Bilateral TKR Massage?

[Josephine]

1. Pain levels : lowest 2. Highest 6

Okay

2. I had to drop the dilaudid and the Tramadol because of this terrible aggravating rash that manifested on the entirety of my legs and back. The stupid rash takes up a great deal of my energy and willpower not to scratch.
Meds I am taking:
Oxycodone 5 mg 4xday
Gabapentin 300 mg 4xday
Tylenol 1000 mg 2xday
Benadryl 25mg 4xday ( for the rash)

Shame you can't take Tramadol, it's a jolly good pain med.
All other drugs okay except Tylenol which you could take two more doses of per 24hrs provided the Oxycodone doesn't have any in it.

3. Swelling : moderate to slight

Okay

4. ROM: extension=0 flexion=78 as measured last Thursday however I believe it has now improved and I dare say it would be 85-90 if measured today.

Not bad!

5. Icing: I use the cryocuff 2-3 times per day at 40-60 minutes each time. I also use a small freezer pack for the back of my knees 2x day for 30 minutes. (I really hate the ice.)

Okay - good

6. Geez. Should I be doing that stuff now?

Well, you're only 2½ weeks out so yes, you should be elevating. Elevate while you ice.

7. no cooking, cleaning, shopping or housework. I pretty much stay in my bedroom and alternate sitting in the rocking chair and my bed and walking the long hallway. We have a set of 18 stairs to get down stairs and I manage to go down on my butt using my arms and back up again on my butt using my arms every 3 days or so.

Why are you not doing stairs on your feet? You'll have to some time.

Ankle pumps x20 x10 a day - if you're walking so much then you don't need to do these
Pressing knees down, hold for 20 seconds, x5 - if you extension is 0, then you don't need to do these
Rocking chair knee flexes 10 minutes x5 - okay but don't overdo it
Hallway walk with walker 2 loops, x3 a day (40 yards per loop) - good!
Dangling/ swinging legs x5 minutes, x5 day - okay
Leg elevation above heart, 20 minutes, 2x day - I thought that earlier (q6) you asked if you should still be doing these! And I said yes! Well, it seems you are!


Formal PT
She has come to the house twice so far and will probably be here twice next week. After that I will be released to go to the formal PT center at the hospital.
She has shown me the exercises I should be doing but because of the tight tendon problem and the rash that’s eating me alive, we did not do much this week. Sigh. - I suggest you kindly decline the hospital PT. Many people on this forum has found it's just as good to do without.

However, if you are concerned about refusing to do therapy, you need to read this Saying no to therapy - am I allowed to?

 

[Jayla]

Maybe I had my response numbers out of order but the “geez should I be doing that stuff now?” Was referring to the housework question. Anyway I think you figured it out.

stairs

I am doing stairs now. I face the banister and go down one step at a time. I do the same going up. I was a little nervous about the stairs because we have an old Victorian house and there are 18 steps to go up and down so it’s a long way to fall.

Flexion 5 days ago was 97 on the left leg and 102 on the right leg.

I really hadn’t considered not going to PT. Quite a novel idea as I found in the past they didn’t really offer that much most of the time. I am going to go to the first apppointment next week and see how it goes. I have to say, though, that your concept of no PT has made me feel empowered to say “no!” if I don’t like what they want me to do or if they are hurting me. I feel like my recovery is going very well and I am constantly improving just doing my own thing so I am not going to let them railroad me into PT if it’s really not ay good.

Thank you so much for your comments and your strength to help me stand up for myself in the face of the self-righteous medical community.

 

[sistersinhim]

I wish everyone had the courage to stand up to PT and just say NO when it's too aggressive for where their knees are in their recoveries. You sound like you are in control. You go, girl!

 

[Jayla]

Hi folks. New question.
I was checking around on the internet for swelling reduction ideas, like eating ginger, and I came across a website that was giving medical advice as to the do’s and don’ts after knee replacement surgery and one of things they recommended was using heat on the muscles surrounding the joint to help relax the muscles. What do you think about that?

 

[sistersinhim]

Heat on the joint in the early days causes more swelling. If you try it, make sure you're not on the knee, then make it a trial and error thing. If it works for you, great. If not, then don't do it again. So much of this recovery is individual trial and error. What works for one might not work for another.

 

[Josephine]

I was a little nervous about the stairs because we have an old Victorian house and there are 18 steps to go up and down so it’s a long way to fall.

Just make sure you grip the banisters firmly each way. I still do!

Flexion 5 days ago was 97 on the left leg and 102 on the right leg.

That's excellent!

Heat on swollen knees? Absolutely not! It will encourage blood flow into the knee and thus increase the swelling and the pain. I doubt those sites were speaking of heat on a post-op TKR knee! Probably just a twisted or bruised knee - quite a different thing.

 

[Jayla]

Hungry? I have no desire to eat anything. The only thing I am mildly interested in is fruit. My husband is doing a great job of cooking and he is providing a variety of different meals which I feel like I am forcing myself to eat. So I am eating but it’s a struggle. I don’t feel nauseous or sick to my stomach I just don’t feel like eating. Is any one else feeling like that? Is that normal?

 

[sistersinhim]

Many of us had so desire to eat for a month or so. I think it had to do with the pain meds and the overall exhaustion from the surgery. It does come back and so did my weight loss!

 

[Jockette]

. I don’t feel nauseous or sick to my stomach I just don’t feel like eating. Is any one else feeling like that? Is that normal?

Oh yes, I felt like that and so did many of us. Unfortunately for me, my appetite came back before I could lose any weight!

 

[kneeper]

If the muscles are sore, heat well away from the knee is ok (I did that at times), but that's completely unrelated to helping with swelling.

 

[donnag1108]

I am right there with you. I've had no desire at all to eat. So much so I've had to force myself because I know I need to. I've lost 15 pounds since the end of September, 10 of that since leaving the hospital. I'm told it's normal.

 

[Jayla]

New question.
Tuesday 1/8 I will be 3 weeks post op. My OS gave me a hard time about giving me another prescription for pain meds so I have made an appointment to speak to my primary care doc to see if she will work with me and continue to give me pain meds. I am taking (3) 5 mg oxycodone and 3000 mg Tylenol each day. Honestly I would really prefer to take (4) oxy’s but I am trying to make what I have last. Otherwise I will be down to Tylenol because we obviously can’t take NSAIDS after surgery. So I am trying to organize my thoughts to be able to make a compelling argument for a few more weeks of the oxy which I don’t think is unreasonable. Thoughts?

 

[Jayla]

How can I cut my toenails after a bilateral knee replacement? Should I go to a nail salon? I am worried about infection. Thanks.

 

[bottomshollow]

above, @Jayla, from the December Recovery Club thread into your personal thread where it really belongs. Remember that the team club is primarily to allow you to see who has had surgery the same month as you. Discussion of issues, comments, and questions regarding recovery should be kept in your individual recovery threads. You and your questions and concerns will not get the attention they deserve on this thread like they will in your own threads.

You can cut your toenails just like you always have. Normal nicks and cuts will not cause an infection at your surgical site.

 

[Jockette]

Are you having trouble reaching your toes to trim the nails? (Like I still am?!)

Personally, I think I’d worry more about an infection at a salon. I’ve never had a pedicure and don’t plan to.

At less than a month out I didn’t want anyone touching my leg or feet and I couldn’t imagine getting my leg into a position comfortably for a pedicure.

Maybe go to a podiatrist? That would probably be the best sterile place.

 

[Jayla]

Thoughts on icing. Initially, ice was my best friend to manage pain. However, early on, I felt that the ice was making my knees stiff and I felt like icing made it harder to bend and straighten my knees. I was reading up on icing and found multiple articles talking about how the inflammation after an injury (no references to surgery) was actually important for healing to occur because the inflammatory cells release factor Igf-1 which is a growth hormone which aids in healing. In fact, Dr. Mirkin (drmirkin.com) who was responsible for the acronym RICE (rest, ice, compression, elevation) is now saying he was wrong and the studies are flawed and that ice shuts off the blood flow that brings in the igf-1 to enable healing. Does anyone have thoughts on this?

 

[Larryhg3]

Like many things in recovery, people react differently to applying ice. Several members here have reported that ice seems to aggravate more than help. For me my PT has me ice for 30 minutes front and back of knee after PT and after work. He says it will keep the internal swelling down. My OS says to ice heavily during early recovery (4-6 weeks) then use as needed for swelling.

 

[Mutti3]

My thought on ice usage, this is my experience. I used ice continuously the first 14 days. When I started to go to outpatient PT at day 15,only iced and elevated periodical after that.

 

[Dolly Girl]

You're doing better than you think, and you had two done. It's just going to take time. The ice machine got to be too much for me so I went to clay filled ice packs. Hang in there and don't let anyone push you at PT.

 

[sistersinhim]

Put any topic out there on the Web and you'll find different experts backing us their completely opposite views on that topic. If icing works for the person, then do it. If not, then don't do it! I'm another one that it was a God-send to. I iced the whole time I was sitting or laying down for the first month or so. Did it slow down my healing? Who knows! Did it reduce my swelling and pain? You bet it did! Icing is a personal choice.