MUA My unresolved TKR issues!<

[Freesia]

OK Thanks, that all sounds good. I'm going to get my meds reviewed asap due to the breakthrough pain and low BP effects.
The quad firing thing I don't really know but when doing leg raises the PT said to tense up the quads to fire them up and wake them up. As I was not feeling great at the time, I do not recall any more, had to sit down during corridor walking as BP went down and I felt unwell. I'm not going to any PT now for 2 weeks and will do as suggested here. My knee is very tight and stiff at present so giving it time. Thanks for all the advice.

 

[Josephine]

PT said to tense up the quads to fire them up and wake them up.

But your quads aren't 'asleep' anyway. They are injured and require rest.

 

[Freesia]

Here is an update. I have gone down the less is more route and felt a little better yesterday. But today, seem to have regressed as my knee has swollen up rock hard and won't budge to bend.

My joints are all aching and I have dull stomach pains. I was ill with a number of gut issues last year though and had gallbladder surgery December. I feel unwell, but my temperature is within normal and my knee incision seems OK, though sore. There is a super sore area around the inside of the knee cap, very painful to touch. No redness. just swelling. I'm icing and elevating though it does not seem to do much except calm the pain a bit. I have no energy and so tired. Grabbing a light nap here and there when I can.

On the plus side, I can sometimes lift the operated leg, mainly when I don't think about it. When I try consciously, nothing happens, but moving around, sometimes it just does it.

Still dizzy at times walking more than a few steps.

I keep breaking down and crying which is not me at all. I still regret the surgery at this point as I have not gained anything and the pain is so much worse than ever it was, although I appreciate the healing time needed before a real judgement can be made and the majority go through mixed feelings early on. I was still "me" with my old knee, painful though it was, not this empty shell I am now, with no quality of life at the present. I'm fearing my old gut issues have flared up due to all the stress and meds and that is scary to face again. I will try to be positive for my family's sake.

I am sorry for the negativity but need to express these thoughts as I'm trying to put a brave face on for others but crumbling inside. I hope I will have more positive things to post soon.

I will go back to the GP again as the pain relief is still not working out although they try to persuade me off strong meds at every opportunity. I know the side effects are awful but the pain is too much for OTC meds at this stage, as most people seem to find.

Hope everyone out there is making progress and doing OK and that I will be soon.......

 

[Celle]

I'm sorry you're in so much pain. It's a good idea to go back to your doctor.

It sounds as if the blues have hit, too. Hang in there, because they will pass:
Post op blues is a reality - be prepared for it

I'm going to ask @Josephine to advise you.

 

[Josephine]

Thanks Celle but I already gave what advice I could on the previous page.

 

[Freesia]

@Celle Thanks for reminding me re the blues thing. Yes, I guess it hit me and I understand why. I've been quite ill for the 2 years before my TKR, with other things as well as the OA and knee pain and my nutrition was not the best due to this. Every area in the body has had injury or challenges in this time, so no wonder it all gets too much. I have several members of the family with illnesses too. It all adds up.
I am following the advice on here and noticing that healing IS going on, although painful.

 

[Celle]

Hang in there, Freesia. It might not seem like it now, but things are going to get better.

 

[Dragonfly7]

Try small, high protein snacks frequently and lots of fluids (water, herbal teas, juice). I'm eating better now than usual to help with the healing and hydration process.


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[hvtx51]

@Freesia I hope you are feeling better today. I did a search on lipoedema and your thread came up. I've never been officially diagnosed with lipoedema but I'm pretty sure I have this. I am 9 weeks post op and still have tremendous swelling. Pain isn't bad, just swelling and the feeling of having a concrete block in my leg. Did your OS say anything about the lipoedema related to healing? Do you take any anti inflammatory? All the best.

 

[Freesia]

Hi @hvtx51
I was diagnosed with lipoedema in my 50s but had it most of adult life. It was a physio that diagnosed mine when I was going with knee pain and they recognised the condition, then I was referred to the lymphoedema clinic and assessed, given compression stockings and checked yearly - there has not been much else on offer, but my 2 daughters were also picked up as having this condition I'm sorry to say as there is some genetic component.

Knee problems are very likely with lipoedema due to the heaviness and altered gait etc. Swelling and increased pain, bruising are often the case, even without undue trauma.

I was originally told TKR would be too risky as there is a chance of the lipoedema turning into lipo-lymphoedema, but the OS did not seem to be concerned re this and I was having such trouble with knee I thought it was worth any risk and many ppl with lipoedema have had TKR successfully it seems.

That said, I do think the condition is affecting my recovery - swelling does not go down even with elevation and ankle is very swollen as well as knee. You say you have a lot of swelling too. The swelling does restrict my bend and walking is OK but very painful. I had a lot of bruising as I normally do with even the slightest knock.

I am in the UK so I may be different where you are but it would be worth finding out what is available in terms of being assessed for lipoedema and you may then have some MLD (medical lymphatic drainage) treatment or compression offered.

I have been prescribed some anti inflammatories though I have to use care as have had some stomach issues.

My progress seems slow but it is good to know from this group that time will be our friend, not aggressive therapy. I wish the medical professionals I see had this philosophy though! All the best with your recovery and future.

 

[Josephine]

in terms of being assessed for lipoedema and you may then have some MLD (medical lymphatic drainage) treatment

I have a private MLD therapist treat me for about a year and it was very successful. There came a point a few months ago that I decided to stop it but I've just this week asked her to come back as my feet and ankles are getting a bit puffy!

I have been prescribed some anti inflammatories though I have to use care as have had some stomach issues.

If you have stomach issues then you shouldn't be taking NSAIDs at all! It really isn't worth the risk. Read this Medications: acetaminophen (Tylenol, paracetamol) and NSAIDs, differences and dangers

 

[Freesia]

I've never had MLD myself.
The GPs prescribed the NSAIDS with a PPI. Not taken them - I have hiatal hernia, had H Pylori treated and have gastric parietal cell antibodies, though no signs of inflammation on last scope.

 

[Freesia]

Feeling concerned because I have gone by the advice here but knee bend sticking solidly at only 35 to 40 degrees and there is threat of MUA hanging over me. I just do not feel ready for any interventions yet as I'm only just feeling a bit better after a rocky start. All my joints are stiff and painful at the moment (OA) and I have some vertigo but keeping gently mobile round home etc. Still have some pain and skin sensitivity but more manageable overall. I'm doing a few gentle heel slides about 3 times a day, no force, and keeping up the ice and elevation.

I do believe that most people's bends do return in time naturally once swelling and inflammation goes down, but should I be worried that there is something not right here? Seen GP and physio and made clear I do not want force applied and they are saying this is why I am not progressing! I have no date for a consultant follow up yet, I'm at 5 weeks post op.

 

[KarriB]

It's really early to think about an MUA. You're just 5 weeks post op and soft tissues can still be swollen and angry at this point. I would imagine your lymphodema may have an impact on swelling as well.

 

[Josephine]

Seen GP and physio and made clear I do not want force applied and they are saying this is why I am not progressing!

Well they are wrong! Just bide your time and let things settle on their own.And I agree, it's far too early to be thinking about an MUA.

Who suggested that, btw? The surgeon, the physio or the GP?

 

[Freesia]

It was the GP - not her call I know, have not seen surgeon yet. Ironic since GP has been the one wanting to reduce pain meds all along. They seem in a rush - presume it is a target or something - they are insisting on the so called window of opportunity. I'm not going to agree to anything yet!

 

[Josephine]

Oh well, you can ignore her! GPs generally know little or nothing about knee replacements!

 

[Freesia]

Still struggling with swelling and bend, supposed to be getting a follow up date this week, after much chasing up!

Now I have a flare up of a dental problem that has been bothering me off and on. I was cleared by dentist to have the knee surgery, but have a couple of teeth that had a lot of restoration done after an accident and they are often unsettled, then had a mild infection flare up after surgery, took antibiotics and followed a super strict hygiene regime and it became controlled.

Now it is flaring up so have to go back. It is all so worrying wondering if it will affect knee, although I read the articles that there appears no firm evidence linking dental to knee, all the experts seem in disagreement and other research links dental infections with heart trouble and other stuff, it does set the imagination running. The dentist has been in favour of conservative treatment, but it seems it does not want to go away and the teeth are very sensitive. I cant imagine it is good for the health having this going on.

On top of all this, antibiotics cause me problems but I would still rather have them of course. Trying to help look after my elderly Mum who has been very poorly and feeling sorry for myself too! A chink of light at the end of the tunnel would be welcome right now.

 

[Josephine]

Now I have a flare up of a dental problem - wondering if it will affect knee

No it won't. Those other articles you mentioned, an awful lot of them are actually quite old so shouldn't be taken fro granted. And that "all the experts seem in disagreement" is also misleading as the only opinions you need to trust is that given out by the leading agencies in these fields being those who issued the declaration in here Evidence insufficient to recommend prophylactic antibiotics for dental procedures being American Academy of Orthopaedic Surgeons (AAOS), and the American Dental Association (ADA), British Society for Antimicrobial Chemotherapy is that patients with prosthetic joint implants.

 

[Freesia]

Oh, OK @Josephine. Everyone's dentists and surgeons do not all seem to be aware of this, going by various online discussions I have seen anyway.