TKR bumneej's recovery thread<

[Josephine]

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?

 

[bumneej]

Thank you so much for the reply. It really helps!!

I am feeling much better now and maybe it was just a bug. I panicked and got so emotional that my husband, who was on his 4th day of a 7 day golfing trip with the boys, became worried and flew home right away. Of course I was much better by the next day.

One of my problems is a few days after my surgery my surgeon called and said that he just found out that there had been a problem with the sterilizing machine that sterilized the instruments possibly used on me and others. He said Infectious Disease from the hospital would be calling and following me for 90 days.

Since this was my first surgery I of course am just waiting for something bad to happen and I thought that was happening when I got so dizzy and nauseous so quickly and I was alone. My surgeon said they have no idea who the instruments were used on and before that machine they had gone through several other sterilization procedures and it was very unlikely that I had anything to worry about. But I am a worrier.

Anyway, thank you again. I have decided for now to just see what I can accomplish on my own as far as PT until I can find someone who has a gentler approach. I wish I had found Bonesmart before my surgery, I probably would have backed out. But too late for that and I just need to keep pushing forward...at a slower pace. Thank you for being here!!!

 

[bumneej]

Sure Josephine, I will try to answer the questions.

 

[Jockette]

 

[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.

 

[kneeper]

You may have started off like gangbusters but have hit your limit trying to do so much. I had weird "hot flashes" when on pain meds post surgery even though I didn't have a fever at all. I was covered in blankies in the heat of summer. ;)
I think you were right to eat something with the pain meds but even then as others have said sometimes they can mess with your stomach.

Hang in there with the recovery rollercoaster!

 

[bumneej]

Here you go Josephine...
1. Pain level is 4 to 7 just about daily.

2. I am now only taking 1 Meloxicam 7.5mg in the morning and 2 Tylenol 325mg around 3pm and again at bedtime. My doctor refuses to give pain meds after 6 weeks. I also had what I think was a reaction to the Hydrocodone/acetaminophen 5/325mg so decided not to push for more pain meds.

3. Swelling is between slight and moderate.

4. Bend 105 extension 8

5. I use the ice machine 2 or 3 times a day for 90 minutes each time. I also use an ice bag between those times usually 3 times a day or more for about 45 min.

6. I elevate when I use the ice machine 2 or 3 times a day. I sit in a recliner with legs up when I use the ice bag.

7. I do some cleaning, laundry, some cooking with my husband and take the dog out about 5 times a day and take care of our parrot. I drive myself to PT and doctor. And do my home exercises twice a day and walk around the house as much as I can.

8. Exercises done at home daily except for PT days...
Knee bends while laying on bed x 5
Knee extensions with towel under ankle x 5
Bend knee forward with foot on step x 5
Knee extension while sitting in chair with foot on coffee table x 5
Knee slides x 5
And straighten my leg and try to push my knee down using only my leg muscles several times a day

Exercises done at PT...
Knee bends while laying on the table while the PT pushes it 5 times relax and does it again.
Not sure what you call this but it is very painful later. He pulls on my leg and while holding the leg
underneath the knee and pushes on the knee at the same time x 5. Then does it a second time.
Extension stretches with tube thing under ankle and recombent bike.

I am starting with a new PT clinic tomorrow. They assured me it will not hurt. We shall see.

 

[bumneej]

I am just wondering if it is normal to get tired so easy at 5½ weeks out. My legs get so tired and I feel so exhausted even without doing much.

The last couple of days have been a challenge between feeling sorry for myself plus having stomach issues from taking Tylenol and ibuprofen. I have IBS and it is NOT liking all this extra stuff going through my body. And terrible heartburn too.

I have to take something for the pain and today started back on Meloxicam which my doctor wanted me to take for 2 months but I have not done that. It is also hard on the stomach but only once a day so I am hoping that will help. Today has been better so I guess I am at the top of the roller coaster for a few hours.

So frustrating!! Hope everyone is improving and having a good day!

 

[sistersinhim]

Are you able to take a probiotic and an acid reducer? They will help with your stomach distress. Also, eating protein before taking your meds will help to coat your tummy.

 

[Josephine]

1. Pain level is 4 to 7 just about daily.

Hmm - that's not good.

2. I am now only taking 1 Meloxicam 7.5mg in the morning and 2 Tylenol 325mg around 3pm and again at bedtime. My doctor refuses to give pain meds after 6 weeks. I also had what I think was a reaction to the Hydrocodone/acetaminophen 5/325mg so decided not to push for more pain meds.
The last couple of days have been a challenge between feeling sorry for myself plus having stomach issues from taking Tylenol and ibuprofen. I have IBS and it is NOT liking all this extra stuff going through my body. And terrible heartburn too.

I think if you have a pre-existing reflux then you should NOT be taking Meloxicam or ibuprofen. Very dangerous. Read this Medications: acetaminophen (Tylenol, paracetamol) and NSAIDs, differences and dangers.
You say you are taking 2 regular Tylenol twice a day which is only 650mg. I suggest you take 1,000mg 4 times a day at 6hrly intervals. It will be much more effective.
I also suggest you approach your GP to see if s/he will prescribe you some Tramadol to supplement the Tylenol. Tag me if you are successful and I will give you a chart on how to take them.

3. Swelling is between slight and moderate.

Swelling/pain comparisons

4. Bend 105 extension 8

105/+8? That's not too bad at 6 weeks out

5. I use the ice machine 2 or 3 times a day for 90 minutes each time. I also use an ice bag between those times usually 3 times a day or more for about 45 min.

Good but could do with more

6. I elevate when I use the ice machine 2 or 3 times a day. I sit in a recliner with legs up when I use the ice bag.

good

7. I do some cleaning, laundry, some cooking with my husband and take the dog out about 5 times a day and take care of our parrot. I drive myself to PT and doctor. And do my home exercises twice a day and walk around the house as much as I can.

That's far too much. Did you read the recovery guidelines in post #3 of this thread (Dec 22nd)? There was one Activity progression for TKRs which you obviously did not read! You should read it now to see what you should be doing at 6 weeks out!

I am just wondering if it is normal to get tired so easy at 5½ weeks out. My legs get so tired and I feel so exhausted even without doing much.

Well, for a start, you're doing far too much and secondly, you obviously never read those recover articles because one was Energy drain for TKRs.


Exercises done at home daily except for PT days...
Knee bends while laying on bed x 5 - you don't need to do these, your flexion is already good
Bend knee forward with foot on step x 5 - this is the same as for knee bends above
Knee slides x 5 - I take it these mean heel slides which the above also applies

Knee extensions with towel under ankle x 5 - these exercises are more likely to obstruct your extension rather than improve it
Knee extension while sitting in chair with foot on coffee table x 5 - this is also the same
And straighten my leg and try to push my knee down using only my leg muscles several times a day - same again

Exercises done at PT...
Knee bends while laying on the table while the PT pushes it 5 times relax and does it again - as for knee bends above
Not sure what you call this but it is very painful later. He pulls on my leg and while holding the leg underneath the knee and pushes on the knee at the same time x 5. Then does it a second time. - it's an extension exercise which you don't need - as) because it's causing you pain and b) because the pain is causing you excess swelling
Extension stretches with tube thing under ankle and recumbent bike - this also is unnecessary

PTs and others have a tendency to insist that in order to improve ROM, one MUST work hard a exercises and that the consequence of not doing so will render the knee stiff and non-bending. This isn't true. Read this Myth busting: the "window of opportunity" in TKR
Also Myth busting: no pain, no gain

In summary
1. you need to change your medication as suggested earlier
2. you need to reduce your general activity
3. you need to stop ALL exercising and PT. Your ROM is plenty good enough for you not to need any of it any more.
4. You need to cancel your PT sessions

If you are concerned about refusing to do therapy, you need to read this Saying no to therapy - am I allowed to?

 

[bumneej]

Thank you, Josephine! I see my primary doctor on Feb. 5th. If I am still having a lot of pain I will talk to her about it. I did stop the original PT for a week and rested. I started with a new one yesterday and explained what I want. So far so good. I do not have a problem stopping again if needed. I get horrible diarrhea from Tylenol so I am really hesitant about taking so much. The pain has been better the last couple of days. I hope it continues!! I will try to slow down but it is so hard.

 

[Josephine]

I get horrible diarrhea from Tylenol

That's MOST unusual. NEVER heard of anyone getting diarrhoea before and it's not listed in any lists of side effects in the various drug sites. Are you sure it's not something else like NSAIDs?

 

[bumneej]

Yes, I’m sure it is the Tylenol. It has happened at other times before knee surgery. I know it is weird but I have a very sensitive stomach, etc. I can’t take much of anything unfortunately. I have found I can take 2 reg Tylenol, then 2 ibuprofen, then 2 Tylenol. Any more then that I have problems. I just have to cope with the pain. Icing helps.

 

[bumneej]

Hello...I have been having a lot of calf pain in the back and also shin splints. My PT recommended knee high compression stockings. I wore thigh high for a month after surgery but they were always slipping down. With the knee high I am concerned about it rubbing on my incision. Has anyone ever tried knee highs for calf pain? Do you think the thigh high would be better? Would open toe be okay? Opinions please??

 

[maryo52]

You can always tuck some padding in under a knee high compression stocking. When I get pain like that I automatically want to put my leg up. We are never too old to baby ourselves!! Also, how is your fluid intake? I start the day with a 16 oz. glass of water. I find as I've aged, and with the meds and all the effects of surgery, I need to be better about drinking water.

 

[bumneej]

Thank you! I have decided to just use the thigh high ones the hospital gave me for now and see if that helps first. I try to drink more water and usually always have a glass of it next to me. I am not a water drinker so it is hard. Right after surgery I was always thirsty so drank a lot then but that has slowed down. I will try harder. Hope you are doing well!

 

[sistersinhim]

I found the pain meds made me very thirsty. When I came off of them the thirst came down. It's easy to get out of the habit of drinking water. I keep green tea around me all the time, but water would be much better for me. If I drink water, it's usually the carbonated kind. For some reason that goes down better.

I had calf and shin pain for a while after my surgery. I think during surgery they move you all kinds of ways resulting in very sore muscles.

 

[bumneej]

Very happy!!! I saw my surgeon today for my 2nd post op visit and he is very happy with how I am doing. My ROM is where it should be and although I do still have some pain through out the day that is pretty constant, it is slowly getting better in intensity. He said that is normal and it will continue to get better as my body heals. It is getting better and also my energy level. I can now see a light at the end of the tunnel. I hope it lasts. Thank you for all the advice I have received here. I really appreciate your help and support!!

 

[Pumpkin]

@bumneej
You'll notice that I have moved your newest recovery post with your original recovery thread. For several reasons, we prefer that you post your recovery updates in your thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• Posting your recovery in another members thread, you will miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.

 

[Pumpkin]

I can now see a light at the end of the tunnel.

Glad to hear you are making good progress, and are on your way to having your life back.