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Revision TKR Knee replacement is not nice to me...

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I'm trying to limit my movements, but even just sitting to teach has been painful. I am continually stretching my leg out and trying to put it up and everything. Once I come up stairs to my classroom in the morning, I stay here. I could understand the pain if my EMG had come out showing nerve damage or problems, but my nerves and muscles are apparently functioning very well.

I wish I could go home, but I've missed too much school and my kiddos have a big test coming up.
 
Coachie,

Is it worth asking your GP to refer you to a pain management specialist, given how difficult it is for you to get effective pain relief with your allergies etc.

I know you saw that Physiatrist who gave you the EMG, and you are awaiting your bone scan, but in the meantime and in parallel with orthopaedic treatment, is it worth finding someone who can do something temporary to help you with the pain?

Surely a pain management specialist will be able to come up with some decent meds?
 
We've tried the pain management route but unfortunately she sent the referral in February and the earliest they can see me is in the middle of June. I went to the Physiatrist- who I thought would/could help, but she didn't. Getting in to see her took almost 4 weeks.
For those who are thinking that I've just been sitting back and waiting for things to happen, I have been pushy and tried to get in sooner to all these appointments. I've put myself on cancellation list after cancellation list and nothing gets me in sooner. I can't go during the school day as I cannot continue to miss school for these appointments. I've called Dr's on my own time and due to insurance regulations, had to wait for my family doctor to send in referrals- which she does not want to do until after they get results of my bone scan.
 
Coachie,

I'm sorry - hadn't really realised you were stuck on awaiting list. Waiting times were like that with the UK NHS until recently, but I'd always assumed that they were shorter in the US.

I can see that you are on the case and doing everything you can in a really difficult situation.
 
Dewy- Hope I didn't come across as nasty or mean here as I was not intending to be. I am just so frustrated with everything and ready to move on from this already. I really do appreciate everyone's helpful hints and tips.
 
Pain is still here, but I have a short day at school so I can make it.

Did get some good news- my knee does not have any parts that were recalled. I know that some people think that Dr's will not tell you if they are recalled or not, but I am going to trust my Dr in that he can do the research just as well (if not better) than I can, and he said that it is okay.

Now we just need to figure out why it's still hurting. He reminded me that just because it hurts and could be loose does NOT necessarily mean that it was a recalled part (or parts.) It could be loose from any number of things: my bone not growing up properly around the implant, the implant pegs not staying put, etc. Hopefully I'll get more information today when I meet with the revisionist.
 
Nothing can be done to help me at this point. I'm done fighting it and am just going to learn to live with the pain.

My bone scan results simply said: In the right knee, there is a more extensive pattern of increased uptake in the proximal tibial metaphysis.
Also, that there was mild increased bone turnover in the proximal right tibial metaphysis near the interface of the prosthesis and bone. The pattern is not consistent with loosening but does indicate some stress in the area, or at least some component of bone turnover.

I'm going to step away from this site for a while as I need to try to figure out how to live this "new" adjusted life that includes daily pain and immobility.
 
Coachie,

I am so sorry you are in so much pain!:friends:

I don't know what to tell you about your findings but Jo will have some insight so Please stay with us! Your life is not meant to be painful and we must find answers for you!

Don't give up on us! We will work with you! I know you are down right now, but there is an answer out there and I know that it CAN be found!
 
Coachie,

What did the Ortho say about these results? You had an appointment with the Ortho to talk about the bone scan results. Does this mean it definitely isn't loose or is not that clearcut? What other tests can be done now?
 
You know we are thinking of you . . .
 
Dewy- I got those results from the ortho today. He said that it wouldn't be wise to operate because he couldn't see that it was loose enough or whatever. He said, "sorry, but I really can't help you at this point." and then said he'd do more x-rays in 6 months.

I am pretty down- really sad and don't know what to do anymore.
 
Find surgeon with more common sense!
Either it's loose or it's not - there's no such thing as 'not loose enough'!
It's like being a 'little bit pregnant'!! :DOH:

 
This is the 4th orthopedic I've seen. Each one has said something different about the reason for the pain, but they have all said, "I don't think I can help you."

I can't keep going to orthopedic after orthopedic and getting my hopes up only to have them dashed when they tell me they can't help me.
 
Coachie,

I wish I could say something more useful.

What I think is that the ortho may have meant that the bonescan wasn't sufficiently clear as to whether or not there was loosening. Perhaps as more time passes the signs of loosening would become more obvious?

Orthos are very reluctant these days to revisions unless they can find something wrong with the implant, based on what I've read - for example https://medicine.tums.ac.ir/fa/User...IENTS WITH PAINFUL TOTAL KNEE REPLACEMENT.pdf .

You must be feeling at a very low point now. All I can say (although I realise that this may not be very helpful) is that there are a couple of options:

1/ Wait a few more months and see ortho(s) again and evidence for loosening or other issues should be clearer. In the meantime see pain specialist for proper help with pain - you have appointment in June. This sounds grim, but maybe the pain specialist can actually help you?

2/ See a better ortho who might have some more sensitive tests. Why not that chap that Jaime suggested? Even he also says wait a bit longer until signs become clearer, at least then you know you can't do anything other than pain management.
 
If I have to wait 6 months and he then finds something wrong, I will have to wait another 6 months before being able to do anything about it since I cannot miss school in the middle of the year in order to fix anything. That is what is the most discouraging. That I am looking at another full year of pain and immobility.

I would love to see someone else, but without referrals, I cannot do that. I do not have the money to pay for appointments without the help of insurance- which doesn't cover everything and all of these appointments also have copays- and in order to go to Boston or further would require hotel stays, gas money and all of that, so at this time it all seems like a pretty unrealistic thing for me to think about. I appreciate the hints and help, though. I really do.

The pain management appointment was canceled after I got the appointment with the Physiatrist as she said that she thought she could help me since the ortho (#3 that I saw) told her it was all nerve related. When my EMG showed that I had no nerve problems, I was not given any other appointments with her. I think the problem I have with pain management is that they are not going to treat me but simply cover up why I am having pain. I don't want to live on pain pills and I want to figure out why I have pain, not just mask it with a pill.
 
Jo- at what point does the bone turnover slow after a tkr? I am 11 months post-op as of Sunday and I would think that the bone would be done growing by now?
 
I do apologize for being so negative. I am just extremely frustrated and sad about this. I really do appreciate all the help you've all given.
 
Coachie,

Just throwing in a couple of ideas in case they are of any help:

1/ Do they have occupational benevolent societies in US? They provide advice and financial assistance to people in defined occupational groups like teachers and civil servants. Not sure how you would feel about applying to a teachers benevolent society, but presumably it must be cases like yours that they are there for?

2/ Are you a member of a union? They also provide advice. I would have thought that if you did need an op part way through the school year you would be entitled to paid leave (assuming you are an employee?). The school would just have to get a fill in teacher - it would be their problem.

3/ Rather than travelling to Boston, would it be possible to ask the ortho in Boston to just look at your bone scan report and X-rays etc and say whether he might be able to help at this stage if you came and saw him? I don't know whether this would be sensible or not, but perhaps worth asking?
 
Dewy said:
1/ Do they have occupational benevolent societies in US? They provide advice and financial assistance to people in defined occupational groups like teachers and civil servants. Not sure how you would feel about applying to a teachers benevolent society, but presumably it must be cases like yours that they are there for?

2/ Are you a member of a union? They also provide advice. I would have thought that if you did need an op part way through the school year you would be entitled to paid leave (assuming you are an employee?). The school would just have to get a fill in teacher - it would be their problem.

3/ Rather than travelling to Boston, would it be possible to ask the ortho in Boston to just look at your bone scan report and X-rays etc and say whether he might be able to help at this stage if you came and saw him? I don't know whether this would be sensible or not, but perhaps worth asking?
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1) not that I am aware of
2) I cannot get any more paid leave than what I have banked. I had to use time this year due to the MUA that I had in late August and all of the doctors appointments that I have to go to take a sick day as well (even if I am only gone for 1/2 an hour during the day, I get charged a full sick day due to regulations.) Once we use all of our sick days, we cannot get paid nor will we have any health insurance. I can get unpaid leave, but since Maine does not have short-term disability there is no way to get money if I were to miss 4-6 weeks of school next year. I am single and have no other means of financial support if I cannot work.
3) I don't know if I can do that with a doctor in Boston or not. I'll have to find out.
 
Coachie said:
Jo- at what point does the bone turnover slow after a tkr? I am 11 months post-op as of Sunday and I would think that the bone would be done growing by now?
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I already addressed that in two previous posts, honey.
Josephine said:
if the bone isn't fully grown in after 10 months, another 6 months isn't going to make much difference! The bonding of bone and implant occurs in about 3-4 months. If it hasn't happened by then, it's not going to!
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Josephine said:
Either it's loose or it's not - there's no such thing as 'not loose enough'!
It's like being a 'little bit pregnant'!! :DOH:
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Coachie, send me the names and clinics of the people you have seen so I can research them. By pm if you want. There's something not quite right here .....
 
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