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TKR My Journey as of 12/16/13 - Over 1 Year and Still Trying

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Thanks @Phil75070 and @TexasTee for the information regarding the refund from the pain clinic. Trouble is, I have NO patience and would rather get that money back sooner than later because, apparently, one of my pups caught wind of the fact that I was getting a refund and devised a way to spend it plus much more. I came home last night to see my 2nd oldest man with an uber swollen cheek and closed eye. Tooth abscess requiring sedation, teeth pulling and lots of other fun stuff. Boo. Tracked down my vet last night, via FB no less, to see which clinic he was working at today and took my boy in. Too bad my vet, the only one I trust with my boys, is leaving for a 3 week vacation tomorrow. So until he gets back, it's antibiotics, pain meds and stinks canned food for TJ. With senior bloodwork and all else needed, it will be over $1,000. Crud.

Anywhoo, I just picked up my scan summary. Guess I really did want something/anything to be found in order to explain why I am in the boat that I'm in, but alas, nothing. Here is what the summary said:

" There is a considerable amount of scatter artifact from the metallic hardware components, however there is no definite evidence of loosening or infection. No adjacent fractures, lytic lesions or malalignment seen. There is a small joint effusion. I do not detect any intra-articular loose bodies. No surrounding soft tissue masses or abnormal fluid collections seen."

Aside from not knowing what a joint effusion is, this pretty much says my knee is 'fine'. I wish someone would explain that to my knee.........
 
@71Beetle , I'm a bit further along than you are, my dear. 8 months vs 8 weeks should allow me to chip away floor tile. ;-) As for the tattoos, no sordid details, I've got 4. :-) One of them was starting to fade badly (after 28 years, I'd guess it would) and was starting to morph into something other than what it was originally, so getting it removed. Yes, the procedure HURTS! Much more than getting the actual tattoo did. And is costing about 10 times as much. I think it's lovely that your son got a tattoo to cover his scars and remind him of how strong he is! Kudos to him!

My mother, btw, followed me around for months trying to spit wipe my tattoo off my shoulder blade. She hates tattoos as well, but too bad. Mine are small, all mean something and I love them. Once this one is gone, I will most likely replace it with something else. :-) xoxoxoo
 
OMG, Seriously?!?!? I just looked up 'joint effusion' and I have apparently just paid $700 in order to be told that I have a swollen joint. The report doesn't even say WHERE this swollen joint is....argh...totally annoyed right now..
 
Sounds expensive but if you are having swelling wouldn't that be the reason for the pain? Why don't you tag Josephine and see what she has to say.

So sorry to hear about your doggie. I had a cujo that stressed me out every vet visit. I finally found a farm vet that would make house calls. She was the most amazing vet I ever met and my dog thought so too.

Hang in there - I do hope your pain lessens. Enjoy your holiday weekend!
 
Hmm, something is causing the swelling but it sounds like it isn't what they consider the usual suspects causing the problem. Maybe Josephine can interpret for you.
 
I agree, we need josephine to interpret it for us. I'm so sorry you are having such an expensive but horrid week, it probably doesn't help you right now but we are all here for you, so when you want to have the rant you are totally entitled to, go ahead, we're listening xxx
 
Your $700 does also pay for someone to SPEAK to you about what that might mean, doesn't it?! I googled effusion as well and recall something about you saying something about a vargus/valgus issue? I might have made that up. This cat has some interesting thoughts in case you want to do some more research.

https://www.louortho.com/documents/TKR DEEP FLEXION -Sweet web.pdf

I'm very sorry about your pup! Toothache is no fun, my vote is for ice cream until the doc is back :-)
 
@DogLoverx3 Sorry about your doggie. We are in the being jealous phase with the addition of our latest dog….she also needs teeth cleaning etc.
So you have a small joint effusion and everything else is good --nothing new! The problem goes back to dealing with the continued pain until it resolves naturally. Perhaps time for the pain doc again?
 
What is "scatter artifact"? I am sorry this is so very frustrating. I would be frustrated too.
Was there any explanation as to why the joint is swollen?
I am thinking of you.
~hopefaith
 
hopefaith said:
What is "scatter artifact"? I am sorry this is so very frustrating. I would be frustrated too.
Was there any explanation as to why the joint is swollen?
I am thinking of you.
~hopefaith
Click to expand...
@hopefaith Scatter artifact occurs when the "waves" used for the CT scan bounce around from metal in the body --the waves cannot penetrate the metal so bounce off it.
 
Thanks all. No, my $700 does not include a personal consult. Especially since 'nothing' is wrong. Boo. Thank you for posting that link @TexasTee , although my eyes glazed over and most of the terms went right over my head, I got the gist of it, but basically it was all things I would need to know prior to the surgery as it's a done deal now. No clue if my 'slightly valgus' knee prior to surgery has anything to do with what's going on now. I had specifically asked for the radiologist to study my patella and whatever else is under the implant on the inside left side (patella? femur? tibia?) as that's where a lot of my pain is coming from (aside from my knee itself feeling like it weighs 100 lbs and looking like a cantaloupe) and the report says nothing. I couldn't garner from that article if it was referring to general good ROM post TKR or more specifically good ROM post TKR if you had limited ROM prior. My ROM has always been good.

I'm just annoyed in general. Nothing new. ;- ( Also worried about my dog and the fact that at 15 it's very dangerous to put him under sedation as well as feeling bad that the poor guy has to deal with his sore face/mouth for 3 weeks until it can be 'fixed'.

I appreciate everyone checking in and I know that you all were just as hopeful as I was that something definitive would have been found via the CT. I will concentrate on my pups, my pain meds, getting a brace and some other piddly things until I can figure out where to go from here. Thinking I'm out of options aside from going back to PT, but I really don't see that being of any benefit to me.

I hate to bother Josephine when she's so busy, but will track down one of her pain charts so I can give her the specific quadrants before bothering her.

@Chihuahuan , hopefully all is going well with the new addition. I'm sure you already know, but pups, like people get jealous easily. Until things settle down around the house a few suggestions are to 1) feed the new kid last 2) don't leave toys/bones laying around when no one is home 3) always greet the original 4 leggeds before the new guy. :-) Silly rules, but they work!
 
Hi @DogLoverx3- just read up on the latest for you, sorry about your dog but yay about getting some money back! I'm sure you're frustrated that there wasn't a definitive answer regarding your knee scan. I certainly hope that you get some sort of relief soon. Thinking of you!
 
I agree with the other your dogs will make you feel better, they understand more than we think, they know when you don't feel good.

Good luck with your recovery.
 
Sorry to hear about your pup and your results (non-results?). It must be so frustrating for you.

I feel so petty for my 8 week noise when you are going through all of this after 8 months! Where is the pain exactly? My pain is not in my knee, though there is still a lot of bruising so if I touch it, it hurts. My pain is all in the muscles and ligaments and tendons that we have all had pushed and cut and mangled for the sake of new knees. I think that makes me feel better as I know they will repair with time but your pain certainly seems to be more than that!

Have you seen a Pain Management Doctor? I had never heard of one before joining this forum but I believe others have had success from seeing them.

I think it is cute that your mom thought she could spit wipe your tattoo off! The visual I got from that is hilarious! Did you look at covering your tattoo with another one as opposed to having it removed? I catch those tattoo shows on A&E and TLC on rainy weekends and find it fascinating how they can turn a really ugly tattoo into something beautiful by covering them.

My boy's choice was a semi-colon, a bit bigger than I would have expected. He says he got it because it symbolizes where the author could have ended the sentence, but chose to continue. It is part of a Self Harm and Suicide Prevention Movement. I love my little man and I will never regret why he got it. But I still don't like it. Maybe I can chase him around trying to remove it like your mom did. :)

I hope you find some relief from your pain and your puppy's pain. I feel for you both.

Take care.
 
Goodness, don't EVER feel petty for being worried/annoyed/frustrated with your recovery; regardless of how far out you are from surgery. It all seems overwhelming and we all wish we could just 'be better' now. We'll all get there, in time, just at different rates is all. :-)

I love the symbolism of your son's semi colon! I think that's awesome! I like fairly simple tattoos, so covering my old one wouldn't work as it's a scroll design and what I want to do next is a completely different size and shape. May choose a different location for it as well. ;-)

I have seen a pain management doctor. I have had one 'test' sympathetic nerve block (which translates to a 6" needle being stuck into my spine in order to numb my knee/leg). Certainly didn't love it, but it's an option...

I'm sorry if I made you feel bad for worrying about your pain. I remember my early days. They were horrible! The blues, the extreme pain and all else. At least I can say my pain is 'better' than it was back then. As for where it is, aside from my knee always feeling very heavy and swollen, I have had repeat issues with my Patella and the area directly under my knee cap as well to the left and below left. I have chronic nerve pain which I take Gabapentin for and it helps, but the other pains are somewhat like being stabbed with an ice pick...lovely. Sometimes they're just very brief, yet intense, and sometimes they're continual. I can't ice anymore as that actually hurts. I'll get it figured out. ;-)

Thanks for your thoughts for my pup. Poor guy. I feel bad for him. :-( xxoxoxoxoxo
 
You did not make me feel bad at all @DogLoverx3! I am just sorry that you are going through this so long after your surgery. Sending good wishes and healing vibes your way!
 
Hello @DogLoverx3 - you know what I am thinking and not allowed to say (!) but I am really annoyed that lack of alerts and lack of me being alert and actually having a roam around all the threads, meant that I wasn't there to generally commiserate on your situation yesterday. Not quite sure how I managed to miss it, but miss it I did. One minute @TexasTee was saying she couldn't wait to hear what the results were, now pages full of stuff!! If it makes things any better, I was thinking of you ...........

So sorry about the poor pup and his tooth - he must be feeling grotty and it hurts so much when you cant make it better for them quickly. Is there anyone else you can trust, or are you bound in to a policy with just one vet practice?

The CT results must be so disappointing for you - you didn't want anything grim to be found, but at least if they had found something, action could have been taken. I think everything has already been said on here that can be - I am just gutted for you that it didn't provide an obvious solution for your knee.

@71Beetle - I think that tattoo on your son's wrist is both poignant and commendable. Not a great lover of them myself, and if my daughter had got one I think I would have gone down the same route as Ellen's Mum, (but possibly with a pot scourer and some sink cleanser). However your boy is obviously a lovely and deep thinking young man and I am glad his demons are behind him. My daughter preferred to go down the piercing route - her Dad still doesn't know, and she has long since removed them. She had them done while at Uni, so I was unable to advance on her and remove them with pliers while she slept! Forever sensible and not wishing to spoil future career opportunities she first had her tragus pierced (the gristly bit at the front of the ear that runs into your cheek) as that was easily removable for interviews and when she saw her Dad! Then later, she had a lingual frenulum piercing, which is the sort of web bit under your tongue. I don't know how she dealt with them - back in the day when I had my ears pierced, it took me weeks to be able to change my earrings without throwing up! Weird really as I am usually good with wounds and blood and stuff.

Well my painters are clearing up and about to head off for the day. I need to speak with them so must go.

Doggy hugs to TJ and love to you Ellen - talk again soon .............. promise!

XXX
 
Hi Ellen - it is a rather eye glazing article but there were a few passages I thought might apply -

In the TKR patient, normal kinematics must also be guided by a functioning PCL. If the TKR

is posteriorly unstable, paradoxical anterior slide of the femur on the tibia occurs and normal knee

kinematics are not exhibited3 This paradoxical anterior slide of the femur on the tibia during flexion

can be a cause of symptoms. These may include difficulty with stairs and inclines (particularly

going down), soreness when the knee is flexed and loaded, such as with recreational athletic

activities, and paradoxical anterior femoral slide on the tibia can be a cause of intermittent effusions

as the femur repetitively stresses and irritates the anterior capsule of the knee.

And later he talks about the valgus - but if yours was slight they probably didn't mess with it, do you have your surgery notes?

Valgus contractures are more difficult and dangerous to manage due to the risk of peroneal

nerve injury. Release of the popliteus tendon is usually required. Further soft tissues considered

for release include 1) iliotibial band, 2) lateral collateral ligament, and 3) PCL. The likelihood of

requiring a PCL substituting knee increases in knees requiring extensive release to balance a

severe valgus contracture.

Clearly you've seen surgeons who know what to look for much more than an HR chickie from Texas but if it were I - someone telling me I was fine when I was clearly not would be infuriating so I was just trying to find a few directions for you to look. If it was some damage to either the PCL or the peroneal nerve that would be a place to at least look to see if your symptoms match.

Hmm, so I just looked, strike the peroneal nerve from the list - that would cause loss of sensation and weakness in your ankle/foot and it would have been right away. Looks like the PCL might be a place to check out more closely though. OR completely disregard...I won't be offended, I love research and often go off on tangents.
 
@TexasTee That explains why my OS told me today that he is actually better at correcting varus deformities and if I am happy with the correction he did of my valgus knee I should be ecstatic when he does my varus knee.

@DogLoverx3 If your knee was valgus, do you know if they removed the PCL? Mine was removed and my OS said he always removes the PCL in valgus corrections. Thus the need for a "posterior stabilized" prosthesis as it replaces the function of the PCL. If there is no alignment correction that needs to be done of it is a varus deformity, the condition of the PCL will dictate to him whether he leaves it or replaces it.

Also something that may, I say MAY give you some encouragement is that some studies indicate ROM can take up to TWO years to return fully, so that would seem to indicate to me that total healing for some people can take that long so pain, braces, whatever may yet be a thing of the past for you without more surgery. You are certainly one of the unluckier ones in that regard!
 
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