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TKR "Super Hero" knee #2!!

I was taking oxycodone but never felt any type of withdrawal. By week 4 I was forgetting to take meds and sleeping through doses, so I began cutting pills in half.
 
Each knee is different. Hang in there.
 
@Josephine, @Celle, @pumpkin...or anyone out there!
I need advice, support, or even a pep talk, please!

Before I begin with the main issue here's an update on meds: everything is going smoothly, pain under control, and my doctor was wonderful in offering her support, reassurance, and stressing the need for proper amount of pain medicine, especially in the early part of recovery. The article from Celle on medication, and my doctor's talk have really calmed me down! Thank goodness!!
My knee is bending at 95 now, extension measured at 5 yesterday and 0 a week ago (?), but I don't worry about it because overall doing great.
The most upsetting thing right now is my scar!! When they first took the bandage off a couple weeks ago, I was shocked at the mess! It was puckered, jagged, creased, and it was sticking up because it was as thick as a ring finger!!! My husband joked saying it looked like the thick stitches on a cadaver. We pointed it out to the assistant, but he just shrugged and said it looked fine to him. We laughed it off then, thinking it was just swollen and it would flatten out in no time. Needless to say it hasn't!
Friends and family have commented on how different it looks this time. Home PT and my primary Doctor looked at it too, but didn't say anything because I think they were more worried about the pain and my mental state over meds!
However, yesterday was my first appointment at outpatient therapy. I know and like my PT, Jessica, because she worked with me on the recovery of the RTKR. She really is a great therapist who follows so much of Bonesmart mantra, even though she had no clue what it was when I asked if she was familiar with it! Lol!
So imagine what I felt when she confirmed my suspicions that my scar was not right! First words out of her mouth after greeting: "Did you go to different Doc...because this looks like s--t!!!
Well it was same Doctor, but new assistant! After evaluation and some massaging and stretching, she called over other therapists. Together they came up with plan to try to flatten and "fix" my scar. They are trying taping first. I'm so hoping it works. I've been upset on and off since yesterday because here is one more thing gone wrong with my second knee!!!
Sometimes I feel I'm making too much of it, yet the therapists assure me it is not the norm. They've only seen one other worse than mine. I only have my other scar to compare it too, and, yes, it looks totally different! One is professional while the other is amateurish!! I definitely feel more self conscious about this scar. We've had very warm weather, so I wear comfortable shorts out. Whereas before I got glances, this new scar brings outright stares. It is very noticeable when it sticks out half inch above your knee! I just want to cry!
I don't know whether I should call the OS and talk to him about it. He hasn't even seen it since his assistant does the two week post-op and the OS does the six week post-op. My husband thinks I should bring it up since its his name on that surgery and he should be checking for quality control in all aspects of the surgery. I don't know what to do!!!
I feel dumb after reading this over considering the more serious things going on with fellow members on this site. I'm not a vain person. I knew I would have scars and did not feel bothered too much about it, but this one is making me so self conscious. Help! I'm a mess!

Here are some pictures. The taping the PTs did (notice the scar bulging out) and a top view. Unfortunately , I don't have a side view of the scar. This doesn't look so bad in the photo, but believe me, in person it looks like mountains and peaks on a world relief map!

Sorry, I keep getting an error message when I upload a photo. I will keep trying







11 July, 2016
 
I don't think you're being silly at all. I do have a terrible scar because of the double surgery and get a lot of stares from children mostly. I've joked about getting a shark bite tattooed around my scar, but I'm too much of a wuss to do that?

There are people who develop keloid scars. So a photo would definitely help Josephine. Here is some info on scars.

https://bonesmart.org/forum/threads/scar-abnormalities-keloid-and-hypertrophic-scars.5779/
 
I don't think you are being silly, we all know that we are going to have a scar but I feel that the surgeon has the responsibility to make the scar as minimal as possible, when I choose a doctor I expect him to perform the surgery from A thru Z, my doctor is the only one that worked on my knee, he has an assistant but the OS is the one that sutures. I think you should call your OS.

My OS told me that at six weeks, once my scar was totally healed, I could use Mederma, I use the one with SPF 30 during the day and Mederma PM intensive overnight cream at night. I have been using for 11 days and my scar is totally flat now, I really notice the difference!
 
Well, I've tried uploading a photo all afternoon and it gives me a message "server failed." Any suggestions, experts?!?

@KerriB I don't think mine is either type of those scars. Rather, it is Doctor ( or assistant) error. They pulled the sutures so tight that it puckered and made a thick ridge as thick as a finger in the middle of the scar. Top half of the scar is raised and the bottom half looks okay.

@uva55 I totally agree with you! I just had the right knee done by the same OS 4 months ago. That scar is so thin and flat!! We were under the impression this would be the same, but my husband says an assistant came out to let him know that OS had moved on to next surgery, but that my replacement had gone well, and I was being sutured closed. I am going to call, plus I see him in two weeks. He won't be pleased because his name is definitely on that scar even if he didn't actually suture it. I don't know what can be done, though. Almost feel it's too late for me. I'm just counting on the physical therapists to come through. It will never look as nice as the first, but I'd be happy with flat instead of an ugly raised, puckered ridge!! [emoji30][emoji30]





11 July, 2016 LTKR
29 February, 2016 RTKR
 
Is there a chance the puckering will settle down? My PTs would massage the scar and knee with Palmers Cocoa Butter. What are the PTs planning on?
 
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Don't feel dumb or vain, I think it's completely normal to be worried about how a scar looks when healed. I hope your OS can reassure you and your scar settles down.
 
@KarriB,
They did massage with cocoa butter on my first knee also, even though the puckering was minimal, but they said it's too early to start massaging this scar. I need a couple more weeks of healing before they can start that.
For this knee they used kinesio tape ( a flexible stretchy athletic tape) in a crisscross pattern to put tension on the scar, and hopefully flatten the bulging. They usually use it on patients to help temporarily stabilize injured muscles. For my right knee she would put it on either side of my knee to help my IT band. One of the therapists used it on only one other patient whose scar looked like mine. She said it worked wonders! So I'm really praying it works for me!!!





11 July, 2016 LTKR
29 February, 2016 RTKR
 
@kneeper
Yes, I have seen those scar photos! In fact, my beautiful scar is #620. I have been trying to upload this recent scar, but I keep getting an error message. If you could see the difference, you would agree that they did a terrible job suturing the new one!


11 July, 2016 LTKR
29 February, 2016 RTKR
 
Definitely too early to put anything on that scar. Hopefully the tape will work, but I'm sure you'll still talk to the OS.
 
I just wanted to send you positive thoughts. your journey sounds just like mine except for the ugly scar part. I too had the same surgeon first knee great the second a nightmare with no pain control and i suspect my OS PA did more in the surgery than i thought. When my pain was out of control of course my surgeon was gone by then and "Corey" the PA came in and pulled out my drain like that was going to fix it.
I hope you are doing well and your scar can be your badge of honor. their all kind of out there anyway right? :)
 
@ Kneewords
Thank you for your kind words. I, like you was very disappointed to have had the PAC take a bigger role in my surgery. We later found out he had only been working for the OS for 3 months. Just my luck that his previous assistant, and the one who sutured my first incision, is now a Nurse Practioner and is working elsewhere, and left this practice a month after my first surgery. Ugh!
I'm just hoping the PT will be able to flatten it out.
I'm so sorry to hear about your experience with pain. What role did your OS assistant take? Did he take part in the actual replacement? I know mine did not! Thank goodness for that!


11 July, 2016 LTKR
29 February, 2016 RTKR
 
I hear your scar is doing better yay:yahoo:. Im not sure what my PA did honestly but he was supposed to be the one "on call" i called a couple of times and he would just act like nothing was a big deal. I don't even know how someone who is a PA is allowed to be a part of surgery. I am so disgusted with my first surgeon i know i not the only one with a bad outcome from people i was in therapy with after my TKR.
 
Kneewords,
No, scar not better yet, but therapists working on it and hoping it will improve.
I emailed my OS through an app called Health Loop letting him know how dissatisfied l was with the work. I even sent photos. But, guess who answered? Yep! The PA! Said I was not giving it enough time to heal! I didn't respond. I don't even know if OS saw the email. I'll just have to wait till I see him personally.
I, like you, also met two people in therapy who had surgery same day as I did with the same surgeon. They weren't happy either! Can't believe things changed so quickly within months of my first TKR!


11 July, 2016 LTKR
29 February, 2016 RTKR
 
i just think its crazy a PA can be that involved and i know i didn't even meet mine till he pulled my drain out in the hospital. its nuts! my TKRs were over 10 years apart i thought the first one my OS didn't spend enough time with me but compared to the second TKR it was way more. EXAMPLE he would come in and literally spend 2 minutes would look at the X-ray and say you're fine. one time his phone rang he answered it and walked out of the room after 1 minute didn't even say good bye just left! I never did see the PA again i have visions of Greys Anatomy where the intern did all the surgery ! but at least on that show it was an intern not a PA!! Hope you're hanging in there keep the faith and be good to yourself
 
PA story-an infectious disease PA was visiting me everyday in the hospital and transition unit. I also saw the ID Doctor, but for some reason the PA would come in, each time suggesting my infection was MRSA. This petrified me. The first time she mentioned MRSA I asked if the cultures had grown showing it was MRSA, the answer was no. The second time the same scenario took place and then a third time, at which point I asked her not to return. I told her I didn't need her coming into my room, scaring me with no evidence or results. The next day I was in pt/ot just chatting because I wasn't allowed pt and who should walk in, the PA took one look at me and turned around and walked out. The pt/ot staff were dumbstruck! I have had very good PAs, but this was not one of them.
 
@KarriB
Good for you! Glad you put that OA in her place! Sometimes they are over eager to participate and diagnose!! My particular PA whipped out a prescription pad, during my 2 week post-op, and was eager to write pain medication prescription for me. I said "No , thanks, my Primary Doc taking care of my post op pain management. He was not happy, but I don't care.
It was such a hassle the first time being in contact and getting meds from the OS because he's 11/2 hour drive away that I just had my Primary take care of me. Works out so much better since she knows me better than the surgeon.


11 July, 2016 LTKR
29 February, 2016 RTKR
 
I am in no way excusing any doctor for allowing others to do part of what should be his/her job, we all expect our surgeons to handle our procedures from beginning to end, however part if the problem is the insurance carriers and their reimbursement, for example, my OS billed out $8097.00 for the tkr, my insurance carrier paid him $1975.00, in my opinion that is ridiculous, it is way too low, so doctors are forced to do more procedures in one day, or spend less time with patients in the office because they have to over book and allow other staff members to pick up the slack. These days doctors need more staff to handle all the referrals, authorization, and fighting with insurance carriers for the reimbursement they do receive. So the patients pay the price by not receiving the quality of care we deserve.

I was so very fortunate, my OS handled my TKR from beginning to end, the PA was the one who visited me in the hospital and remove the drainage tube, after my surgery I only saw OS once in the hospital the evening I had surgery and each time I see him in his office he takes his time answering all of my questions!!!

Again I am not excusing them, they chose this profession and all the good and the bad that comes with it!!!
 
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