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[REVISION TKR] Elaine’s slow-as-a-snail revision recovery

Discussion in 'Knee Replacement Recovery Area' started by eelainea65, Aug 11, 2018.

  1. eelainea65

    eelainea65 junior member
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    Really nervous and hoping someone who has been in my situation can shed some light.

    Both knees (9 ms and 12 ms) are giving me fits. Ibuprofen (600 mg) hardly masks the pain. The responsibilities of life are difficult and going to work daily even harder.

    I felt I was making slow improvement until about six months post-op. The swelling never went away, just kind of moved around. Now it has settled in a pocket under the knee and on the inside of upper calf. The discomfort is constant, only minimized when off my feet. My job as a courier only allows me to ice and elevate once or twice a day.

    Anyway I just visited my orthopedic surgeon for the 1 year follow-up. Both xrays looked great, but he ordered blood work. When results returned, I noticed he circled my ESR of 40 and my CRP of 16.4 (3x higher than acceptable?!).

    He decided to aspirate both knees. Wow. I was not prepared for that experience. Not fun. (Still reeling from that days later.) He was able to draw a sample from my newest knee, but the other was stubborn. He made three attempts but couldn’t draw any fluid. Finally told me he’d like to do it at the hospital, under general anesthesia and with a particular xray he didn’t have in his office.

    I had financial concerns due to a high deductible so he opted to wait on results of the one knee’s culture.

    So, here I am waiting for two weeks to pass. Trying not to obsess, but doing just that. Does anyone have any idea what might be going on, besides an infection?

    Thanks for reading.
     
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  2. NavyGunns

    NavyGunns FORUM ADVISOR Forum Advisor

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    @eelainea65, welcome to BoneSmart. I’m going to tag our nurse director @Josephine as she is most likely best able to address your questions.

    In the meantime, don’t forget to ice and elevate to control the swelling. I hope you get the answers you need in order to move forwards.
     
  3. Celle

    Celle FORUM ADVISOR Forum Advisor

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    Hello @eelainea65
    I'm sorry to hear that both your knees are causing you pain. Does your surgeon suspect you have knee infections?
    I hope that the aspirate from the first knee will come back to say there is no infection present.

    I don't think it's a good idea to keep taking Ibuprofen, especially since ti doesn't seem to be helping. Ibuprofen is an NSAID, and they can cause bleeding particularly from your stomach.
    They also have other dangers:
    NSAIDs Diclofenac. ibuprofen increase risk of heart problems: new study

    Instead, try taking Tylenol 1,000 mg Four times a day, to a daily total of 4,000 mg. Make sure ther isno Tylenol/Acetaminophen in any other medication you are taking. If there is, cut back one or two of your Tylenol doses, so you stay within the safe daily total.

    I'm going to ask @Josephine , our Nurse Director, to advise you.
     
  4. eelainea65

    eelainea65 junior member
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    I’ve never gained any benefit from acetaminophen, except for the rare headache. I’m aware of the dangers of long term NSAID use. Aside from narcotics like oxycodone (shudder) it was the only medication that helped the pain for the 10+ daily hours I don’t have the luxury of elevating and icing.

    I don’t know if my OS “suspects” infection or simply wants to rule it out. He did seem a tad concerned/frustrated with the situation. He’s hard to read.

    Thanks for your input.
    Just curious to know if there’s anybody here with a similar story.
     
  5. Celle

    Celle FORUM ADVISOR Forum Advisor

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    Try Tylenol now, in the 1,000 mg doses. Many people who take a smaller dose find it doesn't work, and it never seems to work for osteoarthritis, but it can work post-op.
     
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  6. chicklet

    chicklet junior member

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    I second Celle’s suggestion about Tylenol. It never worked for me before, either. I hadn’t taken it in years until my surgery. After I finished the narcotics I started taking Tylenol and it definitely eased the pain. For me, the key was keeping it my system, taking it around the clock.

    I hope you don’t have an infection and that your issue resolves on its own. Welcome to the forum.
     
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  7. eelainea65

    eelainea65 junior member
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    Thanks. I appreciate your suggestion and encouragement. The idea of a revision definitely doesn’t excite me. O_o
    P.S. I’m not sure why it’s classifying me as a “new member.” I joined a year ago. Have visited/posted several times.
     
  8. Spex10

    Spex10 post-grad

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    Sounds worrying @eelainea65. Aspiration must have been awful. I'm a Tylenol fan. It's all I took post op as I didn't want any narcotics. I've found it works well. Give a proper dose of it a try. Good luck.
     
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  9. Eeek

    Eeek senior

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    Hi @eelainea65 - i‘m so sorry you‘re going through this and hope you get some answers soon.

    I hardly ever took Tylenol/acetaminophen before my tkrs. It never worked for headaches, etc, but it has helped a lot for post surgical pain. Might be worth a try!
     
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  10. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    The reason you are still classified as new is because this is your 7 th post. It goes by the number of posts, not length of time. As you post more that description will change.
     
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  11. eelainea65

    eelainea65 junior member
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    @Jockette Good to know. Guess I just lurked a whole bunch!
    @Spex10 Wow! You must have a high pain threshold. Couldn’t even imagine getting through those first couple of months without oxycodone.
    @Eeek Thank you. Yeah, what have I got to lose by trying?! I’ll up the dosage.
     
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  12. Spex10

    Spex10 post-grad

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    I don't know why @eelainea65 but somehow pain hasn't been a major issue for me for either of my TKRs. I had the nasty Oxycodon/Oxycontin and Tramadol stuff last time and absolutely hated them. They made me sick and horribly agitated and distressed. I told the anaesthetist that I didn't want them and he agreed.
    Paracetamol seems to work very well post operatively and suits me. I didn't take any today but haven't been doing much as slightly overdid things yesterday.
     
  13. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Your 'ranking' is dictated by the number of posts you have made.
    Read this User Subtitles
     
  14. Eeek

    Eeek senior

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    @eelainea65 - i’ve taken only paracetamol for both my tkr. In the hospital I had a couple shots of morphine but I hate how it makes me feel.

    I take a max of 4grams (4000mg) every 24 hours. At almost 4 weeks, i’m usually doing 3000mg.

    I didn’t believe it at first, but a good icing for an hour or so is an excellent pain reliever.

    It’s not that I’m stoic, but I was also used to much worse pain before my knees were replaced.
     
  15. eelainea65

    eelainea65 junior member
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    Well, it’s now been 18/15 months since my TKRs. I’m still extremely uncomfortable. And still struggling with chairs, stairs, and putting on my socks. I never fully recovered. My C-Reactive Protein (CRP) fluctuates between 15-17 and my Sed Rate has ranged from 41-49. Both knees have been aspirated with no signs of infection. A bone scan showed no hot spots. Xrays say alignment is good.

    I have learned my surgeon chose to not resurface my patellas. I’m wondering if that was the right choice. I will be visiting a fourth ortho doctor Tuesday. My issues have baffled those I’ve consulted so far. I’m repeatedly told it’s difficult to determine the source of inflammation. The pain isn’t like that of being bone-on-bone (pre-TKRs). It’s more like a strongly uncomfortable, burning, throbbing, festering, buzzing, tingling, mad-as-hell-aliens-in-my-body type of feeling.

    I read with envy of those who have not only gone on with their lives, but often forget they have implants. I feel robbed. And trapped in this body that longs to hike and dance. Working FT (driving long distance as a medical courier) is becoming increasingly difficult as are household chores. I never stopped using my elevated toilet seat and shower bench. (I hide them out of embarrassment if company comes over.). But, honestly, I still feel disabled.

    NSAIDs stopped providing relief and I learned of a family history of kidney disease, so I avoid them now. Was recently prescribed the topical Voltaren, but notice very little difference.

    To make matters worse, between my limited mobility and unconscious self-medicating with food, I’ve put on 30 lbs since my last TKR! And my left hip is beginning to hurt. Very frustrating indeed.

    Thank you for reading this far. I would greatly appreciate if anyone has had a similar experience and or could possibly shed light on what might be happening to me.
    Even more appreciative of prayers as I’m becoming quite depressed about my physical health. This is so humbling. I’m only 53!
     
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  16. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Have you ever been tested for metal allergy? That might be something to request.

    I’m going to tag @Josephine for you.
    I understand as I feel the same way. My partial has never felt right. I’ve had 2 second opinions and no one will look past my X-ray that doesn’t show any problems. It’s very frustrating.
     
  17. JDinCT

    JDinCT member

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    @eelainea65 So sorry to hear you are having continual chronic issues. I would be very frustrated as well. Sorry that I don't have any direct experience that might be of help.

    However, I just had my RTKR at Hospital for Special Surgery in NYC. They are a world leader in all types of joint replacement including knees. They are also the place that takes on very complex situations when no one else can or will.

    They also offer "remote" second opinions. This is usually for initial surgeries, but I would venture to say that if you speak with them and provide you history and background, they would likely provide some insight to your issue.

    Here is a link.... it's worth a shot...

    https://www.hss.edu/econsult-second-opinion.asp

    I wish you all the best and will keep you in my thoughts and prayers!
     
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  18. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    Are both of your knees hurting? Is one worse than the other?
     
  19. eelainea65

    eelainea65 junior member
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    ABCDB3E0-7AC6-4901-B5CC-6024E0B5DD77.jpeg 9C690BEC-9F0B-4610-9A8D-619FFDD79DAD.jpeg


    @Jockette No, I did bring up the possibility of a metal allergy to each of my providers, but it was unequivocally dismissed every time. I was essentially told it was rare or nonexistent. Incidentally, I have Biomet Vanguard implants. (See pictures for more details)

    @JDinCT Thank you so very much for your prayers and the valuable information. I might very well be reaching out to them! Wishing you a successful and comfortable recovery.

    @sistersinhim Yes, this is happening with both knees simultaneously. However, I’d have to say the left is slightly worse than the right. Could be that it’s my preferred leg or because it was the most recent one to be aspirated.
     
  20. SnowHare

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    @eelainea65 I used to use the OTC Voltaren, when my rheumatologist gave me a prescription fo Diclofenac cream. He said it has the same medicinal ingredient, only many times more powerful, hence the prescription. I don't know if it it affects the kidneys/liver, if it is used topically.

    I had to stop taking Diclofenac by mouth, as it started to eat the lining of my stomach.

    My surgeon gave me a new prescription for it to help with the pain I have. It does work for me.

    I hope you find something that will help you soon, soon, soon.

     

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