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[Nvstig8tr]

Thanks!


Left Total Knee Replacement on Tuesday, June 7th, 2016.

Sent from my iPad using BoneSmart Forum

 

[Dawni]

[emoji372]thank god for that,know how you feel

LTKR 11 May 2016

 

[sistersinhim]

Wonderful news, Bill. I know how that 'just can't go' feeling is! I'm taking a stool softener twice a day and Miralax once. It took a few days, but I'm finally there! Your incision looks good!

 

[Timetolive]

Please be sure you continue to take a stool softener and Miralax EVERY day while on pain meds. I developed diverticulitis from the constipation and straining while on mine.

 

[uva55]

Glad you are feeling better!

 

[Nvstig8tr]

Rough night! The day started magnificently when I realized that I could NOW walk with my cane, so it was amazing as I zipped around the kitchen doing my coffee routine and spent several hours in my office, alternating between standing and sitting (motorized UpLift Desk) while straightening out a few things.

I tried some "extreme" elevating and I also began icing my upper thigh and lower leg while the Polar ice machine did its work on my knee.

I did not use my walker until 6:00 pm when everything seemed to go to hell in a hand basket. It hurt SO much even to get out of my recliner or bed to go to the bathroom. It was then I noticed that the swelling and fluid retention had increased on the surgical leg, which made it look double the size of the other leg/knee. So I went straight to bed elevating my leg sightly with one fairly-flat memory foam pillow. I woke up every 60 to 75 minutes needing to urinate. My side of the bed is literally 6 feet from the master bathroom door, but just getting out of bed (and back in) was so painful that I thought "something is drastically wrong!" and considered calling 911 to get me to the ER. But I was able to endure the night and I must have eliminated a lot of fluid in those hourly trips to the toilet. I slept well once I got settled and the pain only manifested when I got in/out of bed for the bathroom trips.

I will insert some photos from my iPad app, because it's a pain doing it from the website which I prefer for typing.

 

[newlybionic]

It sounds like you paid a visit to the ODIC (over did it club). We've all done that. You start out feeling very well and start going back to do things that you always did but your knee has reminded you that it wasn't ready got it.

 

[Happydale]

I hope your fever is all gone now! I want to share my niece's post-surgery protocol to counteract the side effects of narcotics. She has had countless ortho surgeries, one of which resulted in an ER trip due to severe stomach pain. It turned out to be constipation!! The doctor told her to use Miralax and that it is not something that you have to worry about overdosing. So now after her surgeries, she does not take a drink of anything that isn't laced with Miralax. She told me to buy the big bottles at Costco for my upcoming surgery, so I'm stocked and ready!

 

[Celle]

Bill, newlybionic is right. You paid a huge visit to the ODIC and overdid it big time. Your knee and leg let you know that, in a way you can't ignore. It's something we've all done, because it is difficult to get the balance right between "just enough" and "too much".

You won't have done any permanent damage, but do try not to do that too often. It's unpleasant, as you found out, and doing it too often might lead to chronic inflammation.

Until your leg settles down again, you'll probably need to spend a few days of doing very little apart from rest, ice, elevation and regular pain medication.

 

[Nvstig8tr]

After the rough weekend, I called my surgeon's office on Monday morning to see if I needed to take a diuretic to help eliminate some of the massive swelling in my surgical leg. He had called me twice during the weekend just to check on my situation, which I especially appreciated since he was out of town with family for the weekend and he didn't have to call me at all. His nurse told me, "No, he doesn't want to put you on a diuretic, but he wants to see you first thing on Tuesday morning (yesterday).

I could tell he was a little shocked and concerned over the swelling, which covered from my toes all the way up to my hip joint. He sent me for an ultrasound to rule out clots (came back negative) and gave me several 6" wide cotton bandages with instructions to wrap my entire leg several times daily with elevation of my knee above my heart; and he reduced my Percocet dosage from 10 mg to 5 mg. Today is the first day of using the reduced dosage pain meds; and my knee is not happy about it.

No one could give an explanation of the swelling, since it's isolated to the surgical leg and it's the entire leg, which seems strange, rather than knee itself.

 

[sistersinhim]

Bill, that sounds really scary. I pray the wrapping helps reduce the swelling. I don't understand why the lowering of the dosage of the Percocet would help that unless one of the side effects is fluid retention. Can you take Tylenol with it or does it already have it in it?

 

[Nvstig8tr]

Here is a photo taken on Monday morning, 6 days post op, that shows the swelling on my entire left leg.

Left Total Knee Replacement on Tuesday, June 7th, 2016.

Sent from my iPad using BoneSmart Forum

 

[Timetolive]

I am sorry you are having this swelling. I am 7 months out and I have swelling - but just in my knee. I went to a therapist that specialized in the edema wrapping. She taught me how to wrap my leg and it really works. Do take the time and wrap your leg to get the swelling down. Are you supposed to keep it wrapped 24/7? When your bandages get stretched, just wet them, roll in a towel to partially dry, then lay on a towel to dry. This will help shrink them back up. Good luck! It will help.

 

[newlybionic]

I did have swelling like that but only for the first week. I made sure my knee was above my heart and my foot above my knee. I sat like that for a few days getting up just for the bathroom before it finally went down. Hopefully your swelling goes down soon. It's good you were checked for clots so you don't have to worry about that. Percocet does have some Tylenol in it but you can take one extra strength Tylenol with it.

 

[Pumpkin]

Glad you do not have blood clots.
You might want to ask your OS or GP about seeing a lymphedema specialist for your swelling.
You can also try this, On your back, Breathe in your nose, out your mouth 5x slowly, Bilateral ankle pumps 5x, Gluteal (rear end) squeezes 5x, Quad (press your knees into the bed) sets 5x, all gentle. Do a couple of times a day, it helped with my swelling.

 

[Nvstig8tr]

Thanks for your responses!

At 11 days post-op, here's an update:

1. Swelling is still my biggest issue. Every morning I put on a knee-high pressure stocking, then wrap my entire leg from the stocking to the top of my thigh. I'm elevating my leg (above my heart) for 10-12 hours each day, plus another 6 hours while sleeping. Most of my day is spent flat on my back with 4 stair-stepped pillows for support. In the evenings, I'm in my recliner with legs horizontal to the floor.

2. Pain is very close to swelling, in terms of being an issue. I started with Hydrocodone-Acetominophen (H-A) 10/325 every 6 hours from the day of surgery. Seven days later, my OS dropped to pain med to H-A 5/325 every 6 hours, and he agreed to allow Tramadol 50 mg in between doses of H-A since I have Tramadol on hand prior to surgery. When I complained about the constant pain, his response was that I was trying to do too much too soon; and he advised me to stop walking around the house so much. I've only used a cane since Day 7.


Left Total Knee Replacement on Tuesday, June 7th, 2016.

Sent from my iPad using BoneSmart Forum

 

[sistersinhim]

Bill, I'm so sorry to hear about your pain. It sounds like you need more pain meds, but what can you do if your doctor doesn't agree. Do you think you are trying to do too much? If you're like I am, you do a little then rest. I'm finding some days are more painful then others. I haven't been able to nail down the causes of the pain. It's just depressing when the pain comes back so strongly when you think it's on the way out. Maybe try doing like your doctor says and cut down on your walking around. I hope it helps.

 

[kneeper]

When I complained about the constant pain, his response was that I was trying to do too much too soon; and he advised me to stop walking around the house so much. I've only used a cane since Day 7.


Left Total Knee Replacement on Tuesday, June 7th, 2016.

Sent from my iPad using BoneSmart Forum

Just because you're able to walk with the cane doesn't mean you should. Maybe try using the walker for a day and see if that gives the knee more of a break.

 

[Nvstig8tr]

Need some advice following my 14-day post op appointment with OS!

Met with my surgeon yesterday and got my staples removed (ouch!). He was very happy with my incision. The nurse thinks I will have a very "nice" scar that should hardly be noticeable after awhile. The OS observed me walking with my cane and he was pleased with my form and stride; however, he was not as pleased that my ROM is only 35˚-40˚ and my extension is about 5˚. He stated that if I don't achieve between 80˚ and 90˚ in the next four weeks, he plans to do Manipulation Under Anesthesia (MUA) to increase ROM. Obviously, from what I have read on this forum, I do not want to go through an MUA.

I have been unable to do any PT for these first two weeks due to extreme swelling, which has completely subsided; and so I am ready to begin outpatient PT starting today!

The PT facility has an indoor pool with all sorts of available aquatic therapy. So I was thinking about going to PT 5 days per week over the next four weeks: perhaps doing aquatic therapy 3 times per week (Monday, Wednesday, Friday) and other forms of PT 2 times per week (Tuesday & Thursday).

Here is a link to the company providing my PT: https://www.selectphysicaltherapy.com/services/physical-therapy/

What do you recommend? My insurance will cover 50 visits. Are there particular types of PT that you would recommend? I am 61 years old in extremely good physical condition, having lost 60 pounds over the past year and until the knee began acting up in February 2016 I was engaged in walking 5-6 miles per day.

 

[kneeper]

That plan sounds like serious overworking of the knee, bound to cause more swelling. IMHO it's fine to do some exercises each day but your knee is still a baby and still needs ice and elevation to get or keep that swelling down.
There still can be inflammation there inside the knee that is not obvious.

Don't see the "threat" of an mua as an indication to go crazy with the exercises. Your ROM seems a bit low, but there will be plenty of time to decide on an mua if you don't make progress over the next few weeks.

It took me about 6 weeks to get to 90--I stayed stuck in the 70s until my swelling came down more. Then over the next couple of weeks I made steady progress.