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TKR Sailor's Recovery Thread

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SFBaySailor said:
Over the last week or two, I've noticed that the lower 3 inches or so of my quadriceps/quadriceps tendon seems inflamed, and is also very hard to the touch. There is some pain, but not constant, and it is more like a burning sensation when I flex the quad. I'm wondering if I've got a case of tendonitis?
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Before I reply, I have some questions to ask you

To start with, can you tell the the exact location of your pain using this chart? Each square needs the number for the row (horizontal) and the column (vertical) to identify it, plus let me know if it's front or back. When you've done that, I'll come back and talk with you some more.

[Bonesmart.org] Sailor's Recovery Thread


Also:
1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine)
2. what pain medications have you been prescribed, how much are you taking (in mgs please) and how often?
3. how often are you icing your knee and for how long?
4. how high are you elevating your leg, how often and for how long?
5. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and
6. what kind of PT are you doing? How much and how often?

I'll be back shortly! :wink:
 
Joesphine,
Thanks for the reply. See my comments below.

Before I reply, I have some questions to ask you

To start with, can you tell the the exact location of your pain using this chart? Each square needs the number for the row (horizontal) and the column (vertical) to identify it, plus let me know if it's front or back. When you've done that, I'll come back and talk with you some more.

[Bonesmart.org] Sailor's Recovery Thread

The areas I am referring to are C-L3 and C-L2.

Also:
1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine)
The pain is not constant, but when it occurs it is about level 2-3. It is more of a burning sensation.
2. what pain medications have you been prescribed, how much are you taking (in mgs please) and how often?
I was prescribed Vicodin several weeks ago (at about week 6). I have not had to use the Vicodin recently. I am using either Tylenol 1000 mg or Ibuprofen 800 mg, twice per day.
3. how often are you icing your knee and for how long?
Twice per day, for 1/2 hr.
4. how high are you elevating your leg, how often and for how long?
Toes above nose.
5. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and
I reduced my activity level by finishing PT. This was a couple days before the pain started. Activity the last 2 weeks has been minimal. Go to work 2-3 days/week. Work from home the other days. Last week, I went into the office only one day, due to my wife's illness. Minor household chores (take out trash, etc). No heavy yardwork over the last 2 weeks.

6. what kind of PT are you doing? How much and how often?
I completed formal PT 2 weeks ago, so no PT now. I will say that the last PT session 2 weeks ago was somewhat grueling, as they measured the strength in my TKR leg before discharging me. This involved pushing through about 160 lbs of weight on the leg press. No pain immediately afterwards. It was 3 days later that I first noticed the pain. Since then, at home, I am doing exercise bike 10 min every other day, and ROM stretches & very light muscle building exercises on the other days.

I'll be back shortly! :wink:
 
SFBaySailor said:
This involved pushing through about 160 lbs of weight on the leg press. No pain immediately afterwards. It was 3 days later that I first noticed the pain.
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Well, I think this was your problem - 160kbs on the leg press?!! No wonder you quads tendon is complaining! And yes, that's what we call tendinitis!

I would recommend you rest your leg completely, ice it and take simple pain meds like Tylenol 1,000mg 3-4 times a day. You might also find this helpful Acupressure massage. It will resolve eventually but only if you rest it lots.
 
Josephine said:
Well, I think this was your problem - 160kgs on the leg press?!! No wonder your quads tendon is complaining!
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Thank you, Josephine!!!
This is what I suspected. Sure, I'll take it easy over the next few weeks. How long does it typically take to resolve?
I'll try the acupressure massage. Thanks for the link!

Roger
 
This is the same type of irritation we can get even in a non-TKR leg. So the remedy is the same: ice and rest, mainly.

I see you take 800 mg ibuprofen twice daily. Do you need 800mg? It might be better to take 400-600 mg 3-4 times a day, such as with meals to limit any GI irritation. I don't know if it bears out in research, but I was always told that to combat inflammation/pain, taking ibuprofen at regular intervals worked best. Who knows? Just a thought. It's hard to get through this TKR recovery without random muscles, tendons and ligaments complaining. But it's depressing when the professionals we hire are the cause!!
 
maryo52 said:
But it's depressing when the professionals we hire are the cause!!
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maryo52
I know, this is unfortunate. But I don't entirely fault the PT facility. 80% strength in the TKR leg is a requirement for discharge. I pushed to 160 lbs in an effort to get discharged that same day. I could have had a few more sessions and waited until the leg was a little stronger. So some of it is my fault!

No, I don't need the full 800 mg dose. I have taken smaller, more frequent doses, as you suggest, and it did help. No GI problems so far. I'll try your suggestion. Thanks!

Roger
 
My PT's, during the latter stages of my recovery---had me do leg presses, as the regimen was for me getting back to umpiring. One thing though---they never let me go above my weight---they had a very good point---I did not need to and I was not entering any contests. WE all get in a hurry---but one should never increase the workout by more than 10%---and only when the muscles, etc., are ready for it. By moving too fast, too soon, the body itself will put the brakes on (I have learned that and re-learned that many times!)
 
Roger, i am sorry to see you go, but understand your convictions. I have experienced some of the same, but have succeeded in seeking out the support of folks like-minded in what they want out of this forum. I just consider the comments you describe as noise, and read past them. It is hard to stay positive during this recovery, but it is also important to do so, just to keep your mind in the game to be disciplined about your homework...or PT.

I hope you will return if you come to reconsider after being away. I certainly have enjoyed your posts and the important questions you have posed to the forum. One thing is for sure...medicine is not an eaxct science!

Good luck in your remaining recovery! I hope to read more of your posts in the future.

Bob
 
Hi Roger:) I am sorry that you are considering leaving:cry: and hope that you are doing great. I have enjoyed writing back and forth to you and have found you to be a very positive influence. This recovery period has not been easy we reach out to others for understanding and support . You have helped me with your posts on those days when you feel alone with this whole process and are very kind in the way that you write about your family (your wife and beautiful dogs even got to see your beautiful baby. Hope you change your mind you have helped others as well coming on to this site and making someone new to this surgery feel less like they are on their own make them feel more comfortable. I am not sure what posts have caused this feeling have been busy with my husbands and my medical issues but sad to think that someone has made you feel this way. You are a valuable resourse and through communications I consider you my friend. I wrote to a cross-stitch forum and the atmosphere was not always friendly lots of judging some even embarrased others for their typing skills and spelling. :yikes: I had been writing to them as I love cross-stitch and the negative posts made me also consider leaving which I did .Not relaxing when reading peoples posts fighting and degrading. I really enjoy bonesmart but wish that you had not experienced negativity. :console2: Hope you reconsider there are lots of us who will miss you and have enjoyed sharing our days with you and yours with us. Hope things keep getting better and better and please don't leave us. Thanks for the friendship and making me feel nice on those really difficult days. If you leave us you will be missed. Holly :thankyou: :flwrysmile:
 
@SSBaySalior, when I first joined the forum--it seems like 100 years ago!---I also ran into a little bit of negative posting---I made the remark that I thought stapled legs looked gross. (I know, it was NOT tactful)

I got quite a flurry of answers---some of them like this "Oh, so you think I look gross" I was horrified and embaressed and also thought of quitting the board. Oh yes, I was also angry!!

I did pop on once or twice to see if the negative people continued on---but, they did stop and frankly, I needed the support that this board brought me, so I began to post again. The rest is history, as they say, here I am four years later as a Moderator on this board.

Remember too that just as you are maybe extra sensitive right now while in the midst of recovery---some folks are struggling with recoveries that might not be going well or family situations which make everything worse for them. I try to be tolerant and think 50 year old has got it right---just brush away or in our case, delete what you don't want to hear and move on---most of us are pretty nice and understanding.
 
Hi, all.
Well, I had my 14 week post-op today with my OS. It went pretty well! He acknowledged that I have a mild case of tendonitis in the quads tendon. He recommended that I continue with NSAIDs, as well as light compression (knee brace) and ice/elevation. He urged me to contact him in 6 weeks if the condition doesn't improve by then. He mentioned 2 steps back, 1 step forward. Sound familiar?

He said the knee felt warm, and that is a normal part of the healing process. I've always been somewhat of a slow healer, so I'm not surprised. I mentioned the other small shooting pains I occasionally have around the MCL, the kneecap and at the top of the tibia. He also said those are normal at this stage as the nerves and tissues heal. I didn't ask for any prescription for pain meds, and he didn't offer. I've been fine using just OTC pain meds the last few weeks.

He had my PT report, and commented that he thought I had done well in PT, and he felt there was no need for me to continue with any strenuous muscle building at this point, since I had demonstrated strength in the leg, and especially considering the tendonitis condition. I haven't been doing any of those types of exercises in the last 2 weeks anyway. He said that continuing with the exercise bike and ROM stretches are fine right now.

He measured my ROM, which was 125 unassisted, and he was happy with that. So was I. He explained how the knee still has quite a bit of fluid in it, and that my ROM will continue to increase up to a year or more. That also sounds very familiar, doesn't it? :)

He gave me the green light to get my upper teeth extracted. Interesting, he mentioned that he had been informed that the risk of knee infection due to dental work had been downgraded. Josephine, maybe the information is finally starting to make its way down through the ranks? He did still recommend that I take the course of Amoxicillin after the dental work, to err on the side of caution.

Oh, and he finished by saying that I should try not to obsess over the knee. :scratch: I think he meant that, since progress has been made, to try not to worry about it all the time, and to get on with my life and activities. This was very comforting, as I was a bit concerned about the tendonitis and the upcoming dental work. But I left the office with a nice, warm fuzzy feeling! He set the next appointment for 1 year post-op. May 2014 :egypdance:

Roger
 
Wonderful report, Roger! :happydance: I'm glad to hear that things are going well and that your OS is happy with your progress. Sorry to hear you have tendonitis. That's a bummer! :boohoo:

Keep us updated. I'd like to hear how you are doing. It is wonderful to hear from you!

Take care :flwrysmile:
 
Maria,
Thanks! Yes, it definitely made my day.
Fortunately, the tendonitis isn't so bad, just a little burning sensation in the quads from time to time. Definitely not a constant pain.

Cheers,
Roger
 
Hi Roger Nice to see you back you were missed. Hope they get that pain under control and things get more comfortable for you. I am not having to much pain anymore just on inner knee sometimes going to see my surgeon today this morning and see what he says. I am very happy with the results just over 90 degrees but think that it might be a bit higher since last massage as it is feeling like when I am walking it is trying to bend its on its own sometimes catches me a llittle off guard. Going to massage every other week now as recommended by massage guy Devon he says I have done really well not high bend might be all I get but told not to count the numbers just live and be happy. Massage has been the best suggestion made to me doctor hit it right on the button. I am very happy and feel like doing more things that I did before. Try not to think about it starting to feel like my own knee accepting it and actually think I really love it my left knee has to be replaced trying to take the pressure off left knee a bit as it is not strong but right knee is giving me less discomfort. Hope you have had enjoyment sailing your boat and that each day with life getting more back to normal we will get past all of this really soon also good luck with your tooth surgery Roger best wishes Holly
 
Holly,
Good to hear from you again! I'm happy that you are pretty much pain free and becoming more comfortable with your knee! And glad to hear the massages are working.
I'm still bothered a bit by the clicks and clunks. The doctor said this is normal, and they will either go away, or I will become used to it!
I haven't been out on the boat much. Just once since my TKR. I've been so busy with work and chores around the house which were neglected while I was recuperating. I hope to get out this weekend. My new avatar is a picture I took about 3 years ago off Alcatraz Island in SF Bay. It was a lovely day.

Cheers,
Roger
 
Hi Roger I think your avatar is nice. Hope you can make some time to have a nice bit of time with your boat. I saw my surgeon today happy with his reaction pleased that at this point past those days of unbelievable pain for now will see him next spring will kind of miss him he is a very patient man and has a kind way about him very caring. I am going to have massages till coverage runs out and by then it I will be ok probably another 3 or 4 more times. Did a bit of walking today had errands with my Mom and my husband and my leg is kind of tender tired but feel very content. Nice to hear from you wishing you the best Holly
 
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