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Bilateral TKR MUA suggested 8 weeks out -please advise

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I agree with Jamie. Ice and elevating will help, and foot pumps and gentle stretching could be beneficial. I don't remember anyone going through what you have experienced either! That is horrible! They tried the femoral block on my first 2 knee replacements, and neither were successful. But I was also given GA thank goodness! My spine has lesions from MS, so they will not attempt a spinal on me. I am glad you found us! Please keep posting and know that we care about you! :friends:
 
I went without painkillers with a very painful femoral wedge osteotomy, due to the fact that I had a reaction to the IV pain meds they gave me. they were inflexible I told them I normlaly use ibuprophen after eating something first, but they dont have any. they gave me paracetamol which doesnt even take care of a headache... now just had the plate and screws removed same story!! ice ice ice
 
Oh I am so sorry that you had the problem. Its one those surprises we could do without. I am so glad you are getting better. Please make sure you will rest and ice, ice, and ice, Move very slowly and don't tire yourself. Did you get any exercises at all? Please be careful and do keep us informed so we can be hear for you. Post at any time and someone will be here for you. Please take care. Tashia
 
Wow! That sounds completely hellish Kneed for Speed!!!!! Did you take stool softeners and other helpers?

Limpy
 
Limpynomore said:
Wow! That sounds completely hellish Kneed for Speed!!!!! Did you take stool softeners and other helpers?

Limpy
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yes plenty but it takes a long time in my case for the GI track to wake up without the use of all the laxatives. It was the most horrific series of events and my concern is lack of flexation from falling behind. I went to outpatient rehab and the pain limited my progress due to mild intake of any pain management. I trying to stay mentally tough and I am consumed about going thru all of this and not making any substantial progress with bending. Very frustrating.
 
You really should read the articles in the library drop down list above that concern knee recovery.

The question to address is what is inhibiting your bend? Is it swelling? In most cases, it's swelling. You must be very aggressive tackling swelling by proper elevation (knee above heart), good icing, for 30 minutes every couple of hours. This is more important than PT at least right now. Make your every day about getting the swelling down. Not only does it inhibit bend, it inhibits healing. So get your leg in the air most of the hours of the day (in other words, as close to 24 hours as possible!)

Another cause of poor bend in rare cases is the ortho didn't put things in right. You can ask your ortho's office to tell you what your extension and flexion were after the knee was installed -- or better yet, obtain the operative notes.

What are you doing in terms of activity every day? Rest is so important, but for active people, it's like a prison sentence. We need to know you are only doing what's necessary every day, e.g. range of motion movements a few minutes twice a day, some walking, but nothing more, really.

In terms of bowel function, Metamucil is king.

Also, it's hard for us to help you without you telling us how much your knees bend. Is it more or less than 90?

How well is your pain managed?
 
Did you ever have Ileus before your surgery? Or other problems in that area before surgery?
 
My left knee is very swollen after 3 weeks. 70 degree bend in left and 84 in right. I did not obtain any operative notes and I will elevate more than I currently doing. My day involves stretching and some bending on my own . PT 3x per week just started Monday. I have never had Ileus before or any GI problems in the past. My pain management is minimal due to the Ileus and heavy narco is out for now due to that condition . It is extremely hard to PT BKR with no heavy pain meds. That's my story right now and I think im not resting enough or icing enough. Im still worried that im set back by having little PT due to Ileus. Thanks you for your input.
 
Please read my lips: the lack of PT during ileus did not set you back. Even though your bowel routine is working, do try Metamucil. It's not a stimulant but simply fiber and works excellently.

Two: as mentioned, attack the swelling!

Three: consider going to your PCP to discuss pain management. Someone on here was given a fentanyl patch. This is an option that will spare your GI system. They are others. Are you taking NSAIDs?

Let us know how these measures work.

I'm being to the point and direct because you're a guy! Obviously you are worried -- though it's more than worry, isn't it? It's an overwhelming feeling that things are not on track. I had it too. We will help you along.
 
What a horrible experience for you - no pain meds is impossible to imagine.

The experts have chimed in: the flexion will come. Despite your delay, in any knee replacement the timeline for rehab is long term. However I sympathize with your anxiety over the PT.

Take care and keep us posted.
j
 
Please try not to worry. The swelling you see and feel is what is holding your progress back with your knee bending. Things will improve as the swelling gets better. So, resting/icing/elevating are your primary job right now along with those gentle stretches and bends several times a day. Your numbers are not that bad for a normal person and REALLY not bad for someone who has been through what you have!!! It's going to get better. You just need to be really, really patient and give your body time to heal from all this.

Please do discuss any addiitons to what you're taking (even over-the-counter things like Metamucil) with your doctor. You need to be very, very careful until all of this with your GI tract is behind you.
 
Don't worry about the lack of PT retarding your progress. It hasn't. In fact, it may have helped, because over-enthusiastic PT in the early days can actually retard progress. Just do gentle bends and stretches and ankle pumps. That, and walking around the house, are all the PT that is necessary in the early days.

I had no formal PT at all until the fifth week post-op. By that time, much healing had taken place and much of the swelling had gone. Result: perfect function and ROM, in my knee's own sweet time.

Recovery from a TKR is a long and slow process. You can't rush it. Try to think of it as a marathon, not a sprint.

Try not to get too hung up on the numbers, either. For some reason, PTs keep measuring ROM. I think it's because an improved set of numbers proves to them that they are doing something recordably worthwhile. :whistle: For practical purposes, it's function, not numbers, that is important.
 
try not to use the word "should"--as in I "should have X bend." Hang in there, and like others have said, rest, elevation and ice and gentle activity to keep the knee moving are all on the right track.
 
KneedForSpeed said:
Its called Ileus. I have never had Ileus before or any GI problems in the past.[
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Actually, it's called paralytic ileus as in 'paralysed ileum', the ileum being the small bowel between the duodenum and the large bowel. When people have large bowel removed for conditions like colitis, the stoma is called an ileostomy as it derives from the ileum. (I'm sure you really wanted to know all that!) Most cases of PI are one off events. They never had problems before and they'll most likely never have it again. Nobody really knows what causes it but the experience is a MAJORLY horrible event!
KneedForSpeed said:
Tube down my nose into my stomach to pump out bile and enemas to clear the small intestine.
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Yep, that's the treatment to keep thje patient ticking over while the ileum decides to wake up and get going again. What we used to call "drip and suck" because you never mentioned the IV you had as well to keep you fed and watered in the meantime.
KneedForSpeed said:
I am extremely worried because I have little flexation in both knees. I could walk with a walker but bending is very difficult. Its almost 4 weeks and I'm so far behind because of this very scary scenario and wondering what the time frame is before its too late to get my knees bending again
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(sp: just flexion not 'flexation') As has been said before, this probably did you a big favour in one respect, that your knees were allowed to rest and heal before you started beating them up again with exercises! You are still only 4½weeks out so still plenty of time to get things where they need to be, knee-wise! There's no such thing as being behind in recovery - it is what it is when it is. Everyone's different! And 70 and 84 isn't half bad for a bilateral considering.

maryo52 said:
In terms of bowel function, Metamucil is king.
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Doesn't suit me at all. My fave is Fybrogel. Each to his/her own!
 
the hydrocodone is not helping with pain. Has anyone tried Tramadol or suggest what I can take with the hydrocodone to help with pain?
 
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