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Bilateral TKR Second Year Progress

Josephine said:
It certainly is an NSAID, it's the same drug as in Diclofenac tablets. And what is more, it is about the most pernicious of them for causing stomach problems. Adverts will tell you that this topical gel 'bypasses the stomach' but this isn't true. The substance does get into the circulation and will effect the stomach just not with the same intensity as tablets do.
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Thanks for this, Josephine. I wondered if this prescription was in the nature of a little hand holding by my doctor, who seems to be making a good effort to support me during this time with the sensitivity to the sutures. Also, I can report that some of the itchiness and inflammation on my knees have healed. In conjunction with that, some of the stitches appear to have healed as well. There are only three that are problematic right now, two of which have not erupted but look like they might, and the one that has been juicy for some time. The latter has settled down quite a bit, but it is located right on my knee cap, so every time I move I can feel it. And it continues to ooze somewhat.

Best,

Mary Lou
 
Resuming tutoring (or any prolonged activity, even if only a few hours) certainly contributed to sorer knees. Your schedule doesn’t seem too harsh, though, so you’ll probably adjust soon. Just keep other activity to a minimum until your knees are settled.

Your neighbor sounds like a great resource. It’s so helpful to have people to talk with who have been through knee replacement. People who have not traveled this road have no idea.
 
mlwreader said:
but who fell and landed on that knee about a year after the surgery. She had to undergo another surgery to repair the damage,
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What happened to your neighbor's knee when she fell on it that caused her to have to have surgery? I fell directly on mine when I stepped in that hole and broke my ankle and foot. The knee fussed for about a month, but I figured that was because I couldn't use it because I was non-weight baring on that leg.
 
sistersinhim said:
What happened to your neighbor's knee when she fell on it that caused her to have to have surgery?
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Sisters: My neighbor apparently landed full force on the knee on the concrete garage floor, and that caused damage, plus a laceration, and they had to go in and do surgery to fix it. I get the sense it was like a revision, there was so much damage from the fall. We had all just moved in, so I didn't know her then, but from what she tells me it was pretty horrendous. It had only been a year since her TKR. She showed me the scar the other day. My knees are still so sensitive to touch I can only imagine what a fall on them would be like - yikes!

@SusieShoes how right you are that those who haven't traveled this road don't have a clue. I'm just so glad having done both at once that I don't have to go back in six months and do the second one. Shoot me now.
 
I fell on mine when it was less than a year old, but I fell on the ground, not cement. That's probably why I didn't damage it. I thank God that I didn't!

I asked to have both done at once, but my OS didn't recommend it because of my knees' history and weakness. I still have one to go, but am going to put it off as long as I can!
 
sistersinhim said:
I asked to have both done at once, but my OS didn't recommend it because of my knees' history and weakness. I still have one to go, but am going to put it off as long as I can!
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Sisters: I originally was scheduled for RTKR only, but developed another health issue that put the whole thing off for several months. At that time my left was ok, and diagnosed that it was not ripe to TKR, but probably would be in a year or so. Once the right knee was scheduled, I thought I was all set. Then one day I stood up to do something, and the pain I experienced in the left knee, the alleged good knee, was intense. So intense that I wound up in the emergency room and was sent home with a walker and pain pills. I now had two nonfunctioning knees. My doctor would not consider doing them both at once, and I had some other problems with him as well, which I talked about at length in an earlier post. So I got a second opinion with a friend's referral, and I liked the second doctor so well, and my friend raved about him, so I went with him. He thought there was no reason not to do both knees at once, because they were both so bad. That's how I came to have them both done at the same time.

I don't regret that decision at all. The operation and post surgery were all way more challenging than I envisioned, but for different reasons that I would have expected. The post surgery pain and discomfort are about what I would expect. It is my body's reaction to the surgical sutures and staples, and the length of time it is taking for it to resolve, that has tilted me sideways. I just don't remember reading about that possibility or even it being discussed with me prior to surgery. Probably because it is not a common thing.

If I had only done the one knee, I would be thinking the way you are - put the second off as long as possible. I agree with that, except both of mine were so bad I would not be putting it off for long. And I didn't want to undergo anesthesia twice unless absolutely necessary. Plus I live alone, and had to orchestrate extended family members to come and help post surgery. I felt that would have been difficult to pull off twice.
 
Hello BS members:

I had a terrible night last night. I remember reading about something referred to as "zingers" on this site, and wondered if I could get some information and feedback from folks.

Last night I was woken up a few times with intense short spurts of pain in the knee cap area - randomly in the right and left knee. It happened at least two times in each knee. Sharp enough to wake me up. Finally at 5:00 AM I couldn't go back to sleep. I am exhausted today after only about 4 hours of sleep.

I was thinking back on my activity yesterday, and here's what my day looked like: I had four hours of tutoring, which required me to sit at my desk. However, I was able to fit in 7 minutes on the stationary bike at no resistance, and a short walk in the fresh air after the first hour. Plus icing and elevating. Then I had two hours in a row, but was able to walk the second floor corridor of my apartment building in between those hours. Then later in the day I had my fourth hour of tutoring, followed by icing and elevating again. One other thing I did was walk down a flight of stairs very slowly on my way out for the walk.

The zingers just seemed to keep on coming last night, and I am thinking it has to be related to the sitting at the desk. Not sure what else to do to break those tutoring hours up. I really need the income, so I'm hoping this will ease up in time. I guess I'm also hoping some of you guys will second that thought. I wonder, should I ice and elevate in the middle of the night?

As for medication, I took a Tramadol right after my last student at 5:30 PM. Then at 10:00 PM I used the Diclofenac Sodium Topical gel prescribed by my doctor, which really seemed to settle the knee down before sleep. But then the zingers came in the middle of the night. I probably should have taken tylenol as well - I called my pharmacy this morning and they told me it was ok for me to take the tylenol while using the topical cream. I still have one problem stitch on the left knee and two on the right, and my gut tells me that some of this pain is related to my body working to get that suture material up and out of the knee. I have no evidence to support that, it just seems like as each stitch has healed, that area of the knee has settled down. Still those zingers are awful, almost like getting an electric shock.

Ok well that's a lot of information I just posted, and it is so helpful just to put it out there. Thanks, as always, for reading.

Mary Lou
 
I am so blessed to be able to wait until my left knee makes me get it replaced. And who knows? Since my new knee has taken over so many duties, maybe I'll never have to have it replaced!

Since you had no choice, you did what you had to do, and now both of them are done! What a blessing!
 
I suspect your connection of the zingers and your emerging sutures might be on target. Zingers are a word we use on this site (not sure if the term is used anywhere else) for the pains, like electric shocks, caused by the reconnecting of superficial nerves that were cut during surgery. That same kind of superficial pain could well be caused by your sutures pushing themselves out.

If you want, we could change your title —or you can easily do it yourself— to include the word Zingers, which will draw responses from people who’ve had them.

https://bonesmart.org/forum/threads/changing-your-thread-title.26369/

I only had a few zingers, but can attest they are powerful!
 
I never noticed any connection between anything I did and when I had zingers. Luckily they were fairly short "firestorms" for me.
 
Way to go, @mlwreader!

My zingers came on for no reason what so ever. I could be sitting there minding my own business and then all of a sudden...OUCH!
 
I like to think of my zingers as a positive thing. Nerves knitting back together, waking up and testing the new connections. Not altogether sure that is true. But it seems to me that I'll have a hard batch of zingers for a week or so, then they will ease off and maybe take a little of the numbness with them. Until the next batch starts. Im 5 months out and still have a few zingers now and then but its much less frequently than a month or two ago. I think many of us have them and mine seem to act up only when I'm down on the couch for a couple of hours or less frequently at night. I never seem to notice them while walking around. Think positively. It means you are healing.
 
Well, the zingers have settled down for now. In fact, the past couple of days everything seems to have settled down. I am noticing improvement in the worst of my stitches, the nighttime pain is so reduced I didn't even take tylenol at all yesterday, and I am just generally more comfortable. I am coming to realize that this healing process is two steps forward for a few days, then maybe one back for a bit. Netting out to improvement overall, just slow and steady. I have another doctor appointment this Friday before the holiday, so we'll see what my OS has to say.

Another issue for me has been my emotional status. In the beginning after surgery I had many, many days of tears and feeling depressed and mentally just awful, interspersed with hopefulness and joy. Lately there has been much less up and down, but I am still having some emotionally charged feelings. The majority of the time I am not down, but all of a sudden the tears will come over me. Part of the process I guess.

I think the holidays add to the mix. I don't feel like I can travel just yet, so I am not going to be with part of my family like usual. However I will be seeing the other half of the family on Christmas day, and that is great.

Here's a miracle: This morning I took a load of wash to our community laundry room, completely pain free, no walking aids, marching down the corridor like a normal person, laundry in tow. Now I am upstairs after the load has been washed and dried, and I am thinking back on what it was like to do laundry pre-surgery, when I was confined to the walker. I had to mentally gear up for the pain, gather the laundry and sling it onto my walker, take my water and phone and a book with me because the pain was so bad I couldn't come back upstairs between the washer and dryer process, so I had to stay in the laundry room. And then when removing the clean clothes from the dryer, I moved slowly, had to lean on the walker or have it close at all times, and when finished, move painfully down the corridor and up the elevator to my apartment. And when inside my unit, I had to lie on the couch or the bed for some time to recover from the pain, before I could even think about putting the clothes away. Just a small slice of life, doing the load of laundry this morning, but what a difference it makes in quality of life. How blessed am I?

Happy Sunday all!!!!!
 
Being able to do the laundry without pain is a huge step forward! :yes!: :santaclap::dancing:
 
As if having stitch absesses from sensitivity to suture material isn't weird enough, I am now told by my doctor that I developed a topical fungus infection at the site of the healed absesses. He was not terribly concerned, other than to warn to be careful to wash hands after treating so as not to spread it. Sends me to CVS pharmacy to purchase over the counter topical fungal cream. When I asked the pharmacist about it, she directed me to the . . . . . athlete's foot area for heaven's sake. And the ointment box discusses athlete's foot and jock itch. What do I have, jock knee?

I went to WebMD and learned that this type of infection can become a problem after taking antibiotics, among other reasons. Well I've had three courses of those, three different kinds, all oral, since my surgery in September, so that may be the reason, I'm thinking. I am still having intestinal difficulties so I know they affected me big time. And the first two were prescribed when it was thought I had developed cellulitis. So they were strong. (The doctor has revised his original diagnosis of cellulitis to a reaction to the staples and irritation to the sutures and resulting infection. I never developed a fever or had any intense pain other than post-surgery pain.)

Since beginning treatment with the anti-fungal cream Friday night (today is Tuesday) I can say that the affected area has shrunk, and the awful itching has calmed way down. Has anyone else ever experienced this? I'm guessing not too many, because not too many bs'ers had heard of stitch absesses developing at 8 weeks, like mine did. @Josephine have you had experience with this or heard of it?

Other than my ongoing skin issues, I am feeling great, I can report. I am filled with joy at being able to walk places, do ordinary living tasks without having any knee pain or without having to strategize how I am going to be able to get things done while coping with pain. Things like walking the main street of the very picturesque beach town where I live, window shopping and seeing all the holiday decorations, going to the library, grocery shopping for Christmas brunch, standing on my feet cooking Christmas brunch, walking to the park with my grandchildren and son, all of it pain free. Now my leg muscles get tired, because they have not been used like this in at least the past year, and only with a walker in the four months leading up to surgery. And my muscles behind my knee and my quads all need stretching and strength training, because I do tire out. However, 30 or so minutes elevating and icing does the trick.

And no more zingers for a bit, plus I don't dread nights anymore because the nighttime post-surgery pain has settled down so much. I am so very grateful, I feel like I have a new lease on life. Such freedom to be able to walk. I feel like I have so much more awareness of what folks with physical disabilities need to do to navigate life. I don't even have a handicap sticker anymore, as mine expired and I frankly don't need it anyway. Plus have you noticed how much more difficult it is to find a free handicap parking space? They are always full up, it seems.

I hope everyone had a lovely holiday. I have been reading many of the posts on bs, and enjoy reading about all the camaraderie and affection that is so apparent here.

All best.
 
mlwreader said:
When I asked the pharmacist about it, she directed me to the . . . . . athlete's foot area for heaven's sake. And the ointment box discusses athlete's foot and jock itch.
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Well athlete's foot is a fungal condition! What's the diff? Funnily enough my own sister asked me to day that she was told by her GP to use Canesten for a skin issue but when she got it, it said it was for athlete's foot and like you, she was mightily perplexed! But a fungal infection is a fungal infection, after all.
mlwreader said:
this type of infection can become a problem after taking antibiotics
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Indeed it can! And if you find it affecting you like that then you should try taking some pro-biotics. You can get it in natural form or in yoghurt. Personally I preferred the capsules which I got from a health food shop.
 
Josephine said:
Personally I preferred the capsules which I got from a health food shop.
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I am now taking the probiotics so I'm so glad to see you recommend them. How will I know when to stop the anti-fungal cream? It's getting harder to see the fungal irritation because there is already some redness from the healed absesses. I'm still seeing some flakiness so I know now is not the time to stop. On the box of the medication it says 2 weeks for jock itch and 4 weeks for athlete's foot. Somewhere in that general time frame I would guess, do you agree @Josephine? And bless you for your help and encouragement.
 
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