MUA Getting Back in the Saddle

[Josephine]

Your OS comments were ridiculous

It wasn't the surgeon, it was the GP. But it was still ridiculous!

so she can break down this haematoma, stop the "hypersensitivity" and get my knee moving

And so is this! Utter rubbish!

Her (GP) view is that I have an infection!

I doubt it but I do think you have either excessive swelling or a haematoma. Either way there is no invasive treatment to be carried out. Juts rest and wait.

She has prescribed a very strong double dose antibiotic and said that the knee should be resting and should not be bent.

Antibiotics won't do you any harm but she's right on the button about the rest!

we had the usual discussions about my poor progress and why I need to be force bending my knee every hour and giving myself firm, painful scar massage

If this is what she has been doing then SHE is the problem, not your knee! She has caused the swelling and the pain and you were dead right to tell her no more!

But my GP felt I should be loads better than what I am "You're nearly 3 weeks out, you should be getting going now" and should not be running a temperature nor experiencing so much pain.

So clearly evident that your GP knows squat about TKRs! At 3 weeks I was upping my Tramadol to 3 at a time a couple of times a day (by doctor's orders). And I needed it.

Here's the famous five again
1. how often are you icing your knee and for how long?
2. how high are you elevating your leg, how often and for how long?
3. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and
4. what kind of physio are you doing? How much and how often?

 

[new knee in June]

Allison,
I am so sorry you are going through this I hope you don't have an infection. We are very proud of you for
Making p.t stop hurting you.
Did you know you were running a fever....at least now you get to rest & have stronger meds on board.
I am for you ...please keep us informed.....we want only the best for you......your horsey babies want you
Better too.
Best wishes......Diana....

 

[HorseyLady]

Diana - Thanks for your best wishes. I really hope I don't have an infection but I just don't know what to think about this knee any more. The Hospital have rung this morning and told me NOT to take the antibiotics until I have seen my OS. So I have an urgent appointment with him tomorrow afternoon. In the meantime I am just elevating and icing with some short, slow walks in the garden for stretching purposes. I have stopped everything else until I know what is going on.
No stronger meds but if I am not being tortured then I don't need them as Tramadol takes care of usual pain. It just can't cope with massage
There is definitely a huge hematoma above knee which is preventing ROM as I just cannot get past 50 without really bad pain. There is lots of swelling, heat and redness all around the knee but the wound itself is dry with no leaking. Touching anywhere is uncomfortable.

Josephine - to answer your questions:

1. how often are you icing your knee and for how long? About 4 times a day for about 30 minutes at a time with an hour or so in between. I am using frozen peas.
2. how high are you elevating your leg, how often and for how long? I am elevating my leg all the time when seated - resting it on 3 pillows piled on a footstool so its above waist height. I spend every evening lying on my bed with it elevated on pillows. I sit with it down at mealtimes but it is elevated the rest of the time.
3. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., Nothing in way of housework, cooking, cleaning, shopping! My lovely husband is taking care of everything. I have short walks (5/10 minutes) in the garden round the patio for stretching purposes and to get some air. I am walking with 2 crutches and I walk slowly but try to stretch gently my thigh as my bend is so poor. In the last 2 weeks I have had 3 short car journeys (25 minutes) when I have been driven to the stables to see my horses. I sit down when I get there for about 20 minutes and cuddle the horses and feed carrots so hardly any walking although my leg is not elevated.
4. what kind of physio are you doing? How much and how often? I was doing my exercises 3 times a day, 10 repetitions - mainly heel slides, statis quads, inner range quads, flexion, slr's etc. but they also recommended some hanging flexions which hurt. The Rehab team have been 4 times in last 12 days to do additional exercises with me, measure me etc. but no change from 50. My problem is that they insist on doing soft tissue massage which is excruciatingly painful over the hematoma and that is why I told them to stop. Since yesterday I have stopped all physio and just doing slow walking to stretch out until I know if knee is infected or what OS says tomorrow.

 

[Josephine]

There is definitely a huge hematoma above knee which is preventing ROM as I just cannot get past 50 without really bad pain. There is lots of swelling, heat and redness all around the knee but the wound itself is dry with no leaking. Touching anywhere is uncomfortable.

It does sound like it though at three weeks, it's a little unusual. Will be very interested to hear what the surgeon has to say. Which hospital do you go to, btw?

As for your answers, all very good and okay. Only thing I would suggest to change is that you get some large gel packs for icing instead of the peas. The cold lasts a lot longer.

 

[new knee in June]

Horsey lady,
You sound like you are in a lot of did you see your doctor yesterday...what did he say...
My daughter was told to do anti-biotics & they called & said to stop taking them. Because she didn't
Have an infection. I hope this is what has happened in your case
Please keep icing that hematoma maybe the swelling will diminish....
Happy 4 th of July
Talk soon,
Diana

 

[HorseyLady]

Happy 4th July Diana! Hope you are having a great day.

I have seen my surgeon today and he says I don't have an infection But he says take the antibiotics anyway just in case there is something else going on that is causing a fever. I had an xray of my knee and he says all looks fine and he isn't worried about anything. I do have excessive swelling, bruising and a hematoma but for me, that is to be expected. He was very nice and explained that most people have TKR for arthritis but I was different, it was post trauma, the 5th surgery on my knee and all the scar tissue that goes with it. Therefore my recovery would be longer and I will have to work harder than most people to get where I need to be.
On the down side, he doesn't seem to follow the Bonesmart mantra and he said I have to "push, push, push" through the pain to get that knee to bend I will see him again in 4 weeks.

Josephine - I go to Calderdale Royal Hospital in Halifax, my surgeon is Mr Walsh.

I am feeling reassured so will restart the exercising tomorrow

 

[Josephine]

he said I have to "push, push, push"

Well, he's not wrong - it does move it into a totally different category so I suppose I shall just have to grit my teeth when I read about your exercise programme! And he has an interest in sports injuries as well which also alters the playing field (pardon the pun!)

 

[puffin]

Glad to hear that your OS does not think that you have an infection
I feel your pain regarding the slower recovery - I also feel that mine is going slowly but I am also a post-trauma TKR. I guess I am just lucky that they leave you alone to work on ROM for 6 weeks hear in Sweden
Take care of yourself

 

[HorseyLady]

Thanks puffin. I see your accident was 2010 too - I guess we seem to be following a similiar pattern. I was knocked over by my dog which fractured my tibial plateau, tore the meniscus, tore the medial collateral ligament etc. I had plate and pins put in and things just went downhill from there and the tibia plateau eventually collapsed due to necrosis. What happened to you?
I always knew that TKR was likely but I have to say that I didn't realise I would have a slower recovery than other people nor ROM problems. I found it frustrating in hospital when people 20 years older than me were far more agile with better ROM, even the poor lady with MS could bend better than me I stayed 9 days and was still only at 50 when they eventually released me. I wish I lived in Sweden!!
You take care - and I am following your recovery too

 

[Josephine]

I was knocked over by my dog which fractured my tibial plateau, tore the meniscus, tore the medial collateral ligament etc.

My guess is that he isn't a Yorkie then?

 

[HorseyLady]

Lol, no she is a greyhound She was running at about 30mph and hit me head on at the side of my leg just at the joint line. My knee kind of fell apart

Not her fault, just a freak accident but so many people have said to me "did you get rid of the dog". Errr no, I still have her and she is a much loved family pet, we were lucky she didn't break her neck - just carried on running - so things could have been a lot worse.

 

[HorseyLady]

Well today has been one of those days when I am tearful and feel totally fed up with my knee. My ROM is not improving at all and in fact feels to be getting stiffer, bending it kills and the huge lump is not going down. On the positive side we are having lovely weather here so I have made a nest in the garden and am exposing "elephant leg" to the sun with a good book and an ice lolly!

Question - I have been able to borrow a laser therapy unit which utilises an LED wand to apply some laser therapy to my knee. I am told it can reduce swelling and stimulate healing. Has anyone ever used one of these? Any success stories? I am desperate to improve my ROM and get rid of this swelling.

 

[new knee in June]

Hello horsey lady,
Just checking in with you I am sorry you are having a bad day.....have you been to your surgeon about the
Hematoma & rom....what did he say...if he says ice,elevate, gentle bending, is he upset with your progress.
Glad you had a nice day to go out in your garden it has been so hot here..I can't even sit in my yard
High 90's & 2 days 100 degrees I hate the summer.....
I will check on you tomorrow
Diana

 

[HorseyLady]

Thanks for thinking of me Diana. My surgeon does not seem worried or upset with my progress, he has explained that it will take me longer than most people because of my history. But he does say I have to keep pushing - he is not a fan of the Bonesmart mantra and thinks I need to push through the pain but I will get there. It is just me who seems intent on giving myself a hard time and comparing myself to others Even the people on here having MUA bend better than me - I am just worried that I am heading for that too.

So hot here today, very rare for the UK, but I am loving it I need a pool, a cabana and the cabana boys

 

[new knee in June]

Dear horsey lady,
I hope you keep icing & elevating & meds. On time. as you know all to well....a swollen knee will not bend
Your surgeon seems to think you had a very damaged knee...possible will take a little longer for swelling to go down.
In the mean time........imaging yourself sitting by the pool... I have sent the cabana boys your way..
Their names are packo & ram one....packo would be so pleased to get you your favorite ram one is
There to massage your aches joints& feed you grapes & small little sandwiches
Have a relaxing day....you may use the boys as long as you like
Hugs to you,
Diana

 

[Dulcimer Diva]

Hi, Alison,
So THAT's where those cabana boys are--all the way across the pond in the UK! Guess they didn't want to put up with the threats of thunderstorms here along the Great Lakes. Will have to let my kitty Happy (the 5-yr-old 15-lb perma-kitten) be my personal assistant; just have to make sure he doesn't try to do scar massage. Ice lolly sounds good (is that what we in the US call a "Popsicle" or is it ice cream on a stick?). In my freezer I have some sugar-free Popsicles and a chocolate-covered soy ice cream bar. Think I'll wait till the "Paleta man" comes by: he has a little freezer attached to his bike; and the Mexican paleterias around here have exotic flavors like guava, passionfruit, prickly pear, coconut, piña colada, horchata.......

Bob just got back from church; the French Carmelite nuns were there, selling their pastry. I now have a huge blueberry-creme anglaise tart sitting in the fridge. Can't eat it with just one hand like an ice lolly, but I'll cope. Sending a virtual slice to you in the UK....

 

[HorseyLady]

Ooooh Sandy, thanks for the virtual slice of anglaise tart - sounds lovely. But virtual is no good ... I want a real one And I also love the sound of the Mexican palaterias - I wonder if your man on his bike would like to visit the UK? If so I'd like to preorder some pina colada ones please.
I love Chicago - my husband ran in the Chicago marathon several years ago and we had a fantastic stay. You are very lucky to live there...

An ice lolly is like a popsicle so in this weather they are lovely. It is not often that we have very hot weather but we are enjoying a mini heatwave at the moment so I have been able to let "elephant leg" get some healing rays of sun. I have scared off the neighbours though

Yes, I have 2 cabana boys, thanks to Diana They are not allowed to touch "elephant leg" nor do scar massage (way too painful!!) but I am letting them massage other parts and also to bring me drinks and nibbles. If they promise to be careful I might let them do some gentle heel slides later. They have promised to deal with the Rehab Team if they visit tomorrow and not let them touch me

 

[new knee in June]

Hello horsey lady,
How are you doing good i hope. How was p.t today......did they go gentle with you....I can't imaging
You would want anyone going near "elephant" leg I hope the cabana boys are treating you well
They seem to like you a lot & have asked if they could stay with you
I'm thinking of you....hugs....
Diana

 

[HorseyLady]

Hi Diana. A quiet day today - and the Rehab team didn't turn up so no PT Just a few gentle exercises myself and a day resting and elevating in the garden - being tended to by the cabana boys
Tomorrow I am having a trip out to my out patient PT - and he will be touching "elephant" leg so I'm practising shouting STOP
Yes, I will be keeping the cabana boys thanks - they are very well trained , you've done a good job with them!

 

[bottomshollow]

HorseyLady, read the article this link takes you to, to see if perhaps this is the problem you're having with your flexion, which will mean you need to cut the PT out for a while and spend lots of time resting, elevating and icing, and taking your pain meds on a schedule. Swollen and stiff knee: what causes it?

Take care and keep us posted. We care.