TKR Josephine's 2nd knee story - short version

[Jamie]

Pain is controlled up to a point but grinding and persistent. I'm taking my meds are per this chart but it doesn't seem to be enough. I shall have to rethink it for the early weeks.

Jo, did you mean to post a chart of your pain meds? I would be interested to know what you're taking. I don't like hearing that your pain is not under control. We need a happy bunny! Of course, those MWOAs (manipulation without anesthetic) on the stairs could be part of the problem! You are now officially banned from talking and walking........at the same time while under the "influence."

Hon, you must keep repeating......early days, early days! You are a scant week out!!! We're here for you when you're not snoozing. You're gonna be just fine!!! What's that famous BoneSmart word......oh yeah.....patience (said with love)!!!

 

[Josephine]

do you have any friends or neighbours that can come in for a chat?

Yes I do but she's not much of a conversationalist! Totally lovely lady and would do anything.

What was the problem with the cryo cuff connector tube?

The connector tube was blocked with algae. It hadn't been used in 5 years! Got a new tube now so all is well!

you must keep repeating......early days, early days!

Oh I do, I do!

 

[Josephine]

I am NOT a happy bunny today. Leg is as hard as a rock and I ache from the hip right down to mid-calf. Mostly the bruising, I suppose but I wish it would go away!

I've actually managed to transfer to one crutch for most manoeuvrings! I'm still being extremely careful tho but! And only 8 days out. Done a heap of elevating and icing and actually got my swelling on my foot down from looking like a lump of uncooked dough to something vaguely like a foot!

 

[Jamie]

I just talked with Jo and she is having a tough time of it right now. Her new knee is fine, but she thinks she has developed a whopping case of cellulitis. She has seen a doctor and is on antibiotics, but is still feeling very rocky. She'll be calling the doctors again on Monday. She'll be back online once she starts feeling more "human" again, but I'm sure she'd appreciate hearing from you all!

 

[Josephine]

Hi all - sorry for being AWOL. Thanks for all you good wishes.

Update is that I feel ILL and then some. Mostly, I think, due to the cellulitis. Shaky, feeble, no appetite, full of pain, disinterested in everything, especially food! Can't even cope with phone calls because my fingers shake too much to dial a number. Strangely, I'm better when I'm up and about than when I'm sitting down. Most odd.

On the plus side, I am now able to get about the house with neither stick nor crutch (as my surgeon predicted!) though don't get too concerned, I do still use furniture and stuff for support and progress carefully. Today I had my carer carry some laundry upstairs and hang it out in the spare room while I got on with my shower on my own. I have been doing it on my own all along but with the carer 'on duty' in the doorway just in case! So having managed that and feeling more like working to my own schedule instead of sitting about waiting for them to turn up, I told the agency I don't want them any more. My neighbour's been far more helpful to me than they ever have anyway, doing washing up and getting in shopping for me. Bless her heart, she's been a real gem.

 

[Josephine]

Thanks all.

hopefully those antibiotics will see it off quickly.

They appear to have done just that.

Are you sure you should be without a crutch or anything yet?

Well based upon my surgeon telling me that ALL his TKRs now leave hospital on day 2 with no assistive devices whatsoever, yes.

Had staples out today. Being rid of those and the dressing seems to have also removed a considerable amount of restraint from my leg bend. Was going to take a photo but I have discovered my camera has gone missing. Only 'other' people who have been in the house since I last used it were 3 carers. Ho-hum.

I was going to go to bed properly last night but when it came to it, I just couldn't. Could I have developed a bed-phobia?!!

 

[Josephine]

Well, the cellulitis wasn't giving up that easily! Had a flare-up a few days ago and had to have another course of antibiotics. It's still making me feel ill, sickly, anti-food and generally feeling very sorry for myself. Sorry can't be more upbeat than this.

 

[Josephine]

Well, I had a really good day from 8am onwards. Did a little bit of tidying up in the kitchen and a lot of posting on the forum. But then at about 6pm, the pain suddenly returned like an incendiary and now I can't get comfortable any way I try. Legs up, legs down, sitting up, laying back, doesn't matter how, it hurts in different places each time. Mainly it's focussed on my calf and outer thigh which is the IT band area. I know it's that because sitting on an ice pack relieves it. But the calf, which is the principle area of cellulitis, just doesn't want to give up. If I rest my foot on a cushion to relieve the pressure on the calf, the knee complains because it doesn't like the stressed extension. If I lay on my side, the entire leg complains. Can't win. Only time I am marginally comfortable is standing or walking around (thus proving it's not a DVT!). I can't take any more pain meds until 11pm (it's now 8pm) so I shall just have to grit my teeth. I'm so desperate for a nap I could cry.

 

[Josephine]

Once more, thank you all again. Your posts lift my spirit.

Things have taken an upturn at last. The pain seems to have become more manageable though I'm still taking 100mg Tramadol and 2 paracetamol 4 times a day. I find that if I only take 50mg, it just plain doesn't work. But then, I'm not even 3 weeks out yet so still early days. I'm also able to get about with confidence (though still with care!) with neither crutch nor cane, even going up and down stairs. I can get up from sitting relatively easily and my ROM is about 110/0 which is amazing! And just in case you were wondering, exercising thus far has consisted of 2 or 3 heel slides every other day and one attempt to go upstairs sequentially which I managed but was a bit shaky so won't try it for another few days. I'm also sleeping in bed comfortably and getting a good night's sleep to boot!

I go for a post-op assessment on Thursday with the orthopaedic nurse practitioner (not the brightest spark of cheer in the group!) but since I haven't been out of the house since the 7th, my wonderful neighbour is going with me for moral support. I don't expect the nurse will keep me for long.

Only real problem I have is knocking in the knee. This isn't the clicking kind but a regular changing of gears, a kind of triple clunk. In fact, not to put too fine a point on it, it feels like a bag of marbles in there! The thought has crossed my mind that I may need a bigger spacer but I'll wait and see what 'sir' has to say about it.

I tried the underline feature several times and it was not responding.

@hhilltop I edited your post. Somehow you'd got a url in your post. It was the url of one of the Library articles - did you copy/paste a title in there and then remove it?

 

[referee54]

I am happy to read that the pain is better controlled---but I hope that they do not need to replace the spacer!

can get up from sitting relatively easily and my ROM is about 110/0 which is amazing! And just in case you were wondering, exercising thus far has consisted of 2 or 3 heel slides every other day

Our members need to read this---especially the ones that believe that progress can only come with tremendously hard work!

 

[Fancypants]

Hello @Josephine not sure if I need to tag you on your own page? I am taking Tramadol 50 mg every 2 hours instead of 100mg every 4 hours. I cleared it with a couple of pharmacists and then my GP to make sure it was ok. As long as I don't exceed 400mg daily. Knowing I only have to wait 2 hours makes all the difference and it certainly works for me. I'll go 3 hours or even 4 if the pain is not too bad but usually 2hrly. . It's the evenings from about 5 that it starts to get really annoying isn't it? Thank goodness for Silent Witness......and now Wolf Hall!!!!!!!! Hope you continue to improve. Mel.

 

[Josephine]

I am taking Tramadol 50 mg every 2 hours instead of 100mg every 4 hours

Yes that would be perfectly okay provided you don't mind spending all day every day thinking about pill taking!

It's odd but the schedule (below) that I worked out for my other knee and that worked so very, very well, just doesn't for this one.

This time the only thing that works is 100mg at a time but that means only 4 doses a day - ergo 5-6hrly.
However, I never had cellulitis last time either. That's probably the difference.

 

[Josephine]

Does the tramadol work better for you than narcotics? I can't remember whether you can or cannot take narcotics!

Well, being a synthetic form of morphine, Tramadol is actually a narcotic but not an opiate as it's not made from the root form (opium). But having been given oromorph and oxycontin in hospital, I hated it as it made me feel icky and muddled. Tramadol doesn't do that to me.

 

[skigirl]

I have to admit that Tramadol did not do it for me. I had oxycontin 10 mg for 10 days with 5mg of Percoset every four hours. I did take half every two hours for the first week. Then at my 2 week checkup I switched to Lortab hydrocodone every 4-6 hours. At 4 weeks, I began to get tramadol and tylenol 3.

 

[Josephine]

For sure things don't suit everybody all the time! We's all individuals!

 

[Josephine]

Yes,I know some people may have a problem with strong pain killers, also things like Valium and Atavan, but statistics show they are very much in the minority. I took Tramadol for 3 months with my last knee though it's unlikely I will need to do that this time as I am already missing doses because the pain is reducing - and I'm only 3 weeks today!

I would also report that my flexion seems to have increased to about 110+ as of this morning and I have done ZERO exercises though I have actually done about 5 heels slide throughout this period just to see how things were progressing! Now I'm not advocating this for everybody as it's entirely possible I've just been incredibly lucky but it does show that, given the chance, our bodies are perfectly capable of returning things to normal without any 'help' from us!

 

[Nana moon 27]

Hi Josephine

I completely agree with your post. When I first had my TKR I has more problems because of over zealous enhanced recovery PT's, who had me doing stuff way before I should have. I remember you saying no,No,no, too much!

You are a living testament to the mantra of take it easy, in your own time and you'll heal. Believe me I shall adopt this with my next TKR.

Keep up the great recovery, I know you had a rough time recently and I hope you're coming through it ok.

Love Nana moon 27 xxx

 

[Josephine]

I expect most of you have heard the old saying "the proof of the pudding is in the eating"? Well, today was the proof of that!

Yesterday my flexion measured at around 110. This morning I woke early-ish and turned over in bed, curling up and wrapping my legs round one another as you do. I was startled into full wakefulness by the realisation that my left leg had a more normal feel about it than before. No tightness or discomfort, no restriction. I later measured it with my measuring stick and overnight it's increased to 123! I am flabbergasted, stunned, delighted and intensely satisfied! So much I feel moved to quote another little homily which, with a stretch of imagination, might compare ...

Little Bo Peep had lost her sheep and didn't know where to find them.
Leave them alone and they'll come home, bringing their tails behind them.

I hope you get the analogy!

 

[Remy]

Way to go Josephine!! Your recovery is going well now. It's amazing how quickly your body can adapt isn't it? I'm 8 weeks out as of Monday and, besides some swelling in the evening when I've done a lot, you'd never know I've had a knee replacement. As you, of all people, it's a long process but the first days of "normal" make the rest seem like a sunny spring day!

 

[Josephine]

Had a review at the hospital today carried out by a nurse practitioner. First comment - where are your stockings?!
Then 'was I doing my exercises'. Now I know this young lady and she's not above launching into a scold rant so I said yes I was. She felt my knee for warmth and then asked me to lay on the bed and bend my leg. Her comment was that it was 'a little over 90'! That I argued with and she just shrugged her shoulders. No encouragement or positive input. What a waste of time!