Bilateral TKR 4th knee dislocation on my tkr'

[newfiemama]

Hello I had BTKR on Jan 29th. Here in Canada we don't go to rehab after I spent 8 days in the hospital some partly due to the pain medication side effects namely severe constipation. My left knee is my problem child also. Today it is giving me more trouble. Not sure if I am brewing an infection or not. It is a bit tender. I have been hot as hell then shivering not sure if it hot flashes or not. I hear ya on the energy drain. My ROM is 103 on left and 105 on right. I was doing so walking without the walker but PT told me I have to continue as my back is causing issues now.

 

[referee54]

Welcome to the forum, newfiemama! We are certainly glad that you found us.

I took the liberty of moving your post to a thread of its own, so you could get the individual attention that you---and your knees---deserve! I am also an alumni of the BTKR Club, so I know what you are going through.

I spent 8 days in the hospital some partly due to the pain medication side effects namely sever constipation.

Yes---that is quite common! Many of us had some type of "stoppage" after our surgeries, as well.

I also had one good knee and one bad knee---my left knee was an angel for most of the time,while my right knee was the "problem child."

I am sorry to read of your issues with the chills and the sweats. Have you put in a call to your OS or your GP? I will tag @Josephine and @Jamie, who can also advise you about this, too.

Have you had a chance to take a look at our forum library? It is full of rather short, but very informative articles about all of the aspects of a TKR or a BTKR recovery. Here they are for you:

First are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

Next is a FAQ (Frequently Asked Questions) thread.

And here are some very crucial articles
The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Activity progression for TKRs

Healing: how long does it take?
Chart representation of TKR recovery
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling

Home physio (PT) and activity progress: suggestions
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

And then some wise words from members who have shared their experiences ...
Where are you in recovery?? (TKR)
Five “P’s” of knee recovery
TKR: work “smarter” and not “harder”
Recovering a knee - from one who knows!
It's never too late to get more ROM!
It's worth the wait for ROM

Please come back and tell us more about yourself---we will be here for you to help you throughout all of the aspects and issues of recovery. Ask any question or pose any concern---we will be here for you!

 

[Hitech]

welcome

 

[Threads]

Welcome @newfiemama from the west coast of Canada. I had my BTKR a little over 3 months ago and this forum and the BoneSmarties on it have been a lifeline! Follow the BoneSmart mantra that @referee54 has given you, and you can't go wrong. Don't push yourself and don't do anything that hurts your new knees. They are still "babies". I was able to go into rehab for 4 weeks (as you know our health care is under provincial jurisdiction, so you have access to things we don't in BC and vice versa. It should be uniform across the country IMHO). When I went into rehab at 5 days, I was given a wheelchair and a two wheeled walker. I used the walker until PT let me graduate to a 4 wheeled walker and 2 canes. It took time and patience but I left rehab at about 5 weeks post surgery, using one cane. Please take your recovery in baby steps, there is an incredible amount of healing going on in those new knees of yours. I think we BTKRs all have one knee that more of a "problem child" than the other, so that is normal. Have you taken your temperature to see if it's higher than normal? That might give a clue as to whether you are brewing an infection. Your ROM is great now and let it gently increase.

You've come to the right place for support through your recovery period!

 

[Josephine]

pain medication side effects namely severe constipation

Tell me about it! Isn't it awful! You need to be really on top of this. Here's some help Constipation and stool softeners.

I have been hot as hell then shivering not sure if it hot flashes or not.

Very normal. Your body's had a severe assault. It's bound to have comebacks.

My ROM is 103 on left and 105 on right

That is superb for 3½ weeks! Do read my thread for my second replacement Josephine's knee story and amazing progress. You will be surprised at how I managed even better ROM!

I was doing so walking without the walker

Nothing like that, my dear. You are FAR too early out. Stick with your walker for another 6 weeks minimum. And read those articles Tim left for you. You need the information within!

 

[referee54]

I was doing so walking without the walker but PT told me I have to continue as my back is causing issues now.

I agree with Josephine and your PT---it is better to go three days longer than necessary than leave the walker or other walking aid too early---regain your strength and gait---and then begin to think about going away from your walking aids.

 

[newfiemama]

Thanks guys for the helpful information, wish I had found this post. It is the best thing I have ever did and no regrets. I am gonna go over to emerg tomorrow to have my insicion looked at. There is quite a bit of heat coming out of it and tender. I will let you know what happens.

 

[referee54]

Please let us know how things went!

 

[newfiemama]

Morning everyone, I ended up in emergency yesterday with my knee and after 8 hours they said it was an infection in the incision and is not in the new joint. I have been placed on antibiotics 4x a day and I have to see my surgeon this week for him to check on it. By the time I got home I was so exhausted and sick but feeling better this morning. The only thing is when I stand the incision opens up and drains which is a pain they told me to leave it uncovered to let the air at it. Praying that it heals fast.

 

[vinny]

Hope you feel better soon..

Vinny

 

[Homeport]

Hoping you feel better soon that is a shame you got an infection but it is good it was dealt with so quickly


20/01/2015

 

[Maggie94]

hi @newfiemama Congrats on your new knees - I got mine the day before you Sorry to hear about your infection but at least you are on top of it now.

I am walking with a cane 75% of the time... I don't always use it around the house. Slow and steady If you are interested my recovery thread is http://bonesmart.org/forum/threads/maggie94-tells-the-story-of-the-stryker-twins.27855/

Take care, read and ask questions - cheers Maggie x

 

[Threads]

@newfiemama - I'm glad to hear you were proactive and went to emergency. Rest, and take care of yourself, you'll be over this bump in the road soon and on to a slow and steady recovery.

 

[newfiemama]

Well seen the surgeon about my infection and he said it is healing nicely even though it is still draining pus. I have to take an additional week of antibiotics and re check in a week. Also had my physio session and they said my ROM is perfect now and I can use my cane in the apartment and building hallway where I live. but any walking that involves more than 5 min I have to use walker. If only my back would clear up I would be estatic.

 

[Threads]

That's good news @newfiemama! So glad to hear that the infection is under control. One thing about using a single cane early in the long road to recovery is to remember to count your return trip in your 5 minute journey. I recall setting out with a single cane and then the challenge came when I needed to return to my starting point.

Keep up the good work and keep us posted on how you are doing!

 

[newfiemama]

I will be two months on Thurs the 26th, I have started having swelling in my legs again more so my left which is my weaker one. But I am also having pain from knee down calf and into my toes is this something others have had or is it just muscles and nerves regrowing. I still can not lay my lap top on top of my legs with out pain so I balance it on my belly LOL. Thank you for all your helpful advice in advance.

 

[Josephine]

@newfiemama
PLEASE NOTE THE ANNOUNCEMENT AT THE TOP OF THE PAGE
I merged your threads as per this request One thread for your recovery please?
Please don't keep starting new threads about your recovery.

The reasons for this are that it
1. makes it easier for guests to read the continuous story of a member's recovery - the most important reason
2. avoids people duplicating and repeating things like links to articles
3. helps us to refresh on what you've had done and when, plus what advice was given previously
5. keeps all advice previously given on hand for the poster
6. makes it unnecessary for the member to keep repeating surgery details
7. just makes it easier for everyone all round!

Thank you very much!

 

[Josephine]

I have started having swelling in my legs again more so my left. But I am also having pain from knee down calf and into my toes

I'm going to ask you some questions and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

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!

) Also don't forget to include other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness

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 ROM - that's flexion (bend) and extension (straightness)

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

7. what kind of PT exercises and exercises at home are you doing? How much and how often? (and detailed details would be appreciated, please! **Reps, sets and sessions** and all that)

** If you're not familiar with this, it goes like so:
1 lift of your leg = 1 rep (repetition)
5 reps and then a brief rest = 1 set
5 sets and finishing = 1 session.

 

[newfiemama]

1. what are your pain levels right now?

Pain is about 7, I am having soreness it almost feels as if the pain is numbing and it throbs in the calf going down to too. I am not too bad for stiffness. I still can not sit on hard chair for more than 15 min other wise I have to have someone help me up.

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

I am on 100mg of Demerol twice a day when needed. I was off the daytime dose but have had to go back on it one tab 50mg. I take two tyenol 500mg with each dose and a gravol. My family doctor feels I should not have to be taking anything now but she did renew the script for one more month.

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

I have been icing for 20 min at a time at least once a day and have found also My heating throw helps on times.

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

Yes I am elevating my leg at least 6 to 7 times a day. Last couple of days I have had to lie on bed and raise legs higher than the head as my PT told me to. I do this at least 20mins at a time or longer.

What is your ROM - that's flexion (bend) and extension (straightness)

My ROM is 113 and 115 for the past 3 weeks I will find out again onThurs on PT session. The lateral I don't know the numbers but PT said it was execellent. My left leg is the weakest.

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

I walk in the hallway of our apt building as it is too slippery outside [ie Newfoundland lots of snow and ice out] I average around 2200 to 2800 steps a day including the cooking and very little housework as hubby will still not let me do it. I get out for errands at least once a week for 2 to 3hrs at a time. I do use the scooter if available at some stores.

7. what kind of PT exercises and exercises at home are you doing? How much and how often?

my exercises are stairs every other day with I strong leg going down first to get my weaker knee flexing more if I cannot do that then standing on stair and gettiing my toes to touch and bringing back slowly. Static quards, static hamstring, heal slide, straight leg raise, knee flex, knee stretch, at least once a day sometimes twice if able to. I also have balancing exercise every other day where I try to balance on one foot for 10 to 20 seconds on each leg. I am now going to my PT at the hospital every two weeks. They have said that they have patients that are 3 months out and not as far along as I am. I am on an approved walking program that is modified by the PT that walking 15 every other day and increase on the 5th day to 20 but instead of progressing each week I progress every two weeks.

I am suspecting that the legs are sore due to more activity as prior to surgery I was not able to move and get around.

 

[kneeper]

I can tell you that you can ice more. Maybe 40 minutes at a time several times a day.
Also I'd keep my leg up almost any time I was off my feet.
I'd use heat on the muscles but not on the knee itself early in the recovery.