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[REVISION TKR] I want my life back

Discussion in 'Knee Replacement Recovery Area' started by BridgetJ, May 3, 2019.

  1. BridgetJ

    BridgetJ new member
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    I am a very positive and optimistic person but this journey is seriously testing both of these qualities.

    Long story (not sure how to make it short) 3-wheeler accident when I was 20 years old resulted in serious infection and 2 surgeries at the time. One to repair the compound fracture, install hardware and cast. Next day another surgery - hardware removed (due to infection). Bottom line, lucky to have my leg as surgeons actually discussed amputation at the time with my family.

    Fast forward 10 years after being told I would not walk without a limp, ever run or do all the things I love, I did them all! Yes, my leg was not pretty and over 20 degrees valgus but that did not stop me. At 30 years old, the severe angle started causing knee problems and so I had surgery to straighten my leg.

    At the time, the best they could do was about 9 degrees. Served me well for over 2 decades until the pressure finally took its toll - severe arthritis and no cartilage. Underwent TKR May 2018 and surgeon was able to straighten leg nearly 11 degrees! I was elated and optimistic.

    I could resume skiing, cycling and hiking. Unfortunately things never got better - had 2 MUAs (June 2018 and Aug 2018). Seemed to get worse every day after and pain was excruciating. Referred to a surgeon at USC who said this knee needed to be replaced again.

    April 16, 2019, total knee revision. Surgery went well but once in recovery they realized when the tibia was moved forward an artery was damaged causing a blood clot. Back in for another surgery to remove blood clot. Vascular surgeon could not perform angioplasty (tried for over an hour but too much scar tissue) so I had to have a bypass. Incision from my bikini line to my knee and then another down my calf.

    I am 16 days post surgery and am scared. I can only bend about 70 degrees and not quite full extension. Will this work? I am sad/mad. Will I be able to do the things I love with my family and friends ever again? I am in pain. Will this leg ever feel normal? I maintain a positive attitude by focusing on my blessings but I have my moments.

    My husband, family and friends are all super supportive. I feel like I need to put on a positive front - I am tired of this long journey....certainly everyone else is tired of hearing about it also.

    I have read all the threads on pain management, recovery, etc and I find them all helpful.

    I guess my question is how will my recovery be impacted because of the bypass surgery? I feel like I am not doing as much as I should because I am so weak and tired. I was in ICU for a couple days because of the bypass/blood transfusion and when I was finally released my iron level was extremely low (7). I have been eating an iron rich diet and taking supplements and now am up to 10.7. I walk each day on crutches and am up to 1.5 miles. Besides that and some light housework, all I do is sleep and rest, ice and elevate. Should I be doing more?

    I am just hoping someone has had a si lab perspective and can offer insight. Thanks in advance.
     
  2. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    @BridgetJ Welcome to BoneSmart! You have had quite a journey with this knee!

    Please remember that you have just had 2 major surgeries. Of course you are exhausted and weak. Your body has experienced major trauma. All you should be doing is icing and elevating as much as you can during the day. Stop all that walking until your knee calms down. Light housework can wait. Focus on healing and recovery.

    Here are some articles that might offer you a bit of guidance through this recovery.

    Knee Recovery: The Guidelines

    1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary

    2. Control discomfort:
    rest
    elevate
    ice
    take your pain meds by prescription schedule (not when pain starts!)
    don't overwork

    3. Do what you want to do BUT
    a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
    b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

    4. PT or exercise can be useful BUT take note of these

    5. At week 4 and after you should follow this Activity progression for TKRs

    6. Access these pages on the website

    The Recovery articles:
    The importance of managing pain after a TKR and the pain chart
    Swollen and stiff knee: what causes it?

    Energy drain for TKRs

    Elevation is the key

    Ice to control pain and swelling

    Heel slides and how to do them properly

    Chart representation of TKR recovery

    Healing: how long does it take?

    Post op blues is a reality - be prepared for it
    Sleep deprivation is pretty much inevitable - but what causes it?

    There are also some cautionary articles here
    Myth busting: no pain, no gain
    Myth busting: the "window of opportunity" in TKR
    Myth busting: on getting addicted to pain meds

    We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

    While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
     
  3. 2tkr

    2tkr junior member

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    Hang in there. I am so sorry to hear about your agony. My 2nd TKR was this past Feb 19. I’m finally starting to see a tiny light at the end of the tunnel. I’m still exhausted, my sleep pattern is still on hiatus(hence chatting at 4:48am). But life is becoming livable again with each day. I read somewhere that it takes a year for your new knee to go unnoticed. Again, you will feel better every day. But when you have a weird feeling in your knee, remember that you are fine if you can put your full weight on one knee. And give your body a year, it will go by super fast.
     
  4. BridgetJ

    BridgetJ new member
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    I am 23 days post surgery. I can get around the house (slowly and uncomfortably) without crutches. I did my daily outside walk with only one crutch but felt my form suffered. How long should I be on crutches?
     
  5. FCBayern

    FCBayern member

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    I would say until you can walk (although slowly) with a normal gait.
     
    • Agree Agree x 1
  6. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    There is no set time, keep using them until you feel you’re walking better. As Celle often says, there are no prizes for giving them up early. They are a tool to help you walk better and to help prevent a fall.
     
  7. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    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?
     
  8. eaglemom

    eaglemom senior

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    I'm thinking you need to put the brakes on everything - focus on the knee - resting & elevating. Your doing far too much. Your body is telling you its tired, listen to it. (Sorry if that sounds harsh)

    We are all hard on ourselves, but in reality what is best is rest. Goodness your not even a month into two major surgeries. Yes recovery is a slow process but over doing only extends that process. Lots of naps, reading, Netflix - you get the idea. Hang in there it will get better - over time.
     
    • Agree Agree x 2
  9. BridgetJ

    BridgetJ new member
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    Had my one month check up with tests and appointments with the vascular surgeon and orthopedic surgeon. All 3 incisions are healing nicely, iron level is back near “normal,” blood is circulating at the same levels as the non surgical leg.....overall everything is good. Two big concerns are quad is not engaging and leg is only bending to about 70 degrees. If I don’t get to 90 in 2 weeks (6 weeks post-op) then MAU. I had 2 MAU on this leg when the first knee was put in in May 2018 - I AM NOT DOING IT AGAIN! They were more painful recoveries than the actual surgery. I will do everything in my power to get to 90 degrees in 2 weeks. My husband said I should maintain an open mind and that if I don’t get there the MU may be the best option. I am so frustrated - my swelling is still significant and I think that is what is inhibiting my flexion. I ice and elevate frequently, wear the TED hose during the day and have cut back in my walking. Not sure what else I should do?
     
  10. BridgetJ

    BridgetJ new member
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    I just saw your post. Yes, I am happy to answer any questions.
     
  11. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    First of all, you cannot make your leg acheive a certain number by a certain date. Your swelling doesn’t work that way.

    Doing everything in your power should consist of lots of rest, ice and elevation, especially the resting! Activity makes the leg swell.

    Don’t think of it as doing nothing, think of it as giving your leg/knee the best opportunity in which to heal.
    Yes, swelling is inhibiting your bend. You’re only 4 weeks post op and your knee is very upset from the surgery and has barely had a chance to start healing. Complete healing takes an average of 52 weeks.

    Your are entitled to decline the MUA if that’s what you want. Your surgeon can’t do it without your consent. It’s way too early to even consider it anyway, but surgeons are impatient and want recovery to happen right away. Our knees don’t agree with that, and our knees are in charge.
     
    • Agree Agree x 1
  12. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    It's your knee and no one can make you do anything to it that you don't want to do. Jockette is right, it's way too early in your recovery to even think about a MUA. Your knee has to heal. A MUA will set that recovery back because it will tear away all those soft tissues that are trying to knit back together. Just look at what's done inside your knee:
    https://bonesmart.org/forum/threads/closing-surgical-wounds-how-is-it-done.4286/#post-90691

    You are correct. When that swelling goes down the bend will increase and not before. You can't work to increase your bend, but you can rest and get rid of that fluid to increase that bend!
     
    • Agree Agree x 1

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