MUA Ruby's Tuesday--July 11th, 2017<

[knit2tog]

So happy to hear you are home. There is no place like it!

 

[nensi]

It's amazing how awful you can feel when the poop factory isn't functioning correctly. It may take some time to settle down, but you are through the worst part ! I have been eating a few stewed prunes a day in addition to a stool softener and drinking enough water. It's working well !


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[sistersinhim]

Miralax helped me. I took a cap full twice a day until I was off the Oxy.

 

[bashbago]

There is no place like home. I never sleep well in hospitals. It seems you finally get to sleep when they wake you to take medicine, draw blood, or take vital signs. Sounds like you and DH have it under control.
Keep up the good work!

 

[kneeper]

Re: early morning blood draws--I was told they do them so early because the doctors want the results for their early morning rounds. But no one turned the all the lights on for stuff like that for me.

Glad you're home and have a good helper in your husband.

 

[rubyyarn]

Ouch! Nothing like a laxative that empties both ends at the same time! Now that the initial unplugging is done, maybe things will settle down to normal. MiraLax every couple of days is working for me.

 

[Ruby9297]

Ok, so in my state of acute pain last night, I thought I wrote a post, but I don't see it reflected here. I will try again to post a picture, but I keep getting an error message that my picture files are too large to post. My TKR leg is painful and swollen, and this progressed over the course of yesterday. I also ran a low-grade fever for the first time since I was in hospital:99.2. My leg became more and more swollen and painful. By. 7:30, I texted my home health nurse with my concern and the photo comparing my two legs, but I got no reply. By 9:00, I called and spoke to a nurse on call, who put me through to my surgeon. He upped my pain meds and told me to ice. Well, I'd been icing a lot yesterday. I have 2 ice machines. He also told me to call his assistant today and get in for an ultrasound to rule out a clot. All I really needed to know was if this amount of swelling was normal, or if I should be concerned . It was difficult to get an answer.


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[Ruby9297]

Above is a picture of my legs side-by-side last night. Is this normal? I must say my surgery leg hurts quite a lot. Any input would be appreciated. Thanks, Ruby9297


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[VW54]

Hello Ruby9297
Just read all what you're going through. Poor you!
I think that op knee is quite swollen. I d be worried just like you are. I'm sure there will be more qualified people replying as well.
Have you measured the circumference difference and told doc about it?
It's additional information. My clinic doc wanted my knee c. for each knee measured pre release for 4 days. And temperature measured.
Probably some statistical info the clinic was doing?
I hope you will get prompt attention and follow up good care!
Good healing vibes sent your way~~~~~~

 

[Ruby9297]

I have been scheduled for an ultrasound this afternoon to rule out clots. Meanwhile: ice, norco, elevation, rest. Thanks.


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[SusieShoes]

The ultrasound is a good precaution. If it is a clot, there are things they can do to resolve it. If it isn't, one less thing to worry about!

Your knee does look quite swollen to me. Your temperature being a little high might not mean anything. I also had a slightly elevated temperature a few times during the first post-op week. I was told not to worry unless it got much higher. Sending prayers and healing thoughts that you soon feel relief!

 

[sistersinhim]

Are you elevating with your toes above your nose? It doesn't look like it by your photo. Also, ice, with a tea towel between you and the ice pad, the whole time you're down. You can't elevate or ice too much! That will help that swelling to go down.

It's good to go for the blood clot check up. Let's us know what happens.

 

[Ruby9297]

Are you elevating with your toes above your nose? It doesn't look like it by your photo. Also, ice, with a tea towel between you and the ice pad, the whole time you're down. You can't elevate or ice too much! That will help that swelling to go down.

It's good to go for the blood clot check up. Let's us know what happens.

Not always goes above nose because PT told me off, plus sometimes it hurts. I'm using lots of ice because of a mix-up I ended up getting two ice machines. I just took it off for the photo. I could tell from my vantage point, and because of how painful and taut my leg felt that I was swollen, but I needed to take a Birdseye shot so I took the icer off for that picture.


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LTKR scheduled on July 11th, 2017 [emoji51]

 

[sistersinhim]

Not always goes above nose because PT told me off, plus sometimes it hurts.

I don't understand what you mean that PT told you off. The higher you can get that knee, the more the fluid can move down to your kidneys and out the body. You aren't keeping your knee straight, are you? You should have a slight bend in your knee to keep the pain down.
https://bonesmart.org/forum/threads/pain-and-swelling-control-elevation-is-the-key.7602/

 

[labbieb]

Ruby9297, I'm one day behind you and my leg is at least as swollen as yours. Black & Blue in many places too. This is worse than I expected (pain-wise), even though everyone said it's bad. I'm elevating, icing and taking my meds on a schedule. I can barely bend my knee or ankle for the swelling. Ugh!

 

[Ruby9297]

I don't understand what you mean that PT told you off. The higher you can get that knee, the more the fluid can move down to your kidneys and out the body. You aren't keeping your knee straight, are you? You should have a bend in your knee to keep the pain down.
https://bonesmart.org/forum/threads/pain-and-swelling-control-elevation-is-the-key.7602/

PT prefers that I keep my leg out straight, except when doing exercises. She came in and saw my leg propped up on pillows and told me I shouldn't be doing that


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LTKR scheduled on July 11th, 2017 [emoji51]

 

[Celle]

PT prefers that I keep my leg out straight, except when doing exercises. She came in and saw my leg propped up on pillows and told me I shouldn't be doing that

In this instance, you need to disregard what your PT said. Your leg is swollen and nothing but elevation is going to get that swelling down. The idea that your leg must be kept straight all the time is wrong as well - it's perfectly OK to have a slight bend. In fact, keeping your leg straight all the time can be very painful.

Do read this article again:
Elevation is the key to controlling pain and swelling

Your leg needs to be elevated at least this much:

Another thing: It is your leg and your knee and you are the only one who is allowed to say what will happen to it. Others, such as you surgeon and your PT, can advise you, but you have the right to choose whether or not to accept that advice. Your PT works for you, not the other way round. You don't have to please her/him. They have to please you.
Saying no to therapy - am I allowed to?

 

[Jamie]

Celle and sistersinhim are very correct about how you should be positioning your leg. Next time the therapist says you need to keep the leg straight, ask what her reasoning is. If it's something like....you'll lose your extension....or....you won't get the proper ROM in your leg....then you know it's not good advice. Keeping your leg straight all the time is not the way to better movement. And, as you have experienced, it can hurt and cause swelling. Be sure you're not attempting to do too much in these early days. You don't need a lot of therapy right now. Just some gentle bends and stretches throughout the day along with getting up and walking about for 5 minutes every hour or two are fine.

 

[Jamie]

Ok, so in my state of acute pain last night, I thought I wrote a post, but I don't see it reflected here. I will try again to post a picture, but I keep getting an error message that my picture files are too large to post. My TKR leg is painful and swollen, and this progressed over the course of yesterday. I also ran a low-grade fever for the first time since I was in hospital:99.2. My leg became more and more swollen and painful. By. 7:30, I texted my home health nurse with my concern and the photo comparing my two legs, but I got no reply. By 9:00, I called and spoke to a nurse on call, who put me through to my surgeon. He upped my pain meds and told me to ice. Well, I'd been icing a lot yesterday. I have 2 ice machines. He also told me to call his assistant today and get in for an ultrasound to rule out a clot. All I really needed to know was if this amount of swelling was normal, or if I should be concerned . It was difficult to get an answer.


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The photo files coming from your phone will be too large for us to accept. You need to reduce the pixel size before trying to upload it. You should be able to do that right on your phone. I resized this photo because it was still too large for good viewing.

I'm sorry you're experiencing problems. The low grade fever is quite normal and, while you should keep an eye on it, it's not really something you need to worry about.

Your leg (as you know) is swollen. That will cause pain. Be sure you take your pain meds on a set schedule at the max dosage your surgeon authorized until this is under control. It may make you sleepy, but that's okay. I doubt if it's connected to a blood clot, but it was good of your surgeon to check this out anyway.

Be sure your therapist is not working you too much. While you're in pain and swollen, you really don't need to be doing any exercises. And the therapist should never, ever push on your knee or pull your leg into a bend. If you can't do it on your own, you're not ready yet. It's okay to set limits with the therapist. What would be more helpful for you is a lymphatic massage if your therapist knows how to do that. Keep that leg iced and up. You'll get on top of the swelling, but it may take a while. The lymph system works very slowly and that's a lot of fluid to get rid of.

 

[Pheebs52]

Oh Ruby, I'm so sorry to see your leg so swollen; ugh! Mine was similar during the first two weeks despite near constant ice and elevation. I really hope yours resolves more quickly than mine did.