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[TKR] Good Strong Knee - No Bend<

Discussion in 'Knee Replacement Recovery Area' started by Gel-girl, Jan 27, 2018.

  1. Gel-girl

    Gel-girl member
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    Perhaps a strange time to start a recovery thread but here goes. Quick recap on recovery so far.....if it hadn't been for bonesmart I'd have thought I was the only one in the whole world who was suffering with pain, crying at the least thing and wanting to shout at GPs and physiotherapist 'you wouldn't treat me like this if you'd have had a whole knee replaced!!!'
    So 13 weeks out of surgery
    a) I am still in pain,
    b) still taking the meds - will list them below - over 24 hours,
    b1) still elevating but not in bed,
    b2) still icing for well over 40 mins using gel pads (best thing since sliced bread - hence the user name!) 4-6 times over a 24 hour period
    c) waiting for the pain clinic to see me (18 week waiting list - so many people in pain at the moment [truth not sarcasm]),
    d) appointment in less than 2 weeks to see my GP about 'all' the meds I'm on,
    e) signed off from the surgeon at 5 weeks,
    f) physio not signed me off but quite happy for me to do my 'exercises' at home and will see me for a massage in 4 weeks 9 (just don't push that knee down again! She did the first time - not the second!! - lovely girl though) exercises consist of heel slides with foot up only heel on bed and quad squeezes. I only do these when I remember which is not every day and usually only when I feel like it usually 5 each, never more than 10 - don't tell the physio thought!!!
    g) half cycles on the static bike at home, also not everyday just when I feel like it so twice a week for about 5 minutes - I feel I should do more!
    h) and walking up to 5000 steps a day without crutches or stick, trying to stride, walk without a limp and with a straight back. Sometimes I do more but boy can I tell!​

    Two days ago I made a two hour drive to Gatwick airport - well hubby did - I just kept falling asleep next to him! Stopped once on the way. Managed to get all my 2 week medication through security (we only had hand luggage, no hold luggage) spent time in the airport walking around and sitting drinking and eating. I had my beautifully colour co-ordinated green compression stockings and a tubigrip round the offending knee (in retrospect this wasn't such a good idea and I felt it caused some of the swelling that happened as the day went on).

    I decided to use my stick on the airport just to show people not to mess with me - haha, no to give me a little confidence. I also decided not to use 'special assistance'. We ended up using the back steps to the plane but as there were not many people about my slow ascend was fine. The 2½ hour flight was ok I got up to walk the length of the plane twice and once to use the loo.

    At the other end I was still using my stick and my 'not that slow', 'one step at a time' but quick descend from the back steps was fine with other half going ahead and waiting and me moving to one side so people could get past. Luckily we were very near the exit and I was directed to a short 'human' operated passport control instead of having to queue with the electronic readers. We were soon at our place and I was able to put my leg up with very cold cloths round the knee and makeshift gel pads in the freezer using freezer bags and water which I used during the night as my sleep was very restless with quite a lot of pain between meds. Anyway the change of scene and the sun has made a difference to my psyche but might have been better to have had a weekend away in Bournemouth!!

    Meds List
    Tramadol 50mg 8/day - 2 every 6 hours
    Paracetamol 500mg 8/day - 2 every 6 hours
    Codeine 30mg 8/day - 2 every 6 hours with paracetamol
    Ibuprofen 6/day - 2 every 8 hours
    Gabapentin 300mg 3/day - 1 every 8 hours
    Zomorph 10mg modified-release 1 at night


    My personal feeling on the meds are:
    Tramadol works, paracetamol works, not sure about codeine but because I take it with the paracetamol it's difficult to tell if it works, Ibuprofen works, Gabapentin sort of works and has certainly taken away my sensitivity. Zomorph is something left over from before my TKR to help me sleep with my arthritis. Not sure it worked although my sleep at the beginning of the night was good (and still is) but as soon as the pain kicked in I was quick to take the paracetamol.
     
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  2. Angiebabe

    Angiebabe junior member

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    How come the surgeon signed you off so early that doesn't sound right?
     
  3. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    That history concerns me Gel-girl. I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
     
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  4. Gel-girl

    Gel-girl member
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    Angiebabe it’s usually 6 weeks but he was on early Christmas holiday so 5 weeks it was!
    Josephine good to hear from you. Of course you can as any questions to help me out and anyone reading in the future. Some of your comments in the past have certainly helped me so thank you.
     
  5. Angiebabe

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    Just curious..who then is 'in charge' of your care? my surgeon follows up at 2 weeks ,3 months, 6 months and a year.
    I would feel at sea if I didn't have his support.
     
  6. Gel-girl

    Gel-girl member
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    Angiebabe - Me I guess and my local doctor and the physios! He didn’t say he would see me again and the letter sent to my GP implied I was now their responsibility (I was sent a copy of the letter by OSs PA
     
  7. Gel-girl

    Gel-girl member
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    I don’t really feel at sea but that could be because of Bonesmart so if I have a problem and I’ve had many I just read some of the articles and threads and feel supported. I guess there have been times I have felt isolated but that was in the early days when I had so much pain and no one seemed to think I needed anything. One nurse practitioner gave me Tramadol which helped but a GP I saw told me there was nothing else he could do but prescribe Gabapentin. This helped a little. I’m seeing a Gp when I get back from this break. It’ll be interesting to see what she says!
     
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  8. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Well Bonesmart is the best place to get info and support. I trust it way more than my surgeon!

    My surgeon has me come in a lot, and since I found Bonesmart, my checkups stress me out, because I’m following the Bonesmart way, not my surgeon’s way. I don’t like to disagree with people.
     
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  9. Angiebabe

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    Oh no disrespect I was just interested in the different protocols. I just didn't want you to be signed off by the guy that did the job and has seen inside your knee and has the expertise hopefully in the early rehab phases.

    My gp is lovely but isn't a TKR specialist and is guided by the surgeon for aftercare. The best info he gave me was how big a deal the TKR was and that he would have my back afterwards.

    Good luck with it all. We are county neighbours in the UK!
     
  10. Gel-girl

    Gel-girl member
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    Oh didn't take it as disrespect. Didn't realise my OS should've kept me on! Quite interesting to know. I guess I could contact him through his PA if I need to and the hospital gave me plenty of phone numbers if I had any problems just felt most of my problems were petty but maybe not in retrospect. Maybe OSs are different in different counties as well as different countries.
    I've had quite a lot of pain last night and a bit today. Had a short walk this am to get moving but not really done anything much rest of day but elevate, ice and watch TV. Knee quite hot and swollen. I hope I have a better nights sleep tonight.
     
  11. Angiebabe

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    By the way the date on my data is wrong my surgery was also the 27/10/17 so we are knee twins
     
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  12. Space Knee

    Space Knee junior member

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    Last time I was through Gatwick I had my mom along -- she has two bad knees and uses a walker. We registered for a wheelchair and got the royal treatment all the way through the airport!

    I note that you, too, are taking Gabapentin -- my doc prescribed it because the sciatic nerve kicked up and was causing problems. They put me on a baby dose (100 mg), and it seems to work a treat.

    Keep doing the icing and elevating -- it's cheap and easy. ;)
     
  13. Gel-girl

    Gel-girl member
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    Space Knee perhaps I should have gone for the royal treatment we did think about it! Oh well my knee got over that and is back to normal! Normal still being painful but yep the gels are amazing things. Went to the Chinese market again today to get 3 more so I can almost be constantly iced!! Angiebabe must look at my signature my date is 26 October 3017. I went in for a partial knee replacement but my whole knee was shot at so he gave me a tkr so bit of a shock when I came round. I know you sign up for full knee but really didn’t expect it.
     
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  14. Gel-girl

    Gel-girl member
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    Bad night last night. Saw every hour on the clock. Iced 4 times and dozed. According to fit bit I had 4 hours light sleep but no deep sleep! I usually get at least an hour deep sleeps sporadically through the night. Reckon I did too much yesterday. The pain was specific. It is my left knee and the pain was interior below the knee and slightly to the back. It was a constant pain not an ache and made worse every time I moved. The ice helped and walking to the loo and the freezer 4 times helped too. Perhaps I should have gone for a night walk!
     
  15. Gel-girl

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    Josephine I know your a busy lady but just a polite reminder about asking me some questions. I am up for that as I'm not sure if I should be further on than I am. Also need to know if I should be lowering the meds before I see GP in 10 days time. Much appreciated.
     
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  16. Gel-girl

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    @rtkneeandy
    Didn't have PT till 5 weeks after - waiting lists! I only really had 2 'knee class' sessions where a few of us rotated round different exercises but I found who ever ran it expected us to do each exercise 3 sets of 10 which was too much for me. At home I tended to do 3 sets of 5 of a couple of exercises but at 3 different times during the day. I also found it all too painful and ended up in tears on both occasion so was asked if I wanted to leave which I did! I also had a physio who massaged my whole knee twice. The first time it was quite pleasant but at the end she tried to push it down to get my extension which hurt and I had to move her hands whilst saying No very loudly - she was a little startled. The knee swelled up that night and was very painful and the next time which was less than 2 weeks ago it was pleasant again and she didn't try to push it down or push it back when I was seated. My flexion was 90 and my extension was +10 which she said was OK but I could do to have more flexion.
     
  17. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Here y'go then!

    It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

    1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

    2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

    3. how swollen is your leg compared to these?
    ai63.tinypic.com_eta39s.jpg

    4. what is your ROM - that's flexion (bend) and extension (straightness)

    5. are you icing your knee at all? If so, how often and for how long?

    6. are you elevating your leg. If so how often and for how long?

    7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

    8. are you doing any exercises at home? If so what and how often?
    This is the most crucial question so please help me by using the format I have left as an example
    (which means please make a list and not an essay!)

    Exercises done at home
    - how many sessions you do each day
    - enter exercise by name then number of repetitions of each
    etc., etc.

    Anything done at PT
    - how many times a week
    - enter exercise by name then number of repetitions of each
    etc., etc.
     
  18. Gel-girl

    Gel-girl member
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    1) Pain Level 4 during the day, 7 during the night as interferes with sleep
    2)Top of scar is still sore
    Still get ‘some’ stabbing aching and stiffness when I get up during the night and first thing in am
    No burning anymore although still need to keep my knee outside the bedclothes Knee hot to touch in between Icing
    Swelling every day and night

    3) Pain Meds
    Tramadol 50mg 8/day - 2 every 6 hours
    Paracetamol 500mg 8/day - 2 every 6 hours
    Codeine 30mg 8/day - 2 every 6 hours with paracetamol
    Ibuprofen 6/day - 2 every 8 hours
    Gabapentin 300mg 3/day - 1 every 8 hours
    Zomorph 10mg modified-release 1 at night

    4)Leg Swelling – 2

    5)ROM 90 with push and +10

    6)Icing every time I sit and elevate (using gels back and front) leave them about an hour.
    4-6 times a day and 4 times at night.

    7)Ironing-Washing – not much, little as possible cooking. Clean bathroom every 3 days
    Keep kitchen clean. Food shopping every 2-3 days (small shops). Hoover. Husband still doing quite a lot!

    8)Actual exercises are very sporadic – once a week, twice at the most
    Heel slides with heel up – hurts if foot flat, usually on bed sometimes on a chair, 5 - 3 times a day when I remember
    Thigh tightening push knee down, 5 - 3 times a day when I remember
    Static cycle – half turns and some full turns if I stand up, 5 minutes when I remember
    I walk everyday without a stick, without a limp and try to do heel toe and stride out. Fitbit tells me I do 5000 steps a day that includes indoors too. Some days I do more but I pay for it at night and day after!
    Not had too much PT as they push too much and expect you to exercise for too long

    8)PT attended 2 classes but only stayed 10-15 mins after doing one exercise each time 3 sets of 10 with rest in between. Too much for me ended up crying with pain on both occasions!

    sat on bed slide Leg toward body grab ankle pull hold for 10 secs. 3 sets of 10
    squats against wall feet well out slide as far down as possible hold push back up. 3 sets of 10. I quite liked this exercise it felt good but not after 2 sets. I didn’t manage the 3rd set!
     
  19. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Okay
    Well, you shouldn't be taking Tramadol and codeine at the same time. I suggest you stick with the Tramadol and paracetamol only.
    Ibuprofen is a poor pain med and shouldn't be taken as such. I suggest you read this Medications: acetaminophen (Tylenol, paracetamol) and NSAIDs, differences and dangers
    I take it that by this you mean medium?
    Do bear in mind that the only number that counts when you are
    Good
    Okay

    Heel slides 5 - 3 times a day - you haven't said how many!
    Thigh tightening push knee down, 5 - 3 times a day - yeah, don't do these. They cause pain!
    sat on bed slide leg toward body grab ankle pull hold for 10 secs. 3 sets of 10 - no pulling. Don't do these
    squats 3 sets of 10 - never did like this as an exercise. It causes pain!
    Static cycle – half turns and some full turns 5 minutes - okay

    PT attended 2 classes but only stayed 10-15 mins after doing one exercise each time 3 sets of 10 with rest in between. Too much for me ended up crying with pain on both occasions! - that tells you all!

    Fitbit tells me I do 5000 steps a day - your Fitbit tells me you are doing far too much!
     
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  20. Gel-girl

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    I’d read about the codeine and Tramadol but thought that must be ok as GP kept prescribing them! I’ll stop taking codeine as never felt it did anything! Will stop the ibuprofen too even though felt that helped. Stopping these may help my case to stay on Tramadol and paracetamol. Perhaps I should ask for a blood test to check the liver?

    I set out to do 1 set of 5 heel slides 3 times a day but don’t always manage that so realistically I only do 1 set of 5 a day! I will stop the thigh tightening and the other ones I mentioned I only ever did twice at physio where it all ended in tears!

    Walking is my only real exercise and I do enjoy it but I’ll talk to my fit bit and tell it to do less!

    Thanks for that Josephine it is much appreciated. I feel I’m doing ok it’s just not quick enough, I’m a bit fed up with the pain (I thought I had a high pain threshold once upon a time) and would love a full night's sleep. It’s so true ‘it’s a marathon not a sprint’.

    Thanks again and Bonesmart too - you're doing a great job.
     

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