TKR 13 days in on the other side

[susanc]

bottomshollo - thank you - I realized I did something wrong after I created a new thread - so I'm glad you fixed me!

 

[susanc]

hello pumpkin and roy - a couple weeks ago my PA from the orthro group said to me he was just concerned with being straight and at 0 degrees vs. the bend- he said the bend will come later - I told the PT group this and they didn't agree with that - one told me that in my knee area the tissues are "cementing" to my bone or something in there and that is why I can't bend the knee. The knee still feels a little swollen (feels like a bottle of water) and I don't have much feeling on the right side of the leg in that area. PT told me not to ice it that much anymore because I was using ice 24/7 and sleeping with it (it felt so good). They said just ice it for 15 min.s after exercise. Now I use a heating pad on my knee area and on the quad muscle and the calf muscle too. PT told me to keep moving all day long and to get back to a normal routine of cleaning the house, cooking, go to the store, etc. I still can't do this all day long and need to rest during the day. I won't be able to drive for a while. They took me off my walker and cane so I am practicing walking around the house with no aids which my husband says I am doing straight legged, so I need to bend more. There is not a day that goes by where I don't cry because I am so discouraged especially when I see other people doing so well. But I will take your advice that everyone is different and start a new positive outlook. I have cut down on my pain pills so that is a good thing - can't wait to get off all the meds!

 

[ladymax]

Hi ! Try not to worry too much about range of motion. Just do your best. From reading back posts here, I see that the range of motion comes at different times for everyone. I'm 4 weeks post PKR, with one manipulation under my belt (surgeon really pushed it, and I was too weak to say no!), and still only have 85 degrees, but folks on here are drumming in to me not to worry.
I also couldn't lift my leg till about 3 wks after surgery. Muscles are traumatized, and it takes a while for them to wake back up. Give it time.
Best of luck to you as you march along this recovery road with all of us

 

[susanc]

hi ladymax, oh no, I hope they don't try a manipulation on me this wed. during my 6 wk. checkup - I've gotten to 78 so far with a lot of tears during a heel slide and sitting on the edge of a chair. I hope they give me a few more weeks, the others are saying not to worry too. I think I need to massage the knee much more than I'm doing now to break the scar tissue too. I'll have to say at this point I wouldn't want to ever do this again (on the other knee) I don't even want to know how the left knee is- no one has ever checked it. Maybe I'll change my mind in another month when I feel better. Thanks for your reply, I really appreciate it and best of luck to you too!

 

[midwest girl]

Hi @susanc so sorry things aren't going as well as you would like. If I were you I would continue icing. I ice all the time and even at bedtime. I don't think I would be doing heat on your knee tho. Did PT suggest that? Heating does not help with swelling at all. I'm @ 6 wks post op also and my therapist doesn't want me doing heat at all at this stage. The only time I use any type of heat is when I'm in the shower. I sit on my shower chair and hold the nozzle on my quad and while doing that I work on my flex by sliding my foot under my chair. I get really good flex by doing that. My PT was fine with doing this. Everyone has their own rate of recovery. Just focus on you and do the best you can do. I also have my 6 wk appt tomorrow. He will be taking X-rays. How did your appt go today?

 

[Wednesday]

You will be surprised at how much your perspective changes with the passage of time. During the first several weeks I would have happily strangled my OS; today, I would hug him. Give it time.

 

[susanc]

I think I am heating too much - I'm probably sealing the tissues inside! I'll try heating my quads and my calf muscles in the shower like you are doing. That is a good idea. My visit to the PA yesterday was good except for what he told me at the end of the visit. He gave me some tips on using my stairs to bend the knee in increments and then he showed me how to place my surgery knee on a high surface and bend forward, wait a couple minutes and bend a little farther and so forth (I do this already but not as high as he placed his leg). He said my knee was still warm but that was normal and I couldn't go swimming yet until all the scabs fall off. My report from the PT showed that my straightening was at 0 degrees (achieved when another PT pushed down on the knee which sent me jumping off the table practically!) and I was at 80 degrees. The PA said if I don't reach 90 degrees on the bend within 15 days, we have to talk about manipulation! So I am sick about it . He gave me a new prescription for an anti-inflammatory medicine and told me to get off the Tylenol extra strength pills.

I do really appreciate the PT's. One of them actually stays with me for the whole 2 hours I am there and there are many other patients in she could be working on, so I am thankful for that. And she always introduces new exercises for me - yesterday she put me on the treadmill which was pretty good because it didn't hurt!

Thankyou both for your replies! I can't tell you how much it helps that someone is thinking about me. In exchange I hope you both continue or retain your wonderful progress.

 

[bottomshollow]

@susanc, here are links to Library articles on Manipulation Under Anesthesia:

MUA (Manipulation under Anaesthetic) and Adhesions
MUA: the ineffectiveness of early MUA (JBJS)
Myth busting: the "window of opportunity" in TKR
Myth busting: the "window of opportunity" JBJS

Maybe reading up on this will ease your mind. And you do not have to consent to have MUA if you feel you'd like more time to work on gaining more ROM. Try to remember that you are the boss---your surgeon works for you, not you for him.

Take care and keep us posted. We care.

 

[midwest girl]

2 hours of PT - wow, that's a lot!!!! I think I'm at the clinic for maybe an hour and 15 min and that includes the 15 min on the Nu-step and 20 min of icing and stim. Although that could change now that I'm full weight bearing. No more taking it easy. I wouldn't worry about that threat of a manipulation. They can't make you do it. I would say if you are improving by even a degree or two every week it shows that you can get there, it's just taking time. Why do they not want you taking Tylenol? That's what I take for pain - 1000 mg Tylenol + 1 tramadol 3-4 times daily. And ice. Ice works wonders for me for pain. I just can't tolerate the Percocet that was prescribed for me. Just keep at it my friend. I believe you will get there. Try and stay positive.

 

[susanc]

thanks for the replies and thanks for the links about manipulation. I still need to read them since I just logged in, I'm so sick of pain that anymore pain that may come my way (manipulation)makes me want to move out of town. I know someone who had 2 manipulations and they did not help her. She is still at 90 degrees and she is a year out. They put me on a Prednisolone drug (21 Tabs) to ease the inflammation and the dr. told me to stop taking the Tylenol until I finish the new drug but the Pharmacist said I could take both. I got on the bike today - put the seat really high and could kinda get around but only going backwards and only with my heel on the pedal. so not sure I'm doing any good with that. Yes I'm lucky my PT works with me even over 2 hours (she must think I'm the most needy maybe) and I don't even heat or ice. I do that before I go (heat) had to look up what a Nu-step was - I wish I had a recumbent bike at home. Glad you are doing well and thanks for reminding me to stay positive!

 

[tiredwife]

@susanc If your knee is swollen it won't bend. My husband always elevates and ices after PT. We only had one PT that pushed on his knee, and she will never touch him again. It causes so much pain and swelling. Take care of yourself and your knee.

 

[susanc]

thanks tiredwife (love the moniker). I got back at one PT (didn't really mean to) that pushed on my knee a few weeks after my surgery. I grabbed his crotch area in panic by accident and needless to say that particular PT stays away from me now!

 

[susanc]

Midwest girl - we had our surgery the same day, just curious what your numbers are for bend and straightening? Also how long was it before you were able to pedal all the way around on the Nu-Step bike?

 

[tiredwife]

@susanc LOL. His happened on the day he was released from the hospital, she did it without warning. She didn't like his ROM and thought she would just help it along a little. I turned in a complaint on her.
I think you are still comparing yourself to others, can't do that, everyone heals differently. Even 2 knees on the same person done at the same time will heal differently. As long as you are making some progress every week, remembering that there will be set backs, then you should be fine.

 

[midwest girl]

My numbers are 0 extension and 125 flexion. I was at almost 0 extension and I was at 90 flexion before I left the hospital. But please don't compare my numbers to yours or get discouraged by that. I have a really good therapist that when checking numbers has never pushed down on my knee and as far as flexion she has only helped with that when I've asked her to. I ice and elevate a lot. When I'm sitting in my recliner I may sit with a towel under my heel to allow gravity to work on extension. You can also put a small weight on your knee to help while working on your extension at home. Yes I still work on extension. I've found that when I'm sleeping in bed I'm bending my knee so in the morning it's stiff. I want to keep it at 0 so it helps with my gait. As far as my recovery, I've been very gentle with any kind of exercises that I do at home. Just a few here and there. I agree with the others, if you're swollen it won't bend. Icing and elevation will help with that. I ice for hours at a time. As far as the Nu Step I think we are talking about 2 different things. The Nu Step is a recombinant type bike that you just push the "peddles" back and forth. It's not rotating peddles. At least the Nu Step I use isn't. I haven't been on a typical bike yet. And I've been on the Nu step since day 1 of therapy for 15 min at the end of my sessions & before icing & stim. This past Wednesday I've started doing more challenging exercises at PT such as squats and things to work on stability. And if tell her I had pain or swelling from that session she backs off a little the next session. If you have any opportunity to do pool therapy I highly recommend it. My facility has their own pool (with 92 degree water) and I do water therapy every Friday. It really has helped. I'm sure it can be so discouraging and frustrating. Hang in there. I'm sure you'll turn a corner soon.

 

[susanc]

my PT said I'm 2 weeks behind - I'll have to tell them about the Nu-Step - that would be a heck of a lot easier then going all the way around on the traditional bikes. You did really fantastic! I have to keep remembering not to compare myself but I do get discouraged quickly. They have me do dozens of different exercises and always add more. But now my PT told me to just concentrate on riding the bike and do the straightening exercises from now on. I can't go swimming until my scabs disappear but my scar looks really good. I can't wait to jump in my daughter's above ground pool or another pool nearby but wonder if I can handle the straight ladder ok. I would think it may be good idea to avoid swimming in lakes vs. pools. My dr. told me to always beware of any type of infection and get that treated right away for the rest of my life. Wonder if that goes for those that have hip replacement, etc. as well. I learned from a knee replacement seminar I went to that the first month of knee replacement is hardest of course and people feel worse than they did before, the second month the patient feels the same as they were before surgery and the third month the knee is supposed to feel much better and people are happy they had it done. I can't wait for the 3rd month.

 

[midwest girl]

Yes I've heard that about the 1-3 month thing. I'm actually several weeks behind. I wasn't able to go full weight bearing until week 4 and my OS released me from the walker just this past Thursday. I had the MCL repair so everything has been very slow & very gentle - all to protect the MCL. So due to that I'm several weeks behind. And even tho I have good numbers I still compare my progress to others. As far as the pool I would think the straight ladder may be a challenge. Does she have a shallow end you can get in and out of? I don't think I would do a lake or ocean for awhile. Your surgeon has given you a lot of information. At my 6 wk appt this last Thursday he just basically had me show him my extension & flexion, said I could get rid of the walker & use a cane anytime I leave the house, protect that MCL and don't fall. He really stressed that - don't fall!

 

[Quasi]

@susanc and @midwest girl
Hello! I had my LTKR on May 13th also! The last time my ROM was measured About 3 weeks ago, it was 107. I had home PT for first month, but I had to go back to work around June 3rd 3 days a week full time. So I am not doing outpatient PT yet due to exhaustion and being on my feet part of the day and sitting at desk half the day. But I am still experiencing pain and swelling, usually at night and always worse after working 8 hours. But tomorrow I will be making a PT appointment. I had an area in lower part if knee that is very painful and gives me sharp shooting pains throughout the day. My OS said it was tendinitis and to ice, elevate and rest and stay on pain meds!
This pain makes it really hard to do my exercises though. When I do use the recumbent bike, I have to have an ice pack on it the entire time. After consulting with Josephine, she suggested an article that shows you how to do accupuncture massage. I am trying to do this but I don't think I am doing it correctly, so I'll see what the PT will do, and then try to find a chiropractor who can do this for me!

As you can see from all three of our stories, everyone recovers at their own pace!

SusanC, I am a little ahead of you but not much, and way behind midwest girl!
I had absolutely no idea how hard this was going to be! I have been using a cane now for several weeks and am not worried about my ROM, However extension is one of my worries as when I try those exercise, the tendinitis rears up! So, I am hoping PT will help.

And I am not sleeping much, just about 3 to 4 hours night, hoping that gets better soon,

Susan, blessings And prayers to you! Hopefully we will both be better each day!
Midwest Girl, Congratulations on your progress! Sounds like you are doing great!

 

[susanc]

Midwest Girl/Quasi - hello -it is quite something that all our stories since May 13th are so different!

My OS told me to never ever fall (the rest of my life) and what did I do? 3 weeks in, I was not use to the wheels being put on my walker and I was moving a little too fast and the back legs caught on my living room rug (have since taped it down) and I started to fall which seemed like slow motion. I fell on my good knee and luckily had just put on an ice wrap on my bad knee so it was in a rigid position. Anyhow, not sure how I managed it, but I did a complete roll and never hurt my bad knee. It was scary and in a way I'm glad I don't have that horrible fear of falling since I know how it feels now. Just hope I can get through another horrible winter up here since I'm always falling in my driveway because I live on a hill! When I told my OS about the fall he said "I told you not to do that" and then wanted to know how my good knee was and I wanted to tell him stay away, you aren't getting that knee! They also told me never to get an infection , like a urinary tract infection, a boil or any other thing. and if I do to take care of it asap (for the rest of my life as well )

I thought my numbers would be better last PT session since I've been taking the new prednisolone drug - I can walk almost normal but I could only get to 83 degrees with them pushing on me again. I'm scared to go tomorrow. I do tell them to stop sometimes but I really want to reach 90 before July 10th and my next appt. when they are going to talk about manipulation. I can turn it down maybe but not sure if that is a good idea at this point. I'm still confused. I looked a little bit at the links on manipulation but virtually get sick reading about it. You may think I'm nuts but I couldn't even look at my knee after and it was hard for me to even touch it! Now I massage it but am not happy about having to do it. Sometimes, I hang my legs off the bed laying on my stomach and let the bed massage my knee for me by rolling back and forth! How pitiful can I be!

Quasi - I can't tell you how sorry I am that you had to go back to work. At 3 weeks in , I was a total physical and mental wreck. This operation has been really hard on me and I give you so much credit and total respect for doing what you had to do. It took me a long time to finally sleep through the night but finally after taking gabapentin (prescribed by my OS) and a pain pill closer to 11PM I was able to sleep through the night. I also still sleep in the recliner so my knee is above and I think that makes a big difference rather than laying straight in a bed with pillows under my leg. Hope your tendinitis stays in check.

Here's to good health and healing to us all!

 

[kneeper]

My OS told me to never ever fall (the rest of my life) and what did I do? 3 weeks in, I was not use to the wheels being put on my walker and I was moving a little too fast and the back legs caught on my living room rug (have since taped it down) and I started to fall which seemed like slow motion. I fell on my good knee and luckily had just put on an ice wrap on my bad knee so it was in a rigid position. Anyhow, not sure how I managed it, but I did a complete roll and never hurt my bad knee.

You're a stunt woman!