TKR beth1954's Recovery Thread

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Morning Beth. I am so so sorry you are going thru this with your tkr. Please look for a revision specialist not just an OS. I will tag @Jamie who usually has good suggestions. There has to be someone in San Antonio who would be a good choice for you.

It must be frustrating to be dealing with pain all this time. No wonder you have been crying. I would too but then I would be furious with my outcome and take steps to get it fixed right.

We are all here for you and hope you keep letting us know how you are!

(((Hugs)))
 
You might work with your insurance. Some have advisors who can guide you to a doctor on their plan who specializes in this. You might also contact the state organization of orthopaedic surgeons for guidance. Good luck!
 
@beth1954 ,

I am so sorry that you are detecting doubt. I hoped it came across as caring. We are not in your shoes; so no we can't imagine what you are going through! When I battled MRSA, I got so down at times that I just cried.

Friday, I got conflicting messages about my broken foot, it is healing, but then show me a picture of a crushed blood vessel? I cried a lot this weekend, and I can't say that this feels any different in terms of significance from my infected knee episode.

So yes, I have experienced pain, hurt, and what ifs but not in the same way you have.:console2:

Please give us the benefit of the doubt! We really do care!
 
(((Hugs))). We are here for you no matter what you decide. Take care!
 
[Bonesmart.org] beth1954's Recovery Thread
[Bonesmart.org] beth1954's Recovery Thread
@beth1954.

[Bonesmart.org] beth1954's Recovery Thread
 
That's so sweet....making me cry. I'm just so discouraged right now. I have requested a CT scan and I've checked into getting another opinion.
 
Glad to hear you are moving forward. So sad for you too. It is hard enough to deal with all these things when you feel good. To have to take care of things when you are in pain is very difficult and very depressing. Don't apologize for your tears. They help you heal. We are here for support and to lean on. I will keep you in my thoughts and prayers!
 
H i, @beth1954, I am sorry you continue to experience so much pain. I have been so frustrated with my ongoing pain and lack of improvement with no explanation. You are much more courageous than I. I can't put myself through another MUA. My MUA's in March were terribly traumatic for me (though I know that's not normal). My surgeon sent me to another highly respected revisionist in Dallas, and he sent me to a back surgeon! Ha! Of course, that was a dead end. BUT I saw my original surgeon again, and he suggested I try a special kind of therapy from a group called Airrosti. He said he used to be skeptical, but he has had a number of patients with ongoing pain following replacements that have found this type of therapy very successful. So he set me up with a therapist close to my hometown.

I have only just started treatment. I will not lie, it is painful at the moment when he is applying pressure (not for range of motion but "by soft tissue and joint mobilization through a hands-on approach to improve the healing potential of the target area and the surrounding tissue"). He has never forced my knee to bend beyond what is comfortable. He said if it is going to work, I will naturally gain some range of motion. I also have special exercises (non weight bearing) to do at home, and icing is also very important. He also applies kinesio tape after each session, and it has been VERY helpful in giving me more support, stability, and pain relief. I have also had chronic groin pain (following hip replacement in 2003 and still following my revision last summer), which he is working on as well. I am hopeful that this therapy will at least help relieve some of my pain. Well, I already have less pain... just hoping to get rid of the pain and to be able to walk without my rollator. .. and hopefully to gain more ROM!

I know what you mean about PT. Previously anything (exercises or just being more mobile) made my knees worse. This is different. The exercises don't aggravate my knees. My muscles get sore, but my knees actually feel less stiff. I don’t know yet if this is just temporary.

The therapy is covered by most insurance companies, and you don't have to have a referral to see one of their therapists. Airrosti lists numerous locations in San Antonio... in case you want to look into their therapy. I don't know if Bonesmart rules allow me to post an actual website, but you can find them easily by searching for Airrosti on the Internet.

I feel like our experiences have been very similar, so I wanted to let you know what I am trying. I think of you often and pray for pain relief soon... for both of us!
 
Doc said something he noticed was that behind my recently replaced knee (and I have extremely chubby knees) the fat seems to have hardened.What could cause that?
Well it's very simple really and well explained in here Swollen and stiff knee: what causes it?

Simple fact is that when you get swelling anywhere, it's not only in the muscles, it's mostly in the fat ! You see, fat is far less dense than muscles or any other tissues so readily accepts the extra fluid which is what swelling is. We are, after all, 80% water as any high school student knows! And it readily moves around the body via the lymphatic system and where there is inflammation or pain, it will pool - hence swelling. If the pooling is excessive, then the fat becomes hard. No big mystery there.

How to deal with it? Well, the ice and elevation is one way but depending upon circumstances, massage could be helpful. Specifically lymphatic drainage massage.

However, it was said you had an MUA recently. It would ever so helpful if you could tell me when this took place as it's not in your signature.
 
Well, like I think I said, I'm waiting on the operative reports to be transferred to the revision specialist and then I can get my appointment with him. In the meantime, I mentioned to my doc's assistant that I would like a CT scan or something that could tell them more of what is going on in my knee. I'm waiting on a call back to schedule an appt, but I will not wait much longer. I am about to pick up the phone again. 8 months of no progress at all is enough. Yes, I understand that swelling, etc. goes on for a long time. This is different. There is something specific holding me back but I don't know what it is yet. This is not just "bad ROM" or a little swelling. I know my body and I know something is wrong.

Doc says that when he does the manipulation that it moves just fined to the same degree my other leg does (which is about 110). How can that be? So I guess it has the capability of doing it but the pain that it brings (when I am conscious) is more than I can bear. He said that it didn't even feel like there was that much scar tissue. AGAIN. That's what he said the first time. So now I'm feeling like I've been swindled into spending more money on a manipulation that I didn't need. I should have had the CT scan first. I knew that in my heart, but didn't push for it. My bad.

@Josephine, that makes sense about the fat taking up the fluids and hardening. My doc whom I have had nothing but the utmost respect for until recently............acted like he was SO bewildered about that whole thing. I have really had enough of his pompous attitude and him running out of the room the minute I shed a tear. I cry every time I go in there because I am so damned depressed about my knee/leg. So I never really get to discuss things with him because then he runs off.

After this manipulation he didn't recommend PT or anything. I think because he knew that there was nothing there......no scar tissue......no reason that even a manipulation should have been done. He's making me feel (w/o saying it) like it's all in my head and I don't appreciate that. I cannot bend that knee more than about 85%......I don't care what ANYONE has to say about that. That's a fact. I have pain upon getting up, I have pain upon walking, I have pain when I do almost anything.

Josephine, do you have an xray of a "bad" knee prosthetic? I would like to see what that would look like. My xray looks beautiful. I sincerely don't believe it's my new joint, I think it's the soft tissue/connective tissue, whatever it might be.

**My manipulation was on August 8, 2014 -- a week ago today.

2H2K, you are so sweet. It does seem like we have had similar journeys. It's funny you mention Airrosti. I have been giving that some thought. After my CT scan I might try that if there is nothing that can be done otherwise. I have had people go to him for different things and they have had good results. There is actually an Airrosti "person" in the same office area where my family doctor is and he gets rave reviews from everyone that has gone to him.

I'm trying to get a grip on my depression now too and with all this going on it's difficult. Then I had a series of life annoyances that didn't help. (AC went out in the house, I was w/o AC for 5 days and it's been 100+ degrees every day......I got a small window unit so I had at least one "sort of" cool room to stay in. I somehow left my freezer door open for a couple of hours and had to throw everything away.......my AC cost $2,000 to fix, among other things. It's been a rough couple of weeks, and then a rough 8 months of pain and frustration with my knee.

Not to mention getting run off of my job that I had for 30 years. I'm beginning to realize now that I identified myself with that job more than I thought.

Anyway, I've rambled enough. Thanks again everyone. I hope things start going better. You are all wonderful!!
 
That's a good summary of what happens sometimes with these TKRs. It is so frustrating sometimes! I hope you find a doctor you can trust and can get the help you need. And your right, our employers expect us to take a little time off, and be right back to regular duty. Add to that life's regular irritations (I live in Texas, so I do understand how ac breaks in 100+ weather). And yes, you do have to spend whatever to get it fixed. I asked for an antidepressant because I am so tired and frustrated with continual complications. Keep putting one foot in front of the other. Good luck with everything, and I hope things start turning around for you. Hang in there, keep posting, and know that there are people who care and understand.
:-)
 
Doc says that when he does the manipulation that it moves just fined to the same degree my other leg does (which is about 110). How can that be? So I guess it has the capability of doing it but the pain that it brings (when I am conscious) is more than I can bear. He said that it didn't even feel like there was that much scar tissue. AGAIN. That's what he said the first time.
Well then he was correct, wasn't he?
So now I'm feeling like I've been swindled into spending more money on a manipulation that I didn't need. I should have had the CT scan first.
A CT won't show much as by the sounds of it, it's just fatty swelling.
After this manipulation he didn't recommend PT or anything. I think because he knew that there was nothing there......no scar tissue......no reason that even a manipulation should have been done.
Because he demonstrated to himself that it wasn't necessary. There's often a point where a surgeon might be pretty sure he's right but does the procedure anyway, out of an abundance of caution in case he's missing something.
Josephine, do you have an xray of a "bad" knee prosthetic? I would like to see what that would look like. My xray looks beautiful. I sincerely don't believe it's my new joint, I think it's the soft tissue/connective tissue, whatever it might be.
I don't think there is such a thing. Implants don't fail. So you are correct about it being soft tissue issue.
 
Okay, enough's enough. I need to know some facts about your situation to see if I can help at all.

I'm going to ask you some questions and 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 compare this with the bone-on-bone pain you had before surgery!
[Bonesmart.org] beth1954's Recovery Thread
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2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how often are you icing your knee and for how long?

4. are you elevating your leg, how often and for how long?

5. What is your ROM - that's flexion (bend) and extension (straightness)

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. what kind of PT/exercises are you doing? How much and how often? (and detailed details would be appreciated, please! Reps, sets and session and all that)

Note:
If you're not familiar with this, it goes like so:
1 lift of a 500kg bell bar = 1 rep or repetition.
Doing 5 reps and then a brief rest = 1 set of 5.
And doing 5 sets and finishing = a session.
 
Beth, I know this must be so very frustrating for you. I think you are right about getting a bit more assertive with it all. You've been strong through all of this and I am proud of your tenacity! I'm sure it also seems like you've gone over all this information Jo is asking for a hundred gazillion times. But I hope you can provide her with lots of details and let her put on her super dooper robot thinking cap. There has to be a way to get you some relief!!!
 
Ok Josephine, I will be honest with you on all the questions!
1) pain levels, upon rising in the a.m. sometimes 7-8 on my first trip to the bathroom.
Throughout the day it varies from 2-8. Always worse when I first get up after sitting or sleeping.
2) I do still have some Vicodin (10-325) but not from my OS. About a month ago I had emergency surgery to remove my gallbladder and I have some left from that. I normally take about 2 vicodin per day and 8 ibuprofen a day (1 Vicodin and 4 ibuprofen in the a.m. and then the same towards evening. I had asked for a refill on the Vicodin from my OS but never got it. I have some Melaxicam from my OS and I took it religiously for awhile. It works for me about the same as Celebrex--which is it DOESN'T do much of anything for me. I also have some Tramadol which doesn't help much either.
3) icing has not seemed to help this knee at all. I'm serious. On my other knee I could see and feel results but not on this knee. Since my manipulation one week ago today I have iced a couple of times a day with no results. My knee is still swollen with HARD FAT!
Elevating has not given me any good results either. I cannot elevate in bed because sleeping on my back hurts my back. Since I did a good share of sleeping on my back for many months after my surgery in December 2013, I can't bear to sleep on it anymore!! So elevating is is the recliner and not that often.

I haven't been measured but I would say my flexion is somewhere between 80-85. I did have zero extension but I believe I would be around 5 now.

I have done very little in the way of exercises for awhile now, they seem futile. There is something not allowing my knee to bend and no amount of anything makes a difference. It just frustrates me and hurts me. I get on the bike every day which is what doc has told me to do. I cannot make a full rotation, I'm not even close. When I push too hard (I try to be very careful not to) I only end up with more pain and swelling.
I get groceries using the electric cart because I have such a pronounced limp that it makes my back hurt terribly if I walk very far.
My activity level is low. I do dishes, laundry, vacuuming, sweeping, picking up clutter, easy meals, take care of my 8 indoor cats......however my working in the house is usually done in about 10 minute intervals with long breaks in between!
Go easy on me! I have not done well for awhile now but that was with at least 6 months of REALLY trying hard. My depression is overwhelming right now as you can imagine.
 
Hi Beth - hopefully Josephine will be along soon. The only thing I suggest to you is can you get more pain meds from your GP? If not I would go to a pain management clinic. I only suggest this as the U.S. most doctors will not prescribe meds. I am looking forward to Josephine's response to your answers. (((Hugs)))
 
@beth1954
Dear Beth,
I hope you don't mind me saying this, Could you possibly ask your Doctor for an
Anti-depressant ? You keep mentioning you are depressed, this must be treated.
When I was recovering, the pain meds & loss of mobility caused a situational depression.
I asked my doctor for an anti depressant & it did help.
I am so sorry you are in pain :console2:
I will keep you in my thoughts & prayers,
Sincerely,
Diana :catbutterfly:
 
Hi Beth - hopefully Josephine will be along soon. The only thing I suggest to you is can you get more pain meds from your GP? If not I would go to a pain management clinic. I only suggest this as the U.S. most doctors will not prescribe meds. I am looking forward to Josephine's response to your answers. (((Hugs)))

@Jozilla: I have not tried to get pain meds through my GP yet. I need to do that for sure.
Pain management would be a last resort. I did that once for my neck issues and it was horrible. I was treated like a criminal because one time my neck was doing really good and I didn't take the vicodin for awhile. When I went in, I had no vicodin in my system, so they started interrogating me about what I was doing with the vicodin. Was I selling it??? It was awful. They wanted me to stay doped up all the time and I got several shots in my neck (under anesthesia) and nothing ever worked.............

Diana: I am on medicine for depression. I have been on meds for depression for 40+ years off an on. Mostly on. As a matter of fact, what he has me on right now has started helping a bit. It's just that there have been so many BIG things going on lately and my knee is one of them. I'm just so overwhelmed. But I would be worse off w/o my new antidepressant................I also have some Ativan for when I get really upset. I don't really take is often as I should. My daughter keeps reminding me to take one when I get upset enough to cry..........
 
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