Knee Infection* Revision #3 Journey

[Jockette]

I sure haven’t read anything about delaying PT for six weeks. Does anyone else find this unusual???

Considering how much PT is recommended, yes, this is a bit unusual, but, this delay is giving your knee the best circumstance in which to heal, without stressing it with too many exercises. @sistersinhim wore a brace for quite a while and her ROM returned fine.

Remember:

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all along just waiting for 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. Normal activity is the key to success.

 

[sistersinhim]

his rehab is so very different from the first two surgeries. I sure haven’t read anything about delaying PT for six weeks. Does anyone else find this unusual???

I think this is a good thing and that OSs here prescribe PT way too early. With all my knees' surgeries, I never took PT at all, just did what you are doing, daily activities. I always recovered my ROM with no problem. After getting out of the braces at 6 weeks for one and 8 weeks for the other knee, I just used my knees naturally without adding any exercises. It works!

 

[celynda]

@sistersinhim, thanks for sharing your perspective. I’m not worried about regaining mobility due to delayed PT. I will follow the BoneSmart method. The OS isn’t promising a pain-free recovery and I am okay with that. He also said there’s an 85% chance the implant will fail after 10 years.

I live alone and am worried about managing alone. I live in a very small town and until I can drive, I am basically trapped in my house. One grocery store will deliver but the pharmacy doesn’t. We don’t have any Uber or Lyft services.

Since this was my third knee surgery, I thought I knew what to expect. This has been a total surprise from the length of the hospital stay (10 days), the brace (two weeks instead of 5 days), the WB (30% instead of 50%) and the delay in PT/activity (five weeks instead of day of surgery). X-rays today will determine next steps re WB and level of activity. I have to FedEx the x-ray images to the OS so it will be a couple of days before I hear from him on next steps. It will also determine when I need to see him again.

Thanks for listening to the rant.

 

[Layla]

Hi and a happy Tuesday to you, celynda.
Stop by here anytime you feel the need to vent. There will always be a listening ear and support and encouragement are never in short supply.

I’m sure you know those zingers you mentioned along with other odd sensations like tingling, pins and needles, itching, burning and even the feeling of a minor electrical shock, are usually good signs that the nerves are spontaneously firing through the regeneration process.

Something you may consider for your heel slides is a plastic bag under your foot. It will give you more ease of movement by eliminating friction.

As for prescriptions if you’re in need of a refill, unable to drive and your local pharmacy won’t deliver, check out WalMart and see if they’ll deliver and if so have your physician call in your prescription there.

Good luck with your x-rays today. I hope you hear some good news soon.
We’re rooting for you, celynda!
@celynda

 

[sistersinhim]

When I broke my foot and ankle, my TKR was less than a year old. I was NWB for 4 weeks because of the breaks and my new knee absolutely hated it. At least you can partial WB which should make it easier.

I also recovered mostly alone but had church friends and neighbors that helped me out, which was a huge blessing! I didn't drive for 7 weeks since it was my right knee.

Did your doctor tell you why he said that your new implant had an 85% chance of failure? If mine told me that I'd find a different doctor. Mine did tell me that I'd never be pain-free but would be better and I'm not pain-free but am a lot better!

We're here for you!

 

[celynda]

I asked home about the 85% and he said it was because it was the 2nd revision plus risks of falling and/or infection. I knew that every time you replace the implant the longevity of the implant decreases so I am okay with his response.

The only pharmacy that delivers isn’t in my network so I’m going to check prices for paying cash. Wal-mart will mail prescriptions but not opioids so I am out of luck in using them.

I may have to ask the neighbors for help, even though I really don’t want to. Driving is the thing I miss the most. If I could drive, I would be able pick up Groceries at Walmart (not RX though and there’s no drive-though).

I hope to hear from the OS on Friday as he should have the images on Thursday. I hope he receives and reviews them promptly.

At least the heel slides are getting easier now. Today was the first time, I could slide to close to a 90% bend. Not for more than 10x though.

Thanks all for listening and being here for me and the rest of the BoneSmarties.

 

[celynda]

Three days until I am left on my own. On the one hand, I am thrilled to getting my house back and not worrying about someone else’s tastes, habits, and expectations. On the other hand, I’m on my own for all ADLs. I need to work on getting neighborly help organized.

Still waiting to hear from OS after his review of Xray images. The CD should arrive today. I don’t know if I’ll hear from him Friday or Monday. The Home Health PT came this morning for an Assessment. Interestingly, she didn’t take any measurements. She wanted to see how I moved and was doing the exercises. I really liked this one. She’s a PT by day and a farmer by night. She sells goat milk soap, chicken and pork at the local farmers’ markets. Life in a small town is great.

She gave me a couple of pointers in doing the exercises more effectively and added a standing weight-shifting exercise using the walker. In addition, she wants to me to start using the walker to get to the bathroom a couple of times a day instead of relying 100% on the wheelchair. The goal is to prevent losing muscle tone in the rest of my body. I have managed twice today, so far and will rest the remainder of the day. Tomorrow, we’ll see how I feel. This extra activity is definitely exhausting and will require additional ice and elevation.

My mental recovery is a little slower as I am also looking for a job. My position was eliminated on 23 June. My team was moved to a different department and I am really bummed. There may be a couple of opportunities with other divisions in the company so I am somewhat hopeful of returning. Otherwise, it’s going to be fun searching for a WFH job in this economy. I live in a very small town in southeastern West Virginia and the opportunities are extremely limited. I’ve even thought of trying to live off my savings until Social Security is possible in March 2024.

Decisions, decisions…

 

[celynda]

Update from OS today:

“…reviewed your x-rays – everything appears stable and healing well. Okay to advance your WB to full over the next few weeks. I would continue with a walker and wean from a walker to a cane over a few weeks then wean from a cane to nothing if possible over another few weeks. I would ideally then get a new set of x-rays at 3 months…”

I received the update via email as I’ve not seen the OS since I was discharged from the hospital in June. I wrote back asking about a PT order and when he thinks I should be able to drive. Home health PT is still involved so it’ll be interesting to see their plan. As soon as the incision is completely healed, I want to get in a pool. The local PT group uses aqua therapy so I am interested in learning about their program. Otherwise, I’ll just walk in the local pool.

Still no news on the job front.

 

[benne68]

Good news on the knee front, @celynda! I'm sure you are relieved to be given approval to weight bear. Please take it slowly moving from the walker to cane and be sure to focus on your gait, even with the walking aids.

Keep us posted.

 

[Layla]

It is two months to date since your revision. I hope you're doing well.
How did transitioning to full weight bearing go? Let us know as time allows, we'd love to hear from you.
Take good care!
@celynda

 

[celynda]

@Layla, thanks for checking in. It’s been a rough couple of months for non-knee things. I’m still looking for a new job (and thinking about not going back to work if I can make it til March 2024 when I turn 62).

My dad died on July 16. He was 91 and suffered from dementia and Alzheimer’s. His death was unexpected and very quick. I managed the week long trip back to Florida okay with my knee. I rode down with family and managed pretty well with the walker. I flew back and that trip was a bit rougher because of the large Charlotte airport and small airplane into my little town. I started outpatient PT tomorrow and feel pretty good about my progress so far. I’ve even started taking short walks outside (~10 min). I plan to increase the distance over time. My goal is to be able to walk at least one of the dogs. I’ve not yet gotten brave enough to attach a leash to the walker. Maybe by the end of week.

Had a minor setback last week as I came back from the funeral with COVID. This was my first experience with the disease. I think the Paxlovid helped keep the symptoms in check. So now I am battling the fatigue and trying to do more with the bum knee.

The biggest problem I’m having now is remembering to tighten the quad muscle when standing to prevent the knee from buckling. I think the hinged implant causes much of the buckling feeling. Pain wise, things are pretty good. I’m down to one or two 7.5 Hydrocodone a day. I still take gabapentin, methocarbinal, moloxicam and tylenol.

 

[Layla]

You're welcome, celynda.
Thanks for sharing an update.
I am very sorry to read the sad news about your precious dad. I am sending a warm hug your way.
Then...Covid?! You poor dear. I hope you're able to get the rest you deserve and your stamina returns soon.

You have experienced more than your share over the last couple months. I pray things begin looking up for you.
We're here for support whenever you're in need...that you can count on. Please stay in touch.
@celynda

 

[sistersinhim]

I am so sorry to read of your dad's passing. It's hard enough when it's expected, but being unexpected sends us into a shockwave. I pray for your peace and healing.

 

[celynda]

@sistersinhim, thanks for your prayers. They are very much appreciated. We are all still processing. We think it was an undiagnosed UTI which is not uncommon in older adults with memory issues. He lived a good life. This picture was taken about a week before his death.

 

[Jockette]

I’m so sorry for your loss. What a great photo!

 

[sistersinhim]

He was so handsome! That smile was beautiful. He looks truly happy.

 

[Layla]

He kind of looks like our President at first glance! Anyone ever tell him that?

 

[mendogal]

What a wonderful smile. I'm sorry for your loss.

 

[Jamie]

I'm so sorry to hear all you've been through lately. Your father's photo is such a happy one and I hope it brings back good memories of the live he lived and good times that you shared.

It sounds like you did extraordinarily well handling the trip and the COVID. Of course all that may cause some delay in your recovery process. Hopefully now that you're back home, you can rest up a bit and settle into a good recovery routine. One caution I have for you, though......your post above mentioned "hooking a dog leash to your walker." Please don't every do that. You could be one squirrel away from a very bad fall. If you are still using a walker for stability, you are not ready to walk dogs yet as they can be unpredictable. If you don't have a fenced area or cannot put the dog on a chain when outside, enlist the help of friends, family, neighbors, or even a walking service until you are strong and steady enough to deal with the possibility of the dog lunging on a leash. No matter how well trained our pets are, this is something that can happen. A fall would be very bad for your new knee.

Hang in there.....things will get better!!

 

[celynda]

Jockette, sistersinhim, Layla, mendogal - thanks for the kind words and glad you liked the picture. This is one of my favorite pictures of him and we have a lot.

@Jamie, thanks for the reminder re the leash and the walker. Fortunately, I have a nice sized fenced-in back yard for them to use.

I started outpatient PT two weeks ago and the therapist is pushing too hard so I’m ready to fire her. I have pain in primarily two areas: in the lower thigh (above the implant) and on the inside (medial) of the knee, right at the knee cap. It’s tender to the touch and hurts even at rest. I’m not sure which of the exercises did it. It’s probably the combination of them. Needless to say I’ve stopped doing them for awhile. I am going to wait til the pain subsides. My last PT appointment was on Monday and the pain persists. I cancelled today’s and may cancel Monday’s depending on how I feel.

Even though I am almost three months post-op, I feel like I am six weeks out because I was mostly non weight bearing for the first six weeks. Is this an appropriate approach or should I be more active? I do use the walker in the house and when I’m out. In addition to crossing the street to get the mail, I try and walk about 10 minutes each day in front of the house. On Saturdays, I make the loop in our local Farmer’s Market. So I am not exactly just lounging around. When I am in the kitchen, I use the counter and walk sideways from sink to fridge to stove. According to my iPhone, I’m averaging 1500 steps a day. Next week, I’ll aim for 2000.

I’ve spent a few hours the last few days at my desk and boy am I stiff when I get up. the knee doesn’t hurt while I am sitting. It complains furiously when I get up and hobble back to the reclining sofa.

There have been a couple of nibbles with the job search. So far, the most promising involve relocation. While I don’t mind moving for a job (I’ve done it six times so far), the thought of moving any time soon is pretty scary.

Thanks for letting me rant.

Christa