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

Josephine

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10 weeks out
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.
O-er! That's not nice!
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.
What about Tylenol? It's one of the best non-prescription meds on the market and terribly underrated. I suggest you try 1,000mgs 4 times a day (6hrly) and you can take that with the Naproxen.
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.
No it won't because ibuprofen is a fairly lack-lustre pain killer! And it has some pretty ghastly side effects.
Medications: acetaminophen (Tylenol, paracetamol) and NSAIDs, differences and dangers. Naproxen is an NSAID too but one of the 'nonselective COX inhibitor' so less likely to have those side effects.

Penetrex is a compilation of the following:
Water (Aqua)
Arnica Montana Flower Extract
Helianthus Annuus (Sunflower) Seed Oil
Glycerin
Glyceryl Stearate
PEG-100 Stearate
Cetyl Esters
Steareth-20
Pyridoxine Hydrochloride (Vitamin B6)
Methylsulfonylmethane (MSM/DMSO2)
Glucosamine (Vegetable Source)
Bilineurine Bitartrate
Ethoxydiglycol
Methyl Gluceth-20
Cetyl Myristoleate
Aloe Barbadensis (Aloe Vera) Leaf Extract
Butyrospermum Parkii (Shea Butter)
Boswellia Serrata (Frankincense) Oil
Mentha Piperita (Peppermint) Oil
Cinnamomum Camphora (Camphor)
Melaleuca Alternifolia (Tea Tree) Leaf Oil
Tocopherol (Vitamin E)
Dipotassium Glycyrrhizinate
Dimethicone
Ammonium Acryloyl-Dimethyltaurate/VP Copolymer
Phenoxyethanol
DMDM Hydantoin
Iodopropynyl Butylcarbamate​
However, apart from all that, I saw a documentary not so long ago that investigated the claims of topical applications, specifically Voltrol Gel and Ibuleve, and proved beyond reasonable doubt that the substances actually don't penetrate much more than a very few mm into the skin. Certainly not into the deeper tissues, much less the knee joint! In short, pretty useless.
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.)
So left is 110/0 and right is 106/-5 which is pretty okay in my book for 10 weeks 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.
Okay, that's good!
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.
Good, good
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. :)
And a stool to elevate your legs on I trust!
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.
Oh no, that's bad! I am so please you are not doing that any more. Truth to tell, there are LOTS of members on here who have done their TKR recovery yet done NO exercises at all! I recommend you read my recovery thread to see how little exercising I did for either knee! Knee recoveries UK style Parts I & II (Josephine). Yet despite this, we all had really good outcomes!

Home exercises:
Heel slides 10x2 times a day - two things here: a) your knees don't need any more of these. And b) you're doing them all wrong anyway! Read this Heel slides and how to do them properly.
Hang my knees off the bed for extension for 10 minutes once a day - you don't need these either. ONe knee has zero and the other is very close behind.
Stretching with my daughters help as she works my quads and hamstrings once a day - you shouldn't allow anyone to 'help' you do exercises. It's very, very bad for you.
I confess I find exercises confusing. This forum talks about no exercise and yet I feel compelled to do something! - you need to control this. You're actually doing quite enough activity anyway and really don't need any of those exercises.

So in summary, your approach is that if you're not doing exercises your doing nothing, is that right? So what about this
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
That's not exactly doing nothing, is it? It's activity and that's all you need right not.

Because of those exercises (on top of everything else) you are getting a 'stabbing pain that takes my breath away, stiffness that gets to me too. rate the stiffness at a 6 and have moderate swelling'

Your activity is fine but you need to not cut back on exercises but cut them out! There are the cause of the pain, stiffness and so on that you are complaining about. Of course, stopping them won't mean those symptoms go away completely. It will likely take several weeks for it to abate but abate it will. Be patient!
 
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DLC1128

DLC1128

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Hi Josephine!
Thanks for all your advice! I will cut back on exercises ad continue the activity! Today I am cleaning out cabinets! But, I am taking frequent breaks and icing my knees during them.

I'll keep taking the Naproxen and add Tylenol. It is slow and steady!
Diana
 

sistersinhim

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Slow and steady is definitely the way to recovery!
 
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DLC1128

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Stiff, STIFF, STIFF! This is what I am most tired of! I understand all the pathophysiology behind why doesn't mean I have to like it! People keep telling me that it may last for "months". Well, how many months? 6? 9? 10? 12? I just want to be able to get up from a chair and out of my car without looking like an old lady with arthritis! (well, I probably am that but hey!)
 

sistersinhim

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I hated that patience word! But, that's what it takes to get through this recovery. The stiffness is usually the last thing to go. That stiffness comes from the inside swelling. Once that is gone, so is the stiffness. Again I say that word...patience!
 

KarriB

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Getting up and out of a sitting position was difficult for a quite a while. As a first grade teacher I was up/down a lot and never felt good about it. It took a full year for it to come naturally. Remember this is a new part your body is becoming accustomed to using along with the healing that’s still happening even though you can’t see it.
 

kneeper

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Yes, though it diminished over time, I'd get stiff if I stood for more than about 20 minutes at a time or sat for an hour. At 3-6 months, my leg would feel like a (achy) log after standing to teach a class for an hour or so.
The good news is that month by month I could "work it out" with a few steps (for sitting) or sitting for a few minutes (for standing). I'd say it took about a year to become a non-issue.

Doesn't help you right now, I know. But there is light at the end of the tunnel.
 

Kayaknlady

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I’m 14 weeks post op and have stiffness, especially in the morning. I find riding a stationary bike really loosens up the knees and I’m ready to move. I take naproxen in the am as well.
 

kmak81230

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As others have said, the stiffness is one of the last things to go -- I think I stopped being so stiff after getting up or after sitting for a long time around the 6 month mark. I'm just over 8 months and don't really notice it anymore. Like Kayaknlady said, the biking helps to get things loosened up - or just walking it out.
 

rickj

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Hi DLC,
So I’m 13 1/2 months cooked now.
Stiffness is a minor thing now, although if I’m sitting in the car for an hour or more, I still get a little stiff and have to walk it off. It may be like this for the rest of my days, oh well!
So in my recovery , For the last few months, I’ve felt about 90 percent healed, and the process seemed to slow down. I still go to the gym 4 times a week and bike (stationary) some elliptical,knee type machines ( geared for quad muscles and hamstrings) although I feel like I am close to the finish line, whatever the hell that might be, it feels like the improvement is quite slow, maybe slower than my first year.
Not complaining mind you, I could hardly walk,the few months pre-surgery. But I was concerned about why my quad muscles particularly in my left knee would feel real sore when walking downstairs most of the time. These muscles should be healed by this time, dammit!
Then I re-looked up scar tissue. I had been working the area around my knees with these little yoga balls, but I decided to really amp up how hard I worked the “sore“ spots with these yoga balls.
I’ve been doing this for about a week and a half and my God! What a huge difference in how my knees feel.
So I’m having a longer and longer stretches of not even thinking about my knees , They’re feeling stronger, and that old dirty word, patience , keeps knocking me on the head. In essence after a little over a year knees are still improving..
 
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DLC1128

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Hi, I am nine months post op bilateral TKR and recently started experiencing new pain in my right knee. I've also lost a little ROM in that knee as well. It has always been the knee that has lagged behind the other one but recently it has expressed annoyance more often.

I have been to my surgeon and he placed me on a steroid pack but it has done no good. He wants to inject the knee or consider MUA, but I don't want either of those. I'm really more worried about the possibility of an infection that may have set it but thinking that nine months out that shouldn't be a problem.

Any thoughts?
 

Celle

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Hi @DLC1128
You'll notice that I have merged your newest thread with your original recovery thread. It's still less than a year since your surgeries and your previous thread might throw some light on your current problems - I'm sorry you have new pain.
For several reasons, we prefer that you only have one recovery thread:
  • That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
  • If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
  • Having only one thread will act as a diary of your progress that you can look back on.
So please post any updates, questions or concerns about your recovery here.
Don't worry that we won't see your question because, between us, the staff read all new posts every day.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

If you prefer a different thread title, just post what you want and we'll get it changed for you.

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.
 

Celle

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I'm sorry your right knee is causing you problems now. I think it's a good idea to ask @Josephine for her advice.
 

Josephine

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recently started experiencing new pain in my right knee.
Sorry about this - let's see if we can get to the root of it.
Can you show me the site of this pain using this chart?

aa knee-references-horz.jpg




And then 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?
 
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DLC1128

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The pain is in my right lateral side on the outside of the of the right knee. It comes and goes but is getting worse and not better. Also, there is still some swelling in my right knee as well. Not sure how else to describe it.
 
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DLC1128

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RickJ how are you working the scar tissue? That might make a difference for me...

Thanks!
 

Josephine

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The pain is in my right lateral side on the outside of the of the right knee.
@DLC1128 this is no good - I need the references from the chart. If you don't understand what I mean, look at the smaller of the two images which explains it.
 
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DLC1128

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It is in the RF1 D&E portion of my knee.
 

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