Revision TKR Never give up, keep trying, don't settle - that's me, Bonnie

[Oldie]

Bonnie, yes the pain in your shin area is probly from the long stems, that's what I had. My OS told me to use moist heat on the shins really helped. I also don't think the soreness in your knee is from night movement, its more likely you are doing some exercise that is aggravating the knee, Are you doing squats? they would do that to my knees, stop for a week or so then try again.
You are doing great.

 

[RunA42K]

Hi @Oldie, thanks for checking in on me. No I had not done squats until today and I just did quarter squats. Everything up until now was heel slides, quad sets, TKE's. After today's Physical Therapy I can really tell that I used my knee, but it is ok. Just enough exercise, but not too much. I've had my feet up for about 4 hours now and iced plenty. I'll have plenty of time to get rested before I go again on Thursday.

I figured that the shin pain had to do with the implant. I looked at the picture of my X-ray again and with the implant and cement it goes midway through my leg. You're right, heat works better on that then ice.

 

[RunA42K]

Oh...btw this is my 4 week scar. Just took this a couple of hours ago.

 

[Jamie]

Your knee looks GREAT!!! I think you are exactly right about that shin pain. I had it off and on even with a short stem.

For the restless legs, here are some things to try. If one pain pill is getting you to sleep okay, you don't need two. Whether you take one or two, they will only last about 4 hours. So you could take a second one midway through the night. Or you could take a couple of Tylenol (as long as your total of acetaminophen stays below 4000mg in a 24 hour period). You might also try putting a heating pad at the small of your back. Amazingly that can work to relax the nerves leading to your legs. Another option is to ice your knee front and back all through the night. I used gel packs and replaced them once during the night when I would get up to use the bathroom and take another round of pain meds.

 

[turtle68]

Sounds like you're doing well. I think I've read in other;s posts about the shin pain. I've been having some of that as well and I'm at 10 months, but still learning how to pace myself. We went to Ikea today and had a heck of a time trying to get outof there - they seem to have you going in circles with exit signs everywhere. I wanted to keep on going to Lowes and Container Store but find I do much better if I try to contain my activities to less per day. Walking on concrete is just about the hardest thing so I am very happy with the wood floors in our new home. Maybe if you take 2 pain pills at night it will help you sleep more restfully. Take care and yo know tha ROM will keep on improving. 100 is really good for 4 weeks out.

 

[RunA42K]

@Jamie Thanks for the good idea Jamie, I'm going to try the heating pad on the small of my back. I actually did sleep pretty well last night, 11:00 pm till 8:30 am when my dogs said I had to get up! I took only one pain pill last night and a dose of OTC ZzzQuil. I think this was a good combination. I don't feel like I was moving my leg all night, or if I did I was not aware of it for once. My knee is somewhat sore today from Physical Therapy yesterday. It does not hurt to walk, more like when I first move my leg, that movement is sore just starting out. The shin ache is there resting, but more so in walking. My PT told me to take it easy today and I will.

 

[patbike]

My Rom is 141 and a negative 2 extended. I had arthritic swelling prior to the surgery and that was restricting my ROM pre surgery. That swelling is gradually dissipating and is now less than pre surgery. As far as drugs for the first month I was taking 20 mg hydrocodone every 4 to 6 hours. At the time I did not want pain to interfere with my ability to exercise which it didn't. I do think I should have tapered the frequency and or the dose a little sooner than I did because the drug make me feel weird and I think I may have developed a dependency. Somewhere around 8 weeks I totally stopped them. They really did help me sleep in the early days. We have lots of bike groups in my area and if you have the time you can ride with one or the other every day. I don't have any soreness from riding. Spinning is a good substitute if there is bad weather.

 

[Celle]

Hi Bonnie,
Happy New Year! I'm glad to read that you are making good progress and I hope that 2014 is a much better year for you than 2013 was.

Caryl

 

[RunA42K]

Wow @patbike, I am jealous I want to be just like you with that ROM! I don't need to take pain pills all day long, but find I do better at night if I take one. Mine are 10-325 Hydocodone/Tylenol. Do you figure if I took two before Physical Therapy I'd do better? I have some 50 mg Tramadol too. I don't know if that works as well as the other. They both are every 4-6 hours dosage. Any thoughts anyone?

 

[tek'smom]

Some dogs stay in your heart forever. Molly sounds like one of those. Racing in the Rain is a wonderful, wonderful, book. Hug

 

[RunA42K]

Ahh thanks @tek'smom, you must have looked early in my thread. Yes, Molly is always with me. I wear a sterling silver dog bowl charm with her name engraved on it, and a 26.2 sterling silver charm on a necklace everyday. Two major things I lost in my life when I got a new knee. Molly and my running past are always with me.

Racing in the Rain? I'll check it out. Thank you Happy New Year.

 

[tek'smom]

Two minds think alilke. I have a silver watch chain (big links) and on it I have an engraved charm for each dog of my lifetime, plus a few misc. dog charms. At the moment, there are 12. Trying to put a positive spin on it, I had a charm made for the dog who is currently alive, kicking, and the dog of my life!

 

[RunA42K]

Two minds think alilke. I have a silver watch chain (big links) and on it I have an engraved charm for each dog of my lifetime, plus a few misc. dog charms. At the moment, there are 12. Trying to put a positive spin on it, I had a charm made for the dog who is currently alive, kicking, and the dog of my life!

I too have a charm bracelet with a Cocker Spaniel (Molly), a Dachshund my Gracie who is laying beside me right now, and a Paw print for my Border Collie Lucy who is laying on the floor near me, (can't find a Border Collie charm). Yes, you certainly understand

 

[patbike]

I think mine were 10/325 as well and I was taking two every 4 to 6 hours.

I had read pre op or just after the op to take enough pain meds so that I could fully participate in the therapy but i think I just over did it with the meds. Ie I could have done just as much with less. Also Tramadol did not seem to work much for me.

In retrospect I don't think more pain meds would help the therapy much if at all. Just use your judgement.
In my case I think I was taking too much of the meds and didn't need them at that dose/level for that long.
The only exercises that were at all painful were the heal slides and my pt did not really force them nor did I.
My rom hung around 125 for the first 4-5 months or so and then in the last 6 to 8 weeks has really improved. I think due to the reduction in swelling. My only regular exercise at this point is biking and occasional knee bends for thigh strength (not rom). I was very rigorous for the first 4 months and had a pt during that time.



By the way I used to run 5 miles every day and had to take up biking due to knee issue about 10 years ago. At first I didn't think I could enjoy it as much but I really enjoy it now and can get my heart up to max for long periods like when running up a grade. Biking is a little less convienient in that you have to have a bike as opposed to just a pair of shoes and shorts but it is more joint friendly.

Duke vs T AM is a little surprising.

 

[RunA42K]

I think mine were 10/325 as well and I was taking two every 4 to 6 hours.

Duke vs T AM is a little surprising.

My husband is watching too and is not happy!
I have two bikes, road and mountain and just itching to ride them. I looked back into my thread to see where I was at different times. 6 weeks and 4 days I was 113 degrees, and was 8 weeks before I could make a rotation on the bike, so I guess I am not behind myself so far. I need to be patient I guess.

 

[Celle]

Hi Bonnie,
It seems to me that you are doing very well this time around.
Remember not to compare your progress against anyone else, or against your previous experience - "no two knees are alike". I'm sure you've read that here and I expect you've advised other people of that, too.

Happy New Year!
Caryl

 

[patbike]

My first rotation was on a stationary bike. It was a little while before i could rotate my bike pedals but once I could I started riding on the level paths for a mile or two and I would gradually lower the seat to improve the flexion (rom). The other exercise I liked for strength was stepping up and down on to a low platform. My Pt had me doing about six other exercises which I am sure you are doing as well (or the equivalent). Improvement was pretty much gradual and rom always seemed to be governed by swelling which given my pre op swelling has been improving perhaps a little more slowly than if I had come to the surgery without a swollen knee.

Even now I can still feel some of the soft tissues in my knee at times. they are not painful at all, I am just aware of them at times. my O/S said these sensations too will gradually dissipate.

ps that t/am quarterback is something else.

 

[Josephine]

today I am 4 weeks post op. I was disappointed that my ROM was only 100. A week ago it was 105

Bonneee! What's 5 degrees? Almost nothing. It could even be accounted for by the way the PT was using the goniometer! Variations in usage can account for as much as 10 degrees difference.

today I woke up with a sore knee.
Pain in my shin, a deep achy pain, more so on weight bearing.
Today I picked up a refill of pain pills RX of Norco. I didn't need them yet

A bit of a contradiction here, wouldn't you say? I can't believe you don't need painkillers are 4 weeks.
And the extra pain is much more likely to be due to over-activity than anything you do in your sleep!

So I have some questions to ask you:

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 compare this with the bone-on-bone pain you had before surgery!

)

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

3. how often are you icing your knee and for how long?

4. are you elevating your leg, how often and for how long?

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

6. what kind of PT/exercises are you doing? How much and how often? (detailed details would be appreciated!)

 

[Foxmyster1967]

I'm pre op and just floating around being Nosey and come across your thread, I can't believe what happened to you it's terrible. I'm so sorry for you I'm laying on top of my bed with my wife and 4 terriers yes 4, 2x Lakeland terriers... 1 x patterdale terrier and a cross shitzu/ yorkie ??? I've always had dogs and lost 3 in my life time all lived to a ripe old age and as yours died at home. Glad I didn't have to take them to the vets to go. Bless you Bonnie thinking of you . Foxy.xx

 

[RunA42K]

Uh oh...@Josephine...you are asking me those questions that after all this time you should not have to ask me.
1. If I am laying down doing nothing all I have is this ache in my shin #4 level I'd say. When I move my leg my knee hurts with just the weight of my leg #5 level. Walking shin goes to a #5, ankle still hurts walking #4.

2. I have been prescribed Hydocodone 10mg with 325 mg Tylenol in it. First it was take 1 every 4-6 hours as needed. The refills say take 1 every 6-8 hours as needed. I did take two at a time shortly after my release from the hospital. For the most part lately it's been take 1 about noon for 1:00 pm Physical Therapy, no Physical Therapy days I have not taken any unless I'm especially achey but usually everyday I take 1 at about 5 pm then another at bedtime 9-10:00 pm. So in the past couple of weeks probably not more than 4 in 24 hours usually. Today I took one at 8:30 am then again at 2:30 pm.

3. I ice my knee about 4 times a day usually keep the ice pack 30 minutes minimum.. Yesterday I only iced once but had my feet up pretty much from 3pm till midnight. Just getting up to get something to eat or drink or go to the bathroom. But from 9 am till 3 pm I was on my feet home, at gym exercising upper body (not legs) one trip to grocery store, a trip to the mall to get the band in my new watch shortened. Drive thru Starbucks then back home.

4. Here I confess, not much elevating at all. Usually on bed with legs straight out or chair with feet straight out on ottoman. I'm bad...

5. Answered some of that in #3. But daily, feed dogs, shower, make bed. Fix something to eat. Do laundry as needed. Put dishes in dishwasher or empty clean dishes from dishwasher. My husband won't let me do any house cleaning or go to grocery store...yesterday I only told him I was going to exercise and get my watch band adjusted, not telling him about the grocery store or he'd tell me no!

6. Formal outpatient Physical Therapy 2X per week. Quad sets, heel slides, wall slides, straight leg raises 30 each leg in all 4 positions (strengthen quads). Toe tapping standing and sitting 50 each (building shin muscle). TKE's 2X 25 times (straightens leg). Clam shells 2X 25 each leg (strengthens hips/gluteus). Last but not least (hurts the most) is laying on stomach legs off Physical Therapy table below knees hang 3 pound ankle weight on TKR leg for 8 minutes (straightening leg). The day after doing that twice a week, I pretty much do nothing but daily living in my house. Second day after that heel slides at home, quad sets, TKE's 2X 25.

So there you have it. My doctor has just freaked me out about not refilling pain pills so I know I don't take them as often as I should. I do have 50mg of Tramadol in the house but were not prescribed by my OS. They say take 1 every 4 to 6 hours as need for pain. I have not been taking those. Thought I'd keep them as a back up when I run out of my pain pills.

I've had ice on my leg the entire time composing this which is a long time, but with legs straight out on the couch :( Okay, let me have it, I need it...practice what I preach!