Revision TKR Here I go again - round three

Oh, yeah, evenings can be rough and I know just what you mean about the "get me off this recliner NOW!" phenomenon... dunno what your chosen distractions are but I find myself rotating through about five different ones in rapid sequence! (snuggle cat! read an article! do an online jigsaw puzzle! walk around looking out every darn window! watch a dumb movie!...)
Increased pain and/or swelling late in the day and at night are usually an indication that you are doing too much during the day. Cut back on your activities and see if you have less pain at these times.
Believe me I’ve done hardly anything today. Outside of icing and elevating and trips to the bathroom the only up and about activity has been to make my lunch (a sandwich) and make my supper (bowl of fresh veggies and some crackers). That’s it. Very little activity today.
My lower back (reminds me of sciatica pain) just couldn’t take the recliner anymore for sleeping. And I just couldn’t take it anymore of keeping my leg straight all the time. So last night I tried Sleeping in my bed. No elevating, no icing. I got 5 hrs of sleep. And I was even able to get about 1/2 way rolled over on my side (left surgical leg). It helped with the back pain while sleeping, but it’s still there this morning and even moreso while sitting in the recliner. I think because of the one leg being elevated and the other not, it has affected my hips. They’re tilted. It was noticeable at PT yesterday. My surgical leg is longer than the non-surgical leg. I may call my chiropractor today and see if something can be done that wont affect my knee. My knee was a little stiff and slightly swollen this morning, so now I’m icing and elevating until I have to get ready to go for a dr appointment, which is pointless in my opinion. But it was ordered by my surgeon to see my PCP for a post hospitalization office visit.
Hi, I changed recliners/chairs during the day, so I wasn't always in the recliner I slept in which seemed to help my right hip discomfort. Seems like you are doing well in bed which I couldn't do until 10 or so weeks. You probably need to see your pcp because you are off your B/P meds. Sometimes anesthesia will do that especially if you are not staying hydrated. This happened to me with my last surgery. I found the best way to build up my stamina was to take a shower every day. Good luck to you.
Saw my PCP this morning. My bloodwork was perfect. He was surprised I wasn’t anemic being this close to when my surgery was done. He said he usually doesn’t see this good of lab results 11 days post op. He approved my Tylenol/tramadol schedule of taking those every 4 hours as long as I don’t exceed the 24 h max. He said the new recommendation is actually 3000 mg Tylenol in 24 hrs. He said over the next couple of weeks he would like to see me drop one or two of the tramadol schedules or stretch out the duration between doses, as long as the pain is controlled. By the time I saw him this morning I was getting close to when my next dose was due, and I felt like I was doing a catch up anyway, so I was miserable waiting in the room. He noted it the minute he walked in and said ‘you look miserable‘. Haha. It was a little tough fighting back tears when he asked how it was going. But overall he thinks I’m doing really well at this early stage of recovery. Validation is a good thing.
@Flashlight my recliner is my only chair besides my kitchen chairs. And I have found sitting in those are uncomfortable. But I do force myself to sit there for some of my meals. The only other seating is my sofa. And that is too low for me to get up out of safely without torquing my knee. My blood pressure was normal today so my PCP advised that I still stay off of BP meds for awhile, but to keep monitoring my BP until I see him again on 8/18. While sleeping in bed felt great, I don’t know if I’ll do it again anytime soon unless I set up a polar ice machine in my bedroom. Living alone, it’s a hassle to move those things from room to room. So the recliner is it for awhile.

Haven’t attempted a shower yet. Even though my incision is cover with what looks like a waterproof bandage, (and of course I would wrap with Saran) I’m just a bit leery of not wanting it to get wet. Especially since I saw that I still had places on my incision that aren’t closed yet. I know that’s being overly cautious. When I had my original TKA on this knee one part of the incision took so long to close that I ended up going to the wound clinic for 6 weeks. I just don’t want a repeat.

And good news, my PT told me she thinks I am able to drive. As long as it’s only to PT sessions or to my PCP or the pharmacy. Being it’s the left leg and my flexibility is pretty good for this stage she thinks I can do It. So I’m going to try it tomorrow when I go to PT. I’ll go out early in the morning to see if I can get in and out of the car ok. If not, I’ll call my friend for a ride. I’m thinking it’s going to be easier getting into my car than it has been in the SUVs my friends have been picking me up in. You never know you’re ready until you try. And from past experience, I’m super cautious and take the back road/side streets to my destination. Haha.
And good news, my PT told me she thinks I am able to drive. As long as it’s only to PT sessions or to my PCP or the pharmacy.
Your PT is not the one to say you can drive, it's your OS. Many insurance companies will not cover you if you are not released to drive by your doctor. You should check with your insurance company before getting behind the wheel. I personally think it's way too early to even think about it yet. You will be subconsciously protecting that knee while driving and not completely concentrating on the road.
I understand about narcotics and driving. I could be on tramadol for another month or more. Before surgery I used tramadol for when pain was too much for just Tylenol, and I was at work and drove. I’m not justifying anything, just saying I know how tramadol affects my body.
I won’t drive myself to PT.
I’m not justifying anything, just saying I know how tramadol affects my body.
I understand and agree with you. But, if you had an accident and your blood was tested you'd be under the influence. Even if it wasn't your fault, your blood would probably be tested. It's not worth taking a chance.

Also, your doctor is the one to release you to drive, not your PT. I doubt the insurance company would accept that.
Hello midwest girl,
It's been one month since your revision and we haven't heard from you in a few weeks.
Wondering how it's going for you? I hope all is well and you're enjoying steady progress.
Hope to hear from you soon!
@midwest girl
Today is my 1 month anniversary for my revision. I’m progressing ok or according to my PT, progressing as expected. I had an appointment with my surgeon on August 3rd To remove the stitches. He thought I was doing great (they read the PT report I brought with me). They all thought the incision looked great. He did ask if force was being used by the PT when flexion was being measured. I said yes, they gently push on the leg. He said nope! Don’t allow them to do that. Wish they would have wrote that in the PT order from the beginning. Also found out that he did a quadricepsplasty on my knee. That explained a lot of why I was having so much pain during exercises in a certain area on my leg.

A couple of weeks ago during a Friday PT session, we were doing a simple exercise - stepping up and down on a step, about 3” high. During a step up we heard a loud pop in my knee. But no pain, and no pain for any exercises after that. When it was time to lay down and have the e-stim and ice therapy, I went to raise my legs to lay my legs on the wedge, I had an incredibly sharp pain directly above the knee. So intense that it felt like I tore something and so intense that it brought me to tears. After the icing etc, I was able to walk with no problems. I rested the knee a lot that weekend and always used the leg lifter to move my leg. To give the quads a rest. After that during exercises I would just get pain doing leg raises or stepping up. Talked with the surgeons office, the popping noise they think could have been adhesions breaking loose. As far as the sharp pain, that was the area where they cut/repaired the quads. They said to just watch it. If the pain worsened to come to the office. It never did and it’s been slowly improving. I think when I raised my legs to put it on the wedge, that I just raised my legs so fast that my quads rebelled.

As of today my extension is at 0 degrees and my flexion is at 114 Degrees. I’ve transitioned to using a cane, which has slowed my walking pace. I’m still sleeping in the recliner. I’ve tried my bed several times, but either my back or my knee doesn’t like it. Before the PT incident I didn’t have much pain and I was able to lengthen the time between meds doses from every 4 hrs to 6-7 hrs. The surgeons PA would like me weaned off the tramadol by next week. I still use ice and elevation as the primary method for pain relief. I just don’t think the tramadol is having much affect anymore. I’ve slowly increased my activity from just sitting in my recliner all day icing and elevating the leg. Swelling is the indicator I’ve done too much. I’m originally scheduled to return to work on 9/11, and told my PT I just can’t imagine being ready to do that. She said that’s another month, I should be ready. One of my challenges are seats. Amazing how many seats/chairs are so low, or seem like they are low.

Overall, I’m doing ok. My PT , ortho dr and PA , and others I see all say how well I’m doing or how well I’m getting around. I had some pretty dark days a week or so ago. But I think I’ve turned a corner there. I just think the quadricepsplasty has set me back a little, especially when I had that sharp pain in PT. Slow and steady I’ll get there. My next appointment with my surgeon is August 31 for xrays at the 6 week mark.
Nice update! Thanks for sharing, midwest girl.
Best wishes for your appointment and x-rays at the end of the month. Let us know how it goes. A great rest of the week to you!
@midwest girl
Well today is less than stellar. Yesterday I noticed a lot more popping in my knee. Getting up from a folding chair. This morning getting into the shower. But no pain with it. When I was leaving the house this morning and I was going down the steps my heel caught on the riser of the step when I was in the process of stepping down. A loud pop. But no pain. Get to PT getting my leg up onto the peddles of the bike I had increasingly sharp pain on the medial side of the knee - where all the popping has been. Even using my hands to help lift my leg such sharp pain. I had a different PT today. He’s actually just a PTA. so walking to the table where I lay down to do exercises my knee buckled a few times. I couldn’t do any leg raises on my own without sharp pain. I just started crying. I’m so tired of these hurdles. So pt was pretty lite today. All he did was have me do quad tightening exercises and leg raises where he assisted my leg. He had a PT come over and examine my knee also. He said the implants are stable. He thinks I just severely strained my quad muscles. It’s buckling because it’s strained and there’s no strength. So he said just do quad tightening exercises this weekend, try leg raises using my leg lifter as an aide to help control the movement. Doesn’t want me doing nothing with my knee all weekend but to keep doing gentle exercises. My flexion I got to 115 degrees which is where I was on Wednesday. I have to go back to using the walker to give me the stability. So as of now I only have pain when I try using quads like straight leg raises, lifting my leg etc. and it’s not stable. My quads above the knee aren’t tight and my knee buckles. They said that trip or whatever it was just made my quads angry.
I’m so done with this. So tired of these set backs. And always at the worst time. It’s discouraging.

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