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TKR Finally in recovery

Jamie

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I am shocked and saddened by these posts about poor treatment in the hospital. There is a lesson to be learned here for everyone who comes along and reads this thread. I know a patient is in a difficult position when you're in the hospital, hurting, and people aren't helping. But it is important when things like this happen that either you or an advocate for you (friend, family member) does it. TimeBuster did the right thing.

When you are in tremendous pain and no one is helping, you can ask to see a nursing supervisor. If that doesn't work, you can ask that they contact your doctor. If that still doesn't work, most hospitals have a patient advocate number you can call when you're having problems. Then afterwards, report everything that went wrong on evaluation forms and, in the case of the "wiped off IV" write a letter of complaint to the hospital with a copy to the state medical board.

Doctors prescribe several levels of pain management for patients. It is not up to the nurses to arbitrarily determine that you're not hurting enough to have the higher level of pain relief. That is poor treatment and it should not be tolerated. If you were asking for medications over and above what has been prescribed, that's one thing that would be between you and your doctor. But you all HAD the prescriptions....they were just denying you the pain relief.

I know it goes against what we're taught to believe to challenge the medical "experts." But these days a person must be their own advocate (or have someone help with this). Not everyone in the medical field is a top flight caregiver and you have the right to ask for a supervisor or other person to help you when things aren't going right.
 
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Finally

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Hello all! I've been reading here everyday and it has been so helpful. I haven't been posting because my keyboard is refusing to let me type the letters R or W. I have to keep bouncing to the on screen keyboard. Not an easy task! Especially when I was on painkillers regularly.

Six weeks today. Pain is more of an ache than pain. I am walking with a cane but it's more of a security blanket than a necessity. Knee is stuck at a 70 degree bend. From reading here it seems to be more from swelling. I also have that tight band feeling above the knee that I have read about others having.

As far as meds...was just put on Meloxicam once a day along with Pepsid for swelling. I was on Celebrex for the first week but the acid reflux was horrific. I was very sick from it. So far so good with this one.

Taking Tylenol with oxy as needed. Trying to only use at night but if I do too much even resting is too painful.

I was going to PT until 2 weeks ago. PT contracted corona and they shut down. Fortunately, I am fine. They are opening again but I choosing to not go for now.

I am doing the exercises the best that I can at home. Have a telehealth appointment with surgeon on Wednesday.

Question about meds...Is it normal or even ok to still need a bit more than Tylenol at this point? I feel so much better when I can take the oxy/Tylenol twice a day. Once about mid morning, it allows me to do exercises with less pain and not have that ache and then one before bed.

The only instructions that I have from doctor are to take as needed. I am not good at judging this. I have never taken anything for pain before. I have had chronic pain in this knee since I was 10. Diagnosed with resolved osteochondritis dissecans when I was in my 40's but the damage was done. Not sure if I am being a baby about the pain or if I am pushing too hard to not take anything. How much discomfort should I tolerate? Probably sounds silly but I don't want to get too used to the pills.

I am icing several times a day for at least a hour at a clip. I do the exercises in short spurts. The bending is the worst. Walking is getting pretty good. I am doing laps on the deck. About 20 on a 40 foot deck with 3 steps in the middle that I am using both legs to climb.

Other execise

20 side leg lifts while standing
20 rear leg lifts
squatting while holding counter, until it hurts too much
heal slides until I get stuck, about 20
20 leg lifts while on my back
I also use a band while sitting to try to get leg to bend more

I don't do this all at once but throughout the day several times.

I have been able to do some daily living chores. Cooking meals as long as I take breaks to sit. I vacuumed yesterday.

Does this sound about on target for 6 weeks? I keep worrying about my ROM and then I read here. I calm down. The next day I start worrying again!

Thanks for reading. I know it was long!
 

Jockette

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You are doing waaaay too much for 6 weeks post op!

Leg lifts are not necessary, squats put too much pressure through the knee, and using a band to bend your knee more than you can yourself is also unnecessary. All these things are increasing your pain level. Please stop doing these things.

Trying to do some coking, with breaks, is ok, but please don’t vacuum yet. I couldn’t vacuum for months.

Since you are already taking Tylenol, try taking it more consistently. A very effective dose is 1000 mg, every 6 hours. I took this 4 times a day, which means a dose during the night, and this kept a steady amount in my body. Just be sure you don’t exceed 4000 mg in a 24 hour period. If you take any other medications with Tylenol in it, count that amount also. I did this for months and found it helpful.

You are doing a good job icing, you could do more if you want, just be sure to have a cloth or towel between you and the ice source.

Elevating is also very important:

Staying out of a PT office is a good idea, because of the virus, and also because they have you doing too many unnecessary exercises. Here are two that we recommend and they truly are all you need:
Extension: how to estimate it and ways to improve it
Heel slides and how to do them properly
 
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Finally

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Hi Jockette,

Thanks for the quick reply. I won't vacuum again! Feeling it today. I have 3 dogs and the hair just got to me yesterday.

I have been doing what PT had me doing. Guess I will ease off. I don't mind the leg lifts. My thigh muscle was starting to atrophy before surgery. Trying to regain some strength. I hate using the band! No argument for stopping that!

Do you think I should be off the oxy/Tylenol combo by now?
 

Jockette

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I think it’s fine to still be in the oxy/Tylenol, 6 weeks is really still very early days in this year long recovery. I think if you cut back those exercises your pain will reduce, and you’ll have less need for the oxy and then Tylenol will do the job.
My thigh muscle was starting to atrophy before surgery. Trying to regain some strength.
You’ve just had a very major surgery that caused a lot of trauma to your body. Give it more healing time before you work on strengthening. You have plenty of time.

Even though you don’t mind the leg lifts, all the ones you are doing are not necessary and are contributing to your pain. Save them for later when your pain has diminished.
 

pamsknees

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Finally - I totally get the need to vacuum - I have 3 dogs also. Have you considered a robotic vacuum? I’ve had one for several years now & while it’s not perfect, it does a decent job
 
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Finally

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Still having a rough time, 7 months out now. I am better but still swell if I walk or stand for too long. Home Depot makes me swell as soon as I walk in the door. I have a bend of 118 but still have some discomfort even when sitting. So, today I went to Home Depot, quick in and out. Knee swelled, elevated, iced and then tried to massage kneecap like PT showed me. Oddest thing, when I touched the kneecap it clicks. I can tap it and make it click. I could play castinets on my knee. Is this normal?
 
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Finally

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Just testing, my last post didn't seem to work
 

Jockette

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Where you are at 7 months is fairly normal for a lot of us, I was the same way.

I never had clicking, but many do, it’s another normal thing.

Here’s an article about the clicking:
 
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Finally

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Hi Jockette,

Just saw your reply this morning. Thank you.

I went to surgeon last week. The pain is not getting better, waking me at night. Seems he finally listened to me. He is concerned about the amount of fluid, warmth and night pain. He also mention that the knee is a bit wobbly from side to side and the possibility of a spacer. I can bend, straighten, walk, just everything hurts!

He sent me for blood work to check for infection. I don't have a fever. Just saw my white blood cell count is elevated and something called a d dimer??? is elevated.

I did ask about the knee cap noise. He said it was because there is so much fluid and there is a gap because of it.

Going back this Tuesday. Not sure what to hope for. Hoping nothing is wrong but that means living with this pain. If something is wrong then it can be fixed! Just hate this. I don't know what I would have done about work if I hadn't gotten laid off. Of course that is a problem for the near future. Ughh...
 

Jockette

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I hope you get things sorted out, still being this uncomfortable this long is difficult, I know. In my case, things got better with a lot, and I mean a lot, more time. My knee still isn’t great, but it’s manageable.
 

szrmom

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Reading your stories makes me really glad mine were outpatient at a surgery center, and I never had to deal with hospitals.
 
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Finally

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Saw surgeon today. Blood work is ok, he did aspirated fluid to be sure no infection. He has suggested replacing the spacer. I am so upset. This has been so hard. Almost 8 months of constant pain. I am terrified of having surgery again! Just not sure what to do. I go back k next week. Just letting it sink in now.
 

Jaycey

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He has suggested replacing the spacer.
Did your surgeon give you a reason why he suggested this? So sorry this has been a long haul for you. Hang in there!
 
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Finally

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He suggested this because of the pain, it wakes me up. He wiggled it and said there is a lot of play from side to side. The knee is very warm and was very swollen until he drained it. I have good rom and extension, it just hurts to move it. I can do it but the pain is awful. Honestly I was better before surgery.

Today, since it is not swollen for the first time since surgery, I feel better, not great, still hurts to move it but the constant ache when at rest is not thete.
 
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Finally

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there. For typos...new phone
 
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The ache is back. Having the fluid drained gave me so much relief although it was for testing for infection. Unfortunately, it only lasted for a couple of days. It doesn't look very swollen but it feels it. The ache when at rest is very hard to deal with. It makes me so tired and it is hard to concentrate on anything else.

I go back to surgeon on Tuesday to discuss replacement of spacer. Hate the thought of going through recovery again but hopefully this time it will be worth it. Any questions that I should ask? How do I know that this is truly the problem? Just don't want to go through this for nothing.
 

Qdogpa

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I have aches at 9 months post op, but it is not pain...whenever I walk or move the knee it aches..I am of impression it’s will continue to get better ...
 
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Finally

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Hi Qdogpa, I wish I could say that I only have aches for a reason! I seem to have aches all the time with the occasional good hour or so. I have pain that is waking me still. It's 4am and I am up after a very restless night. I keep trying to convince myself that it isn't that bad. I am so nervous about another surgery. I had a bit of a rough time and don't want to do that again!

If I could be sure that it would improve I sure wouldn't have surgery again. My flexion and extension are good but it hurts to walk, stand, sit, climb stairs and I don't even attempt going down stairs the correct way anymore. I would gladly give up some flexion to not hurt anymore.

I hope that you continue to heal and the aches go away.
 
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Finally

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Hi jsa. White cell and d-dimmer were just slightly elevated. I am going to ask him about this again. I have an appointment today. I suppose we are going to discuss surgery. Wondering if there are any other tests that could confirm that spacer needs to be replaced besides him wiggling my leg. Doesn't inspire much confidence.
 

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