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    Old 06-30-2012, 06:47 AM   #1
    Grammie76
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    Tkr

    I'm to have a TKR in mid August; am currently undergoing chemo for bladder cancer. Anything I can do now to get ready for the TKR?
    Grammie76

     
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    Old 06-30-2012, 09:07 PM   #2
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    Re: Tkr

    Hi there and welcome!

    If you're not already doing so, you should ask your Orthopedic surgeon who will be doing your TKR to send you to physical therapy for the next few weeks to strengthen the muscles in the knee. This way, you will probably have a much better outcome and faster recovery because the stronger the muscles surrounding the TKR are, going into surgery, the easier it will be for you to re-hab the new knee.

    Also, since you are going through chemo, MAKE SURE that your Orthopedic surgeon works very closely with your Oncologist so that your surgery itself goes smoothly.
    (I'm actually a little surprised that your Ortho surgeon is willing to do your TKR while you are undergoing chemotherapy.)

    Anyhow, best wishes for a great outcome and I assure you that you will be glad you had the TKR once you finish your rehab! It takes an average of 3 months to totally recover from TKR surgery, so be patient, and just make sure that you DO EVERYTHING THAT YOUR ORTHOPEDIC SURGEON AND PHYSICAL THERAPIST ASK OF YOU to get a good outcome.

    Been there, done that twice in the past year and glad I got both knees done! (Right TKR - 4/5/11 and left one - 3/23/12). I'm all healed up from both surgeries and now have full mobility restored WITHOUT THE PAIN!! I also had the most wonderful and caring Ortho surgeon anyone could hope for! He did a great job on both knees and I'm eternally grateful to him for that. He's my Medical Hero!

    If you have any other questions pre-op, don't hesitate to ask on this Board.

    Keep us posted and I hope your cancer treatment is very successful too!

    Best regards,
    Carol

     
    Old 07-01-2012, 09:47 AM   #3
    Grammie76
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    Re: Tkr

    Carol, thank you so much for your helpful reply. Where did you have your knee surgeries done? I'll see if my knee surgeon will agree to my having PT pre-op. Not sure how much I can do, since I have severe nerve root compression in my lumbar spine, which produces much pain and poor leg function, but sounds like anything I can do will be better than nothing. Being slammed with 3 problems at once makes dealing with each one more complicated! The spine surgeon said I must get the bladder cancer treated first, then the knee, since to have the spine surgery be successful, I will need to walk a lot post-op. But I'm going to try my very best to get moving well again.

    Actually, the bladder chemo will be finished July 31. The chemo drug is instilled into the bladder, so doesn't cause all the systemic sickness that IV chemo does. I may have to have maintenance bladder chemo at intervals the rest of my life; for sure will need cystoscopic exams frequently, as this type CA has a high rate of recurrence and requires close surveillance. I have stage 3 renal insufficiency, so he didn't think I could tolerate IV chemo. Being 77 years old doesn't exactly help, either!

    This support group has been a life saver to me! I have learned so much that has been helpful, and everyone is so friendly. Thank you again!
    Paula

    Last edited by hb-mod; 07-03-2012 at 04:36 AM.

     
    Old 07-01-2012, 09:02 PM   #4
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    Re: Tkr

    Hi Paula,

    I don't know if you live in NY in or near Westchester County, but I had my knee surgeries at Sound Shore Medical Center in New Rochelle, NY. (My Orthopedic surgeon is Chief of Orthopedic Surgery/Joint Replacement there.) With your bladder cancer treatment ending 7/31, and with your spinal issues, I can tell you that my surgeon would be VERY reluctant to take you on as a patient right now. (Besides, he books two months in advance for TKR surgery, so his August schedule is probably all filled up already.) The thing that would concern him MORE than the bladder CA tx, is your spinal issues. (I had a bad back spasm mid-January that was a delayed reaction to an EMG - nerve conduction test.) He would NOT agree to schedule my left TKR surgery UNTIL I had been to a pain management doctor (anesthesiologist) who was able to give me cortisone injections at the site of the back spasm. That cleared up the spasm within TWELVE HOURS and the following Monday (1/30), I went back to my Ortho surgeon and said, "Okay, my back is cured. NOW will you PLEASE schedule my left TKR?". Which he agreed to do and I had the surgery 3/23/12 and everything went EXTREMELY WELL! (I am all healed up as far as both TKR surgeries - the right one was 4/5/11, but now I have lower back pain that is spinal in nature. Had nothing to do with my TKR surgeries. Had probably been brewing for a while pre knee issues. My spinal issues include lumbar spondylosis which is arthritis in the lumber region of my spine, spinal stenosis which is compression of the spinal column, , spinal disc protrusions, and a shifting of my lumbar spine - lower section of my spinal column about 25% to one side. I MIGHT have to go to a chiropractor in addition to having my pain management doctor do my two spinal nerve blocks - see explanation of procedure below. He said that he's not sure how much a chiropractor would be able to straighten my spine since it's so far off to one side. But he said I don't need spinal fusion surgery for quite a few years, if at all. I sure HOPE NOT!)

    Where do you live? If you are NOT in or near Westchester County, NY, I might be able to ask my Ortho surgeon for the name of someone near you whom he would trust to do right by you.

    But, again, your age, CA treatment, Stage 3 renal insufficiency and spinal issues COULD be a problem for most Ortho surgeons regarding performing a TKR on you at this time. Your risk factors for an infection or other complications may be too high for their comfort level to agree to a TKR at this time. I'm just giving you a head's up on what you might encounter. If you can POSSIBLY put off the TKR for another 3 or 4 months till the bladder chemo drug is out of your system and you are in remission, I'd advise you to do so. I also think you should look into getting treatment for your back problems FIRST before you have a TKR. You don't want to be having pain in your back while trying to recover from a TKR at the same time! There is a more minimally invasive procedure for the type of spinal issue you describe here that a pain management doctor could perform instead of spinal fusion surgery. (It's called a nerve block, where the pain management doctor injects cortisone at the site of the pain under the guidance of an x-ray machine so he knows EXACTLY where to insert the needle safely. This MAY give you relief long enough to go through with the TKR surgery without added pain from your back! I'm actually getting this procedure done on each side of my lower back on 7/13 and 7/20. - see above re my explanation of my back issues.) It IS MAJOR SURGERY AFTER ALL, and it can take up to four MONTHS to completely re-hab from TKR surgery! Been there, done that with my first TKR last year, so I know what I'm talking about.

    Talk to your current Ortho surgeon again this month BEFORE you jump into going under the knife in August for the TKR. You want a good outcome, obviously, but right now, I'm not so sure your surgeon would be doing you a favor by rushing you into this TKR with everything else going on with you, medically!

    Think about it and let me know what you decide to do.

    Hope this advice helps.

    Carol

    Last edited by ldy12; 07-01-2012 at 09:30 PM. Reason: more info

     
    Old 07-01-2012, 10:40 PM   #5
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    Re: Tkr

    Thanks, Carol. I live in Colorado Springs, CO (yes, where the monster fire has been burning for over a week--more than 346 homes burned to the ground--I live a few miles from the fire area.) Your surgeon sounds wonderful--if I lived there I'd surely want him, but unfortunately I'm too far away. Traveling is almost out of the question for me. :-( However, I would be interested in who he would recommend as a top-notch spine surgeon in my area. The neurosurgeon I've been seeing is with Boulder Neurosurgical Associates. One of my sons lives near Boulder in Thornton CO, so it seemed best for me to have the spine surgery done near his home, as I live alone in CS. My other son lives in PA.

    I've had lumbar epidural steroid injections for years, now. In June, 2011, my pain specialist had difficulty getting the injection in. Oct 2011 went back again--he said my epidural space is blocked so I can no longer have the steroid injections (which were what was keeping me going). My PCP had me see another pain doc for 2nd opinion--he said I need a laminectomy (I've been told in the past, even at Mayo Clinic, that due to my severely degenerated spine plus scoliosis that laminectomy was totally contraindicated). Next my PCP sent me to a neurosurgeon, who recommended implanting an X-Stop device. Subsequently my PCP sent me for a 2nd neurosurgeon opinion--this one took a lot of time to consider my case, studied my MRIs, Xrays, at length, etc. He said it's a very difficult case; for several days continued to study my spine films and then called a case consult with his 4 partners, and after much discussion they all agreed with him that I should have spinal fusion of just the 3 worst lumbar levels, as that is where the most severe nerve compression is--both central and foraminal. He didn't want to do more than absolutely necessary because of my age and co-morbidities, but wanted to do what he could to relieve my pain, and enable me to stand and walk enough again to remain independent in my home.

    Folks on this Board encouraged me also to get an orthopedic surgeon's opinion, so I saw one at Colorado University Spine center in Denver. Without even considering all aspects of my situation, he recommended fusion of the entire lumbar spine! He is a professor at CU.

    Anyway, I was scheduled for the fusion surgery May 2, 2012, and the Boulder surgeon ordered CT scan of abdomen/pelvis for surgical mapping (he was going to do the anterior spine via a minimally invasive procedure); CT found the bladder tumor incidentally. I also had a knee MRI the same day of the CT and it showed bone on bone. The neurosurgeon told me that obviously we'd have to postpone the surgery till the bladder issue was settled, and also said I'd need to get the knee working better before spine surgery as I'd have to do a lot of walking post-op for the spine to heal successfully.

    Saw a knee ortho surgeon recommended by my PCP, who said he is "wise" and had taken a 1 year sabbatical not too long ago to study complicated knee procedures in Europe. Knee surgeon said to get the bladder taken care of first, and then return and we'd discuss TKR, since over the years I've already had several courses of various injections--Synvisc, Hyalgan, Eufflexia, steroids, etc. plus had arthroscopic surgery for torn mensicus in 2005--"you've already done the easy things."

    I was convinced (foolishly) that the bladder "lesion" was nothing, as I had no hematuria or other symptoms, so wasn't very concerned. But when I had the cystoscopy 4/23, behold there was a large tumor. TURBT followed (5/11) with no complications, but path report of high grade stage 1.

    My urologist felt the safest route for my treatment would be Mitomycin bladder instillations, once a week for 6 weeks--said IV chemo or BCG would make me too sick (I also have renal insufficiency). Had the 2nd biopsy and the first MMC on June 26, and got along fine--just a little aching and tiredness for about 24 hours. Path report is pending. Uro did say that this is an aggressive cancer and I'd need ongoing close surveillance the rest of my life. My son asked him if he thought I would eventually need an RC--he replied, "I hope not." But advised me to get an appt. with the knee surgeon and get the TKR scheduled for 2 weeks after my last chemo (July 31)--"we need to get you walking better". Of course, knee doc's first available appt is July 23 (on vacation 2 weeks in July), and scheduler said his surgery schedule is full till some time in Sept.

    So that is where I am now. Neuro says can't do the spine till knee is taken care of. And you suggest the spine should be done before the knee! :-) Ah, me. It's complicated having 3 things hit all at once. Looks like my body is showing signs of wear and tear, but in spite of everything I don't feel old.

    I have an appt July 9 to discuss all 3 issues with my PCP, who has known me for many years and is my hero. He takes care of me as though I were his mother. (He also was my husband's PCP.) I would have seen him sooner, but his office and home are both in the evacuated fire area. I trust him implicitly and will follow his advice. He's a very conscientious Dr., and also very conservative about surgery--always wants 2 or even 3 opinions before deciding. But he knows I'm in severe pain and losing independence due to the difficulty I have walking, from both the spine and knee problems--has recently prescribed some morphine for me to take when pain gets intolerable. I'm averse to taking narcotics, but right now there's no other recourse.

    This has become such a long and involved missive I'm afraid you will regret "friending" me. I do deeply appreciate your concern and advice and will be interested in your take on all this. You've been down a long difficult pathway yourself, so what you have to say is definitely worth listening to! I hope you will continue to do well.

    Thank you again,
    Paula

    Last edited by Administrator; 07-07-2012 at 09:04 AM.

     
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    Old 07-01-2012, 11:23 PM   #6
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    Re: Tkr

    I failed to tell you that my spinal epidural injections have been under fluoroscopic guidance, and I've had the nerve blocks. My chiropractor ceased giving me any kind of treatments in 2002 after he saw my MRI--said manipulation would be too risky, could cause paralysis. I also have bulging/herniated lumbar disks, facet arthritis, spondylitis, grade 1 spondylolisthesis, have had 2 spinal fractures (L1 in 2008 and T11 in 2010), as well as the severe stenosis and scoliosis.

    I used to swim up to an hour a day, followed by an hour in the gym--treadmill, bike, strength training, and weight lifting. But my back pain finally put an end to all that in 2007. What a loss! Had already had to retire due to severe pain, and that was a big loss as well. I've had repeated PT over the years also--many months of PT after being in braces after the fractures, to build up core muscle strength again. Had Axiom DRX 9000 decompression treatments which worked well for quite a while. Massage-- I think I've tried everything except acupuncture, and implanted Medtronic Neurostimulation System which my pain specialist suggested and I declined. One of my brothers is an anesthesiologist; he told me he didn't like taking part in the neurostim procedures as the patient has to be awake to give feedback to the surgeon, and he felt so sorry for the patients--after all, his career is for pain relief/prevention! So I wimped out of that procedure--it was invasive and no promise of success, anyway.

    My greatest loss has been my precious husband and best friend who died 12/26/08, less than a month after being diagnosed with acute myelogenous leukemia. What a vicious, cruel disease. I guess all cancers fit that description at some point. We had been married for over 50 years, and were one entity. I'm so thankful for our 2 sons; life would be bleak without them, their sweet wives, and my 2 dear grandchildren.

    Enough rambling.

    Have a wonderful 4th of July!
    Paula

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    Old 07-02-2012, 10:59 PM   #7
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    Re: Tkr

    Hi Paula,

    Boy, you REALLY have been through the ringer over the past few years! I think YOUR multiple problems happening all at the same time is probably WORSE than what I had happen with my knees and now my back! At least my back problems (the worst of them which started about a month and a half ago) did not appear until AFTER I was able to get both knees replaced and full mobility restored WITHOUT PAIN!

    I went back to my Ortho surgeon today (Mon), because I had some qualms about the spinal nerve block procedures. (I had lunch midday Monday with my nurse friend who's been my medical guidance person for 25 years, and after I told her what was going on with my back and the treatment plans recommended to me, she said to MAKE SURE that the spinal block procedures would NOT affect my bladder in terms of giving me severe stress incontinence - already had surgery to repair that problem in 1989 - don't want to go through that one again!)

    My surgeon and his physician assistant, who has also been wonderfully supportive to me in the past year and a half, said that I should definitely have the blocks done and not to worry because where the pain management doctor will be inserting the needles is BELOW my bladder and other related organs. My surgeon also said I should go to the chiropractor he referred me to for at least a consult. He said the chiropractor will be able to tell pretty much right away, how much he can straighten my lumbar part of my spine which is off to one side about 25%. Since, as you can tell by my last post, I trust my Ortho surgeon IMPLICITLY, I am going to the chiropractor Tuesday (now today), and hope that he can help me, at least a little bit.

    Both my Ortho surgeon and his P.A. said that spinal fusion surgery for what I have, is really NOT an option, mostly because I have not tried more conservative treatments first, and also because it might actually make my spinal problems WORSE! So they essentially, much to my relief, actually, took spinal fusion surgery off the table as a viable option for me. (My oldest cousin had two or three, I forget which, spinal fusion surgeries and two neck fusion surgeries and she's STILL in a lot of pain all the time! They didn't work for her.) That's why I was very clear with my Ortho surgeon when this back pain started in late May, that I did NOT want spinal surgery! I knew what my cousin had been through and I didn't think it was worth the risk to me.

    A quick aside - after I left my surgeon's office Monday to go pick up a copy of the DVD of my January spinal MRI for the chiropractor, I was stopped in traffic and got rear-ended by this stupid young 20-something kid which jolted my back even more! I won't bore you with the particulars of THAT situation, but after the cop was finished talking to me, I went and picked up the DVD. On my way back home, I was passing my Ortho surgeon's office and knew he and his P.A. would still be there getting ready for Tuesday's surgeries down at Sound Shore where I had my knee replacements. I was totally in tears when I walked back in and told the P.A. I'd been rear-ended and it made my back hurt worse. She and my surgeon calmed me down and said that if I had to have this happen, at least it was the day before I was going to the chiropractor!!! They both joked that maybe I need a chauffeur! Just wish I could afford one! The drivers here in NY are insane with the way they ride your bumper, and they think it's the funniest damned thing when they upset me about it!!

    Anyhow, the P.A. told me that my back is going to be pretty sore for a couple of days, but it would be okay to use the muscle relaxer, the painkiller and the lidocaine patches to calm my back down. She asked me to call the office in the morning Tuesday and leave a message on her's and the other P.A.'s voice mail to let her know how my back is feeling. The other P.A. will get word to her, even though she'll be assisting in surgery with my surgeon all day Tuesday. She said she would TRY and call me at the end of the day if she can.

    And yes, my surgeon IS WONDERFUL!!! Just absolutely the most caring surgeon I've ever had in my entire life with all the surgeries I've been through in my 56 years to date! He knows that I don't complain much and have really been very compliant with EVERYTHING that he's asked of me. So when something like my rear-end accident on Monday reduces me to tears, he is just THERE for me to reassure me that it's not as bad as I thought and /or as bad as it could have been. He goes into his teasing mode to get me out of my upset and makes me laugh.

    Since I came in without an appt. Monday afternoon, they squeezed me in, and though I knew I'd have to wait a bit to see him after talking to his P.A., he always apologizes for keeping me waiting! I just have that kind of special rapport with him. He always calls me "Rascal" now which is the nickname he gave me post surgery in March after I showed him how motivated I was about walking the same day of surgery when I had my left TKR (I walked 200 FEET on the walker and so he started calling me "rascal" since I was always up and on the walker my entire hospital stay!) When I was there Monday in the office for the office visit, not my return trip due to the accident, and he called me "rascal", I said to him, "Wait till you see the holiday present I'm getting you. You'll be able to hang it on one of the walls here." He laughed and I think he probably has an idea what it's going to say!

    Anyhow, back to YOUR issues. I can imagine by what you've told me here that you must be a bit confused about which order to do things in by now. Especially since I gave you MY experience back in January where my Ortho surgeon did the OPPOSITE of what your surgeons are recommending! (Getting my back spasm cleared up first and THEN agreeing to the left TKR two months later.) I think it is good that your primary care doctor is so thorough and wants two or three Ortho opinions BEFORE you go under the knife for either the spine OR the TKR first. And it's great that you trust him implicitly like I trust my Ortho surgeon COMPLETELY! I didn't mean to confuse you with my advice. I just wanted to show you that different Ortho surgeons think differently about both simple, straightforward cases and more complex ones like yours. I guess it's hard to know WHOSE advice to trust as the right decision when you have so many consulted surgeons. (the old, "too many cooks spoil the broth" adage which is so true here.) My nurse friend, at lunch Monday, said to stop asking so many people what I should do about my back problem and just go with my Ortho surgeon's advice since she knows I trust him the most. She's right.

    I'm afraid I won't be able to get you a referral name from my Ortho surgeon this summer. He's going on a one week vacation next week and since I've already taken up so much of his time the past couple of weeks, I really can't bother him with that right now. Sorry about that. If, however, you do end up putting off the TKR until the fall (like October, maybe?), I see him on Sept. 24th for a follow-up checkup for my left knee TKR. I could ask him then. Hope you understand.

    (And by the way, I wish you DID live here in Westchester County, NY so you could go to him! You would have loved him!) As I said, he's my Medical Hero just like your primary doctor is yours.)

    As for "friending" you, why would you think I'd regret doing so? These Boards are for helping each other and giving practical, patient perspective advice. If we become long distance "friends" because of our medical issues that we have in common, all the better. It's always nice to have someone who's been there, done that, giving others some practical pointers if you have the same or a similar issue. Just makes it easier to get through treatment, when you know you're not the only one going through these problems!

    But, to lighten things up a bit, maybe we could, via private email on this site, exchange interests we might have in common, like hobbies or whatnot so we don't always have to focus on the health stuff all the time. I'd like that if you're game!

    Best regards and let me know what the outcome of all those consults is!

    I, in turn, will keep YOU apprised of what progress I make over the next three weeks with my chiropractic treatment and the spinal nerve block procedures.

    It's been a LONG day and I have another coming up Tuesday before the Wednesday holiday. Time to grab a few Zzzzzz's!!! (If I can because of the increased pain due to my accident, that is!)

    Best regards,
    Carol

     
    Old 07-05-2012, 12:24 AM   #8
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    Re: Tkr

    Hi there - just a quick note. If you have muscle spasms, I recommend trying acupuncture. However, you should look for a practitioner who inserts needles directly into the problematic muscle.

    I had one treatment with just points on the arms and legs, not directly into the back, which was unhelpful. I have since found a wonderful practitioner who treats muscle spasms with direct insertion. It provides me more relief than any muscle relaxant ever has, and I have been on Soma, Flexeril, Skelaxin, and Baclofen. Plus, no side effects! I go once a week, but I would be there three times a week if money were no object. (I know that this is more back-related, but I know Grammie76 has been dealing with both, and 2012 carol has mentioned back problems as well.)

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    Old 07-05-2012, 11:07 AM   #9
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    Re: Tkr

    I'm interested to know this, SweetPea; I've never talked to anyone who had acupuncture for the type back pathology I have. Would want to know the acupuncturist used sterile needles, etc. Some years ago I attended a continuing education seminar for nurses that included a lecture on acupuncture. Don't recall any reference to using it for bone problems, but if the muscle spasms are related to the joint issues, I can see how it might work. Will ask my PCP about it.... Thanks

     
    Old 07-05-2012, 07:43 PM   #10
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    Re: Tkr

    Hi Grammie76,

    So, now, in addition to the added pain from Monday's accident, I woke up July 4th with bad laryngitis!! (Just not a good week for me, is it?) Went to my primary care doc this morning (Thurs) and since my throat looked red, she put me on the Z-Pak antibiotic because apparently it's also an infection, not just laryngitis. Trying to rest my voice as much as possible the next few days. I used to get this every year around this time a few years ago when I was still going to karaoke. The strain on my vocal cords, I guess was the problem. But since I quit karaoke in 2010, I have not had the problem as much. Not sure what caused this episode, not that it matters as long as I'm taking care of it.

    Anyhow, I'm surprised your chiropractor would say that continuing treatment would cause more damage and be too dangerous. Also, why did you stop getting the spinal nerve blocks? (If you did stop, that is.) I talked to my surgeon this evening because the pain was going UP my spine, not down to my legs. He said to absolutely let the chiropractor continue to work on me until the next two Fridays (13th and 20th) when I'm due to have the spinal nerve block injections of cortisone. (The pain management doctor has to do one side of my lumbar spine at a time.) My surgeon also said that because I also have some muscle tightness, to continue to go to my physical therapist also. He said the back muscle pain and lumbar nerve and disc issues are two different things.
    So, I will definitely listen to his advice. Hopefully, by the end of the summer and into late September when I see him for my 6 month left TKR checkup, my back will be in WAY BETTER SHAPE!! I sure hope so!

    As SweetPea suggested, maybe you COULD try acupuncture for your lumber spinal problems. It's been used for THOUSANDS OF YEARS by the Chinese and has a proven track record. And in the past couple of decades, acupuncture has been recognized by "traditional" American Medicine as a viable alternative treatment for a variety of ailments. I would look into that if I were you. (If the chiropractic treatment doesn't help me all that much, but I think it will, acupuncture may be the next thing I look into for my back problems.)

    On a lighter note, I just finished watching my NY Mets come from behind in the 9th inning to beat Philadelphia, when the Mets were down to their last strike 3 batters in a row! They've been winning a lot that way all season long!!!!

    Now it's close to 11 PM here, so I will just have a small evening snack, read a bit and then lights out!

    Keep us posted on how you are doing.

    Regards,
    Carol

     
    Old 07-05-2012, 07:54 PM   #11
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    Re: Tkr

    Hi--I had my second Mitomycin instillation on 7/3; got along fine, and had no side effects the next day like I had last week. :-)

    I had laryngitis yesterday, too. First time I tried to speak in the AM, no sound came out; gradually became able to talk some later in the day, but with a very raspy voice. Still gravelly today, but improving. I don't have a sore throat.

    Take care.

     
    Old 07-05-2012, 08:02 PM   #12
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    Re: Tkr

    Don't you just HATE when you get laryngitis and discover no sound coming out? LOL! I had my voice, it was just very raspy and squeaky! So I have to remember to modulate it while I have the laryngitis so I don't strain my vocal cords.

    Hopefully by Monday, my voice should be almost back to normal, given that my doctor put me on antibiotics.

    Keep me posted on how you are doing.

    Regards,
    Carol

     
    Old 07-05-2012, 09:34 PM   #13
    SweetPeainSF
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    Re: Tkr

    I have to imagine that the wild changes in weather that have been occurring are not helpful for throat health. So glad the mitomycin went smoothly!

    OK, so this is back specific for me, but since grammie brought up back issues, and many folks with lower limb pain also have back issues, it may be helpful to others. I had a lumbar fusion surgery in Dec 2011 (ALIF L4-L5) and developed complex regional pain syndrome affecting my right foot. (This condition was formerly reflex sympathetic dystrophy, but someone changed the name.) I have also had three right hip arthroscopies, with a little more than half the acetabular cartilage found detached in the last scope. The surgeon reattached with microfracture under the flap and three Pop-locks stitched through the cartilage and into the bone at the edge of the acetabular rim. The hip surgeon tells me I will feel better at 14 months post-op, just 6 weeks from now. Fingers crossed.

    I started acupuncture to treat the CRPS, but the practitioner has been treating my hip pain and also back spasms. The CRPS is unchanged; the hip pain is no better; but the back spasms abate significantly after each treatment. From what I know, CRPS not changing could be perceived as successful, in that it has not spread. The hip pain will likely only improve via mechanical change. The acupuncture helps my back spasms, which trigger the most back-specific pain for me, more than any muscle relaxants have helped. I also have radicular pain, which the acupuncture does not affect.

    So, if grammie needs to hold off on getting her back treated and the muscles are spasming, acupuncture could be really helpful in the interim, especially while trying to ambulate after a TKR. I know that acupuncture is advertised as helping other conditions, but I only have a significant experience with the muscle spasms.

     
    Old 07-06-2012, 10:00 PM   #14
    Grammie76
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    Re: Tkr

    Thanks for your detailed email, SweetPea. Very helpful. I can't imagine having CRSD on top of spinal fusion surgery, and now the serious hip issue. The neurosurgeon who was planning my spine surgery (3 levels XLIF and PLIF) told me I should be prepared for 100% chance of complications because of my age and comorbidities. As an RN, the diagnosis RSD would always strike terror to me, because it is so very painful and there is so little that medical providers can do for it. I am very sorry for all the suffering you have endured. That comes with a high emotional cost.

    I have an appt with my PCP on 7/9, and will ask him about acupuncture. I doubt my insurance would cover it, though, and when I looked into it a few years ago it was going to cost $250, so I had to decline.

    We have had a couple of measurable rains in the last few days--a wonderful blessing for dry Colorado. It can present flash flooding though, with the mountainsides so denuded by fire. I hope and pray all the unfortunate people who have already faced the fire calamity will not have to deal with floods now.... All kinds of trouble in this world!
    Grammie

     
    Old 07-06-2012, 11:12 PM   #15
    SweetPeainSF
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    Re: Tkr

    Fires and flash floods make the CRPS look like a dust mite. I am fortunate in that I was early diagnosed and receiving aggressive treatment. I also haven't suffered any truly debilitating symptoms, so I am looking at this condition as a potential monster that needs to be driven into remission. (I am more than a little stubborn.)

    My insurance covers 15 acupuncture visits per year. The practitioner offered a bulk deal after my insurance visits are exhausted, if I am willing to pre-pay for the services. So, if you are interested, it is worthwhile to ask around for different rates and packages available. For me, at some points in the past, I would have emptied my back account to make the pain stop. However, I have never found any explicit guarantees for that!

     
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