TKR June 10th is in the rear view mirror

[sf-slim]

No back problem.
Thanks, good to have support. I'm pretty scared.

 

[tiredwife]

@sf-slim Sorry to hear you are in such pain. My guess would be nerve.

 

[msmechanic58]

Did you get ahold of your OS?

 

[sf-slim]

He sent a message that he was calling in an RX for Gabapentin (I don't know what strength, my husband is out picking it up). Too booked up to see me and said that's what he would do anyway, had he seen me.

I know I had that same drug post op in the hospital, I think in my IV.
I'm looking forward to starting on it because from my research it seems it can be very successful for the kind of nerve pain that I have.
Thank you for your attention

 

[kneeper]

Good that your OS was quick to respond. I hope this works well for you.
That kind of nervy pain is miserable.

 

[sf-slim]

Good that your OS was quick to respond. I hope this works well for you.
That kind of nervy pain is miserable.

Thanks kneeper, I took my 1st one six hours ago and actually I'm having a better day than I've had for a full week.
Also my PT came over for last in-home visit. He was very reassuring and massaged and showed me how and where to massage my knee. I felt so much better after he left. I thought I had lost ROM this week, but I hadn't.
I even went outside (with walker) and cut a rose.
I'm afraid of the pain returning, but mostly accepting the gift of today.

 

[Texan]

@sf-slim, So sorry to hear you have had a setback. I hope the meds work for you, making this a minor setback. I have been weening myself off of the pain medication, too. I take extra strength Tylenol most of the time and occasionally add in a Percoset if I have had a busy day. The pain meds make me feel terrible and not want to eat. When that happens, I start getting weak. If I keep my leg elevated and iced, the Tylenol seems to be enough the majority of the time. Hope you are feeling better today.

 

[DanaDelight]

@sf-slim -I am so sorry I missed your postings from the last few days. I have been dealing with my own ups and downs with pain and emotions. I am sorry you went through the increased pain and depression for so long. One day is too long in my book. Do you think this new drug is working? Were you able to talk to your doctor so he could do an examination and see if there actually was something going on that was bringing on more pain? Sometimes doctors just prescribe a different medicine with looking over the patient because a physical exam might revel something very important. I just reread your posting from yesterday that says you are feeling better so I am happy to hear that. I would still schedule an appointment to discuss in person what your exact symptoms are so that the doctor can look into things such as infection, blood clots, loosening of the prosthetic, etc. Stay on top of your meds and if at any time they are not working or a new symptom appears please get your knee into the doctor's office or ER. We wouldn't want anything to jeopardize this new knee. Let us know how it is going. Sending hugs!

 

[sf-slim]

@DanaDelight, @Texan, thanks for keeping up, it means a lot. Even with the new med. (Gabapentin), there is this scarey hovering nerve pain, that if I move slightly in a certain way, it threatens to send a whopper, and an involuntary yelp comes out of my mouth. I'm very afraid to go further in that direction so I quickly back off, but I'm left doing the Frankenstein walk (one leg straight and pulled along). This all makes me both depressed and angry because I have the ROM to walk normally, though I haven't, even before this, been able to do stairs normally.
Texan, I too am, just for today, going to try for doing Tylenol instead of the Hydrocodone, of course still doing the Gabapentin. It just seems like this momentarily debilitating nerve pain would just laugh at some of these drugs.
DanaDelight, you are such a humane person to be concerned and caring about others when, right now, you are having huge challenges and unknowns in your own recovery. Your time in the pool seemed like heaven, and then to get hit with this nasty stuff again is mind boggling. I will be checking your recovery thread all day to see what's unfolding for you.
I will definitely throw myself on the floor in my Doc's waiting room and twist and shout until he sees me. Very bad for business.
Onward.......wow, what a journey!

 

[Josephine]

@sf-slim Just my opinion, but I think you should be taking your pain meds to the limit right now, not cutting back

 

[sf-slim]

@sf-slim Just my opinion, but I think you should be taking your pain meds to the limit right now, not cutting back

Thank you Josephine, I did take the Hydracodone exactly as prescribed for two and a half days. It doesn't come close to addressing this kind of pain (and I don't think a week or two weeks of it would either). It just makes me dopey and does nothing for this. I would love to know what this could be.
I just dangled my legs over the side of my bed and let out a blood curdling scream that brought my husband running, this one has taken a lot longer to subside. Seems to get triggered by my forefoot leaning forward yet I can do ankle pumps, in bed, no problem. I don't understand this and after two weeks of no pain like this where did this come from?

 

[Texan]

@sf-slim, That has to be so frustrating!!! I would recommend calling your o/s but if he is anything like mine, that would be pointless. Wish I could be more help.

Cindy

 

[sf-slim]

I had such an awful pain again that I'm going back on full dose Hydrocodone. I've been reading some articles about peroneal nerve damage during TKR. One of the risk factors that jumped out at me was about dealing with an extreme Valgus deformity. Which, in my case, made my surgery an hour longer than what was usual. The o/s came out, after surgery, and told my husband that it had been more difficult because of my deformity.
I don't understand why everything was so good for two weeks, and now this debilitating turn of events.

 

[Phil75070]

@sf-slim I'm no doctor but from what I have read (since I also had a valgus deformity) peroneal nerve damage usually presents itself as numbness, tingling and decreased sensation around the foot and ankle. It also typically presents itself shortly after the procedure, like in the recovery room or when first moved to one's room. The literature I have seen doesn't talk about this presenting itself as pain in the knee (I assume this pain of yours is in the knee as you don't really specify exactly where you are feeling it). I think after almost a month that peroneal nerve damage just showing up now is not something to be concerned with. It is also very rare, like .3 to 1.3% chance.

Obviously something is going on and that can only be determined by your OS.

 

[Josephine]

as you don't really specify exactly where you are feeling it

Good point, Phil

@sf-slim Can you tell me the exact site of your pain using this chart?
Please note the instructions in the smaller image

 

[sf-slim]

If I'm reading this correctly it would be DRF1 sometimes going all the way down to G and H RF1, and sometimes (though not today) a numbness over my toes.
I've seen my post surgical X-rays and it looks like someone left an old erector set in there that runs half way down my tibia.

Also Phil, peroneal nerve damage is just something I looked up, trying to make sense of what's going on. I'm happy for it not to be that, but what is it? I'm so afraid to make certain movements that I'm walking around like someone from a Zombie movie.

 

[Josephine]

I've seen my post surgical X-rays and it looks like someone left an old erector set in there that runs half way down my tibia.

Can you be a bit clearer on this? I don't know what and 'erector set' is!

If I'm reading this correctly it would be DRF1 sometimes going all the way down to G and H RF1

Like this?

That certainly does look like a peroneal nerve issue.

Also Phil, peroneal nerve damage is just something I looked up, trying to make sense of what's going on. I'm happy for it not to be that, but what is it?

The peroneal nerve is a branch of the sciatic nerve. It splits off at the back of the knee, comes to the surface and runs down the outside of the lower leg into the foot.

Just below the knee, it runs over the top of the small bone called the fibula where it can be subjected to trauma of various kinds, most commonly a sustained pressure such as might occur during knee replacement surgery if certain pieces of equipment are unintentionally used without care. But often no-one really knows what the cause is. The recovery from this is varied and uncertain, going from a few days of moderate to severe pain to many weeks or months. There is also no way to predict which it will be.

I'm so afraid to make certain movements that I'm walking around like someone from a Zombie movie.

I can imagine. It's a very unpleasant condition to have. Just wish I had more helpful and/or informative advice to offer you.

 

[sf-slim]

Josephine (I'm following instructions not to tag you),
I so appreciate your very thorough reply.
About the erector set it was brand of metal toy construction sets when I was growing up (dates me). My brothers and I built bridges and towers and all kinds of constructions. What called it to mind was that, when it saw the X-ray, there were jagged edges to my new knee also parts that went half way down the tibia. I would attack a copy, if I knew how.
The illustration above describes exactly where the shooting, debilitating pain is on certain movements, down to the little dark blue triangle above the toes, however there isn't pain in that area but rather a numbness.
There is such a deep bodily fear of this pain that I'm walking straight legged, after having had an almost normal gait (according to PT and PA)at two weeks. I still have a good ROM 0-120, for this stage (four weeks tomorrow).
Each day I think it's going to be better and then I make a certain move, and there it still is. Resulting in my moving guardedly for the rest of the day. It's 11:00 am here and I haven't had a zinger yet.
I'm taking full dose pain meds (Hydrocodone-Acetaminophen 5-325 mg) and Gabapentin 300 mg., which it had high hopes for.
I have my first outpatient PT tomorrow, maybe they will have an idea.
Again, thank you for your attention and concern.

 

[Josephine]

Josephine (I'm following instructions not to tag you),

Nooooo! Of course you can tag me if you want me! That's perfectly okay. I just asked people who just mentioned my name in passing to not unthinkingly put the @ in front of my name, that's all. Of late there seems to be a growing trend to do that with everyone's name.

About the erector set it was brand of metal toy construction sets when I was growing up (dates me).

Ah - I think in this country we call it Mechano! I remember my brother making things with it when he was a boy.

As for your neuropathy, I think you might need to see one of the following - a neurologist, a chiropractor or a pain specialist.

 

[sf-slim]

"As for your neuropathy, I think you might need to see one of the following - a neurologist, a chiropractor or a pain specialist."

Thanks Josephine, I too think the answers and hopefully relief will come from those specialties. I have my first outpatient PT tomorrow and they have electric stimulation equipment and something with needles, might help.
Also I've made an appointment with my acupuncturist, who I was seeing pre-op and I partially credit for my initial remarkably fast recovery. This is a bump in the road that these forums and you have made smoother.
You are appreciated.