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TKR Winner winner, chicken dinner! Bionic Liz's new RTKA

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L.I.T

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First, I want to say THANK YOU for everyone who has contributed, shared, bared their soul, and provided encouragement on this forum. Because my OS and I did not decide on a TKA (vs PKA) until 2 weeks before my surgery, I missed the 'class' on what to expect. And since I am 41y/o, everyone said 'you are young, you'll do great'.... so I truly had no idea of what to expect. THANK YOU for being here, and allowing me to realize that my recovery seems to be pretty 'normal' so far.

My story is this... At 18y/o, my right knee swelled to what I call 'sausage' status (I'm originally from the South, so everything relates to food :)). We didn't have insurance, so the quack shack put me on crutches for 6 weeks. The swelling went down, but would periodically come back. At 21 y/o, I had my first MRI and was diagnosed with moderate to severe chondromalacia throughout my knee.

As time went on, in addition to my knee, other joints would hurt - for usually 6weeks to 6 months - then they would be OK again. At 32y/o, I discovered I had Raynaud's. I had the complete rheumatology panel done, and came up normal on everything except a slightly elevated complement c4. None of it made much sense, but life goes on.

I have never played sports or anything cool like that - I was always the geeky type, instead. But 5 years ago, my hubby and I were blessed with an opportunity to move outside of Zion National Park, and I discovered that I LOVED moderate hiking! Nature, taking time to enjoy the serenity of the mountains and listen to the sounds of nature. It was like a blanket for my soul!

Two years ago, after three moderately strenuous hikes in 4 weeks, my right knee finally gave out. Full thickness exposed tibial bone, grade 3OA on the femoral component, and bone marrow edema on both the femoral condyle and tibial surface - all confined to the medial compartment.

After trying PT, a surgical scope, PRP, and BMA (all failed, obviously), it seemed a replacement was my only option. After long talks with the OS, we could not rule out a seronegative inflammatory arthritis (contraindication for a partial), so a total replacement was on.

Fast forward to now.... I am exactly 7 days post op today! It's funny how it feels like it was months ago... Like most people, I seem to have moments where I am OK, and others where I want to cry, lash out, and sock anyone who patronizes me with comments to like 'you worry too much' or 'you just need to get a grip'. (OK, maybe that's just my husband.... The neurologist who sometimes thinks he is an expert in all fields of medicine :umm:).

I have already had an interesting turn of events, as yesterday (while wrapping my leg in saran wrap), my husband used a pocket knife to cut the wrap.... And (you guessed it) grazed my surgical leg with the blade. Luckily, it was very superficial, but it did draw a wee amount of blood. So, per the PA, I am dressing the tiny cut with polystyrene and a bandage and we will see how it looks at my 2.5 week follow up appt.

I have done loads of reading here, and am so thankful to see the many mantras and advice given. I am a person who 'loves to swell', so I have been in sausage mode until about two days ago. I was just then beginning to be able to walk with a little less pain, a little more movement, and without feeling exhausted just by going to the bathroom.

Then enter home health PT yesterday. True to this forum, I didn't do any exercises that hurt much at all (granted, I did take a pain pill beforehand)..... But about an hour after he left, OUCH!!! I was back to sausage status, and feeling like I did on day 3 - ready to cry. So I elevated, iced, took 2 pain pills, and knocked myself out!

I do have one concern. In 2011, I had breast reduction surgery - I ended up developing adhesions (scar to rib cage) on both breasts, afterward. Granted, I had a hyperinflammatory response to the dissolvable sutures, and had to be put on a steroid dose pack.... But clearly, I have a propensity for adhesions.

So now I am somewhat worried about doing the same with my RTKA. The hospital had us aggressively start PT from day one through my release on day 3... My surgeon prescribed the CPM, zero knee pillow, and in home PT. My first visit with the physical therapist was more informative - he told me to not worry about the exercises yet, since I was in the 'pain and swelling' stage. But yesterday's therapist obviously had a different view, having me go through 4 separate exercises (short arc quad, leg lift, extension stretch, heel slide - with pulley, as well as lunge stretches and 5 minutes on a portable cycle). None of them hurt when I did them, but afterward the pain was nuts! I guess I should have expected it, though, as even just using the CPM machine for an hour causes some swelling, but I wasn't expecting swelling to that degree!

So being that my body does have a tendency develop adhesions.... And considering I don't feel much pain when doing the exercises, how should I judge 'how much is too much'? I'm half afraid of not doing enough and getting adhesions... Or doing too much (which was only once) and aggravating the swelling and pain like I did yesterday. Also at the back of my mind is ROM b/c I was 145- neg 5 before my operation.

And just because I know they are pertinent, I'll answer Josephine's standard questions...

1. what are your pain levels right now? Ranging from 1 (rest, little swelling) -8.5 (swollen sausage after PT) with most of time around a 5-6 which is tolerable for me.

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often? 7.5mg hydrocodone 325 acetaminophen (1 every 6 hrs.... And 1 pill extra if pain is 8.5) and 200mg celecoxib 2 times daily. 1 325 aspirin per day.

3. how swollen is your leg compared to these? Slightly above moderate at rest...huge after PT. B/w moderate and huge after CPM machine for 1hr.


4. What is your ROM - that's flexion (bend) and extension (straightness) - about 90-5 currently

5. are you icing your knee at all? If so, how often and for how long?Icing for 30-45 minutes approx 12-15 times a day (mostly during the day, and the usually twice during the sleep hours) with ice machine

6. are you elevating your leg? If so how often and for how long? Yes - with leg elevator pillow (which I sleep with) - and 95% of the time. If I am not walking to go to the rest room, shower, or to get something from the kitchen (frozen water bottles/food/etc), (or doing the zero knee) I am reclined and elevating.

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc. Aside from feeding cats, changing litter, getting something from the fridge, shower, restroom, PA..... I am not doing much housework at all. No unnecessary trips out of elevated leg status.

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
(which means please make a list and not an essay!)

Exercises done at home: (how many sessions each day)
enter exercise then enter number of reps and sets
etc., etc

CPM machine 1-2 hrs per day
Short 3-5 minute walks in house 10-12 per day (includes shower, bathroom, etc)
Zero knee 10 min 3 times per day
Heel slide 5 reps 2 times per day, light stretch

When PT comes,
Short arc quad 10 reps 5 sec hold
Leg lift 10 reps 5 sec hold
Extensions (roll under heel) 15 rep 10 sec hold
Heel slide with pulley 15 rep 20 sec hold
'gentle' lunge 10 rep 3 sec hold
Cycle 5 min on portable bike

Once again, thanks to everyone for being here. It's like finding a second family! Healing wishes to everyone!!

Liz
 

Red's Mom

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Welcome to BoneSmart! I'm sure the folks who really know the answers will be along soon. In the meantime keep the pocket knife in the pocket :). It's a journey is all I'll say. I hope your recovery will be uncomplicated. The BoneSmart way has worked well for me thus far. Keep us posted. The support you will find here is unbelievable.


Sent from my iPad using BoneSmart Forum
 

skigirl

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Well, first, DO NOT TAKE A PAIN PILL for PT---as you have now learned, it masks the pain from the exercises.

Lunges at day 7? you need a new PT, tell that one to go back to school and find out about the new tkr rehab.

Here is what worked for me---for the first three weeks, we did gentle rehab---clam shells, leg lifts--and then iced the knee and elevated. I did absolutely no exercises at home. I stayed mostly in bed the first two weeks with my knee elevated and iced:
Elevating your leg to control swelling and pain
Using ice At about 3 weeks, I began to so some leg stengthening exercises. I did lunges at 3 months!!

I had a revision because of adhesions and at that time, my OS told me repeatedly that if you have the tendency to adhesions, you must not exercise a swollen, hot knee. After the revision I did no exercises at all until 3 weeks, then very gentle stretching and massage. I did almost no weight bearing exercises until week 8.

So, slow down--no aggressive PT. Tell the PT to stop if anything hurts you. Do not take extra pain meds before PT!! Honor your body and slow down. If your knee is swollen and hot---it does not need exercise, it needs ice and elevation for hours at a time. Relax, you don't have to work the knee---you have to treat it gently so that it can heal from major surgery.

I am going to give you the readings from our library that we recommend to those in recovery. You can read them while in bed with your knee propped up on three pillows!!! They are all short and easy to read.

First are the BoneSmart Recovery Philosophy. . .

- rest, elevate, ice and take your pain meds according to your prescription, don't wait for pain to occur, don't overwork.
- If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
- If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it.
- If you won't die if it's not done, don't do it; if you must do it, short and sweet, not hours on your feet.
- Don't stand if you can sit; don't sit if you can lie down, don't stay awake when you can go to sleep
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

Next is a FAQ (Frequently Asked Questions) thread.

The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs

Myth busting: no pain, no gain
Activity progression for TKRs
Heel slides and how to do them

Extension: how to estimate it and ways to improve it

Elevation is the key
Ice to control pain and swelling

Healing: how long does it take?
Chart representation of TKR recovery
Myth busting: the "window of opportunity" in TKR

Myth busting: on getting addicted to pain meds

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?
 

KarriB

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Welcome to BoneSmart! I'm going to tag our forum nurse @Josephine (check post #1)so she can reply to your questions. I love that you know the importance of them and took the bull by the horns!
 

Celle

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skigirl is right, Liz. She knows what it's like to have adhesions, and how to avoid them.

Do a bare minimum of exercising. For now, just walking around the house is plenty.
In spite of what your PTs will probably tell you, it's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen so it can show itself.

You don't need to use the CPM. Studies have shown that whether you use it or no makes no difference to your eventual ROM. So, since your leg swells more after using it, stop using it.

It would be a good idea to ask your husband to read the articles skigirl posted for you - so that you are both on the same page concerning your recovery.
 

Josephine

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he told me to not worry about the exercises yet, since I was in the 'pain and swelling' stage. None of them hurt when I did them, but afterward the pain was nuts! I guess I should have expected it So being that my body does have a tendency develop adhesions.... And considering I don't feel much pain when doing the exercises, how should I judge 'how much is too much'? I'm half afraid of not doing enough and getting adhesions
"not doing enough and getting adhesions" is one of those myths the PTs just leeerve to spread around! The fact of it is that doing too much exercising actually makes the tissues hot. Hot tissues = dry tissues and the heat and the dryness will create adhesions. So you can see why that 'advice' is actually the reverse of 'good'!

Thank you for pre-empting with the questions!
Ranging from 1 (rest, little swelling) -8.5 (swollen sausage after PT) with most of time around a 5-6 which is tolerable for me.
But not for your knee! If you can get it down from that, you should do so.
7.5mg hydrocodone 325 acetaminophen (1 every 6 hrs.... And 1 pill extra if pain is 8.5) and 200mg celecoxib 2 times daily
This is woefully inadequate at one week out. You should take two hydrocodone at least once a day.
Slightly above moderate at rest...huge after PT. B/w moderate and huge after CPM machine for 1hr.
Then don't do PT. AT ALL! Or the CPM.
about 90-5 currently
That's okay with huge swelling. entirely to be expected.
Icing for 30-45 minutes approx 12-15 times a day (mostly during the day, and the usually twice during the sleep hours) with ice machine
:scratch: Why not just ice all the time and be done with it!
Yes - with leg elevator pillow (which I sleep with) - and 95% of the time. If I am not walking to go to the rest room, shower, or to get something from the kitchen (frozen water bottles/food/etc), (or doing the zero knee) I am reclined and elevating.
That's good but I do hoop you're not elevating with a straight leg are you? A bit of a bend is normal and quite okay provided you don't overdo it! Here's some examples of good and bad

aa elevate 4-horz-vert.jpg


Aside from feeding cats, changing litter, getting something from the fridge, shower, restroom, PA..... I am not doing much housework at all. No unnecessary trips out of elevated leg status.
That's good. Just about right, in fact.

My comments in bold
CPM machine 1-2 hrs per day - personally I'm not a big fan of CPMs as there are so many surgeons who don't use them and they get just as good, if not better, results without it.
Short 3-5 minute walks in house 10-12 per day - fine
Zero knee 10 min 3 times per day - do you mean you are stressing your knee to get extension? Then don't! Extension will come in time but it cannot right now because of the swelling.
Heel slide 5 reps 2 times per day, light stretch - heel slides are really easy to do badly. I suggest you read this Heel slides and how to do them properly.

When PT comes,
Short arc quad 10 reps 5 sec hold - once you can do these, you don't need to do them any more. And 10 is too many. 5 is more than enough.
Leg lift 10 reps 5 sec hold - same as above.
Extensions (roll under heel) 15 rep 10 sec hold - as I said previously, this is counter productive as the poor extension is due to the swelling and this causes more swelling. So I suggest you stop doing it.
Heel slide with pulley 15 rep 20 sec hold - absolutely not! Don't do these at all
'gentle' lunge 10 rep 3 sec hold - and no lunges either!
Cycle 5 min on portable bike - that's okay provided you're on the highest setting and just going back and forth on the pedals. No full rotations yet.

I suggest you stop the PT coming to your home. Tell her and whoever else it concerns, that you'll do fine on your own. It's not the exercising that gets you your ROM, it's time. Time to recover, time for swelling and pain to settle and time to heal.

One thing that seems to be missing from all the PT's protocols is that all your ROM is there right from the start, just waiting for all that to happen so it can show itself. In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Exercise as in strength training is counter-productive and does more harm than good. Normal activity is the key to success.
 
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L.I.T

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Thank you ALL!

Yes, I've made many "notes to self" so far along this process! :unsure:

You guys answered one of the main questions I had - the conditions under which adhesions develop. I am 'hoping' that my breast reduction adhesions were a result of my reaction to the sutures - I literally had a burning (and itching) red halo around my incisions for two days before the steroids were called in.

But when I had my shoulder SLAP repair and R knee scope, I had no such reaction - and no adhesions. I do have a hypertrophic scar on one of the shoulder port sites, but I believe that was due to too much stretching of the incision site later.

That being said I will heed everyone's advice about resting, icing, and elevating my knee. As for icing full time, you can bet I would, if it didn't make me lose circulation in my toes :wink:

Luckily, I won't have to worry about PT much, as they only have me scheduled for twice more - then it's on to my outpatient phys therapist who knows my body's tendencies pretty well. For my shoulder repair and knee scope, we just did ultrasound, laser, and tens to reduce the swelling.... No more - b/c after the swelling was down, the ROM was never less than fine. Just like you guys say! So until I get to my regular guy, I'll just politely tell this home therapist to skip all the 'working' exercises!

@Josephine, a couple of questions. If I'm doing OK with pain management as is, it OK to stay with this regimen (4 pills of 7.5mg hydrocodone per day and extra pain if needed)? I realize the importance of pain management, but since I have the genetics (in multiples) I'd like to try to err on the side of caution as long as I'm not very uncomfortable. My pain was about a 4 pre-op, and I didn't take anything but Tylenol... So I'm not really too far from what I was managing in the first place.

On a complete separate note, are you aware of any research that correlates bone marrow edema and post op TKR pain? I ask because the majority of my post surgical pain is on the medial aspect of my knee - which is where I had bone marrow lesions. And, although both medial and lateral portions of my bone were shaved, the lateral doesn't hurt nearly as sharply. I have no functional reason for asking - simple curiosity from someone who is also in the medical field, but with a Neuro (instead of ortho) background :)

Thank you guys, again, for all the support and help. What a fabulous network you have going on! As they say, it takes a Village!

I am eternally grateful!

L
 
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Welcome Liz! :welome: So glad you are able to manage your pain so well already. Since I have no expertise with the issues you raise, I am simply here to cheer you on:wowspring: and leave the advice-giving to those who can better help you!! You are clearly in the right place and others will log in in no time to wish you well!
 

little red canoe

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I had no issues from hydrocodone.. As a matter of fact I was prescribed 90 and have about two thirds of them left three months later.
I do like wine too well and my father had cirrohsis. Hydrocodone did not make me warm and fuzzy.. actually I found it didn't do much.. Tylenol did more for me.. I think I associated hydrocodone with pain and not with fun nor high feelings. I still have 60 of the tiny pills and have to take them to the Police Dept..
 
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L.I.T

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Hey there, Nightquilter! Thank you for the warm welcome. I don't know for sure about pain control - I have had quite a few times in the past week where I was brought to tears! And I am certainly far from pain free - but I have had arthritic pain for half my life - and 'growing pains' and 'leg aches' before that. It may be that my mind has adjusted to tuning some of it out. But, for some reason, I seem to tolerate surgical pain *fairly* well. I am truly truly thankful for this. I didn't take more than 7 pain pills for any of my previous surgeries.... So, for me, what I am taking now is a good dose of drugs! Now give me stomach aches, food poisoning, headaches, or a paper cut, and I am the world worst wuss! Honestly, I think I am really lucky with surgical pain... Because anything else literally drives me bonkers!

Hi, Little Red Canoe! Thank you for your experience - tbh, aside from making me sleepy, the pills take the 'edge' off the pain... No euphoric feelings for me either. I feel very fortunate. But I also know that sometimes addiction can be like a switch, and all of a sudden it's different. And I do have a hard time giving certain things up (SUGAR).... So I just want to make sure I don't step too close to the edge of the cliff. If I did, it might hold... But then again....

Thank you guys for taking the time to write! It's nice to be able to speak openly about these things without being judged!

L

L
 

KarriB

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I took oxycodone after my TKR, it made me sleepy and a bit fuzzy as well as managing my pain. I believe we don't get he euphoric feeling because our body is using the drug for pain. After a week of take bg oxycodone I expressed my fear of becoming addicted, my best friend who has had over a dozen surgeries explained to me that if the pain wasn't present things would be different.
 

Celle

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Hi Liz,
I understand your concern about developing an addiction but, even with your family history, I think it's unlikely. People taking opiates for post-op pain control seldom become addicted, because they are taking them purely for pain relief, not for the "buzz". Some do become habituated, but that is a different thing from addiction.
Myth busting: on getting addicted to pain meds
 

NightQuilter

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@L.I.T - Liz - I so agree with the comments above. There is such a phobia in the US about developing addictions to opioids in the US, perhaps with some concern, but as others have commented here and the Library literature seems to support, if taken for pain, it doesn't develop into addiction. My mom was an alcoholic and had a very low tolerance to meds; I had no issue weaning down after the pain was more controllable (except for trying to wean down too quickly and the wrong way!! Read the article in the library for the right way to wean off - Josephine and the articles were a Godsend for me!!).

Moreover, the tears are not unnatural. Yes, we need the meds to manage the pain, but they do wreak havoc with our systems. I had a LOT of crying jags while on them ... whether due to the pain or the meds or, more likely, a combination of those and the psychological impacts of having to deal with the pain and loss of control in our lives, and everything going on around us. Guess what? It is OK! We recover and we feel good! So glad you feel you can handle surgical pain well - what a blessing.

How many other surgeries, 'cause girl, I am getting jealous since I have # 6 or 7 coming up and you are only 41!! lol. You can go into your signature on your profile and list what you have had. That may help those who have literally walked in your shoes on some of them relate.!
 
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L.I.T

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I know you guys are right about the pain being a mitigating factor between addiction vs usefulness - and I completely agree there is a difference between dependence and addiction. I definitely have read up on it in the past, and believe whole-heartedly that addiction is unlikely for most people - even those with a predisposition. 99% of people (maybe more) will never need to consider the issue.

Please understand, however, that because of the propensity of addiction in my family that I have a mild concern *for me* only. Obviously not enough for me to not take pain pills when I need them - but just for me to be somewhat cautious about taking more than I need. My feelings don't generalize to anyone else. In fact, my husband actually has a very low tolerance for operative pain and can go through 90 oxycodone in a week after a shoulder surgery - I see his pain, and know that he is taking it for a real reason. We are all built differently, and that's what makes life interesting.

Now *emotional* pain - there you've hit on my weakness. So far my operative pains have been temporary - but emotionally (with regard to chronic pain), I am a complete train wreck. I have multiple joints with early onset OA - my left knee is not far behind my right, my right thumb, left 3rd finger, and left lateral metatarsal (foot) are all affected. I may be young, but my outlook is not all that promising. Emotionally, I have always been hypersensitive and prone to depression. So the long term diagnosis of chronic pain throws me for all kinds of loops. I try to make light of it - laugh, joke, etc... But the deep truth is that I'm frightened and scared. I may have been blessed with a higher tolerance for operative pain, but I'm not as strong when it comes to emotional pain.

Nightquilter, I don't know if you still feel jealous, but I can promise that where you may see something I am 'lucky' with, I can promise I am terribly ill-equipped in plenty of other areas!

And, as you can also see, my pain tolerance doesn't include the general 'discomfort' that keeps us all up every night. Argh, lol!

I don't want anyone to think I am competing for pain tolerance status... Or that I am trying to make a blanket statement about opiates - because I am not. I am simply being honest about the current pain level I feel, and a viable fear that lurks in the back of my mind. I am not being a martyr with regard to my pain - trust me, when it hurts too much, I take more! It's just what is working *for me* at the moment. And for all I know, it may change in the future!

Ironically, my mom just had the same RTKA done 4.5 weeks before me. Her pain pills (and nsaids) made her so nauseous, she couldn't eat. She lost 18 lbs in the first 3 weeks. She ended up having to stop all her pain meds AND her nsaids after week 3. Now there's a woman with some serious inner strength - the thought of not having my aspirin, celebrex, AND my pain pills makes me want to whither and die! I don't know how she does it!

Eh ,we are all different. I'm just thankful to have a place where I can be honest and share what my personal experience is.

L
 
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KarriB

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Liz, please read the link to post op blues. I have never had a problem with depression, but boy, did the blues hit me hard. After my infection surgery, on two different antibiotics and pain pills only intermittently, I was not in good shape emotionally and wished I had know about BS at the time.

My dad also had two TKRs and a THR from a broken hip and only took norco for a week or two. Everyone is different, as you said and every recovery even for an individual can be different.
 
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L.I.T

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Thanks, Karri. It actually was one of the first things I read :blush:. I may be in for a wild ride b/c I have had pre-op blues/depression for nearly the past two years while trying to find ways to 'beat' my knee and avoid a replacement.

When my first xray were done, the surgeon said 'well, the good news is that you will not need a replacement for a long time!' Then, when the steroid shot didn't work, the MRI revealed my hidden issues. The surgeon let me know that he did not want to operate b/c there weren't too many options for a satisfactory revision surgery (I know now that isn't entirely true... But I didn' t know that at the time). I went to rheumatologists, regenerative medicine docs, and a host of physical therapists. Some of them told me (based on my xrays) that I didn't have a physical problem, but that the pain was in my head. Those that took the time to read the Mri reports or look at the images didn't understand why my knee was this bad so young, and everyone had a different view on unloader braces, bone marrow aspirate, synvisc, biocell collagen, glucosamine solutions, and other various supplements.... All of which I tried, of course. I was terrified of not having a good option when I turned 60.

Then there was the decision of whether to try a partial replacement and *maybe* get 10 additional years.... But the quality of my lateral compartment cartilage was pretty cruddy (Spongy and thin)... So it would be a big gamble and I might go through the partial in 3 or so years. I guess it was not something I ever anticipated having to consider at this age.

Anyhow, I finally got a second OS opinion (I met 4 people who had great TKR results by him), and he actually took into account my age, my quality cartilage, multiple joints.... And then he said the magic words "if I were you, or if you were my wife, I would go ahead with a TKA. I can make it solid so that it will hopefully last 20 years, and you can be able to hike and bike while your body is still in a condition to do so." It was nice to hear someone be realistic yet somewhat optimistic at the same time!

So here I am, feeling lucky that I found BS while searching for knee answers in the wee hours of my post op nights... And feeling genuinely grateful to find a community of people, such as yourselves, who are willing to listen to me blather.

How is your knee doing, BTW? I can only imagine how frightening it must have been to hear 'infection' and then the emotional roller coaster which must have followed. I had a wee bit of serous discharge 4 nights ago, and had already jumped to panic mode, thinking I would die if I had to redo the pain on nights 3 and 4 over again.

I can't say it enough. Thanks for being here!
 

KarriB

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I found it helped me to get out, even just to a friend's house or a restaurant, always keeping my leg propped up though. It was a cold and miserable winter, so there weren't a lot of options.

My TKR is good, I still take a low dose of antibiotics daily as prescribed by my infectious disease dr. However my experince as kept me from making a decision about my left knee. My infection wasn't easy to get rid of, it took a month of iv & oral meds before the seeping stopped, then at 6 weeks my body stopped making white cells as a result of the antibiotics. But God was good, I was able to bend my knee, live my life and went back to teaching part time at 12 weeks. My faith played a huge role during my infection and the emotional toll it took. So although it was a scary time, I'm thankful for everything I learned.
 

Celle

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Hello again, Liz,
Thank you for expressing your concerns so clearly and honestly. :flwrysmile:
We're here to listen and encourage, any time you need to vent, or need a shoulder to cry on. We've been there and we understand.

I understand all you're saying and I'm right with you about the arthritis in multiple joints. So far, my hips and right elbow are unaffected ( :fingersx: :prayer:) but I have OA in almost all my other joints. I also have a high pain tolerance and I seldom need pre-op pain relief on a regular basis. Because of a minor bleeding disorder, I can't take NSAIDS. I find that my joints seem to take it in turn to flare up and then settle down again. Sometimes icing a joint helps, and sometimes heat is more comforting.

I had a PKR at 59, which lasted eleven years, and was then successfully revised to a TKR. I had a TKR on my second knee 2 years ago. Since TKRs can last for 30 years or more, I'm hoping they outlast me.
Currently, I am battling with OA in my left ankle and hind-foot joints and a triple arthrodesis may be in the plans some time soon. I'm not looking forward to that, but other measures seem to have failed.

Ironically, my mom just had the same RTKA done 4.5 weeks before me. Her pain pills (and nsaids) made her so nauseous, she couldn't eat. She lost 18 lbs in the first 3 weeks. She ended up having to stop all her pain meds AND her nsaids after week 3. Now there's a woman with some serious inner strength - the thought of not having my aspirin, celebrex, AND my pain pills makes me want to whither and die! I don't know how she does it!
I feel so sorry for your mother. NSAIDS aren't much use as pain killers post-op. They do cause gastric disturbance and can cause bleeding, so I think they're no loss. However, it's a shame that an anti-emetic, such as Zofran, couldn't have helped her. All the narcotics make me vomit, so I insist on Zofran being prescribed for me.

As well as a family tendency towards addiction, I suspect that you have also inherited your mother's inner strength, and that will be a great bonus for you.
 

Josephine

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my breast reduction adhesions were a result of my reaction to the sutures. But when I had my shoulder SLAP repair and R knee scope, I had no such reaction - and no adhesions.
This shows that people generally don't have a propensity to adhesions even though surgeons and PTs will tell them so. Adhesions are a one off occurrence, each instance of surgery having it's own risk factor as I believe I said before.
I do have a hypertrophic scar on one of the shoulder port sites
There is no connection between adhesions and hypertrophic scars. They have totally different causative factors.

are you aware of any research that correlates bone marrow edema and post op TKR pain?
This is a strange question because bone oedema to a greater or lesser degree is bound to occur after any surgery where bone is cut. So of course it will be related to post-op pain!
I am a complete train wreck. I have multiple joints with early onset OA - my left knee is not far behind my right, my right thumb, left 3rd finger, and left lateral metatarsal (foot) are all affected. I may be young, but my outlook is not all that promising.
I think your depression may be making you view this situation in a very poor light. I know many who have had poly-arthritis (poly=many joints) and have had surgeries for them quite successfully. One patient of my acquaintance had 2 each of hips, knees, shoulders, elbows, wrists, thumbs, great toes and 8 fingers: 20 joint replacements in all, and she was very optimistic through all of them! She looked forward to a better life and she did get it though she obviously went through a lot to get there.
 
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L.I.T

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KarriB, I am so glad that all turned out well (in the end) with the infection. It must have been grueling, but I definitely can see how strong faith, and staying social, would be an amazing help during that time. I am so happy you persevered!

Celle, you did the PKR and got 11 years out of it before converting!! That's excellent! I may always wonder if that was the way I should have gone... But I already had some lateral meniscus extrusion, and my tibial cartilage was thin (as well as poor quality), so I suppose ultimately I played it 'safe' - but I'm so glad it worked for you!

As for the polyarticular OA, I will say my prayers, keep my finger crossed, do a little hopeful dance to the OA gods, that whatever your future holds, it involves quick recovery and much less pain as a result! Sometimes I think this type of OA is like having an antique car - you are constantly hearing odd noises and wondering what will fail next.... But at the same time, as long as we are vigilant, we can keep our precious bodies running! Lol

I think Josephine is right in that my depression sometimes clouds my outlook. But, then, that's kind of nature of depression - which came first, the chicken or the egg? :wink: Regardless, there are good days and bad days - and the key for me is learning to appreciate the good ones and simply persevere during the bad. But it is comforting to know that we are not alone and that we have a place to come for support, guidance, and understanding.

Re: the Zofran, they tried that on my mom in the hospital, but it was not effective. Phenergan, however, did work enough to keep her from constantly vomiting. She was able to keep a little food down for the first couple of weeks. I think the problem got worse when she was transitioning from pain pills to NSAIDS. She was just too nauseous, still, to eat much while on the pain pills and Phenergan, and they wanted to take her off so she would not lose any more weight - but the dose of NSAIDS they used to replace it upset her stomach even more, so she just stopped them all. I think she found the pain more tolerable than the nausea! And thank you for your kind words about me having my mother's inner strength.... I really hope I do - it's an admirable thing to aspire to!

Today was a bit bipolar for me - I woke up feeling fairly well, with a bit less swelling, and a bit more motion. But one of he other tele-neurologists my husband works with was out, so my husband was swamped with extra work, and he wasn't able to do some of the extra home duties that he has been so graciously taking care of while I ice and elevate.... So I ended up walking around the house a bit more than usual - in addition to subbing for him at his desk for an hour so he could get to the post office to pick up our mail (we live in such a tiny town that we get assigned a PO Box and there is no home delivery).

Needless to say, by the end of the day, my knee decided to protest with swelling, pain, and immobility. It's funny how fine a line is 'too much' with recovery. So I've been icing like mad, trying to get it back to an agreeable mood :). Aside from PT tomorrow morning (which I plan to limit), I will take the rest of the day to remain horizontal and let my knee relax.

Just out of curiosity, how long was it before any of you were able to simply sit (without your leg elevated) and not have your leg swell into log-leg status? I literally can feel the weight coming back to my knee when I sit or stand for more than just a couple of minutes.

We've also been toying with the idea of going to see a movie in the VIP theater (this weekend) where they have reclining seats with leg support.... I was thinking I could bring a pillow or two to further elevate my leg. But that may be a bit optimistic at only 2 weeks out :praying:

Hope everyone has a happy new year! :cheers2::happydance:
 
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