After knee replacement surgery

Posted by beatricefay @beatricefay, Jun 16, 2016

Had left knee replaced 9 days ago. Right knee two years ago. Having a problem with inflammation so hard to bend knee and exercise. Trying to ice and raise knee above heart. Doctor suggested getting compression hose. Anybody have this experience and can offer suggestions. So tired all the time from pain interrupting my sleep and painkillers. My insurance refused to pay for the painkiller recommended by surgeon so have to take one with more opiates. That’s frustrating. Two years ago it was covered but now too expensive for me to use. Seems the drug companies, not our doctors are determining what we use.

I have found the anti-inflammatory Aleve best for me. Compression stockings & 325 aspirin to avoid clotting.
Sleeping is a challenge yet for me too, but getting better.

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@gailfaith

@contentandwelll @ hopeful33250 Yes, when using the passive motion machine, it is not like 10 minutes or whatever a day. It does take time (hours) but you can use it while you are asleep at nite. When I had it in the nursing home, I had it going whenever I was in bed. I work up from the surgery with my leg already on it! gailfaith

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@gailfaith Interestingly they told me to not use it when I was in bed! If I could have it probably would have been more tolerable. I will be interested to see what is recommended by my current ortho.
JK

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@lisalucier

Hi, @maryx1937–Thanks for making your first post to Connect. I moved your message from the Rehab group to this active discussion called “After knee replacement surgery” so that you can meet other members talking about recuperating from knee surgery. Please meet @gailfaith @contentandwell @cheris @cobweb @niazumbanut @beatricefay and others. Just click VIEW & REPLY to read through the discussion.

Mary, I see from your message that you are 80 years young and in good health, and that you are recovering at home with the help of home health. Do you have a physical therapist coming to your home to work on rehab with you? When was your surgery? How are you doing?

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@maryx1937 Mary, good for you, it sounds like you are doing great. I went straight from a walker to walking independently in a few weeks because I found both canes and crutches were difficult for me! I liked the home PT a lot, the young man I had developed a real bond with me and we hugged when I had to let him go. I had to though because as long as they come to your home you have to be home-bound and I needed to get out. Thankfully the PT at the outpatient center was also great.
JK

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@maryx1937 Unfortunately after transplant the only over the counter pain reliever I can take is tylenol, in a limited amount. People, even some doctors, are always surprised that I can take tylenol because tylenol taken in larger doses, particularly if drinking alcohol, can damage your liver. I am not sure what the other meds do.
Have any of you with liver transplants also been banned from taking other pain relievers, and if so do you know why you cannot take things like ibuprofen?

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Check the mg. in Aleve. Stockings: a friend was told by Dr. leave them under pillow and do not get out of bed, put them on, then get up.

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@gailfaith

@contentandwelll @ hopeful33250 Yes, when using the passive motion machine, it is not like 10 minutes or whatever a day. It does take time (hours) but you can use it while you are asleep at nite. When I had it in the nursing home, I had it going whenever I was in bed. I work up from the surgery with my leg already on it! gailfaith

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@contentand well.. I wonder if you and I are referencing the same machine? (passive motion machine???) I can’t imagine being even able to use it in any other way as your leg is strapped onto the machine. As i mentioned, I woke up from the anesthesia both times with my leg already on it! And both times I left the hospital both times with more than 100 degrees of bend, I never had any pain while on the machine either!!!!!.And as they increase the bend they do it slowly so after a few bends I felt NO discomfort. The second time I left the hospital with 113 degree of bend and without the machine in that nursing home was up to 123 degrees and left the nursing home with 134 with just PT and no stretching of the knee …..just general PT so I lost no strength lying in bed.. That was 11 years ago and my present therapist measured it recently ( and both knees are about 5 degrees more than the last figures i knew.

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@gailfaith

@contentandwelll @ hopeful33250 Yes, when using the passive motion machine, it is not like 10 minutes or whatever a day. It does take time (hours) but you can use it while you are asleep at nite. When I had it in the nursing home, I had it going whenever I was in bed. I work up from the surgery with my leg already on it! gailfaith

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@gailfaith Gail, maybe it is not the same then. I do not remember having it in the rehab center (which does not necessarily mean I did not, memories are vague) but I was supposed to use it at home. It was strapped to my leg with the knee at the center. There was some plush fabric that went with it which they did not take back since when it was rented to new patient they would give her a new one. It was uncomfortable and I really did not feel it helped at all. I do remember thinking that it would be less of a nuisance if I could use it while sleeping. When I called to turn it in after just a month (I actually only tried it for about two weeks) I was told it receives mixed reviews from patients, some love it and some find it useless.
JK

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@gailfaith

@contentandwelll @ hopeful33250 Yes, when using the passive motion machine, it is not like 10 minutes or whatever a day. It does take time (hours) but you can use it while you are asleep at nite. When I had it in the nursing home, I had it going whenever I was in bed. I work up from the surgery with my leg already on it! gailfaith

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@contentnandwell. Will have to ask my therapist if he knows of any other kind of machine used to bend the knee? Will let you know if so! Cant help but wonder if you were told to only use it in the bed, not out of the bed! especially since you say that you think it would have been more comfortable to use in the bed!!!!. gailfaith

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This fall I’m undergoing TKR, my first. I’m currently talking with Mayo Rochester MN. (Was previously scheduled for 4/14/17 in Roch but 4/11 my appendix burst and I almost bit the dust.) Ten years ago my husband had both of his replaced (in Illinois–we’ve moved), six months apart.

Ten years ago: he used the passive motion machine for both knees, both in hospital and home; he had an electronic ice machine (like a cooler with a motor) that pumped ice water through the giant pads; he went to physical therapy for a few weeks, that after he had in-home therapy for a couple weeks. But my, how things have changed! Also ten years ago his doctor said if he didn’t have TERRIFIC pain control he wouldn’t do what he was supposed to and his knees would not heal properly.

For the most part the passive motion machines have been done away with as *many studies showed that a year or two after surgery there was no difference in those who used one and those who didn’t. Many docs believe using your own muscles more quickly begins the resuming of strength more quickly. There is more to recovery than degrees of bend; strength matters too. So, no machine for me since doc doesn’t believe in them. Guess after wrangling around with that giant machine after my husband’s surgery, I’m inclined to think doing without makes sense.

The only people I know lately who’ve used an electronic ice machine purchased one themselves. I’m assuming this has to do with insurance. ??? They were a God-send for my hubby so I’ll be getting one on my own dime whereas he was given (well, insurance paid) a new one with each surgery.

I’m now being told I will not have any official therapy unless my at-home, on-my-own post-op therapy is not productive. My Mayo doc said there are too many too-aggressive therapists, and there’s nothing you can’t do at home that’s done the same with a therapist watching. It’s discipline that matters–PLUS being very gentle with the leg that first while, which is apparently when we’re most vulnerable to a therapist over-doing things. I have heard stories on both sides of this coin, but more than not people did admit their therapists pushed so hard, the pain was so bad, that they sometimes had to skip the next day’s work. (Other side of coin: my husband loved his therapist who he partially credits with how well he did. He also had a terrific surgeon.) I’ve also heard there is a case to be made that we are more susceptible to infection at therapy facilities. I guess that makes sense.

Today pain meds and their abuse are under fire. However, if you’re in too much pain to properly do your exercises, where does that leave you? I do know there’s certain amounts of pain we just need to gut through. But good pain control so I can properly exercise will be something I’ll go to bat for.

All this to say … My how things have changed.

I wish everyone well and am firing up prayers and healing thoughts as I type. I notice nobody mentions Doc names. Perhaps there is a rule? It would be great to compare docs’ thinking.

REPLY
@lisalucier

Hi, @maryx1937–Thanks for making your first post to Connect. I moved your message from the Rehab group to this active discussion called “After knee replacement surgery” so that you can meet other members talking about recuperating from knee surgery. Please meet @gailfaith @contentandwell @cheris @cobweb @niazumbanut @beatricefay and others. Just click VIEW & REPLY to read through the discussion.

Mary, I see from your message that you are 80 years young and in good health, and that you are recovering at home with the help of home health. Do you have a physical therapist coming to your home to work on rehab with you? When was your surgery? How are you doing?

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It’s good to hear your success story. Yes, I will be ready to get out by the end of this week I’m sure. Thanks.

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@challie

This fall I’m undergoing TKR, my first. I’m currently talking with Mayo Rochester MN. (Was previously scheduled for 4/14/17 in Roch but 4/11 my appendix burst and I almost bit the dust.) Ten years ago my husband had both of his replaced (in Illinois–we’ve moved), six months apart.

Ten years ago: he used the passive motion machine for both knees, both in hospital and home; he had an electronic ice machine (like a cooler with a motor) that pumped ice water through the giant pads; he went to physical therapy for a few weeks, that after he had in-home therapy for a couple weeks. But my, how things have changed! Also ten years ago his doctor said if he didn’t have TERRIFIC pain control he wouldn’t do what he was supposed to and his knees would not heal properly.

For the most part the passive motion machines have been done away with as *many studies showed that a year or two after surgery there was no difference in those who used one and those who didn’t. Many docs believe using your own muscles more quickly begins the resuming of strength more quickly. There is more to recovery than degrees of bend; strength matters too. So, no machine for me since doc doesn’t believe in them. Guess after wrangling around with that giant machine after my husband’s surgery, I’m inclined to think doing without makes sense.

The only people I know lately who’ve used an electronic ice machine purchased one themselves. I’m assuming this has to do with insurance. ??? They were a God-send for my hubby so I’ll be getting one on my own dime whereas he was given (well, insurance paid) a new one with each surgery.

I’m now being told I will not have any official therapy unless my at-home, on-my-own post-op therapy is not productive. My Mayo doc said there are too many too-aggressive therapists, and there’s nothing you can’t do at home that’s done the same with a therapist watching. It’s discipline that matters–PLUS being very gentle with the leg that first while, which is apparently when we’re most vulnerable to a therapist over-doing things. I have heard stories on both sides of this coin, but more than not people did admit their therapists pushed so hard, the pain was so bad, that they sometimes had to skip the next day’s work. (Other side of coin: my husband loved his therapist who he partially credits with how well he did. He also had a terrific surgeon.) I’ve also heard there is a case to be made that we are more susceptible to infection at therapy facilities. I guess that makes sense.

Today pain meds and their abuse are under fire. However, if you’re in too much pain to properly do your exercises, where does that leave you? I do know there’s certain amounts of pain we just need to gut through. But good pain control so I can properly exercise will be something I’ll go to bat for.

All this to say … My how things have changed.

I wish everyone well and am firing up prayers and healing thoughts as I type. I notice nobody mentions Doc names. Perhaps there is a rule? It would be great to compare docs’ thinking.

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@challie, @contentandwell Hi again. Interesting how many things you hear that are different and I wonder where the truth lies. I had heard that the discontinued use was because as the replacements lasted longer without the use of the passive motion machine (pmm)! I just had both knees x-rayed as I have a walking project as I am fighting to stay out of wheelchair due to my rare form of muscular dystrophy to check on the TKR’s, now 13 and 11 years old. And though I had the pmm, neither show ANY signs of wear and since Aug of 2016, I now have walked 110 miles that I have actually measured with a measuring wheel tied to my left cane, and this does not include any other walking thru the day either inside or outside. Before I bought a measuring wheel the VP here at the retirement community measured with a 10 inch wheel the distance of the circular road on the South campus here. I bought a 4 inch wheel and though the total distance is 0.5845 miles, we differened only 1 FOOT from our separate measurements so I know my 110.6045 miles is pretty close to be the actual distance. We both measured to the 4th place! I just learned he measured it while on a bike and I when walking!!!!!!!! gailfaith

REPLY
@gailfaith

@contentandwelll @ hopeful33250 Yes, when using the passive motion machine, it is not like 10 minutes or whatever a day. It does take time (hours) but you can use it while you are asleep at nite. When I had it in the nursing home, I had it going whenever I was in bed. I work up from the surgery with my leg already on it! gailfaith

Jump to this post

I had a simple brace that you put on your leg. It had cranks on it you would “dial” to bend or straighten your leg. Basically you would just turn the dial and it would force your leg to bend or straighten depending on which way you turned the dials on the brace. The brace itself consisted of 4 straps that started at the shin area and when up to the upper thigh. You only wore it when you wanted to use it.

I was encouraged to use this because my recovery was so poor. In the end, I don’t think it helped. I had really aggressive scar tissue formation, however, I think I am personally more to blame. I don’t think I followed my rehab instructions thoroughly enough. Make sure you adamantly follow your surgeon’s instructions, it really is the best way to achieve success.

REPLY
@challie

This fall I’m undergoing TKR, my first. I’m currently talking with Mayo Rochester MN. (Was previously scheduled for 4/14/17 in Roch but 4/11 my appendix burst and I almost bit the dust.) Ten years ago my husband had both of his replaced (in Illinois–we’ve moved), six months apart.

Ten years ago: he used the passive motion machine for both knees, both in hospital and home; he had an electronic ice machine (like a cooler with a motor) that pumped ice water through the giant pads; he went to physical therapy for a few weeks, that after he had in-home therapy for a couple weeks. But my, how things have changed! Also ten years ago his doctor said if he didn’t have TERRIFIC pain control he wouldn’t do what he was supposed to and his knees would not heal properly.

For the most part the passive motion machines have been done away with as *many studies showed that a year or two after surgery there was no difference in those who used one and those who didn’t. Many docs believe using your own muscles more quickly begins the resuming of strength more quickly. There is more to recovery than degrees of bend; strength matters too. So, no machine for me since doc doesn’t believe in them. Guess after wrangling around with that giant machine after my husband’s surgery, I’m inclined to think doing without makes sense.

The only people I know lately who’ve used an electronic ice machine purchased one themselves. I’m assuming this has to do with insurance. ??? They were a God-send for my hubby so I’ll be getting one on my own dime whereas he was given (well, insurance paid) a new one with each surgery.

I’m now being told I will not have any official therapy unless my at-home, on-my-own post-op therapy is not productive. My Mayo doc said there are too many too-aggressive therapists, and there’s nothing you can’t do at home that’s done the same with a therapist watching. It’s discipline that matters–PLUS being very gentle with the leg that first while, which is apparently when we’re most vulnerable to a therapist over-doing things. I have heard stories on both sides of this coin, but more than not people did admit their therapists pushed so hard, the pain was so bad, that they sometimes had to skip the next day’s work. (Other side of coin: my husband loved his therapist who he partially credits with how well he did. He also had a terrific surgeon.) I’ve also heard there is a case to be made that we are more susceptible to infection at therapy facilities. I guess that makes sense.

Today pain meds and their abuse are under fire. However, if you’re in too much pain to properly do your exercises, where does that leave you? I do know there’s certain amounts of pain we just need to gut through. But good pain control so I can properly exercise will be something I’ll go to bat for.

All this to say … My how things have changed.

I wish everyone well and am firing up prayers and healing thoughts as I type. I notice nobody mentions Doc names. Perhaps there is a rule? It would be great to compare docs’ thinking.

Jump to this post

@challie I believe what you were told about the passive motion machines is the same that I heard when I turned mine in. Some patients feel they help but many do not. I would love to have one of the icing machines. Any idea of the cost if you cannot get a prescription? I plan to ask my surgeon about that.

I am sure there is more to recovery than flex degrees which for me never got where it should have but my knee is reasonably strong. It does hurt though still at times and I cannot flex it well. If I try to kneel on it, it really hurts and occasionally at other times too.

I had an at home therapist and he was great, definitely not overly aggressive but very helpful and very supportive. I have had him two times, after a knee replacement and then again after my transplant. They give you therapy to help you get back on your feet after transplant. The therapist I had at a center is also great. I had him two times but not for my first knee replacement. I think I have been very fortunate in that regard. I have had physical therapists in the past for other things and none were too aggressive except for one, the one I had after the first knee replacement. She was aggressive and pushed my knee to get it to flex more, to the point where I literally screamed. Seriously, that cannot be good. I was not working at the time but the pain was not so bad that it put me out of commission the next day.

Regarding to the therapy center I went to, I think it was a good center, I had 3 or 4 sessions a day of various types of therapy but I cannot honestly say how much that helped. This ortho though is very opposed to the centers because of the higher incidence of infections and now that I am on immunosuppressants there is no way I would risk that.

I have never heard of a rule about naming doctors but most people would not mention a doctor’s name if they were going to say anything negative I think. With all the legal cases who would want someone to say they damaged their reputation? Certainly not me. I happily will mention my transplant surgeon’s name – Dr. Nahel Elias. He is the best in my opinion. My ortho whom I am going to for the knee replacement is Dr. Wolfang Fitz whom I hear nothing but good about. He is one of the developers of the Conformis knee which is custom made for each patient — no “pick a close knee off the shelf”. He gives you other options, I would imagine he would have to because just doing his would be considered a conflict in interest probably. There are other doctors who use that knee also, you can find them if you google Conformis. Before the surgery you have a CT for them to use to manufacture the knee. That is done about 6 weeks prior to surgery.

JK

REPLY
@challie

This fall I’m undergoing TKR, my first. I’m currently talking with Mayo Rochester MN. (Was previously scheduled for 4/14/17 in Roch but 4/11 my appendix burst and I almost bit the dust.) Ten years ago my husband had both of his replaced (in Illinois–we’ve moved), six months apart.

Ten years ago: he used the passive motion machine for both knees, both in hospital and home; he had an electronic ice machine (like a cooler with a motor) that pumped ice water through the giant pads; he went to physical therapy for a few weeks, that after he had in-home therapy for a couple weeks. But my, how things have changed! Also ten years ago his doctor said if he didn’t have TERRIFIC pain control he wouldn’t do what he was supposed to and his knees would not heal properly.

For the most part the passive motion machines have been done away with as *many studies showed that a year or two after surgery there was no difference in those who used one and those who didn’t. Many docs believe using your own muscles more quickly begins the resuming of strength more quickly. There is more to recovery than degrees of bend; strength matters too. So, no machine for me since doc doesn’t believe in them. Guess after wrangling around with that giant machine after my husband’s surgery, I’m inclined to think doing without makes sense.

The only people I know lately who’ve used an electronic ice machine purchased one themselves. I’m assuming this has to do with insurance. ??? They were a God-send for my hubby so I’ll be getting one on my own dime whereas he was given (well, insurance paid) a new one with each surgery.

I’m now being told I will not have any official therapy unless my at-home, on-my-own post-op therapy is not productive. My Mayo doc said there are too many too-aggressive therapists, and there’s nothing you can’t do at home that’s done the same with a therapist watching. It’s discipline that matters–PLUS being very gentle with the leg that first while, which is apparently when we’re most vulnerable to a therapist over-doing things. I have heard stories on both sides of this coin, but more than not people did admit their therapists pushed so hard, the pain was so bad, that they sometimes had to skip the next day’s work. (Other side of coin: my husband loved his therapist who he partially credits with how well he did. He also had a terrific surgeon.) I’ve also heard there is a case to be made that we are more susceptible to infection at therapy facilities. I guess that makes sense.

Today pain meds and their abuse are under fire. However, if you’re in too much pain to properly do your exercises, where does that leave you? I do know there’s certain amounts of pain we just need to gut through. But good pain control so I can properly exercise will be something I’ll go to bat for.

All this to say … My how things have changed.

I wish everyone well and am firing up prayers and healing thoughts as I type. I notice nobody mentions Doc names. Perhaps there is a rule? It would be great to compare docs’ thinking.

Jump to this post

Very thorough report of good information for many.

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ALL these mails re tkr just reinforce that I will keep pursuing stem cells – even if I have to go out of the country.

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