5 weeks out and very little bend in knee

[Jennifer]

Hello everyone, I have been reading all posts for the past few weeks, and haven't seen any other post with my problems. I was supposed to have both knees done sep 9 hopefully only partial replacements, but instead I ended up with total knee replacement in my left knee, and because the drill bit broke in my bone, was under for 3 hours and only one knee done.
My problem has been non stop pain and surgeon cutting back my meds. Was on tramadol 50mg 2 every 6 hours and codeine 30mg 2 every 6hr, but he cut that back at 3 weeks to just tramadol 1 every 6 hrs. I luckily had some codeine left and have that down to 1 every 6hr as well as the tramadol, but still pain. I do have full extension but no bend or very little.
Being completely honest, I just can't take any more pain, so needless to say the exercises are very half hearted, but still have so much swelling. I ice all the time, can walk without crutches, can put weight on new knee etc. Just can't get the bend going. I find I have lost any sense of humor, seem down a lot, and quite cranky. I am sleeping 3 hoursat a time at night, wake up take pain pill and go back to sleep for another 3 hrs.
I'm wondering how much the drill breaking in my bone, is affecting the pain. I normally have a very high pain tolerance, but not this time.
After reading your posts, I'm wondering if being undermedicated is my problem. Any help at all will be much appreciated at this point. Thank goodness I found this site!

 

[hess]

Jennifer,

Your body really needs to be comfortable right now. There is NO way that you will get the most out of your exercises if you are not properly medicated. DON'T think that your pain tolerance is too low, because you just came off of a major surgery, and 5 weeks isn't far enough to be worrying about that! You really need to talk to him, or maybe see your primary physician, and he or she might be able to help. Good luck, and please push for more meds, because you truly do need them! Keep us posted as to how you are doing.
Hess

 

[Simon]

Jennifer

Being in pain is counterproductive. You can't exercise and get the bend needed with that much pain. If your OS will not provide correct pain relieve, call your primary doctor.

If the OS gives you any grief about the pain meds and won't cooperative with your primary physician tell him that his surgery will be a failure because you can't exercise do to pain. I was lucky as my OS actually had a TKR so understood that but due to distance I just had my primary care doctor manage the pain.

Things will be more comfortable and the ROM will come when you are more comfortable.

Simon

 

[Nursepair]

Jennifer, so sorry to hear you are still in so much pain. You really need to be on stronger meds. Your OS needs shooting in the kneecaps and told he can't have any strong pain killers!! Either keep pestering him or his office daily or see your GP. Are you having Physio outside or only exercise at home?

You should be at physio still. I know in England (my place of birth) they don't always give enough physio, my mum and aunt are living cases after hip surgery, my mum can't bend to put her shoes or anything on, has to use aids, and my aunt can't walk more than 2 steps, in my opinion they never had enough physio, about 2 weks I think.

How is the after care in NZ? Anyway, wish you all the best, keep posting. Sue

 

[Linda2]

You definitely need better medication! I don't know how it works in your country, but get the pain meds from your primary care physician if you can. If not, badger the OS. I might skip shooting him in the kneecap--I hear they aren't so generous with pain meds in prison.

 

[Jennifer]

Thanks for your replies, as I suspected that I needed more pain meds and see my surgeon next Wed and if no help will go to primary Dr next. I'm going to physio once a week, (at my own cost) and she is very good but doesn't know what to say as to why no bend but figures it has to do with the extra trauma the leg has gone thru getting the drill bit removed. Has anyone ever heard of drill bit breaking in leg bone before. OS doesn't discuss that part of surgery at all!!
What I am so worried about is will the bend come after this amount of time.Will be 6 weeks next tues. Plus with both knees needing the replacement and only one done, my non operated knee is in a lot of pain and swelling especially since so much more pressure is put on it to save operated leg. Don't see how I can win that one. OS originally wanted to do second knee at 6 weeks but I know that is not an option for me. In fact if I can bear it, it definitely won't be til next year I hope.
Being so dependant on friends bothers me a lot, as I'm normally such an independant lady.My dog and I moved to NZ 2 years ago from Canada, so have no family here, so thank goodness for friends, but I never imagined I would still be needing so much help still. Feeling very housebound as driving is out of the question of course. Dog is a little upset over his lack of walks as well!! Going down to corner and back just doesn't cut it with him.

 

[Josephine]

You are in a fix, and no mistake! I am totally with the others about nagging your surgeon for more meds. I find it odd you all have to go back to the surgeons because here in the UK, once you're out of hospital, all after care in terms of meds is down to the GPs who generally seem to be more sympathetic.

As for the drill breaking, I have seen it happen about twice in my career and on each occasion was down to heavy handed usage plus one was a drill that probably shouldn't have been on the tray in the first place as it had been in use for almost two years. These tools have a certain life and there are some shouldn't even be used a second time yet they get put back on the trays time and again because the TSSU staff (Theatre Sterile Supply Unit) have either not been trained properly or have management that is sloppy so no-one cares.

What ever the reason for the drill being in use, when it snapped it became a round object in a small cavity and trust me, that is not an easy thing to grasp! In my experiences, the struggle to even get a hold on it, much less pull it out, is testing to say the least. Then the reason the drill snapped is because it got impacted inside the bone which means it was tight in there too. Sorry if this graphic description is making you queasy, but you did ask! The end result is yes, yes! the struggle to remove the drill bit would very seriously affect your recovery and the amount of pain you are experiencing. I am shocked that your surgeon is being so parsimonious about pain meds under the circumstances that it's HIS fault you are in as much pain as you are. You should say as much to him and if he tries to fob you off, stand your ground and say it again!

As far as your other knee is concerned, if I were in your shoes, I'd sooner travel a 100 miles to someone else than let him anywhere near it. Just my personal opinion, you understand!

 

[AlaskanTKR]

Jennifer -
Sorry to hear about all that you have gone through. I know that the American System of health care definitely has many flaws - but fortunately for me both my husbands insureance and mine have been excellent. We rarely use them so whe we do it is usually a big one. We haven't met deductibles in 2 years but this year - Oh Boy! My kid broke her wrist and then my knee - we are covered at 100 percent for the rest of the year. hopefully by then I will be released from PT - now that the MUA has been done. I am one of the lucky one here - I am at PT 3 days a week - and they are awesome - They have even said I can swing by any time to use the toal gym or the bike (I own a great treadmill - bu the bike has been excellent). Not only are the pts great to work with as far as the knee itself - but they are also fantastic sources of moral support.

I can't even imagine how your knee feels - Haing a drill stuck and then removed has had to cause a great deal of pain in addition to the normal pain associated with all this - I too would seek someone else out to discuss your other knee. I don't think the guy you are seeing currently has shared enogh info withyou about what really happened. And I can't believe he cut your meds back so early. i tried that myself -thinking I was more than ready - NOPE - Bad mistake. Now I am being a good little patient and taking them as directed all the time and what a differnce it is making!

The people here have been great with advice and more importantly the moral support that it sounds like you need right now. My family is NY, My husbands sister-in -law is relatively close by and the group I work with is wonderful - but their plates are full and I never wanted to ask for much help outside of the school day - but the members here are just wonderful - they can make you giggle even on the worst day. Check in regularly - They understand what we are each going through like no other friends I have - I am 42 so most of my firends have little or no experience and son't really understand why it is important to get your bend back - or why the knee actually hurts 3 months after an operation - or why I need to elevate and ice so much or go to pt - Here - we share a common theme - besides the knee - its really about the friends here you can sympathize (and know exactly where you are coming from -

Hang in there - I finally turned the corner after 3 long months - and it feels so much better knowing I could share not just the "whiney" moments (and I have had many) but also the silly goofy wonderful feeling sof success - like when the bike peday went around for the first time or when I hit a new ROM number.

Marianne

 

[justjuls]

I am 9 weeks out and have had one manipulation. I still can not bend. I do my excersises like I should and see a therapist 3 times a week. I am starting to question if my therapist(not through my OS office, but through my local hospital) is doing all that they can do for me? Or if I should go to the OS office for therapy(which is over an hour drive each way).

Also, my Therapy office has an aquascisor (spelling) and has wondered if that would help me at all. Can anyone advise if they've used the underwater treadmill in their recovery and if so did it help? I don't see why it would hurt and I am going to talk to the PT tomorrow when I get there.

I am still depressed but not as bad since I started the Lexapro but my thigh is so sore. The OS says it is swelling that eventually will go away, but to me it feels as though my knee is too big for the space it has. Can anyone tell me how long this feeling last?

Again, this website has been a lifesavor, as I can not even tell you all how dark my thoughts have gotten through this entire process.


Thanks for listening!

Juls

 

[mvo]

Hi Jennifer,

Greetings from a fellow Kiwi

I suggest you go to your GP very soon, dont wait, and get him/her to prescribe more/better pain medication. Don't wait until you see your surgeon.

Regards,
Monica

 

[AlaskanTKR]

Juls -

I am a fellow Lexapro user - It really did wonders for me when I needed it. I was extremely worried about "needing" something for my anxiety issues. Just a sidebar - I ran out last week -I was so worried the anxiety would just hit me like a brick once it was out of my system - especially dealing with the MUA and hip thing I have going - My prescription is via the mail so I have been out almost a week - they came today and I can't decide if I should start back on them. So... if you forget or run out - don't panic - I have sone just fine. i am going to call the Doc and see if I should try life - now that things are looking more positive without them for a while. Not sure what she will say. But theywere a real lifesaver for me.


I guess the pain just takes a while. I was pretty "pain free" until we would push at PT to the max rom - since the MUA now it really hurts when not elevated - I am pretty sure it is just a side bar to the MUA and will improve - from what I understand from my hubby - the os did a lot of shoving around. I wish the husband had asked better questions. i knew I wouldn't see the OS after the procedure - He slid me in and then had to get over to the office for regular hours - I was 7am and his office visitis started at 8am- so... I may call down to ask a few questioons but may hold off till I see him in a little more than a week.

Juls - hang in - Ive been here since June - and I try to get on everyday - I stopped for a bit when school first started and was miserable - I thought my posts were all so whiney and negative - and they were - but the forum here truly understands and is here to support you through the ups and downs.


They were brutally honset about my typing skills the day of my TKR (stoned teacher on a computer - not a good scene) and when I looked back on those posts I really laughed!

Ok - enough rambling - I had better prep for those meetings before I fall asleep!

Marianne

 

[Jennifer]

You guys are great, and it does help all the good advice, even your graphic description Josephine : )
When I did question the OS how he got drill bit out, he did say he could see the end of the bit, and had to chisel bone away from it, till he could use a tool to grab it and get it out. That is all he has said. That with your description does make me believe that I'm not imagining this pain.
I did have physio yesterday and took the advice and took 2 tramadol before, and lo and behold we did much better, and got it bending more than ever before. Of course I'm paying for it today, but I always try to take it easy the day after. I also brought with me a Costco no name pill equivalent to Alleve, and am adding that to my daily intake. So hopefully things will come better. It's sat here so no Dr until Monday but will go see my primary Dr and get something done right away. Thank you all for your support and advice, and it does certainly help knowing you are not alone.
ps to fellow Kiwi (I call myself a KanWi) - where in NZ do you live? I'm in Rangiora north of Christchurch.

 

[mvo]

Hi Jennifer,

I live in Hamilton, but had my surgery (left total hip replacement) in Rotorua, nearly six weeks ago.

This forum has been invaluable. I did a heap of research before my op, but all focused on the types of procedures, implants etc and pretty much didn't think about the "afterwards". Of course, when the afterwards becomes "now" you have a whole different set of questions and worries

 

[schoust]

Hey there Jen!
It seems to all of us that your surgeon has not been doing you very much justice! heck as far as I am concerned you should be moving on especially if he is not even concerned about how your pain is! I do not know how the system is down under but I have believe that you have to have pain specialists?? If so I regroup and seek one out immediately! There simply is know reason what so ever for what you are having to go through!! Man it fires me up when I here things like this! Do your research Jen and ask lot's of questions three simply has to be someone that can help!!
Ralph

 

[Jennifer]

Hello again to everyone, and thank you all so much for the input. Ralph there is no pain specialists that I know of, but I do have an appt with my primary doctor for tomorrow. I don't know if he is aware of what has happened, but will talk to him re pain control. Hopefully this is the beginning of improvements. I do see the OS Wed am, and will see what he has to say. I know that I won't be doing the second knee this year, but will wait til early next year. i hope all is good with the rest of you, and will keep you posted as to what happens next.

 

[mvo]

Hi Jennifer,

All the best with your GP visit tomorrow. Your GP should have had a summary/discharge letter from your surgeon/hospital which describes what was done to you (including the broken drill bit!) and the state/condition you were in when you were discharged. I hope he or she is properly sympathetic and prescribes appropriately.

Monica

 

[Jennifer]

Hello again, just wanted to share a laugh with you all, and let you know what both doctors, primary and OS had to say.
Saw primary yesterday, and good news is he gave me some oxycodone and for the first time in years and especially last 6 weeks, no pain for almost 8 hours. Was an incredible feeling.
Went to OS today, and feels I might need a manipulation come 3 months if I can't get bend by myself. Asked what I was taking for pain, I told him of how much pain I'm in, and I only mentioned the tramadol (that he had prescribed) and his answer was to get off it, and just take aspirin when I needed it!! Took all my willpower not to laugh out loud, and just meekly left, and took my oxycodone for the day as soon as I got out of his office. Been doing exercises today, and must say it's much easier to grin and bare it and get I'm getting a little more done that what I was previously able to do. So thanks for all the advice, and I'm a much happier camper.
Take care

Jennifer

 

[mvo]

Hi Jennifer,

Great to hear that your GP got things sorted. I don't know how you kept your face straight for the OS. Impressive willpower, I think I would have blurted out something very rude!

All the best,
Monica