TKR Carole’s recovery thread

[Carole4815]

I love reading your thread! You are so positive, funny, and very caring! You are doing wonderful!
Are you still off the pain meds?

Thank you! And yes, I haven't taken any pain meds at all for over a week, because they haven't been needed.

Yesterday I told the oral surgeon's scheduler that I want to wait before having that wisdom tooth extracted because I feel like recovering from one surgery is enough for right now. So, I am just living my life and finishing out the 10 days of amoxycillin that my OS prescribed for me when I mistakenly thought it was an abscess.

I just hope that the wisdom tooth pain doesn't return. If it does, I have hydrocodone but I might have to reconsider if/when I want that wisdom tooth extracted.

 

[Didot]

Sounds very positive. So nice to feel it’s becoming worth the struggle. Will keep following your progress.


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[LindaO]

Awesome on the pain meds!!

You know your body better than anyone so just listen to what it tells you!

 

[Carole4815]

Awesome on the pain meds!!

You know your body better than anyone so just listen to what it tells you!

Right, thanks! I am concerned that perhaps the amoxycillin antibiotic that I am taking is why my tooth doesn't hurt any more, and that once I am done with amoxycillin (tomorrow) it might start hurting again due to bacteria growing in that area that aren't growing now. The pain wouldn't be so awful (since I have a lot of hydrocodone pills left), but I wouldn't want an infection to affect my knee. Nobody seems to think that will happen unless it's an abscess, which it isn't. (sigh) I keep thinking, "what so magical about the word "abscess" that makes that the only danger for infection?" but then hey, what do I know. I am seeing my OS again on the 30th.

I have some terrific surgeons but all of them are almost impossible to contact by phone, because you get one of those automated phone trees ("press 1 if you need to make an appointment" and so on) that goes on for an eternity and gets you nowhere. And my dentist is off on a two week vacation.

I told my sweetie (who is utterly brilliant and has good judgment) about my concerns, and he is not worried. He said that what we should do (given the unexpected wisdom tooth diagnosis) was just not made clear to the two of us by the OS at my last appointment back on the 5th, and that he thinks my plan of waiting is probably the best thing to do.

My body is telliing me, "huh-uh!! No way! I need ALL of your energy and nutrients to finish healing your knee, and any of either that went to healing a wisdom tooth surgery would be robbing your knee, don't do it yet!"

 

[Tykey]

Brilliant

 

[Jamie]

If you're worried about the prospect of waiting for oral surgery, check with your dentist to make sure all is going well with the wisdom tooth. If you're not in pain with it once the antibiotics are completed, chances are really good that you won't have a problem waiting for the extraction. From what you've described, it sounds as thought the discomfort you were feeling was most likely from the tooth coming in and not anything sinister.

 

[Carole4815]

If you're worried about the prospect of waiting for oral surgery, check with your dentist to make sure all is going well with the wisdom tooth.

Well, like I said, he is on vacation and impossible to contact for another two weeks, until about the time when my OS appointment is. I can't blame my dentist; he has almost never taken a vacation since he got out of dental school in 1999.

When my dentist took a look and told me it was the wisdom tooth, I was still in considerable pain from it. (It had been just hours since I saw the OS and got on amoxycillin for what I thought was an abscess.) So the dentist had his hygienist clean the area (since my oral hygiene has been hit and miss after the TKR), and wanted me to have his oral surgeon friend extract it. But since that time, no more pain.

If you're not in pain with it once the antibiotics are completed, chances are really good that you won't have a problem waiting for the extraction. From what you've described, it sounds as thought the discomfort you were feeling was most likely from the tooth coming in and not anything sinister.

That would be great.

 

[Celle]

I am concerned that perhaps the amoxycillin antibiotic that I am taking is why my tooth doesn't hurt any more, and that once I am done with amoxycillin (tomorrow) it might start hurting again due to bacteria growing in that area that aren't growing now.

As long as you complete the course of antibiotic, any bacteria that were causing the pain should have been killed, so it shouldn't flare up again once the Amoxycillin course is complete.

I keep thinking, "what so magical about the word "abscess" that makes that the only danger for infection?"

An abscess is an infection that produces a collection of pus. A dental abscess is a more severe infection than a simple dental infection and it can be more deep-seated, spreading deep into the tooth, gum or even (although rarely) into the jaw bone.

It's possible for the infection from an abscess to be carried into your blood stream and thus, potentially, to other parts of your body, including your knee.
Even so, the bacteria in your mouth are not the ones usually associated with a joint infection.

 

[Carole4815]

Thanks, Celle, Jamie, and everyone.

Forgive me for one final bit of advice, just be careful, keep your guard up, as my PT was sneaky more than once and caused me a lot of pain, even though he was pleasant and soft spoken and sounded so caring, as he slowly continued to push my knee into an excruciating pain level.

Well, I hate to admit it but you were 100% right in the above statement and you have my sincere thanks for alerting me to this possibility. Apparently I need to watch my PT like a hawk, as you suggested. Although the first PT session went so well, yesterday at my second PT session she started a more hands on approach, pushing my knee to painful places. When I stopped her and said "don't do that! You didn't do that last time" she said "oh yes I did" but that was not truthful. I let her do a tiny bit too much of that before refusing, and after PT I had so much trouble walking; it hasn't been that bad for weeks, I was just hobbling along, clutching my metal walker for dear life and progressing only at a very slow, nearly glacial speed.

As you might imagine I am planning to just rest and ice this whole weekend. No permanent damage done but so much for all the progress I made after the first PT session. I didn't sleep well last night, but didn't feel like level 2-3 pain from PT would justify taking a hydrocodone so basically sleep was just a series of naps and a lot of icing.

Just to confuse the issue, at least 3-4 PTs were working with me at various times throughout the session. They directed me to do things that I obviously CANNOT do given my degree of disability before TKR; the things that suggested will take me months more to be able to do, so obviously they were not remembering me and treating me like a replaceable cog in a machine. I had to go through my medical history with them AGAIN right there in the middle of the session.

I don't have PT again until Monday and I am going to have to lay down the law again. (sigh) I really do want to have more days when I gain from the PT, like right after the first session, if I can get them to back off like that again. So I'm not yet ready to just quit PT right at this moment, but they had better shape up.

 

[LindaO]

I’m glad you know your limitations! Continue what works for you!

 

[judgar]

I told my in home therapy guy. I will not go to a pt place. Just because of that reason. Iam going to stick to my guns about this. I went through that with my other knee.try to rest this weekend.take a easy

 

[Carole4815]

Thanks, Linda. I will.

And thanks to you too, Judgar. I am planning to rest and ice this weekend, at least until I get back to where I was. That might take the whole weekend, or maybe not. I don't know.

Oh I also forgot to say that they had me using a conventional leg press machine like the ones at most gyms. It was just set at 40 pounds but given my present physical condition I think I am going to refuse to use that machine again, to protect my knee.

 

[Jockette]

I’m so sorry your second appointment was not as good as the first. And here I was feeling guilty for over cautioning you.

It seems that so many PTs are like that, especially at out patient facilities. Too many of them have a one size fits all protocol. We are recovering from a surgically induced injury, we are not training for the Olympics. Our knee will bend when it’s ready, there’s no need to force it.

After her surgery, of our members, @beachy went to a trusted PT that she had worked with before her surgery, and he had a very different protocol and attitude towards rehab after knee replacement. She was so mad she left in the middle of the session. If I remember correctly, the PT left the room first. And she’d had a very good relationship with him in previous appointments for other things.

 

[Carole4815]

Don't feel guilty, Jockette! You did what your conscience told you to do, and it turned out that you were absolutely correct.

I still want to see if I can take charge enough to get a sane, reasonable PT session out of my PT again. The results from that first session were helpful. If push comes to shove, I'll push, I'll shove, and if necessary I'll march right out of there.

 

[Jockette]

I never had more than one therapist per session, I was always in a private room and one on one with the therapist, except when I was on the bike, which was out in the main area with a lot of other bikes.

Oh, I just remembered, my pool session was a big group, but that was different. (another bad experience)

This recovery is hard enough at times without the stress of watching our “therapists” like a hawk. Which is why I’ll do my own, at home, next time.

 

[Jockette]

Oh I also forgot to say that they had me using a conventional leg press machine like the ones at most gyms. It was just set at 40 pounds but given my present physical condition I think I am going to refuse to use that machine again, to protect my knee

A leg press machine is very bad for a new knee. It’s listed in this article as something to avoid:
https://bonesmart.org/forum/threads/bonesmart-philosophy-for-sensible-post-op-therapy.37103/
This article was in the Recovery Guidelines.

 

[sistersinhim]

I really do want to have more days when I gain from the PT, like right after the first session, if I can get them to back off like that again. So I'm not yet ready to just quit PT right at this moment, but they had better shape up.

It's not a matter of getting them to back off, it's you taking complete control of what happens to your knee. You are the one that has to deal with the after effects of bad PT, not them. You can see how the wrong PT puts your recovery behind. Now, you have to play catch up to where you were before you went there for your second session.

Oh I also forgot to say that they had me using a conventional leg press machine like the ones at most gyms. It was just set at 40 pounds but given my present physical condition I think I am going to refuse to use that machine again, to protect my knee.

No, no, no weights. This is proof that your PT has no idea how to rehab a knee replacement.

 

[luvcats]

Ok, that was not a good experience. Maybe you could talk to the practice manager about only working with 1 therapist per appointment? I really, really hate ot when they trade you off like that. Especially since you came into the replacement with a slew of extra challenges that PT needs to help you through.

I did PT at one point for a different issue where they worked as a team. I think it's just a dodge so they can cram more patients in per day. It is definitely to the detriment of the patient, particularly if the issue isnt straight forward.

Keep standing your ground.

 

[Carole4815]

Somehow after all that complaining, resting all day yesterday fixed me up and I am feeling fine again. How embarrassing. Honestly I wasn't trying to exaggerate how bad that PT session was. But the healing powers of Mother Nature are amazing sometimes, and now I am at least back to where I was, or better.

This morning I was feeling energetic and actually trying to think of reasons to walk places inside my house, probably for the first time since my TKR. Who knows, maybe my stamina is *finally* coming back. So anyway, when my sweetie came over we decided to go out to lunch and a long pleasure drive. That was fun. I ordered a cup of seafood and corn chowder, which is something I enjoy.

Another advance I have noticed recently, is that I can sit comfortably with my feet on the floor for a half hour or hour. I no longer feel that I have to have my feet up. Speaking of my feet, while normally the foot on my surgical side has been swollen quite a bit, along with the leg and knee, it has been "un-swelling" for long periods for no perceptible reason. For example right now it looks fairly normal. My surgical knee (right above it) looks less swollen too. I am sure it won't last but I am enjoying it a lot. Yes, I swell easily, always have.

Although I can get up from lower seats than I once could, still, the low wooden chairs at the restaurant are tough to rise from. They are about normal level for restaurant chairs, or perhaps an inch or two lower than normal. Before TKR I didn't notice them as being unusually low. Anyway, I hope that problem rising from them is one that lessens soon. Right now I can get up from them but with great difficulty.

This afternoon I plan to take a brief nap, and then do laundry. All by myself. With the passage of time, and all this extra stamina, I think that task is becoming much more reasonable. Life is good.

 

[Jockette]

That’s great that you can have your feet on the floor for a while. It was many months before that was comfortable for me.