MUA Oct 2017 TKR - Hematoma - MUA - Finally past 90!<

[funkymuse]

@rubyyarn we are not sure what caused the Hematoma.. I had the TKR tues 10/17, no pt that day, 2 light sessions at hospital on wed with Physical therpists and I think also on thurs and then home thurs night. Friday I myself was aggressive due to them telling me I needed to be (hadn't found this site yet). That night I felt I'd done too much. Sat my leg began to turn red on top of knee and the searing pain and horrible heaviness began when i would get up to walk and so it went on as I explained in a previous post, going to emergency, mis-diagnosis, etc.

@SusieShoes - great idea. I'll use that as my angle in the discussion with the doc!

 

[funkymuse]

And thanks @Jockette for the words of sympathy.. it was an "ouch" for sure!

The wonderful news is that I finally got to take my first shower today and wow - the bad news is after today I'll have to wait for the scar to heal again! Ha ha.. those emotions are so funny.

BUT today I've noticed I have a better attitude and I feel lighter in my spirit knowing something is going to get done!!!
My first outside PT will be next Wed so I'll have plenty of time to rest, elevate and Ice to get the swelling down and then begin slowly. I'm fully prepared to NOT let them push me!

 

[sistersinhim]

You stay the boss and in control over what happens to your knee.

 

[KarriB]

Holy Smokes! What a nightmare! I was so afraid someone would drop my leg I didn’t let anyone move it. I used my leg lifter to get it on the bed, ottoman, etc. I’ll just add my 2 cents, no MUA at 2 weeks post op.

 

[Josephine]

@funkymuse, you quoted an article about the benefits of early MUA but we have an article saying the exact opposite! MUA: the ineffectiveness of early MUA (JBJS).

And before you make any decisions to go for this, I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?

 

[funkymuse]

@Josephine - Yes thank you Josephine! I did read those articles.. I think someone else sent them to me. I just find the whole thing completely confusing due to all the conflicting articles and testimonies out there! But I trust the 'experience' and stories of healing on this site more than anything else so yes I'm very happy to answer your questions. Thank you for taking the time to inquire and help me out.

 

[Jockette]

So did you have the hematoma taken care of today? I’ve been thinking about you!

 

[Josephine]

I'm very happy to answer your questions.

Here y'go then!

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 forget to factor in 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 swollen is your leg compared to these?

4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

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

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[funkymuse]

Yes @Jockette and everyone ... just got home about 2 hours ago.

The doc came in and said there was a lot of clotted blood on the top of my knee that he removed and that I needed to keep the tight ace, (from foot up above knee), on it until Friday because there is now a loose amount of skin where more blood could go in and fill that up again... so I'm sitting here in my comfy bed with my Cold Rush going although on the highest setting but I'm not sure it's doing much cause the ace is so thick. When I feel my skin underneigh I don't feel that it's cold.

Do you think I should remove maybe a single layer of the wrap so that cold can reach my skin???

He also said he did a gentle push back and and that was it.. so I'm not sure if that's a MUA or not. We didn't talk about it before the surgery and I looked carefully at the surgery sheet and the MUA was not listed so I didn't think he was going to do it and I'm not sure what he did was exactly an MUA. But maybe I'm being naive here.

Anyway.. my knee does not feel like I've got a 5lb weight sitting on top of my kneecap anymore and there's not a horrible feeling of gravity feeling like the front of my knee is being pressured into pain anymore! FREE!

PT came in as well and I got up and walked into the hallway with quite a bit of stiffness due to the leg wrap and post op surgery soreness, and then we did some very gentle heal slides and a couple of quad tightenings and that was it. As soon as I felt any pain, I stopped. Plus I had not taken my pain pill before she came in so I really knew how it was feeling! Overall she was pretty gentle in her approach and her suggestions.

Thank you for thinking of me. I'm anxious to take this wrap off and see how things look but for now.. doc's orders!

 

[Jockette]

I’m glad you got the hematoma taken care of and that he was he went easy on the bend!

I do agree that it is confusing for us newbies when we first come to Bonesmart and read things that conflict with what our surgeons tell us. I’ve been on here for 6 months so I’ve read the info over and over on everyone’s posts and Bonesmart just makes so much more sense to me that I now trust them more than I do my surgeon.

I hope you rest well tonight!

 

[funkymuse]

1. A 4 but I did take my 5mg oxy at 1:30pm. It is throbbing a bit.. it is stiff and I'm sure there is some post op swelling. Had hematoma removed yesterday.

2. Before the hematoma surgery I was taking 5mg oxy every 3 hours and extra strength Tylenol now and again. Maybe 4-6 over a 24 hour period. After the surgery he put me on 10 mg every 3 hours but now I'm back down to my reg 5mg every 3 hours.

3. Before the Hematoma surgery I was in between moderate and slight. BUT that hematoma was on top making the top look like a red muffin top! But very minimal swelling on the sides and most of the bruising had gone away.

4. Have no idea. No one has measured because I had the surgery on the 17th and then by the 20th the hematoma was present and growing but I didn't know it was a hematoma but the pain and pressure was getting worse by the day. I wasn't able to do much but sit here and ice it and didn't know anything about the crucial 48 hours of hematoma treatment.. Heck I didn't even know what a hematoma was!

On the 23rd I went to the emergency room because I could not even walk to the bathroom because of the pain. They misdiagnosed it as cellulitis and so home I went with antibiotics only to find out when I checked in with MY doc on the 25th that it was a hematoma. So he sent me home bandaged up and told me to keep it up and ice it and it would most like take care of itself in a couple of days. Well.. no cigar! Monday I went in for my regular 2 week post op and was wheeled in because I couldn't walk and he talked to me and said.. we've got to get that hematoma removed and so Tues I went in and now here I am free of that awful weight and pain on my knee!! Next Wed, I go in for my first PT evaluation and I'm sure they will measure then.

5. Yes I try to ice as much as possible now that I have my Cold Rush machine and I know that more is better right now from reading this site. I was using Pea Bags on and off prior to this for 20 min on 20 off 4-5 times a day per the instructions of the nurse.

6. Yes, elevating as much as possible now. I did half as much before I got the hematoma diagnosis and now I do it as much as possible.

7. Currently NO activity... due to this crazy hematoma issue. I was literally stopped in my tracks as the searing pain and pressure began to increase 3 days after my surgery.

8. When I got home from the hospital I did a bunch on that Friday and then I was shut down from the hematoma, and have not been doing any due to doc's instructions after the hematoma diagnosis. Now of course that it's removed, I can begin slowly with some walking and heel slides. Not much else. I'll be watching the swelling closely.

I haven't been doing any exercising as explained in my reply to your question 8 but plan to start. And I haven't even been to a PT session yet - had to cancel two due to this hematoma issue!

 

[KarriB]

Hoping things begin to look up with the hematoma gone. This recovery is hard enough without added complications.

 

[Josephine]

there is now a loose amount of skin where more blood could go in and fill that up again

Did your surgeon tell you that? Because it's not exactly how it works. The pocket will fill up a but but with tissue fluid and maybe a little blood. But the intention of it will be to stick the top back down to the tissues underneath and thereby let it heal.

Do you think I should remove maybe a single layer of the wrap so that cold can reach my skin???

No. Leave it alone for now. Why would you want to reach your skin anyway?

He also said he did a gentle push back and and that was it.. so I'm not sure if that's a MUA or not.

Well it is, just!

Plus I had not taken my pain pill before she came in so I really knew how it was feeling!

You should never take pain meds before a therapy session. You need to experience the pain so you know how bad it is. In other words, you shouldn't allow ANY pain at all during PT. It's very, very bad for you.

1. A 4 but I did take my 5mg oxy at 1:30pm. It is throbbing a bit.. it is stiff and I'm sure there is some post op swelling.

Well, obviously!

2. Before the surgery I was taking 5mg oxy every 3 hours and extra strength Tylenol now and again. Maybe 4-6 over a 24 hour period. After the surgery he put me on 10 mg every 3 hours but now I'm back down to my reg 5mg every 3 hours.

You haven't said how much Tylenol you were/are taking. If it's only 500 or 325mg then you need to up it to 1,000mg providing there is no acetaminophen in the oxycodone. If there is, then also make sure that you are not exceeding the maximum per 24hrs of 4,000mg.

3. Before the surgery I was in between moderate and slight, very minimal swelling on the sides.

I'd expect that at 2 weeks out.

4. Have no idea. No one has measured

Okay

5. Yes I try to ice as much as possible now that I have my Cold Rush machine and I know that more is better right now from reading this site. I was using Pea Bags on and off prior to this for 20 min on 20 off 4-5 times a day per the instructions of the nurse.

You accomplish little or nothing in 20 minutes. Ice for at least 40-60mins and more than 4 times a day.

6. Yes, elevating as much as possible now. I did half as much before I got the hematoma diagnosis and now I do it as much as possible.

But are you elevating correctly? Here's some examples

7. Currently NO activity

Well I assume you are walking to the bathroom at least? And the kitchen?

8. When I got home from the hospital I did a bunch on that Friday. Now of course that it (the hematoma) has been removed, I can begin slowly with some walking and heel slides. Not much else.

I suggest you don't. There is not need to do anything like that. Your knee will improve on its own.

 

[funkymuse]

Did your surgeon tell you that? Because it's not exactly how it works. The pocket will fill up a but but with tissue fluid and maybe a little blood. But the intention of it will be to stick the top back down to the tissues underneath and thereby let it heal.

GREAT! I am happy about this for sure!

No. Leave it alone for now. Why would you want to reach your skin anyway?

Well.. I thought one should at least 'feel' the cold. I don't even feel the cold and my skin is not cooling at all. It's only cooling the top layers of the bandage. Any further advice on this would be appreciated.

You should never take pain meds before a therapy session. You need to experience the pain so you know how bad it is. In other words, you shouldn't allow ANY pain at all during PT. It's very, very bad for you.

My plan exactly as per reading your comments on many other threads about this.

You haven't said how much Tylenol you were/are taking. If it's only 500 or 325mg then you need to up it to 1,000mg providing there is no acetaminophen in the oxycodone. If there is, then also make sure that you are not exceeding the maximum per 24hrs of 4,000mg.

Well I'll have to get a magnifying glass out to read the bottle to find out how many mg's and then I will follow your instructions. Even with my glasses the type is too small!

You accomplish little or nothing in 20 minutes. Ice for at least 40-60mins and more than 4 times a day.

Yes as I said, before I read this site it was 20 min on, 20 off but now I ice as much as possible which I'm thrilled about because it feels so good and a great anti-inflammatory. The doc told me to take Tumeric for anti-inflammatory benefits since I cannot do Iburprofen and the like because of stomach issues. Any comments on the tumeric would be appreciated.

But are you elevating correctly?

Oh yes, I read this when I first joined and made sure I was!

Well I assume you are walking to the bathroom at least? And the kitchen?

It's been just to the bathroom and back until today! Yay!!!! Now I can walk to the kitchen! woo hoo! I mean really, I'm so thrilled! Being confined to the bed and 10 painful steps the to bathroom has been brutal!

Thanks so much for your comments and suggestions @Josephine

 

[funkymuse]

Hello everyone... anyone getting restless leg syndrome when starting to ease up on the Oxycodone? I was on 1-5mg every 3 hours and then when I went in for the Hematoma removal, they put me on 10mg every 3 hours and that lasted for 2 days and now I've taken myself down to to 5mg every 3-1/2 hours.... and Tylelonol as needed. This restless leg syndrome started yesterday I got home from the hospital and stopped the 10mg.

I'm going crazy from this!!

 

[Teri59]

I had RLS before the surgery. I am on Gabapentin for it. It did increase as I started to heal up and come off of the other meds. I take it especially at night. I talk to my family doctor and she increased my dosage so I can take an extra of the day for a bit. Until I get it under control. For me working and the daily stuff so not to be thinking of it.
Yes it will run a person crazy. If possible talk to your family doc and tell them.

 

[Celle]

Here's an article for you about restless legs, @funkymuse :
Restless legs following knee replacement surgery

 

[funkymuse]

Thank you Celle and Teri59 ... I used to get them when I ate badly... sugar, junk, etc., and I think all that affected my hormonal balance that caused my legs to act out - but since I don't do that anymore, I have been free from that awful feeling until now!!! I couldn't figure out what the heck! So I thought it must be the drugs or the surgery or a combo of it all.

Also I'm feeling really down today since I lost two weeks of recovery due to that Hematoma. I keep reading about where everyone is at two weeks post op and gosh darn it, it's like I'm just starting. I had a weepy time today in thinking on it. But I'm trying to find the good which is that my leg got a real rest for two weeks since I couldn't do much... and most likely had a chance to do a bit of deep healing without me pushing it. So I guess that's the plus side.

Hope you all are doing ok out there this evening in knee-recovery land! So glad to be a part of this support group.

 

[Jockette]

I’m sorry you’re feeling down today, I am too, a bit. It’s part if the rollercoaster ride of this recovery. There’s an article on here about post op blues. Check it out.

 

[Celle]

Also I'm feeling really down today since I lost two weeks of recovery due to that Hematoma. I keep reading about where everyone is at two weeks post op and gosh darn it, it's like I'm just starting. I had a weepy time today in thinking on it. But I'm trying to find the good which is that my leg got a real rest for two weeks since I couldn't do much... and most likely had a chance to do a bit of deep healing without me pushing it. So I guess that's the plus side.

I'm sorry you're feeling down about this. The post-op blues are a reality and you've had a knock-back, so it's understandable that you feel a bit sad. You have every right to feel that way. Have a little bawl if you want to - tears are healing and we've all been like that, so we understand.

Right now, losing two weeks feels like a big deal, but if you can look at it in terms of a year-long recovery, it's only 2/52 of your healing time that you've lost. In a few months' time, losing those weeks won't seem like much at all.

As you say, deep healing will still have been going on - it's just the superficial part of your wound that has been affected.

Hang in there now, because I think you'll find as the weeks go by that you have made up at least some of that lost time.