doubts, misgivings and worries!

[GoldenBoy55]

the real drawback to being a manic depressive is the soaring heights of despair are always longer and more intense than the occasional troughs of positive delight!
I have always been of the soldier on and dont complain brigade, but I really really am not happy! I want to be able to say specifically what it is that is wrong but I can't. And the reason I can't is because I have absolutely no point of reference for what I think I am experiencing. I try to convince myself that its all really OK and its only been just over 2 weeks so I am still bound to have some discomfort/swelling/lack of movement but I feel that there is something not right.
Guys I have nobody I can turn to but you, I'm rambling I know because I dont know what to say (if I dont say it then its not really real right!)
Firstly I feel completely abandoned, like I had the op, the hospital kept me in for the minimum time (sent me home with antibiotics because I had heat redness & swelling which may indicate an "infection") no PT apart from a piece of paper with several diagrams and descriptions of exercises! I have absolutely no idea how many times to do each exercise or how often or anything! I have tried to do a few and reasonably often, but all the time I consider what you guys say here that its more important to rest and recuperate than bash out the exercises. Saying that I dont even have a clue if I should be walking? I dont mean getting around the house because I can handle that OK, but actually going out, into the real world and walking! Should I or not? If I should then how often? How far? I dont seem to have any pain when walking, it really feels weird though!
Today my knee is definitely swollen, it feels tight and it also feels hot, I havent really done anything to create a reaction I would associate with exercise. If its still the same in the morning I am going to get the doctor to take a look (it appears IF there is a problem that might need hospitalisation I have to go through my local GP!)
Guys I am really trying to stay positive but being an inveterate over-thinker I find myself drawn to the dark side, I guess I must really be Luke Skywalkers long lost brother! What the heck am I suppose to do?

I have re-written this several times and failed to post it each time because I am embarressed and dont want to make something out of what is probably nothing! But ..........................

 

[Tykey]

Hi GB. This overthinking is a real pain in the a**e isn't it! I wish we lived closer because I'd call round and share a pint or two with you.

You remind me of myself some years ago. I developed tinnitus and had real problems with it. My doc told me I was highly analytical and a masticator of thoughts. He was quite right. I can see from your recent posts that you are very intelligent, and that's a sign of an overactive imagination (See my thread on urban myths, if you need proof that I'm the same:D)

What was happening was that I panicked and the adrenelin kicked in, the tinnitus seemed to get worse, so I panicked some more, and more adrenalin kicked in, and so on and so on down the slippery slope.

By the end, I couldn't sleep, it sounded like the Grimethorpe and Rastrick brass band had taken up residence in my ears, and I couldn't concentrate on work. What a mess I was in!!!

What I noticed was that when I met someone else with tinnitus who said they had no problem, it immediately got better for a while.

So the moral of this tale is that for the likes of you and me, the brain can be both a real friend but our worst enemy at the same time.

My tinnitus has gone 99% these days, but I needed a few antidepressants, a supporting shoulder, and relaxation exercises to turn the corner. Maybe you need the same

You'll be OK, matey:thmb::thmb::thmb:

 

[Jamie]

GoldenBoy....you ARE letting your mind do you in!!! My friend, at two weeks out from this VERY major surgery, you need to be resting, icing, elevating and taking your pain meds on a schedule. You don't need to be thinking about out-of-the house excursions. Walking is important. At this point, that means puttering from one room to another in the house and possibly a VERY short jaunt outside.

You can do those simple exercises once or twice each day too. They will help with your flexibility. If you are swelling, though, it means you need MORE rest, ice and elevation. You have to observe your body and react accordingly.

My suggestion is for you to go to the forum LIBRARY again and reread the threads on healing times, pain management, and all the other ones associated with recovery. You are barely beginning the recovery journey. It's going to take time and you must allow yourself time to heal.

If you find yourself slipping to that dark side, don't be ashamed to come here. We've all had irrational thoughts and the best cure is to get the reassurance that you're normal. You are.

 

[Carolyn]

Hi Golden Boy,

Oh yes, the dark side! I can so relate to what you are going through. Unfortunately it appears to be part of the package for some of us with a TKR. We have ventured into the unknown. No matter how well I thought I was informed, I had no idea that it would be so intense a recovery.

The depression does get better, for me it improved when when I was able to get off the narcotic pain pills, they scrambled my emotions, however I don't advise rushing off of them. I spent alot of time crying, not sleeping and being down right miserable.

Try getting out of the house for little outings, it helps. Some fresh air, sunshine and a change of scenery is beneficial for healing, just don't over do it. Ask some friends to come visit or take you out for a drive. I had some friends come for a visit 2 weeks after my surgery they stayed for 7 days. Their visit helped me to keep my mind occupied. Yes, I am an overthinker too! I imagine everything possible has gone wrong, but the reality is my healing is taking it's own sweet time. This too shall pass!

As far as the pt questions - I can't help but wonder and agree that the slow and gentle route the UK does is the best approach. I have had pt since day one both at home and as outpatient. If it has made a difference, I don't know. The good part of the pt was having my therapist answer my questions and reassure me. My rom is ok but not great. The hard part was it would take me 2 days to get over the swelling from the pt.

I know you are having a rough time right now. It is so good you found the Bonesmart forum. Just reading and posting has helped me so much. Bonesmart is the best place to go for answers, venting, reassurance and love.

Keep your chin up, it will get better!
Regards,
Carolyn

 

[Josephine]

I have re-written this several times and failed to post it each time because I am embarressed and dont want to make something out of what is probably nothing!

We have a saying here that there is no such thing as a stupid question! Having got that out of the way, let's see if I can help you out some here.

I want to be able to say specifically what it is that is wrong but I can't. And the reason I can't is because I have absolutely no point of reference for what I think I am experiencing.
Guys I have nobody I can turn to but you, I'm rambling I know because I dont know what to say (if I dont say it then its not really real right!)

I try to convince myself that its all really OK and its only been just over 2 weeks so I am still bound to have some discomfort/swelling/lack of movement but I feel that there is something not right.

Today my knee is definitely swollen, it feels tight and it also feels hot, I havent really done anything to create a reaction I would associate with exercise.

If its still the same in the morning I am going to get the doctor to take a look (it appears IF there is a problem that might need hospitalisation I have to go through my local GP!)

All you are experiencing here is perfectly normal post-operative swelling and pain. For that you need to

- elevate your leg and rest
- take your pain meds by the clock
- ice your knee

Firstly I feel completely abandoned, like I had the op, the hospital kept me in for the minimum time (sent me home with antibiotics because I had heat redness & swelling which may indicate an "infection") no PT apart from a piece of paper with several diagrams and descriptions of exercises!

Yes, I remember that abandonment feeling very well. After a few days of intense attention, suddenly it's out you go and get on with it! But we can help you so don't get in a tiz waz!

As for the antibiotics, all joint replacement patients are put on them after surgery. Always.

I have absolutely no idea how many times to do each exercise or how often or anything! I have tried to do a few and reasonably often, but all the time I consider what you guys say here that its more important to rest and recuperate than bash out the exercises.

Exercises should be done just a few about 3/4 times a day. You need do no more than heel slides, which is sitting in your chair with your bum on the edge and sliding your foot back until the knee is as bent as you can manage without too much pain - discomfort yes, pain no. Do a set of 5 and rest, then another set of 5 and rest and then a third set. You should also continue to do the foot twirls and ankle pumps they told you to do in hospital as this encourages the circulation and helps ward off clots.

Saying that I dont even have a clue if I should be walking? I dont mean getting around the house because I can handle that OK, but actually going out, into the real world and walking! Should I or not? If I should then how often? How far? I dont seem to have any pain when walking, it really feels weird though!

Walking is good but not too much just yet. A walk around the house, to the loo and the kitchen and back is fine. Perhaps next week, weather permitting, you could take a short walk in the garden or outside in the road if you don't have a garden. A few yards will be enough, about 10 mins to start. Day two make it twice that, day three, three times and so on. By the end of the week you should be walking about a 100 yards and back. Use your crutches for security. But no long hikes just until about week six. Until then it's just rest and elevation.

Here's some reading for you to do in the meantime!
The importance of managing pain after a TKR and Jo's pain chart
Discussion on managing pain in TKR surgery
Using ice
It's never too late to get more ROM!
How Long Does Healing Take ......
Elevating your leg to control swelling and pain
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it

And please don't be shy of asking questions here. None of us were experienced in this stuff before we had the operation - not even me and I worked in it for 50-odd years! So given that we don't know anyone in real life to go to for advice and help, that's what this forum is for. We're all here for you and want to help where ever and when ever we can. Okay?

 

[Carolyn]

Golden Boy...I just read Jamie's post perhaps my advise to get out of the house maybe premature??? I don't know....:pzld:

 

[Josephine]

Rats, Jamie - you beat me to it again!! :rant:

 

[Jamie]

Rats, Jamie - you beat me to it again!! :rant:

There go our brains in tandem again! Except you did a much more thorough job!!! Maybe having BOTH of us saying the same thing will help convince GoldenBoy that he's really doing just fine and shouldn't worry.

 

[Tykey]

Golden Boy...I just read Jamie's post perhaps my advise to get out of the house maybe premature??? I don't know....:pzld:

I would agree with your first advice, Carolyn.

A potter into the garden or pub for lunch and sitting in the open air for a while works wonders:D.

Don't let Seasonally Affective Disorder set in!!!!

 

[Jamie]

I agree with the idea of getting out, but I do think at 2 weeks out you need to be careful about that first journey outside. It's really easy to overdo things at that stage and it is better to start with a short walk outside like Jo suggested and then work up to a car trip.

 

[kneesrus]

GB,
Everything you are going through is the norm. I agree with most of the post from fellow smarties. I problem is, we live in a drive through world, and this is not a drive thru surgery. You have to broken bones and your body is saying, what the H is going on here. Your body is a biofeed back system. When it's sensors notice something is not right, it reacts. It sends message to you by swelling, aching and staying hot. Stay on point, go back to the ground rules, ice, elevation and do not force the issue. Let the body heal. Get in tune with what is going on, don't fight it.
Best of luck, Mate
David
L TKR 12/19/07

 

[cotton1958]

Hi GoldenBoy. Tough surgery it is. Hope you are feeling better. It does get better. Takes a little time. Days get better. Make some notes to compare your days. You have the best folks here. No one knows what you are going through much than the folks here.

Try to eat some decent food like protein. It does make you feel better to eat right. If you do wander out, save some energy to get back! And cat-nap. Napping/sleep time is when your body finds time to heal.

And come back here again and again. As we're always here!! Also, watch what you have on TV...some dreadful commercials and TV can be found. And don't listen to what folks say as most people don't have a clue what this surgery is about unless they've gone through it.

 

[JCCHASE]

GB:

There is some great advice here - use what you can. There is little doubt you are overwhelmed with a good dose of fear added for good measure. It's OK and normal to be scared just as it is easy to be overwhelmed.

I'd suggest you take a clear look at each source of anxiety and make a plan for each one.

In the case of PT, you need a licensed trainer directing your rehabilitation. When I got home, I too tried the exercises - boy, did I suck - but once though a couple of days, I signed on with the same PT who helped me get through a broken shoulder. The point is, I transferred my anxiety to the trainer & now at home I do those she showed me to do and leave the rest to her. My PT worries were gone!

Drugs: When I got home, I handed the bag of drugs and prescriptions to a significant other & asked her to get me through the next 6 weeks of medications. She loved the idea of being a care giver. I now have a spreadsheet laying out medications and times AND someone who makes sure I take them. As with PT, no more anxiety over drugs.

I'd do the same with every major stressor except one, the one that leaves you to get better, just a little bit everyday. Don't measure yourself against anyone other than yourself. Your progress is the only one that matters.

And finally, take comfort in those who have walked the same path. Reach out to them, seek their presence, talk with them, ask their advice and use their strength to build your own communion of strength.

Good luck! I look forward to reading of your successes!

 

[Josephine]

Great post, Jon. But GB is in the UK and we don't make a great deal out of PT unless the patient is having any severe problems. Mostly we are expected to just get on with it. Hard as this may seem to you over-achieving guys across the pond, mostly we seem to come out pretty good at the end of the process!

 

[Tykey]

Where are you, GB??????????????

 

[Josephine]

Just what I was thinking. I looked at his profile and he's not been here since October 29th, 2010 at 11:33 PM

 

[JCCHASE]

The 4 years I spent in London are a highlight in my life. I love you Brits for all you are!

 

[Josephine]

That's nice! Glad you enjoyed your stay!

 

[GoldenBoy55]

first my apologies for posting the lead and then disappearing! blame the router/modem thingy, I had a problem which stopped me getting online but its all fixed now!
actually that should NOT be the first thing I address, the very first thing should be my deep and sincere thanks to each and everyone of you for taking the time to respond with your positive thoughts and your sympathetic advice. I didn't expect anything less but its great to have ones faith in human nature reinforced..........again thank you all so much!
as you all clearly recognized my ramblings, such as they are were, are so similar to the feelings everyone who has gone through this feels. Its clear my fears and worries are normal and its also clear my head had still not come completely to terms with just how serious this operation is. The desire to run before I could walk was very strong, (or should that be walk before I can hobble?) and I was disappointed with myself that I wasn't able to do more. I hope having had all this wonderful support I can be more relaxed and less anxious about my progress or currently lack of progress.
I would be interested to know what pain relief everyone was prescribed? Particularly my fellow UK friends (but only because I may recognize theirs rather than US drugs) When I came out of hospital I was sent home with dihydrocodine (30mg), diclofenac (50mg) and paracetamol (500mg) along with the antibiotics. Having run out of these painkillers, I got in touch with my GP who has put me back onto co-codamol (30/500mg) and diclofenac (50mg).
I dont think they have that much effect to be honest LOL maybe just a little bit of a buzz but thats all, I probably need to go back to swallowing them with a glass of vodka! OK just a joke!!!
Again my heartfelt thanks for all your kindness and I do apologise if my absence caused you any concerns

 

[Jamie]

Those pesky router problems will do it every time! I 'm glad you are okay and back online now, GoldenBoy. We missed you!!!

Your meds sound pretty typical to me, but if you don't feel like they are getting the job done with pain management, have a chat with your GP. He (or she) can always make some adjustments.