TKR Bip and Bop<

[ATHIKER]

Now it hurts lifting the leg. Not in the knee but in the muscle

 

[sistersinhim]

I am so sorry you did this. It can happen so fast without even thinking about it!

 

[Josephine]

So something like this?

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?

 

[ATHIKER]

Sure. Now that the picture is bigger they both may be down a ways. Fire away with questions

 

[ATHIKER]

Fire away

 

[ATHIKER]

My knee is at the point where it hurts to use the quad muscle at all. The knee does not hurt. I went to the emergency room tonight it got so bad. No blood clot. X-ray looks good and my blood work showed no infection. So I guess it's the quad muscle has been hurt someway. He told me to stay off it and make appt with OS. I'm having to move it like I did when I first had the knee done. Boy I hope it doesn't take two months to he back where I was two days ago

 

[sistersinhim]

I am so sorry this happened to you. You were doing so well. It's a good thing to make an appointment with your OS just to be on the safe side.

 

[celynda]

Oh my. I hope you get to feeling better soon. It's so frustrating to be doing well and then taking what seems to be several steps backward.

 

[SusieShoes]

It’s smart to have your surgeon make sure there’s nothing seriously wrong. Chances are this is just a setback and you will resume your excellent recovery after your body works it out. Just a shame to have to take a break when you want to go forward.

 

[ATHIKER]

Gosh my friends am I going to be losing ROM because I can't do anything much now. That is really depressing me hope someone has an answer to this.

 

[Celle]

No, you won't be losing ROM. In fact, your knee may even appreciate the rest.
We've had people here who were in a splint and not allowed to bend their knee at all for months - and yet they regained ROM all right.

It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.

My surgeon doesn't allow any PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house.
After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home.
His patients all do well and achieve good ROM, as I did, and he hasn't had to do a manipulation to help with ROM for the past 4 years. I think that speaks for itself.

 

[ATHIKER]

Thank you so much

Since it seems to be the muscle I have started alternating cold and warm. More cold than warm. But could I use a massager on it do you think it would help or hurt

 

[Celle]

Alternating heat and cold might help. However, I wouldn't massage it. It sounds as if you tore some muscle fibres, so they will need a bit of time and gentle treatment, so they can heal.

 

[ATHIKER]

Ok thank you

 

[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.

 

[ATHIKER]

1. When I'm doing nothing about a 1 or 2. But using the quad the lift the leg about a 7. And since the hurt quad the stiffness is more then it was

2. Oxy 5mg one every 24 hrs but I break it in half and take every 12hrs with Tylenol and ibuprofen

3 moderate swelling

4. ROM was 1/120 but has dropped some probably 1/90

5. icing About 3 times a day

6. Elevate most of the night and in a chair with it up several times during the day

7. Cook, dishes. I was walking a mile but haven't since Tuesday when I hurt the quad

8. Right now none just the walking around house
I've been released from PT

 

[Josephine]

ATHIKER, you've not answered these questions as completely as I requested. Can you do them again please?

with Tylenol and ibuprofen

"how much are you taking (in mg please) and how often?"

icing About 3 times a day

"how often and for how long?"

Elevate most of the night and in a chair with it up several times during the day

"If so how often and for how long?"

Cook, dishes.

Is that all? Totally all?

 

[ATHIKER]

I'm taking the pain pills as I need them so some days more some less. Tylenol 1000 two times a day. Ibuprofen 600 mg three times a day just while this is going on. I don't normally take IBs because of BP.
Icing morning and night for about an hour
Elevate for about four hours at night toes above nose. And anytime I'm sitting it's in a chair with my feet up.
Exercise. Before I hurt the muscle I was walking about 3/4 miles a day and doing slides and the stretches. But after I hurt the quad I'm really resting it. Just walking around a little in house and doing little chores as I said

Heard from OS today and he is sure I just pulled the muscle the first appt I could get would be after my left knee replacement so I'll see him then. I may need to talk to those who have had both done if the quad hasn't healed by then

 

[sistersinhim]

When is your next tkr scheduled? I think your quad muscle needs to do a lot more healing before your leg can handle taking on almost all of the walking responsibility. Is it any better yet?

 

[ATHIKER]

Yes it is feeling much better. Not totally healed and has slowed me down when I walk to keel from limping I don't take as long a step. I see the OS on the 4/4 to sign papers and the tkr is on 4/9 I'll talk to him on the fourth and see if we need to postpone.
I was thinking I might get some info from the brace people who had them both done at the same time