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[BILATERAL TKR] 9 months post op and new pain<^

Discussion in 'Knee Replacement Recovery Area' started by DLC1128, Oct 17, 2017.

  1. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    That's interesting and concerning. I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
     
  2. DLC1128

    DLC1128 junior member
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    Ask away!
     
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  3. rickj

    rickj junior member

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    Boy, you are impatient! Actually probably right on track and it sounds like you’re doing really well. I’m at 10 months and a week. I’ve been posting responses here and there where I see somebody’s post that really kind of strikes my reality
    I’ve made a couple of recent posts of how well I’m doing at this point, enjoying longer periods where my knees feel quite well, and I’m able to walk at least 4 1/2 miles.
    One thing that is always seemed the truest for me, is that my recovery is best defined for me, is— one step forward, 3/4 of a step backwards.
    This is true even to this day.,
    I have continued my physical therapy by going to the YMCA where I have a routine of about 10 minutes on the exercise bike, 10 minutes on elliptical, various other machines like crunch machines etc. some pool -water walking and stuff I’ve made up in the pool
    Machine that I love to do work on now in addition to the above is a quad machine specifically to strengthen my quads. It was probably at the start of the 10th month —again for me, that I had finally reached the other side. The other side meaning I no longer felt overwhelmed by the recovery process, but that I was on top of the recovery process. The swelling has reduced to probably 5% of the worst of the swelling through this process. (I’ve got a feeling that I suffered at least as much swelling and stiffness as anybody in this forum. )I’m happy to say I’m at the positive end of this.
    As a matter fact this particular day, I figure 3/4 of the day I totally enjoyed the feeling of, “My knees sure feel good“.(mmmmmm yessss!
    I felt almost this good 3 days ago and hit the gym—-the following days I felt sore and stiffer. I’ve learned this works for me -gym one day then 2 days no gym. I still go to work
    What this really means is today was the day to go to the gym and aggressively work on my knees with bicycle elliptical swimming etc. and my knees are not going to feel real wonderful tomorrow, and it’s going to be probably 2 to 3 days where I again feel like “my knees sure feel good“, but in three days I’m going to have that feeling for 10 minutes longer than I did today. And that’s just the way goes for me- so slow. But after 10 months and all those little increments of an eighth of an inch of improvement a day, add up and I feel 80% healed, and I also feel that I have more healing to go, but it is so so much better, and like I say the bulk of today I felt a nice normal. And I do realize that I’m probably not gonna feel like that every day for maybe another 2 to 3 months. I’ve certainly learned patience.!
    I’ve also realized I’m pretty grateful And I’ve got new knees, it’s just a year-long roughly deal for me.
    Maybe it won’t take this long for you, just wanted to let you know there is an end to this thing!!
     
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  4. SusieShoes

    SusieShoes FORUM ADVISOR Forum Advisor

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    Rick makes some really good points about being patient with how long this recovery takes. Keep in mind that he’s ten months into his recovery, so some of the things he can do now, people only a couple months into recovery should not do yet —like leg presses and other gym machines (except for upper body). He’s working his recovery his way. Started out slow, realized it was slow, and is now working with knees he knows very well indeed.
     
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  5. DLC1128

    DLC1128 junior member
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    Sigh, I had some major swelling last evening and this morning so today I am elevating and icing. I’m at 11 weeks now so I’ll keep going. The improvements are harder to see now. One day good, two days bad. I know I’m walking too much for my stage of recovery. Can’t seem to help myself. I grocery shop, lunch with friends, drive my car and clean house. Somedays my knees hurt so bad at the end of the day that I can barely keep still. I’m going to try and rest the next few days. See how it goes from here.
     
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  6. rickj

    rickj junior member

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    At 11 weeks you are!
    Sounds to me you’re maybe pushing a little too hard.
    I really know how you feel. I really do!
    The fact is, even though you feel like doing a lot of walking stuff like that, you have a lot of healing to do. Healing. That’s cuz those tissues in your knees and surrounding area have been ravaged. If you have any doubts about That , Watch the video of the TKR procedure. We got torn up pretty good during this operation. And it’s got to heal, and it takes time, and patience.
    10 months I still elevate, sometimes ice not so much.
    Maybe focus more on your ROM if it’s not as good as you’d like it to be. Stretching, rom exercises.
    My PT’s and my surgeon made it pretty clear that at about 12 weeks and even beyond, they were not concerned About me walking at all. He said there’s plenty of time for that later, work on your ROM while it’s fairly easy to get improvement on ROM.
    It did take me a while before I felt like I could really enjoy a feeling of relief. They’re coming. Trust me.
    Be patient. If you feel sorry for yourself watch some wounded warrior videos. These guys have a bigger struggle than you and I have. I watched a show about a guy who lost both of his legs below the knee, and he worked his butt off to get up and walk again with full prosthetic legs from the knee down. Hell of a guy. Made me feel embarrassed for feeling sorry for myself.
    I don’t mean to negate the fact that recovering from BTKR is not a tough haul. It is. And it’s obvious you’re in there fighting. But you Gotta get some discipline on the elevating and taking it a little easy.I guarantee you, from a 10 month guy, you’re going to really enjoy your new knees You’ll get there, you’re certainly feisty enough
     
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  7. rickj

    rickj junior member

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    Sorry to be so blabby. But at 11 weeks, oh boy, you are so early on the recovery. What you’re experiencing is normal. Sorry, they lied to us! We’re not done at three or four months! don’t know maybe some people are.
    Personally, I’m going to be putting myself to the test December 16. I’m going to Disneyland with my grandkids. Actually I feel pretty confident, but I know I’m going to be doing a lot of walking
     
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  8. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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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?
    ai63.tinypic.com_eta39s.jpg

    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.
     
  9. kneeper

    kneeper FORUM ADVISOR Forum Advisor

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    You do have to pace yourself for quite a while. It can feel frustrating to not be able to do everything you want to all on one day, but it does help.
     
  10. DLC1128

    DLC1128 junior member
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    1) Pain levels are at 6-8. There are times I have no pain, and other times I have stabbing pain that takes my breath away. The stiffness is the thing that gets to me too. I would rate the stiffness at a 6.

    2) I am not taking any prescription pain meds anymore. I was prescribed Percocet, but quit taking those fairly early in my recovery. Percocet makes me feel funky and Tramadol does nothing for me. I have reactions to almost all narcotic pain meds so tend to stay away from them. I am allergic to MSO4 and to Dilaudid. I take naproxen 200 mg twice a day.

    3) Moderate swelling; Left is more swollen then right. Right is more stiff then left. Go figure. I still have inflammation in both knees as both are warm to hot every day. I use a cream on them called penetrex which helps the inflammation. I will take ibuprofen for the inflammation sometimes (not for pain) but it doesn’t seem to help.

    4) Flexion is at 110 degrees for left; Right at 106 degrees; extension is 0 for left; right is at 5 (I can’t quite get the right knee to straighten out.)

    5) I ice sporadically. Today I have iced most of the day and kept my legs elevated. Tomorrow I hope to do the same. Otherwise, I have been icing in the evening when I am essentially done for the day. I can ice for 30-40 minutes at a time for each knee.

    6) I have a bed that has an elevation feature for my legs and I have been elevating them every evening in bed. When sitting in the living room I also elevate them, so unless I am sitting in a restaurant my knees are up. It doesn’t seem to help the swelling, however.

    7). Level of activity: well I confess I belong to the ODIC club. I live with my daughter right now (while I am recovering) who has three teenagers. So I find myself washing dishes multiple times a day and straightening up the house. I don’t cook, but will fix a sandwich or something for myself to eat during the day. I also have lunch with friends quite a bit as well as running errands. I do drive and I have a stick shift. I do grocery shopping about once a week and have been Christmas shopping as well. I go back to work January 3rd and I am a college professor so will be on my feet a bit. I plan on making sure the lecture hall has a stool for me to sit on. :)

    8) No PT at this time. I did 12 sessions and they sent a plan of care to my OS for approval to keep up the PT, but they have not heard back from him. I wasn’t terribly happy with my PT anyway as he had me do leg presses, using bands on my ankles and squats. I always felt terrible after he finished and needed to go home and ice and rest.

    Home exercises:
    Heel slides 10x2 times a day
    Hang my knees off the bed for extension for 10 minutes once a day
    Stretching with my daughters help as she works my quads and hamstrings once a day.
    I confess I find exercises confusing. This forum talks about no exercise and yet I feel compelled to do something! So any help you can give me on what to do I would appreciate.

    I think that covers it. There is one thing you should probably know. It has impacted my “sitting still” and also how I feel about this whole thing. My youngest daughter died this past summer quite unexpectedly. She was 41. She died in July and I had my surgery in September. I thought about delaying the surgery for a bit, but knew Rachel would not want me to do that. She knew how much my knees bothered me. In hindsight, the emotional upheaval I was (and am) still working through, along with the physical pain, was really too much at one time. It impacted my willingness to endure pain (not!) and my emotional state. So I know this has impacted my recovery as well.
     
    Last edited: Dec 7, 2017
  11. rickj

    rickj junior member

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    Hi 1128 !
    Reading your posts brings back some of my recovery from the great blur!!
    I remember I did have some restlessness also, and had to figure how to keep myself busy, and do something productive!

    Yes....the heel slides! I got some exercises from my PT’s, but I also kind of improvised some exercises also. Curling my toes towards my head—which stretches calf muscles leg lifts. Had a yoga friend help teach me to breath.
    (I’d forgotten about that, made a huge impact in the initial really painful pt exercises). Huge!
    Do you have a pt that can help you put an exercise regimen together?
    I bet one of the forum advisors maybe can help refer on that?
    My two cents would be to incorporate some yoga breathing in there
    I’ll keep you posted on my Disneyland trip!
     
  12. rickj

    rickj junior member

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    Can you do exercise bike????? Even a tiny bit????That’s been my number one once I got beyond the real basic rehab exercises. And for the longest time not really to pedal against resistance but just to move my legs and get my knees in motion
     
  13. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    @Dlcrn1128, I'm so sorry to hear about your daughter. What a terrible loss for you. My condolences.

    However, two things:
    1. can you please answer my personal message otherwise I shall have to change your username for you

    2. you mention taking Percocet and Tramadol but failed to answer the rest of the question which was "how much are you taking (or did you take) and how often". I need that information before I can proceed.
     
  14. DLC1128

    DLC1128 junior member
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    Josephine,

    I am not taking any narcotic pain meds anymore. I was prescribed Percocet, but quit taking those fairly early in my recovery. Percocet makes me feel funky and Tramadol does nothing for me. I have reactions to almost all narcotic pain meds so tend to stay away from them. I am allergic to MSO4 and to Dilaudid. I take naproxen 200 mg twice a day.


    I am no longer taking Percocet and never took Tramadol.
    Percocet 5/325 1 tab 4 tines a day for a couple of weeks.
    Currently:
    Naproxen 200 mg bid

    Change my user name to DLC1128

    Diana
     
  15. DLC1128

    DLC1128 junior member
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    @rickj Yes I have access to an exercise bike. My daughter has both a bike and an elliptical trainer I could use. I just need to get off my tush and do it!

    No PT around to help. Do have a fairly good idea of what I need to do, however. I do o much walking that I’ve kindda figured I didn’t need much else. I’ll rethink that.

    The past two days I’ve elevated and iced and really stayed off my knees and the swelling is much better this morning as well as my extension and flexion are much improved today. As a bona fide member of the ODIC, I have to work on elevating and icing.

    I see you are in Glendale. Are you impacted by the wildfires? My daughter is going to LA this weekend and is wondering if she should have bought refundable tickets!

    Diana
     
  16. rickj

    rickj junior member

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    Oh that’s great news!
    For myself at first, I’d use the exercise bike, again, not so much to push against resistance, but really just to keep my knees in motion. Get them started up for the day! After a while it became therapeutic not just because my knees were loosened up a little bit, but it just started to feel good to move them. You know what I mean ? (Some actual payoff!) If you don’t yet, you well.
    As I continued I kept the resistance low but adjusted the seat lower gradually which forced a little more bend each time. Again I did this gradually. Even now when I go to the gym I do pedal against more resistant, but my focus is more on Length of time pedaling and dropping the seat step at a time more and more to force bend on the knees

    Again for me, it seems like it was always one step forward, 3/4 of a step back. And so the progress for me was slow.
    most of the time I had a hard time telling if I was making any progress or not. I’d kind be moaning that I don’t feel like I’m making much progress, and my wife would throw her hands up in the air ingreat disbelief, are you kidding??!! Why last week you couldn’t even blah blah blah!
     
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    Last edited: Dec 8, 2017
  17. rickj

    rickj junior member

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    Oh Re the fires
    Not so so much personally impacted. 3 Different friends were evacuated but they’re getting back without their homes being burned!
     
  18. rickj

    rickj junior member

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    Whats ODIC?
     
  19. KarriB

    KarriB FORUM ADVISOR Forum Advisor

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    You’re right, walking is great for your knee! I now walk a few miles 4-5 days a week and bike on a recumbent nearly every day. But if your knee is swelling that’s a cue to back off of activity and rest that new knee.
     
  20. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    :scratch: I expect it would do nothing for you if you never took it!! (joke)
    Done and thank you.
     

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