TKR Timetolive's Nov 9th TKR Post -OP<<

[Timetolive]

Good morning. Well, we celebrated too soon. At least I had 2 days of normalcy. I am going to double down eliminating foods and seeing the reaction.

We are going to have snow! I am so excited. I wonder how Ralph will take to shoveling snow? Our drive is a hill, so we shovel it, then we do our elderly neighbor's drive and walk also. Perhaps I will just build a snowman and observe my husband working hard! Hahahaha! No snow angels, I am afraid I would never get up!


@Josephine, I have a sharp pain when rising or bending my knee that morphs into an ache when sitting. It is on the medial side of my kneecap near the top. If I am looking at my leg from a sitting position with it straightened out, it is in the 7:00 o'clock position. It has been there for about 6 weeks. I feel I injured something doing the leg press machine at PT. When it happened, I immediately stopped, told them, and never did that again. What is in this area? If I injured something, how long does it take to heal? I have moderate swelling over the area (I have a very large leg, so it is hard to see swelling) when I do too much activity around the house. I have stopped PT and I am riding my recumbent bike @ 15 min a day with no resistance per OS instructions and doing heel slides (10, 1x) and just basically moving with chores around the house (I DON'T do the heavy stuff -just cooking, laundry, dusting, and picking up the endless clutter ). I ice whenever I am sitting and use heat twice a day - again per OS instruction. I am on ES Tylenol only when the pain is too much. (Still recovering from an acute diverticulitis attack - diarrhea/loose stool going on 6 weeks now, so not putting anything extra in my body). Any ideas what this could be? What can I do to help it along? Thank you in advance for taking the time to help me.

 

[midwest girl]

If I were you I wouldn't shovel snow. Have your husband do it or hire someone to do it. Last winter I was 6- 8 months post op and shoveled snow on my long driveway. My tka knee did not like it. Our snow is heavy wet snow (and drifts) and you will be surprised how much you use your legs to lift. So if doing chores around your house causes your knee to swell, shoveling snow will as well. Especially at 10 wk post op! It's not worth it. This winter I hired someone to move snow for me. And I'm so glad I did.

 

[PegGar16]

Aren't there any neighborhood kids that like to make money shoveling snow? Shoveling would be brutal on your knee.

 

[macduf387]

@Timetolive Janis that is fabulous news I new you could do it.
Now for a little normal in your life

It just feels great to feel normal again and accomplish things we are used to doing.

Agree with @Celle I had no problem with the Xarelto and liked that I only had to take one tab a day and not have blood tests all the time. It just once again shows how different we all are and how we react differently to meds.

Have a great rest of the week.

 

[Timetolive]

Thanks all! I was not serious about shoveling. I probably will just watch from the window. There is NO way I want to fall!

 

[Timetolive]

Madeleine and Celle, I know Xarelto does not cause many people any problems. I am glad! It is nice not to have to have your blood checked and be able to eat Vitamin K foods. I was happy that I was prescribed it at the time. I think some of us are just very sensitive to certain drugs (goodness knows I am sensitive to everything!) and it truly caused me a lot of problems. I feel like I lost two weeks due to the excessive bruising and swelling. It took the full 9 weeks for my leg to be a normal color and at times there is still a darkness to it. There is another person on here that had a large hematoma as a result of the Xarelto that had to be removed surgically. As in all drugs, we should be aware of the side effects and not be afraid to speak up if something is amiss. I have friends that are on it (due to heart conditions) and are doing well. At least I was able to pass along those drugs and not waste all that money! My stepdaughter works for Glaxo Smith Kline and my granddaughter is in the Doctor of Pharmacy program at USC - we have LOTS of drug discussion in our home! Hahahahaha!

 

[Celle]

I agree with you, too, Janis. There is no drug that suites all people. There will always be some people who react adversely to any drug. Unfortunately, you reacted to the Xarelto.
Individual differences in reactions to drugs are one of the main reasons why I believe that doctors need to be open to adjusting prescriptions, to suite each individual.

 

[Glamg1979]

When I asked about heparin or xarelto my OS told me studies showed that the blood thinners can cause more problems post-op such as what you experienced and excessive bleeding at the surgical site and possibly infection from the pooled blood. One or two aspirin daily was found to be just as effective without causing those problems. Certainly I can see using it with patients that are high risk or have a history of blood clots, but I was extremely relieved I didn't have to take it. I do find it interesting reading about all the different approaches the OS's use. CPM vs. No CPM, aggressive PT, no PT for a month post-op, strong opiods vs. tramadol/Tylenol, etc. But what is important that in the long run we all have the desired outcome

 

[Timetolive]

@Glamg1979, that is so true about all the different modalities! It becomes very confusing at times knowing what to do! The difference between PT in the states is really in contrast with PT overseas. Our journeys are all different and yes, we hopefully arrive at the desired outcome. It is really nice to have someone to walk with you here on Bonesmart!

 

[Josephine]

Any ideas what this could be? What can I do to help it along? Thank you in advance for taking the time to help me.

@Timetolive, in order to advise you properly, I really need to ask you some questions if you don't mind, and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't compare this with the bone-on-bone pain you had before surgery! ) Also don't forget to include other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how often are you icing your knee and for how long?

4. are you elevating your leg, how often and for how long?

5. What is your ROM - that's flexion (bend) and extension (straightness)

6. how swollen is your leg?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. what kind of PT exercises and exercises at home are you doing? How much and how often?
This is the most crucial question so please help me by using the format I have left as an example

Exercises done at home: 3 sessions a day
Heel slides x10 (reps)
Straight leg raises x10
Steps x10

At PT
Squats x5 (reps) x2 (sets)
Wall slides x5 x2
Clamshells X5 x2

 

[Timetolive]

@Josephine

1. With use of the leg, the stabbing pain becomes an 8, then settles into an aching 4.
2. I am only taking an 81 mg aspirin daily. I take 1 ES Tylenol perhaps 4 times a week at night. Josephine, I am VERY sensitive to medication and prefer to not take anything as I WILL get the side effects. No NSAIDS per the urologist and gastroenterologist. I had kidney stones and very elevated liver functions prior to surgery. Urologist doesn't want me taking much Tylenol. I wrap my knee at night with the Saran Wrap to make it comfortable.
3. I am icing twice a day for at least an hour - until the packs are no longer cold.
4. I elevate while icing ^^
5. ROM was 118 and extension was anywhere from 3-8 depending on who measured.
6. Moderate -as I stated, I have a heavy leg and the swelling is mostly what I FEEL - not see. The knee swells on the front over the area I have described as painful.
7. I cook - simple things, no big Sunday dinners, do laundry, dust, light stuff. My husband helps a great deal with the heavy things.
8. I have stopped formal PT after it was just becoming too painful.
Recumbent bike: 15 min with no resistance - slowly
Heel slides: 10 before getting out of bed to get the knee going.
After my shower while the knee is loose, I try to bend it until I feel pressure, hold it, then do that twice. Then I try to straighten the leg and hold it and release it - twice.
That's about it right now. I had in my mind that this place needs to heal?

Thank you.

 

[macduf387]

Hi Janis oh boy it's the roller coaster ride again. Hope you nice and warm and inside watching the snow, I was watching the weather report for your side of the nation and it looks like you guys are being hammered. Stay safe.
I hear you on the meds it's just like I am ultra sensitive to dilaudid/morphine in general. That's why we are all different and respond differently to stuff.
I was just reading your response to Josephine and personally think you are not icing enough. I still use my ice. Machine every night on my knee. It really helps, I wake up and start with very little swelling and at the end of the day it's nice to attach the ice machine.
Take care have a great weekend.

 

[Timetolive]

Thanks @macduf387, Madeleine. I really only have swelling when I have been up on it a LOT. Then, I ice. The area of pain is what I just really would like identified and know what to do with it. If it wasn't for that, I would be very happy with my progress. I think my knee is right on track with where it should be - other than this painful area!

 

[smarttoys]

The area of pain is what I just really would like identified and know what to do with it. If it wasn't for that, I would be very happy with my progress. I think my knee is right on track with where it should be - other than this painful area!

Hi Janis,
I had a few painful areas early in my recovery that I felt were holding me back. I kept telling myself that if it weren't for that pain I would be doing great. When one area felt better a different pain would pop up. I would say the same thing again. If it weren't for that one pain I would be doing great. Thankfully many of my pains are finally fading away. Hopefully with some rest and healing your main area of concern right now will get better and no new ones will pop up.

 

[Timetolive]

@smarttoys, Thank you John. I can almost pinpoint when it happened. The pain was incredible and it was at that time when I was REALLLLY sick with the diverticulitis. (The nausea, vomiting, etc.) I stopped and told the PT that he needed to go get my paperwork for the doctor ASAP because I was going to throw up. I sat there on the machine, my husband happened to come in to pick me up and rushed down there since I was holding my head in my hands trying to maintain my dignity in a gym full of people (my PT was in a gym). Now, it is funny - not so then. I was on the leg press machine and PT had lowered me past the point of quads being parallel to the platform. It had to have done some damage for the pain to be so intense as to make me almost throw up. It has been at least 4 weeks, and no improvement. Although, I was still going to PT all that time and not letting it heal.

How are you feeling now? Did you go back to work? Get the stool sorted out?

 

[smarttoys]

Janis,
I hope your painful area is nothing serious and hopefully another week or two of taking it easy will calm it down.

I'm not back to work quite yet. Jan 26th will be my first day back and that will put me a day over 10 weeks out. I've been stopping in at work once or twice a week just to keep tabs on things. I've tested out my high stool on wheels a couple times and as long as I keep it on the cushioned mats in my work area it shouldn't roll away from me like what happened to midwest girl. I would sure hate for that to happen.

 

[Josephine]

1. With use of the leg, the stabbing pain becomes an 8, then settles into an aching 4.

Ouch!

2. I am only taking an 81 mg aspirin daily. I take 1 ES Tylenol perhaps 4 times a week at night.

Oh poor you! Unable to take anything. I've met a few folk like that on here. It must be very hard.

3. I am icing twice a day for at least an hour - until the packs are no longer cold.
4. I elevate while icing ^^

You accomplish little or nothing with that. Ice longer and more than 4 times a day.

5. ROM was 118 and extension was anywhere from 3-8 depending on who measured.

Oh well, it can still make ground.

6. Moderate

That could account for you extension problems.

7. I cook - simple things, no big Sunday dinners, do laundry, dust, light stuff. My husband helps a great deal with the heavy things.

Okay

My comments in bold
I have stopped formal PT after it was just becoming too painful - good
Recumbent bike: 15 min with no resistance - slowly - the slower the better
Heel slides: 10 before getting out of bed to get the knee going - there is an art to heel slides - read this Heel slides and how to do them.
After my shower while the knee is loose, I try to bend it until I feel pressure, hold it, then do that twice. Then I try to straighten the leg and hold it and release it - twice - hmmm okay
That's about it right now. I had in my mind that this place needs to heal - yes it does!

I think your biggest problem is the inability to take pain meds. Sad but it's a fact - pain meds do contribute to the healing process and progress.

 

[kneeper]

Have you talked to your OS about the leg press incident?
And add me those chiming in about icing more.

 

[Timetolive]

@Josephine, do you have any insight in what this pain could be coming from in this area? Yes, it is unfortunate that I am unable to take the pain meds. It has been a tough journey, but it is amazing what one can stand with the Lord's help.

 

[newlybionic]

I can empathize with you about having problems with pain meds. I had to stop taking them a little more than two weeks after my surgery. It does certainly make recovery tougher.