TKR MSuki’s Fabulous Recovery Journey

[Layla]

Good Morning MSuki,
I hope you made it through the activity of yesterday without major struggle or pain.
You were feeling pretty rough on Wednesday. With any luck the discomfort you were dealing with has eased and you're able to enjoy the weekend in comfort.
@MSuki

 

[MSuki]

The PT I am getting is not primarily focused on ROM I just realized, it is more getting strength back. Either my therapist is more enlightened or not worried because I’m ahead of her schedule. I have not had the experiences of others where anyone tries to get more bend or more extension from me. But since I have not had that much swelling in my knee itself, it bends fine on its own, 116 at my 2 week visit. I had more swelling in my ankle and up my shin for some reason with the pitting edema both places. Also they try to help with my misc glitches from the realignment of my leg. The only things I do related to ROM are about 2 minutes of heel slides where I am told to relax my leg and stop before the point of pain. Also I do a few reps of pushing down with my quad. The other stuff is more strength, stretching, and a little balance.

 

[MSuki]

Today’s complaint….

I feel like I have a different problem every few days. For the last few I have been having sciatica and pain in my hips and upper legs. Worse on the operated side. I was blaming that on my chair and the realignment of my leg. I have a massage gun and tried to reach around and hold it on the worst spots, and noticed that all around my lower back are places that are sort of stingy and very sore to touch like a trigger point. Now my upper back is starting to knot up between the shoulder blades when I wake up. I’m not used to sleeping on my back but I don’t think I had this much trouble with it last time. Wish I could go get a massage but I know it’s too early. I don’t think I could lay face down on the table. I guess I’ll try a heating pad or maybe even get on the floor and use a foam roller. Any ideas?

 

[mendogal]

My massage therapist, as most I imagine, has various bolsters and techniques for folks who can't lie face down (think advanced pregnancy or after abdominal surgery!).
She had me lie on my non-surgery side with my new knee leg at a comfortable flexion and fully supported up on a bolster parallel to the table.
She never touched near the knee but did amazing thigh, hip, pelvic, and sacral work that released so much tension!
also...
Please don't let PT overdo strengthening just because your ROM is ahead of schedule!!!!! The muscles really need a good six weeks and many surgeons' protocols don't call for strengthening before then.

 

[MSuki]

I might call about a massage in a week or so. I feel like all my issues are side issues. My knee is fine, PT is fine. But for the last few days, I have had a pain in my butt/hip and upper thigh. Might still be from the extra walking at the hospital, or the realignment of my leg. Could not find a pain free way to sit. I put heat on it the first day and it was way worse the next day. After 2 days of ice I think it has settled down to a low level. I also had two spots that were ridiculously sore from the ultrasound. She would run the instrument over my leg with one hand and had her thumb? stuck in one of two spots: one was the outside part of the back of my knee and the other was top of inner thigh near groin. I guess they are compressing a blood vessel? I am still having trouble getting motivated to do anything even though I technically could. I ran 1 load of laundry yesterday but none today, also yesterday I emptied and reloaded the dishwasher. Otherwise I am mostly trying to get a comfortable position and watching TV and using ice. I feel like I slept a little more soundly for a while last night but not getting more than about 6 hours sleep which comes in two 3 hour sessions. Swelling in my foot has gone down but I still have episodes of foot pain. And my digestive system keeps swinging back and forth one direction or the other.

 

[mendogal]

I hear ya! Those "side issues" can really bring morale down.
Based on your activity, I don't think lack of motivation is a problem though; I think of it as the mind-body system automatically reminding us we need to do less than we normally do in order to let the body heal. Here's hoping for better sleep!

 

[sistersinhim]

You are being smart in your recovery. You are in the really early days when doing less=more healing. You can always up your activities as your knee and body allow. After this surgery, your whole body is affected by this traumatic surgery it just went through and needs lots of time and TLC to recover.

 

[MSuki]

Thanks for the encouragement - I feel like I’m just complaining to my husband with one thing after the other. It seems so strange to wake up in the morning and my knee is a 2 or 3, my foot is a 6, and my hip is a 7. And then I’m nauseated and upset stomach off and on. Trying to look at it that the knee is coming along well and these other things are hopefully more transitory.

 

[MSuki]

Today’s difficulty: so I was getting a refill on my hydrocodone today and worried all day because my dr was in surgery so the order didn’t come in until after hours. I have been taking the 10/325 and asked them to take it down to the 7.5. Cutting it a little close because before Thanksgiving was too early. They will only dispense (the pharmacy, based on my insurance?) 7 days at a time. The prior prescription was every 4 to 6 hours so 7 days was 42 pills. This time he sent a prescription for 42 but the instructions said every 6 hours so they would only give me 28. They said if I was supposed to get more the doctor would have to wait 7 days then write a prescription with the modified instruction. I am mostly going 6 hours but can’t go 7 yet so this gives me zero leeway, and will have me scrambling again next Monday. Plus it’s already a 25% reduction.

I am getting about 5 1/2 hours sleep per day since the surgery so my tolerance for problems is currently close to nil. Maybe I’ll do better this coming week. But I hate having to feel like I’m rationing the medication.

 

[sistersinhim]

You shouldn't have to ration it so early in your recovery, but a few abusers have made it bad for all of us who really need the pain relief. Does ice help to reduce your pain? It did for most of us. I iced the whole time I was sitting or lying down for the first month or so. This helped me to reduce the number of meds I needed to take.

 

[Layla]

This is unfortunate and something we shouldn't have to stress over when we're feeling vulnerable, dependent upon others for a lot, and in pain. I do hope you have a good week and the pain is manageable.
@MSuki

 

[MSuki]

New issue this week: I am getting cramps in my feet and hamstrings. Any ideas how to combat this?

 

[mendogal]

New issue this week: I am getting cramps in my feet and hamstrings. Any ideas how to combat this?

Yep...
I have an intermittent but long history of foot, calf, and hamstring muscle cramps. It definitely flared up after each TKA.
The current research doesn't fully support it as effective, but I and lots of people I know have had excellent results from taking a magnesium supplement in the evening.
I also keep a topical magnesium spray that often provides immediate relief - spray and massage.

 

[MSuki]

Thanks I may have a spray but I think I’ll visit Amazon and order a supplement.

Also, day 21 just had a major milestone - I slept 6 1/2 hours straight! Previously had been sleeping about 3 hours or so at a time.

 

[sistersinhim]

Also, day 21 just had a major milestone - I slept 6 1/2 hours straight! Previously had been sleeping about 3 hours or so at a time.

That is fantastic! I wish I could sleep that well. At only 3 weeks out sleeping that well is practically unheard of. You go, girl!

 

[mendogal]

Yayyyy for good sleep!!!

 

[MSuki]

OK so just when I felt I had taken a turn for the better, I sat down on the sofa last night and something happened. It was not where I usually sit and probably a little low. I had weight on operated knee as I sat and I felt a sharp pain. I don’t think I twisted and would be a tiny twist if I did, may have just bent it further than normal, but it really hurt for a few minutes, then became an ache. It was just an extra ache all day today but then I felt a pinch of a sharp pain tonight when bending my knee. I also had spent extra time on my feet tonight and did my recumbent cycle for 10 minutes for the first time earlier. Hoping that I just aggravated an area of soft tissue. It is on the front of knee toward center. Interestingly the same spot on my older knee gets sore still and is currently sore if I push on it.

I am thinking I should just give it a few days and see if it improves.

 

[mendogal]

If it's sharp only when bending the knee, definitely give it overnight, do less activity tomorrow plus more ice and elevation.
If there's continuous sharp pain, a marked increase in swelling, or unusual warmth or bruising, definitely check with your ortho team!
But I've certainly done similar a couple of times on each new knee, and whatever was glitching resolved quickly.

 

[sistersinhim]

I hope you are feeling better today. Unfortunately, these ups and downs do happen. I imagine you angered those involved soft tissues with your miss-sitting down and your knee let you know she did not like it at all. You can increase your icing to help with any lingering extra pain from it. If it doesn't get better in a few days definitely call your doctor.

 

[MSuki]

Day 23 update:
My foot and ankle swelling is much better. Most of the time my foot doesn’t hurt, every once in a while i have a little pain on top of foot but not like it was.
Hips and lower back are still a problem, it’s hard to find a position that isn’t aggravating this.
I spend about 3 days earlier this week severely nauseated, yesterday I didn’t want to even move my head early in the day because I felt so sick. Pretty sure i have narrowed it down and it’s the senna (pills from dr) that was not agreeing with me. Feeling much better today after I skipped that last night, although still slightly queasy.
Knee is better from when i twisted it, I’m being careful not to irritate it more. Knee is feeling OK other than area just above kneecap which is sore.
My calf continues to be angry. It feels sore, tight, and crampy all the time.
Starting to get some sore spots on my heels from sleeping on my back. I had this last time as well. hopefully will be able to sleep on my side soon.
I went to physical therapy today and we took it pretty easy mostly to keep from aggravating the knee. Despite sitting around the last few days my ROM was 119.

May have said before that my mobility seems better with this knee but pain seems a little more. Maybe i’m doing more because i think i can, i don’t know.

Did dishes and some laundry today. Also we went and picked up my handicap placard. I’m hoping to be able to drive soon. I had planned to go earlier but did not make it. This worked out great though since we’re in December now - i have an extra month compared to if I had gone to the tax office in November.