Revision TKR Loosening, RA ?Second Revision

[Hopper]

Oh Shortie - I've no idea what it might be but I really do feel for you.
You've been doing so well. I hope it's nothing much.
I'll be thinking of you and wishing you well.

 

[StillShortie]

Thank you Hopper.

I did sleep OK ish last night knee still feels slightly odd pains just in medial edge of top of tibia this morning but I am now scared to do anything I case I have done something to it, just feeling really low and fed up and just a bit scared I am hoping that this is just a massive case of ODIC and by Wednesday I will be back to how I was.

At least the sun is shining and I have the joy later of collecting my daughter who has been on scout camp all weekend so I guess I will save my energy for washing or hosing down depending on how muddy she is!

Hope you all manage to have a good Sunday.

Shortie x

 

[StillShortie]

Sorry to bother you Josephine (but you are the knee god! ) I just wondered what your advice to me would be at the moment re my post about odd feeling knee - should I rest, elevate, medicate and ice and see how it goes or PANIC lol - sorry I am a rubbish patient and I know it is a roller coaster but I just don't know when to ride it out or when to get off!

Thank you

Shortie x

 

[Josephine]

Oh Shortie, Shortie - what AM I going to do with you? You keep on saying you're not overdoing it but then I read of kayaking in Centre Parks at 4 weeks - no knees in use? Perhaps but you have to use your thigh muscles lots. More on that shortly. Then you're doing other crazy things like 3½ miles on the bike at 5 weeks and so on and so on!

So let's start from scratch and a few questions:
First, what pain medications are you taking currently?
Are you still icing your knee and does it help for this 'weird feeling'?
What's your activity level like at 11 weeks? What do you do in the way of housework, cooking, cleaning, shopping, etc.

Then there's the site of the pain. Would you pick out a box on this chart and tell me the grid references - that's a vertical and a horizontal reference, please.
And what's the pain actually like - usually scale of 1-10!

And what about work? Do you have a return date yet? with a phased return?

 

[Toothfairy]

Hello Shortie, sorry to hear of your knee pains. Hopefully it is just a bad case of overdid it and will soon settle.
When I pulled my knee a couple of weeks ago when I managed to step down two steps at a time ( please don't try that at home) by accident it stirred up all sorts of strange aches and pains. It all settled after about a week of resting, icing and elevating. In my case it was soft tissues being angry with me. Hopefully when you answer Josephine's questions she will be able to reassure you. If you are still worried it might be worth a trip to see your doctor.
I hope your meeting with your boss goes well on Tuesday and also your meeting with occupational health on Wednesday. I am starting back to work on Tuesday. I will be working Tuesday morning, Wednesday afternoon and Thursday morning this week. I have my Pre op assessment for knee two tomorrow morning at 08:30 so I will need to be up bright and early.
Hope your leg settles. Let me know how you are getting on, hugs, Toothfairy x

 

[Josephine]

Oops! I almost forgot - ages ago you asked me about those knobbly bumps in your knee and even post a photo for me! I was rude not to reply sooner but now I can see it, they are just internal sutures. I think the surgeon (or more likely his assistant!) rather cobbled things up in there and that's what's made it feel knobbly! Eventually - any time soon, actually, the suture should give way and the knobby bit will gradually smooth out. You can help it along with a little knuckle massage, if you want to!

 

[StillShortie]

Thank you Josephine

I know I did over do it a few weeks ago although bike ride wasn't until 8 wks and Kyaking not until 9 was but yes as always you are right it was too much too soon and at the time I kind of realised it was - Sorry Knee

So in answer to your questions;

I am taking Naproxen 500mg twice a day and taking omeprazole to stop side effects) and paracetamol 1g three to four times a day. I do also take Oxynorm 5mg as needed but don't very often as it makes me feel a bit sick and woozy so won't take it if I need to drive anywhere.

Yes I am still icing but it doesn't make any difference to weird feeling.

My activity level is 'light ambulation' around the house I don't lift anything heavy I still am having to come down stairs one step at a time. Homework - my OH will say I do nothing (I am not a houseworky person!) but I do do the washing and hang it out and odd jobs getting kids bags ready and putting stuff away after them! I have yet to attempt a supermarket shop on my own yet, I did manage to push the trolly around half the shop last week before handing it over to OH. I have done very short shopping trips i.e. A few shops over 45 mins to an hour and a half then I am done in! We have been for a few short walks with the dog ( very mad springer spaniel - I daren't take him on my own in case he pulls me). I do cook some dinners too.

The sight of my pain(s) is as follows;
The tight band is all around at L1-4, D
The real ouchy / stabbing pain is at L3, D
And the anterior pain is mostly in the evenings at L2-3, C/D
The last time we went for a short walk I had really painful hot shooting pains from the tight band all the way down my led, shin and into my foot - I've not dared go for a walk since.

As for work I was aiming for 12 weeks however I have since thought maybe an extra week would be good then thought another two weeks then I think lots weeks extra, then I go thorough the whole should I go back at all - some of it I think isn't related to my knee just that I have been off for so long so a bit apprehensive about going back, however it is not a job I will feel comfortable going back to without being fully able to what is needed from me - not something you can fully plan for in A&E!

I am seeing my boss tomorrow and going to ask if I can dramatically reduce my hours and then as I able to do more I can always pick up extra shifts if there are any available. And Occ Health on Wednesday to discuss phased return. So no actual date yet - just really don't know what to do!

Re bobbly bits, thank you for explanation - I'm not worried about what it looks like my legs were not really models legs to start with but it's nice to know what the bumps are.

Thanks again for your imput

Shortie x

 

[kneeper]

I'm not surprised you are done in after 1 1/2 hours--especially if you are doing other stuff too. It is ok to take lots of breaks and take a day "off" if you have been on your feet a lot the day before. You know you can still ice and elevate after you've been active, right? I was still icing at times at 12 weeks.

 

[Josephine]

Naproxen 500mg twice a day and taking omeprazole to stop side effects) and paracetamol 1g three to four times a day. I do also take Oxynorm 5mg as needed but don't very often as it makes me feel a bit sick and woozy

Naproxen is an NSAID and as I am frequently saying on here, NSAIDs are rubbish pain killers. Omeprazole is, as you know, not a pain killer and quite frankly I am appalled at GPs who will prescribe an NSAID and a PPI at the same time. I've been on it for years but because I have a gastro-oesophageal reflux but even so, I wouldn't take NSAIDs on a regular basis now for anything because of the occult side effects. Read here the difference between Aleve (naproxen), Advil (ibuprofen) and Tylenol. More on this later ....

The tight band is all around at L1-4, D
The real ouchy / stabbing pain is at L3, D And the anterior pain is mostly in the evenings at L2-3, C/D

Which is - surprise, surprise - PAIN! This is quite common at 10 weeks and may continue for many more weeks yet. It may not surprise you to learn that there is an article about it in the Library "Tight band" feeling across the front of my knee. It certainly will get worse as you are not taking any pain meds!

Did you have a problem with Tramadol? Or codeine? Can you take co-codamol? You need something more than naproxen, anyway! And just paracetamol won't cut it either. Whatever, you need to have a serious talk with your GP and explain that the naproxen is doing nothing and you need something less than oxycodone but better than paracetamol as you are still in pain!

 

[StillShortie]

Thanks very much,

I do unfortunately have problems with both codine and tramadol, codine does nothing in a low dose and a higher dose makes me vomit and very dizzy! Tramadol is OK if I don't want to function on this planet or need some zombie time, it also disturbs my sleep i.e. if I take it at night I just don't sleep until about 6am! Since breaking my sturnum in May 2012 and then subsequent progressively worse knee pain then TKR I have tried a selection of pain meds and it has been really difficult to find something that does anything to help with the pain without unacceptable side effects - although immediately post op the oxynorms side effects were worth it (the morphine PCA's weren't!!) so to be fair to my GP we have tried a lot of different sorts in lots of different strengths and some modified release, etc. the naproxen with omeprazole was a bit of a compromise on both sides and not intended to be too long term but I realise from what you say I do need something which works for longer than I hoped. I am seeing my GP on Thursday and I will discuss it with her then.

I am relaxing a bit again thanks to your advice / comments I don't know if I am a bit panicky as I get near the 12 week mark - the magic 12 weeks that 'if you do a job where you are on your feet all the time you "may" need "up to" 12 weeks off work'!!! But I now think blow 12 weeks! I am off to see my boss today and one question I will ask her is how long will my job be open for and if it isn't long enough well me and my family despite the reduced income come first!

Thank you
Shortie x

 

[Josephine]

If you're going down that road - and assuming you have a permanent contract with your hospital - you have entitlements which are that you are permitted 12 months absence before they can terminate your contract. During that time, you have 6 months on full pay and 6 months on half pay. During the second phase you are also entitled to apply for additional benefits. Here is a link to the DWP site on broken link removed: https://www.dwp.gov.uk/healthcare-professional/benefits-and-services/statutory-sick-pay/. If you are a member of a union or the RCN, then I suggest you also contact them for advice and support.

You may also want to discuss this with your GP and the Occupational Health Service at the hospital. Actually, the OH department has the yea or nay on your return to work and if you don't feel ready, that will be a factor also. They may also refer you to the OH physician who will also take your own feelings of readiness into account. Hope all this helps.

 

[StillShortie]

Thanks.

I have seen my boss today and all is good for a bit longer she is in no way rushing me to get back to work before I am ready which is good, I feel so relieved that my job is open for longer and also the option of retuning on reduced hours. Unfortunately my SSP has already stopped as been off since Oct 12 (and already had 5 weeks off for # sternum) I only got 4 months full and 4 months half pay as I had only returned to work in 2010 after 10 years off with my kids. I am now claiming Employment and Support Allowance.

I see OH tomorrow so will see what they say.

Thanks again.

Shortie x

 

[Josephine]

Ah right - that's good.

 

[StillShortie]

OK so a combination of Josepine and my boss have calmed me down!

I am no longer stressing about rushing back to work (although TBH I do feel a bit of a wuss that I won't manage to get back to work at 12 weeks and yes I know, I know I shouldnt but I do!) and I do feel that a weight has lifteted and I don't feel pressured to be fit NOW! So I will chill and take it all a bit more of a day at a time.

So off to Occupational Health today just to double confirm everything so hopefully by this evening I will be super chilled and maybe have a little glass of rosé (midweek I know) to celebrate!

Hope you all have a good day x

Shortie x

 

[StillShortie]

Well visit went to OH went well and won't see her again until 19th July. There was one slight mmmmmm moment when she had initially said should be back at 12 weeks, I said I'm not ready and my boss agrees she got out a massive OH guidelines book, looked up one thing said 'that doesn't tell me what I wanted to know' then looked in different places looking under joint replacement and then conceded that the 'OH bible' said that for joint replacement everyone recovers at their own rate and there is no specific guidelines!!!

Anyway saw GP yesterday and I am signed off for another 6 weeks which is a relief and so now I can recover and get fitter at a sensible rate and not try to rush things or panic. I still do feel a bit of a wuss taking so long but I do need to do what is best for my knee and me. Although I am not being paid at the moment my job is being kept open for me.

So the sun is shining today, I'm relaxed (at last) I hope everyone has a good day.

Shortie x

 

[Hopper]

Spot on - look after yourself. Glad they are keeping your job open. Enjoy the sunshine!

 

[Toothfairy]

Hi Shortie, I have caught up on your thread today. I am glad that you are feeling less stressed about your return to work. We are all different in our healing, in where we were before the surgery and also in the jobs we do. There is no one size fits all solution. You are certainly not a wuss in any way!!!
I think taking it one day at a time is a really good idea. Enjoy the opportunity to get stronger and healthier before you return to the fray.
Did you get your gym membership through?
I have started swimming regularly and I am really enjoying it.
Have a great weekend,
Hugs, Toothfairy x

 

[turtle68]

Josephine I was just reading your comments above about the tight band, and my knee tightness and pain are in the same locations, sometimes tightening up instantly where I can almost not walk. I had been toughing it out with tylenol only but have started taking 2-3 hydrocone a day - 10/325 when it gets really tight. Once again, your good advice gave me reassurance that this will pass eventually. Thank you.

 

[StillShortie]

Thanks all.

TF I am starting at the gym next Thursday - I am really looking forward to it as I haven't been on ex bike at home since knee was naughty as a bit scared but I am hoping having the personal trainer he can show me what exercises to do safely to get fit and shift the ton of lard I have accumulated!

Have a fab weekend everyone

Shortie x

 

[StillShortie]

12 weeks post LTKR today!!!

So my roller coaster is on an up at the moment which is great - it is during these times I really feel 100% confident that my knee will be absolutely fab (although I know it isn't quite there yet).

We did a bit of garden centre shopping at the weekend - we ended going to three different ones as we were looking for something specific for a present, the first two I was actually walking normally and although having to concentrate I had no limp and didn't 'wander' too much. The third one I was a bit stiff and limpy as we had been sat in the car for a bit before going and so my knee had stiffened up a bit but gradually loosened up a bit.

In the evening I then went with a friend, her two children and my two to a local gig in which our sons guitar teacher was playing - it was so good to go out and be 'normal' i.e. not having crutches, being able to walk! Being able to carry drinks, just getting up to pop to the toilet without some sort of military operation etc. We were only out for a couple of hours or so but it wasn't because I needed to leave but because the kids had school this morning!

So roller coaster on the up I hope the next down isn't a massive heart stopping vertical drop (that's what the last one felt like) I am hoping for any down to be a gentle rambling scenic one in which I can sit back, leg elevated with a glass of wine and relax (yes Josephine I WILL relax!!)

Hope everyone has a good Monday

Shortie x