PKR 1 month out<

[pacosmom]

I had PT this afternoon. It went well, but I did a lot, and she massaged my knee & quad more than usual. I wasn’t in any pain- I did take ½ an oxy an hour before. Now, 8 hrs later, it’s starting to be pretty achy and feels warm.... both on the inside and when I touch it. Is that normal, or should I be worried about infection? I don’t remember having this feeling before.

 

[HoneyB]

That warm feeling is normal. Mine also turns red when it feels warm. Even my LTKR which is 18 weeks post-op feels slightly warm sometimes, but my 3-week-old RTKR gets really warm. My surgeon, my physical therapist, and lots of folks on Bonesmart told me after my LTKR that this warming is completely normal and can continue for a long time.

 

[SusieShoes]

That warm feeling (even hot feeling) is perfectly normal after a TKR. There’s a lot of heat-producing healing and blood flow going on in your knee right now, and it’s all good! My knees felt warm for a good three to four months after surgery. The heat is one reason icing feels so good for most of us; later on you might notice that your ice packs (if you use those) don’t warm up quite as quickly as they did in the early days.

Also, just want to point out that we recommend you not take a pain-killer just before therapy. The reason is you don’t want to tone down what your body is telling you about exercise. Pain is your body’s signal that you’ve reached a limit. Taking a pain-killer right before therapy makes it more likely you will overdo the exercises. We advise taking pain meds after therapy.

 

[pacosmom]

Thank you both! And, I will take my pain med after therapy on Friday, that makes total sense. I’m not sure I really even need to take one at all any more.

 

[skigirl]

at seven weeks my doc told me that I should be resting and down for every two hours I was up. Of course, I felt better at 8 weeks, so I wanted to ignore the advice, but I did find that taking a rest during the day and putting my feet up was a big help to the rest of the day. You are not ready to go full tilt, you still need some rest to complete your recovery.

 

[MCC]

@pacosmom I’m totally with you! I had my partial (along with a few other procedures) 6 weeks ago, but I’m still so swollen that I’m stuck at 70 degrees, I can’t be up for long without the swelling getting way worse and I’m sooooo ready to do more! It does seem like a lot of people are progressing faster, and the 6-7 week blues are totally real! I haven’t had any until now, but realizing how far I have to go is bumming me out! We’ll get there though! You’re not alone!

 

[pacosmom]

at seven weeks my doc told me that I should be resting and down for every two hours I was up. Of course, I felt better at 8 weeks, so I wanted to ignore the advice, but I did find that taking a rest during the day and putting my feet up was a big help to the rest of the day. You are not ready to go full tilt, you still need some rest to complete your recovery.

Thank you, I’m elevating & iceing as am I’m reading!

 

[pacosmom]

Thanks @MCC I know you are right. I’m trying to just focus on today and not think ahead too much!

I am going to a new chiropractor tomorrow and am looking forward to that

Does anyone know how long the stitches inside take to dissolve? I am having a new, pinchy but not super painful spot today.... wondering what that could be. I suppose 1 of many things lol

 

[Josephine]

I think my PT finally realized that her bending it for me is not the answer- it might look good while I’m there, but then the next day it’s so swollen I can’t do much of anything! She’s at least stopped doing it.

Finally! Some commonsense!

I feel like PT is a waste of time, what I really need is to have the swelling go down and I think everything will fall into place!

You are right!

I’m scared my quad is going to disappear altogether at this point.

No it won't. It takes a lot longer than a few weeks for quads to 'disappear'!

I feel like I must be doing something wrong that my quad isn’t working,

I doubt it but lets take a look - 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?

 

[pacosmom]

Yes of course, ask away @Josephine



My PT got a little chuckle when I told her that I felt like my quad muscle has faded all away or is no longer attached lol

 

[Josephine]

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

3. how swollen is your leg compared to these?

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.

 

[pacosmom]

Here ya go @Josephine

1. pain level right now.... I'd say 3 probably. I have a low tolerance for pain!
2. was prescribed oxycodone 5 mg immediate release. I'm not taking it on a regular basis anymore. Take 1/2 on PT day and usually that night as well. Taking only Advil, Aleve and/or Tylenol.
3. swelling is moderate - most of the swelling seems localized to over the knee cap area and above near quad muscle.
4. ROM, on my own about 95 bend and can straighten all the way easily and with no pain.
5. Icing (elevating) 3 or 4 times a day for about 30 minutes each.
6. Elevating as above when icing, and I'd say about 70% of awake hours.
7. I believe my activity level was too much too early. I've slowed down since week 4. Now, some days I go nowhere, some days just to PT, and a day or 2 go to the grocery store, etc., maybe an hour trip, then back home. I did overdo this past Sunday - I didn't know how much walking I would have to do once I got to the place I had to be.
8. Most day I'm not doing exercises at home any longer (since about week 4). If I do anything, it's:

straight leg lifts, no weight 10-12 a few times a day
step up with surgical knee, down with other knee (3-4" height) 10 times, a few times a day
just plain old bending to where I can while I'm laying down, off and on during awake hours

PT - 2 times a week:
Exercises vary a little each time -
Always start with recumbant bike for 5 mn at a bend that I can comfortably
Step up & down (like above)
A good stretching exercise 30 seconds, 3 times
Straight leg raises with 1.5 lbs weight, 10 times (just started that yesterday to work on quad)
Leg press at 30 lbs, 10 times (also to work on quad)
A lot of massage by PT
End with ice/compression machine for 10 mn

My non-working quad seems to be a big issue lately!

Thanks

 

[Josephine]

. pain level right now.... I'd say 3 probably.

Okay

2. was prescribed oxycodone 5 mg immediate release. I'm not taking it on a regular basis anymore. Take ½ on PT day and usually that night as well. Taking only Advil, Aleve and/or Tylenol.

First thing: never ever take a pain med in order to cope with PT. Pain has a function which is to warn us when we do too much. Mask that and you are at grave risk of doing yourself injury.
Don't take Aleve or Advil - they are NSAIDS which have some pretty awful side effects as here Medications: acetaminophen (Tylenol, paracetamol) and NSAIDs, differences and dangers.
You never said how much Tylenol you take so I shall assume it's 325/500 mgs. I recommend you take 1,000mg up to 4 times a day.

3. swelling is moderate

Which I trust you factored in to your overall pain score yes?

4. ROM, on my own about 95 bend and can straighten all the way easily and with no pain.

Good!

5. Icing (elevating) 3 or 4 times a day for about 30 minutes each.

You accomplish little or nothing in 30 minutes. Ice for at least 40-60mins and more than 4 times a day.

6. Elevating as above when icing, and I'd say about 70% of awake hours.

So ice when you elevate.

7. I believe my activity level was too much too early. I've slowed down since week 4. Now, some days I go nowhere, some days just to PT, and a day or 2 go to the grocery store, etc., maybe an hour trip, then back home. I did overdo this past Sunday - I didn't know how much walking I would have to do once I got to the place I had to be.

all that and you never told me WHAT you are doing!!!

Most day I'm not doing exercises at home any longer (since about week 4). If I do anything, it's:
straight leg lifts, 10-12 a few times a day - a tip, once you can do these there is no need to do them any more!
step up with surgical knee, down with other knee (3-4" height) 10 times, a few times a day - steps, very bad for the muscles
just plain old bending to where I can while I'm laying down, off and on during awake hours - eh?

PT - 2 times a week:
Always start with recumbent bike for 5min at a bend that I can comfortably - pleased to hear that
Step up & down (like above) - as above, very bad for the muscles
A good stretching exercise 30 seconds, 3 times - okay
Straight leg raises with 1.5 lbs weight, 10 times (just started that yesterday to work on quad) - never ever use weights , very bad for quads
Leg press at 30 lbs, 10 times (also to work on quad) - never ever use weights, very bad for muscles

My non-working quad seems to be a big issue lately!

Well exercise is not going to resolve it! You need to just let it recover in it's own good time.

 

[pacosmom]

@Josephine thanks for your response. As for #7, it's kind of hard to explain, but as I said in my answer, for the last few weeks, some days I don't go anywhere, some days I go to the grocery store or Target, etc., for about an hour, then back home. While at home, I don't do too much. I walk around enough to get food, go to the bathroom, etc. I try and get up and walk around a bit every 30-60 minutes.

I went to a chiropractor this morning and I absolutely loved it! He is total about natural healing and I don't need much work as far as my back. I felt great when I left there! We're doing the cold laser which is supposed to help in healing soft tissue. My daughter had this done 3 years ago after a meniscus surgery and really felt it helped, so I'm excited to see how it goes. He recommended EFAC Pain Releiving Cream and tablets. I'm looking into those and can't wait to go back to see him next week.

 

[Josephine]

Oh I'm a great believer in chiropractic treatment too! Can't beat it!

 

[pacosmom]

Well, I think the chiro may be just the piece I needed! Saw him Thurs, had PT as usual on Friday- and knock-on-wood, today is the best my knee has felt so far! Yesterday was 8 weeks, so I’m sure each day helps also. My PT did say she noticed that while she was bending my knee yesterday, it felt like the resistance didn’t start until about 100 degrees, which is better than ever before! I’m so praying that by adding the chiro in addition to just time, things are finally on the upswing! I haven’t had this many mentally good days in a row for quite some time & im so grateful

 

[Jockette]

You will have more better days when you stop letting your PT bend your knee for you.

 

[pacosmom]

You will have more better days when you stop letting your PT bend your knee for you.

She's more of a guide, she won't go further when I tell her to stop.

 

[Celle]

I'm glad your PT stops when you tell her to, but really there's no point in her bending your knee at all. The flexion numbers you get with help don't count. It's the ones you get by using your own muscles that count.

 

[pacosmom]

10 weeks out today and I have to say, I feel beat down by my knee I think the chiropractor has helped overall but, I think once again I had grand expectations and they have not been met lol. I’ve definitely experienced the 1 step forward, 2 back (if not more). I don’t have pain really other than some of the stabbing type pains every once in a while. I assume that’s nerves healing. Not taking any pain meds,not even Advil or Tylenol, so that’s good. Swelling & stiffness is really a huge issue. I was at 108 ROM a couple weeks ago, barely 95 today. So disappointing. I’ve been sitting & elevating & icing most of the day-every day. Don’t do much other than some exercises & regular walking around the house. I’m really afraid by the time the swelling goes away (or even down), my quad & hamstring will be so weak/tight I’ll never be able to bend my knee!

See my OS on Monday. I’m a little nervous to see what he thinks. At my 6 week visit he said if the swelling hasn’t gone down by this visit, we’ll talk about it.....