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TKR Ellejay's recovery threads, first and second

Hi @TexasTee - I have no idea what model it was, and didn't ask until I was leaving my 6 week check up. OS answered with a ridiculously long name that ended in what sounded like rotator cuff (didn't have time to ask him to write it down) - and added that in his opinion it was currently the absolute best and hideously expensive. I have no idea if it was a cement or naturally attaching version. When I go back on 12 May I have a lot of questions for him (ha ha an awful lot!)
 
Whoops I leant on the send button by accident! I was going to say I intend asking him all about it then.
X
 
Thank you all so much for all your messages, it was so wonderful to log on just now and know that you had all been thinking of me. Well........apparently I've spent the last fortnight unable to walk properly
because the cortisone injection had worn off, and its likely that something had got caught in the knee, causing the extreme pain. He reckoned that another injection will do the trick, I already have one booked for May 8th. He said he would do an arthroscopy in August. I asked if I could avoid this as I had two on my other knee before I had the replacement, couldn't I just go straight to the replacement, but he said no, it was worth trying the keyhole procedure first. So, fingers crossed, I will have the guided injection and be able to go to France a few days later. I must admit I would prefer to just get it all over and done with and have a new knee, but that is not to be, he wants to save the knee for as long as possible, he's talking now of a couple of years, I was banking on a few months. So it's looking as if I won't be anybody's surgery buddy. I have been seeing this consultant under the 'Choose and Book' scheme, whereby you get to choose the hospital you want. So I'm seeing him in a private hospital, which officially is no longer part of the scheme. I am really worried that he will do the arthroscopy and then sign me off, leaving me to have the next TKR with another surgeon in the local NHS hospital. There's nothing I can do about it and worrying in advance isn't going to help, I will have to cross that bridge when I come to it.
So, next step - see GP next week to review meds, then radiologist for guided injection and hopefully a pain free summer.
 
Hi @Ellejay,
I am sorry you didn't get the outcome that you had hoped for. Your surgeon sounds pretty confident that the Arthroscopy will work. I understand your concerns. I don't know how long your previous arthroscopy lasted for but my one and only lasted eighteen wonderful months until the knee went completely. In a way it may be better to hang on and recover completely with your new knee and then have it done. If I'm not mistaken that was your original thoughts anyway? I'm sure he knows what he is doing, he sounds pretty certain of what he has suggested to you. I will cross my fingers for you for a pain free summer. You so deserve it.

How long did you previous arthroscopies last for before. Xoxoxox (big hug Ellejay) x love Nana moon 27 xxxx
 
Thank you Anne, I was disappointed at first, but the more I think about it the more I think he is probably right. The first arthroscopy lasted a year, but I was never happy with it from day one, the second was done by my present OS, and lasted two years, with a few injections to keep it going. He said that he felt it was too soon after the first TKR, and he wanted me to be able to exercise that one properly. By the way, I was amazed to hear that I'm not due any check ups on my TKR knee. I said I was 3 months + and would I see him for a 6 month / year check and the answer was "no" - there is no funding. If I have a problem contact him :sad:. That not too good is it?
 
Good grief @Ellejay that's shocking. Even here in Brum with our totally overstretched service I'm to be seen in September!!!

You're right about us both being disappointed but we have to accept their advice and expertise even though we may not really agree with it. I can see both sides of this I really can.

Hey, I bet if you paid the £4000 or whatever it cost they'd be falling over themselves to do a replacement! It's sickening. I still feeling in shock that there is no more follow up for you! Goodness me!

Love Ann xoxo
 
No @Nana moon 27 it's not £4000, my OS originally told me it would be £9000 - actually he said only £9000, which is probably ok on his salary, but from my teachers pension???? I mustn't be mean, he is actually a lovely man, but I was shaken to hear I'm on my own. He recommended more physio as I'm really not happy with my ROM, still only just over the 100 which is where it was weeks ago, but again, only if I pay for it myself. I've just paid £180 for physio but that was only four sessions, I can't keep doing that.
 
Ellejay I'm pleased you're getting some sort of solution to that painful knee maybe not what you were hoping but I'm glad you're going to get some relief at last..I'm begining to think an injection would be good for my knee too. I will have to see my GP about that tho.. You will have the holiday in France to look forward to now. One question. Do you find the injections painful.. A physio did my first one and that was unexpectedly painful. A consultant did my next two which were midly better.


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@Ellejay - I was really surprised to hear what your OS said today. Especially not having a follow up in a year. My OS normally sees you at 2, 6, and 12 weeks and then on a yearly basis. My surgeon also would not do an arthroscopic on me before hand or I may have tried it. Nor we will he give me any more injections. Some of that might be because of my insurance carriers policies or what they will and will not pay for. I totaled up my tkr one day and if I remember it was billed at $120,000.00 USD. Synvisc injections here are $4000 per knee. Thank god for health insurance or I would never have had any of it done.

If it still bothers you after this procedure can you then have a tkr and will there be a long wait? I am not sure how things work there with your healthcare. It is always a big politics issue in this country.

Take care! We are here for you!

Xoxo JoAnne





RTKR - 9th December, 2013
 
Hello @Ellejay - like NM27 - sadly not quite the result you were hoping for from your consultation today. Whatever is done the important thing is that it gets you pain-free and walking properly and comfortably again. I'm not sure when you talk of arthroscopies what you actually had done - was it meniscus repair and removal, assessment, a general tidy up and clean out, like mine? If so I don't think the relief lasts for too long. My Aussie friend who had her TKR while we were in the Middle East was convinced that surgeons are scissor happy, chopping away bits of cartilage and stuff, which means there is very little cushioning left. She said it is a slippery slope leading to TKR and told me to hang out for as long as poss before having it done, but sadly I did not have that option.
Really hope that the guided injection helps - I have never been offered one of those, only a cortisone injection soon after I had the original procedure back in 1987.
As for you being signed off at 3 months - my OS intended to sign me off in a fortnights time at 14 weeks if all was OK, as well. So it may be the usual procedure for 'Private hospitals/consultants. I am going to ask for a further check up in a few more months given the setback I have had - my physio thinks the OS may well suggest this himself, but agrees it is sensible. As for the cost of physio, it is scary. I had already used up my 'allowance' before my setback - I shudder to think how much I have spent in hydro and physio over the last 6 weeks, and I am still not done!
BTW - I ordered that Knee book on eBay - it was cheapest there.

On happier subjects I thought your daughters cake was a triumph!
Night, night
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It would certainly be a bonus to have your recovery complete and your range of motion where you want it before doing number 2 - hope so! Have you tried any of the exercises in the knee book? Just wondering how that really compares to having PT.
 
Hi all,
First of all @robynhood the injections are mildly uncomfortable but really not painful. I've had a couple in my thumb joint , not guided, and the practitioner touched the bone, which was very painful, but these into the knee, because he can see what he is doing on a screen don't go anywhere near the bone. You come away with a massive bandage around the knee and you do have to rest it for a couple of days, but then carry on as normal, except without the pain.
@dogwheels, the two keyhole surgeries I had on my right knee, before the TKR, were both supposed to be just washouts, but both times the meniscus was trimmed, so I had very little left by the time I had the TKR. This is why I would have preferred to go straight into another TKR, the meniscus in the right knee is very thin, and if he goes in there and trims it I'm soon going to be bone on bone.
@TexasTee I am certainly doing exercises from the book, exercises given by the PT and hydro exercises given by @dogwheels (&my PT), sometimes I am spending all morning exercising and using my static bike. What I've never had is any massage to my knee and I do wonder if this would improve things.
Thank you for your kind message @Jozilla, those figures you quoted are very large. Over here we all pay into the NHS, we can also have our own private health insurance, which I haven't done, and up until now haven't needed, so I could have been paying for years and never used it, and even now, when you think I'm seeing a private consultant and was In a private hospital I still didn't need insurance, but I do wish I could have some more PT. The problem is that there are just too many people on our small island and our fantastic NHS just can't cope. I will ask my GP next week if he can refer me for some PT, but I expect there will be a three - five month waiting list.
 
Good morning @Ellejay. Thanks for putting me straight about the arthroscopies. My OS always refers to them as meniscus repairs - I suppose because there were great big tears showing up on the MRI and that was his main purpose for going in there.
As one who has had more than their fair share of physio, I really do think that the massage has helped considerably. You know that it has been done - and it certainly reaches the parts that other things don't reach, but I feel so much better afterwards, and you can usually feel the benefit immediately. It was strikingly obvious over my knee where the scar is. It actually felt quite bruised at each end of the scar, and when I bent my leg you could see the skin tugging slightly across the top of my leg. She attacked each end of the scar with her bionic thumbs and it was agony. The next day it didnt feel half so bruised, and was not dragging so much so I figured if she could do that so could I. Every day my masochistic self had a good go at the scar and it is brilliant now - really mobile and fast disappearing - plus no pulling which I am sure helps with the bend. When you consider my last 6 weeks, 95% of all my land physio has been massage. The other 5% of each session has been measuring ROM and a tiny bit of her gently pushing while I do a ham string curl whilst massaging!
As long as you are sensible and reasonably diligent with the exercises you can do those yourself - but the massage you cant.
I must admit that 'this time round' I have found the most benefit in doing little and often, throughout the day. When I pass the stairs I do a set of lunges, while the kettle is boiling I do 15 rotations on my 'wheels' and then move the seat forward and do 15 more etc etc I don't do my all my prescribed exercises in one go, several times daily like I did before and I'm sure it's helped.
Anyway - enough from me. Talk later
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Good morning! Thank you for the explanations! It is so hard to keep up with insurance issues! I am fortunate I am working and have good insurance thru my employer for a very low cost. My OS does not do arthroscopy was before TKR. That's why I was wondering how effective it was. I am already bone on bone but I would have tried it if he said it would give me a year or two. Are the guided injections using Synvisc or some kind of steroids? I had guided injections in my back which were very effective and lasted about six months. I would do it again but the clinic here does not take my insurance. That is an issue we face. I think there is good and bad in any system. I do hope you find relief and it definitely sounds worth a try!

Funny about your son. So similar to mine too! Never a problem or issue so his sister was quite a shock. We are in parallel worlds for sure. I have a beautiful granddaughter from him and his wife. She is going to be 12 in June. Hopefully she will not take after her Aunt!

Have a great day everyone. Spring is coming!!!


RTKR - 9th December, 2013
 
Hi @Jozilla - I have been seeing the same OS for the last 6 years. I saw him back in 2011 having had an arthroscopy and meniscus trim/repair 3 years earlier. MRI showed completely bone on bone - and he told me he was not prepared to take any further action as there was nothing more that he could do to improve the knee in that situation, short of TKR. I was told to go away and to come back when I thought I was ready and needed the replacement.
I suspect @Ellejay that as there is still some remaining meniscus (albeit minimal) your OS will be trying to delay the TKR until all possibilities are eliminated.
Just as a side note, I waited 2+ years before returning for the TKR and during that time my knee joint, bone on bone had actually eroded and I had a large bit completely worn away .... he was surprised I had waited that long!
X
 
Hi @Ellejay you're so right about the cost of all this. When a surgeon says only, yes like you say on his salary it's probably affordable. It's unfair to expect you to pay for further physio. Its like Freddy said to me today, the NHS only do the bare minimum they can get away with. To say that a five percent bend is acceptable and ok for discharge is ludicrous. He said over time that five percent bend on your spine is no good for your whole musculoskeletal skeletal system. Eventually this will create back problems, hip problems and make our lives a misery. I'm already getting bad back and hip pain. I don't want that for the rest of my life. You and I are both have limits on what we can actually spend on things. The thing is we have paid our National Insurance all our lives. Why shouldn't we get something back out of this system! If we haven't contributed then our husbands /partners have or do!

Any way that's my rant. I'm going to try and have a nap before we go out. Take care love Nana moon 27 xxxx
 
[Bonesmart.org] Ellejay's recovery threads, first and second
Hi @Ellejay - I'd definitely try the massage, I've heard from multiple sources that the direct massage to the scar helped a great deal with range of motion...and you need just a bit more to be able to ride your bike. How exciting!

Re – newlywed…yes, I have to say if we make it through this we’ll be golden – we already survived a cycling accident and a broken collar bone for him so hopefully I’ll be as good a patient. Unlikely though…

here we are - 2/28/14 in Playa Mujeres, Mexico

@dogwheels - I think we must have a similar threshold for pain – when my OS took the last x-ray and it’s clear that there is a decent bit of bone damage and bone spurs but I’m still pretty active – well extremely active for a TKR patient. As you’ve noted, might be a double edge sword – it might be pretty hard not to overdo.
 
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