TKR A new chapter begins - 16 Dec 2014

[kaydubs]

Hope you're feeling better!

 

[lunula]

Hello all. I had to take some time from the BoneSmart boards as I found myself getting very depressed and jealous of others' progress when I was having so many issues. I know I should not compare my story to anyone else, and I also know that some of you have many more issues than me - but I couldn't help feeling more and more sad each time I came here. But, enough of that.

My surgery was a little more than 3 weeks ago. I have been doing a lot of in-home PT and had my surgery follow-up appointment yesterday. Through a lot of hard work, icing, elevation, rest and medications - I am at around 75-80 in my flexion and doing well with my extension. My surgeon told me their benchmark is 90 degrees by 6 weeks, so he felt I was a little ahead of the game and told me to continue on my path.

This morning I woke up and my knee was literally as stiff as a board. I have been icing and elevating all morning and will do some PT as soon as I am done with this post in hopes of loosening it up a little. The cold therapy unit I received after surgery was only a 3-week rental, so I ended up buying one since I find it so useful. Really LOVE this machine.

I am also using a CPM machine which I find very helpful just to keep my knee moving. I ended up renting it for an additional week out of pocket, so I will have it right up until my in-home PT is over. I also purchased an exercise pedal machine using an Amazon gift card I received for Christmas. That should arrive today and I am hoping it will help with just keeping my knee moving.

Unfortunately, I have developed an ugly rash on my surgery knee, on the inside and outside of the knee. This popped up 2 days ago. My surgeon didn't seem concerned, but of course, I am worried it is an allergic reaction to the implant. Given my history with allergies, I am trying to remain calm about it - hoping it clears up soon.

Currently taking OxyContin extended release 10 mg twice per day, and Oxycodone 10-325 every 6 hours or so. I no longer set alarms at night to take meds and I am sleeping through the night about 50% of the time. Also taking Benadryl as needed for my itching and rashes.

Hope all of you are well.

 

[TexasTee]

I'm glad you're back! I totally understand the need to step back though...no matter how often we tell ourselves this surgery is hard and there are very few "text book" recoveries...we still think we'll have one!

I know in my head that knowledge and prep only go so far but it still doesn't really compute that there is only so much that will give you and honestly, it's not all that much.

I'm glad to hear your doc thinks your flex is on track - that's great news!

 

[Celle]

My surgery was a little more than 3 weeks ago. I have been doing a lot of in-home PT and had my surgery follow-up appointment yesterday. Through a lot of hard work, icing, elevation, rest and medications - I am at around 75-80 in my flexion and doing well with my extension. My surgeon told me their benchmark is 90 degrees by 6 weeks, so he felt I was a little ahead of the game and told me to continue on my path.

I really don't think you need to worry. You still have almost 3 weeks before you next see your surgeon and you're already at 75 to 80 degrees. That's actually pretty good.

I'm glad you are resting, icing, elevating and taking your medications, but please don't think that you need to work your knee hard to increase your ROM. Just enough exercise to keep it moving (heel slides are best) is all you need at this stage. As the swelling goes down, your ROM will continue to increase.

I had to take some time from the BoneSmart boards as I found myself getting very depressed and jealous of others' progress when I was having so many issues. I know I should not compare my story to anyone else, and I also know that some of you have many more issues than me - but I couldn't help feeling more and more sad each time I came here.

I'm sorry you felt like that, because really your progress is quite normal. You're getting close to the time when everyone feels frustrated - we call one month out "the dark days of recovery". You feel as though you've been recovering for ever, and think that you should be further ahead than you are, but realise that there is still a long way to go. We understand - but this will pass.

Do try not to compare your recovery to anyone else's. Every knee is different and your knee is recovering according to its own plan.

 

[Clipless]

Your rash sounds more like some kind of contact dermatitis. I wonder if it's an allergic reaction to your new ice machine cuff, or the fluffy liner of the CPM machine. Try wrapping your knee in a smooth pillowcase before using either of those items. In the hospital I was apparently allergic to the vinyl SCD cuffs ("squeezers") on my calves. Luckily the RN caught it early and protected my calves by wrapping them in pillowcases. No problems after that.

 

[SuperSnapper]

Great news that you are on track and feeling better. This is a hard journey. We're all so different and from what I've read each knee is different even for those who have bilateral surgery. You are still in really early days yet.
Just think how far you've come and take each day at a time. I can't believe what a difference a few weeks makes!

Best wishes.

 

[kneeper]

Yeah, my first thought was the cpm machine, but the cold pack liner is another good guess. I didn't get a rash but did put a pillowcase between my leg and the cpm machine "fluff" as I found it uncomfortable.

 

[lunula]

Hi all! The rash is really what bothers me the most right now - I am totally okay with my ROM as long as my OS is happy. I always use a pillowcase or towel when using the cryocuff, so it has never come into contact with my skin and I wear pajamas when in the CPM so my skin isn't in direct contact. Also, my knee/leg doesn't even rub against the sides of the CPM machine, so no way it's a friction rash. I actually have a lot of allergies to detergents, cosmetics, etc. - so no new soap, lotion, etc. I also have eczema, so I used my prescription for that on the rash thinking it might be that, and that hasn't helped one bit.

I started taking photos of it so I could monitor it to see if it gets any worse/better. I will likely just have to wait and see if it is all the medications I am on...that's what I am praying it is!

 

[treypops]

@lunula I feel terrible! I hope I wasn't one of the reasons you had to take a hiatus. My recovery is going pretty well, but I assure you that we are all facing similar challenges, and that every recovery is different. The great thing to me about this forum is the wide range of experiences everyone has. I try to be as positive as possible in my updates as I can because I want to be a source of encouragement, and certainly not a depressant.

I hope you get that rash sorted out. I had a small rash break out at the top of my incision as well, but it cleared after a few days.

 

[Celle]

Perhaps it would be a good idea to show your own doctor that rash? Show him/her the photos too.

That could set your mind at rest, and might produce something topical to put on it, to ease it. That would be better than staying at home and worrying about it.

 

[lunula]

@treypops - oh no, it wasn't you! I am very happy that you are progressing so well, it gives me hope!

@Celle - I ended up calling my dermatologist today and they have moved me to the top of their cancelation list for next week, and she sent in a prescription for a topical steroid ointment that will hopefully alleviate the symptoms until she can see me. I am going to continue taking photos every day.

Both my dermatologist and the OS nurse are concerned after hearing my symptoms and both find it odd that it's only on my surgical knee. I have a terrible feeling it is my nickel allergy and I am deeply regretting that I got the Persona knee. I trusted my OS and his firm recommendation was the newer technology knee and he assured me it only had trace amounts of nickel and I wouldn't have any issues.

Why the heck do they even make these implants with nickel? :(

 

[DogLoverx3]

Well shoot, I will keep good thoughts that your rash is not a reaction to your implant and is able to be dealt with easily.

I've taken several 'breaks' from BS over my extended recovery, so I understand completely. I, too, was always happy to read of people's awesome recoveries but there was always a nagging 'why not me' aspect to it. I promise you though that everyone gets to the same place in the end. Some of us just take the scenic route. ;-) Your ROM is right about where mine was at 3 weeks. I gained and lost ROM several times during my recovery but ended up with pretty great flexion (@145 right now and oddly enough, still increasing!). It just seemed to take forever. I know how hard it is to hear 'be patient' and how early on you are, but you are and you WILL get to your desired outcome!

Please keep us posted on things as you've got a good support group here!

 

[lunula]

@DogLoverx3 - thanks so much for the kind words. I know I am still early in my recovery, but with the onset of the rash I am also experiencing more stiffness. I use my CPM range as a judge - a few days ago, before the rash, I got up to 79. Today, I can barely endure 70. Trying to keep it together, but of course my mind goes to the darkest places! The ointment so far has had zero effect.

I know you've had complications of your own, so it's especially nice to hear from you. Thank you.

 

[Jamie]

Can you post a photo of your rash here for us? Please try not to worry. I doubt if it is related to the implant itself. People frequently do develop cellulitis though. Is it worse, improving or staying the same?

 

[lunula]

Let's see if I can post photos..

Outside of knee:


Inside of knee:


Rash is a little worse than it was a few days ago.

 

[vinny]

All medications even aspirin have some side effects.....might want to google the meds you are taking and see if any list a rash as a side effect.....just a thought...

 

[DogLoverx3]

Of course I'm keeping tabs on you! Your knee is my knee's Irish Twin . I'll be anxious to hear what @Jamie thinks about your pics. She knows her stuff, so hopefully she's right in her initial thoughts. The temporary loss in ROM (and I promise, it IS temporary) could be attributed to any number of things. I used to drive myself batty trying to figure it out; doing too much, not doing enough, the weather, what I ate, yadda yadda. It's best, yet hard, to try not to second guess things. I know you're worried, and I completely feel for you, but try not to let things get you down. That whole annoyingly zen "try not to worry about things you have no control over", although impossible to actually follow, kinda holds true with some of this knee business.

I'm keeping good thoughts for you and I went ahead an tagged Jamie just in case she missed your pics. If she's not on tonight, she probably will be tomorrow.

 

[treypops]

@lunula Hang in there. I really hope someone can get to the bottom of this rash as soon as possible. We are all in this together.

 

[TexasTee]

Agree with all of the above! I hope your dermatologist can set you mind at ease quickly.

 

[Jamie]

Thanks for the photos. The two areas appear in the photos to look different in their presentation. Is that the case? Is the one on the outside of your knee older and maybe started like the one on the inside? Are either sore or warm to the touch? Now that @Josephine is back home and checking in on the forum now and then I'd I'd like her to take a look.

I do think you need to be seen by either your GP or dermatologist. The inside rash looks possibly like cellulitis to me. The one on the outside, though, actually appears more like bruising. I still believe neither would be associated with problems with your implant.