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TKR Hopefaith's Ups and Downs of Recovery

Hello all, haven't posted here in a few days. Today at PT, she moved my scar around some. She said it needs to be able to move with the skin around it. Now the scar area is sore and it wasn't at all before.:scratch: also she instructed to do 50 reps. of the vmo muscle tightening/day. Is that a good amount for 1 month out? I don't know how to describe the exercise. (does the brain just go away for awhile?:thud:) I am icing big time after all of that. I am amazed about ice. It is the BEST pain relief around and I would never have known how MUCH to ice unless I had bumped into this site. SO grateful.
 
How about working up to 50 reps a day. Start with 5 or 10, if it does not increase pain, do 5 or 10 an hour later, repeat, if at anytime you have pain or discomfort stop, that is your limit for that day. Continue to increase as tolerated pain free each day. If too sore, take a day off. You should be up to 50 reps a day in 10 to 15 days. Slow and easy. Be sure to spead this exercise over the day not all 50 at once.
Hope that helps,
 
@hopefaith to understand what is happening on June 2nd you need to know some background information. Here is an abridged version of events

I used to work in industry in my younger years as a materials engineer. This involved some lab work analysing component failures.My work included metals containing cobalt and chromium and I have developed allergies to the two metals along with other materials and chemicals.

Two and a half years ago when I needed a TKR I had a special knee fitted made out of titanium and zirconium because of the allergies. The pain swelling and warmth never went away after this op and my ROM wasn't good. I didn't know about Bonesmart in those days. I had very aggressive physio which did not help. I had trouble controlling the pain and eventually 9 months later I had another op to take samples from inside my knee and a synovectomy. The patella button was replaced as the surgeon thought the original one had a metal ring on it but this proved not to be the case. Again I didn't do well afterwards and eventually my original surgeon said I had to live with it as it was.

The next month I visited my rheumatologist about my fibromyalgia and he was very concerned about my knee and ordered a white cell scan to check for infection, blood tests and a referal to another orthopedic knee surgeon at the same hospital. An aspiration was done and this was negative for infection as was the blood tests but the scan was positive. The surgeon wanted to do a 2 stage revision and treat the knee as if it was infected. I have had low grade temperatures since the original TKR. Whenever I took antibiotics and/or antihistamines since the original TKR my knee improved no one could understand. When questioned the surgeon wasn't sure why he wanted to do the op but felt that some people improve after it.

I then decided that I wanted a second opinion at a different hospital and I found and joined Bonesmart. I was not at all confident of letting the original hospital having another go at fixing the knee. I found my current hospital and surgeon. He thought it may be an infected and did another aspiration and again it was negative. He decided to go ahead with a 2 stage revision in Nov 2013 with the old knee taken out and only cement between my my lower and upper leg where my knee was as the first stage. It is as I am now. It is effectively a fusion with my leg fixed and no bend at all. The brace I wear supports and protects my leg. He thought removing the knee would stop the pain and inflammation and warmth. This hasn't been the case. I have wondered all along whether I've been still reacting to something in my knee. In Feb 2014 he went in again and removed tissue samples from above and below the cement and sent them off for analysis. No infection was found again but the results came back as a foreign body reaction. I'm reacting to something inside.

I have been offered a permanent fusion a couple of times but I've refused to have it. The surgeon is going to have one last attempt at sorting out the problem. He is having a custom implant designed and made to give me the best chance of success.This is the op that is scheduled for June 2nd, replacing the cement with a new custom made knee.
 
@busylizzie wow. As I read through your story, I feel so much compassion for you! I was trying to find your recovery thread, so I was so glad to see your post! Many prayers. (hope that feels okay) You have been through SO much. Let's keep in touch. Your story really is moving to me.
 
Thank you for your prayers. I just wish it hadn't taken so long to get to this stage. I keep having my hopes built up for the next stage then the dates keep slipping each time. I know that I've got a good surgeon and that my pain after the op should be OK this time with the epidural in place. I'm being listened to at last. My case is rare and there isn't much research into allergies and foreign body reactions except for Nickel, Cobalt and Chromium.

Hopefaith, you mentioned at PT today that she moved your scar around and that the scar is sore now. Could it be that the numbness around the incision is wearing off and that the nerves are regenerating? You are getting feeling back in your knee. Is it that sort of pain? I've always massaged my scars each time. The physio told me to do it after the first op.
 
@busylizzie I really hope/pray for really good pain management. That'll top my thoughts, truly. I am very glad you have confidence in your OS. SO important.

I had never massaged my scar, was kinda scared to touch it much. It may be from some of that numbness wearing off. It certainly feels "weird" on that exterior part.
 
The surgeon cuts through nerves, as a result it feels weird. If your incision is closed it is OK to touch it. Wash your hands first to be on the safe side.
 
Ouch, ouch and OUCH. Apparently I overdid it at PT today. I am at 6-7/10 pain. Haven't had this level in a long time. Problem is, I can't tell at the time it is an "overdo". She massaged my quad on the lateral area and it felt good at the time. I think I got caught in the too many rep.s trap. I need to say " I only do this amount of reps." I guess I screwed up....sure didn't see this coming. :beg:
 
:yes:
(yes, you wonderful people, I have been icing all evening.)
:yes:
:yes:
 
Hi @hopefaith, I do work full time as a nurse in a busy clinic. Mon-Fri, and sometimes I ask myself the same thing.
i went back to work after 3 months and took a heavy duty ice pack with me that lasted for the majority of the day. I could not afford the Cobra and the rest of the bills on the disability I was receiving. Now that I know how things work if it has to occur again with the other knee I will plan a bit better. You will be able to do things you love. Check out my site when you get a chance. I just came back from a trip to the Bahamas. I did have some discomfort in my knee while there, but I actually got in the salt water hoping that would help a bit and took my pain meds with me. It does take time. When they say a year I am certain it will be that and then some. Also with having RA, that doesn't help the knee much either. Hope you are starting to feel better real soon.
BTW, do you take your pain meds before going to PT. That's how I would do it so when I came home I would not be so sore and just lie down and take a nap afterwards.
 
@busylizzie, you certainly have been through the mill. My prayers and thoughts are with you as well.:prayer:.
@hopefaith, I think it was the first week that my PT started massaging my incision area and I went to PT after two weeks of having PT at home. It softened up the incision area and I started to do the same thing at home. Not as vigorous, but did it applying coco butter to the area at the same time. Okay to massage incision area. :yay: :yes:
 
It is easy to over do when you feel good. We are still in the less is more phase of recovery.
5 reps are enough right now.
 
Hi hopefaith
I have read through most of your posts and have just read that you are only around a month out from op. I was in awful pain as are most people. It will resolve but gradually. You talk of your sciatic pain and I will tell you what happened too me. I had five days and four nights in hospital before I came home which is a fourth floor flat with no lift. (stairs are one of the easiest things to climb or decend) for me only my right knee so it's up on the left leg and down on the right. However I digress. On the second night home I awoke from sleep and was in horrendous pain in the whole of my right leg. I rang my girlfriend and said you may have to come and take me to hospital! I took some more pain relief and drifted back to sleep. Next morning I was ok until I had a shower and the pain returned with such a vengeance I was panting to get breath, I called the hospital and they told me to come in. I got there and was ashen in colour. The duty doc said maybe it is sciatic pain and told me to double my pain meds. I was in so much pain the cab driver had to help me in and out of his car. Climbing the three flights of stairs was dreadful. Once In I called my Chiropractor friend Dr Adil Karmali and told him. He came to see me after work and immediately found that my Piriformis muscle ( it is a small muscle run across from pelvis to hip) was in total spasm and causing the sciatic nerve to rub on the pelvis He proceeded to manipulate the muscle whilst I bit on the pillow!!!. He worked his way down my leg to my calf which was solid from the stress caused by the Piriformis. In just ten minutes it was gone. I had two more much gentler manipulations for the muscle and it has never returned. We worked out that I was lying it such a position it caused my spine to twist. I was doing anything to relieve the pain when lying down! I am a regular user of my chiro and Adil has cured several of my Personal Training clients who suffer Sciatica. I would suggest you find a chiropractor who knows about knee replacement rehab. Chiropractic is all about realigning the spine as all the nerves in your body pass through your spine and exit to their particular site in the body. This may well help with your Fibromyalgia as well. I hope this helps. It is a long road and although I never cried I did get very depressed until week seven when the pain started to lift. Don't feel alone as their are many friends on Bonesmart. Ask away if you want to know anything however trivial it may seem. Good Luck and think positive.


Sent from my iPad using BoneSmart®
 
@hopefaith Sorry to hear about the hard time you're having. I had mine done 5 days after you. My recovery has been a bit easier than yours, although I haven't sailed right through it, and I think some of it may be because I've followed Bonesmart's mantra and exercise protocols from the beginning. I had a rougher time at the beginning, but as I listened to others and stood up for myself, it has gone a lot easier. Most of my day still consists of elevating and icing. My PT still comes here for one more week-she comes 2 or 3 days a week, and we do very gentle PT. I do a little on my own at other times, but nothing that hurts; it may be a bit uncomfortable, but never actual pain, and that seems to have not only kept it from swelling more, but the swelling has gone down quite a lot-it's less swollen now than it was before the surgery! I still have swelling, but that will continue to go down over time. I am only able to take Dilaudid, and I take 2 mg every two hours-I'd take 4 mg every four hours but it wears off at 2 hours so I split it up. I'd love to be able to take a long lasting pain med, but can't. My pain level has gone down, but is still too much to stop taking the meds. I suspect that I'll need them for a couple of weeks more, but I don't really know-as long as I need them I'll take them and stop the minute I don't need them. I resolved early on to put my knee totally in charge of my recovery and I set no goals at all, and that has been a good decision.
 
@lovetocookandsew I read your post in the beginning of your recovery. I felt SO bad for what you went through. I think my sciatica bout has really affected my pain levels, but I have found a lot of relief from that in the past few days. Thanks for posting here. Love to hear from others. I remember you could only take Dilaudid, and I felt so bad for you. I am glad that you are doing a lot better. Those first few days are so very hard. I have been on Bonesmart since a few weeks before surgery. I ice and elevate most of the day too. My knee gets very stiff if I don't.
 
@ChubbsterPT I just lost my whole response to you. Thank you so much for posting. I really love hearing others stories and getting ideas with how to deal with things that come up. I just started back with my Chiropractor. I was quite skittish and protective of my knee and how I would lie face down on the table he uses. But, he was very reassuring and placed a bolster under my knees. The 3 adjustments I have had in the past 10 days have helped so much. Also, he does acupuncture on my knee to assist in the healing process. What do you think of that? Have you heard of that in aiding a recovery? My Piriformis muscle was fired up too. Getting that to let go ........oh my!!! It is better. Elevating and icing are good for my knee but not good for my piriformis, thus sciatica. I have twisted my spine trying to take care of my knee. Your description of what you went through is incredible. I think I have some idea of that pain. It is SO very painful! Again, thanks so much for your post and thoughts. yeah, I am only 1 month out today. (I must post and whine WAY too much.)
 
@chestnc As I read your post, I am amazed at how you are working at three months at such a busy, somewhat stressful job. Are you on your feet most of the time. That is wonderful that you have moments that you forget about your knee. I read on here that that is a real indicator that that "baby" Josephine describes is growing up and needs a LOT less attention. (: I will go to your thread and read about your trip. Was it wonderful? I hope it was very recharging. Also, the insurance stuff is awful. I am overwhelmed by it.
 
@lovetocookandsew I totally agree with you that my knee is in charge and I am also not setting any goals. I think that is defeating. Hopes....but not goals with time frames.
 
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