TKR RTKR followed by Revision . Now LTKR giving trouble.

[Josephine]

So your pain sites are here - got to admit, I somewhat flummoxed by that
Wouldn't like to say what it is.

Current pain levels everyday 6-8 sometimes as high as 9-10 (ER visit at this level.
Current RX's (just saw pain mgmt today)Percocet 10/325 1po 6h, soma 350mg 1 po qid, Tramadol 50mg 2 tabs q4 prn

Well, can't say you're not medicating enough.

Icing every 4-5hrs for 30mins, some days less some days more.
Elevation: I'm generally laid out in bed or on couch most of the day. I'd say a minimum every 2hrs for at least 30-45mins

You don't accomplish much in 30 minutes. Much better to leave it on for an hour or more As long as it feels helpful.

I don't do a lot of work around house as it is so difficult to move around. I do laundry, sweep floors, do dishes and clean pool every other day. Trips to stores maybe once a week as it is difficult to walk long distances.

Clean the pool? Isn't that a bit testing? However, I admire for you for doing that much.

PT and Gym I quit one month ago due to what I called abuse and pain.

And quite rightly too!

I do some flexion exercises with a band, I move around in my pool, try to take short rides on my bike - some days I can and some days I can't. I've been forcing heel toe walking.

Well, you know not to do this so it makes you hurt, don't you? Discomfort but never hurt.

I use a cane all the time.

That's good. Might even be good to use two.

I get massages on the leg also.

And does that help?

Momma, I'm afraid I have no wonderful advice for you. You're in a tough spot and I doubt anything will change quickly. Only spot of hope I can offer is that at 7 months, it's still likely this will settle in time. It's obviously a nerve related issue and they can take a year or more to heal.

 

[mommabarefoot]

@Josephine the weightlessness of the water provides some relief for the knee and back. It's not strenuous since I'm inside the water. I also float around, something my late mum taught me as a child. You said you wouldn't want to say what it is. As a nurse do you have any thoughts as to what it could possibly be or something I might suggest to my Dr?

I've thought that the implant is slightlyoff, or too large, or my body is just rejecting it. What are your thoughts on that? I really need help or guidance in a direction I might take. People have suggested Dr Maale in Dallas/Plano area which is 5 hrs from my home. I'm willing to go that route if I can't find a competent OS specialist in the Houston area that is willing to look at me. I'm really at my wits end. I truly appreciate any insight you might be able to provide. FYI my later mum was from England herself and I feel as if coming across you might be a little help from her.

 

[mommabarefoot]

@RunA42K from a suggestion I received you might know a Revision Specialist in the Houston, TX area. I live South of Houston and would really appreciate any assistance you can provide. I truly appreciate your time and any guidance you can provide. I NEED HELP.
Sincerely Mommabarefoot

 

[mommabarefoot]

@Josephine sorry I forgot another tid bit. The knee itself hurts deep inside with a pressing or vice like type pain and the calf and thigh have a feeling of like a toothache in the bone pain. That's the best way I can describe it. Sorry to pester you.

 

[pjw]

Hi Momma. I too live south of Houston and I would highly recommend Dr. Vasilios Matthews at Texas Orthopedic. I have had a rough time getting through this knee replacement but his work was excellent. My problems have come from other health issues. Best of luck finding the answer that will relieve your pain. I can do things now that I haven't been able to do for five years. I have to start back at the pool and increase my bend and stamina.
Pam
Ltkr 12/19/11

 

[mommabarefoot]

@pjw Thank you for your suggestion. Is Dr M a revision specialist? I'm not sure what I need, but with my current Dr talking revision in Dec I just want to make sure I cover my behind. Glad ur doing better. Bless you

 

[pjw]

Dr. M has a good website and I would suggest you call and talk to his office to see what they say about revisions. I would at least get a second opinion from someone who is concerned about your pain.
Pam
Ltkr 12/19/11

 

[RunA42K]

@RunA42K from a suggestion I received you might know a Revision Specialist in the Houston, TX area. I live South of Houston and would really appreciate any assistance you can provide. I truly appreciate your time and any guidance you can provide. I NEED HELP.
Sincerely Mommabarefoot

Absolutely!!! After 4 knee surgeries and 4 doctors I can tell you that Stephen Incavo' is outstanding. He is the chief of adult reconstructive surgery for Methodist hospital in the Texas medical center. While he does routine knee and hip replacements, he specializes in problems/revisions. You can red about him on The Methodist Healthcare web site or www.drincavo.com 713-441-3569. My revision surgery was a piece of cake compared to the original TKR. This revision knee is 100 times better than my first. Go to the best the first time and get it right. I'll never go anywhere but the Texas medical center again, the best of the best are down there. Well down from me but maybe up from you!!

Good luck!

 

[Josephine]

the weightlessness of the water provides some relief for the knee and back

I bet that feels good!

You said you wouldn't want to say what it is.

I think I said I couldn't say what it is, meaning that I really don't know.

I've thought that the implant is slightly off, or too large, or my body is just rejecting it. What are your thoughts on that?

None of your symptoms are in keeping with this scenario.

People have suggested Dr Maale in Dallas/Plano

I believe I was one of them! I do know that you can be fully confident that Dr Maale will sort you out. He specialises in the kind of cases that flummox other surgeons. Do get in touch with him. I don't believe you have to actually go there straight off.

The knee itself hurts deep inside with a pressing or vice like type pain and the calf and thigh have a feeling of like a toothache in the bone pain. That's the best way I can describe it.

You describe it very well and it further confirms in my mind that this is nerve related and nothing to do with your new knee.

Sorry to pester you.

Honey, you're not pestering me! That's what I'm here for.

 

[mommabarefoot]

@Josephine and @RunA42K thanks for both of your responses. I will contact Dr. M and Dr. Incavo as well as Dr. Matthews whom @pjw suggested. Some how some way I will get this issue resolved and fixed. Does anyone have any clue or have they experienced the following:
Starting 4 days ago when I go to bed at night the nagging calf cramp has started to have what I call contractions. It feels just like a dang contraction. All of the sudden it will go from a nagging cramp to an excruciating pain, Charlie horse or a fire poker driven into the back of my leg type feeling in and area about 3" x 3" . It lasts maybe 30 seconds to a minute and brings me to the brink of tears. On a pain scale I'd give this thing a good 9-10. It lasts maybe 30mins then goes away. It does comeback throughout the night and will wake me right up yelping in pain. It does happen during the day but not near as much.

 

[kneeper]

 

[Jozilla]

It sounds like nerve pain. Talk to your GP as there are special medications that might be worth a try like gabapentin.

 

[H2OPoloMom]

I am so sorry to hear that you are having such a hard time with your tkr! I do not have any answers for you, but what caught my eye is your descriptions of your nightly cramping. I also have had issues with this lately. The first time, I described it to my husband was very similar- it felt like my knee was in labor and I was surprised in the morning that I didn't have a new baby knee nearby. Saying it hurts is an understatement! The only time it happens is when I have PT and have done too much. So I work hard to back off- all day and ice and elevate - all day, getting up only to use the bathroom and eat. I have found that when they hit, if I extend my leg (as much as I can) and flex my foot, it does seem to help stop the pain from hitting the high point. They do keep coming, but if I extend and flex, it keeps the pain to a 5-6 instead of an 8-9.

It is so hard to do nothing, but when your knee hurts like that, it is telling you to do nothing. Not the minimum, but nothing unless u need it to keep you alive. If you need extra help around the house and with the pool call a nearby church or check your local high school for high school students that need some service hours (Ask one of the secretaries if she can get you in touch with the National Honors Society adviser).

I hope this is of some help to you! I will send positive thoughts your way and hope that this starts to get sorted out for you!

 

[Josephine]

As I said before ....

it further confirms in my mind that this is nerve related

And your latest developments definitely confirm that.

 

[mommabarefoot]

Thanks all. With the spinal fusion I cannot lay down all day. Guess I'm going to have to figure out a happy medium. I have tried gabapentin (?) but no luck either. Today's been a very painful day for Mr Knee. @Josephine r anyone: any suggestions as to why I could be experiencing nerve pain like this after as I didn't have it before. I can hardly walk this evening

 

[mommabarefoot]

One other question. WhenI wake in the morning or after I've been sitting for a bit my knee does not like to bear weight. This is to the point I have to use both hands on the cane like a crutch. Does this also seem to be a nerve problem?

 

[Gingiebot]

I'm no expert, but my knee is much worse first thing in the morning, or after I have been sitting. I think that symptom is fairly common and I ascribe it to age stiffness....stiffness caused by less blood flow to the area. As soon as I force myself up and move around the stiffness and pain begins to decrease.

 

[Josephine]

Since this situation is complicated by your spinal issues, I feel I am not competent to comment. It's likely that your weight bearing issues might be due to your spinal problems.

 

[mommabarefoot]

@pjw and @Josephine I wanted to let y'all know that I have scheduled an appt with Dr Maale for mid August for an evaluation. Dr M is 300 miles from my home, but we decided after researching him that he would be well worth the trip. I will keep y'all updated. PJW did u use him personally? I think someone else told me they were treated by him.

 

[Jozilla]

@RestAssured used Dr Maale with phenomenal results. Good luck. Sounds like he is very special.