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[REVISION TKR] Ouch...CRPS!<<.

Discussion in 'Knee Replacement Recovery Area' started by Jordon6, Dec 12, 2015.

  1. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    I don’t ice as much as I used to, but when I do I put the ice pack on my knee when I go to bed. It’s easier as I’m going to be laying there anyway. And I still sleep all night with my leg elevated on the wedge that the hospital sent home with me. I didn’t like it in the early days, but I love it now. It just relaxes my whole leg. I was always a side sleeper and I’m shocked at how comfortable I am in bed now, on my back with my leg elevated. Who knew!
     
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    Last edited: Nov 5, 2017
  2. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    Actually, it's even more fundamental than that. Most medications are only effective in the system for about 4-5 hours so you need to take them every 6 hours routinely. And I suggest that your last dose before bed should include 100mg Tramadol.

    Here's my chart I created for my second knee which might help though of course you can vary the doses of Tramadol as you prefer.

    aa Tramadol routine 1.JPG
     
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  3. Jordon6

    Jordon6 member
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    Ok here’s my 6 month update—
    I am still struggling with my motion. I have a slight limp- not to bad! I went to my 6 month follow up and the surgeon said that everything looked good in the X-ray but when he checked my ROM it was probably 70 ish. I believe that in therapy it was always that but they pushed it to about 85/90- ouch!My extension was about 5. I am working full time and by mid morning I’m in pain , probably about 6 on the pain chart. I take Tramadol in the morning and at night. I ice and elevate occasionally. My quad is still sooo weak that my doc feels that it’s a big reason why my range isn’t better. I could never do heel slides because my quad would not engage! It’s still that way. I literally have to pull my leg up with my hands to bring my heel toward my body!

    Sorry for the long post but... what can I do to help myself. My lack of range make life really difficult. Would ankle weights help me gain strength in my quad? I cannot squat!
     
  4. Mscant

    Mscant member

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    @Jordan6, I had to go back and review everything that has happened to you with your knee. I feel terrible that you continue to have problems. I had a TLKR in March of 2013. I had terrible trouble. I did everything that I could think of in the 6 months after surgery, except the MUA or the surgery to remove scar tissue. My flex was never more than about 105, but that was with much pushing and pain from the PT. I didn’t discover this blog until much later.
    I ended up with a chiropractor who massaged my scar tissue out. It was very painful, but it helped. The downside is I have to continue to have it massaged as it comes back. My flex is only about 100, but that works for most of what I do. I have had 2 hips replaced since then, the last one in October of this year. My hips have healed beautifully. No problem with scar tissue there. However, for some weird reason the quad muscle and the hamstring above my replaced knee have begun to tighten up and feel sore. I exercise 5 days a week, and have for years, so not sure what’s up. It has something to do with my knee, I’m pretty sure. Anyway, I continue to ice and elevate. It has become habit, and it still helps. Perhaps, when your knee isn’t too sensitive, you might check with a chiropractor. I hope you find some relief soon.
     
  5. Jordon6

    Jordon6 member
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    @Mscant thanks for sharing your story. I know we’re not to compare journeys but I like reading how others are doing.

    Chiropractors is probably the only thing I haven’t tried! I tried massage and I was sore for days! I’ll look into a chiropractor! I’m open!
     
  6. Mscant

    Mscant member

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    I tried medical massage. That was a whole different kind of pain, and I stopped doing that. You need to wait until you think you can to submit to touch. She would only do it for maybe 2 minutes at a time each time I went. Eventually it stopped hurting. But I know when it begins to form, and have her massage it before it gets to tight.
     
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  7. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    Jordon, in NO way was that a long post! Nor even a medium one!
    You know, the only number that counts is that which you can achieve on your own. Pushing does't count and it also doesn't help. Never ever let them push you
    Absolutely not!

    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?
     
  8. Jordon6

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  9. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    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?
    ai63.tinypic.com_eta39s.jpg

    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.
     
  10. Jordon6

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    @Josephine Thanks!

    1. what are your pain levels right now? 2 at rest, 6/7 in activity, longer days can get to 8

    2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often? 10 mg Tramadol 2 times a day. 1000 mg Tylenol 2 times a day, sometimes 10 mg Tramadol plus 1000 Tylenol twice a day

    3. how swollen is your leg compared to these? slight

    4. what is your ROM - that's flexion (bend) and extension (straightness) 70 flex, 5 extension

    5. are you icing your knee at all? If so, how often and for how long? Not often, some days in the evening if I'm in a great deal of pain

    6. are you elevating your leg. If so how often and for how long? Not any more

    7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and
    Working 50 hours a week teaching ( on my feet) cooking, shopping, housework

    8. are you doing any exercises at home? If so what and how often? No, light stretches in evenings
    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-none

    Anything done at PT- no PT
     
  11. Jordon6

    Jordon6 member
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    I’m trying to figure out if my increased stiffness/pain is something different going on or is it just because I’m not taking strong pain meds. This morning, because of the stiffness, I tried some stretches that I used to do and I struggled! I’m kinda on high alert since I’ve had a revision. Trying to rationalize why. Then I though, I was on heavy pain meds for about 4 months and unfortunately did it made me feel better than I was?

    Tramadol takes the edge off but does not totally relieve my pain, especially when walking. At the height of the medication time, my pain goes from about a 7 to a 3 but the efficacy of it quickly diminishes at about the 4th hour ( of a every 6 hour schedule).

    Also, I’m in Georgia and today we had below freezing temps so maybe that’s it too! Just sooo tired and frustrated!its been difficult enjoying my holiday hobbling around!
     
  12. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    Jordon, can you expand on this please? What stretches are you doing, how many and how often?
     
  13. Jordon6

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    @ Josephine. I have a bench that I sit on and try to move my foot inward toward my body. My quad won’t engage to move leg so I stand up and move my leg closer inward and sit on the bench. I measure my foot placement and try to place it a bit more inward each time that I stand/sit.

    I usually do this about 3 times holding my leg in place about 30 Sec. Then I sit leg extended and back straight and push my knee toward the floor to stretch my hamstrings- 3 times holding the stretch 30 Sec.
     
  14. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    You mean similar to either of these?

    heel slide chair 2.jpg hamstring 3.jpg
     
  15. Jordon6

    Jordon6 member
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    @Josephine Yes similar to the first picture. My foot doesn't slide so I stand and reposition my foot inward and sit stretching the knee. The extension stretch I am seated with my leg extended out straight, heel on the floor and toes pointed up and then leaning in toward my knee.
     
  16. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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  17. Jordon6

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    I have a question for anyone out there in bonesmart land or @Josephine!

    I feel like again I have developed some aggressive scar tissue after my revision. I have lost range and possible working on 65 degree flexion (had 90 degrees after surgery until about 2 months ago of my 6 month post revision).

    My OS said that he will not manipulate my knee because pre and post surgery evaluation my muscles were very tight (I suffer from MS). He said the knee moved freely before mending my quad but after it was stitched up it only bent at the most to 90degrees. He fears breaking my legs in an MUA.

    I am limping terribly and have to gain at least 10/15 more degrees just to make every day tasks more manageable. The limping is causing old habits and my entire leg muscles are sore. I'm terrified that the stiffness, incorrect gait, and scar tissue will cause my knee to become loose again!!

    I'm contemplating chiropractic sessions or massage therapy to help gain mobility, possibly helping break up some scar tissue. So--my question, which should I consider either one or are they both not good options?

    I would like some input from those with experience with both.
     
  18. Jordon6

    Jordon6 member
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    Looking for suggestions on chiropractic care or massage therapy to help with stiffness.
     
  19. KarriB

    KarriB FORUM ADVISOR Forum Advisor

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    Jordan, Josephine is away from the forum this week. It may take a while for her to get to your question. Would you like us to change your thread title to something that may help with your question?
     
  20. Jordon6

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    @KarriB yes please change it to "Implant ok...now what?"
     
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