TKR Puffin is soaring into the sky
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Titianlady
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Yes, Puffin, did the staple removal go alright? How are you feeling?
OP
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puffin
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Hi all
Have been for the dreaded surgical staple removal - not as bad as I was expecting although a few were a little reluctant to come out. Strange to see the scar for the first time - looks OK although I still have this fist sized swelling in my quads. I'll try and get a picture tomorrow but the nurse put tape on the scar that I must leave on overnight.
I was happy that I even managed to hop around the health centre on my walker rather than use the wheelchair which I was not sure that I would be able to do until today.
However totally wiped out by the trip out - have been sleeping on and off every since I got back 7 hours ago. Amazing that such a small trip can create so much exhaustion
Have been for the dreaded surgical staple removal - not as bad as I was expecting although a few were a little reluctant to come out. Strange to see the scar for the first time - looks OK although I still have this fist sized swelling in my quads. I'll try and get a picture tomorrow but the nurse put tape on the scar that I must leave on overnight.
I was happy that I even managed to hop around the health centre on my walker rather than use the wheelchair which I was not sure that I would be able to do until today.
However totally wiped out by the trip out - have been sleeping on and off every since I got back 7 hours ago. Amazing that such a small trip can create so much exhaustion
OP
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puffin
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Josephine
I have some questions to ask you - please tag me when you've answered ..
1. what medications have you been prescribed, how much are you taking (in mg please) and how often?
Dolcontin (morphine sulphate pentahydrate) – 50mg x 2 times per day
Paracetamol 1000mg x 4 times per day
Oxycodone 5mg – as needed for acute pain – currently max once per day (down from 3-4 - 2-3 weeks ago)
Pradaxa 220mg once per day (OS very concerned about post surgical blood clot risks)
2. how often are you icing your knee and for how long?
Icing as much as possible – most of the day as knee become very hot without ice because of swelling. Ice at night as well
3. how high are you elevating your leg, how often and for how long?
Elevating at chest/head height as much as possible
4. what is your activity level? (all of it!)
Very little other than exercises –
- some trips out in car as going stir crazy + one trip to supermarket in wheelchair – but the 40 steps a major problem. Usually feel wiped out and sleep rest of day
- have been naughty and done some work this weekend (hanging my head in shame) – pain levels increased because of this but it was acute. Don’t recommend editing text on morphine however.
5. what kind of exercises are you doing? How much and how often?
- heel slides – 30 x 2/3 times per day
- pressing knee into bed to extend - 30 x 2/3 times per day
- assisted lifts with rolled towel under knee 20 x 2/3 times per day (cannot do this myself yet – will hopefully get leg lifter but disability aid shop 40 miles away and don’t feel up to trip yet)
- stretches with rolled towel under ankle – 2-4 minutes 2/3 times per day – bruising at back of knee makes this hard
- sitting stretches under the chair
Walking with walker/crutches – do around 5-10 minutes several times per day
6. have you read (or reread) the recovery articles?
Yes – not sure how much is going in and retained so will re-read again
Have you any specific advice for recovering from the type of complex operation I had?
Any ideas on how long recovery may take from my operation? - as there seems to be very little information on hinged prostheses out there – for example I noticed in the hospital that my walking/weight bearing was generally worse than the other TKR patients on the ward although I had a decent ROM when I left hospital (83)
I have some questions to ask you - please tag me when you've answered ..
1. what medications have you been prescribed, how much are you taking (in mg please) and how often?
Dolcontin (morphine sulphate pentahydrate) – 50mg x 2 times per day
Paracetamol 1000mg x 4 times per day
Oxycodone 5mg – as needed for acute pain – currently max once per day (down from 3-4 - 2-3 weeks ago)
Pradaxa 220mg once per day (OS very concerned about post surgical blood clot risks)
2. how often are you icing your knee and for how long?
Icing as much as possible – most of the day as knee become very hot without ice because of swelling. Ice at night as well
3. how high are you elevating your leg, how often and for how long?
Elevating at chest/head height as much as possible
4. what is your activity level? (all of it!)
Very little other than exercises –
- some trips out in car as going stir crazy + one trip to supermarket in wheelchair – but the 40 steps a major problem. Usually feel wiped out and sleep rest of day
- have been naughty and done some work this weekend (hanging my head in shame) – pain levels increased because of this but it was acute. Don’t recommend editing text on morphine however.
5. what kind of exercises are you doing? How much and how often?
- heel slides – 30 x 2/3 times per day
- pressing knee into bed to extend - 30 x 2/3 times per day
- assisted lifts with rolled towel under knee 20 x 2/3 times per day (cannot do this myself yet – will hopefully get leg lifter but disability aid shop 40 miles away and don’t feel up to trip yet)
- stretches with rolled towel under ankle – 2-4 minutes 2/3 times per day – bruising at back of knee makes this hard
- sitting stretches under the chair
Walking with walker/crutches – do around 5-10 minutes several times per day
6. have you read (or reread) the recovery articles?
Yes – not sure how much is going in and retained so will re-read again
Have you any specific advice for recovering from the type of complex operation I had?
Any ideas on how long recovery may take from my operation? - as there seems to be very little information on hinged prostheses out there – for example I noticed in the hospital that my walking/weight bearing was generally worse than the other TKR patients on the ward although I had a decent ROM when I left hospital (83)
Josephine
NURSE DIRECTOR EMERITA
Puffin, before I reply to your answers, I want you to remember some facts:
1. you are only 3 weeks post op
2. you should be resting more than you are active
3. your knee is going to be like this for at least a month and there is little or nothing you can do about that except be careful!
I suggest you cut down to this for the next two weeks until the swelling subsides some:
- heel slides: 10 twice a day
- pressing knee into bed to extend: 5 twice a day
- assisted lifts with rolled towel under knee: 5 twice a day
- stretches with rolled towel under ankle: none not yet anyway
- walking with walker/crutches only when you need to go to the bathroom or do something else, total of 30-40 minutes for the whole day.
The specific advice I have for you is above. It's not the hinged knee now that is causing you the problems, it's that punishing routine that's been set for you. This knee recovery shouldn't be any different from any other total knee replacement recovery and it needs just as much, if not more, TLC and gentle handling in the first few weeks. I hope this has been helpful.
1. you are only 3 weeks post op
2. you should be resting more than you are active
3. your knee is going to be like this for at least a month and there is little or nothing you can do about that except be careful!
I understand you are going stir-crazy but your knee is not and it comes first. Every time you go out or go up and down stairs you are making things worse and lengthening your recovery. It's really not worth it, the pay back is too big.
This is all too much and is what is largely responsible for your swelling.This regimen is more for a knee about 6-8 weeks post-op.
I suggest you cut down to this for the next two weeks until the swelling subsides some:
- heel slides: 10 twice a day
- pressing knee into bed to extend: 5 twice a day
- assisted lifts with rolled towel under knee: 5 twice a day
- stretches with rolled towel under ankle: none not yet anyway
- walking with walker/crutches only when you need to go to the bathroom or do something else, total of 30-40 minutes for the whole day.
The specific advice I have for you is above. It's not the hinged knee now that is causing you the problems, it's that punishing routine that's been set for you. This knee recovery shouldn't be any different from any other total knee replacement recovery and it needs just as much, if not more, TLC and gentle handling in the first few weeks. I hope this has been helpful.
OP
OP
puffin
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Josephine
Thank you for you comments - i think you are right that I am overdoing it at the moment. Probably inpatient as I have been rehabbing this knee for almost 3 years now. I'll cut back. The lump on my quads is large and rock hard - more like a bruise or a hematoma
One thing that I have noticed is that I have a lot of deep bone pain - especially mid shin-bone. It feels at times like I am walking on a broken leg, similar to the fracture just after the original accident. Could this be due to the prothesis or bone inflammation from the drilling/hammering? I remember the OS talking about the bone one day when he swished through on rounds but can't remember what he said
Thank you for you comments - i think you are right that I am overdoing it at the moment. Probably inpatient as I have been rehabbing this knee for almost 3 years now. I'll cut back. The lump on my quads is large and rock hard - more like a bruise or a hematoma
One thing that I have noticed is that I have a lot of deep bone pain - especially mid shin-bone. It feels at times like I am walking on a broken leg, similar to the fracture just after the original accident. Could this be due to the prothesis or bone inflammation from the drilling/hammering? I remember the OS talking about the bone one day when he swished through on rounds but can't remember what he said
Josephine
NURSE DIRECTOR EMERITA
or swelling!!
or swelling!!
Try reading this again Pain management: importance of managing pain after a TKR and the pain chart. There is an explanation in there about the connection between pain and swelling.
OP
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puffin
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So exhausted ever since my trip for staple removal yesterday - I keep falling asleep. I've been trying to watch Midsommar Murders with Mr. Puffin and keep falling asleep and missing who the murderer is
As per Josephine advice yesterday I have cut back on the exercises now that I can see the extent of the swelling and bruising for the first time without the huge dressing
The scar looks OK but there is a lot of bruising and swelling - especially above and below the knee
![[Bonesmart.org] Puffin is soaring into the sky](https://bonesmart.org/forum/attachments/knee-scar-jpg.13135/ "[Bonesmart.org] Puffin is soaring into the sky")
As per Josephine advice yesterday I have cut back on the exercises now that I can see the extent of the swelling and bruising for the first time without the huge dressing
The scar looks OK but there is a lot of bruising and swelling - especially above and below the knee
new knee in June
supremo
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Dearest puffin,
Your scar looks good...for swelling only ice and elevating will do. Do you have an ice machine yet. They are wonderful, if you don,t have one, try to get one....maybe on amazon. I hope you are feeling much better and I think of you often.
Take care....diana
Your scar looks good...for swelling only ice and elevating will do. Do you have an ice machine yet. They are wonderful, if you don,t have one, try to get one....maybe on amazon. I hope you are feeling much better and I think of you often.
Take care....diana
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Given everything that you have been through, I also think the scar looks good. Slow and steady is the pace---Your recovery will be longer than some of the others, but recovery is hopeful.
Yes, the staple removal is sort of an "event" in more ways than one. I remember days like that. I would put on a dvd of some show and
it would take me 3 tries to remain awake for the end of the episode. I had to keep restarting somewhere in the middle. 
But your body is telling you you need the rest, so go with it.
Titianlady
post-grad
puffin that scar looks good!! Looks like all the inconvenience of that dressing and leaving the staples in for the extra time paid off well.
I think that you will come along just fine. It will take a bit longer as you had a lot of damage to correct, but I can just see you this time next year walking and going up and down your stairs without a second though. I'm so glad you finally got your knee replaced! You certainly waited your share of time in pain and disability with no end in sight for improvement. Now the waiting and discomfort are all for healing!
I've read your thread from the beginning, and have been following your progress. Will be rooting for you puffin. I can't wait to hear when you take that first unaided step down the road a bit. How wonderful that will be.
I think that you will come along just fine. It will take a bit longer as you had a lot of damage to correct, but I can just see you this time next year walking and going up and down your stairs without a second though. I'm so glad you finally got your knee replaced! You certainly waited your share of time in pain and disability with no end in sight for improvement. Now the waiting and discomfort are all for healing!
I've read your thread from the beginning, and have been following your progress. Will be rooting for you puffin. I can't wait to hear when you take that first unaided step down the road a bit. How wonderful that will be.
Hey Puffin - that knee looks really good! You can flash that at the wedding no problem at all. 
Midsummer murders have a slightly sleepy England effect - it's good that they are making you rest anyhow.
I'm sure your knee is healing slowly but surely and is very glad of a chance to lie back and just get on with the process.
How are you doing with the stairs?
Midsummer murders have a slightly sleepy England effect - it's good that they are making you rest anyhow.
I'm sure your knee is healing slowly but surely and is very glad of a chance to lie back and just get on with the process.
How are you doing with the stairs?
My way
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Well done! Looks like it's healed nicely. Now I can see the "lump". How are you feeling? I hope the staple removal has given you some relief from your discomfort. Mind, you don't start doing too much now. You know I would never overdo it.
(sitting here rubbing my knees and groaning very quietly so himself doesn't hear and lecture me) He would have a valid point though. 
(sitting here rubbing my knees and groaning very quietly so himself doesn't hear and lecture me) He would have a valid point though. Hi Puffin 
Your leg looks great and what a relief to have the staples out. I worried about my leg and know that it is just as all of the bonesmart experts and friends have said all will be and just take the time to let it heal they were absolutely right.What a wonderful place this is and wonderfull people as well. 
wishing the very best 
Holly
Your leg looks great and what a relief to have the staples out. I worried about my leg and know that it is just as all of the bonesmart experts and friends have said all will be and just take the time to let it heal they were absolutely right.What a wonderful place this is and wonderfull people as well. wishing the very best Holly
OP
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Seem to be suffering an extra tired and achy day today - although I did sleep of 6 consecutive hours for the first time since my accident almost 3 years ago
But everything seems to hurt so much more even though I cut down on the PT. The kneecap seems very sore for no apparent reason and there is a tiny bit of oozing where the staples came out
- might be the weather - hardly June sunbeams' weather
- instead it is very cold (12C/53F), raining with a cold north wind
- might be that I cut back a little on the slow release morphine to eke it out a little longer - only 5 days of those tablets left
But everything seems to hurt so much more even though I cut down on the PT. The kneecap seems very sore for no apparent reason and there is a tiny bit of oozing where the staples came out
- might be the weather - hardly June sunbeams' weather
- instead it is very cold (12C/53F), raining with a cold north wind- might be that I cut back a little on the slow release morphine to eke it out a little longer - only 5 days of those tablets left
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