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Revision TKR Lovetocookandsew’s long road to recovery

Wouldn't a non-swollen knee / leg be a nice thing? There are many of us wishing for that. Patience isn't my long suit, but I'm trying.
 
@CricketHip As you know, I still have a large amount of swelling in my knee and leg that won't go down. It has restricted my flexion to something like 90 degrees, which means I am quite restricted in my ability to do things I want to do. Add the continued stem tip pain to that, which is showing very little signs of bone remodeling around the long stems, and I'm not where I'd like to be. Josephine mentioned to me about lymphatic drainage massage, and I made an appointment with a PT who specializes in the procedure. Any advice or knowledge you can give me would be more than welcome. Thanks!
 
@lovetocookandsew hello! I jumped back several pages in your thread to get familiar with your story and oh my goodness, your swelling has been rather tenacious, hasn't it? I'd love to give you some tips for self help but am so happy you have an appointment with a MLD ( manual lymph drainage) specialist. This person will most likely address many areas and it should help get things moving.

Since I could see some of your pictures, it appears you have significant swelling above your knee so the first thing to address is to get your upper body, which is the most important part of our lymph systems, primed and working.
So lets start with this:

While lying on your back with your feet elevated-- try taking big, deep breaths.. our bodies have a large amount of lymph nodes deep in our abdomen and "priming" them with deep breathing will help create a drawing (suction) effect. You can also help things along by placing your hand on your naval area.. take a deep breath, enough that you will see your hand move and then as you breathe out, press gently, yet firmly down on your naval area and repeat this exercise at least 5-6 times. You can start with gentle pressure and increase pressure as your stomach softens and relaxes. this is all to your comfort level!!

Then please remain lying down and place your right hand over your inguinal area, you know, where your thigh meets up with your trunk of your body? Keeping your hand flat and soft,, start pressing your full hand into the inguinal nodes that are located there and with an upward, semi circular motion massage up towards your midline- where your naval is located. I hope this makes sense.. it's really easy to do.. it's not with your fingertips, use your full hand and part of your hand will be on your upper thigh area.. I would stay in this area and gently massage for at least a minute or two.
Then return to doing the deep breathing exercise then repeat the groin/inguinal exercise. Please take the time to do the left side too. Like I said, it's easy to do and you can't hurt this area but keep your hand soft and flat, no harsh fingertips jabbing.

Let's see how that goes first? Do this 3 times a day and see how you feel.. I'd love to hear that you notice you are visiting the bathroom more! But it may take more patience and time.

I'd love to do one more thing but lets wait until you do this above exercise today and tomorrow?
 
P.S. Your OS mentioned last year about pool walking and exercise, and I'd like to respond to that. Water presses on our bodies when we are in it. The deeper we are the more "atmospheric pressure" is applied.
This is why when we go swimming we seemingly have to run to the bathroom more!

I think that is why he wanted you in the pool.. not so much for the walking and exercise but for it's very effective lymph drainage tool Especially if you can get as much of your body as possible into the water.. like treading?

OK maybe he meant for the exercise..:loll:but water is our friend when we have that kind of swelling.

Good luck! and please ask if I've confused you on anything.. @lovetocookandsew
 
I'm going to ask some stupid questions so don't mind me if they sound ridiculous.

You had a revision June 2018 and you're still having a large amount of swelling? Why?

I also had pain coming from the long stem in my tibia for years. Before I had my two-stage revision my new OS took x-rays and immediately identified from the x-rays that the bottom metal component to the tibia was loose. The x-rays also showed the long stem inside the canal was pressing to one side of the canal. (I have an x-ray of the stem pressing to one side if you would like to view it) So, every time I would put any bear weight on my leg because of the loose component the stem in my tibia would shift side to side pressing against the inside wall of the canal which cause me a very sharp pain every time I tried to walk.

I'm not saying this is your problem, but it's something to look into.

For that very same reason, I had to get a unique style of prosthesis components. Cementless prosthesis and the long stems had ridges so the bones could grow around the ridges of the stem ensuring durable stability.
 
@CricketHip That was a lot of very helpful information to digest, so I will read it over a couple more times, then do the different things you mentioned. I would be happy to do regular pool walking but we don't have a pool. I was going to purchase a two year membership to the fitness club near our house, but knew we were going to be moving before the two years were up. Now that I know when and where we're moving, I won't buy one as there is no club near our new home. Thank-you for taking the time to write all that and I'll let you know how it goes!
 
@TimeBuster No question is a stupid question. I do have a lot of swelling; as to why, that's the million dollar question. My OS isn't sure, and no one else has been able to pinpoint a reason. I am going to start lymphatic drainage massage and see if that helps.

As for the stem pain, in normal people the bone fills in around the stem and the pain goes away. But, as everyone who knows me knows, I'm far from normal :heehee:; I have a body that does crazy things, so naturally my body has not really done the filling in as of yet. Since it's been a year now, I don't see it happening, but there's always hope. I see my OS again in Sept. to see if there's any change, if so, great, if not, then we talk about options :banghead:. The components are unlikely to be loose; it's more likely that the bone around them moves when I move certain ways, and the post then touches the bone giving me the sharp, shocking pains.
 
Oh, its not too difficult, really. it sounds like a lot when it's put into words but you're just doing some belly breathing and compressions and massaging your groin/thigh area.. does that make it sound less intimidating? :ok:
Shucks, I wish you had a pool nearby. We are lucky, the high school right down the road lets our township use their pool for a small membership fee.. it's perfect for what we want it for. But no matter! Just some simple breathing and massage and then you'll see the MLD therapist soon..
 
Sorry to hear of the problems that you are still having it look as though you too have been through the mill. It is very demoralizing when you think you are having something done to help you get mobilized only to find that you have gained yet another problem. I hope that you manage to get some relief with the lymphatic drainage massage. I totally empathize with you and am sending you understanding and best wishes.
 
Thanks, @TimeBuster . I appreciate your kind words. I'll post on my progress after I start seeing the therapist. I wanted to see a specific one and her first appointment for a new patient wasn't until July 29th, but I figured it's been a year of swelling so what's another few days.
 
@CricketHip Still trying the massage. I haven't noticed any difference, but I can't guarantee I'm doing it correctly. When I see the therapist, i'm sure she'll show me exactly how to do it at home, so I'll let everyone know how things go afterwards. Thank-you for your advice-I will continue the massage until I see the therapist.
 
hello and thank you for the update! Im sorry it hasn't helped, darn! Maybe we can add a couple things. there is another aid that you can buy and they are inexpensive, too. Have you seen the boar bristle back brushes? They are really helpful for doing a very light massage starting from your foot and up to your torso/heart. I will attach a link to show you a picture of one. It's called dry brushing and may help after you do the abdominal and groin massage.
It would be worth a try, for sure. I use mine in the shower and immediately post op I dry brushed my leg several times a day but couldn't lean over far enough to include my foot and ankle.
Did you know that you have lymph nodes behind your knee also? If you are willing let's add that to the mix!
Take the palm side of your hand and place it right behind your knee- right in the fold/bend, keeping your hand soft and flat just start pressing gently into that knee bend and up towards your thigh. This will be AFTER the other techniques are done. it's like a circular mixing motion..
There are so many other things to do but you've had your swelling for so long that I think you will need the specialist to find the areas that are blocked and get things moving again.

But! You will have tools to help yourself in between sessions, and you will need several, then the dry brushing is a wonderful tool for all of us to incorporate into our post op care. Many of my oncology and surgical clients use this daily and think it helps.

Here is the link to show you a dry brush:

Amazon product ASIN B07HKVFB41
 
@CricketHip The link didn't show up on my page. I think what I'll do is just the massage on my upper thigh and add the back of the knee. I'll do that until I see the therapist and see what she has to add and if I'm doing it all correctly. Thank-you so much for your help!
 
I do have a little progress to report. I just noticed a couple of days ago that I'm standing squarely and evenly on both legs, which I haven't been able to comfortably do in years. And my right knee extension when standing is basically even with the left knee. I can't hyper-extend it like my left knee, but I'm thrilled with what I can do. Also, when I shift my weight onto my right leg; as long as I don't twist/swivel the knee at all, it doesn't hurt my knee to stand with most of my weight on that leg. I still have the post tip issues and the swelling, but I'm happy to have a little progress! :yay:
 
@Roy Gardiner Since you seem to know a lot about bikes, can you help me get back on mine? I know many people can't ride at first, but eventually can as the swelling dissipates and their muscles, etc, heal and strengthen. Since I still have a lot of swelling, I have yet to be able to bend enough to pedal. I've heard there are ways to adjust the pedals, or buy some special ones, to allow someone to ride without full flexion, but don't really understand the process. I have a really limited flexion; at my last visit my OS eyeballed it and said he thought it was about 90, and that is nowhere near enough to ride a bike. I really, really want to get back on it and could use any and all advice you (or anyone else with knowledge in this area) may have. I'm also hoping if I am able to ride again the post tip area isn't triggered by that movement so I can enjoy the exercise. I can't enjoy a pool much since I discovered I can't tread water or swim laps, so I really hope I can find a way to ride my bike again. Thank-you in advance. Kim
 
Regarding your statement that you can't enjoy water. Buy a "noodle" for the water. I can't swim, however I "ride" the noodle (put between your legs) and I walk up and back in my pool and do about anything one could do treading water in the deep water. Enjoy the water!
 
lovetocookandsew said:
Since you seem to know a lot about bikes, can you help me get back on mine?
Click to expand...
I can try. You need a static trainer on which you can set your bike.

[Bonesmart.org] Lovetocookandsew’s long road to recovery


These are not ridiculously expensive.

  • Set the trainer to zero resistance
  • Set the saddle as high as possible and rock the pedals back and forth as far as you can with discomfort but no pain
  • Repeat several/many times a day, but don't go mad. Diminishing returns will apply; my guess is that half a dozen reps would be enough
  • And if you get any pain or swelling in the 24 hours after doing this, cut it down until you don't
Here is a bit more chat and some pix and how 'healing' and 'training' are different

When you can make a rotation
  • Set the bike to zero resistance
  • Set the saddle low enough so that a single rotation is a challenge; difficult but not painful. When a rotation becomes easy right from the start, lower the saddle a max of 1cm.
  • Gently turn the pedals, through discomfort but without pain.
  • Continue until the knee is 'warmed up' and the rotation is now easy, or for 2 minutes, whichever is the shorter time.
  • Repeat several/many times a day, but don't go mad. Diminishing returns will apply; my guess is that half a dozen reps would be enough
  • Do not pedal fast or for more than 2 minutes, this is a stretching exercise, not training.
  • And if you get any pain or swelling in the 24 hours after doing this, cut it down until you don't
 
@Calgirl Thank-you for the suggestion. I can walk around the pool.......well, I can walk in the shallow end at least, but I've always been a swimmer (not a great one, but I was on a swim team for a while and enjoyed it) and am not yet ready to accept a limitation there. Riding a pool noodle would work, but stubborn me wants to swim laps, both breast stroke and free, and tread water. So, I'm going to get some lymphatic massage and see if that will help reduce the swelling, and am hoping and praying the bone will fill in around the posts so that that pain stops, leaving me free to be fully active for the first time in years. Then, if none of those things work, I will accept my limitations and work around them. Oh, and I plan to avoid breaking my toes in the future so I don't walk like a gimp on both legs.....:rotfl:
 
@Roy Gardiner I was hoping to actually ride my bike, not on a static trainer, but out on the streets. My revision was over a year ago, and I'm past the need to just rock the pedals. My problem isn't lack of strength or a new surgery, it's that my knee has continued to be quite swollen after all this time. I have heard of some ways people can ride their bikes out and about even with swollen knees that won't bend much and that was what I was hoping to learn about and understand so as to adjust or re-fit my bike to accommodate my lack of flexion. Thanks for taking the time to respond and I hope you see what I want to do and are able to help in that area. :)
 
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