PKR Floridoris's Recovery Thread?

[Josephine]

I think it would be better if you didn't wear them at all!

I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?

 

[KarriB]

What Josephine said! I hated wearing compression hose in the hospital and rehab. A month ago I tried them on again hearing it was wise to wear them on a long flight, but I decided I wouldn’t make it through the flight with them on.

 

[floridoris]

Interesting. I find the hose help with leg pain when walking around. I don't wear them at night.

Yes, of course, @Josephine. Fire away.

 

[Josephine]

Jolly good! Here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

2. how swollen is your leg compared to these? Check this out first Swelling/pain comparisons

3. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[floridoris]

1. Pain level - Right now, I'd say 2, mostly the nerve endings. But early this morning, it was maybe 7. The morning is the worst for me.

2. Swelling - slight, occasionally veering closer to moderate.

3. Hydrocodone 5 mg/325 acetominaphen. I take it approximately every 8 hours (3 times a day).

4. Extension is 0, no problems there. Flexion is 90.

5. Icing - yes, 5-8 hours per day. My ice machine has 30 minute cycles, so I have a rough idea how many times I press the button each day. I don't ice overnight.

6. Elevate probably 18-20 hours a day.

7. Daily activity - I fix my meals, take a shower, feed the dog, let my dog out to do her business, get the mail, tidy up. Occasional trips to grocery store or doctor's appointment. No driving yet.

8. None. I stopped Physical Therapy two weeks ago.

 

[Josephine]

8. None. I stopped Physical Therapy two weeks ago.

What were you doing when you were doing it?

 

[kneeper]

My PT suggested something called Tubigrip for compression if what you're thinking in terms of is knee swelling. It's different than the compression hose we're given to prevent blood clots right after surgery.

 

[floridoris]

@Josephine A large chunk of the time was spent walking around the facility. There was a "mini staircase" only two stairs to go up and down steps, but only one foot at a time. He did some massage and ice, and also use that Tens unit with the electrodes for my shoulder (tendonitis) as well as knee. Some balance work - holding a beach ball and passing it. Some stretches for my shoulder. A few repetitive exercises like pulling shoulder blades back, marching in place.
I miss some parts of it, like the massage and having a walking space that is indoors, but I don't feel better or worse for having gone, if that makes any sense. I feel less worn out since I've stopped going, but I don't feel either more or less pain or more or less stiff since then.

 

[floridoris]

@kneeper, does that go over the knee or it is a wrap around like an Ace bandage?

 

[marieltha]

You do not ice at night?

After both of my PKR’s and now my shoulder RCR, I loved icing at night. I put the cryocuffs on at bedtime for 20 minutes. Usually, I wake up once during the night to use the bathroom, walk slowly a bit, and when I get back in bed, I ice again.
If I don’t feel like fussing with the ice when I get up during the night, I put aspercreme with lidocaine on.
LOL, I set the timer on the bed to change position after 20 minutes, which wakes me up enough to take the cuffs off.

I always do gentle stretches and lightly massage my legs a bit before getting up. If I am really aching, I will put voltaren gel and the aspercreme lidocaine on before or right after I get up. And I always walk a little slowly first thing.

I also found taking smaller doses of the pain meds closer together to work better than 8 hrs apart. With the half doses, I was able to take it during the night, sometimes w a tylenol, which I think made me less painful first thing in the morning.

Hope you feel better.

 

[kneeper]

The tubigrip (I think that's a brand name) is similar to ace bandage material but is a sleeve type set up. My PT sent me to my local pharmacy that carries medical supplies and they measured and cut a length of it for me. You wear it over the knee and part of the leg. It offers some compression but not so tight as to cut into your leg. I think it comes in different "strengths" depending on your need. I found it offered some compression (to help with knee swelling) but wasn't uncomfortable.
You could probably do the ace bandage route if you have one handy. Tubigrip is nice because it is slip on-slip off.

 

[Josephine]

does that go over the knee

As kneeper says, it's a form of elasticated stockingette and actually pretty useless as a form of therapy (in my opinion!)

 

[kneeper]

Possibly more for "comfort" than therapy...

 

[Benay]

Early on I found my Ace bandage to be a great comfort. Wish I'd known about the slip on sleeve.

 

[floridoris]

Yes, comfort - particularly for sleep. Had a rough night last night. Not so much pain per se last night, but the nerve endings kept zapping away. And I'm still not able to lie on my side yet - that does hurt when I try.
So if I could lie on my side and the zapping went away, I'd be happy. "If ifs and buts were candy and nuts", as they say.
I started reading a book, and I've managed to get nearly halfway through and still follow it. So that is something!

 

[Jockette]

I started reading a book, and I've managed to get nearly halfway through and still follow it. So that is something!

 

[KarriB]

Wow! If I could’ve read during recovery that would’ve been phenomenal! Yay for You!

 

[Josephine]

Yes, Tubigrip certainly is more for comfort. Also for keeping dressings in place. It has no therapeutic value whatsoever.

 

[floridoris]

Okay fellow Bonesmarties, tell me what you think about this.

Today I went to see the surgeon for a follow-up appointment (7 weeks and 1 day post-op).

He asked if I was still doing PT, and I said no. He asked why, and I said that I found it too tiring and just too much. He stretched my leg and then pushed my knee back to see how far back it would go - and that hurt! It was about 100 degrees, but again, it hurt when he did it. He said, "No pain no gain!" He wants me to be at least at 110. He wants me to start PT again because he said this is a "critical time to get my range of motion back." He mentioned scar tissue and some other things. He wants me to take two Aleve in the mornings and two in the evenings to prevent swelling. He didn't seem to care one way or another if I iced or not. And he actually said I didn't have to "baby my knee."

He gave me the name of another PT center, and I want to go with my daughter to look at it and talk to someone there before I agree to it.

I'm feeling a bit discouraged because I felt like I was doing pretty well - I don't use a walker or a cane and my pain has become manageable with the hydrocodone on most days. Yes, I'm still not driving yet because I'm apprehensive about it, and I'm still not sleeping on my side like I want to. And I get SO tired very easily. And I'm still apprehensive about curbs because there is no rail, so I avoid them. But I quietly disagreed with a lot of things he said, and I came out feeling worse mentally than when I went in. (My knee feels okay now, though we'll see how it does later.)

 

[Jockette]

You are coming along just fine. Everything you described is par for the course at 7 weeks.

My surgeon pushed my knee to a painful place at all my appointments until finally at the 7 month appointment I declined to get up on the table where he would have easy access to my leg. I declined again at the one year check and that’s the last time I saw him. If I need a replacement in the future it will be with someone else!

This is what I think of the “no pain, no gain” theory:
https://bonesmart.org/forum/threads/myth-busting-no-pain-no-gain.14317/

Personally, I will not be going to PT if I do this again. All you have to do is give your knee gentle mobility by doing your daily activities, and increase them as you are able, and that will rehab your knee just fine.

I think if you are happy with how things are going, that’s all that counts. I was always discouraged and frustrated after my check ups, but was too chicken to cancel some of them.

There were many things I disagreed with that my surgeon told me.

And, Josephine told me in my thread that I couldn’t baby the knee too much.

Best wishes on your continued success!