TKR Am not dead!

[Ms.fixit]

.....also, in my own defense, I have wicked Fibromyalgia, have had for years, so the all over body pain also causes me to be VERY unwilling to voluntarily expose myself to any more pain or disability. As it is, right now on a good day I can be up for about 3 hours til the Fibro pain forces me home to bed, even with Capsaicin patches plastered all over. I't a drag, but it's been my reality since 2 bad bouts of Lyme disease in the 90's. I'm hoping that when I am all the way healed, it might not be as severe as it is now.

 

[skigirl]

I agree that you know your own body best---also, the specter of pain and surgery, anesthesia, etc is a very real consideration. It sounds like you are improving, just slowly. Since you were a dancer, you have the self discipline to work on your own recovery. I hope things improve soon. I know that Margaret Campervan was able to slog along and had some stunning results.

 

[Ms.fixit]

Hark! I haz made progress!

I went to NYC this week to take care of my Mom and was amazed to find that I have more ROM than I realized, because I was able to descend the Subway steps normally! Last time, I had to lift my hip a little, so it is a small improvement, but very real. I also walked 30 blocks or so and felt really good, plus Mrs Knee didn't get upset with me later..no swelling or tightness (til next afternoon when I really pushed my luck because I felt so good).

While I was in the City I took Mom to get her hair done and talked to her hairdresser who had TKR about 5 years ago. I asked her what she thought of my ROM so far, and she said"That's great! At 4 months it's really too soon to have much more than that anyway". It was very reassuring to talk to someone who had progressed slowly and had not had an MUA, but who 5 years later, has full flexion with only gentle PT and exercise.

Another observation..all the stairs I do at home every day might have something to do with my tightness..In NYC it's all flat, or elevators, and it seemed to do me good to have a few days off from stairs.
I'm checking in with my surgeon tomorrow..don't know what he will think, but I am feeling really happy about my progress and that's what matters.
My energy levels are also higher..I don't have to crash for 2 days anymore when I return from NYC;today I went out in the yard and did battle with our bamboo grove and my lopper for a couple hours.
things are starting to get really good!

 

[skigirl]

What wonderful news!!!

 

[bottomshollow]

Great update, Ms.fixit!!!!! Funny how one day you just realize that all kinds of things have gotten so much better. And things will keep getting better and better for you!!!

Take care and keep us posted. We care.

 

[Ms.fixit]

Thank you so much, ladies!
Today I saw my OS for my final post-op check and was declared awesomely recovered and free to roam the land.( I walked into the office in my beloved 4" platform boots..I haven't been able to wear those suckers for a year!) The doctor and my PT, who was also there, were both very pleased with my progress..full extension and about 97 degrees of ROM.. and didn't say boo about an MUA, just advised me to continue my exercises and come back in a years time. I am finally free of medical supervision and am feeling more energetic by the day! This is beginning to be fun..bet you never thought you'd hear me say that!

 

[skigirl]

Wonderful news--send us photos of the the new shoes!!!

 

[Ms.fixit]

Hi , smarties! I'm doing really well here..full of energy and motivation!
I went from wondering if I would ever want to do anything again, to having my husband beg me to slow down because he cannot keep up with me at the mall.
Right now I'm experiencing that twangy tendon that gets kind of "caught" on my kneecap when I bend it. It's on the inside side of the patella. It can actually be sharply painful as it slides over that spot but I have heard other patients mention it, so I'm not too freaked. It does bring me up short with a yelp, no matter where I am the last 5 days or so, so I hope it quickly runs it's course.
Still at about 92 degrees of ROM, but I still have a lot of stiffness at 4 months out, so I don't push it too hard, just slow and steady stretching, with the assumption that the joint will continue to calm down and allow me to move more as I heal.

 

[denpucc]

I too am really afraid of the pain management. I've had so many surgeries that perocet doesn't even tough my pain. sometimes i feel the docs think i'm a drug addict because it was difficult to get my pain under control after arthoscopic surgery!!! I just want the pain to be managed so i can rest, ice and elevate and do some PT. my surgery isn't until december which means i have many months to worry. i will talk to the OS before the surgery to see what he does for pain management but i'm concerned the same thing will happen to me - felt prepared because discussed before the surgery but am ignored after!

 

[Ms.fixit]

Denpucc, one thing I failed to do prior to the surgery was to attend the seminar they give for each batch of patients, where they actually have the pain team there and anesthesiology as well. I was having wicked fibromyalgia that day and had been to the OS and went home to bed..but I hadn't been aware that those people would be there, either or I might have toughed it out.
Anyway, if they offer this at your hospital, GO! You can talk to them there and you have a good chance of being heard. Also, keep someone with you the day they take out your nerve block, or otherwise dramatically de-escalate your pain meds post-op. that way if you start to go crazy, they can stay on top of things for you. Good luck!!

 

[skigirl]

Ms.fixit---I was thinking of you and wanted to say that one of the things that I did for myself at 4 months was to wear either a compression stocking or a compression sleeve when I was going on a long walk or a prolonged activity. In my case, I think my lymphatic system has been affected by six surgeries on that left knee and it does not always drain properly. I find that a compression sleeve or a thigh hi footless compression stocking helps to avoid swelling. So, when you are looking at a trip to NYC or a two mile walk, you might try one and see what you think. I bought the compression hose from a website called Discount Surgical Stockings and the sleeve from a running stuff store---you probably have better access to things right in stores since you live in a city environment. I live in rural Montana and lots of things just don't exist out here!!!

I wore the compression stocking for standing for long periods and aggressive physical stuff for almost six months--it really helped. I also had a lymphatic massage specialist look at my leg. I thought her suggestions and help were very useful. She put a wrap with lots of tunnels on my leg---I thought it looked pretty hokey and only wore it to be nice!! I was so surprised the next am to see the swelling visibly diminished.

 

[Ms.fixit]

Oh, Kelly,what a good idea! I still have my stockings from the hospital and I'll try this!! Thank you so much! The new knee is still about 2" bigger than the other one..I measure now, because it's not as obvious visually, but I can tell by how tight it is, that a lot is still going on. (Did you also get the painful-plucking/twanging-tendon phenomena near the patella on the inside?)
I just didn't think to use compression any more,I didn't realize it might still help ,but I'll try it as soon as I finish writing you!.
Question..how long did it take you to rebuild your quad? You seem very active also, and this is bugging me having a skinny leg and a nice muscle-y one. I am doing just a touch of leg extension work with weights, but I don't want to aggravate things so I'm mostly hoping normal activity helps..but so far, leg is still too thin and my other leg mocks it all the time.
I'm rural too, when I'm not in NYC, so I am a big mail order shopper too.

Thanks again! Val

 

[Ms.fixit]

Dang! I no sooner get all boasty about how well I'm doing, than I am humbled and temporarily taken out of play. Grrr! Rawr!
I was totally careful yesterday...since the knee was swollen and stiff, I iced and elevated much of the day. No stairs..and usually I am up and down easily fifty or more times a day. Rest helped tremendously;swelling is gone, joint is looser,the tendon that has been snagging is less inflamed, etc. I am resting today til this evening when I am scheduled as a guest speaker at a nearby psychiatric/addiction hospital.

But as careful as I'm being, I reached for something an hour ago..and my back went out!
I'm on ice, wearing a brace, having a sad for myself.

 

[skigirl]

If it isn't one thing, it's another!! I empathize, I have to stop and do water therapy for a couple of weeks when my back yells at me. But, that is the stage of recovery where you are right now---five good days, one bad day, etc. Soon the good days will make you forget the bad days!! I did get some compression sleeves from a running store and they also work which convinces me that it is my lymphatic system that is not working at peak efficiency!!

 

[Ms.fixit]

I'm glad to know I'm fairly normal with the back stuff.
Did you have any episodes of a tendon on the inside side of the new knee, catching painfully on God knows what as it glides past the implant? I'm wondering if it'a happening because the swelling is less and maybe the tendons and ligaments need to shrink to hold things more securely? This is new as of about 10 days ago, so it freaked me out.

 

[Ms.fixit]

Hey Kelly; I took your advice and got a compression sleeve for my knee; thank you.. it definitely helps both the nerve pain and the weird/painful tendon that catches on the implant when I walk. What IS that, though????

 

[skigirl]

I am not sure---not a doc, unfortunately!! I would guess it is either your Medial Collateral Ligament that might be a little Tight and it "catching" when you bend your knee. Or it is possible for a piece of the synovial lining to get caught in the joint itself. This does hurt when it happens. I will tag Josephine for you since she knows a lot more than I do about the anatomy of the knee!

I am glad that the compression sleeve is working. I have thigh hi stockings with feet and without. I also have a compression sleeve that I wear on my calf and I have knee high compression socks. I wear all of them at different times. I am aware of the fact that my lymphatic system is not working as well as it might right now and keep hoping that compression will help.

 

[Ms.fixit]

Oh, the synovial lining thing sounds about right.!.I didn't even know that was a possibility..but thanks very much and also for referring this to Josephine! I bought some Kinesiology Tape today..my PT used it on me right after surgery, when my sural nerve-or-something was on fire and it made a major difference. They have a bunch of videos on their website demonstrating how to address various pain conditions/injuries on the body. I'm excited to learn more.
Thanks again for all the help!

 

[Josephine]

That's called a Hoffa's syndrome and you can read about it here Patello-femoral pain syndrome (PFPS), fat pad impingement (Hoffa's Syndrome).

 

[Ms.fixit]

Thank you so much Josephine! You nailed it, and I am guilty of going up and down stairs a million times a day, which is specifically noted as a causal factor. I notice that when I go to care for my mom in NYC and have no stairs for a few days, it calms down.
I had been doing stairs on purpose because my quad has atrophied and I want to build up the muscle again,( and descending gives it a good stretch, too).
Then I curtailed the number of trips( my office is on the second floor) and it helps. Another reason not to be galloping up and down stairs all the time is that, when I descend, I still have to raise the hip a bit, because our risers are steep, and after awhile I throw my back out. I had almost no back problems for years, until my TKR..but the new configuration of my bod has thrown me in new directions, I've thrown my back twice in 2 months!
thanks so much for this feedback..I know what to do now!