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TKR Pinot's Recovery

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Is it possible for the body to become tolerant of the pain meds? I don't mean the opiates. I took an extra tramadol today and the last couple of days it just does not seem as effective. On the other hand that might be explained by an increase in swelling which I believe is happening, and I don't like that idea either. I've been doing extra ice, about 4 hours a day. It makes me happy to be up and doing some cooking; multi-tasking I might add, leaning on the sink and doing the PT-suggested gentle exercises.
 
Actually the additional pain and swelling you're experiencing is your body telling you it's too early to be up cooking and puttering around the house. You are just slightly over a week out from your major surgery. So the reason your pain meds aren't as effective is because you are causing yourself additional pain. Please go back to mostly resting, short walks around the house every hour or so to go from room to room, gentle bends and stretches for exercise and as much icing/elevation as possible. It's fine to ice every time you are not standing as long as you keep a kitchen towel between your skin and the ice source. I even iced as I slept and it helped tremendously.

It might be a good thing for you to go back and read the recovery articles posted for you earlier in your thread. Your body is still healing and will be for some time. Patience is the watchword right now.....
 
Fell today and my confidence in being able to do normal activites is badly shaken. I have been spending a lot of time at rest and icing and was not taking any chances, just loading paper into a printer... Maybe slipped on paper on wood floor. PA not too concerned, but I am worried about anticoagulant xaralto and osteoporesis. Right hip took the brunt, right operated knee less so. In bed icing everything. And not easy posting from here!
 
Most of us have had a fall or two during recovery. It is very difficult to damage the implant itself which is protected by muscles and bone---but it is always a worry. you are doing the right thing, just slow down, ice and rest. Be sure to elevate the leg too.
Elevating your leg to control swelling and pain

I am pretty sure that you will feel better after a day or two in bed. and really, it is good at this stage of your recovery to rest---even though it is boring!!! If you don't feel better, or feel that something is not right, you can call the PA and ask him/her to see you.

Don't worry too much. I bought a laptop table at Office Max that fit over my bed. I could prop my iPad up on it and it did make life a little easier. I had about 10 pillows---three for my leg and three for my head!! One for the computer. This stage will pass soon enough, try to rest and not worry too much.
 
@skigirl Thanks for your calm reassurance. It's good to know that a fall doesn't have to be a disaster. Still, I have been soooo careful that I am still a bit shaky and unsure of myself. I wasn't doing anything stupid or dangerous and I wasn't dizzy from medication. Feel a bit better reading your post!
 
I am glad that I was able to help---most falls happen when we least expect them. I was at church at 6 weeks, doing the flowers for a funeral. I was a little late and wearing jeans, so I wanted to get out of there as people started to arrive. I walked down the sidewalk as fast as I could go and tripped over a sprinkler head---I went flying forward, tried to catch myself and landed face first in front of the mourners!! I felt like an idiot!! I had to get up and pretend that I was just fine, fine, fine, thanks. Then I got in the car and allowed myself to have a tiny, little pity party!!!

My knee was swollen for two or three days---and I skinned both my knees through my jeans. I also hit my nose which was swollen too---a lovely sight, I assure you. When I went to the PA, who was really very nice---he tried not to laugh but could not stop himself!!

I felt a little like that lady on the X factor who was a really bad singer---Sharon Osbourne started laughting and could not stop---I watch it on you tube when i am feeling bad---it just makes me laugh and laugh.

Anyway, after the PA finished laughing his head off, (I think it was the nose!!) he told me that it is really difficult to damage the implant---there is a lot of soft tissue--muscles, er fat!! and skin there to keep it protected. When we fall, we damage our muscles or ligaments and that is what causes the swelling.

So, rest and ice are the answer----try to watch some YouTube videos---I like the x factor and America's got talent===some of them are so bad you can't help but laugh. Kelly
 
Here is an update at exactly one month. I have concerns but am certainly better off than very early in recovery. I have read the posts about how recovery is not a straight line upward but I do feel stuck on a plateau with pain and swelling being the same or even a bit increased over the past two weeks. Elevation and ice don't seem to make much difference. I want to decrease the pain meds but after a couple of hours in the morning I don't feel that functional and reach for the tramadol, celebrex, tyelenol "cocktail".

The catching and clunking of the joint with movement does not feel right, but I have read about that in other posts. There is no pain with that because of course we are talking about the clicking of a nerveless implant.

The most freaky thing is that a couple times a day I feel like the joint becomes unstable for a moment or two and on the verge of collapse. Again, this is not painful and my walking is usually good. Could this mean the attachment to my thin bones is coming loose? An x-ray at 2 weeks looked good, according to the PA. My next appointment is mid-December.

(In case my recovery thread seems a little awkward it's because my original entry was titled "Halloween in the hospital" because that's where I was. Then to combine two threads the new title, about a car trip, now refers to a later post. So thing might seems a bit out of order. I did not take that trip!)
 
If it's not painful, my guess would be that the unstable feeling is part of the recovery process. A bunch of us have had that happen as our muscles were regaining strength, but it went away as we healed.

Do I understand that you wait a few hours after you get up to take pain meds? I'd say better to take them when you get up. Oftentimes for me the stiffness and pain in the morning needed some taking care of.

Also keep in mind that you're just about a month out, and most of us needed pain meds at that point and were not doing much in the way of activities. "Cooking" for me was heating up something in the microwave or making a sandwich.
 
pinot said:
(In case my recovery thread seems a little awkward it's because my original entry was titled "Halloween in the hospital" because that's where I was. Then to combine two threads the new title, about a car trip, now refers to a later post. So thing might seems a bit out of order. I did not take that trip!)
Click to expand...

Would you like to have the title of your thread changed again?

That can be arranged, if you post and let us know what you would like it to be called.
 
pinot said:
The most freaky thing is that a couple times a day I feel like the joint becomes unstable for a moment or two and on the verge of collapse. Again, this is not painful and my walking is usually good. Could this mean the attachment to my thin bones is coming loose
Click to expand...
The implant, I would say, is fine.

What happens to cause this wobbling is that your muscles---most likely your quads---are somewhat weak and get tired.

It sounds like you are, while a month out, still doing a little too much, and this will tire out your quads and hamstrings in the still-early days of recovery.
 
Thanks everyone. Yes, if possible to change title of thread it would be more clear, don't you think? I would call it "Pinot's recovery" or the original "Halloween in the Hospital" (though I was not at all articulate while hospitalized!) Since I did get a lot of good advice about the cancelled car trip at 4.5 weeks I will say that I did start to consider that same trip at 7 weeks for Christmas instead of Thanksgiving. However, I am starting to think about waiting even longer to take any long journeys.

With the swelling and pain that I have icing and elevating at home I just think a longish road trip will not help. In fact I am wondering if there might be any benefit in ace bandages for swelling in knee and calf. Any opinions? At 5 weeks out I am cleared to stop using TED stockings but I still pull them on during the day as the compression feels good.
 
At 6 weeks I am still dealing with pain which is hard to control and swelling. I am OK with some of this as long as it does not indicate infection or a loose implant due to thin bones. I am on the usual routine of pain meds to be taken "as needed" and physical therapy twice a week. I need the pain meds all the time! PT sessions are not very strenuous but there is a bit of a challenge to hold the moves for the time suggested.

Am I too impatient? I realize that 6 weeks is early but I expect some gradual improvement. I have read and follow the recovery links. I have cancelled all travel plans. I am going to call the surgeon's office today as I don't have another appointment until 12/18. I'll follow up here with the results of that call
 
@pinot I feel your worries! But for some additional perspective my surgeon doesn't want me doing any formal PT until I'm 12 weeks out!! He thinks recommended exercises at home is best since you don't want to push recover (as all these lovely Bonesmart moderators constantly advise us!). My surgeon also told me that an ace bandage wrap is just as good if not better than the TEDs.

One factor (doc recommended) which makes/made a huge difference was my sodium intake. Once I started trying to keep my sodium intake to under 1290mg daily my swelling considerably lessened. And it's really the swelling that causes discomfort. Good luck!
 
Oh, thanks @Katfin. I am going to stop trying so hard in PT and stop being obsessive about doing "homework." I am indulging in a bit more sodium and sugar than usual. Comfort food, you know. I am not very hungry and my weight is down about 10 pounds. This would be a good thing if it were my choice!

The PA called back and told me that if a replacement is loose the patient knows it. He reassured me a bit but not entirely. He said the joint will collapse all the time; mine is unstable a few times a day. I'll bet any loosening of the joint is gradual and not all at once; but I will wait the 1.5 weeks till the next appointment before complaining again. Do you know of any cases where the patient was brushed off and the caregiver did not listen to them? I do! One of the latest was the wife who insisted on a brain scan on her husband and it turned out to be a tumor. Not that I'm saying I have a problem with the joint but eventually I will want hard proof.
 
It's a good idea to ease off the PT. Really, all you need to do is this:
Heel slides and how to do them

For my latest knee replacement I have had no formal PT at all, and the knee is doing just fine. My surgeon never allows PT until at least 4 weeks after surgery. All I had to do was the few, simple, gentle exercises I was shown in hospital.

It seems irrational, but it is true that sometimes the harder you work, the worse you do - you can't make your knee heal faster by working hard at it.

At the moment, your knee is swollen and it won't bend properly until that swelling is gone. Doing less - as well as icing and elevation - will help the swelling to go.
 
From what I hear a loose implant is exTREEMly painful, but I am no expert. I get "give outs" in my surgical leg where it wants to collapse forward -happened once today- however in my case this is due to quad inhibition. My quad is weak vs. the other major muscles and ligaments are overly tight, which is why my knee gives out in the forward direction. I'm assuming you discussed your concerns with PT?

I am glad you decided to postpone your travel plans. I already made two big mistakes- two drives out to the desert and back (four hours round-trip) twice in one week, in my stick shift car. Knee was NOT happy! I refuse to take any more trips I consider non-essential until at least next year, lol. My daughter and I are planning a Sedona trip for April or May 2015. This would normally be a road trip from SoCal, but we're going to splurge and fly.

I hope you get encouraging news from the OS about your knee!
 
Thanks everyone. Both PT and the PA (by phone call) seem to think all is well but I would be happy with more signs of recovery. I don't mean to be negative! But this forum has been described by others as a journal so I am just being honest about where I am, about once a week. I fully expect to be posting that, hey, "I am feeling better" one of these days. Just wait!

How about walking as a form of PT? The in-home guy prescribed two walks a day and I try at least one of a half-mile or more on a flat paved surface. I feel that this type of exercise is something I do pretty well without increasing my discomfort. I concentrate on a heel/toe stride and swinging arms and do not use a cane.

One thing that happened today was that I visited a TKR patient who had surgery at the same time as me. You can barely see the incision. Mine is all wrinkled and discolored, very ugly and abnormal looking according to the other person. On the other hand I have better flex and extension. I felt like we were the parents of infants comparing notes on sleeping through the night and other milestones...
 
pinot said:
One thing that happened today was that I visited a TKR patient who had surgery at the same time as me. You can barely see the incision. Mine is all wrinkled and discolored, very ugly and abnormal looking according to the other person. On the other hand I have better flex and extension. I felt like we were the parents of infants comparing notes on sleeping through the night and other milestones...
Click to expand...

We tell people not to compare knees and recoveries. Every knee is different. Every recovery is different.

I'll bet you that in a year's time there will be very little difference between your knee and your friend's knee.

Please try to stop worrying!
 
My scars take a looong time to go away. Mine is still a little pink looking. but I know from the experience of the last knee that it will fade to near invisible eventually.

My PT had me use something called tubigrip that you can get at a pharmacy that stocks medical supplies. Probably more convenient and comfortable than an Ace bandage, but maybe not better, for keeping swelling in check.
 
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