My Half Knee Replacement Operation in May 2003 (REPICCI KNEE ARTHROPLASTY)
The following are daily notes I made about my REPICCI KNEE ARTHROPLASTY (half knee replacement). I am male large frame and in my late 60s. I’ve posted the notes as they may be of interest to anyone contemplating a similar operation. Twelve months on, the result is fantastic – about a 95% success I would say. I can walk as far and as fast as I like – but jogging is out as is anything that jars the knee. Kneeling is also out, otherwise no problems.
I came up with my own scale to measure the pain –
1. No pain. Normal and full joint movement.
2. Not very painful but joint, movement is restricted and hurts.
3. Painful or aching but not a big problem
4. Painful or aching keeps you awake but bearable – need Panadol / Panadeine Forte.
5. Quite painful
6. Very painful – need strong pain killer like Endone.
7. ……
8. …..
9. …..
10. Unbearable
Medication -
Medication provided for first 2 days after surgery – Endone, Brufen, Keplex and Tramadol or Panadeine Forte for severe pain. Also I was given Coloxyl for constipation. Slow release drug “Painbustert” local anaesthetic catheter in the wound for the first 3 days. Drain in the wound and a drip for the first two days. Chemist sold me Panamax 500 mg which he assures me is identical to Panadol but much cheaper and is cheaper still if on prescription script.
Medication provided by the hospital for use after day 3, for 4 to 6 weeks – Brufen, Zantac and Panadeine Forte or digesic and Coloxyl. I used a lot of Panamax.
Leg immobiliser rented from the hospital used for first 3 days. Remove it at night if you like. Crutches also rented from the hospital, but weren’t needed for very long.
Suggestions
1. Let it be know to all and sundry that you are NOT going to be a good patient – saves a lot of unproductive effort trying to be good, which is not in the nature of the male members of my family.
2. Move a bed into the lounge room so you can have a change of location and watch TV. My wife and I needed to sleep in separate beds so I could spread out and make sure the leg doesn’t get bumped; also so that “nurse” gets a solid nights sleep to help maintain good humour and understanding at all times – very important!
3. Recommend starting the exercises the doctor gives you, as soon as possible before the operation – the longer you do them the better you will be. However, I would say that after the operation, don’t overdo it as you could strain your leg.
4. Buy a “Reusable Cold/Hot Pak – Medi-Pak 620” - 55x25cm – about $25 from physio. This is the larger one and will run the full length of your thigh, knee and calf or will wrap right around the knee. You can “strap” it on with something to get to the sides of your knee. I found it better after the first few days than the “Cryo-Cuff” – well worth the money. Elevate your leg when using cold packs.
5. Buy a nice big wheat bag to microwave as a hot compress.
6. Prior to and after operation eat fruit and vegies and take Coloxyl (or similar) to prevent constipation. Can take up to four Coloxyl (I took two at a time)
7. Make sure they give you the large size TED stockings (XLG) to cater for swelling. Be mindful of DVT - it bears watching and doing all the right things like wearing the TED stockings, regular leg elevation and getting moving as quickly as possible so as not to be immobile for long periods which could result in clots forming. Check for lumps in the calf and any unusual swelling. Get moving quickly to get medical help if this happens – preferably to come to you so the clot doesn’t move – it’s a killer. A friend of mine had terrible problems and almost died from clots after his knee replacement.
8. Take the pain killers as prescribed and don’t try to second guess the likely pain level because you can’t predict it.
9. For a change, lay a firm pillow long ways on the bed to support the whole leg.
10. Learn from my mistake and don’t overdo the exercises while the leg is still sore (don’t be fooled by pain killers in the first week as the knee isn’t really as good as it feels). Until the leg is no longer sore (which for me was about six weeks) do light exercises only, but not to the point where you can feel it hurting or straining – if you do them at all. Only do them to keep the joint a bit flexible. When the joint is fixed, you can do more strenuous exercises and build up the leg muscles. The physio will probably tell you to do all of the exercises all of the time, but it’s no good if it hurts and inflames the joint (I don’t have much faith in physios), the priority at this stage is to get your leg back somewhere near normal. I got nowhere until I stopped the exercises for a while.
11. I took a “Stilnox” sleeping tablet on Day 43, and probably put off taking them two weeks longer than I should have. In hindsight, I should have taken them at the stage when my leg was pretty good through the day, but aching at night and keeping me awake because I couldn’t get comfortable. Had I taken them sooner, I would have got good nights sleep and my leg would have got the chance to settle down without me moving it around all night upsetting it.
12. Prior to the operation, the surgeon told me I could go home the same day as the operation. My wife said “no way – he stays for at least one night”. She was right, so I wouldn’t recommend going home the same day.
So here we go folks - a blow by blow description from my notes-
Day 1 – Saturday 31/5/03
31 May 2003 - Operation at 1.30 PM – In Ward at hospital by 4.00 PM. Saw surgeon who said operation went very well. Knee is Ok with very little pain. I only had one sandwich for dinner. Pain level 2/10, but heavily drugged to control pain. Felt sick and giddy around 2.00 AM Sunday morning and vomited a lot. Pain level 2/10
Day 2 – Sunday 1/6/03
Later in the morning I was still giddy and nauseous. Couldn’t eat any lunch, but started to improve Sunday afternoon and was able to eat all of my dinner. Pain level 3/10. Have to sleep on my back but had a reasonable night. Taking tablets every four hours.
Day 3 – Monday 2/6/03
Up early and “hopped” into en-suite using crutch, to have a wash, shave and washed my hair. Leg was sore to put any pressure on. Pain level 3.5/10. I am waiting for physio to come to show me how to use crutches so I can go home. Pain level in bed 1/10. My wife & daughter picked me up about 2.00 PM. I lay down on back seat of the car and would you believe it, I got car sick on way home but didn’t throw up. Home and in bed; pain is OK. My wife gave me my tablets during the night. Pain level about 2/10. Got reasonable nights sleep, but having to sleep only on my back is a problem.
Day 4 Tuesday 5/6/03
Pain level is about 2/10. Feeling a bit giddy. Now only use the leg immobiliser when walking. As advised by the surgeon. I removed Elastoplast and bandage and cotton wool they put on in the theatre. Then removed the transparent Duoderm waterproof dressing covering the wound. Lightly showered the wound (and myself), patted the wound dry with gauze bandage and gently but thoroughly dried with hair dryer. Applied a fresh Duoderm covering and applied a crepe bandage and put on TED stockings, Can get around OK on the crutches but not going up or down. Started using the “Cryo-Cuff” ice pack 4 times daily. Constipated since AM Saturday! This shows how important it is to start on fibre, fruit & veges and laxatives straight away prior to and after operation. Not a good day, feeling nauseous and giddy. But the knee is OK. Pain level maybe 3/10. Surprisingly though I had quite a good night.
Day 5 Wednesday 4/6/03
Pain level is about 2/10. I am still constipated and feeling nauseous, most likely the Brufen anti inflammation causing the problem. No more Endone pain killers but pain is OK about 2/10. EUREKA, constipation fixed – big celebrations! Now walking with one crutch only and could probably walk without that one. I started the four leg exercises the surgeon gave me to do, today. The knee is remarkably good and handled the exercises much better than I expected except for the one where you have to sit on the edge of a table and straighten the leg and then bend it back as far as it will go under the table and hold it there for 20 seconds. Have to do this 20 times – it hurts! Could only do 11 first up. Pain level still around 2/10. Sitting up in lounge room today and using laptop computer, so on the mend. My wife has been wonderful and a great nurse - very tolerant (I’m a bad patient – hate being sick and laid up!). Night was not so good. Knee was hurting no matter which way I lay. On my back was the best. Took Panadol at 3.00 AM and again at 6.30 AM. I think the exercises upset my knee. Minimum of 2 sets of exercises each day required. I was going to do 3 sets, but will stick to 2 so as not to overdo it. Also, TED stockings were very tight around the top of my sore leg and left a lump. Should have size XLG – one size larger (I’ve got thighs like Xmas hams!). Pain level during night around 3/10 or maybe 3.5/10
Day 6 Thursday 5/6/03
Had a shower (I put Gladwrap over the Duoderm to try and keep water off it even though it is supposedly waterproof). Did exercises OK. Leg was aching so I removed TED stockings after lunch. Felt really agitated and nauseous in the afternoon. Took another Panadol after lunch. Pain level around 2.5/10. Did exercises again about 7.00 PM. Had a restless night. Panadol around 4.00 AM and again at 6.30AM. Still haven’t had to use Panadeine Forte. Pain level 3/10. It is a problem not being able to sleep on my side - only flat on my back.
Day 7 Friday 6/6/03
Had a shower and felt quite exhausted after doing exercises so went to bed for a while. Wound is still clean and healing well. Bruising has come through on inside of knee and thigh. Would be a mistake to do any more than 2 sets of exercises a day at this stage. Felt really good after the rest. Pain level around 2/10. Walked around really well with no crutches – no problem. In fact went for a drive with my wife so as to get out for a while. This is by far the best day so far. Did second set of exercises. My son dropped in and was amazed to see me walking around normally. Pain level only about 1.5/10 and nil at some times. Not a good night - ache more than a pain in my knee all night. Pain / ache level 3/10. Panadol at 4.00, 6.00 & 8.00 AM. Didn’t get much sleep. I think the problem is that I pushed too hard with the exercises. Also, I have been addressing the pain after it occurs, whereas it is probably better to prevent the pain by taking the prescribed medication, so tonight I will take the Panadeine Forte and see what happens.
Day 8 Saturday 7/6/03
Again I am feeling a bit nauseous. Had a shower and bandaged the knee. My knee and leg are quite sore and I am walking with a limp. Pain level under 3/10. Postponed the first set of exercises until around lunch time and didn’t push it too hard. Did some walking around the house to keep it all moving. Felt much better after lunch and the knee is not nearly as sore. Did exercises again about 6.00 PM but didn’t push it too hard. Not much pain when walking. Took one Panadeine Forte at 11.30 PM but needed another at 4.00 AM. Took a Panadol at 7.00 AM. Pain level just under 3/10 during night so a restless night, although I did manage to lie on my side for ½ an hour – heaven on a stick!
Day 9 Sunday 8/6/03
I had a shower. Knee is a bit sore – pain level under 2/10, hurting under knee cap when I walk. Did exercises and again the “bend the leg sitting on the table” exercise was painful. Walking is OK but a little painful and was better than this previously. The wound still looks good. Generally, I think it’s going extremely well. When you consider it is only one week since the operation, it is a remarkable result. I am walking unassisted with very little discomfort. Can’t wait to see if I can walk to the end of the street and back without pain (about 700 metres), as I couldn’t go half way without hobbling back prior to the operation. Did exercises about 7.00 PM which again hurt. Pain level about 3/10. Prior to going to bed the knee was aching. Took two Panadol at 11.30 PM and will see what they do. Not a good night. Took two more Panadol at 3.30 AM and another at 7.00 AM. Pain / ache level about 3/10 during night. Could not get comfortable, however I did get some sleep between tablets. Can still only lay on my back.
Day 10 Monday 9/6/03
Had shower and walked around the house to loosen up and then did exercises and pushed it a bit. Pain level dropped to 1/10 and was so good we went for walk to the end of our street and back – about 700 metres – without any of the former problem (I could only walk about 150 metres before hobbling with pain). Only problem experienced was at the back of the knee, which was painful but I think this is from the exercises and maybe the operation and will subside in time. Knee was a little sore in afternoon (pain level about 2/10), so I decided not to do second set of exercises today. Now 11.00 PM and leg is feeling not too bad, but will be interesting to see if it plays up again during the night. Will take two Panadol when I go to bed. Another restless night. Woke up again at about 3.30 AM. Pain level just under 3/10. Took another Panadol but not much sleep. Leg aching or burning sensation and can only lie on my back. Uncomfortable but not anywhere near unbearable.
Day 11 Tuesday 10/6/03
Had shower and did exercises. Leg is really good once I am out of bed. Pain level between 0 and 1. Deteriorated during day, due I think, to over-exercising. Was difficult to walk in late afternoon due to pain in muscle down the outside of the leg below the knee. Pain level about 3/10. My wife came up with good idea. She cut a section out of panty hose to hold a piece of crepe bandage over the wound thereby avoiding the bulk of the bandage behind the knee. Took two Panadol going to bed, but woke up at 2.30 AM and took another Panadol. Pain level about 3/10.
Day 12 Wednesday 11/6/03
Follow–up visit to surgeon
Alarm woke me at 5.00 AM to get ready for follow-up appointment with physio 8.30 AM. X-ray at 9.30 AM and Surgeon at 10.30 AM – all located at the hospital. Muscular pain level when walking about 3/10, but nil when not walking. No exercises today – leg is too sore.
Doctor was very pleased with result. Said it’s in the top 10 percent. He said sometimes an injection of cortisone in the medial ligament might be needed to settle it down as the ligament is pulled to one side during the operation to get the implant in (probably both ligaments for a full knee). The wound is clean and healing well. Doctor said to treat it just like your other skin from today – no dressing needed. See Doctor again in three months. Got additional exercises from physio, but will give it a rest until muscles recover. Returned crutches, leg immobiliser and Cryo-Cuff to the hosptal. See physio again in 1 month. Left hospital about mid day. Took Panadol when back home. Ice pack on knee – it works better than Cryo-Cuff (Reusable Cold/Hot Pak – Medi-Pak 620 - 55x25cm – about $25 from physio and well worth it). Pain level when walking about 3/10 but is muscular. I am using a walking stick so I don’t fall. Took two Panadol going to bed and expected a bad night but woke up at 5.30 AM – best yet. Found I was finally able to lie on my side for ½ hour or so.
Day 13 Thursday 12/6/03
The leg was still sore when I got up and pain level still about 3/10 when walking with aid of a stick. Had not so good day as walking was difficult – painful and felt the knee would give way. Sure the problem is muscular. Took Panadol going to bed and expected to have a reasonably good night as I could lie on my side for a while. Woke up and thought it would be 3 or 5 or maybe 8 AM but no, it was only 1.30AM! So not such a good night after all with pain level around 3/10.
Day 14 Friday 13/6/03
Surprisingly, when I got up I could walk without the stick and the leg was not too sore – pain level around 1.5 to 10. Did the exercises the Doctor gave me and also the extra ones from the physio. Then cold pack for half an hour or more. Went for a drive with my wife and had a walk in the local park. The muscular problems of the last couple of days seem to have gone. Knee is still swollen and stiff and sore but no more than to be expected at this stage Pain level about 1 to 1.5. Wound has healed nicely. Took two Panadol and into bed about 11.30 PM. Woke up at 3.30 AM took another Panadol but couldn’t get comfortable after this. Leg felt as if it was aching behind the knee and in the calf. Pain / ache level about 2.5/10.
Day 15 Saturday 14/6/03
When I got up the leg was virtually pain free. Did a few laps around the house without problems. Decided to try a hot compress and then did all the exercises and really pushed it. My wife said that I had “cabin fever”, so she packed a lunch and we went to a local seaside park and watched the activity on the bay. After lunch and a short walk, and then went for a drive to watch the whales heading north, but none there at that time. Home at about 4.30 PM and applied hot compress; did full set of exercises again and then applied a cold compress for about an hour. As expected, the leg is stiff and sore behind the knee and in the calf. The knee cap is also touchy. Applied another hot compress. It’s been two weeks today since the operation, and there has been a definite change for the better today. Will see what happens tonight and tomorrow.
Well, took two Panadol and went to bed. Pain level 0 to 1 - no pain at all. Could lay on either side comfortably. But it’s hard to win, instead of a good nights sleep; I was still awake at 5.00 AM. Thought I might nod off but not to be. A dam dog spent the next two hours walking up and down our street barking and sniffing like a bloodhound – even came onto our lawn right under our bedroom window.
Day 16 Sunday 15/6/03
Did exercises; surprisingly after such a painless night, the leg is quite sore today. Went for walk down our street but only got half-way & turned back. Pain level 1 to 1.5 Afternoon exercises were difficult. Hot and cold compresses then to bed. No real pain in bed so no Panadol. Best night yet. Woke up at 5.30 AM; leg is a bit sore.
Day 17 Monday 16/6/03
Had a shower and did the exercises. Takes about an hour and then the time for hot & cold compresses. Leg is pretty sore. Pain level 2.5 when walking. Went to shopping centre with my wife, but only go about 30 metres into the Centre and had to give it away and come home. It is painful to walk and feels like bone on bone on the side and at the front medial. I think I have been too strenuous with the exercises. My son has a lot of experience with training and injuries so discussed it with him. His logic is that you have to get the knee back to scratch after the trauma of the operation and while you are achieving this, you should only do light exercises to maintain joint mobility. Building up the muscle strength can come after the joint is fixed. Makes sense, so I’ll cut back on the exercises and keep them only light until it all settles down.
Awake all night; unable to get comfortable in bed. Have a continuous dull ache in the calf of the leg and sore to move. The pain level is about 2.
Day 18 Tuesday 17/6/03
Had a shower then my wife gave the leg a good massage. Applied a hot compress followed by a cold compress. Not doing any exercises today. Knee joint is very stiff. Difficulty walking any distance – couldn’t possibly go up or down steps yet except with a straight leg. More hot/cold compresses this afternoon and tonight. Pain level is low 1. when lying down but knee is sore when walking. Another massage and compresses before going to bed. I slept through to about 5.30 AM. The leg was aching and I was unable to get comfortable. Put a hot compress on it about 7.00 AM which helped a lot.
Day 19 Wednesday 18/6/03
Shower then a hot compress followed by a leg massage. Got picked up to go to my cooking class – good to get out (my wife would agree). The leg is sore when walking and aching when lying down. The pain level about 2/10. I applied another hot then cold compress which helped. No exercises again today; I think it is helping. Off to bed with a cold compress. The pain level is about 1.5 Not a good night; awake all night again. I couldn’t get comfortable at all. Pain level about 1.5
Day 20 Thursday 19/6/03
Had a shower, a massage and applied a hot compress. Leg is quite sore when walking. Decided to change from Brufen to my old anti inflammatory Vioxx (2X12.5 G) as I can’t notice difference when taking Brufen but I know Vioxx works well.
(PLEASE NOTE – IN LATE 2004, THESE DRUGS WERE TAKEN OFF THE MARKET – THEY CAUSE HEART ATTACKS – GREAT STUFF !!)
I applied a hot and cold compress during the day. No exercises again today. By late afternoon the leg was certainly feeling better. Pain level is about 0.5. On going to bed, the leg was very good – able to comfortably lie on either side. Slept until 4.30 AM, which was an improvement on previous nights. Leg was aching with pain level around 1.5 but after a while was able to get comfortable with virtually no pain or ache.
Day 21 Friday 20/6/03
Shower followed by one of wife’s famous leg massages. I took 2x12.5 mg Vioxx tablets. They are definitely more effective than the Brufen. (BUT SEE IMPORTANT DAY 20 NOTE) Leg is still a bit stiff and hurts in some positions particularly the medial ligament and under the knee cap. Walking is OK but I don’t think I could go too far. Did very light exercises without any strain on joints and cut the number of repetitions by half. I placed a cold compress around the knee. Cabin fever set in, so my wife is taking me to the shopping centre – very exciting, but I still won’t drive yet. Pain level 0.5 Woke up about 3.00 AM – same old problem; leg ache and unable to get comfortable.
Day 22 Saturday 21/6/03
Three weeks since operation. I took Vioxx 25mg. (SEE IMPORTANT DAY 20 NOTE) Drove the car without a problem as I don’t have to mover my leg to go from accelerator to brake. So, I’m FREE again! Leg is stiff and sore; find I am walking straight leg (like Chester). Did light exercises and applied a cold compress and had a leg massage which relieved it a bit. Not painful all of the time; only a sharp pain at sides and under knee cap at times when I walk. The pain level was then about 1.5 Woke up at 3.00 AM – had left electric blanket on “high” – half cooked! Was able to eventually get comfortable and went back to sleep (the first time I think).
Day 23 Sunday 22/6/03
I was able to walk reasonably well around house. Did light exercises and applied cold compress - leg felt quite good. After lunch, took my wife for a drive down to the beach and went for a walk beside the bay. Didn’t expect to get far, but ended up cautiously walking 1.3 klms without a tinge of pain – remarkable. Came home and applied cold compress after which the leg was great – virtually no pain at all (joint is still stiff though). Pain level 0.5/10. Took two Panadol to try and sleep right through but woke up at 4.00 AM with aching leg (no wonder). Don’t think I went back to sleep.
Day 24 Monday 23/6/03
There is virtually no pain except when I tense knee cap or move leg sideways. I drove to our local GP for a consultation. He said to take Vioxx at night to try and overcome aching early in the morning. (SEE IMPORTANT DAY 20 NOTE). Because of the aching, he checked the leg for DVT lumps, which hadn’t occurred to me, but all seems OK in that regard. I asked him for a script for sleeping tablets in case I need them. I went for a drive with my wife and had a very short walk. Went out at night to a function and actually walked up two flights of steps. Met a guy there on a walking stick who said he recently had a full knee replacement. He said his leg was swollen really badly a couple of days after the operation and he ended up with DVT which he said was really touch and go for a while – strange coincidence given my doctors comments about DVT this morning. So it bears watching for DVT clots and doing all the right things like wearing the TED stockings, regular leg elevation and getting moving as quickly as possible so as not to be immobile for long periods. My leg was a bit sore when I got home, so I applied a cold compress and had a leg massage by my wife. I took Vioxx 12.5 mg . (SEE IMPORTANT DAY 20 NOTE) and a Panadol prior to bed. I woke up at 4.00 AM with aching leg.
Day 25 Tuesday 24/6/03
Took Vioxx 12.5 mg, . (SEE IMPORTANT DAY 20 NOTE) had a shower and applied a hot compress which relieved the aching calf. Did light exercises cutting the repetitions by half, but they still hurt the leg. I am walking OK but cautiously with sharp pain at times under the knee cap. Hot and cold compresses late afternoon and took Vioxx 25 mg (try taking full dose at night) .(SEE IMPORTANT DAY 20 NOTE) Generally, pain level is zero. Woke up at 4.00 AM and couldn’t get comfortable so didn’t get any more sleep.
Day 26 Wednesday 25/6/03
Hot and cold compresses and did all the exercises (half the repetitions). I went to Thai cooking class. Walked down the garage steps without thinking; first time down steps. Leg was good all day so I exercised again prior to bed. Pain level 0. This was not a good idea as I woke up at 1.30.AM with sore and aching leg and I think stayed awake Pain level about 1.
Day 27 Thursday 26/6/03
I decided to try something new. Instead of exercises and laying down for ages with hot and cold compresses, went for a walk and managed to go down the street and over the old bridge and back; would be about 2 klms in total. The leg was hurting by the time I got back (about 2 kilometres), but I figure that the ultimate objective is to be able to walk, so if exercise is going to hurt, it might as well be a walking exercise that does it as being able to walk is what I am working towards anyway. Also, the surgeon said that I can’t damage the implant by walking or exercising. After the walk, applied a hot compress front and back follow by a cold compress. In the afternoon, I went shopping with my wife and did a lot more walking without any pain. At least if I wake up early again tonight, it will be because of walking and not just from doing exercises. I am going to cut exercises to a few light stretching type exercises and not do those that currently hurt. Hope the theory turns out to be good in practice. Had a good night; the leg ache is gone!
Day 28 Friday 27/6/03
We went for a walk down to the end of the street and back – about ¾ klm. No pain although the muscles around the knee are sore and the joint a bit stiff; a result of yesterdays walking I imagine. Went to for a drive with my wife and we walked around a lot. The knee is sore and hurts a bit at times when walking but generally quite good and did much more walking than I could do prior to the operation. Hot and cold pack when we got home which helped a lot. Cut Vioxx to 12.5 mg . (SEE IMPORTANT DAY 20 NOTE) and haven’t taken many Panadol for a few days. Best night yet – slept through until 6.00 AM.
Day 29 Saturday 28/6/03
When I got up, the knee was a bit stiff – probably from all the walking over the last two days. I did a few of very light stretching exercises. Went for a walk to the end of the street and back. Knee is stiff and a bit sore. I applied a hot and cold compress when I got home. Went for another walk before dinner, and the knee was very stiff and quite sore. Took Vioxx 12.5 mg . (SEE IMPORTANT DAY 20 NOTE) and expected a good nights sleep but woke up at 4.00 AM. Knee not that sore, but couldn’t get comfortable.
Day 30 Sunday 29/6/03
Leg was surprisingly good when I got up, hardly sore at all and not as stiff as yesterday. Did a few very light stretching exercises before going shopping with my wife. We stopped off at a local Park on the way home in the afternoon, and went for a walk around the park of about 2.5 klms. I couldn’t have walked much further and after the walk, the leg was a stiff and sore but not all that bad. No sign of the pain that was there prior to the operation. I applied a hot and cold compress when we got home. It is probably the best the leg has been since the operation. The leg is still sore below the knee and on the sides. The right side of the knee cap is still numb and the joint is still stiff, but generally is pretty good; took Vioxx 12.5mg. . (SEE IMPORTANT DAY 20 NOTE) I had a reasonably good night. Woke up about 4.00 AM
Day 31 Monday 30/6/03
Leg is pretty good today; able to walk up and down front steps. Did light exercises followed by hot and cold compresses in morning and a walk to the end of the street in afternoon followed by hot and cold compresses. There is really very little pain.
Stopped taking Vioxx (SEE IMPORTANT DAY 20 NOTE) and seldom take Panadol any longer. Had probably the best night so far, waking up around 6.00 AM. Still need to use pillows in bed to get my leg comfortable and the knees apart.
Day 32 Tuesday 1/7/03
Again leg is very good other than tenderness at front of leg below the knee cap and a little stiffness and soreness at times when walking. It is definitely on the mend. Did some light exercises and went for a walk to the to the end of our street - 0.75 klms. Had a fairly good nights sleep; woke up a few time but went back to sleep. Leg was uncomfortable near the morning but not painful. My wife has moved back to our bed now that I can lie comfortably on either side.
Day 33 Wednesday 2/7/03
Went to cooking class and then to an elderly friends place for afternoon tea so no time for exercises or a walk. Hot and cold compress when we got home. The knee is really good and no problems walking and pretty good going up and down stairs. Not taking medication anymore. Strangely, didn’t have a good night at all. Couldn’t get comfortable; the knee ached and hurt at times when I moved, so much so that my wife moved out to the spare bed and I took two Panadol around 2.30 AM. I was awake most of the night.
Day 34 Thursday 3/7/03
When I got up the leg felt really good. Went for a ¾ klm walk without a problem – no pain at all and could have walked further, quite remarkable.
Hot and cold compresses when we got home. Knee cap is still numb on the lateral side and the top of the tibia (which had ¼” of bone removed), is still sore to touch. Will see what happens tonight – good nights sleep would work wonders. I woke up about 2.30 AM with leg aching and hurting at times, but did manage to go back to sleep between waking. My wife went back to spare bed.
Day 35 Friday 4/7/03
Leg not too bad, so I did light exercises, had hot and cold compresses. We went for a 0.75 klm walk at night. I woke up about 2.30 AM with knee aching a hurting down the side when I moved and could not get comfortable my wife moved out again, but I did manage to sleep between wake ups.
Day 36 Saturday 5/7/03
My leg was quite good when I got up, so for the first time since day 17, I did all of the exercises, but without straining anything too much. We went for a 2 klm walk; the knee was stiff and a bit sore by the time we finished, but went quite well and no sign of former arthritis pain. Applied a cold and then hot compress when we got home. I am not taking any medication now. I woke up a number of times during the night but went back to sleep. The knee was aching but better than last night. I managed to stick it out until morning and my wife didn’t have to move out – definite improvement.
Day 37 Sunday 6/7/03
The leg is really good today – hardly feel anything. Did all of the exercises again and pushed it a bit more than yesterday. Applied hot and cold compresses and then we went for a brisk 2 klm walk. I had no pain in the knee at all, but the hamstrings were a little bit tight, which the stretching exercises will fix. This is a big improvement. I applied hot and cold compresses at night. I woke up a number of times during the night but went back to sleep. The knee had dull ache but better than last night. My wife is back in our big bed permanently now.
Day 38 Monday 7/7/03
The leg is better than yesterday – feels really good. Did all the exercises and pushed it even further than yesterday. Hot and cold compresses and went for a walk 0.75 klms. Other than the hamstrings being a little tight, there is virtually no pain and walking up and down steps and stairs carefully. Restless night again – just can’t get comfortable.
Day 39 Tuesday 8/7/03
Leg is a little sore today. Think I have overdone it again with the exercises so didn’t do any today and didn’t go for a walk. I applied hot and cold compresses a couple of times. I had restless night.
Day 40 Wednesday 9/7/03
Leg is still sore, particularly under the knee cap and stiffness at the back of the knee, so no exercises or walks today. I applied hot and cold compresses a couple of times. Another restless night and woke up a number of times but went back to sleep. Towards morning, it was very difficult to get comfortable for any length of time.
Day 41 Thursday 10/7/03
Same as for day 40
Day 42 Friday 11/7/03
Same as for day 40
Day 43 Saturday 12/7/03
Leg is the same as for day 40 except we went for a walk to the end of our street and back with no problem. I took a 5mg “Stilnox“sleeping tablet and had the first full nights sleep since the operation. I woke up about 7.00 AM and felt great.
Day 44 Sunday 13/7/02
My leg feels so good after a full nights sleep. I think taking the sleeping tablet and not waking up and moving the leg around trying to get comfortable has improved it considerably. I got the sleeping tablets on 23 June (Day 24), but have resisted taking them until now. In retrospect, I probably should have taken a low dose a couple of weeks ago and thereby perhaps saved the irritating aches and pains and sleeplessness experienced over the last couple of weeks. Hot and cold compresses continue.
Day 45 Monday 14/7/03
My leg is still very good. I applied hot and cold compresses. I did a lot of work around the yard without any problems. Took another ½ a sleeping tablet (8mg), and had another good nights sleep.
Day 46 Tuesday 14/7/03
The leg is excellent, so today is the last day I am going to record events. For the record, there are no aches or pains; I feel I can walk as far as I like without a problem; cross my legs at the ankles or at the knee; walk up and down steps or ramps; lay on either side in bed (although I am still using a small “baby” pillow between my knees, but don’t really need it). The lateral knee cap is still numb (which the surgeon said could take 12 months to clear – sometimes never) The top of the tibia is a little sore and there is mild stiffness at the back of the knee.
However, all in all, the battle is over with an outstanding result achieved. In retrospect, would I do it again? Without question, most definitely I would do it again – bloody oath I would.
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PS. It’s just on four years now since the operation and my knee is excellent. We have been on another strenuous 3 month “around the world” trip 2005 and just back from an Asian tour in January 2007, without any problem with my knee. The last thing to clear up was the numbness in the kneecap, which has now virtually gone, I still sleep with a small “baby” pillow between my knees, but probably don’t need to do
this.
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I came up with my own scale to measure the pain –
1. No pain. Normal and full joint movement.
2. Not very painful but joint, movement is restricted and hurts.
3. Painful or aching but not a big problem
4. Painful or aching keeps you awake but bearable – need Panadol / Panadeine Forte.
5. Quite painful
6. Very painful – need strong pain killer like Endone.
7. ……
8. …..
9. …..
10. Unbearable
Medication -
Medication provided for first 2 days after surgery – Endone, Brufen, Keplex and Tramadol or Panadeine Forte for severe pain. Also I was given Coloxyl for constipation. Slow release drug “Painbustert” local anaesthetic catheter in the wound for the first 3 days. Drain in the wound and a drip for the first two days. Chemist sold me Panamax 500 mg which he assures me is identical to Panadol but much cheaper and is cheaper still if on prescription script.
Medication provided by the hospital for use after day 3, for 4 to 6 weeks – Brufen, Zantac and Panadeine Forte or digesic and Coloxyl. I used a lot of Panamax.
Leg immobiliser rented from the hospital used for first 3 days. Remove it at night if you like. Crutches also rented from the hospital, but weren’t needed for very long.
Suggestions
1. Let it be know to all and sundry that you are NOT going to be a good patient – saves a lot of unproductive effort trying to be good, which is not in the nature of the male members of my family.
2. Move a bed into the lounge room so you can have a change of location and watch TV. My wife and I needed to sleep in separate beds so I could spread out and make sure the leg doesn’t get bumped; also so that “nurse” gets a solid nights sleep to help maintain good humour and understanding at all times – very important!
3. Recommend starting the exercises the doctor gives you, as soon as possible before the operation – the longer you do them the better you will be. However, I would say that after the operation, don’t overdo it as you could strain your leg.
4. Buy a “Reusable Cold/Hot Pak – Medi-Pak 620” - 55x25cm – about $25 from physio. This is the larger one and will run the full length of your thigh, knee and calf or will wrap right around the knee. You can “strap” it on with something to get to the sides of your knee. I found it better after the first few days than the “Cryo-Cuff” – well worth the money. Elevate your leg when using cold packs.
5. Buy a nice big wheat bag to microwave as a hot compress.
6. Prior to and after operation eat fruit and vegies and take Coloxyl (or similar) to prevent constipation. Can take up to four Coloxyl (I took two at a time)
7. Make sure they give you the large size TED stockings (XLG) to cater for swelling. Be mindful of DVT - it bears watching and doing all the right things like wearing the TED stockings, regular leg elevation and getting moving as quickly as possible so as not to be immobile for long periods which could result in clots forming. Check for lumps in the calf and any unusual swelling. Get moving quickly to get medical help if this happens – preferably to come to you so the clot doesn’t move – it’s a killer. A friend of mine had terrible problems and almost died from clots after his knee replacement.
8. Take the pain killers as prescribed and don’t try to second guess the likely pain level because you can’t predict it.
9. For a change, lay a firm pillow long ways on the bed to support the whole leg.
10. Learn from my mistake and don’t overdo the exercises while the leg is still sore (don’t be fooled by pain killers in the first week as the knee isn’t really as good as it feels). Until the leg is no longer sore (which for me was about six weeks) do light exercises only, but not to the point where you can feel it hurting or straining – if you do them at all. Only do them to keep the joint a bit flexible. When the joint is fixed, you can do more strenuous exercises and build up the leg muscles. The physio will probably tell you to do all of the exercises all of the time, but it’s no good if it hurts and inflames the joint (I don’t have much faith in physios), the priority at this stage is to get your leg back somewhere near normal. I got nowhere until I stopped the exercises for a while.
11. I took a “Stilnox” sleeping tablet on Day 43, and probably put off taking them two weeks longer than I should have. In hindsight, I should have taken them at the stage when my leg was pretty good through the day, but aching at night and keeping me awake because I couldn’t get comfortable. Had I taken them sooner, I would have got good nights sleep and my leg would have got the chance to settle down without me moving it around all night upsetting it.
12. Prior to the operation, the surgeon told me I could go home the same day as the operation. My wife said “no way – he stays for at least one night”. She was right, so I wouldn’t recommend going home the same day.
So here we go folks - a blow by blow description from my notes-
Day 1 – Saturday 31/5/03
31 May 2003 - Operation at 1.30 PM – In Ward at hospital by 4.00 PM. Saw surgeon who said operation went very well. Knee is Ok with very little pain. I only had one sandwich for dinner. Pain level 2/10, but heavily drugged to control pain. Felt sick and giddy around 2.00 AM Sunday morning and vomited a lot. Pain level 2/10
Day 2 – Sunday 1/6/03
Later in the morning I was still giddy and nauseous. Couldn’t eat any lunch, but started to improve Sunday afternoon and was able to eat all of my dinner. Pain level 3/10. Have to sleep on my back but had a reasonable night. Taking tablets every four hours.
Day 3 – Monday 2/6/03
Up early and “hopped” into en-suite using crutch, to have a wash, shave and washed my hair. Leg was sore to put any pressure on. Pain level 3.5/10. I am waiting for physio to come to show me how to use crutches so I can go home. Pain level in bed 1/10. My wife & daughter picked me up about 2.00 PM. I lay down on back seat of the car and would you believe it, I got car sick on way home but didn’t throw up. Home and in bed; pain is OK. My wife gave me my tablets during the night. Pain level about 2/10. Got reasonable nights sleep, but having to sleep only on my back is a problem.
Day 4 Tuesday 5/6/03
Pain level is about 2/10. Feeling a bit giddy. Now only use the leg immobiliser when walking. As advised by the surgeon. I removed Elastoplast and bandage and cotton wool they put on in the theatre. Then removed the transparent Duoderm waterproof dressing covering the wound. Lightly showered the wound (and myself), patted the wound dry with gauze bandage and gently but thoroughly dried with hair dryer. Applied a fresh Duoderm covering and applied a crepe bandage and put on TED stockings, Can get around OK on the crutches but not going up or down. Started using the “Cryo-Cuff” ice pack 4 times daily. Constipated since AM Saturday! This shows how important it is to start on fibre, fruit & veges and laxatives straight away prior to and after operation. Not a good day, feeling nauseous and giddy. But the knee is OK. Pain level maybe 3/10. Surprisingly though I had quite a good night.
Day 5 Wednesday 4/6/03
Pain level is about 2/10. I am still constipated and feeling nauseous, most likely the Brufen anti inflammation causing the problem. No more Endone pain killers but pain is OK about 2/10. EUREKA, constipation fixed – big celebrations! Now walking with one crutch only and could probably walk without that one. I started the four leg exercises the surgeon gave me to do, today. The knee is remarkably good and handled the exercises much better than I expected except for the one where you have to sit on the edge of a table and straighten the leg and then bend it back as far as it will go under the table and hold it there for 20 seconds. Have to do this 20 times – it hurts! Could only do 11 first up. Pain level still around 2/10. Sitting up in lounge room today and using laptop computer, so on the mend. My wife has been wonderful and a great nurse - very tolerant (I’m a bad patient – hate being sick and laid up!). Night was not so good. Knee was hurting no matter which way I lay. On my back was the best. Took Panadol at 3.00 AM and again at 6.30 AM. I think the exercises upset my knee. Minimum of 2 sets of exercises each day required. I was going to do 3 sets, but will stick to 2 so as not to overdo it. Also, TED stockings were very tight around the top of my sore leg and left a lump. Should have size XLG – one size larger (I’ve got thighs like Xmas hams!). Pain level during night around 3/10 or maybe 3.5/10
Day 6 Thursday 5/6/03
Had a shower (I put Gladwrap over the Duoderm to try and keep water off it even though it is supposedly waterproof). Did exercises OK. Leg was aching so I removed TED stockings after lunch. Felt really agitated and nauseous in the afternoon. Took another Panadol after lunch. Pain level around 2.5/10. Did exercises again about 7.00 PM. Had a restless night. Panadol around 4.00 AM and again at 6.30AM. Still haven’t had to use Panadeine Forte. Pain level 3/10. It is a problem not being able to sleep on my side - only flat on my back.
Day 7 Friday 6/6/03
Had a shower and felt quite exhausted after doing exercises so went to bed for a while. Wound is still clean and healing well. Bruising has come through on inside of knee and thigh. Would be a mistake to do any more than 2 sets of exercises a day at this stage. Felt really good after the rest. Pain level around 2/10. Walked around really well with no crutches – no problem. In fact went for a drive with my wife so as to get out for a while. This is by far the best day so far. Did second set of exercises. My son dropped in and was amazed to see me walking around normally. Pain level only about 1.5/10 and nil at some times. Not a good night - ache more than a pain in my knee all night. Pain / ache level 3/10. Panadol at 4.00, 6.00 & 8.00 AM. Didn’t get much sleep. I think the problem is that I pushed too hard with the exercises. Also, I have been addressing the pain after it occurs, whereas it is probably better to prevent the pain by taking the prescribed medication, so tonight I will take the Panadeine Forte and see what happens.
Day 8 Saturday 7/6/03
Again I am feeling a bit nauseous. Had a shower and bandaged the knee. My knee and leg are quite sore and I am walking with a limp. Pain level under 3/10. Postponed the first set of exercises until around lunch time and didn’t push it too hard. Did some walking around the house to keep it all moving. Felt much better after lunch and the knee is not nearly as sore. Did exercises again about 6.00 PM but didn’t push it too hard. Not much pain when walking. Took one Panadeine Forte at 11.30 PM but needed another at 4.00 AM. Took a Panadol at 7.00 AM. Pain level just under 3/10 during night so a restless night, although I did manage to lie on my side for ½ an hour – heaven on a stick!
Day 9 Sunday 8/6/03
I had a shower. Knee is a bit sore – pain level under 2/10, hurting under knee cap when I walk. Did exercises and again the “bend the leg sitting on the table” exercise was painful. Walking is OK but a little painful and was better than this previously. The wound still looks good. Generally, I think it’s going extremely well. When you consider it is only one week since the operation, it is a remarkable result. I am walking unassisted with very little discomfort. Can’t wait to see if I can walk to the end of the street and back without pain (about 700 metres), as I couldn’t go half way without hobbling back prior to the operation. Did exercises about 7.00 PM which again hurt. Pain level about 3/10. Prior to going to bed the knee was aching. Took two Panadol at 11.30 PM and will see what they do. Not a good night. Took two more Panadol at 3.30 AM and another at 7.00 AM. Pain / ache level about 3/10 during night. Could not get comfortable, however I did get some sleep between tablets. Can still only lay on my back.
Day 10 Monday 9/6/03
Had shower and walked around the house to loosen up and then did exercises and pushed it a bit. Pain level dropped to 1/10 and was so good we went for walk to the end of our street and back – about 700 metres – without any of the former problem (I could only walk about 150 metres before hobbling with pain). Only problem experienced was at the back of the knee, which was painful but I think this is from the exercises and maybe the operation and will subside in time. Knee was a little sore in afternoon (pain level about 2/10), so I decided not to do second set of exercises today. Now 11.00 PM and leg is feeling not too bad, but will be interesting to see if it plays up again during the night. Will take two Panadol when I go to bed. Another restless night. Woke up again at about 3.30 AM. Pain level just under 3/10. Took another Panadol but not much sleep. Leg aching or burning sensation and can only lie on my back. Uncomfortable but not anywhere near unbearable.
Day 11 Tuesday 10/6/03
Had shower and did exercises. Leg is really good once I am out of bed. Pain level between 0 and 1. Deteriorated during day, due I think, to over-exercising. Was difficult to walk in late afternoon due to pain in muscle down the outside of the leg below the knee. Pain level about 3/10. My wife came up with good idea. She cut a section out of panty hose to hold a piece of crepe bandage over the wound thereby avoiding the bulk of the bandage behind the knee. Took two Panadol going to bed, but woke up at 2.30 AM and took another Panadol. Pain level about 3/10.
Day 12 Wednesday 11/6/03
Follow–up visit to surgeon
Alarm woke me at 5.00 AM to get ready for follow-up appointment with physio 8.30 AM. X-ray at 9.30 AM and Surgeon at 10.30 AM – all located at the hospital. Muscular pain level when walking about 3/10, but nil when not walking. No exercises today – leg is too sore.
Doctor was very pleased with result. Said it’s in the top 10 percent. He said sometimes an injection of cortisone in the medial ligament might be needed to settle it down as the ligament is pulled to one side during the operation to get the implant in (probably both ligaments for a full knee). The wound is clean and healing well. Doctor said to treat it just like your other skin from today – no dressing needed. See Doctor again in three months. Got additional exercises from physio, but will give it a rest until muscles recover. Returned crutches, leg immobiliser and Cryo-Cuff to the hosptal. See physio again in 1 month. Left hospital about mid day. Took Panadol when back home. Ice pack on knee – it works better than Cryo-Cuff (Reusable Cold/Hot Pak – Medi-Pak 620 - 55x25cm – about $25 from physio and well worth it). Pain level when walking about 3/10 but is muscular. I am using a walking stick so I don’t fall. Took two Panadol going to bed and expected a bad night but woke up at 5.30 AM – best yet. Found I was finally able to lie on my side for ½ hour or so.
Day 13 Thursday 12/6/03
The leg was still sore when I got up and pain level still about 3/10 when walking with aid of a stick. Had not so good day as walking was difficult – painful and felt the knee would give way. Sure the problem is muscular. Took Panadol going to bed and expected to have a reasonably good night as I could lie on my side for a while. Woke up and thought it would be 3 or 5 or maybe 8 AM but no, it was only 1.30AM! So not such a good night after all with pain level around 3/10.
Day 14 Friday 13/6/03
Surprisingly, when I got up I could walk without the stick and the leg was not too sore – pain level around 1.5 to 10. Did the exercises the Doctor gave me and also the extra ones from the physio. Then cold pack for half an hour or more. Went for a drive with my wife and had a walk in the local park. The muscular problems of the last couple of days seem to have gone. Knee is still swollen and stiff and sore but no more than to be expected at this stage Pain level about 1 to 1.5. Wound has healed nicely. Took two Panadol and into bed about 11.30 PM. Woke up at 3.30 AM took another Panadol but couldn’t get comfortable after this. Leg felt as if it was aching behind the knee and in the calf. Pain / ache level about 2.5/10.
Day 15 Saturday 14/6/03
When I got up the leg was virtually pain free. Did a few laps around the house without problems. Decided to try a hot compress and then did all the exercises and really pushed it. My wife said that I had “cabin fever”, so she packed a lunch and we went to a local seaside park and watched the activity on the bay. After lunch and a short walk, and then went for a drive to watch the whales heading north, but none there at that time. Home at about 4.30 PM and applied hot compress; did full set of exercises again and then applied a cold compress for about an hour. As expected, the leg is stiff and sore behind the knee and in the calf. The knee cap is also touchy. Applied another hot compress. It’s been two weeks today since the operation, and there has been a definite change for the better today. Will see what happens tonight and tomorrow.
Well, took two Panadol and went to bed. Pain level 0 to 1 - no pain at all. Could lay on either side comfortably. But it’s hard to win, instead of a good nights sleep; I was still awake at 5.00 AM. Thought I might nod off but not to be. A dam dog spent the next two hours walking up and down our street barking and sniffing like a bloodhound – even came onto our lawn right under our bedroom window.
Day 16 Sunday 15/6/03
Did exercises; surprisingly after such a painless night, the leg is quite sore today. Went for walk down our street but only got half-way & turned back. Pain level 1 to 1.5 Afternoon exercises were difficult. Hot and cold compresses then to bed. No real pain in bed so no Panadol. Best night yet. Woke up at 5.30 AM; leg is a bit sore.
Day 17 Monday 16/6/03
Had a shower and did the exercises. Takes about an hour and then the time for hot & cold compresses. Leg is pretty sore. Pain level 2.5 when walking. Went to shopping centre with my wife, but only go about 30 metres into the Centre and had to give it away and come home. It is painful to walk and feels like bone on bone on the side and at the front medial. I think I have been too strenuous with the exercises. My son has a lot of experience with training and injuries so discussed it with him. His logic is that you have to get the knee back to scratch after the trauma of the operation and while you are achieving this, you should only do light exercises to maintain joint mobility. Building up the muscle strength can come after the joint is fixed. Makes sense, so I’ll cut back on the exercises and keep them only light until it all settles down.
Awake all night; unable to get comfortable in bed. Have a continuous dull ache in the calf of the leg and sore to move. The pain level is about 2.
Day 18 Tuesday 17/6/03
Had a shower then my wife gave the leg a good massage. Applied a hot compress followed by a cold compress. Not doing any exercises today. Knee joint is very stiff. Difficulty walking any distance – couldn’t possibly go up or down steps yet except with a straight leg. More hot/cold compresses this afternoon and tonight. Pain level is low 1. when lying down but knee is sore when walking. Another massage and compresses before going to bed. I slept through to about 5.30 AM. The leg was aching and I was unable to get comfortable. Put a hot compress on it about 7.00 AM which helped a lot.
Day 19 Wednesday 18/6/03
Shower then a hot compress followed by a leg massage. Got picked up to go to my cooking class – good to get out (my wife would agree). The leg is sore when walking and aching when lying down. The pain level about 2/10. I applied another hot then cold compress which helped. No exercises again today; I think it is helping. Off to bed with a cold compress. The pain level is about 1.5 Not a good night; awake all night again. I couldn’t get comfortable at all. Pain level about 1.5
Day 20 Thursday 19/6/03
Had a shower, a massage and applied a hot compress. Leg is quite sore when walking. Decided to change from Brufen to my old anti inflammatory Vioxx (2X12.5 G) as I can’t notice difference when taking Brufen but I know Vioxx works well.
(PLEASE NOTE – IN LATE 2004, THESE DRUGS WERE TAKEN OFF THE MARKET – THEY CAUSE HEART ATTACKS – GREAT STUFF !!)
I applied a hot and cold compress during the day. No exercises again today. By late afternoon the leg was certainly feeling better. Pain level is about 0.5. On going to bed, the leg was very good – able to comfortably lie on either side. Slept until 4.30 AM, which was an improvement on previous nights. Leg was aching with pain level around 1.5 but after a while was able to get comfortable with virtually no pain or ache.
Day 21 Friday 20/6/03
Shower followed by one of wife’s famous leg massages. I took 2x12.5 mg Vioxx tablets. They are definitely more effective than the Brufen. (BUT SEE IMPORTANT DAY 20 NOTE) Leg is still a bit stiff and hurts in some positions particularly the medial ligament and under the knee cap. Walking is OK but I don’t think I could go too far. Did very light exercises without any strain on joints and cut the number of repetitions by half. I placed a cold compress around the knee. Cabin fever set in, so my wife is taking me to the shopping centre – very exciting, but I still won’t drive yet. Pain level 0.5 Woke up about 3.00 AM – same old problem; leg ache and unable to get comfortable.
Day 22 Saturday 21/6/03
Three weeks since operation. I took Vioxx 25mg. (SEE IMPORTANT DAY 20 NOTE) Drove the car without a problem as I don’t have to mover my leg to go from accelerator to brake. So, I’m FREE again! Leg is stiff and sore; find I am walking straight leg (like Chester). Did light exercises and applied a cold compress and had a leg massage which relieved it a bit. Not painful all of the time; only a sharp pain at sides and under knee cap at times when I walk. The pain level was then about 1.5 Woke up at 3.00 AM – had left electric blanket on “high” – half cooked! Was able to eventually get comfortable and went back to sleep (the first time I think).
Day 23 Sunday 22/6/03
I was able to walk reasonably well around house. Did light exercises and applied cold compress - leg felt quite good. After lunch, took my wife for a drive down to the beach and went for a walk beside the bay. Didn’t expect to get far, but ended up cautiously walking 1.3 klms without a tinge of pain – remarkable. Came home and applied cold compress after which the leg was great – virtually no pain at all (joint is still stiff though). Pain level 0.5/10. Took two Panadol to try and sleep right through but woke up at 4.00 AM with aching leg (no wonder). Don’t think I went back to sleep.
Day 24 Monday 23/6/03
There is virtually no pain except when I tense knee cap or move leg sideways. I drove to our local GP for a consultation. He said to take Vioxx at night to try and overcome aching early in the morning. (SEE IMPORTANT DAY 20 NOTE). Because of the aching, he checked the leg for DVT lumps, which hadn’t occurred to me, but all seems OK in that regard. I asked him for a script for sleeping tablets in case I need them. I went for a drive with my wife and had a very short walk. Went out at night to a function and actually walked up two flights of steps. Met a guy there on a walking stick who said he recently had a full knee replacement. He said his leg was swollen really badly a couple of days after the operation and he ended up with DVT which he said was really touch and go for a while – strange coincidence given my doctors comments about DVT this morning. So it bears watching for DVT clots and doing all the right things like wearing the TED stockings, regular leg elevation and getting moving as quickly as possible so as not to be immobile for long periods. My leg was a bit sore when I got home, so I applied a cold compress and had a leg massage by my wife. I took Vioxx 12.5 mg . (SEE IMPORTANT DAY 20 NOTE) and a Panadol prior to bed. I woke up at 4.00 AM with aching leg.
Day 25 Tuesday 24/6/03
Took Vioxx 12.5 mg, . (SEE IMPORTANT DAY 20 NOTE) had a shower and applied a hot compress which relieved the aching calf. Did light exercises cutting the repetitions by half, but they still hurt the leg. I am walking OK but cautiously with sharp pain at times under the knee cap. Hot and cold compresses late afternoon and took Vioxx 25 mg (try taking full dose at night) .(SEE IMPORTANT DAY 20 NOTE) Generally, pain level is zero. Woke up at 4.00 AM and couldn’t get comfortable so didn’t get any more sleep.
Day 26 Wednesday 25/6/03
Hot and cold compresses and did all the exercises (half the repetitions). I went to Thai cooking class. Walked down the garage steps without thinking; first time down steps. Leg was good all day so I exercised again prior to bed. Pain level 0. This was not a good idea as I woke up at 1.30.AM with sore and aching leg and I think stayed awake Pain level about 1.
Day 27 Thursday 26/6/03
I decided to try something new. Instead of exercises and laying down for ages with hot and cold compresses, went for a walk and managed to go down the street and over the old bridge and back; would be about 2 klms in total. The leg was hurting by the time I got back (about 2 kilometres), but I figure that the ultimate objective is to be able to walk, so if exercise is going to hurt, it might as well be a walking exercise that does it as being able to walk is what I am working towards anyway. Also, the surgeon said that I can’t damage the implant by walking or exercising. After the walk, applied a hot compress front and back follow by a cold compress. In the afternoon, I went shopping with my wife and did a lot more walking without any pain. At least if I wake up early again tonight, it will be because of walking and not just from doing exercises. I am going to cut exercises to a few light stretching type exercises and not do those that currently hurt. Hope the theory turns out to be good in practice. Had a good night; the leg ache is gone!
Day 28 Friday 27/6/03
We went for a walk down to the end of the street and back – about ¾ klm. No pain although the muscles around the knee are sore and the joint a bit stiff; a result of yesterdays walking I imagine. Went to for a drive with my wife and we walked around a lot. The knee is sore and hurts a bit at times when walking but generally quite good and did much more walking than I could do prior to the operation. Hot and cold pack when we got home which helped a lot. Cut Vioxx to 12.5 mg . (SEE IMPORTANT DAY 20 NOTE) and haven’t taken many Panadol for a few days. Best night yet – slept through until 6.00 AM.
Day 29 Saturday 28/6/03
When I got up, the knee was a bit stiff – probably from all the walking over the last two days. I did a few of very light stretching exercises. Went for a walk to the end of the street and back. Knee is stiff and a bit sore. I applied a hot and cold compress when I got home. Went for another walk before dinner, and the knee was very stiff and quite sore. Took Vioxx 12.5 mg . (SEE IMPORTANT DAY 20 NOTE) and expected a good nights sleep but woke up at 4.00 AM. Knee not that sore, but couldn’t get comfortable.
Day 30 Sunday 29/6/03
Leg was surprisingly good when I got up, hardly sore at all and not as stiff as yesterday. Did a few very light stretching exercises before going shopping with my wife. We stopped off at a local Park on the way home in the afternoon, and went for a walk around the park of about 2.5 klms. I couldn’t have walked much further and after the walk, the leg was a stiff and sore but not all that bad. No sign of the pain that was there prior to the operation. I applied a hot and cold compress when we got home. It is probably the best the leg has been since the operation. The leg is still sore below the knee and on the sides. The right side of the knee cap is still numb and the joint is still stiff, but generally is pretty good; took Vioxx 12.5mg. . (SEE IMPORTANT DAY 20 NOTE) I had a reasonably good night. Woke up about 4.00 AM
Day 31 Monday 30/6/03
Leg is pretty good today; able to walk up and down front steps. Did light exercises followed by hot and cold compresses in morning and a walk to the end of the street in afternoon followed by hot and cold compresses. There is really very little pain.
Stopped taking Vioxx (SEE IMPORTANT DAY 20 NOTE) and seldom take Panadol any longer. Had probably the best night so far, waking up around 6.00 AM. Still need to use pillows in bed to get my leg comfortable and the knees apart.
Day 32 Tuesday 1/7/03
Again leg is very good other than tenderness at front of leg below the knee cap and a little stiffness and soreness at times when walking. It is definitely on the mend. Did some light exercises and went for a walk to the to the end of our street - 0.75 klms. Had a fairly good nights sleep; woke up a few time but went back to sleep. Leg was uncomfortable near the morning but not painful. My wife has moved back to our bed now that I can lie comfortably on either side.
Day 33 Wednesday 2/7/03
Went to cooking class and then to an elderly friends place for afternoon tea so no time for exercises or a walk. Hot and cold compress when we got home. The knee is really good and no problems walking and pretty good going up and down stairs. Not taking medication anymore. Strangely, didn’t have a good night at all. Couldn’t get comfortable; the knee ached and hurt at times when I moved, so much so that my wife moved out to the spare bed and I took two Panadol around 2.30 AM. I was awake most of the night.
Day 34 Thursday 3/7/03
When I got up the leg felt really good. Went for a ¾ klm walk without a problem – no pain at all and could have walked further, quite remarkable.
Hot and cold compresses when we got home. Knee cap is still numb on the lateral side and the top of the tibia (which had ¼” of bone removed), is still sore to touch. Will see what happens tonight – good nights sleep would work wonders. I woke up about 2.30 AM with leg aching and hurting at times, but did manage to go back to sleep between waking. My wife went back to spare bed.
Day 35 Friday 4/7/03
Leg not too bad, so I did light exercises, had hot and cold compresses. We went for a 0.75 klm walk at night. I woke up about 2.30 AM with knee aching a hurting down the side when I moved and could not get comfortable my wife moved out again, but I did manage to sleep between wake ups.
Day 36 Saturday 5/7/03
My leg was quite good when I got up, so for the first time since day 17, I did all of the exercises, but without straining anything too much. We went for a 2 klm walk; the knee was stiff and a bit sore by the time we finished, but went quite well and no sign of former arthritis pain. Applied a cold and then hot compress when we got home. I am not taking any medication now. I woke up a number of times during the night but went back to sleep. The knee was aching but better than last night. I managed to stick it out until morning and my wife didn’t have to move out – definite improvement.
Day 37 Sunday 6/7/03
The leg is really good today – hardly feel anything. Did all of the exercises again and pushed it a bit more than yesterday. Applied hot and cold compresses and then we went for a brisk 2 klm walk. I had no pain in the knee at all, but the hamstrings were a little bit tight, which the stretching exercises will fix. This is a big improvement. I applied hot and cold compresses at night. I woke up a number of times during the night but went back to sleep. The knee had dull ache but better than last night. My wife is back in our big bed permanently now.
Day 38 Monday 7/7/03
The leg is better than yesterday – feels really good. Did all the exercises and pushed it even further than yesterday. Hot and cold compresses and went for a walk 0.75 klms. Other than the hamstrings being a little tight, there is virtually no pain and walking up and down steps and stairs carefully. Restless night again – just can’t get comfortable.
Day 39 Tuesday 8/7/03
Leg is a little sore today. Think I have overdone it again with the exercises so didn’t do any today and didn’t go for a walk. I applied hot and cold compresses a couple of times. I had restless night.
Day 40 Wednesday 9/7/03
Leg is still sore, particularly under the knee cap and stiffness at the back of the knee, so no exercises or walks today. I applied hot and cold compresses a couple of times. Another restless night and woke up a number of times but went back to sleep. Towards morning, it was very difficult to get comfortable for any length of time.
Day 41 Thursday 10/7/03
Same as for day 40
Day 42 Friday 11/7/03
Same as for day 40
Day 43 Saturday 12/7/03
Leg is the same as for day 40 except we went for a walk to the end of our street and back with no problem. I took a 5mg “Stilnox“sleeping tablet and had the first full nights sleep since the operation. I woke up about 7.00 AM and felt great.
Day 44 Sunday 13/7/02
My leg feels so good after a full nights sleep. I think taking the sleeping tablet and not waking up and moving the leg around trying to get comfortable has improved it considerably. I got the sleeping tablets on 23 June (Day 24), but have resisted taking them until now. In retrospect, I probably should have taken a low dose a couple of weeks ago and thereby perhaps saved the irritating aches and pains and sleeplessness experienced over the last couple of weeks. Hot and cold compresses continue.
Day 45 Monday 14/7/03
My leg is still very good. I applied hot and cold compresses. I did a lot of work around the yard without any problems. Took another ½ a sleeping tablet (8mg), and had another good nights sleep.
Day 46 Tuesday 14/7/03
The leg is excellent, so today is the last day I am going to record events. For the record, there are no aches or pains; I feel I can walk as far as I like without a problem; cross my legs at the ankles or at the knee; walk up and down steps or ramps; lay on either side in bed (although I am still using a small “baby” pillow between my knees, but don’t really need it). The lateral knee cap is still numb (which the surgeon said could take 12 months to clear – sometimes never) The top of the tibia is a little sore and there is mild stiffness at the back of the knee.
However, all in all, the battle is over with an outstanding result achieved. In retrospect, would I do it again? Without question, most definitely I would do it again – bloody oath I would.
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PS. It’s just on four years now since the operation and my knee is excellent. We have been on another strenuous 3 month “around the world” trip 2005 and just back from an Asian tour in January 2007, without any problem with my knee. The last thing to clear up was the numbness in the kneecap, which has now virtually gone, I still sleep with a small “baby” pillow between my knees, but probably don’t need to do
this.
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posted by mandrake at 5:30 AM
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