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Bilateral TKR Vancouver USA Recovers

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@sleenie I never got any massage at PT - that would have been nice. All they were doing was watching me do exercises I could do on my own so I didn't want to keep paying the co-pays for their monitoring. I know some people go for quite a bit longer but that was my decision. My OS agreed; he said they're just watching you exercise and you can do it yourself.
 
:bawl:Another visit to the ER but not about knees. The last couple of weeks I've been having severe nosebleeds. I'm on coumadin and it's been really hard to get these bleeds to stop - sometimes they were lasting an hour or more. Well, Friday night after 3 plus hours of serious bleeding I finally had my son drive me to the ER. I've found that serious bleeding will get you seen in the ER pretty fast (right past those who've been waiting) 'cause they don't want you bleeding all over the waiting room. My blood pressure was sky high which they say happens sometimes in these cases. Well, they put various solutions in my nose and then a balloon type thing in one nostril. After some time and some lab work, they pulled out the balloon and cauterized a polyp I had in that nostril, and then applied another balloon. These balloons put a lot of pressure to stop the bleeding. They sent me home with it in and it has given me horrendous sinus headaches and it's very uncomfortable. I so badly want to cut the thing open and pull it out, but I don't want to take a chance on starting another bad bleed so I'd better wait. On Monday, I have to find an ENT doc to remove the balloon. Also, I have to be on antibiotics to discourage infection.

If it's not one thing, it's another! :gaah::groan::hairpulling:
 
I'm sorry you're having such a bad time. :console2:

Can you remind me why you're taking Coumadin, please? It's some time since your BTKR, so I think it must be for another reason. I'm just wondering why , in view of the nosebleeds, you are still on a blood thinner.

And did they do anything at the hospital to bring down your blood pressure? Do you think you should see your regular doctor about the BP?

I'm sorry if this sounds intrusive. I'm just trying to make sure that your whole person gets treated, not just one symptom at a time.
 
VancouverUSAgal said:
@sleenie I never got any massage at PT - that would have been nice. All they were doing was watching me do exercises I could do on my own so I didn't want to keep paying the co-pays for their monitoring. I know some people go for quite a bit longer but that was my decision. My OS agreed; he said they're just watching you exercise and you can do it yourself.
Click to expand...
I agree, if all they are doing is watching, no reason to stay. I feel lucky to have such a great PT. Normally sessions are 45 min but mine last twice that long. I start with the NuStep machine, heel slides and then she takes over. A good 15 min of massage and then she works with me on stretches and "pushing the limits" but only to the point of discomfort. Then there are exercises that I do on my own before she ices me with the impulse machine. (Don't know the name of it.)

I am so sorry to hear you had to go to the ER for a nosebleed. I'm assuming you are on the medication for something other than your knees after this length of time. (I'm still on 325mg of aspirin but hope to drop that dosage after my followup visit this week.) Just what you don't need, something else to worry about. I hope things improve and you can get into the ENT quickly.
 
@Celle I've been on the blood thinners for about 8 years for atrial fibrillation (to prevent stroke). I'm not taking anything that should have caused this problem to arise. My regular doctor thought my CPAP machine might be irritating the lining of my nose but I've been using that for at least 10 years, so I don't understand what started this now.

I couldn't get an appt. to see an ENT until tomorrow (apparently none work Mondays!) and I'll get my BP checked and blood thinner levels as well. I had a minor bleed in the other nostril last night so I hope they take care of that side as well.

I'm also on Prednisone for sciatica and it's really made my knees feel better - one good thing! Of course that's only for a week, but at least that's one good thing.
 
Thanks for letting me know, Linda. Now I understand. My husband had atrial fibrillation and he's still on blood thinners.
Here's hoping that dealing with that polyp in one nostril will have lessened the risk of further bleeding on at least that side! Keeping your blood pressure at a reasonable level should help, too.

Best wishes for improvement now, my friend! :friends:
 
@VancouverUSAgal
Probably a stupid question, but do you have your PT/INR checked frequently? Does the doc who orders the Coumadin aware of the nosebleeds?
I am sorry you are having to deal with this on top of your recovery.
I hope all this is sorted by now. I am coming in late on this thread.
~hopefaith
 
No more nosebleeds in the last 10 days - so glad about that! I do have my Coumadin levels checked often and all my doctors are aware of the nosebleeds. I saw my primary care doc, the ER doc, and an ENT - they all said different things. If I have another, I will be going back to my primary care doc to discuss whether we should lower the Coumadin or what others options there might be if any. Thanks for your concern. How's your knee doing?
 
Scary when they won't stop. Glad you are 10 days free!!! Does the weather affect them? My dad would get them more often in the winter time when the humidity would drop.
 
I'm at almost 5 months out and having considerable pain in my left knee. I saw my surgeon at 3 months and was progressing satisfactorily (though not spectacularly). He gave me the usual talk about it would take 12-18 months for internal swelling to be gone. He urged me to continue going to the swimming pool to work on flexion. About 5 weeks ago, I was in more than usual pain after my pool visit. I thought I had probably over done things and should take some time off to rest the knees. Well, unfortunately, the left knee has not gotten any better. I have quite a lot of pain upon rising and after minimal walking.

I have not gone back to the OS because I expect he will just give me the talk about recovery being a long process, but I'm beginning to wonder if there could be anything I should be worried about. Both knees are still warm to the touch and I've had inflammatory issues for years. The pain is basically in the same spot where I experienced pain before surgery - below the knee and mostly toward the outside of the leg. @Josephine: Please comment if you have any advice. I'd appreciate it as I don't know whether to just keep waiting/hoping for things to improve or if there's anything to be done. Icing doesn't seem to make much difference and I'm still on pain meds.
 
I can't remember if I've ever give you this before - apologies if I have but let's start from the beginning again

Can you tell me the exact site of your pain using this chart?
Please note the instructions in the smaller image

[Bonesmart.org] Vancouver USA Recovers


[Bonesmart.org] Vancouver USA Recovers
 
I'm not sure if I was supposed to click on the chart on something, but I would say my pain is at DLF4 to ELF4, no pain in the back of the leg. I have no other symptoms so I'm thinking it's probably not infection, but I'm certainly not a medical expert. The pain is worst when weight bearing but the ache continues even when sitting with leg elevated.
Thanks, Linda
 
I should also say that my right knee (done at the same time) is really good. The pain in the left is worse than before or since the surgery (I almost can't bear to put weight on it) so I guess I'm going to have to see my OS.
 
Sorry to hear this Linda. I had my RPTR on March 19 and have often wondered how you were doing. Seeing your OS is a good idea. I hope Jo can put some light on it. Sending you healing prayers.
 
VancouverUSAgal said:
I'm not sure if I was supposed to click on the chart on something, but I would say my pain is at DLF4 to ELF4
Click to expand...
No, it's just a plain old computer thing, not inter-active!

So your pain is about here then?

[Bonesmart.org] Vancouver USA Recovers


This seems to me to be an ITB (ilio-tibial band) issue

Now for the other part of the inquisition!

I'm going to ask you some questions 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!
[Bonesmart.org] Vancouver USA Recovers
)

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. is your knee very swollen?

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 are you doing? How much and how often? (and detailed details would be appreciated, please! Reps, sets and session and all that)

Note:
If you're not familiar with this, it goes like so:
1 lift of a 500kg bell bar = 1 rep or repetition.
Doing 5 reps and then a brief rest = 1 set of 5.
And doing 5 sets and finishing = a session.
 
You've had a rough recovery @VancouverUSAgal . With one good knee, you know your surgery can be successful. Here's hoping rest, elevation, ice will be enough...or that your OS has the answer. :flwrysmile:
 
@Josephine To answer your questions:
1. When weight bearing = 8 or more, After sitting/elevating, it drops to 3 or less.
2. I'm taking Hydrocodone/Acetaminophen 10-325 3x/day, plus extra Acetaminophen 1000mg 3x/day.
3. I had stopped icing prior to this flare-up and seeing no external swelling. I have again begun icing 1 hr. several times/day but it doesn't seem to help.
4. Elevating - at least 6-8 hrs/day
5. Haven't had flexion checked in 2 months and my PT didn't often tell me but I believe OS said extension was 0 and flexion about 110.
6. I have started to notice some swelling at DLF4.
7. My son pays for a house cleaner do I only make my bed, do some laundry (no ironing), and easy cooking. He does the grocery shopping as well.
8. I'm not doing any PT or exercises. I was going to the pool 3x/week until this problem started about 5 weeks ago.

I did go ahead and make an appt. with my OS for next week because this seems to be much more pain than I should be having and is more disabling than the pain I had in either knee prior to surgery.

Thanks for your help.
 
I think I would make an appt with a different doc---one not involved in your current doc's practice. I think you need a second opinion--if only for peace of mine.
 
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