TKR Suggestions needed for “tight band” feeling

[Stiff knee NC]

@Mamie: how are you doing? Hope you are feeling better! Did you get that compression sleeve or did something else help?

 

[Mamie]

Hello Stiff Knee.

The compression sleeve arrived today along with compression socks so I will try them today after my morning coffee.

Good news. Although my swelling is still bad, I have continued to work on my bike getting up to 30 minutes three times a week. I cannot yet make the circle my ROM is now at 100 degrees. My surgeon had said he wants 125 by Monday but I am not sure that will happen by his timing with my knee so huge but it get there. As I have said all along, I am happy at any degrees. I was 60 degrees for 14 years and hardly anything after surgery so I couldn’t be happier.

How are you doing? I’m sorry I have been missing in action but I have been busy with writing assignments.

Thank you again for the leads. !
My prayers are always with You and my friends here.

Stay Safe and keep on gaining ground.

Good night,

Mamie

 

[Stiff knee NC]

@Mamie: SO good to hear from you AND your good news re ROM and being able to bike 30 mins!!! It took me 6 weeks to be able to make the “full circle” while biking. I would be so frustrated and in pain... I sometimes would just cry in PT. But one day... I could just do it! It will happen for you too!

What kind of bike do you use? It sounds like it has really helped! Hope the compression sleeve and socks are equally helpful...

I get my nerve block tomorrow. I’m really scared of the pain (altho he will numb it... and it’s GOT to be less painful than what I’ve been through already!). Really hope it helps.

I also had my blood tested again to make sure no infection/inflammation. It was 7 months ago since it was last tested. Additionally I had blood drawn for some expensive (out of pocket) blood testing at a Chicago lab. It is checking to see if I’m having any allergy/sensitivity to the metals in the implant. Sure hope it comes back with no issues...

Thanks, again, for your prayers! You and several other friends who’ve been through this are in my daily prayers too.

Continued healing and progress!

 

[Mamie]

Hello Stiff Knee NC

I am so sorry you are in such pain and will pray today goes well for you and your blood work. That would not be nice to have an allergy.

I have been having awful pain in my thigh, the inside part of my knee and the one part of my incision that does not want to completely close. It seems some of us just have trouble feeling good again. I am so happy to hear you made the circle on your bike. I use a recumbent bike and can send you the information if you like. My surgeon told me to raise the seat and I could probably make the full circle.

My blood test are today as well. They are rechecking the possibility I am harboring an infection inside the knee replacement but I am thinking positive about that! I will check back in on you in a few days so maybe you will have the results and meanwhile I will keep you close in prayer. Thank you for praying for me too. If only this swelling would go away and stay away, it would be easier to accept the rest.

Stay positive and I am sending you up in prayer as you have suffered so much longer than I and my heart aches for you. I have missed hearing how so many are doing...all we have are each other and our close family and friends...so hang in there my friend.

Mamie

 

[Stiff knee NC]

@Jamie: just today I received the results of my Metal-LTT Analysis blood test (from Orthopedic Analysis, a lab in Chicago). It showed that I am highly reactive (4.1, 3.7 and 10.1, respectively) for nickel in three areas (out of a 15-point Lymphocyte Stimulation Index). (All other metals/cement/etc were below the “mild” reactive readings.) Talked to my surgeon, who said it may explain my tightness/pain...but may not. He does not recommend a revision but said that this is something that we’ll have to keep an eye on.

I’d appreciate any feedback! Next week I have my appointment with an orthopedist at a university medical center. Anything you recommend I ask?

Thanks in advance...

 

[Jamie]

You are wise to get a second (or maybe even more) opinion. My main question with what you heard from your original surgeon is, what exactly is he waiting to see? When you see your next doctor, ask these types of questions so you know what you're supposed to be looking for or expecting:

1. If you are just going to "keep and eye on" the knee, what exactly might he expect to happen if the metal sensitivity was a issue? And what does he expect if it is not an issue?

2. What severity of pain and stiffness is the point at where a revision should be considered?

3. Communicate with him the impact this is having on your daily activities. Is it getting worse? Better? What makes it better or worse? And does he have any suggestions for non-surgical treatments to improve things?

4. At what point in regard to curtailing daily activities should you consider a revision?

5. If a revision is needed, what implant would he recommend and why?

Your original surgeon is correct that there is not a 1 to 1 correlation between these readings and problems with a knee replacement. But it does provide an indicator of what might be contributing to a problem if the sensitivity is causing inflammation in your knee.

Good luck and let us know how the appointment goes.

 

[Stiff knee NC]

@Jamie: Many things to think about and great questions to ask. Thanks!

I should have mentioned two things: I had the nerve block... only noticed slight improvement in bending. Surgeon still encourages me to get a nerve ablation.

And re “keeping an eye on things” he meant that looking at my yearly x-rays, he will look for any loosening. Not sure if loosening is related to nickel sensitivity tho?!

He added that if I ever need a joint replacement (other knee, shoulder, hip) he would NOT use one w/nickel and would use one that’s hypoallergenic (made of ceramic, I believe).

One question that I wish I would have asked him is: is the level of nickel in the implant so low that, even tho I am reactive, it’s not likely that it’s causing my tightness and pain? I have the list of components from Zimmer and have sent it to my second opinion dr for my Wednesday appointment.

I honestly hope my second opinion doctor agrees with my surgeon about not having a revision...it will be very difficult to have completely different points of view!

Will update next week!

 

[Jamie]

Not sure if loosening is related to nickel sensitivity tho?!

I don't know the answer to that, but I've not seen any studies that indicate there is a direct correlation. The whole subject of metal sensitivity is still a bit up in the air. However, I have known of people who found they had a sensitivity and, once they got a revision to an implant that lessens that potential problem, their pain and swelling improved. It's definitely an area that needs more research.

 

[Stiff knee NC]

@Mamie: how are you and your knee doing? Hope the swelling has gone down, that your pain has lessened AND that your blood test results came out ok. And that the one spot (on the incision?) that stubbornly doesn’t want to heal will get with the program!!!

As you might have seen, my metals test showed I’m highly reactive to nickel. They are not sure tho that that’s causing my pain and tightness. So another puzzle piece but nothing (sigh) definitive. I go Wednesday to get a second opinion on that... as well as whether to get a nerve ablation.

Has the compression sleeve made any difference? I sure hope so!!

Just know that I’m thinking of you and continue to pray for your complete recovery!

 

[Daneez]

Hi Stiff Knee! I'm thinking about you with your appointment tomorrow. I've been following your posts. We are on a somewhat similar track, unfortunately. I just posted an update on my thread.

What a journey. I thought Jamie's questions for your appointment were good ones, and I copied for me to ask at my appointment next week.

Take good care!!!

 

[Stiff knee NC]

@Daneez: oh my, I’m SO sorry. I need to scoot over to your thread and see what you’ve been up to! If I can figure out how to follow you, I will. And there’s a new update on my knee situation: I’m abt 99% certain that I tore what’s left of my meniscus in my RIGHT knee last week. I’m beside myself! (Have had 2 previous meniscus surgeries on it.) Take care!

 

[Stiff knee NC]

@Daneez: hope you and your knee are doing better than the last time we wrote! Remember that my blood test showed that I was highly reactive to nickel? Well I got my skin patch put on my back on wed and the dermatologist basically Pooh-pooh’d that blood test! I had the patches removed today and my husband says there are two red areas (that have been the source of some burning and even more itching) on my right shoulder. I will find out Monday what I’m allergic to... will be interesting to see if you and I have the same results. (Your skin patch showed a reaction to titanium, right?). I’m curious what your surgeon said abt your test results and what he/she would suggest for any future surgeries....

 

[Daneez]

Both doctors I saw this week do not think allergies are the cause of my issues. I'll be curious to see what your test shows. (I updated more of what the doctors said on my thread.)
take care!

 

[Stiff knee NC]

An update: my skin patch test was negative for everything as far as an “allergy.” The nickel in two strengths were negative. I showed an “irritation” to vanadium.

The dermatologist said that she doesnt factor in the results of that blood test (that showed an allergy to nickel) because it doesn’t pick up a “level 4 reaction”... only a skin patch does... for someone with an implant.

My nerve ablation is scheduled for Dec. 11. That’s my last hope, unless I heal naturally. Or a revision, which I’m in no hurry to have done!

 

[Nancan]

Hi!
I am curious... have any of your Doctors prescribed Gabapentin ? I have been on it for about a month and have experienced a lot of pain relief. Just a thought

 

[Stiff knee NC]

@Nancan: yep I’ve been on it in the past for maybe 3 weeks...can’t remember the mg...but it didn’t help me.

I should have added that I still have the same aggravating tightness. Hoping that that will go away with the nerve ablation...

 

[Jamie]

I hope the ablation works for you. As you’ve probably realized by now, some of these post-op issues with stiffness pain can be quite difficult to figure out and get resolved. It’s frequently a process of elimination and sometimes even that doesn’t work. That’s one reason we encourage people to continue to pursue additional opinions. Sometimes having a new set of eyes on the problem helps. I’ll be looking for your post after the procedure. Good luck!

 

[Stiff knee NC]

@Jamie: Thanks! I definitely will post next weekend

 

[Stiff knee NC]

Had my nerve ablation last Friday. Oh my... those approx 2 minutes of the ablation were some kind of intense pain. Took a good nap afterwards. I must say the tightness is lessened by at least half! I’m still taking it easy (not exercising, etc). I’ve been told it could take up to 3 weeks to fully be effective. For the first time in a long time, I’m hopeful!

 

[Jamie]

This sounds promising and I hope it does work for you. I'll look forward to hearing how you're doing the next few weeks. Hang in there!