PKR mimi62 in recovery^

mimi62

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I could really use some help here. Just passed the 3 month mark of my partial knee replacement surgery. The nerve pain is relentless. Any advice you can give would be appreciated! Thanks!

I’m having a terrible time 3 months post op after partial knee replacement surgery. I look and see people moving around very well and it makes me very depressed. Any advice?


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@mimi62 You will notice I moved your posts to a recovery thread of your own. You will get more input from our members on this thread.

Can you tell me the exact date of your surgery and which knee? I will make a signature for you.

Are you icing and elevating regularly several times per day? Are you taking any medication for this nerve pain?

Here are your recovery articles for reference:

Knee Recovery: The Guidelines

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary

2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

5. At week 4 and after you should follow this Activity progression for TKRs

6. Access these pages on the website

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?

Energy drain for TKRs

Elevation is the key

Ice to control pain and swelling

Heel slides and how to do them properly

Chart representation of TKR recovery

Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 
Dear mimi, I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
 
Yes, please!


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Thank you. I had a left knee PKR and the nerve pain is constant. Just started lyrica which seems to be helping somewhat. My recovery is very slow. I don’t do much at PT because of the pain. I also have a cyst in the back of the knee which is one of the reasons I had this surgery in the first place.


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I also have a cyst in the back of the knee which is one of the reasons I had this surgery in the first place.
Mimi, I can assure you that knee replacements are NOT done for a Baker's cyst. It's more likely that when you had investigations for the pain in your knee, the arthritis was noted and that resulted in the knee replacement.


Here y'go with the questions then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?
ai63.tinypic.com_eta39s.jpg


4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.
 
I also found/find the nerves super-sensitive to fabric. Months before I wore pants. Worst of all was/is shaving. I switched from razor to electric to avoid nicks/infection, but even that gets the nerves going.

Hope this helps.

PS I’m 14 months after the first PKR and not quite 3 months after the other.
Walking always helps, no matter how few steps.
 
Extremely sensitive to fabric! I usually wear shorts with a scar away strip which can help. The pain is still bad though. I’m almost 4 months post op. I’m going to see pain management soon for some relief, hopefully!


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I still wear shorts as much as possible due to my knee.

I’m sorry you are still having a lot of pain. I had a partial, also, with a much more painful and slower recovery than I was led to believe I’d have. My partial was a Patellofemoral. Which partial did you have?

I see that Josephine left her questions for you. Once you answer them she will have the information she needs to fine tune her advice for you.
 
I’m not sure about what type of partial I had. I would give anything for a nerve block. My recovery is so slow. I’m also diabetic which could account for such bad nerve pain.


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Josephine's questions are in Post #6, @mimi62 .
Please answer them, so that Josephine can give you appropriate advice.
 
Yes, please do. I really, really want to help you.
 
I’m sorry, just tough to answer the questions because the pain changes everyday. I keep seeing doctors & just saw pain Management yesterday.

I ice twice a day. Physical therapy makes the pain even worse afterwards. I have moderate swelling but the sensitivity is constant. Yesterday it was called “complex regional pain syndrome.”

I just started nucynta for pain and was given a 5% lidocaine cream. My pain levels run between a 7-8 everyday. I exercise in my pool but I’m not sure what my ROM is yet. My surgeon is extremely unsupportive.

I’m not doing well, hopefully pain management will do an MRI to see if anything’s going on.

I’m sorry for not answering all the questions. I just don’t see here that anyone is having trouble almost 4 months post op. A little disheartening for me.

I would appreciate any suggestions as I’m becoming more & more depressed everyday. My life has been so difficult since the surgery. I also am Type 2 diabetic which doesn’t help matters, I guess.


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Just keep posting your questions and answers right here @mimi62 and Josephine and the rest of us will see.
We've definitely had people here who have had very sensitive skin after their tkrs. Hopefully someone will be along soon to share with you what helped them.
 
Physical therapy makes the pain even worse afterwards
Physical therapy should not hurt like this. It means that you are getting bad PT.
I’m sorry for not answering all the questions, I just don’t see here that anyone is having trouble almost 4 months post op, a little disheartening for me. I would appreciate any suggestions as I’m becoming more & more depressed everyday. My life has been so difficult since the surgery.
I have a partial, also. Mine is a Patellofemoral. Which partial did you get?

I was still struggling quite a bit at 4 months, so you are not alone. None of the things I read about partials came true for me, about them being a quicker recovery, and my personal favorite, “a more natural feel since only one part of the knee is replaced.” Nothing about my knee feels natural and I’m 2+ years post op.

I had a lot of pain at PT and suffered unnecessary setbacks due to the approach they took. I suspect that’s what’s going on with you.
 
How good it is that you have found this forum.
Everyone supports each other.

Every time I get discouraged or feel low (4 surgeries in 16 mos: 1 MOHs for basel cell removal and facial reconstruction, 2 partial knees, and a really painful shoulder Rotator Cuff Repair, plus a foot injury and a ligament sprain), I have to remind myself that I am fixing my damaged body parts and that the process is painful, but will be worth the struggle. Sometimes I have to repeat it like a mantra.

I also have very sensitive skin and was and am very sensitive to the nerves being upset by the surgeries. I am not diabetic, but my late sister was and her nerves reacted after any surgery or trauma.

Medications can sometimes set my skin off. When I had the MOH’s surgery, the surgeon said that with my skin, I should never use the OTC neosporin and prescribed bacitracin (single ingredient) instead. What a difference! No redness, itching, or irritation.

Also, is your pool saltwater or chlorine? It is possible to be sensitive to or aggravated by chlorine without being technically allergic to it. My skin much prefers the saltwater pool.
If I go in a chlorine pool, I rinse off before and shower immediately after.

Another thought, which Josephine will no doubt know more about, is to consider if sunlight is aggravating your sensitive skin, particularly if any of your meds might increase sun sensitivity? I have a very thin lycra SPF 50 bodysuit (scuba.com) that I wear swimming (even in hot weather) if I am taking any antibiotics or other meds that increase sensitivity.

Lastly,do you see a dermatologist? Mine always checks all my meds for any possible skin interactions. And she had me switch from chemical sunscreens to natural (titanium dioxide & zinc oxide—neutrogena60 sensitive skin is my favorite), and that really helped.

Hang in there. I hope you feel better.
 
@mimi62
With chronic pain/CRPS you need to ask the pain clinic about Therapeutic Neuroscience Education.
Your present PT is not meeting your needs, find another PT that has had pain science education, if you want help, l may be able to assist.
Here are some online resources for you, retrainpain.org , Curable Health (fee based, they have a free trial), and the Pain Reframed Podcasts.
 
Pumpkln, thanks so much for the info!


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