TKR 12 Days Out from LTKR and Struggling

[Twocaledonias]

I had a terrible in home PT visit today. I was very tired and was moving a bit slow. During some assisted heel slides, he pushed a little hard and it was excruciating (8 or 9 out of 10). Made me tentative the rest of the appointment. He (a PT assistant) questioned how the PT (his supervisor) who was here Friday got me to 50 degrees. At the end of the visit, he said that, through no fault of my own, I was way more than two weeks behind, and farther behind than some of his slower patients. He told me that I am for sure facing MUA or revision, that I'm nowhere near ready to do stairs, and that I should be at more than 90 degrees going into outpatient PT. My rational brain knows that this was uninformed and inappropriate, but it was still awful and has had me in tears in and off since.

I talked to my sister who said outpatient was a game changer for her and that she progressed very quickly once starting. And a friend who recommended the outpatient facility I'm going to on the 23rd raves about it...says that they were very gentle, listened, and even told her to slow down a bit during her recovery. I'm going to call them tomorrow to have a phine conversation, but I'm really nervous again.

I'm also wondering if I'm backing off the pain killers too soon. I'm taking Oxy every 4 hours (10mg, 5, 5, 5, and 10 before bed). I'm also taking Tylenol. I finish the blood thinners in 4 days, so I'll be able to take anti-inflamatories at that point. My sister said she stayed on Oxy for almost 4 months. My OS is not offering any more guidance other than to listen to my knee and adjust accordingly.

I was feeling more positive, but today was a mental setback.

 

[Jockette]

I am so sorry you had this experience. He is wrong, you are doing fine. It is very early days and you have lots of time to improve, in this year long recovery. You can call the office and tell them not to send this PT to you again.

I talked to my sister who said outpatient was a game changer for her and that she progressed very quickly once starting.

We each respond differently to this surgery. Each of us have our own healing timeframe, different knees need different aspects of this surgery, so we cannot compare ourselves to anyone else, or expect the recoveries to be the same. Even people who have both knees done the same day, see a difference in how each knee recovers.

PT can be helpful, but it is not the only thing that helps you recover. There are many aspects of recovery.

Regaining our ROM does not require forceful bending or painful exercises.
Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.

 

[Layla]

Your PT session yesterday sounds awful. I am so sorry you had that experience and for the after effects it caused via pain and tears. The PT's words were threatening, untrue and unnecessary as though he has some authority over you and what future procedures you may need to endure. I would respectfully request that he's never sent to your home again.

Please refrain from engaging in movement that causes discomfort or pain. You do not have to allow anyone to forcefully manipulate your leg. While your range of motion is currently limited, it will naturally increase as the swelling subsides and the pain eases. Give it time.

I recall from my recovery that while cautioned not to compare my progress with other's, the temptation is always there. Naturally, your sister means well as she loves you, but there are many reasons why we each recover differently and what works for one, doesn't necessarily work for another. If you do attend outpatient therapy, I hope you find it beneficial, but please take care to stop them from pushing you to the point of pain.

As far as meds go, adjust your dosage schedule according to the recommendations you received and if you have any questions, contact a member of your surgeon's care team for advice. I am sure they'll be happy to advise. You're not even one month post op so I think you're doing well. Patience is key in recovery as it takes time and does have ups and downs. I hope today feels brighter.
Stay in touch and take good care!
@Twocaledonias

 

[beachy]

@Twocaledonias
That sounds more like a torture session. I'm really sorry you're in pain from it.
I can only echo what has already been said.
Please rest your knee after that torture session. Ice and elevate constantly if you can. Lay off the PT for awhile. Your flex and extension will gradually be there.
I did gentle PT....very gentle..... and my numbers were perfect once my knee healed.

 

[Flashlight]

Hi, you're about 4-weeks out from surgery. I was still on a narcotic for pain but when I finished the aspirin, I started ibuprofen and could start to decrease my narcotic dose. I found my PCP much more helpful than my OS PA for dosage instructions. Everyone has a different pain level, and you have to do what is best for you. Alot of my discomfort was from nerve pain especially at night. The pain medication didn't help this feeling much. I was still using my ice packs and elevating frequently throughout the day. Your new knee is still swollen inside and out, and it takes time for this swelling you can't see to resolve. Give yourself some time to heal before you start PT.

 

[Dharlee]

As Jockette said everyone has different experiences and different pain levels. Even a different knee on YOU can be different from the last. Take it easy and yes, do your exercises, but certainly don't do them to the point of torture! That man wouldn't darken my door again. Please keep us up. Prayers,

D

 

[Twocaledonias]

Jockette Layla beachy Flashlight Dharlee Thank you so much for your advice and support. I was mentally feeling better today and rested some. I did go into my office for the first time for a meeting with my board chair and to explore what kind of accomodations I'll need when I start going in regularly. It was sunny 60 degree day here, so it was good to get out and see my team. I'm now in my happy chair, icing, reclining, resting. I hope you are all taking good care of yourselves as well. ❤

 

[beachy]

@Twocaledonias
One of us is always going to need advice and support. Glad you're having a better day!

 

[Layla]

What a difference a day makes!
Amazing what a little rest, ice, sunshine and an outing can do.
It's awesome you're feeling better!
@Twocaledonias

 

[Layla]

Happy One Month Anniversary!
Have a lovely weekend!
@Twocaledonias

 

[Twocaledonias]

Happy One Month Anniversary!
Have a lovely weekend!
@Twocaledonias

Thanks! I feel like I've made so much progress towards independence. Still using walker, not driving, not walking the dog, and still very limited flexion. But I'm walking a lot, going into work twice a week for a while, doing almost all my ADLs around the house, and finally sleeping in my own bed. We'll see what outpatient PT and my surgeon visit brings this week!

 

[Layla]

It is great to read you're feeling good about your progress! I wish you luck with your PT in outpatient therapy next week. Please let us know how it goes for you.
Enjoy the weekend!
@Twocaledonias

 

[InkedMarie]

Happy One Month Anniversary!
Have a lovely weekend!
@Twocaledonias

Thanks! I feel like I've made so much progress towards independence. Still using walker, not driving, not walking the dog, and still very limited flexion. But I'm walking a lot, going into work twice a week for a while, doing almost all my ADLs around the house, and finally sleeping in my own bed. We'll see what outpatient PT and my surgeon visit brings this week!

Great to see the positives! It took me a couple months to walk a dog.

Marie

 

[beachy]

With your activity and ADLs I'm betting that your doc will be very pleased with your knee!

 

[Twocaledonias]

My outpatient evaluation was today. Have to say I was pretty impressed and am very hopeful. They're all DPTs and many have orthopedic specialties. They heard me loud and clear about my anxiety and where I am at one month out from surgery. They didn't seem daunted by it and stressed individual treatment plans (no "you should be at 90 degrees by now and we have to get there in a week!"). All they asked me to do right now was move more throughout the day and keep up the simple exercises I've been doing. Hopefully the surgeon feels as positive on Thursday!

 

[Layla]

@Twocaledonias
Glad you were impressed. It should make for more relaxed therapy sessions, assuming they will not be pushing you, but instead allowing you to go at your own pace. You'll have to share your progress with us. Best Wishes for your visit with the surgeon on Thursday. A great week to you!

 

[EalingGran]

Glad your out, patient appointment was positive. It really helps when they are encouraging.

 

[Layla]

Happy Two Month Anniversary!
Hope you've had a good month since we last heard from you. Take good care and don't be a stranger here.
We love updates!
@Twocaledonias

 

[Christie b]

My outpatient evaluation was today. Have to say I was pretty impressed and am very hopeful. They're all DPTs and many have orthopedic specialties. They heard me loud and clear about my anxiety and where I am at one month out from surgery. They didn't seem daunted by it and stressed individual treatment plans (no "you should be at 90 degrees by now and we have to get there in a week!"). All they asked me to do right now was move more throughout the day and keep up the simple exercises I've been doing. Hopefully the surgeon feels as positive on Thursday!

Hi there, I just read your thread after doing a search on muscle guarding and was curious how you are doing now. I felt your pain when you talked about the PT that came to your home and left you in tears :(. Happened to me, too. I’m 10 weeks post op and struggling w/ my flexion. PT yesterday said he thinks my muscles are too guarded because I’m afraid of pushing through the pain. He tried cupping which was painful but does seem to have loosened things up a bit. I’m getting a lymphatic drainage massage today to try to combat the swelling. I‘m trying everything I can to get my life back, this is so hard. I hope that you are doing well and please post an update.

Christie