TKR Lesions caused by metal sensitivity

[kar1963]

Glad your home... take it easy on yourself and love love the pink tennis ball on the walker..

 

[Josephine]

I have no control over how fast my body will heal other than doing what my pt and doc say to do

Absolutely right - except even doing what your doctor and PT tells you to do is not going to influence things one way or the other either.

I am in so much pain. I am almost at 4 weeks. I thought the pain was supposed to be over by now.

Who told you that? My knee hurt for around 10 weeks and I was taking a full whack of pain meds for 14 weeks before I was finally onto otc meds.

Then I have been limiting my pain pills because I am afraid of becoming a drug addict. I wonder how a person stops taking heavy duty pain meds if they have been taken for months. I am scared of terrible withdrawals

Hmm, seems like nobody left you the recovery articles. In them is this article Myth busting: on getting addicted to pain meds. You may become dependent but that's not the same as being addicted. The good thing about it is that very gradually, as the pain reduces, you will find less and less need to take pain meds. This usually starts by forgetting to take a dose here and there. The fact that you are so focussed on them now is just because you are in pain, not because you're addicted! So read the article and be reassures. However, so if you do need some help stopping the usage, we have a nice programme here that will do the job. But don't start this until you are in a LOT less pain. Weaning off pain medication.

I was worried that I may have formed scar tissue in the eight days that I didn't have the PT

Most difficulties with ROM are nothing to do with adhesions but with swelling and pain. So I want you to put that right out of your head now, OK?

I was wondering if it was too much PT too fast. The in home company is under the gun to get me to 110 Rom by the 8th of November. They want to look good to my OS who has contracted with them but too much too soon may not be the best for me. Why is there such a big push for ROM anyway? Doesn't it come in time anyway?[

Most certainly you did too much too soon. Most people do and then most people end up bewailing their inability to get progress when they are being forced and pressured into getting results when it's invariably their own actions (by which I mean the PTs) which are causing the hold-up. I'm going to give you the rest of the recovery articles which I strongly recommend you read and absorb. I've highlighted some in bold and the D group articles which are of special interest to you right now.

First are the mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!

And then the articles in order of importance .
Group A
The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Progression of activity for TKRs

Group B
How Long Does Healing Take ......
Chart representation of TKR recovery
Energy drain for TKRs
Elevating your leg to control swelling and pain
Using ice

Group C
Knee Replacement - Where Am I in Recovery?
So What Is It Going to Take? The Five “P’s” of Knee Recovery
Work “Smarter” and not “Harder”
About recovering a knee - from one who knows!
Some suggestions for home physio (PT) and activity progress
Myth busting: The "window of opportunity"

Group D
MUA (manipulation under anaesthetic) and adhesions
It's never too late to get more ROM!
It's Worth the Wait for ROM
Post op blues is a reality - be prepared for it.

 

[ucsbgal1971]

Josephine thanks so much for the information, support, and answers to my questions. I think I now have a more realistic picture of what to expect. For the time being, I will be taking the pain meds around the clock per the pain doctor's orders. That should help to make the pain more tolerable as well as not overdoing the pt. Thanks again.

 

[ucsbgal1971]

I am really disgusted with the pain med situation. The sleep situation I have given in to but I fear I am in trouble now. I took pain meds (oxy) last night and slept 5 1/2 hours got up for 3 and slept another 4 hours and I am still tired. Now I fear I will be awake for days. Oh well, I'll deal.

In reading the posts on this site it seems clearly the people who have good pain control or mostly none do the best of all of us.

I would get the pain and fever under control before I would worry about ROM. Keep us posted.

This pain med thing does seem to be a key component to getting better. I fear taking so much but there doesn't seem to be a good alternative.

Thanks for responding. Hope you too will soon be able to sleep and experience minimal pain.
Best of luck,
Pam

 

[leejaa]

I am glad you are working at getting your pain under control. It really will help with recovery and healing. Have a good day.

 

[ucsbgal1971]

Thought I would check in. I am at seven weeks today. Pain is still getting me down . I have pain on the inner part of the knee and behind the knee. I was told that I have a bakers cyst behind the knee but the doc does not want to do anything about it. I think the cyst is what is causing my rom to stand still. I am at about 95 but can't seem to get beyond that point. I so hope that I will be able to go in a complete circle on my recumbent bike one day. I ended up back in the hospital for three days due to a suspected blood clot. All is well in that regard now but had a terrible time in the hospital when the nurse goofed and gave me an overdose of blood thinner medication. I started bleeding profusely from the IV in my arm, so much so that there was a large puddle of blood on the floor. Hospitals are scary places.
As far as the pain goes, I had to cut the Norco down from 10 to 5 mg because it was making me sick. The 5's are not working so I feel really worn down from pain and no sleep.

 

[ucsbgal1971]

My journey has not been great following my RTKR September 26, 2013. Because I live alone, I was sent to a convalescent hospital for 17 days after my surgery. I had relatively no physical therapy while in the convalescent hospital. When I returned home, I had in home therapy for almost two weeks which wasn't very good and then landed back in the hospital because they thought I had a blood clot. I was having a difficult time breathing which turned out to be a bad reaction to the pain meds. When I was released, I had to start the in home PT again so had another two weeks of not very good therapy. My Rom has consistently stayed at about 95 no matter what I do.

Then I developed an infection in the submandibular gland that still hasn't resolved. My OS has decided to go ahead with MUA even though I still have an infection because he says it has to be done before six months. It will be 5 months on the 26th of Feb.

My leg hurts when I walk and I find myself sitting on the couch most of the time like before the surgery. I haven't had any pt for six weeks because my OS wants me to save it for after the MUA.

Quite frankly I wish I never had this surgery. It is harder to get around than before the surgery.

Does anyone know if the MUA is a good idea if I have an ongoing infection or is time of the essence?

I am so scared and discouraged and don't trust my doctor anymore. I would really appreciate some input. I am also under extreme stress because my son is in heart failure. To top everything off am falling into a depression because I can't get anything done.

 

[Tykey]

Hi, you are having a rough time!! I'm not any sort of an expert on MUAs but I'm certain others will be able to help.
As a general impression on your recovery, you talk a lot about therapy, but in many cases we see therapy as a cause of problems rather than a solution. In the UK, we do no therapy because of these problems, and thankfully it seems to a growing trend in the US.
I think you are trying too hard, cut out any therapy other than a gentle home exercises, and your ROM will increase.
What's wrong with 95 ROM? What can't you do? We don't get a prize from anybody for reaching a particular figure

 

[Tykey]

Sorry, I had to break off for a few minutes before I finished my comments. One of the things we all seem to suffer from is thinking about it all the time, and our imaginations start going wild. I see you haven't had PT for 6 weeks, so could you tell us what activities you are doing. Sitting on the couch all day isn't good, it's a matter of finding a good balance. Difficult as it might be, just getting on with life is good for depression.
I hope your son overcomes his problem.

 

[maryo52]

Quite frankly I wish I never had this surgery.

I felt the same way! And for many of the same reasons. My recovery was so bad, my difficult first childbirth experience fell to second place on my Hardest Things Ever list.

But it will get better, especially now you've found this forum. There is a lot of good info here, and a lot of support.

First of all, as Tykey said, PT or the lack thereof has not hurt you. There is a misconception that our recovery is only as good as the PT. Not so. If you strengthen your quad with straight leg raises and move your leg through the range of motion several times a day, that's all that is needed in the first few months.

When your surgeon is saying MUA has to happen in the first six months, he is not stating fact but stating his comfort zone, and every ortho has their MUA comfort zone. There is not yet any established protocols for dealing with adhesions.

Secondly, how is your swelling? If you still have swelling and inflammation, it would be useful to really work on ridding your knee of these inhibitors to bend before deciding on MUA. If you have an effusion (excess joint fluid), that will also inhibit bend.

Here are some brainstorm ideas for you: There are orthos who will do a MUA after six months. You can seek a second opinion. Even better, you can meet with your PCP to help you address this situation. Maybe you need another doctor to re-assure you that having MUA with this infection is OK (as long as you're on antibiotics). Because, I will tell you, it is normal to doubt your ortho when recovery doesn't go well. I did.

Also, after you get some input from us, consider sticking around and leaning on this forum. We're a great support group, and many of us have experienced having other life problems in addition to a difficult recovery.

 

[Josephine]

Then I developed an infection in the submandibular gland

It's a very strange place to get an infection - who told you that was what you have? I've never heard of an infection there.

My OS has decided to go ahead with MUA even though I still have an infection because he says it has to be done before six months.

It won't matter a bit. Though you should tell the anaesthetist you are have TMJ pain in case he needs to intubate you for the anaesthetic. Though to be honest, it's rarely needed for an MUA. Usually they just use a mask.

 

[ucsbgal1971]

Thanks for your replies. Dr. Larian,the head of the ear, nose and throat department at Cedars Sinai Hospital in Beverly Hills, CA ran a Cat scan and discovered that I have developed a stone in or near the submandibular gland. Not sure which. Apparently salivary stones can cause infection. I have Sjogrens Disease which causes a decrease in the production of fluids in the body and can thus cause salivary gland stones. I think there is also a fluid around muscles that can dry out during surgery. Since I have an impaired ability to replace the fluid this can also cause a problem with rom if I understand correctly. I just got my presurgery blood test back and my white count is normal so I think I will be OK to proceed. 95 rom isn't too bad but the knee is not improving and is pretty stiff. I have cut back on my exercises because the stone has been so painful. I haven't felt like doing anything. The whole side of my face hurts, it hurts into the ear, and even in the teeth. That added to the knee pain just seems to be too much. My white count and lymph count have been elevated but the last round of antibiotics must have worked because the counts are now normal as of this afternoon. They are going to put me on IV antibiotics before the surgery so I guess it will be ok. Because I am at 95 I wasn't sure the risk of spreading infection was worth it and I have lost some confidence in my doctor because he wanted to rush me in for a manipulation at four months. I thought that was a little early and my physical therapist wasn't too enthusiastic about the idea of me having a manipulation. I really am scared that the infection will spread to my knee.

 

[Pjmc]

I wonder if you could get a second opinion ?
If you have lost faith in your doctor I would not proceed with this procedure with that dr.
With everything you have going on .perhaps take a little more time to explore what is best for you .
Wishing you the best. Pam

 

[ucsbgal1971]

Getting a second opinion might be a little difficult because I interviewed all of the doctors that I considered for the original surgery. It would be awkward to go back to one of them for a second opinion now since I didn't select them to do the surgery.

 

[ucsbgal1971]

Tykey, if they don't do PT in the UK, what do they do? Do the doctors just give you a list of exercises and you are on your own? I was under the impression that exercises need to be done correctly or a person can do damage to oneself. How do you know you are doing the exercises correctly without feedback from a physical therapist? Plus I did not realize that I was walking funny until my physical therapist advised me how to walk. Do the doctors just handle that in the UK?

 

[icep707]

Thats too bad. Wish you the best. Please keep us informed. Hope you make the best decision. Are prayers are with you.

 

[Pjmc]

I understand as I am in a similar spot . I had mine done by ortho and should have went with another one that said he would do it.
Truth is this is our life and our leg and we will have to endure some awkwardness to ensure we get the best results for us .
If they other doctors will see you start there .
You said you have doubts about your dr . Better to put up with a little discomfort than to stay with the dr you have .
Yes you may remind me of all I have said as I am in the process of seeing other Drs .
I had some doubts about mine went through with surgery and wish I had not used this dr.

 

[ucsbgal1971]

Mary, Thanks for responding. What kind of exercises should a person be doing at home when he/she is five months out from the surgery? Do you know if it is necessary to continue the exercises forever? Maybe my inactivity has hurt me.

 

[ucsbgal1971]

Pjmc I hope it works out for you. It is difficult when you start to question the doctor. I am pretty sure the doctors would not see me since I didn't select them to do the surgery. I think you would have a better shot if you go to a doctor who you haven't seen before.

 

[Jamie]

You really won't know if other surgeons will see you or not until you try to contact them. You don't have to say that you met with them previously and didn't choose them for the surgery. Surgeons are big guys and they understand that people make choices that may not include them. They can handle it.

Or....how about driving a little more distance to see someone else? You really should not stick with a doctor that you no longer trust. That is your good sense telling you that you need a change. Don't ignore it!