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TKR I'm back again

Hi again,
The icing does sound extreme, I get it, but if you're struggling with swelling it can help. Also, you may feel the need to squeeze in some icing / elevating sessions while you're away from home next weekend. Maybe at least at bedtime and in the mornings before rising, IF, that's all you can find time for...
We're gonna crack the whip so you're feeling your best for party weekend. :heehee: Just kidding with you.:wink:
Hope your evening is a peaceful one. :)
@Dolphin
 
I can fully endorse doing some lymphatic massage @Dolphin5. When I was in hospital for a suspected clot I had scans of my leg the radiographer apologised for having to press so hard and deeply in order to see the vessels below but she said I had an awful lot of swelling behind the knee and calf area and suggested lymphatic massage. I wasn’t aware of the swelling at all there.
As I was too unwell to venture out for a professional I just looked on YouTube and found some really simple videos. The massage is very light strokes not deep massage anything. You’re trying to simulate the action that the muscles usually do of moving lymph, but of course in their weakened state they’re less proficient. I focused on the calf and back of knee (where there are lots of lymph nodes), but eventually worked up from the ankle too. I started doing it about 3 times a day often after elevating/icing stroking upwards towards the groin and stomach (as Layla mentioned). It’s actually quite pleasant and doesn’t hurt. It could be coincidence but after about a week the swelling improved and also flexion.
As much as it may feel like a lot to do so much icing and elevating etc you have weigh up what the alternative is. The alternative is getting stuck. It’s putting up with some discomfort and effort in the shorter term to gain a lot more success in the long run.
 
In order for the ice to be effective, your sessions need to be at least 45 minutes at a time. Do as much as you can through the day and even at night while you’re sleeping. However….if you allow the ice pack to melt, then you’re not getting 45 minutes. So, you must change it out during your icing session or it’s not going to work.

The Geko is applied by the patient. When it’s prescribed, instructions for where it’s applied are given. It’s fine to talk with your PT about it and educated them if they haven’t heard of it. But it must be obtained from a medical doctor with a prescription.
 
Dolphin5 said:
With the elevating, 2 X 45 minutes, would it be better to do 3 x 30 mins rather than 2 X 45 minutes?
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I iced and elevated the whole time I was sitting or laying down, all day and all night. This kept my pain and swelling down. When the swelling is down, the ROM is better. As long as you have a cloth between your leg and the ice, you are OK.
 
Hi All.

Thank you for your posts. As we all know, in life there are givers and takers, mostly takers. I've always considered myself to be a giver but since my op I can only 'take'. I thank all of you on the forum, all of you are 100% givers and I'm most grateful.

My icing is always at least 45 minutes. At the end of 45 minutes the pack is 'luke cold' so hopefully still doing some good at the end of the 45 mins. In the evening I'll swap one pack for another.

I'm definitely taking my ice packs and elevation pillow with me to my sons and intend to do an elevation more or less as soon as I arrive there. And yes I'll be doing (at least) two elevations each day, even the day of my party, with ice packs.

I'm going to try and elevate now at least three times a day, more if time allows. Slight anxiety now as I only have three days to pack, get dog food etc ready for the dog minder and other tasks.

It was interesting to read people saying about 'feeling themselves again'. I'm not myself. I'm a totally different person now and I'm still anxious, mentally, about my party. I've gone from an extrovert (apart from when I'm down), party animal to a subdued slightly anxious person. Sadly I'm still not looking forward to my party all that much. There's still things to organise and mentally everything is such a struggle.

If you remember I did try elevating during the night but after a couple of hours I had a strong ache where my heart is. No idea what this meant but I decided to stop. I'd also barely slept during those two hours which concerned me. However I'll give it another try tonight.

I'll also try the lymphatic drainage.

I'm ringing my doctor tomorrow morning.

I did restart heel slides yesterday. I did three holding for 30 seconds. I did this twice during the day. I'd intended to do a third one but my knee didn't feel up to it. I did suffer pain later and needed to take paracetamol nighttime in addition to my two strong painkillers which I still take every night about 8pm.
 
I'm confused about the lymphatic drainage. Layla you say to do it from the groin upwards, Beraic you say to do it from lower leg up to the groin.....

I will see if I can find a video showing it.

Thank you.
 
I hit the jackpot with the pedicure today. The woman doing it is trained in lymphatic drainage. Instead of another part of he pedicure she spent nearly 10 minutes doing lymphatic drainage on both legs knee downwards. I now know what to do. She said to do the lower knee, knee up to the groin, groin to the tummy, arms and chest. She said clockwise on tummy, and even patting my chest would help. She suggested twice a day. First thing in the morning and last thing.

Aiming for 3 elevations today.
 
Hi Dolphin,
The exercise I shared was one originally shared by @CricketHip who is a licensed professional massage therapist proficient in Manual Lymphatic Drainage. She's scaled back to part time here, but stops by often enough. I have tagged her to let her weigh in on this topic. She doesn't have a set schedule, so please check back periodically.
Have a great rest of the day! :)
@Dolphin5
 
@Dolphin5. I had bilateral knee surgery several years ago. Instead of sitting in a chair trying to slide your knee back under it - try this. My PT suggested I lie in my bed on my back with my bottom fairly close to the wall and legs straight up the wall. (You might not be able to get very close to the wall when you start.)Then let the TKR slide down the wall as far as you can. Gravity helps! (You might not have a bed against a wall - but if you do it's worth a try. It was so much better than the slide on the chair.

While I was still in the hospital from surgery one of the PTs shoved my leg under the chair - after, that was the knee that I had a problem with too.

I can't remember how long after surgery I had that knee MUA at my request. I was put under as an outpatient and went home afterwards. The surgeon did take a picture to show me that my knee could bend the full amount. Exactly what I needed to see to make me a believer. (It hadn't crossed my mind that my hamstring would get a good stretch too )
 
Welcome back, @Gma K. Would you please share the dates of your bilateral knee surgery (did you have both knees at the same time or were they staged?) and also the date of your MUA and whether it was left or right leg so we can add that information to your signature. It is helpful for other members to see your surgical history when you are sharing information about your experience.

Also, as you may have noticed, since you were last here, we have added a membership program and there are new Guidelines for Posting. You are currently a Basic Member. If you are having issues with your recovery or are facing another surgery and want personalized advice, you will need to join our Insiders Club. There are several subscription options from which to choose and you can find that information here.

We are a non-profit organization and the small subscription cost goes toward keeping BoneSmart available for everyone. Best Wishes, and we hope to see you join the Insiders Club.
 
Dolphin5 said:
I hit the jackpot with the pedicure today. The woman doing it is trained in lymphatic drainage. Instead of another part of he pedicure she spent nearly 10 minutes doing lymphatic drainage on both legs knee downwards. I now know what to do. She said to do the lower knee, knee up to the groin, groin to the tummy, arms and chest. She said clockwise on tummy, and even patting my chest would help. She suggested twice a day. First thing in the morning and last thing.

Aiming for 3 elevations today.
Click to expand...
@Dolphin5 Hello! I am so sorry to arrive late to this conversation. We just returned from a two week camping trip in the Florida Keys. I also didn't get the notification that @Layla tagged me in.
I am so thrilled that the person doing your pedicure was trained in MLD (Manual Lymphatic Drainage)... what a godsend for you!
You mentioned that you had one or more lymph nodes removed due to breast cancer, I am assuming that you had some radiation treatments also?
this definitely can slow down the lymphatic system. Not always and not always so much to be noticeable. But after a TKR it is understandable that you are noticing a slower reuptake of your excess fluid.
If you are like me, you like for things to make sense and this larger picture does make sense!!

So, if you are able to do the simple exercises to help assist with your swelling, you should see some gradual improvement. I'm glad your pedicure person showed you the steps to take, but wanted to emphasize that its best to begin with the taps to the chest area, then abdominal, groin, upper thigh and onward to the knee area.
Most of our lymph nodes are located in the trunk of our body and "priming them" first can be hugely beneficial.
She probably couldn't do it in that order because of the positioning of being in the pedicure chair.

Picture it like a dam, that's located around your midsection or groin. After you open that dam, then slowly the trickle of fluid coming up from your knee can turn into a stronger flow.

It sounds like your neighbor helped to get you moving again... that is wonderful! I literally did a little fist pump when I read your post about her.. that's wonderful. Movement is so important for lifting our spirits, plus moving the swelling, which will then help ease the pain and stiffness in your new knee.
I'm hoping that you won't end up back in bed for long periods of time, but if that happens...... it will be the perfect time to do the MLD. :wink:

If you feel "stuck" or unable to do the MLD techniques maybe book another appointment for a pedicure?
I am still amazed at the series of events that put this person in front of you! Literally. :)
 
Dolphin5 said:
I'm confused about the lymphatic drainage. Layla you say to do it from the groin upwards, Beraic you say to do it from lower leg up to the groin.....

I will see if I can find a video showing it.

Thank you.
Click to expand...
Hi All. @Dolphin5 I don’t think @Layla and I were saying different things. What Layla was saying is that you need to get the lymph transported up into the abdomen to allow for filtering I was saying the same thing but also mentioned where that massage begins ,lower leg and behind the knee up into the groin and abdomen. It doesn’t need to be hard strokes. Hope that makes sense.
 
@Dolphin5

Please refer to Crickethip's post above, since she's a professional (and has also taught massage therapy).

CricketHip said:
its best to begin with the taps to the chest area, then abdominal, groin, upper thigh and onward to the knee area.
Most of our lymph nodes are located in the trunk of our body and "priming them" first can be hugely beneficial.
She probably couldn't do it in that order because of the positioning of being in the pedicure chair.
Click to expand...
 
Hi all. Thank you for your messages. CricketHip I hope you enjoyed your trip.

Firstly, I had about 14 lymph nodes removed. I'm was lucky not to need radiation as the cancer was not in the nodes. Also, I've always had bad circulation and often my lower legs would be cold with the rest of me warm. (I've also still got my boobs !!).

I am a Christian and whilst I think 'why me God' I know over my life I've been looked after by Him and often things happen for a reason. So I'm not overly surprised about being brought into contact with the pedicurist on Monday.

Thank you for telling me which order of the body to do the MLD. I find it hard to believe that something so passive works! And it's actually very pleasant to do.

Is twice a day enough? First thing in the morning and last thing at night. I was doing some tapping on my chest during the evening whilst watching TV.

Yesterday evening I noticed my leg was noticeably swollen. Groan. Have I overdone things.......I find this INCREDIBLY hard to know how much and how little to do everything. I did the MLD in bed. During the night I got up for an extra wee. Well the swelling had gone this morning. So is this the MLD working????

This morning no pain in the knee so therefore I didn't overdo it yesterday? But very stiff so therefore I DID overdo it???

Apart from two 10 mins walk outside, pottering a bit indoors, doing a stretch but only twice a day, I did two heel slides in the chair. 3 repetitions and holding for 30 seconds. I meant to do a third one late afternoon but completely forgot. I'm still only managing two elevations a day (45 mins). Meant to do a third one two days ago but ran out of time.

Query: should I have my foot flat when doing the heel slides (on the bed and in the chair) or heel on the bed/floor with toes sticking up?

Thanks again everyone for your input. And I won't be spending long times in bed again. I think the blip was a release of the past 3 months and the huge disappointment of no, or virtually no, improvement. The fact I've regressed will prevent me having another blip.
 
Senior moment. I did have radiation treatment, called radiotherapy then. 32 treatments with the last two double ones. But I got away with no chemo.
 
Some answers to your concerns.

Your foot should be flat when doing heel slides. Ankle pumps are also good to do to loosen things up.

Two times a day is adequate for the lymphatic massage. It doesn’t hurt anything to do it more, but it’s not necessary.

The swelling is going to come and go for a while. If it disappears after a day or so, that’s normal. The important thing is that you didn’t have pain from the activity/exercises you did. That means your body is ready for that level of activity and after a couple of days you could add a little more.

The swelling going down was probably not a result of your lymphatic massage. That body system works very slowly and you wouldn’t see results that fast. There are lots of things that can cause swelling including what you’re eating (salty foods?).

Stiffness may be with you for many more months. It’s not uncommon to feel morning stiffness for up to a year or more. It should get better each day if you do some morning stretches and some walking around to loosen things up. It can show up any time you are immobile for a while like sleeping or sitting for a while. The stiffness is not from overdoing things.
 
[Bonesmart.org] I'm back again

Happy 75th Birthday, Dolphin! Safe travels to your party destination. Make sure you don't get too wild now. :wink:
Enjoy!
@Dolphin5
 
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