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[TKR] Discouraged at 5 weeks post op

Discussion in 'Knee Replacement Recovery Area' started by Matt, Apr 22, 2012.

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  1. Matt

    Matt Junior Member

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    Hello everyone. I am 5 weeks post op with a rtkr. My ROM is about 65-70 at its best. I realize that everyone heals differently however should I not be more further along than this?? I have my 6 week folow up on May 2nd with my OS and I fear he will tell me that I have adhesions/scar tissue. Any information or suggestions would be much appreciated.
     
  2. Ditzzeechick

    Ditzzeechick Senior

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    Hey Matt-

    I can only relay my story, I am a recovery turtle. One week the knees move, the next week they are locked up and stiff. I am 8 weeks with my RK and 7 Weeks with my left knee. The left knee is moving better than the right knee this week. My ROM in the right is 105, ROM in my left is 95 but that just happened 10 days ago! Do not worry about the numbers. I know that my numbers changed because the week they measured I had that subtle change in swelling and was able to move my knee more freely. Do not be dismayed. I was 95 the day I left the hospital and went back to 75/80 by the time I began outpatient PT 3 weeks later. It's a challenging up and down recovery. Take your meds, ice and elevate. Eventually, whether you exercise or not, that swelling will disappear over time and you will be able to do more. Don't borrow trouble assuming you have adhesions/scar tissue. From everything I've read here, those are few and far between. I think you need what the majority of us have needed, TIME TO HEAL! Let the swelling subside, let us know how you feel in 4 more weeks, I think you'll be surprised how much more movement you may have by then.
     
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  3. Matt

    Matt Junior Member

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    Bev-Thanks so much for your encouraging words. I guess I will see what OS says next week and go from there. Will continue to ice and elevate with gentle streching exercises.

    Matt
     
  4. kneeper

    kneeper Forum Advisor

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    sounds like a plan! hang in there Matt.
     
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  5. Ronvictor

    Ronvictor Junior Member

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    Matt

    Sounds to me like you are right on schedule at this time. The schedule is established by your knees,..get ok with it and you`ll be fine.
     
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  6. maryo52

    maryo52 Sr Bonesmartie

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    Hi, and welcome to our family.

    Well I'm going to give you a very different response than the others gave you. While "arthrofibrosis" has an incidence of maybe 1% or 2% or thereabouts, it is a common reason people find this forum.

    I've been where you are. I left the hospital with 85 degrees and got worse ROM with my efforts. I don't know if it's true for others who have arthrofibrosis, but because of my limited ROM, I was pushed, had more pain than average to start with, so I was quite debilitated by pain and poor mobility and a lot of swelling. I knew something wasn't right.

    Your ortho will assess your situation, figure out what's holding you back, and most likely propose a solution. The good news is that if it is indeed arthrofibrosis (which your description seems to suggest), of all the complications, this one is minor and resolvable (look at my signature). Infection, which also has an incidence of about 1%, is a nightmare by comparison.

    As others have said, go easy, ice and elevate, and see if you can be any more successful than I was at being patient. It's hard to be patient when one has undergone a major surgery and finding that the promised results are not manifesting. They will!
     
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  7. referee54

    referee54 Moderator

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    Hello! Welcome to our forum family! I understand your frustration, as I had a BTKR and also struggled with ROM---I did have adhesions, but I worked through them.

    Please do not compare yourself with others, as we all heal differently and in different time frames. You have been given great advice---ice/elevate/rest and do gentle exercises. Please keep in mind that recovery from a TKR can be frustratingly slow---and the knee is in charge.

    Have you taken a look at our forum library? did you get a chance to read the articles there? They have some great information that may help you through this troubling time:


    The importance of managing pain after a TKR and the pain chart
    How Long Does Healing Take ......
    Chart representation of TKR recovery
    Energy drain for TKRs
    Elevating your leg to control swelling and pain
    Using ice
    Swollen and stiff knee: what causes it?

    Knee Replacement - Where Am I in Recovery?
    So What Is It Going to Take? The Five “P’s” of Knee Recovery
    Work “Smarter” and not “Harder”
    About recovering a knee - from one who knows!
    Some suggestions for home physio (PT) and activity progress
    Myth busting: The "window of opportunity"

    MUA (manipulation under anaesthetic) and adhesions
    It's never too late to get more ROM!
    It's Worth the Wait for ROM
    Myth busting: on getting addicted to pain meds
    Post op blues is a reality - be prepared for it

    It is also important to note that regaining ROM is like a roller coaster ride and you will have some good days and some not-so-good days---and some real stinkers in there, to boot.
     
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  8. Matt

    Matt Junior Member

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    Thanks to all for the good advice. This has got to be the most challenging thing I have ever done. I am persistant and never quit so I will get through this. Any thoughts on the average return time to work? I do inside sales which require sitting and standing with a fair amount of walking.
     
  9. referee54

    referee54 Moderator

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    It was absolutely the most challenging thing that I had to go through, too---and I would say that many others would say the same thing. It is challenging, frustrating, and takes much patience.

    Please understand something, though---it is not how hard you work; it is how smart you work.

    We are used to the idea of "no pain, no gain" mentality; in recovering from a TKR, it is just the exact opposite. It is, rather, "no pain, more gain." Your knee is in charge of recovery and you fave to fight the urge to outwork your surgical knee---it will only make you more sore and cause even more frustration.

    I returned to work at eight weeks---my OS said that I could---and I thought that that date was the "magic date" and that I would be all better by them. I teach HS English, British Lit, and Communication. I will tell you honestly that my return to the classroom was too early and it slowed my recovery. I was stiff and sore by the end of the day, even though I iced/elevated and tried to stay off of my feet as much as possible.

    I had others go to the office for me and I had some very nice people help out with copies, etc---but I still was called "Festus" by a great friend of mine due to my ever-present limp. (The limp disappeared at about 5 to 5 1/2 months.)

    Most people return to work at about ten to twelve weeks and some have a phased-in return to work.
     
  10. maryo52

    maryo52 Sr Bonesmartie

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    That's so true, Referee.

    This surgery has a high success rate. It seems as if those who "bounce back" are the ones you hear most about. But it's a roll of the dice.

    I too had a time goal. I learned to adjust my expectations as my recovery lagged. A friend 10 years older had double knee replacement and said a month later it was a piece of cake.

    Matt, everyone is different. Your knee is boss. Let us know what you and your ortho figure out.
     
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  11. Mad Rocker

    Mad Rocker Senior

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    Matt

    These are words of wisdom. You cannot change how you will recover you can only do one of two things:

    1. Go along with the flow, lay back and enjoy the ride....OR

    2. Go kicking and screaming :arghh:the whole time...

    It's all up to us.

    Take care :friends:
     
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  12. Onestepatatime

    Onestepatatime Member

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    Hi Matt,
    Sorry to hear you are having a hard time. We can all relate here. Are you really swollen? I had very little ROM because of swelling. One day it went down, and I was able to do the exercise bike, and got new exercises at PT. I was so happy! But then I felt better one day, even drove a few miles, and then relapsed this week end and feel like i am set back two weeks. Point is, everyone here is right, this is not a battle of the wills with your new knee. Everyone heals so differently. This is really hard, the whole recovery, no doubt. Hang in there, the folks here are great, and there is a ton of great advice. Post often, read a lot, and we all have ups and downs with this.....hang in there.
     
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  13. viver45

    viver45 Member

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    Matt,

    Hange in there. I think we are fairly close in surgery schedules. Mine was March 19 - I see my OS for a 6 week on May 3 - first ofice visit since operation. I have my good and bad days. My knee gets really stiff at times - makes it a little harder to walk.

    Just keep doing your PT and listening to your knee. Rest, elevation and ice are your best friends. Try and keep a positive outlook - we are hear to help you through the rough spots and celebrate your achievements!!!!

    I know you are wondering about returning to work, you will probably find you will need to go back on a scaled down schedule. I have been working from home, but I do IT and telephone system support - so I don't travel, etc. but sit quite a bit. When I go back to work I know I will go back for just a few hours a day for a bit and work my way back. My OS already told me that. I'm thinking I may be able to go back starting the week of May 7. But for only a few hours at a time - and need to stick to that.

    Keep in mind that this is a MAJOR surgery and what all was done to your body - it takes some time to heal.

    Hange in there!!!! You CAN and WILL do it!!!
     
  14. Matt

    Matt Junior Member

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    Thanks Vivian, I will tell you what is discouraging....being able to ONLY go half a revolution on the stationary bike!!! What is going on there?? Are you getting relatively good bend from your knee at this point? I have nearly any right now:cry:. Hope something gives soon.......
     
  15. maryo52

    maryo52 Sr Bonesmartie

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    Matt, I know exactly how you're feeling. I would see this old guy come in to PT who had just had his knee done. His bend was pretty darn good. I was so envious. It's just so discouraging. It's kind of like sitting on the side of the highway with a broken down car watching everyone else whiz by.

    There is nothing you've done to cause this, and you cannot fix it per se. One can only work on getting the swelling down with rest, icing, and elevating, and trying to go easy with PT. Everyone I knew would ask if I was doing PT, as if I had laggardly brought the situation on myself.
     
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  16. speccybecky

    speccybecky Sr Bonesmartie

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    It is not 'a piece of cake' it is the hardest thing I have ever done! Im sure my colleagues think I am skiving as i genuinely thought id be back by now but it's taking a lot longer than I expected.
     
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  17. jwehyam

    jwehyam Junior Member

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    Hey ho Matt..
    I have 10 pennyworth to add..
    My first TKR last August.. Due to administrative balls up (UK) I didnt get to the physio until 3 weeks after the operation.. pain misery and only 60 degrees flexion. The physios shook their heads .. Week later 70 degrees flexion.. but still pain and misery although I was diligently doing the exercises.
    More head shaking..not good they said..

    OK I said.. you bend it and I'll do the screaming.. "fine", he said, "relax" and then with a couple of fingers he pushed it.. and I screamed.. That sounds like pain he said! BUT theres almost no resitance and certainly nowhere near causing any damage..

    BUT.. now I knew what 'pain' really felt like .. I put a series of marks on the 'seat slide' of my rowing machine.. and every couple of hours or so I pulled myself towards a target flexion NO WHERE NEAR as painful as the physio-demo-bend.. but because my head knew where the edge of the envelope was I could push closer to it.

    Anyway.. within a fortnight I was over a 105 and now I'm stable at about 135 ...

    My other TKR this March?.. woke up with more than 90 deg to start with . Now I've got 125 .. different legs.. different surgeons.. who knows why?

    The point is that I think sometimes we have to push through the pain..
    I bet there'll be some disagreement HOWEVER .. Its your leg...
     
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  18. FrogFeathers

    FrogFeathers Post-Grad

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    Welcome.

    You sound just like me, except my numbers were a tad lower.

    Don't be disappointed in this- it isn't your fault. When I was told I had to have the MUA, I thought it was because I didn't do enough or I did too much or something that was MY fault. It isn't our fault. It happens.

    I had my manipulation at five and a half weeks out. A lot of people say that's too early. I say that our surgeons know what they're talking about. My manipulation was exactly what I needed and I gained ROM by leaps and bounds after it.

    But you're doing what you can, with the ice and elevation. So, good luck- and don't be discouraged, you're doing fine.
    :thumb:
     
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  19. Matt

    Matt Junior Member

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    Thanks for the encouraging words. I have change my PT to another company and will have my first visit today. They specialize in a process called ASTYM (has anyone heard or tried this?)which deals with breaking down adhesions and/or scar tissue. After they do this they give you stretching exercises which they stress not to overdo. I can almost feel that this is holding me back so I will give this a try. I beleive my previous PT pushed much to hard. I will let everyone know how it plays out.
     
  20. Ditzzeechick

    Ditzzeechick Senior

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    Matt-

    I was where you are and somewhere between week 6 and 7 my the swelling on the right knee went in half and my ROM and FLEX have jumped way up. Yesterday my left knee joined in and they put me on the semi recumbent ellipitical which allowed me to work my thighs today another change has occurred in my knees and I'm beginning to see the end of the road for my double knee replacement. It's only 5 weeks, you might want to take a deep breath and chill out :wink1:
     
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