Fourth day following TKR

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Well what can I say that hasn't already! Came out the surgery feeling it hadn't been as bad as the picture I had built up in my own mind! Day following surgery was able to do all my excercises and was also signed of by o/t as I had no problem dressing, sitting on the toilet, getting in the shower etc, Great I thought! Then day two, I couldn't even lift my leg! Exercise seemed impossible and my knee was three times the size of the other, physio assured me that was fairly normal and to keep on trying to get through the exercises, taking all the pain relief they had to offer and using loads of ice I finally managed day three exercises, but physio said I can't be discharged until I can get at least 80/85 bend, I'm only getting 65/70 with a push. So they decided to put me on a bend machine, designed for day 5 patients post op, I was very apprehensive about this, anyway the young lad assured it be be fine and once it gets going my leg bend will improve daily, he said I could use the machine as often as I felt able, indicating twice a day for an hour or two, the machine does work very slowly.

So he strapped me into the contraption and off he went leaving me to manage alone, he never returned. After almost the hour I managed to get a nurse to get me out, I had had enough! My leg was agony and I could barely walk. Day four and I'm still in hospital but feel I have taken a step backwards following the kinetic machine, and I don't know when I'll get the bend close to 70 again, right now I'm lucky to get 40/45, has this happened to anyone else so soon after surgery?

Thanks for taking the one to read this.

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  • Posted

    Hi Shirleyann, congratulations on getting through to the "post TKR" stage! Hope youre feeling ok in yourself. 

    Try not to worry too much about losing ground with your bend, its pretty much par for the course in the very early days - as the swelling develops and increases, so your ROM diminishes. Thats one of the reasons icing is such a vital part of our recovery, it helps to keep the swelling under control (to a certain extent anyway). And all the pain relief they pump into us during surgery will have worn off by this point, so things will be harder due to this as well. Im on y 3rd TKR and its happened to me every time. 

    Take heart and keep on keeping on, little and often, baby steps, no matter how little you think you can do every single movement makes a difference.  

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  • Posted

    Hi

    We all heal differently, which has been said many times. When your knee is really swollen exercise has a negative effect in my opinion.

    Good luck

    Good healing

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  • Posted

    Dear Shirley Anne, join the club. Felt like a a million bucks in the hospital. Was almost euphoric thinking it is not as bad as I thought it was going to be.

    Hang in there. It is a long slow process. Icing every two hours. If you can invest in professional icing. Do the exercises. Many times I cried like a baby doing them. Stretch. Elevate. And follow your pain management instructions religiously. You WILL feel better. The first two months was rough for me. Hang in there.🌻

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  • Posted

    One thing no one is prepared for...wait...there are A LOT OF THINGS regarding a TKR that no one is prepared for...but I digress.  The one thing I want to mention is the concept of advances, setbacks and plateaus...with #3 being the worst since you think you'll be stuck there forever.  TKR recovery is NOT a linear process where you get better every day.  Too many fluctuations in the data.

    Everyone goes through this differently so you cannot, should not compare your recovery to anyone else's.  Plus, at day four, you have a whole year of healing ahead of you.  Get rid of all your expectations and timetables...those mind patterns only try to fool you and cause more consternation.  Don't fall into that trap.

    Your knee will heal, you will attain your ROM...but it won't be on any time frame in your head.  It's a slow, gradual process which cannot be pushed or cut short.  Took me 10 weeks of PT to go from -14 / +84 to -1 / +123.  It took a lot of hard work and I had to deal with considerable pain.  From a ballooning knee at five weeks to 11,000+ steps a day (5+ miles) by the end of my eighth month.  You just have to keep at it and manage the pain, which is at its worst in the first 30-60 days.  Don't measure your progress daily...too many ups and downs.  Look back each month to see how far you've come.

    I've done a lot of posts in the group.  Check them out; I'm sure some will be of assistance to you.  Good luck!

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    • Posted

      See what happens when you're on a combination of Percocet and Flexeril after spine surgery?  Did I actually write that in an opioid fog?  Geez...gotta get past this dumb post-op pain so I can remember what I just did...said...wrote...whatever...

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    • Posted

      Just know it is epic. Take Stephen King- his books after becoming sober sucks! Lol.

      I think the drugs act like a truth serum😜

      Really hoping you are doing okay and not in too much pain!

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    • Posted

      Spot on!!!!!  Even though I've had a comparatively easy ride, it's still been a roller coaster because we simply have NO idea about what can happen and there are so many variations on how healing takes place.  I think we all feel as though we're fumbling through and at times as though 'it's all going wrong' when we get a setback, but I really have come to the conclusion now that it IS 'all normal'!  And that at the end of the day 'it is all going to be OK'.

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  • Posted

    Oh boy, Shirleyann, it sounds like a tough ride there!  Are you in the UK, out of interest?  Where I went, in the UK, you get the op done one day and go home the next if your bloods are all good (mine were low in salt so I had to stay an extra night), but while they give you exercises to do, all you have to be able to do before going home is get to the loo, and get washed and changed.  There is no 'test' on bend or anything but if you've got stairs at home, they show you how to do them.  And you get instructions by the physio what exercises to do at home, and then go back at six weeks to be signed off but you have to show you can walk normally without a limp, without aids etc.  The day of the op you get a walker to get about, but the next morning you have to show you can walk on crutches before being sent home with them, and then you're told to reduce that to sticks at about three weeks or when it feels right for you.  When the physio came round on day 2 he said it would be harder to do the exercises then, than the previous day and that the following day would be the worst.  At that point some can't lift their leg at all, but while I could lift mine I did use my hands to help the slide exercise to bend more, but I've been the other extreme - virtually no pain apart from at about three weeks sudden pinching in the back of the knee on a bend of just over 115.  It does hit you though that everything is 'normal' because it can vary so hugely between different people and different operations!  I can only suggest what a couple on here suggested to me, and that made all the difference in the world - when you're wanting to get that bend, put hot damp flannels around the knee (covered with a towel to keep them warm) for 10 -15 minutes - boy did that make a difference!  Also, again suggested on here - I'm now using voltarol three or four times a day to reduce inflammation.  I'm four weeks tomorrow post TKR, have stopped using the sticks and everything but do still walk very slowly.  But then the other knee needs doing too!  But in the meantime, keep icing and elevating all the time!  Good luck:-)

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  • Posted

    Shirley exactly the same happened to me the day after surgery which was 2nd March nearly 4 weeks ago I was up exercised got 70 degree bend was so pleased thought I would be able to go home following day my my what a surprise I got the following day I was in agony black and blue from my foot to my thigh knee and foot swollen badly ended up in hospital for 6 days still couldn't get past 65 degrees when I hot home didn't even put me on a machine as they didn't have 1 available I've had no PT since I got home only an exercise chart that I'm supposed to do 3 times a day and can't manage I go back to see my consultant on 25th April and can't wait . Hope you have better luck than me !!

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    • Posted

      You and I were done very close together, weren't we Eileen (mine was 1st March).  You had yours in the UK, didn't you?  NHS?  No-one measured anything when I was in hospital and actually even never mentioned measuring anything afterwards - it was only on this group where I saw people were measuring bends.  You just go back and show them you can walk properly and do everything you need to do at 6 weeks, having done the exercises they tell you about.  I go back on 18th April but only see the physio to get signed off.  It sounds as though where I went everything is more relaxed.  BUT, having said that, if you want to, you can phone them and get straight through and ask anything from either nursing staff or physio.  They encourage you to do that, but I still don't like 'bothering them', if you know what I mean.  I had purple black and blue bruising on the thigh and around the back of the knee and lighter colours around the front of the knee but never had swelling in my lower leg or foot, but am still wearing the compression stockings.  Are you?  Still doing the icing and elevating too.  I hope things improve for you soon.

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    • Posted

      Hi Chris do you know I feel very neglected lol I was given 1 compression stocking to put on my good leg before surgery and was told that I'd be given another 1 after surgery to wear on operated leg well guess what I never got it and neither did any one else. So when I got didischarged I asked about stockings and their reply was oh it's up to you wether you want 1 or not so wore it 1st night home and woke up in agony with my ankle swollen like a balloon never bothered after that. 2 weeks after surgery rang PT up for appointment and was told oh we don't do physio with you just follow the exercises on the leaflet we gave you oh my well I just get on with it I'm iceing regularly and elevating swelling almost gone and sleeping better now but still not able to bend my knee as well as I think it should bend but hey ho time will tell another couple of weeks and hopefully I can get in my car and get out of the house for a while good luck to you Chris

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    • Posted

      Oh Eileen, I'm shocked!  When I came out of theatre I was wearing a pair and then the nurse came to change them the next day.  They lather your legs with aqueous cream before they put them on too, and they send you home with the pair you're wearing AND another pair, so you've got no excuse not to be wearing them while the other pair is washed, AND they give you a tube of the cream too.  But the pt is similar - they send you home with a DVD and leaflet.  Did you have a very good bend before the op?  I do remember being told that the better bend you had before the op then the better bend you'll get after it. 

      I went back to using two sticks today, just for when we were out because I had a hospital appointment (only for the jaw) and my husband parked about half a mile away, so I decided to use the sticks.  It was about a 50 minute journey each way too, so sitting for a while, so it's back to ice and elevation now LOL!  I'm sure you'll get as much bend as you need, in time.  It was realising that it's a myth that there is a window when you have to achieve whatever is going to be achieved  that took the panic away from me.   You can do it as steadily as you need to.  So what leg are you wearing the stocking on?  The operated one, or the other one or do you alternate LOL!?  I know it's a bit late in the day now but I reckon your GP's would give you another one to match the one you've got.  When I had a hysterectomy they gave me just one pair but they were too short and constantly rolled down into a tight band so I dumped those sooner than I should have because I was worried about them causing  DVT!  It's the luck of the draw, to some extent, isn't it.  But I did research my hospital well for the knee to be done LOL!  I rejected four closer ones LOL!  I'd heard brilliant things about the one I chose to go.  The journey was a bit of a nuisance, but all in all it was a good decision!

      Talking of the stockings, I HATE feeling my toes cramped (got bunions and feel it's making them worse) but I discovered a couple of weeks or so ago that I could turn the toes back on the stockings so it leaves my toes free and it's a bit cooler at night too!  I still couldn't manage to get them on myself though.  My husband gets them over the heel and I can do the rest LOL!

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    • Posted

      Wow! Sounds pretty shocking to me. Remind me to never get a TKR in the UK 😱.

      I am in Califiornia. No support stockings over here think they phased them out, everything was measured in hospital. 3 Day hospital stay. Physio twice a day. Send me home with strong narcotics (Dilaudid), Warfarin and Norco to supplement if needed. Home physio came round the day after discharge and after x2 a week for 5 weeks. Week 6 to out-patient. Have complete access to my surgeon. Simple questions I text him, he replies. See him no less than every 3-4 weeks. I feel very blessed!!!!🌟

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    • Posted

      It's interesting the differences Milla.  I've no idea what it would be if you went privately in the UK - that might be different too.  But I have to say I've been absolutely happy with my treatment for my knee replacement.  Even the waiting time to see the surgeon and rest of the team was only a couple of weeks, with another six or seven weeks to wait for the op.  Since the NHS is struggling so much then I felt my treatment was brilliant!  They did sent me home with codeine for a few days if I needed it, but I didn't.  I think if I'd had more pain in hospital they'd have sent me home with more stuff but when they asked what my pain level was the night before I left, my reply was 'what pain'.  But they did also give me anti inflammatories and anti clotting tablets and a stomach protection tablet for about a week.  I felt lucky too LOL!

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    • Posted

      Chris I disposed of the stocking while in hospital I wanted to wash .my feet and after couldn't get it back on so the nurse said she would do it when she had time ! obviously she never got the time and all 4 patients in my ward came home without stockings. I don't need them now bit late don't you think lol but I do think there was a lot of neglect. Even had the same dressing on my leg for nearly 3 weeks until I had my staples removed they reckon its to stop infection getting to the wound . Lets hope i dont ever need my other knee doing . And i actually used 2 crutches to go the doctors yesterday otherwise im managing on 1 even then i keep forgetting it and leaving it in the bathroom or kitchen ha ha

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    • Posted

      That is good. True you know, I don't really remember reading a post from someone who had it done privately over there so it is hard to say. I think the scary part I keep hearing is no physical therapy and just send home with a sheet of exercises. My physio (also my torturer) had helped me immensely. The home therapy was worth every single penny! The first 6 weeks I was out of my mind with pain and my leg was ginormous from swelling. Felt like my staples was going to ricochet of my leg. If it wasn't for her no exercises would have gotten done. Other side of the coin though- my surgery alone was $94,000. I do have insurance and my portion is $4,000. But add the home physio, the Warfarin home nurse that came around once a week and out/patient therapy, co pay at surgeon. Co pay for all medications I have a hefty debt burden this year.

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    • Posted

      Wow you sure are blessed milla my PHONE sounded disgusted when I rang her to see if anyone was coming to see me she boldly said just follow the exercises on the leaflet we gave you lol
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    • Posted

      Oh my goodness - it gets worse and worse!  Eileen, I feel angry for you!  I was told the staples MUST come out at between 10 and 12 days or they start getting the skin grow over them and it causes problems!  They used an Aquacel dressing on me which is lined with silver and known to aid healing, and that stayed on until staples came out.  I did find that the staples were pulling significantly by the time they came out and actually made holes and bled from them pulling and that was getting them out at 12 days!  It was a relief to get them out then and the dressing off - those bends were much easier then!  That sounds good though with your crutches!  That's what I was doing after I'd gone down to one stick - I kept going to have to look for it LOL!  Crutches and sticks are both left in the car now:-))))  The hospital I went to did tell me they had four patients to every nurse, whereas most have eight patients to every nurse.  When I was in all our wee got weighed too.  And constantly tested.  Was yours?  I'm really sorry to hear about your experience.  If you did need the other knee done, would you choose a different hospital?

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    • Posted

      We were also told to do exercises before the op, in preparation, and given the leaflet the day we met the team.  They also made sure there was someone to look after us, and pets, etc. if we needed help.  The loaned us the crutches too (that could be turned into sticks, but I already had my own).  In some ways I feel it was better to get on with the physio myself and go at my own pace, but that maybe was just me.  A physio would have been helpful at the stage I got the awful pinching/cramping pain behind the knee, but I was able to phone and ask them, going straight through to a physio on the phone.  But I have to say, this group, with the suggestion of voltarol and heat application (especially the heat!) made the miraculous difference!  Maybe if I'd been seeing a physio they'd have mentioned these sooner, but who knows.  But I have no complaints and feel it all went very well for me and would absolutely recommend the hospital I went to.  It was beautifully clean, with someone coming round every day doing all the floors and everywhere, and the food was excellent and the staff were incredibly kind and cheerful.  They absolutely made the stay as good an experience as it could have been.  Even the discharge was brilliantly organised with everything ready before I was told I could go home!  Not like a previous stay in a different hospital - told I could go at 10 am, and then still waiting for formal discharge at 6 pm!

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    • Posted

      Oh my goodness - you had to pay a lot towards yours, didn't you!  A friend of mine lives in the US and recently had a cataract op and the insurance left her with a huge amount to pay for that too!  There have to be a lot of people who just can't afford to get things done, despite needing them?

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    • Posted

      Eileen I'm really sad to read about your experience.  It must leave you feeling neglected and left to get on with it, come what may.  I actually phoned my hospital twice - once as I said with that excruciating pain in the back of the knee where I wondered if there was something wrong, but before that, when brown fluid was leaking out of the dressing, because they'd given me a piece of paper that said if anything came out of the dressing to contact them, but they were very reassuring.  Both times they were incredibly sweet and caring.  I really am sad about your experience though. It really sounds as though staff are overworked and struggling.  Very sad.

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    • Posted

      Yes Chris I think I would definitely go private whatever the cost I'm not being a snob but bad experiences certainly put you off the only good thing is my scar is lovely lol it rearly is so neat and flat not raised at all my daughter can't believe how pale it is

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    • Posted

      Now my scar isn't so great.  It's still slightly lumpy and bumpy and the decorative dots each side (where the staples were LOL!) are still there in part, but it is improving all the time.  I didn't go privately though and would absolutely recommend the hospital but I'm in the Midlands.  I looked this afternoon and their waiting times are slightly longer - a little longer to see the surgeon and 8 - 12 weeks for the op from that point, but I wouldn't dream of going anywhere else:-)  If the NHS stopped doing these ops though I'd certainly pay!  Honestly, I really feel sad about your experience.  Even when I had a previous op done in a closer hospital that is under special measures the experience was actually very good!  And the food was GORGEOUS!

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    • Posted

      Oh well Chris that's the only good thing is that my scar is superb lol you can't even see the holes were staples were so they got something right. Food was disgusting and I'm not a fussy eater my husband and daughter brought most of mine in she brought me salmon sweet potatoe and salad in one evening gosh I felt so guilty eating it . Couldn't complain about the care before surgery we went to a joint class were we given lots of books with exercises to do before op given our crutches and gave measurements in for our toilet bed and bath in case we needed raises or bath chair. Problems were all after surgery when you most need the help. This is so funny Chris I've actually just now had a call from the physio to see if it's all right for them to call out in the morning to see how I'm managing with my exercises well well well that's a surprise wonder if my crutches are bugged lol gosh I'd better make a move and do some exercises ha ha ha

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    • Posted

      That sounds really good on the 'before' bit Eileen.  But not so good after!  Oh LOL!  Big Brother is watching you LOL!  That's hilarious LOL!  Yep, get on with those exercises now LOL!  Don't forget, wrap the knee in hot flannels for 10 - 15 minutes if you're trying to bend it - it worked like a dream for me!  Hope it goes well:-)))))

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    • Posted

      Oohhh have not heard of hot Flannels Chris will definitely give that a try I've only been using ice and to be honest I feel more pain and stiffness after I've iced but feel less pain after soaking in hot bath in fact I'm going to try that right now thank you Chris 👍

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    • Posted

      It was Clive who said the hot baths had given him SO much relief.  I can't remember how many baths he was having in a day but do remember that it relieved his pain and enabled exercise so much more, and it was Sue who said about applying the heat before trying the bend again, and I just had a jug of very hot water and soaked the flannels in it, wrang them out a bit and put them round the knee and covered with dry towels to keep the heat in and refreshed the flannels a couple of times to keep them hot.  It really made a tremendous difference and you might find you can push that bend a bit more like that without bad pain!  Hope it works:-))))  I wondered after if I'd not been doing myself any favours icing before exercise too!

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    • Posted

      Hi Chris as I told you the PT came this morning I told her that when I iced my knee felt tighter and painful but when I apply a warm flannel it soothes it . Well she fumed and said don't ever put hot or warm on it OMG well I'm not listening to her because I think it worked for me lol. Even the hot baths work wonders. So thank you chris

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    • Posted

      Oh LOL!  This is so typical where you get one physio say something and another say something else.  I think if it works for you then do it LOL!  I must admit, I WAS nervous the first time but hey, if it works, then brilliant:-))))  I'm so glad it worked for you too!  It does make sense though because they always talk about 'warming up' so to be applying ice, as I was, before exercise, is crazy if it's going to tighten everything up.

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    • Posted

      I just put in search 'using hot and cold therapy after knee replacement' and it's surprising the different comments!  Some say NEVER use heat because it makes inflammation worse, but put heat on the thigh rather than knee, whereas others say DO use heat and I think the best article was by a Richard A Haynes, called How to use Cold and Heat therapy after a joint replacement.  It's back to the midwives thing after you've had a baby - they've all got different ideas, so I think if it works for you then go with it:-))))

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    • Posted

      Hi I'm nearly 7 wks post op. My experience in nhs hosp was good. Food was very nice & freshly heated on ward so nice & hot & decent portions. Op went well, had 1 stocking on b4 op & other 1 put on following day. Physios came round ward every day & helped u out of bed into chair & encouraged you to do exercises in booklet I had at pre op apt & gave you a bag of ice. Had a frame for 1st day then crutches. Had outpatient apt with physio at bout 3 & 41/2 wks. They checked bend & gave me few other exercises to do. He was very helpful. He told me to ice knee to help relieve swelling but only to leave it on for 20mins also to massage scar with bio oil when it had turned pink to soften & help flatten it. I did this on previous knee op bout 4 yrs ago & scar is quite flat now. I've still got a lot of swelling, stiffness & aches at night. Was given dhydrocodeine for pain. I normally only take 1 at night now. Sleeping is still not great, can only sleep on back with the help of prescription sleeping tabs but still wake up 2 -3 times a night. Had follow up apt at hosp with nurse practitioner today & she said i would start noticing the improvement after 3 months. She said i was doing well & walk as much as poss & do exercises 3 times a day. I'm starting physio gym classes on 10th April so hopefully that'll help get me moving better. Hope you're doing ok x

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    • Posted

      I shall have to try that. I've got a couple of wheat bags that can be heated in microwave, do u reckon theyll do the same as hot flannels? Think heat is for pain & ice for swelling so makes sense.

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    • Posted

      I don't know Suzie - some say moist heat.  I wouldn't put either ice or heat over the scar unless it's absolutely healed though  But you can give dry heat and moist heat a go and see what works for you:-)  I would follow the exercise with ice, too.

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    • Posted

      Hi

      When I was in hospital for my TKR, I was given the Aircast knee wrap and Ice bucket, (I could not take the ice bucket home so I bought one) so I was using it straight after my operation. If it would have been open, I would have been in the Hydro pool on day 2.

      So don't worry about the scar, as long as it heals correctly and use bio oil or something similar things will be fine.

      Good healing

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    • Posted

      While I was told I could shower when I went home, they did say not to prolong the water going over the dressing, but definitely no bath until staples were taken out and dressing off.  It may have been something to do with the dressing I had.  It goes on in theatre and doesn't come off until staples come out.  It was an Aquacel dressing.  Lined with silver to prevent infection, I think.  It had a clear window on the top surface that by 12 days looked absolutely disgusting where blood and stuff had come out and been drawn away from the wound.  But then as they peeled it off there was nice clean skin underneath apart from where it was bleeding from the staples.

      My scar, now four weeks on is still somewhat lumpy and bumpy and a bit tender on the lumps and bumps and still the odd minute scab but it is improving all the time.  I said to my husband this morning, with all this swelling round the knee, am I going to be left with saggy skin!  (I am joking!  I really don't care that much!) but told him I might need to do a 'go fund me' page for a knee lift LOL!

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