TKR Josephine's knee story

[Celle]

Great, Jo! Everything's going well.

When will you get the results of the blood tests?

 

[Josephine]

Oh, I forgot about that! In a day or two, I expect.

 

[speccybecky]

Sounds brilliant to me!
No need to be a hero

 

[zauberflöte]

To use a phrase from yourall's side of the pond, you are doing brilliantly! And in case you wonder, "yourall's" is the Southern second person possessive case of "you"!! ;)


My phone sent this using BoneSmart Forum, clever phone!

 

[Jamie]

Boy, zauberflote......"yourall's" brings back memories of my family in Texas growing up!!! Haven't heard that phrase in a looooong time!

 

[shelli22]

Hi @Josephine. I've been on this forum a while now and have read your threads and am very impressed with both your recoveries and your knowledge base. Regarding your nerve pain, did you find the meds helped? How long do you have to be on them for? Side affects of these meds include the usual but also weight gain. Noooooo! If it's not one it's another! I have just picked up a prescription for some. Do these meds just mask the pain or will the pain resolve eventually? I'm a tad confused as I've just seen OS and I have nerve issues too but from sciatic nerve that is terribly annoying as it makes my leg feel like there's a tight rubber band from my back to knee then down to my ankle. It feels like it's pulled tight. MRI is booked then referral to another specialist. But what then? More surgery or hope it resolves itself?

Sorry for posting on your thread but mine seems to be under the radar and often gets overlooked even when I tag.

Hope you have a continued pain free recovery


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[Josephine]

Sorry for posting on your thread but mine seems to be under the radar and often gets overlooked even when I tag.

That's okay. Are you sure you do your tags properly? Meaning do they go blue and underlined when you post your message? Like this @shelli22

Regarding your nerve pain, did you find the meds helped?

Oh 100% better!

How long do you have to be on them for?

Wish I knew. I think in the end I shall have to tirate off them (or wean!)

Side affects of these meds include the usual but also weight gain. Noooooo! If it's not one it's another!

Oh no as well! I never noticed that. I know it makes one's mouth dry so now that's three meds I'm on that does that. Sometimes I wake in the middle of the night with a tongue that's as dry as cardboard! YUK

Do these meds just mask the pain or will the pain resolve eventually?

They're not a painkiller. According to patient.co.uk, the description is

Gabapentin is used to control the symptoms of seizures and works by reducing the abnormal electrical activity in the brain. Exactly how it does this is not fully understood. Gabapentin is also prescribed to treat certain types of long-lasting pain caused by damage to nerves.

But what then? More surgery or hope it resolves itself?

Have you considered trying chiropractic treatment? It works well for me.

 

[zauberflöte]

@Josephine here we have a anti-dry-mouth mouthwash called Biotène. They also make a spritzer for your purse. I find it works well overnight-- I use it to keep my teeth from getting "divots" in them. Very technical dental term, divot.
@Jamie happy to bring back memories!


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[shelli22]

No @Josephine. I hadn't considered chiro for this but I will now!! Thanks for your replies x
Regarding the tags Yep I do them properly x

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[Josephine]

When I complained, my GP prescribed me a spray.The pharmacist never offered me a choice of favours but gave me one called natural. It was like having a rather disgusting French kiss! I only used it about 3 times. Yuk!

 

[zauberflöte]

Yuurrkkkkk that sounds awful in the extreme. Take a peek in the mouthwash section-- might be something there.

My phone sent this using BoneSmart Forum, clever phone!

 

[Josephine]

I finally got my phone and my computer talking to each other again - don't know if they've had a falling out or something but it was very inconvenient!

So here is my knee on the 21st Jan just after the staples had been removed.
Narry a pinch or yelp from me - that nurse really knew what she was doing!
I think it looks pretty darned good for 14 days out!

 

[Josephine]

I can find toothpaste, mouthwash and gel in the UK but no spray.

 

[Josephine]

Forgot to update on here. Blood tests all normal - phew! But I still have a strange soreness across the base of my leg, just above the ankle. I was suspicious it was a resurgence of the cellulitis so went to see the GP. He hummed and haaed about it and finally opined that it was a low level thrombo-phlebitis. I was a bit sceptical but left it at that anyway and this morning, getting plain daylight on it, I had to agree.

Now I had a really severe dose of cellulitis back in 2003 and as it settled down, I noticed I had a really deep pit just above and behind the outer ankle bone. In fact, it was so deep, I could lay my little finger in it. It was mildly purple and an area around it was bright pink indicative of infection/inflammation or something. I was seeing one of the orthopods about the cellulitis and he surmised that this was most likely the cause of the infection, a fairly minor vein had thrombosed and since I'd had a sore throat a few days before, quite likely the bugs had settled in the clot.

So imagine my surprise this morning to see that I had a similarly depressed area, now darkly coloured and the area around it being bright pink. I asked when in hospital if they wanted to know about this episode of cellulitis 12 years ago and they dismissed it as inconsequential ................... NOT!

So now I ask myself, was this the cause of the cellulitis I had after the surgery.
I think I was lucky to get away with it!



Another sad tale: GP decided I sould have some compression stockings for the cellulitis but my leg was so swollen (and I'm big anyway) it had to be custom made ones. But - I had no-one to measure me. Eventually a nurse turned up at the door to do that. She had no idea what was really needed and didn't even have a chart to fill in. Luckily I did so I gave her one and then had to explain how she filled it in! Measurements done, now she wanted to know what she should do with it! I told her the pharmacist had the prescription (his shop is attached to the surgery) so she should give it to him so he could send it off to the firm.

This was on Feb 2nd. Yesterday, I called in for something and was just about to ask if the stockings had come in yet when she waved a prescription at me and asked what should she do with it! It was my stocking prescription, dated January 27th! They hadn't had the form! I went into the surgery - they hadn't had it either and knew nothing about it. I'd have to phone the District Nurses and find out what she's done with it. I was supposed to hear today but no go!

Looks very much like I'm going to have to have these measurements done all over again!

 

[Angel1978]

((((Huggggs)))) Hope your doing better. Xxxx


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[zauberflöte]

Wow, you come up with the most magnificent maladies! Not to make light of them, of course. I am very glad your blood work is good!! And you have never (here anyway) lost your feisty manner
One more Biotène tip and I'll let it be. Before I knew there was a spray, I carried a little travel size bottle of the mouthwash in my flute bag. I'd get a few drops in my mouth and work them around-- exact same effect! I love what it does for my overnight dental health


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[Josephine]

Well, the measurements turned up. Seems that, instead of handing the chart in to the pharmacist as I asked her to, the nurse just handed them to the surgery receptionist, who, not knowing what should have been done with it, just filed it away in my notes! I shall be pursuing this.

I also thought I'd post a synopsis of my recovery as there were some things I think I missed out. So here goes:

Jan 7: had no less than three blocks!

1. a spinal which was a bit testing as the doctor couldn't get in and kept calling for a longer needle! Once she got it, she was in and done very quickly.
   
2. a femoral block
3. a popliteal block (they called it something else but I've forgotten what!) which consisted of injecting a quantity of lidocaine (or something) in and around th4 back of the joint

The surgery went fine, I was very comfortable after with the blocks though my blood sugar took a nose dive to 5.4 in recovery. The nurse went and asked the anaesthetist about it but he said it was okay. By the time she came back I was feeling decidedly unwell. I explained to her that 5.4 was very low for me and I was having a hypo. She got me some disgusting glucose gel and squirted it in my mouth. It was effective but when she asked me if I felt better, I told her I'd much sooner have had a Mars bar!

Jan 8: was okay, comfortable. Given oxycontin and oromoprh. Didn't like them, made me feel :rolleyes:

Jan 9: physio came and check my ROM which was about 90. Then she got me up to walk but fem block still working a bit so had to be careful to take the weight on the walker instead of the leg. Of course there had to be a moment when I forgot and ended up almost on the floor! I think the shock must have been too much as when I got back to bed, I was horribly sick over everywhere!

Jan 9: was supposed to go home but owing to my living on my own, was kept in an extra night.

Jan 10: went home, slept on recliner settee as planned. Neighbour was unexpectedly helpful which was nice.

Jan 11: carer came and saw me up the stairs where I had an absolutely wonderful shower in my new walk-in shower! Worth every penny!

Jan 13: nurse came and change the dressing

Week 2
Jan 15: NOT a happy bunny. Leg was as hard as a rock and I ached from the hip right down to mid-calf. GP came to visit and declared I have cellulitis. Actually in two sites, one at the side of the knee and another at the ankle. So was back on antibiotics and feeling grotty again! GP ordered some custom made compression stockings as the ones I had worn in the hospital were no longer big enough!

Jan 17: dispensed with the carers as I can manage stairs and shower on my own

Jan 21: staples out. I was relieved to find that the nurse really knew how to remove them and I had not one nip or pinch while she did!

Jan 27: had two nurses come and do a Doppler test for the compression stockings but they wouldn't measure me for them.

Jan 29: Had to go to hospital for a 'review'. My first outing and I drove! My neighbour came with me, bless her. The person doing the review turned out to be a a nurse practitioner I knew quite well but that didn't stop her complaining that I wasn't wearing my TED stockings!

Week 4
Feb 5: a nurse turned up unannounced to measure me for stockings. But she had no form and didn't really know what it was all about. Luckily I did have a form but I had to explain to her how she used it and then that she needed to hand it in to the surgery pharmacist as he had the prescription and was waiting for the measurements.

Feb 6: been having a lot of pain up and down the back of my leg so made a trip to dear old Greg, my chiropractor. He worked wonders on those muscles as they were really, really tight. Arranged to go back again next Friday. Approved of my 'no exercise' plan!

Week 6
Feb 18, 19th, 20th: bought a new settee, had hair done and saw chiro again!
Am now taking no pain killers and ROM is about 120!

Feb 27: have a horrible burning on the outer side of my scar. Saw my GP who immediately declared it to be nerve pain and put me on gabapentin. We also discussed the slight possibility of infection so I decided to phone the hospital and see if I could get seen ASAP. As it happened, I spoke with a secretary who told my my surgeon was on leave but his colleague who was then in theatre, had a clinic that afternoon and she would speak to him and see if her would squeeze me in! She called back a couple of hours later and said could I be there by 2pm - giving me about 15 minutes to get dressed and drive to the hospital! As it happened, I was seen by my surgeon's registrar which was fine by me but he affirmed there was no infection.

March 3: had to start taking pain meds again but infrequently as my knee is aching and doesn't like doing stairs sequentially. Obviously I've been pushing it a bit! But it has to be said, I now have a ROM of 125/0 and this with doing absolutely NO exercising at all! I kid you not - not a single heel slide or anything else. I think I shall write a paper!

March 10: saw GP because the neuropathy appears not to be being held by the 100mg gabapentin and he increased it to 300mgs twice daily which worked very well. Also appears I have a low grade thrombophlebitis in my left ankle which is causing a sensitive area around the leg. Apparently no treatment required but the compression stocking.

Coincidentally, I had to call in to the pharmacy for something and was told that they are still waiting for the measurements that were taken on Feb 5th. Turned out she hadn't given them to the pharmacy as requested but given them to the surgery receptionist who simply filed it in my notes! Took me another week of telephone calls and inquiries to discover this.

March 20: maybe now might be a time to start titrating off the gabapentin so asked GP for some 100mg ones so I can play around with the doses. Dunno - it's still a bit sensitive but worth a try.

Have an appointment with surgeon on 31st and start back to work on April 1st. Only working one day that week so that's okay. So far so good!

 

[PooShay]

Just caught up with you, Jo! Wow. A lot of my experiences came rushing back! On the whole, not too bad, eh?

May I use your pic of the femoral jig? I know a number of people who are going the TKR route who expect to get back to regular work in 2 weeks and teaching exercise class in 4. A picture is worth a bazillion words!

Hugs! And good wishes for continued great recovery.

 

[Josephine]

Oh Pooshay - how sweet of you to post. Feel free to use any images. I take it you've also given your friends a link to BoneSmart?

 

[kaydubs]

I really appreciate your little re-cap! Your no-exercise philosphy definitely should be published! SO different than what most OS's and PT's think, and you've had wonderful success. I definitely did not allow any pain in PT this time around, and what a difference it made. Thanks to Bonesmart and the wonderful admins