TKR Josephine's 2nd knee story - short version

[Josephine]

Another bit of progress on day 24 - ROM now 115/0 and the need for pain meds as reduced considerably. I am now using paracetamol 2-3 times daily and the odd 50mg Tramadol - well I did today at any rate!

 

[Josephine]

It's passed with the aid of pills! However, just to prove that recovery really IS a roller coaster ride, while I was totally fine all day yesterday, on going to bed at midnight, the pain started up and just got worse and worse throughout the night. By 5.30am I had to give up and come back downstairs. I took 5mg Tramadol and paracetamol but 1½hrs later, it was a lot worse. I'd tried ice and moist heat but neither helped so ended up taking another 100mg Tramadol at 06.20hrs after which I crashed out (surprise, surprise!) and was relatively pain free. Needless to say, I slept all morning and didn't rouse till early afternoon. Hey ho!

 

[Ellejay]

I definitely second the 'roller coaster' theory, I think I'm one loop ahead of you, just round the bend .
Sending you all my best wishes, hopefully the next ride we go on will be a lot smoother. Xxx

 

[Ellejay]

I thought the insurance companies didn't like us driving before six weeks?

 

[Josephine]

Not so long ago I phoned about 4 different insurance companies including AA, Churchill, One Direct and Admiral and asked them what their stand was in these cases. All said they had no policy but relied on the common sense of their clients not to drive if they didn't feel fit enough but that it would in no way invalidate a policy.

Had another rough day. Knee very hot and painful. Feeling very yucky, mouth like the bottom of a bird cage and a mouthful of food or drink made me very nauseous. So rang doctor who made a house call and examined leg. Is pretty sure it's neither a DVT or infection but just 'tissue kinetics'. What? Never heard that one before! But apparently it's the scientific term for the mechanism of controlled cell deletion, otherwise known by thee and me as healing! Still I was relieved to hear he was pretty confident it's neither of our most feared nightmares. But he had been prepared to phone the surgeon and pack me off to hospital as an emergency had he thought infection was a possibility.

Feeling a bit better this evening so thought I'd just drop in and explain my absence. But oh for a comfy settee or bed!

 

[Josephine]

I love all your replies! Thank you for caring so much.

Are you eating properly and on time?

No I wasn't eating. I had nothing to tempt me, despite a packed larder, fridge and freezer! Putting a bit of anything in my mouth just made me heave.

Second, are you resting as much as you should. i noticed that one day you posted a lot---were you sitting in a chair? or in bed with your knee up and a lap top on top of a pillow on your stomach? If the former--no wonder you had pain.

Trust me, Kelly, I am resting plenty. And I do my computing on my recliner with the leg flap up. I have a cantilever over-bed table which is extended with a 3 foot length of hardwood that reaches over my legs so I can pull the laptop close whilst I'm resting.

I seem to have been having a good day and a bad day but these last two days have been better. In bed all night, slept well, only first night had to take pain meds in the night. That night I gave up about 5am and moved downstairs to the settee. I took my duvet with me and was so focussed on not getting my feet tangled up in it, I was half way down before I realised I was actually going down sequentially and not one step at a time! I was amazed! The next two nights (Mon and Tues) I had good nights in bed with no pain meds. Today I have done laundry and needed no pain meds at all. When I took the laundry upstairs to hang out, I went up and down normally!

My last dose of anything was 10pm last night! It's now almost midnight and I've needed nothing all day. This evening was a bit uncomfortable and needed to use an ice pack but even those are used infrequently now.

And need I remind you all, tomorrow I am 4 weeks out! Assuming this keeps up, I plan to go see the chiropractor on Friday as my back and neck are getting stiff. I also have ITB and hamstring issues which I've had since early this year and they are now really giving me gip! This will be my first drive out. My neighbour's worried about me doing this and wants to come with me! If she was a driver, I might say yes but she's not so what's the point!

 

[Celle]

I'm glad to hear from you, Jo. I was getting a bit worried!

I hope the nausea has gone and you are feeling more like eating - you do need to eat, in order to have energy for your recovery.

Well done about the stairs! That's impressive.

It might be nice to take your neighbour along, even if she doesn't drive - a bit of company and moral support for you?

 

[Josephine]

LOL!

I think I'm going to stop telling people about my recovery because every time I boast about a good day, it's followed by an absolute nightmare of a night! To related the sorry tale, was up late until about 1am and my knee started being painful - about 6-7. I took 50 Tramadol but after an hour, no effect so tried some ice which made things worse. Walked around a bit which seemed to make things ease so I went to bed. Once in bed it got worse again - by now it's getting to 8-9. Despite using ice and taking more Tramadol, by 4.30am I came downstairs and made a hot wet towel which was blissfully effective. Did this 3 times and then settle down on the settee and slept until 11am! Today I have mild discomfort but nothing more. Strangely this is only when I'm sitting. When walking, the pain is zero!

I think I'll take your advice about my neighbour. I want to shop afterwards so she might like to as well. Plus she just passed me a meal over the fence - steamed meat and vegetable pudding and a big jug of gravy! I have enough for at least 3 meals! Isn't that kind?

 

[Josephine]

Well, I did my first drive. I did take my neighbour who admitted she would enjoy the trip out. I was a barrel of nerves beforehand but, as I had expected, once I got on the road I was fine! Got to the chiro in good time and found a parking spot right outside his door! He has a big ol' flight of stairs up to his rooms which I took really slowly and carefully. My neighbour stood on guard by me the entire time, bless her!

Well, I told Greg my problem was all down the rear/outside of my leg from hip to ankle and then surprised myself by getting onto his couch face down! Didn't think I'd be able to do that but it was easy. Then he got to work! Heaven's above - he found tender, painful sites the entire length of my thigh, calf and even into the sole of my foot! It was like Chinese torture but in some strange way, you just know it's doing you good. The entire area was in a really bad state and I have to go back next week for another session.

I then went on to Asda and did a fair shop. I used an electric kart while my neighbour went on fetch and carry expeditions! Bless her heart! I go home about 2.30pm which means I has out nearly 4 hours. Not bad for a first trip out. and I have to say, I feel so much better already except I've been really, really cold - wrapped myself up in blankets for most of the afternoon! Seems I can't get a happy medium - I'm either roasting or shivering.

Oh yes, and I haven't had any pain meds since 4am yesterday morning! Not bad for 4½ weeks out!

 

[Celle]

I'm glad your outing went well, Jo. You did quite a lot!
It sounds as if taking your neighbour was a really good idea.

Your chiropractor sounds like just what you needed.

No pain meds at all! That shows how well you're doing. When I was off daytime meds, I did find that I still needed to take something at nighttime for a couple of weeks, so do be prepared for that.

Best wises.

 

[Josephine]

Well, 'rough start' continues. Last night I got quite bad pains around my knee.

So:
took Tramadol - 1 hour later no change
rubbed on Volterol gell - 30 mins later no change
tried ice - made it worse
then I remember Poppet telling me that the Chinese preferred heat for pain that wasn't immediately post-surgical so sat myself beside the microwave and rotated two damp cloths. That help a lot but the heat wasn't persistent enough so I got a hot water bottle and treated the back and sides of my knee with it - result

SUCCESS!!

I also came to the conclusion that this pain is nothing to do with the knee surgery but all to do with the muscle spasms in the biceps femoris and hamstrings which, as I said before, have been plaguing me for almost a year.



So, I retired to bed at 2am, slept right through to 9am and woke pain free.
Not only that but ROM in my left leg is now equal to that in my right leg!

Also, appetite has returned about 90% and the pain is still very low.

Just in case you are interested, this is the pattern of my tendinitis pain - in blue

 

[zauberflöte]

You are definitely getting this under control, and I tend to agree that the pain is not the new knee. Could have been related to massage/leg-tenderizing yesterday?
I have several ice packs, store brand, that can also be nuked to be heating pads. They stay warm for a long time, and are only about $5.00, not bad atall.
Keep on rollin', nothing will stop you now! Woohoo equal ROM!!


My phone sent this using BoneSmart Forum, clever phone!

 

[Celle]

I'm glad the hot cloths worked for you, Jo. Any chance some of your pain was due to the big day you had yesterday?

When I sprained my ankle, I had continuing pain for months, due to an inflamed tendon. The physio recommended alternating hot and cold packs, and that helped a lot.

 

[Josephine]

Could have been related to massage/leg-tenderizing yesterday?

Any chance some of your pain was due to the big day you had yesterday?

Thank you ladies but the answer is definitely no. I've been suffering from this pain for over a year now and Greg has treated me for it many times before. The aftermath of the surgery just made it worse. I should have realised and not got it mixed up with post-op pain. Silly me!

I also measured by ROM today 123/0! Not bad, eh?

 

[Josephine]

You know, whenever I post about a good day or progress, it is then followed by an absolutely abysmal night. And last night was no exception. I retired at 11.30pm and after only 30 minutes my knee started raging. This is not pain, I promise. It's a raging heat included with a kind of tightness along the scar like a cheese wire being pulled ever and ever tighter! I tossed and turned for ever and finally, at about 2am, I gave up and came downstairs to try the hot towels and hot water bottle again. This time it didn't work and I finally tried the last thing on my list which was the Gladwrap. That worked too! Wonderfully well. But now I tried to settle on the settee and though I had several blankets on me, the room seemed cold and I got totally chilled. I slept until about 8am and woke even more cold than before. And feeling sick and ill.

Imagine my surprise when I went into the conservatory and found it was roaring hot in there! The sun was shining and people outside were out and about in just cardigans! It took me ages to warm up.

I do hope tonight will be a better night, please God.

 

[Josephine]

Thank you!

I had a lovely night past night. I've actually found it unnecessary to actually wrap the Gladwrap right round the leg. A patch of it, sufficient to cover the wound and both sides of the knee, is quite enough. And since somebody kindly sent me a box of Gladwrap (we don't have it in the UK) and Gladwrap is lightly self-adhesive, the patch stayed put all night! So I slept from about midnight to 9am - long old night for me! But when I got up, I had a whole array of discomfort, hot wound, feel out of sorts generally, foul taste in mouth so no appetite, feeling really chilled so wrapped myself in blankets and about 20-30 minutes later, had a hot flush and threw them all off again! It's only settle down when I replaced the Gladwrap. Hope this means I shall have another good night tonight.

 

[Josephine]

Well, I got to see my GP today. My leg has been burning and driving me potty.

I've tried everything: Tramadol, paracetamol, ibuprofen (singly and in concert), ice, heat (moist and dry) and diclofenac gel. Nothing touches it. The GP felt it and said 'it's not really that warm' to which I replied, you should try being on this side of it! It HOT!' and burst into tears. I never realised till then how much this is getting me down.

So I told her all the rest of it: not being able to eat or drink because of the foul taste in my mouth and feeling generally unwell and grotty. She assured me it wasn't infected (think I knew that but it was a relief to have it confirmed!) and asked me to prioritize the issues. Without hesitation I said the knee.

I also pointed out that this was NOT post-op pain as I'd had a few days without that and on no pain meds very satisfactorily. Then this suddenly flared up for no apparent reason. Her opinion was that it was nerve pain. Well shoot! - why didn't I think of that! It would fit in with the extra trauma done by the split in the skin at the bottom and that flap being everted in order to access the patella. Nerve pain - who'd have thunk it!

So long story short - I'm on gabapentin. I had one tablet as soon as I got home and have had a lovely restful sleep for about 1½hrs this evening! I just hope I can repeat it tonight. She also did a whole slew of blood tests just to make sure nothing else is going on.

I'll keep you posted.

 

[zauberflöte]

Oh ICK nerve pain :( but you have something to help. Does this resolve after a while, or is that a "maybe"?
My cats got gabapentin for the two hour car trip when moving last spring. Vet said they'd be drunk as a skunk-- ha! They howled the whole time. I am glad that you get the sleepy effect. Much better than howling ;)


My phone sent this using BoneSmart Forum, clever phone!

 

[Josephine]

Well, the doctor was right because the gabapentin has worked wonders! Such blessed relief. But I am to take only one yesterday and today, twice daily the next two days and three times a day from then on. Jeepers, I shall be sleeping morning noon and night! However, I slept like a baby last night and felt well on waking.

Does this resolve after a while, or is that a "maybe"?

Eeh, God, Chris - I sincerely hope so! It crossed my mind this morning - would this go eventually or have I got it for the duration?

I also saw my chiropractor this morning for round 2 and asked him to do a little work on the back of my knee as I appear to be loosing extension. I told him I'd been doing the exercise of putting my heel on a stool and letting the leg hang which that it was rather too tight and painful to do. When he got to it, he said he was not surprised as the hamstrings and calf muscle leaders were very tight and angry and what I was doing was just making them even more so. Since he then spend about 5 minutes working on them after which I was already back at 0, I felt he knew more than I did about this and I should stop always banging on about swelling being the culprit because, as the song goes, "in ain't necessarily so"! To be honest, it has tightened up again since but still not as bad as it was last night.

I have also decided to go see Greg on a weekly basis for the time being as this treatment does me so much good.

I think maybe you should get on a regular pain med schedule again for a few more weeks even though you may feel you don't "need" it.

Toni, I have tried all the pain meds are my disposal and not one of them works on this pain. It's not 'pain', it's heat, like someone has a blow torch on it. Not pain meds, ice, heat, diclofenac gel or anything works on it. Glad wrap does up to a point but the gabapentin has been like magic!

What do you do with GladWrap?

See here Night pain solutions using moist heat and clingfilm though I don't wrap it round my leg as in the video, I just apply a patch to the area. I've explained that in the article.

 

[Josephine]

Well, I was too clever by half last night and decided not to take a sleeping pill as my knee had been pretty good during the evening. So another bear of a restless night. Took a gabapentin around 4am and finally got to sleep.
Lesson learned! I'll be glad when I'm on this stuff 3 times a day.