Yet another question for Josephine

[JenniferG]

Josephine, In the mail today I got a letter from my Rhuemy about test result for some blood work I just had. Seems I am Vitamin D defecient. They are looking for a level of 35 or more and I've got 8. Obviously also enclosed was a script for 5000 units Vit D 1xweek for 8 weeks, with a lab slip for restest in 8 weeks. I will call all the necessary DRs in the am but 1. this shouldn't interfer with the big OP on the 18th, 2. May have contributed to the demise of my knees if has been going on for a while? 3. Any Vitamin D megadose side effects I want to know about?

 

[Josephine]

Vit D has a role in calcium uptake and plays a part in the incidence of osteoporosis so yes, it could well have been involved.

Take a look at broken link removed: https://dietary-supplements.info.nih.gov/factsheets/vitamind.asp for more information as I am not a pharmacist nor a nutrionalist and would be stepping outside the limits of my experience to offer any more opinion. Hope you understand.

 

[Pattipoo]

good luck with that, Jen.

Jos....can I adopt you?

 

[JenniferG]

Yes, I understand Josephine, but thanks for trying! Hi patti! FYI, called OS today and they said to start Vit D was OK, so no conflict with Tuesdays big event. Now let's just hope no side effects similar to the pain meds. Jen

 

[Pattipoo]

Girl...I'm right there with you...don't forget that!!! You get yourself to a computer just as soon as you can...we'll be waiting to hear!! I don't care if you can't type anything more than "I survived".....
love ya, sista!

You got that bag packed, yet?? (I took two big pieces of luggage...the nurses giggled at me!)

 

[JenniferG]

bag - Not yet. denial, denial River in egypt. Actually I started it.

 

[JenniferG]

checked the web site, Jo, Chronic steriods, That might be it, the prednisone. Rhuemy has done 2 bone densities just to keep track, sure another one is in my future. Was on fosamax when the prednisone dose was higher. Bet he revisits that as well. Thanks agin for the informational steer. Jen

 

[Josephine]

Oh yes! I could always identify steroid bone on the op table!! Something very different about them but I won't get graphic - Doug can't handle it!!

 

[beachcomber]

Steroid bone? Go ahead--- get graphic. Doug can just look away.

I 've been on prednisone for a couple of years for an autoimmune syndrome (Sjogren's). I've been wondering what effect that might be having on my recovery. Slows wound healing is one side effect I have heard....Could it be slowing the rest of my recovery too?

My OS used a new knee from Zimmer (first time he used that model) that he said required less pounding because he was afraid of fracturing the bone. Steroid effect?

Quite frankly, I feel terrible. My pain is so intense again. I am back to using my trekking pole, barely made it out of the grocery store yesterday, taking pain meds at school, and crying all evening again. I am hurting from hip to ankle and had back spasms at work today that took my breath away.....

I love being back at school but think I might call in sick for tomorrow.

I could use some of those good vibes sent my way , guys. It's a tough time again for me.

thanks
C

 

[Nursepair]

Carolyn, So very sorry you are in so much pain again, Glad to hear you are taking tomorrow off, you need to rest that back. You must be devastated after doing so well last week.

Cry as much as you need to, Josephine always says it's a great release. I have been crying all day today, no new specific reason. Probably just lack of sleep.

Anyway, keep that chin up. I always use heat on my back, it always helps with mine, but I don't know if that would be good for yours?

My thoughtsare with you. Hugs, Sue

 

[Josephine]

Hmmm - well, okay. Steroid bone (my phraseology) has a tendency to be softer than normal hard bone and the inside, what you would call the marrow, often has much more fat content than normal. But the bone heal well also. When you see the bone tissue it makes you wonder but once the joint, screws, whatever are in place, healing does take place more quickly.

Yet that same osteoporotic bone is what causes things like dowagers hump (bent back) and other such things in old age.

Also the skin is often more friable and yet, oddly enough, also shows remarkable healing qualities in that, if the skin is damaged, it heals ever so quickly, much quicker than normal skin.

Odd phenomenon.

 

[JenniferG]

So Josephine, are you saying that we Preddys may heal on the quicker side? Carolyn - GOOD VIBE - GOOD VIBE - GOOD VIBE!

 

[beachcomber]

Re: Yet another question for Josephine and everyone else!

Thanks for the kind thought and vibes. I ended up working after all, just tried to take it as easy as possible and it wasn't as painful as yesterday.

I am really struggling with finding the balance between enough activity to:

1. facilitate my healing
2. getting my work done to meet *some* acceptable standard (but certainly not to the standards I set for myself)
3. control my pain

I rest on the weekend and do my home PT exercises and feel pretty good on Mondays but from there I don't seem to know WHAT to do. I go to outpatient PT twice a week and they are working mostly on my back and hamstrings these days, mostly in the therapy pool. As the week progresses my pain escalates and some days (especially when we have catering jobs to do) everything seems to go out of control. Adrenaline gets me through the catering job itself, but then reality and pain take over. I am still taking pain meds in the pm but try to manage with just Tylenol earlier in the day.

Do I come home and just ice my knee, use heat on my back, and rest?

Or do I (take a pain pill and then) go for a walk or exercise bike, or something to increase my stamina and promote healing? Then ice, heat, etc.?

I always do a set of home PT in the AM and most PM as well to warm up and stretch.

What would you suggest? I could really use some feedback----

Patti, Skeet, Gatiger---- you are all back at work--- what are you doing about this?

Thanks

 

[Nursepair]

Carolyn, I can't say for sure, probably a question for J. I think I would personally ice knee, heat to back and rest as you have been walking and exercising all day. As I say, a question for J? Take care, will be thinking of you. Sue

 

[Josephine]

NP, you have it - spot on. Rest and ice. Chill out and then rest and ice again!! You day is busy enough as it is, gal!

 

[beachcomber]

thank you--- I have been pretty confused about what to do.

It has seemed like my knee and back are telling me to stop/slow down-- but my PTs are saying I need to do more and when I tell them how much my pain has escalated they just look at me disapprovingly and make me feel like I am a lazy malingerer.

One more week of work, then we get a week off for spring break. I think that will be good for me. I just need to get a handle on this activity level and pain.

I appreciate your wisdom and support more than I can say.

 

[Nursepair]

That's great news about your spring break coming up, that will give you time for a breather, and who knows, maybe the break is all you need to get on track again. Not sure if that made sense, I really should go to bed now as I am all woozy now. Have to finish checking the treads first though!! Hugs, Sue

 

[NuNeez519]

All this talk about pain and activity level after returning to work has got my mind all twisted. I walk through supermarkets for 4-5 hours at a time as a Food Safety Specialist and do not know what I am going to do if I can not perform my job duties...
Lots of excercise and PT...I will usethe pool and workout on my own EVERYDAY once I start driving. Can you over do it? and how do you know when you are at your limit??? Isn't it going to be a painful and slow recovery? Is there anyone around that is 1-2 years Post Op around?

Just thought I would vent....

 

[Rowdy66]

Know how those blood tests results and the questions they bring up can put you on a real roller coaster. Just happy for you that your surgery is moving ahead as planned. Will be praying for your speedy recovery. Rowdy or Jan

 

[beachcomber]

YES, you can over do the PT! I thought if two sets of home PT exercises a day was good--- then 6 must be three times as good! NOT!

It seems like you have to find a balance between just enough and too much.

You will go through 2 kinds of PT. The ROM parts have to hurt to get you where you need to go. The other kinds of PT/rehab shouldn't actually be painful. You need to stop short of that. Stretching and pressure are ok-- but not pain.

I have a friend who is 1 1/2 years PO from her TKR and contemplating, reluctantly, having the other one done. Says it is the hardest thing she has ever done in her life. She didn't have an easy time of it.

I don't I have ever heard "easy" and "KR" used in the same sentence.

All this talk about pain and activity level after returning to work has got my mind all twisted. I walk through supermarkets for 4-5 hours at a time as a Food Safety Specialist and do not know what I am going to do if I can not perform my job duties...
Lots of excercise and PT...I will usethe pool and workout on my own EVERYDAY once I start driving. Can you over do it? and how do you know when you are at your limit??? Isn't it going to be a painful and slow recovery? Is there anyone around that is 1-2 years Post Op around?

Just thought I would vent....