TKR One thing after another with my TKR<

[ks1960]

My Dogs (5 of them) have been thrilled with my convalescence because I have relaxed the "no dogs upstairs" rule so I can have them with me all the time. I love that pack more than my own kids!!!

 

[kelrobin]

I don't have kids, so they are mine. This is my youngest Fleece, who will be 2 next month.

 

[Celle]

Nice boy!

 

[ks1960]

My only girl in a pack of boys!!! Zoe is the queen

 

[kelrobin]

Part of my incision looked red today and when I touched it, pus shot out like a zit. I called the surgeon's office and since they were closing for the day (and I'm an hour away), I headed down to the ER.

I talked to the surgeon's PA on the way and she told me what they had found on the Ultrasound I'd had last week. If you remember from my previous post, I've had horrific pain in my quad since the day after my TKR, up until now. That's when the nursing assistant let my leg drop to the ground.

Well that little incident caused a partial tear in the quad tendon. This is why I couldn't flex/bend my leg as much as I should have been.

The incision is infected, but it's surface, not into the joint. I may be reacting to the sutures inside of my leg.

I swear it never ends.

I have been resting the quad since coming here and reading all of your responses. I will find out what can be done about the quad, if anything, when I see the surgeon next.


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[ACDCJen]

Oh no! This sounds horrible! I really hope they can treat the infection and that your quad has the chance to heal.

Jen

 

[BBCG]

How awful, to be dealing with this injury caused by negligent care! I am so sorry! I've had some quad pain and resistance to bending, too, but nothing like you.... I certainly hope they can help th8s heal without further surgery, but I hope it heals soon!

 

[Jaycey]

@kelrobin You will notice that I merged your other thread into your existing recovery thread. Please keep all your updates and questions on this thread so that we have your history in one area and can advise you if needed.

So sorry you are struggling with so many issues. Sounds like it's good news on the infection. Are you on antibiotics?

 

[Josephine]

Sorry, it took me so long to answer

I'm ashamed I took so long to reply! I forgot to put your thread on watch and you never tagged me!

Knee itself is maybe a 2 or 3. Thigh is a 8 or 9

I've had horrific pain in my quad since the day after my TKR, up until now. That's when the nursing assistant let my leg drop to the ground. Well that little incident caused a partial tear in the quad tendon. The incision is infected, but it's surface, not into the joint. I may be reacting to the sutures inside of my leg.

Well that explains the pain in your thigh and as, you say, the inability to get flexion. But the stitch abscess is something else. They are actually quite common though maybe yours is a little worse than usual. What is the pain score in your thigh now?

I'm taking 10 mg-325 mg of Norco-acetaminophen every 4 hours. I'm also on 500 mg of Roboxin (muscle relaxer) every 6 hours and Advil (usually take 600 mg) every 6 hours.

Given the problems you've had and that you're still only 8 weeks out, I don't thinks that regimen of pain meds is at all adequate. And taking a muscle relaxant isn't the answer for this, nor is Advil which is only ibuprofen which is a very mild pain killer at best. I would suggest you take 2 Norco at least twice a day. I'm pretty sure that if you read the pharmacy instructions on the packet it will say one OR two tablets.

Huge, but the swelling actually has gone down a bit with all the elevation and icing I'm doing.

Jolly good!

ROM is maybe 65-70° and my extension is perfect 0

Of course the additional trauma will have been responsible for the poor flexion and will continue to be so for several weeks yet.

Yes, I ice approx 15-20 minutes every couple of hours.

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

Yes, but probably not nearly enough. I have 8 dogs to take care of so it's difficult to just lay in bed

Why do you need to be in bed? You can elevate just as well on the sofa! Here's two examples!

I feel like a slug. I walk around the house at least every hour. I try to sweep the floors of dog hair every other day, dust a couple of times a week, etc. I don't do much shopping right now.

I'm pleased to hear that. But as Celle said, don't think of it as being a slug, think of it as necessary healing! What's more important than that!


My comments in bold
Sessions - usually 2-3 a day - do them no more than once a day and none at all at the weekends!
Quad presses - 10 reps for a count of 10 - well now you know you have a quad tear, no more of these, yes? And that's 100 reps all in one go. A DEFINITE no!
Heel slides - 10 reps, no hold - shouldn't be a hold anyway. But heel slides are a very easy thing to do badly and this is badly - read this Heel slides and how to do them properly.
Hamstring curls - 10 - how, pray, do you do hamstring curls? But anyway, a big no-no to them as well!
That's about it since just about everything else hurts the quad so much - very wise.


I go to PT 3 times a week.
NuStep bike - 15 minutes - like a recliner bike, yes?
exercise bike (back and forth, no going all the way around) - 15 minutes - I'd do one or the other of these, certainly not both

quad presses x10 - as above, none of these with a quad tear!
heel slides x10 - see article above
hamstring curls - same as above - NOOOOO!
hamstring presses - 10 with count of 10 - NOOOOO!
Not sure the name of it, but I lay on my back and put my feet up on the wall and slide them down for ROM - wall slides! Which are flexion exercises. You only need to do one of these - more is too much.

I contacted my PT yesterday and said we are only going to be quad friendly from now on. This quad needs to heal and it's not going to when we make it so angry. I will do my exercises, but if it hurts the quad we're done. She agreed. So at least that hurdle is done.

After the diagnosis of the muscle tear, I'd strongly suggest you stop doing exercises altogether. They won't help with the ROM and may even delay the healing of the injury. I'd stop going to PT period.

All in all, it's not the exercising that gets you your ROM, it's time. Time to recover, time for swelling and pain to settle and time to heal. One thing that seems to be missing from all the PT's protocols is that all your ROM is there right from the start, just waiting for all that to happen so it can show itself. In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Exercise as in strength training is counter-productive and does more harm than good. Normal activity is the key to success.

 

[newlybionic]

I'm sorry to hear that you have a muscle tear. Make sure you make a call to the hospital. You can ask to talk to the patient advocate or someone that handles patient complaints. Let them know what happened so no one else has to face the same idiot NA and get injured. When you see your OS find out if he will go on record that it was the reason for the tear.

 

[Celle]

Did you report the incident when it occurred in hospital? It should have been recorded in an accident report.

 

[Red's Mom]

kelrobin, I hope your thigh is better! We need to form a subgroup of horse folks! And dog folks!


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[kelrobin]

I stopped coming here because nobody ever seemed to respond. I subscribed to the thread to receive notification and never did. I'm sorry.

Anyway, the leg was feeling a bit better. The PA upped my meds to include percocet since she didn't feel the norco was enough. She also put me on Motrin 800mg since she didn't feel just the Advil was enough.

The quad was able to flex a bit without the horrific pain I had been experiencing.

I still feel like a failure that at 9 weeks I'm still having to take such heavy medication. So, like a fool I stopped taking the percocet about 24 hours ago. The leg doesn't hurt, but obviously it needed whatever relief I was getting from the percocet. It's swollen and very stiff today. To the point where the quad is talking to me again, not screaming like it had been, but definitely a bit angry. I gave up and went back on the percocet.

 

[Pumpkin]

Glad you went back on the percocet.

It's swollen and very stiff today.

Swelling and stiffness are manifestations of pain and need to be medicated.
Everyone is different, some are off pain meds right away, others on on them longer. I took opioids for over 4 months, weaning off gradually as I no longer needed them.

I still feel like a failure that at 9 weeks

You are doing fine, you are just on the slow train to recovery that many of us have followed. You will get there.
Merry Christmas!

 

[kelrobin]

Thank you Pumpkin. Merry Christmas to you and yours.

 

[Red's Mom]

Try to remember every journey is individual and adding the muscle tear is huge. Don't let the negative thoughts take hold. For me personally I have learned through 4 major surgeries to wean off the pain meds vs just stopping. I hope your holiday had some happy moments. My hamstring is still agitated at times mostly if I over do activities and that knee is soon to be 8 weeks old. Are things better today then they were on 11/25?

 

[KarriB]

I was taking some sort of prescribed pain meds intermittently at 12 weeks. Having the MUA probably reinjured your soft tissue, to say nothing about the tear. Take Jo's advice and back off the exercises to let everything calm down. Merry Christmas!

 

[kelrobin]

The knee is MUCH better than it was a month ago. The pain in the quad is not as horrific. In fact, I've not really had any until yesterday. Yesterday's pain was nagging as compared to full blown screaming.

Thank you everyone. I'm used to breezing through surgeries and not having lingering issues like this. I also don't like taking forced vacations from riding my horse and showing my dogs. They're bored and I'm bored. Not a good combination.

 

[KarriB]

This surgery isn't the typical surgery so many are accustomed to. Not too many of us enjoy the forced down time and boredom is a side effect. We do the TKR because we want to be active, we want our life back, however in the end the harder we push our new knee the longer it'll take to get back to that life we desire.

 

[kelrobin]

in the end the harder we push our new knee the longer it'll take to get back to that life we desire.

And this is the most difficult thing to understand......but I'm learning.

I'm also a member of a couple TKR groups on FB and I see the push, push, push mentality on there and just wince in pain. I've mentioned this place a few times, so I'm hopeful that a few will find it and start finding relief.

I truly do appreciate everyone's responses and patience with me. Hopefully, it starts to pay off soon.