 times a week? I know you're a lot younger than a lot of us who are on here, but your knee has been through the same trauma and is responding the same way as the knees of us old folks. You may have gotten your energy back quicker but if you continue to abuse your knee instead of resting, icing, elevating and letting it heal, it is going to continue to remain swollen and the longer that goes on the greater the risk becomes you will develop scar tissue and need a MUA. Listen to your body - if you're having pain and increased swelling it means you need to ice and rest.

 

[HookEm613]

Yes, I am going to have a serious talk with my significant other today and let him know that at least for the next week, I am going to take is super easy. When my knee is feeling good, I am super close to 90. Trouble is, 75% of the time, it's too swollen to even get close. I have to be at 90 by next Tuesday (4 weeks) or my doctor wants to do a MUA. The house is going to have to stay dirty or he is going to have to clean. I can't be on my feet as much as I have been. I'm also going to look for crockpot recipes that will last a few days. My daughter's second birthday party is next Saturday so I'm going have him order maid service late this week too. I am cheap, he is always offering the service but why pay for what I can do? But, if there was ever a time, this is it!


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[Celle]

I have to be at 90 by next Tuesday (4 weeks) or my doctor wants to do a MUA

Just remember that this is you surgeon's timetable. It doesn't have to be yours. My surgeon doesn't expect 90 until at least 6 weeks and even then he is prepared to be flexible.

You've seen for yourself that it is the swelling that prevents your knee from bending. Therefor, it makes sense to me that having an MUA is not necessary, as getting rid of the swelling would be more effective.
Instead, concentrate on reducing the swelling, with lots of this: rest, elevate, ice - and don't be lured into working harder with exercises.

In any case, this is your knee. While your surgeon may recommend a MUA, you are the only one who can consent to having it done. You have the absolute right to decide what happens to your knee.
So, you can politely say that you would like a little longer before deciding and your surgeon has to accept your decision.

 

[Suz]

When my surgeon suggested an MUA to me at 6wks where I was only at 50*s in flexion I suggested I would like a little longer to try and get it improved. He was ok with that and wanted to see me in two weeks to recheck it. Did I come home and start banging away at bending it and going to PT? Nope!

I got off of it, got it up & kept ice on it. In 2wks it increased 42*s and my surgeon was happy! In my humble opinion it's allot easier to get that swelling down the BoneSmart Mantra's way than going through an MUA this early in your recovery.

Hoping for great improvement in your ROM in the coming days @HookEm613!

 

[HookEm613]

I am no good at this medicine stuff, somehow I thought that the doctor would release you from care if you refused. I am definitely refusing an MUA this early!

On another note, I woke up still swollen, but I have a noticeable improvement in bend. I spent a lot of time elevating yesterday so perhaps that's why, but I am confused. Is this normal? I would suspect I am at 90 or very close today. I wish I could measure but I'm not going to the store haha.

Either way, I told my significant other that I am doing a whole lot of nothing the next week. The bend today feels amazing and I'm not going backwards!


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[Suz]

I always have more bend when I've elevated for a few days! And yes, it feels awesome! Josephine has a neat chart where you can get a visual measurement- I'll see if I can locate it and post it here for you!

 

[uva55]

 

[newlybionic]

Yeas @Suz there is an article that tells how to take a picture and post it and she can let you know what it is.

@HookEm613 You've now found the key to greater ROM. Stick with it. I know it's hard with young children but the time you take now will be worth it in the long run. Schedule a lot of downtime after your daughter's birthday. You will need the rest.

 

[Suz]

So this one isn't as nice as Josephines but it will at least give you something to refer to until someone can post the article Marian mentioned! Click on it to enlarge it!

 

[HookEm613]

Based on that, I would definitely say I am around 80. Elevation is a miracle worker!!!!!


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