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Revision TKR Difficult recover after multiple revisions

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DEL2021Feb-17

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I agree, quitting PT is the right thing to do, and let your knee heal. As I said earlier, you get plenty of exercise around your house and caring for you fish tanks.
If you really cared you would be more then welcome to come to east coast and help out with the tanks!! Right now I have a 20gallon tall with approx 200 angelfish fry and the parents just laid more eggs on a filter in a 75gallon with more adult to semi adult angelfish. I will even let you only take care of 5-6 tanks how's that?? Just kidding!!
 
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DEL2021Feb-17

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@Celle @Pumpkln or ??
Saw the surgeon this afternoon everything looks as he expected which is good. The staples came out yeah!! I still have a hematoma??, need to work on desensitizing knee ( trust me looking at it wrong hurts ), need to work on extension. Told him about the issue I had with therapist and he had a word for it but any time you take a narcotic for a period of time you will build up a tolerance but he also agrees I was taking it the right way " as needed " and he feels given time I will wean myself off of current meds. I called the office for inhome therapy and told them what the surgeon wants me to work on and it does not mean causing any more pain. I am willing to try but I am not going to pushed. The surgeon wants me to work on extension, with the hinged during surgery its capable of 0 and right now I am at -5. Exercises to work on heel slides, quad sets sure there are others ideas please?? but due to the swelling pain etc he wants that to get better prior to working on getting strength. He did say as far as patients go I am one of the better ones he said some can get very verbal and angry he understands my concerns frustration and how I need a pat on the back on occasion. What would you suggest for making the knee less sensitive? will a wash cloth work or should I use something different? What exercises would you suggest that will help with extension but not cause more pain and swelling??
Truly wish this was just a bad dream and I will wake up and everything will be back to normal.
 
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DEL2021Feb-17

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@Celle @Pumpkln
Going to see surgeon took a lot out of me yesterday. As many times as I have been to see him and out patient PT never really thought much about the walking of course that was prior to this surgery. Once I got home I was drained and the worst part could not get comfortable when I went to bed. Nothing like tossing and turning trying to keep knee comfortable finally gave up at 3am. Its one thing to give advice when someone asks about getting comfortable in bed after surgery its another thing making it work. No doubt in my mind today is going to be long based on lack of sleep but no matter how much anyone complains including me its all part of the recovery. YUCK!!!!!!!!!!!!!!
 

Pumpkln

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Going to the surgeon for the first visit can be rough, just the walk into their clinic.
Sleep is a challenge for most of us, I just slept when ever I could, rather than trying to sleep through the night.
For ROM sometimes you just have to wait for the swelling to go down with healing.
A heel to toe gait helps facilitate extension naturally. As I recall for extension I did quad sets in bed pressing my knee down, heel slides, and heel to toe gait.
Glad to hear your surgeon was supportive about your pain meds.
 
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DEL2021Feb-17

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@Pumpkln

Your up bright and early!! Hope you have or had coffee this morning? Right now I could careless about ROM currently at 127 prior to surgery 132 not going to care if gets better or not. Extension is an issue for me -5 while not bad could be better. As I wrote quad sets heel slides watching how I walk should help? with extension. Getting a decent nights sleep is like flipping a coin sometimes decent other times like for me last night what sleep. What do you sugeest for making the knee less sensitive? If I recall correctly the Dr. said to use a wash cloth and rub the area not too hard and for approx. 15 minutes? Did I miss anything as in should the wash cloth be heated up in microwave or use cold water or nothing at all just the cloth any ideas??
You still need to come to east coast and assist with my tanks you would be taking your helpful suggestions a step further by providing in home moderator support!! Great idea HUH!!
 

Pumpkln

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For sensory stim. a wash cloth, you can switch with other soft materials like t shirt, fleece, denim, etc. Use it on your other knee so you can experience what it should feel like. Then mentally tell your surgical knee, this is what it should feel like.
 
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DEL2021Feb-17

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@Pumpkln

New at home therapist suggested using a full water bottle once frozen it can be rolled ?? You and Dr suggest the same. Am I supposed to apply pressure granted not a huge amount just enough to massage both sides of incision?? So mentally tell Hmm?? might be difficult with my brain.Ha Ha!! I used wash cloth earlier today rinsed it in warm water did not feel to bad. Actually feels weird as I press down you can feel the fluid moving around. Dr. said I also have a hematoma ( built up of blood ?? ) that maybe the fluid I feel? How often should I do this several times a day?
Still not offering one on one counseling to make sure some of us do not over do it? You realize by helping out with my tanks it would cause less pain and swelling right??
 
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DEL2021Feb-17

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By the way this whole recovery process after each surgery stinks even more so with a replacement it would be great if the more times its revised the easier the recovery goes!! Bottom line disliked it the first time and I still dislike it.
 
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DEL2021Feb-17

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Some good news not great but some!! When I saw the Dr. on Monday he wanted me to take Gabapentin 600mg 3x a day so decided to try. While today its still painful and all that goes with it I've noticed its been more of a steady pain as not really gone up even after PT ( that was a blessing!! ). In all honesty its a little better and if there are no major pain swings as its happened a few times I will accept it.
Had another therapist yesterday and explained what I expected what the Dr. suggested meaning if what you want me to do is going to cause major pain forget it. I did some quad sets different exercises for extension calf stretching etc the best part pain did not go nutty after he had left. Another plus!!
 

Pumpkln

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Glad to hear you had a good PT session and the gabapetin is helping keeping your pain level.
Dr. said I also have a hematoma ( built up of blood ?? ) that maybe the fluid I feel?
Most likely the hematoma is what you are feeling.
How often should I do this several times a day?
2-3x a day should be fine for your sensory stimulation to your knee.
 
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DEL2021Feb-17

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@Celle

Have a good question maybe others will benefit?? Well aware the first month or 2 is the toughest and you need to stay ahead of the pain. What is the best way to taper off?? My thought once the pain starts easing up the frequency of taking the pain meds decreases along with the strength. May seem odd but if your taking fairly strong pain meds if you just suddenly stop that cause problems as well.
 

Jaycey

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Jumping in here as Celle is away from the board for a few days having just had her shoulder replaced.

Here's an article Jamie wrote awhile back regarding tapering off prescription medication.

You can do one of two things to begin reducing the amount of drug you are taking:

1. [U]Begin spreading out the times when you take the drug.[/U] If you are currently taking it every 4 hours, for a couple of days make it every 5 hours, then 6 for a few days and so forth until you reduce to one pill a day (usually at bedtime, cuz that's when we seem to need the pain relief most). Then at that point, you can start taking half a pill for a while and then no pill. At that point (no pill), you would take them only periodically when you have pain that over-the-counter medication won't take care of.

2. You can stay on the same schedule (like every 4 hours) and cut back on the [U]amount[/U] of the narcotic with each dose. That can be done by asking your doctor for a lower-strength medicine or by cutting pills in half. Only reduce the amount by 1/2 pill at a time if you are staying on the same schedule - not a whole pill. Then when you get to the point that you're taking a half pill at each dose time (that's about as small a dose as you can get), start spreading out the time between doses. This approach works if you need the pain medicine during the day for PT appointments or other activity where over-the-counter meds won't work.

As you're cutting back, expect that you may have to use NSAIDS to fill in the gaps for pain.... Aleve (Naproxen), Advil (Ibuprofen), Motrin or try Tylenol (Paracetamol).

Just be sure you don't try to cut back too fast. You'll feel it if you do and will need to make adjustments accordingly to slow the taper. The whole process can take several weeks, so be patient and make sure you are stable for a day or so at each level before you make another reduction.

Or....you can contact your doctor and ask what schedule THEY prefer you do. But I believe a person will do just as well taking care of this yourself. Only YOU know how you feel at any given time. You want to cut back just enough so the over-the-counter meds work and not so much that you get those flu-like symptoms or have pain.
 
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DEL2021Feb-17

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@Jaycey

Thank you for the info I hope others read this as well very good advice!! If your familiar with " Murphy's Law " if anything can go wrong it will, well that is me. Started feeling a tiny bit better and then had to feed my fish clean algae off the glass on a couple tanks roughly 30-40 minutes and guess how I feel now?? Give you a hint not great. Currently on ice great way to start the day.

Forgot to write if you hear from Celle please give her my best wishes for a great recovery!!
 

Jaycey

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As I always say - recovery is all about finding the limits, scaling back if you need to. And most important - trying again another day.
 
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DEL2021Feb-17

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@Jaycey

Hate to admit it but the majority of the time you as well as the other moderators I dealt with are accurate. Yes I have tried to prove you guys wrong with previous surgeries but I must say doing it following the advice given here makes it easier. There is no such thing as being pain free after surgery but by not over doing it helps it still hurts but its not the pain that causes tears misery etrc either.
 
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DEL2021Feb-17

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Update Not going to say MAN I FEEL GREAT!! wish I was but it does feel somewhat better not great but better. Pain level instead of a steady 7 is more likely a 6 close to a 7 but not quite. I am doing more but have to careful 2 days ago walked a total of 6 minutes putting it mildly the rest of the day was completely shot. Today the exact same walk approx. 20ft further and yes it hurts quite a bit but after icing and pain pill pain has settled down. Sleeping is still an issue but its getting better. Well aware may feel better today ( somewhat?? ) but I am also aware there is going to be some rough ones as well I still have a long way to go.
 

Jaycey

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Progress is positive - no matter how small the steps forward. Sounds like the icing after activity is working for you. Glad to hear it!
 
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DEL2021Feb-17

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@Jaycey

Maybe I spoke a tad too soon while okay a tiny bit better but boy is the knee weak. Inside my home I can get around no crutches if I am careful but anything other have to have crutches knee has about as much stability as a rubber band its constantly giving out.
One thing is for sure I still have a long way to go YUCK!!
 

Jaycey

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but boy is the knee weak
Of course it is weak. That poor knee has been chopped and changed so many times. Now it just needs TLC. There will be plenty of time to strengthen once that knee recovers from all the trauma. Yes, it may be a long journey - but you will get there!
 
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