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TKR Progress of a November Nimble

The water exercise went well -- and yes, it's SO easy to overdo it. I have had quite a bit of soreness around my knee the last two days, so am taking it easy today. Icing, elevating, etc. while I work. The two most painful are the Illiotibical tract and the medial collateral. These actually HURT when I try to put weight on my leg right now; everything else is merely stiff. ;)

The recumbent bike exercise doesn't seem to affect them quite so much, but I am going to cut back a bit on both until the aches stop. Last night was the first time in quite a while that I actually popped a tramadol -- half of a 100 mg pill. It helped, along with the Tyelenol and some icing. It almost feels like it did when I wrenched my knee skiinig some years ago. SO, learned a lesson there.
 
Wow, 15 minutes of pool activity at 17 weeks and look how sore you are afterwards.

My surgeon ordered pool therapy for me starting at 4 weeks. PT did their pool sessions at the YMCA. My first (and only!) session was 50 minutes and I can’t tell you how many exercises I did, because they told me to. There was one I didn’t do, though. It took 3 days before my knee settled back down to where it had been before the pool. I did not go back to the pool.

That’s when I started googling stopping therapy and found Bonesmart.
 
Yeah, it feels so easy yet it can really take a toll. I'm icing right now and loving every second of it!

C
 
Pool at four weeks?? My surgeon wouldn't okay it until about 12 weeks -- and that depended on how well the scar had healed.
 
Space Knee said:
Pool at four weeks?? My surgeon wouldn't okay it until about 12 weeks -- and that depended on how well the scar had healed.
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I know, right? There were at least 20 or more people in the pool, which made a lot of water movement which scared me as my balance was still off and I thought they’d never let me out of the pool. I was pretty mad by the end of the session. I was also worried about catching something from a public pool.

While my PT was not overly (?) aggressive, there were several aggressive aspects, which will not happen in the future if I ever have to do this again. I’m not a newby anymore.
 
You know better now - good!
If you are concerned, never mind what anyone says. Look after your own safety and your own knee, and just get out of the pool, no matter what anyone says.
 
I may go back to the pool again tomorrow, and cut the exercises in half. The icing is helping a lot.

My surgeon told me about how important avoiding infection is -- she had a patient who had an abscessed tooth that got pulled. The dentist didn't give her any antibiotics and it ended up infecting her knee and destroying the implant. Had to take the whole thing out again, wait for six months, and then do it again. I had my first teeth cleaning since surgery, yesterday, and will be taking the antibiotics before dental work for at least two years. So, I can imagine what pool water can do, even if it IS chlorinated. I waited a good four weeks past the time they okayed me for swimming before I set foot in the pool. Brought along antimicrobial soap to wash with after the dip, too. Can't be too careful.
 
Celle said:
You know better now - good!
If you are concerned, never mind what anyone says. Look after your own safety and your own knee, and just get out of the pool, no matter what anyone says.
Click to expand...
I was afraid they would all think I was a wimp! Only one other lady was nervous in the pool (they got her into the pool by lowering a mechanical chair into the water) everyone else seemed happy to be there. Plus I hadn’t found Bonesmart yet so at that point I was fairly compliant.

I won’t even be in a PT pool next time because I’m not planning on going to any PT.
 
Like Space Knee I am another November nimble whose fast approaching 18th week. Being amputee it's no fun have tightness below the kneecap since TKR. I am icing several times a day which helps dramatically.
 
About the knee-destroying dental work -- the story is that the abscess required a tooth to be pulled and as we all know, the tooth roots reach to the bone. It's a quick route to the bone for any kind of infection. This person apparently had a dentist who dismissed the idea of prophylactic antibiotic, and the infection spread to the bone. Apparently the type of infection it was got to the knee and caused damage to the implant (probably the plastic part). It had to be taken out and the patient had to heal for some months before a second replacement could be done. They didn't give me names or dates, just what had happened.

I had to take antiobios pre-dental visit for some years after the docs discovered a heart murmur. That is important if the murmur is caused by mitral valve prolapse, which allows bacteria to cluster under the heart valve and can eventually cause problems. Since the tooth to the bone is a more direct route, I am not surprised that the surgeons would want to take prophylactic measures to protect an implant.
 
Space Knee said:
My surgeon told me about how important avoiding infection is -- she had a patient who had an abscessed tooth that got pulled. The dentist didn't give her any antibiotics and it ended up infecting her knee and destroying the implant. Had to take the whole thing out again, wait for six months, and then do it again. I had my first teeth cleaning since surgery, yesterday, and will be taking the antibiotics before dental work for at least two years. So, I can imagine what pool water can do, even if it IS chlorinated.
Click to expand...
The normal bacteria in your mouth are not the sort that usually cause infection in a knee replacement, so it isn't necessary to take antibiotics routinely for normal dental treatments.
Dental antibiotics: Evidence insufficient to recommend prophylactic antibiotics for dental procedures
However, a dental abscess is a different thing altogether and that person should have been given antibiotics.

As long as you don't go into a pool before your wound is completely healed, and there are no other open areas in your skin, you are unlikely to pick up an infection there that would affect your TKR. That's why we advise not starting pool therapy, or immersing your body in a bath or hot tub, until your incision is totally healed, with no scabs or open areas.
 
Both my dentist and the OS strongly recommended the amoxicillin prior to tooth cleaning. I am going along with their recommendation. Agree about the abscess--that's a whole other ball of wax and level of infection. Nonetheless, I'm not taking any chances.

I purposely waited two weeks beyond the OS's permission to go into the pool, just to be safe. The incision is completely healed, no scabbing, so I feel pretty good about the pool. But, it did worry me a bit, even though I did wait. Still, I'm glad I did start up the water exercises -- it's so relaxing and takes a lot of weight off the knee. I take it slow and easy -- only doing about 10 mins of slow exercise right now, and resting a lot in between.

I noticed today (18 weeks post-op) that the stiffness in certain areas around my knee is really starting to dissipate. There's still *some*, but definitely not the "metal band" feeling around the knee I've been having. I'm hoping the water exercise is helping. I did give it a rest over the weekend, which also helped, along with the icing.
 
Space Knee said:
Both my dentist and the OS strongly recommended the amoxicillin prior to tooth cleaning.
Click to expand...

@Space Knee My OS and dentist said the same. In fact, when I went to have my teeth cleaned, I had to sign a waiver in the dental office affirming I had taken the dosage. I didn't ask, but I suspect they wouldn't have gone ahead with the cleaning if I had not taken it.

You are so brave to do the water work. I don't know why I'm so leary of it, I guess maybe because I had so much trouble with my incision healing. It's completely healed now, but there are angry scars where the abscesses were.
 
Sounds like a good plan.

My knee is just so weird, it reacts strongly when anything touches it, including and especially water. How weird is that! It’s also very annoying! It really needs to get over itself, it’s been a year now. I’d like to move on.
 
I waited for the pool, too, not so much out of fear of infection —my incisions healed quickly and well— but because I wanted to make sure my knee muscles were built up from walking first and pain-free before I attempted water exercise. I love swimming and could easily overdo that. I’ve been determined all along to take things a little bit at a time and that has paid off for me.

Your slow and easy plan sounds perfect!
 
It is interesting that some weeks I can walk and exercise and no problems beyond the stiffness, etc. Then, I will take a short walk in the store and it gets all huffy for a day. In the main though, things are getting better.
 
Yes, I’ve had that, too. The knee is just saying, hi, I’m still here!

I’m glad things are generally going well for you!
 
Yes, it’s like the knee is saying “Hold on a moment! I’m still healing and have something I need to resolve here.” No knowing when those moments will happen. They just happen. But they’re increasingly fewer and we get past them faster.
 
Yes, I've learned to go with the flow. Some days are definitely easier than others.

Is anyone else using Pennsaid topical on their knee?
 
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