TKR Back to square one?<

[Josephine]

Did I not just tell you to STOP all exercises as they are causing your problems? I thought I did!
In my jaded opinion, exercises never help after surgery!

Plus you are only 12 weeks out and the very LAST thing you should be talking/thinking about is building up muscle bulk. Only do that if you want to get more pain!!

 

[emmysmom]

oK - got it - sorry

 

[Josephine]

Not that I was telling you off or anything! Heaven forfend I should do that!

 

[emmysmom]

I have been doing great for weeks. No pain meds of any kind - able to do anything I wanted. Tuesday evening I was out to do errands.
I set up a return to work in mid-January feeling I was stronger than before the surgery. -5 extension and 141 flexion.

Tuesday while walking across a parking lot I slid on the ice and landed full force on my knee.

Saw my OS on Wednesday, he took at least 4 X-rays and said I did no damage to the replacement and the best way to heal was to walk. Said I could take up to 3000 mg of Tylenol per day for pain.

My knee was swollen larger than ever before - I’ve kept it elevated and iced since. I can barely tolerate putting weight on it and use crutches because it feels unstable. When I walk a bit with crutches I have a sharp pain in the back/right side of my knee.

My husband said if there was any ligament damage the doctor would have said so (He IS a very good doctor)

I’m really worried. Am I looking at spending months recuperating from this?

 

[Josephine]

Said I could take up to 3000 mg of Tylenol per day for pain.

That's the FDA's over-protectiveness! In actual fact it's safe to take 4,000mg per 24hrs but the FDA are worried that people might also take other medications with acetaminophen in them and not add it to the total. So provided you are not taking any other medications such as Percocet, it's perfectly safe to take the higher dose which would be 1,000mg 4 times a day.

Also 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?

 

[emmysmom]

@Josephine - Yes, please!

 

[Josephine]

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?

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.

 

[emmysmom]

1. From Wednesday until today they have descended from 8 to 3. When walking (with crutches) 3, or resting 1.

2.Taking Tylenol, up to 4000 mg per day (thank you for that!)

3.From Wednesday to today it has gone from huge to moderate.

4.Before fall 140 and -5. Today I guess about 90-100 (has improved since Wednesday) and 0

5. Icing almost constantly

6.Elevating almost constantly

7.Pre accident normal daily life, Except for the ride and city walking (on crutches)to visit surgeon, minimal activity

8.Not doing any exercises

9. No PT for months

 

[PoetryChef]

Emmysmom, I am so terribly sorry to hear about your fall. I do hope this resolves itself soon.

 

[Josephine]

1. From Wednesday until today they have descended from 8 to 3. When walking (with crutches) 3, or resting 1.

O)h that's good!

2.Taking Tylenol, up to 4000 mg per day (thank you for that!)

And I take it that it's working okay?

3.From Wednesday to today it has gone from huge to moderate.

Excellent!

4.Before fall 140 and -5. Today I guess about 90-100 (has improved since Wednesday) and 0

That's not a huge difference and it will resolve eventually. Don't worry about it.

5. Icing almost constantly
6.Elevating almost constantly

Jolly good!

7.Pre accident normal daily life, Except for the ride and city walking (on crutches) to visit surgeon, minimal activity

Yes, I would expect so. It will improve ultimately.

8.Not doing any exercises
9. No PT for months

Good!

So all seems to be doing well.

 

[emmysmom]

@Josephine
My concern had been how long I would spend recovering from this fall, due to my scheduled return to work.

Any idea what I should expect to get back to some kind of normal?

 

[Josephine]

Forgive me but this comes to mind "how long is a piece of string"!!

 

[emmysmom]

In my post from Friday, I described my concern with the result of my accident - sharp pain in the back/right of my knee and feeling the joint was unstable.

I was/am afraid of ligament damage though I have no reason for this other than pain and fear.

I was hoping for some sort of information/reassurance about the trauma I have caused to the soft tissue at my knee and the best methods of alleviating the effects.

No so much how long is a piece of string, but have you seen this string before?

Sorry to be so obtuse.

 

[kneeper]

That was a new expression on me, but a fave of Josephine's. Basically you've got it-- "how long is a piece of string?" Your guess is as good as mine.

Personally, I'd keep icing and elevating, be gentle with it and if you don't see any improvement or it gets worse over a week or so I'd check in again with the doc.