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Two weeks out from a total knee revision
Tomorrow I will be 2 weeks out from my total knee revision. Thus far the process has been relatively smooth. I did bang my knee on the shower door two days after I got home from the hospital and that certainly has complicated things. But by far the biggest challenge that I have is that I suffer from severe, continuous bilateral Facial Pain. This is my first post but I certainly plan to write one in the chronic pain section about my enormous challenges with the special thing . But for now I just want to talk about the revision . I knew it would impact my physical therapy and it certainly has. I have had three physical therapy sessions at home so far and I'm at 90° flexion. There has been an enormous amount of pain to be sure, but that is to be expected for this highly invasive surgery. Smacking my knee really hard on the shower door caused bruising and it cost me about four days of physical therapy. So there was some time in bed that would not have otherwise been there. I've done a pretty good job with the icing and a good job of getting up and walking around the house using a walker. I'm now ready to graduate to a cane. My two week post op tomorrow morning and I'll have my Staples removed. I have a brilliant surgeon here in Dallas and so that is certainly a blessing and a mercy. The isolation has been buffered by visits from my close friends in my synagogue. Because of the existing trigeminal pain I have been largely isolated for 10 years. So the mental and psychological challenge of now having to deal with this is significant. As a retired clinical psychologist I have been able to navigate the trigeminal pain, at least well enough to still be here. I have an extraordinarily supportive rabbi and many close friends who come to see me. Sorry for the rambling but I wanted to give you a clear picture of what's Happening. Any help you can land would be greatly appreciated.
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So sorry about the shower door incident. Very glad you have such a supportive community!
This is what I can offer from my own tkr experience. Keep doing the home exercises religiously. The physical therapy, if course, is crucial but the home exercises will help you achieve the range of motion you want (barring any health related issues). Honestly, I hated the home exercises but they did the trick.
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4 ReactionsGood morning,
90% flexation/range of motion after two weeks I think is awesome! It took me 6 weeks to get to that point & I was very faithful with PT at home & at the PT office as well as elevating, walking & icing. Yes, the pain can be very intense, especially the first 4 weeks but if you're taking pain meds, I would recommend trying to use them only at night to help get better sleep (helps the body heal) and maybe once during the day and use on OTC med for all other doses. I'm so glad you have a good support system with your friends as that's so important emotionally for healing as well (as I'm sure you know based on your having been a clinical psychologist). Prayers for you and continued healing both with your knee & the trigeminal facial pain. My daughter has been dealing with that for 11 years as a result of nerve damage during brain surgery to remove a tumor. Take care.
DMG, I am tremendously impressed that at 2-weeks post surgery you are ready to walk with a cane and have 90 degrees ROM! I wasn't there at 2-weeks out, but that seems so long ago. I had in-home PT for 6-weeks, followed by out-patient PT 2-3X per week. Now that I think about it, maybe all that in-home PT wasn't a good idea, but it is the standard "package" where I had my surgery. PT made sure I was up and moving, doing basic exercises to keep my knee flexible, and OT made sure I was doing well-enough to be home alone. Of course, there was pain, mostly at night, and I used the prescribed pain relievers for a week or so, only at night so I could sleep and iced regularly during the day. The PA in the surgeon's office suggested taking one before outpatient PT, as long as I wasn't driving, and I did that. Outpatient PT was the painful part, it turned out -- not so much the routine exercises, but the pressure the PT used to increase range-of-motion. At 3-months, I was only getting 90-degrees when the PT forced it, and that hurt! I was icing after PT with the machine I was sent home with. PT felt sure the issue wasn't scar tissue. I'd had a swelling issue with that leg for a decade, so even before the TKR my ROM wasn't as good on that leg as my other leg. Bottom line, we all recover differently. At 16-months out I am very pleased with my recovery, and have equal ROM on both legs -- most of the time. My advice is, just keep pushing for more and try not to compare your progress with anyone else's. It sounds like you're doing great!
If you were two weeks out from a TKR, I would think you might be frustrated. But Revisions are much more complex and recovery is more difficult. You are doing very well. Keep at it. Glad you have a great revision surgeon.
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1 ReactionThank you all very much for responding. There is one other issue.I'd like your feedback on if you have some. As you might imagine.
On my 12 year journey with this terrible trigeminal pain I have tried solution known to man. I have a long list of highly skilled providers who have failed to reduce my pain . It is no reflection of them as they have done all the right things. I have been told repeatedly that my facial pain configuration is exceedingly rare. Twelve weeks ago I decided to get off the buprenorphine patch because it was not reducing my pain enough to justify its use. I then enrolled in the compassionate.Use program for cannabis and have been using that supplemented with my own cannabis for paying control. It is a little like going to a gunfight with a pea shooter , but I was sick of all the codeine and other narcotics. Because of the major interaction between cannabis and hydrocodone I have not used any cannabis , medical or otherwise in the two weeks since my total need revision because of all the is is hydrocodone. I would very much like to resume that for multiple reasons. I have been reluctant to do so but it is getting very hard or not to resume. Can any of you please share any experience you may have either directly or indirectly. I know this post is probably in the wrong place and would ask that the moderators help me and put it in the right place so I can get a maximum response. Thank you all for your compassion. I am very grateful
@hashemis1
You might want to post the question to a pain support group, or better yet if you can access a multidisciplinary pain rehabilitation program.
Mayo Clinic probably still has such a program. Other health care clinics may as well. They should be able to assess factors in your pain and provide a variety of solutions. I had experience with this type of program in the past, but my experience is dated a few years, and I obviously don't know all of your particular circumstances. I would offer the opinion opioids such hydrocodone in the long run often cause adverse effects and sometimes worsen pain (paradoxically increase pain = opiod induced hyperalgesia), so the help of a good pain team might be in your best interest!
Best wishes
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2 Reactions@tallbackhip that's what I thought I was doing . I am new here and don't know how to use the system yet. Is there a way to move my comment to the chronic pain community posts?
@hashemis1
As mentioned in my previous post, my daughter struggles with trigeminal nerve pain as well & it affects the left side of her face from forehead down to her jaw. Stress and heat seem to exacerbate the pain. She was referred to a great pain clinic (she lives in Grand Rapids, MI) who worked with her to get a combination of low-dose meds to manage the pain. The pain clinic opted for a combination of low-dose meds so that it would not be detrimental to her liver or other organs. Although she's never been a fan of pain meds, she has no option at this point and for the rest of her life she will be on meds to manage that pain. I would highly recommend finding a very good pain management clinic (even if you have to travel a bit) & possibly one who recommends other natural options as well. Best wishes.
@babyjayne5977 thanks for responding. I've already got a great pain doc and his clinic , which also houses my neurosurgeon , is highly thought of here in dallas .
I'm curious, are you saying you have been home alone from when most hospitals kick you out at 23 hours [if you are on medicare]? I live alone and am pre TKR. 82 yr old Lady. I am concerned about post TKR as I think I need support.
Your progress sounds remarkable. Glad you found a clinic for pain. As far as your post, I would copy your message and pase to a new 'thread' for pain. You can still get some great feed back!