TKR 4 weeks post right TKR dificulty bending

[crystals5]

Wow Jamie I am utterly shocked. I thought every state had disability insurance. Apparently not. In California if you pay in through your employer (and I think in CA its mandatory) you can collect state disability for one year and then must apply for social security disability. Its much more than social security disability but can only be collected for one year. I had it about 30 years ago when I had a complicated gallbladder surgery. Its all explained on employment development department website for state of california edd.gov. I also have private short term disability insurance through my employer so I get about 80% of my salary which is a pretty good deal. Check with your state. Its unbelievable that other states don't offer this. I'm so sorry.

 

[crystals5]

I just googled it and these are the states that offer it. Marco, if you are in one of these states you can get disability but I think if you were you would already know it.
States with statutory disability plans

• California — State Disability Insurance and Paid Family Leave (Family Temporary Disability Insurance)
• Hawaii — broken link removed: https://en.wikipedia.org/w/index.php?title=Hawaii_Temporary_Disability_Insurance&action=edit&redlink=1 [1]
• New Jersey — broken link removed: https://en.wikipedia.org/w/index.php?title=New_Jersey_Temporary_Disability_Insurance&action=edit&redlink=1 broken link removed: https://www.nj.gov/labor/tdi/tdiindex.html
• New York — New York Disability Benefits Law
• Rhode Island — broken link removed: https://en.wikipedia.org/w/index.php?title=Rhode_Island_Temporary_Disability_Insurance&action=edit&redlink=1 [4]

Commonwealths with statutory disability plans

• Puerto Rico — broken link removed: https://en.wikipedia.org/w/index.php?title=Puerto_Rico_Disability_Insurance&action=edit&redlink=1

 

[lindaladyishere]

My in home pt would hurt me a lot, i had to tell him on several occations to take it easy on me. When i began going to out patient physical therapy i told the therapist my concerns regarding being hurt in therapy she reported you should not do things that will hurt you, that you will do things in therapy that are uncomfortable. Since only going to 5 out patient therapy sessions my rom was increased 11 degrees, so to me it was and continues to be very helpful. I guess we all put pressure on our bending, but what i am learning that it takes time and to be patient. So be patient you will get there, recognize the progress that you have made since first having the surgery and know progress will continue to happen.

 

[Jozilla]

Jaimie is right about the disability - at least it is that way in New York. Every state I believe has its own laws so check out your states website to start. I may find myself in this situation after my surgery. I will not hesitate to go to social services - if for anything food stamps. I have worked my whole life - 28 years for the same employer. The only concern my boss had was for himself and his vacation and he didn't think my tkr was medically necessary. He also thinks I should be back working after two weeks. A very narrow minded greedy individual. I have been preparing for this by having a six month food stock and I will take a small loan from my 401 so I can pay my bills for six months. I hate my job but hope I can at least get one knee done and in a few months the other one. Then I can think about a new job or disability as I have other health issues. I wish you the best. Let us know how things are going!


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[marco4432]

Hi all,

Thankyou for everyone who responded, Just to let you know, I like most people live paycheck to paycheck, Two years ago I signed up for Aflac Four Polices, short term disability, sickness, cancer, and accident. I am very lucky to have these policies, the sickness paid for sickness and short term disability 6 months, without this I would be living on the street, Aflac has been great I send in a claim and get paid within a week, just like there add says.
The mistake I made was back in July my OS recomended I try PRP & HGH injections before I commit to a TKR, as this is experimental I had to pay out of pocket, my OS said if it was his knee that is what he would do, so I followed his advice and wasted 7 weeks of FMLA, I returned to work in september, and my knee was so bad I could work only 4 hours a day 2 days a week max as pain was thru the roof( the injections worked for two days out of seven weeks ). I had no choice but to have the TKR, I was completley out of options, Hence Surgery, I spoke with my HR dept and they said as long as I keep paying for all my premiums, everything should be ok. which I did, then after the TKR, my HR said I had gone over my limit for FMLA so I have to go on Cobra and pay Aflac directly, then they said if there was an opening I could try to get rehired, I doubt this as they have tried to distance themselves from me. The money I recieve is just enough to cover expences, so I should be grateful because it could be much worse.

Cant look for a job or collect UI, until I can walk and Doc releases me, would appreciiate any comments from anyone who has been thru a similar situation.

Thanks for time,

M

 

[marco4432]

OK I back again looking for advice, this time its on pain management, I'm on heavy opiodes, Morphine 6x 50 mg a day, Oxy er 80 2x day and oxy IR 5 x 30 mg a day, I'm seeing my PCP tommorow, I have work insurance for this months scripts and signed up for Cobra for December, I hope they wil cover the scripts for December.

Heres my question since the TKR I don't feel the need for ER round the clock meds, I think I need instant relief Meds, I would appreciate if anyone has been thru this and are also opiode tollerant, what IR meds would you recommend, the oxy ir seem to have no effect anymore, I'll speak with my PCP tommorrow so if anyone has ant ideas please respond.

Thank you

M

 

[leejaa]

I am tagging Josephine for you as she has the most medical knowledge to answer your questions.

 

[Jamie]

Why don't you feel like the extended relief medication is needed? Quite frankly, I think it is a good option for you now with something else for any breakthrough pain. Of course, your surgeon or GP is going to be the best person to say what is best for you. My concern with trying to deal with this pain using an immediate relief medication is that you run the risk of "chasing your pain." This occurs when you don't take the meds on a set schedule through the day and night. If you wait until you are beginning to hurt, you've waited too long. You will ultimately have to take more medication than if you just keep a steady supply of the pain relief medication in your system.

You are not very far out from your surgery yet. It's likely way too soon to be thinking about trying to reduce your pain medication. The rule is, if you hurt then you still need it. This is tough surgery and an even tougher recovery. You do yourself and your knee no favors by trying to tough it out where pain is concerned.

 

[Hwa1538]

Hi @marco 4432, my op told me to take medication until 6 weeks out. Like Jamie said you don't want to chase the pain. With regarding the bending, you do need patience. Do more frequent small movements to loosen your muscles. Of course, do not push to an extreme which causes pain. I was stuck at 96 for a while, and I was frustrated too. Thanks to BoneSmart friends who gave me encouragement and advice, I continued to make small movements every hour. Now, I am making a good progress. I also found massaging my leg below and above the knee helped too. I press my muscles pretty hard, and after that, you feel muscles relaxed which helps you to make the bend.

 

[Knitter4444]

Every OS should have one joint replacement (whether they need it or not) just joking. You can't relate unless you have been there. That is why I also think every male gynecologist should have their time in stirrups.

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[Josephine]

my op told me to take medication until 6 weeks out

Six weeks??? At six weeks I was experiencing my worst pain ever and my GP upped my Tramadol to 150mgs per dose! I took Tramadol (and acetaminophen) until fully 12 weeks out.

 

[marco4432]

Ok,
Anyone please explain why I'm starting my 7th week post op, and feel like I did in week 2, I'm doing PT, reduced my pain meds just a little, knee wont bend feels completely locked, can't straighten my knee, feel like have to go back to my walker.

I'm getting really depressed looks like i'll need an MUA if I do it will take longer to recover, or has it all failed, as OS said at the begining there are no guarantees !!!


Great what a life I have to look forward to

M

 

[Knitter4444]

What are you doing for PT Marcos? Perhaps too much. Do you have lots of swelling. Knee won't bend well when swollen and sometimes agressive PT causes the swelling. I think lots of us feel worse as we start thinking we "should" do more since it has been nearly 2 months. I would write down what you are doing and share with us.

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[maryo52]

I'm doing PT, reduced my pain meds just a little, knee wont bend

Marco, if you reduce your pain med before your knee has less pain guess what?

And what makes you think that PT advances your healing? I think PT helps guide progress but doesn't cause progress.

At 6 or 7 weeks, it's common to feel as if we should be further along. And since we cannot MAKE things go faster, we struggle to rationalize why things aren't further along. It's hard to accept unexplainable circumstances that are beyond our control.

 

[Josephine]

Marco, I posted these questions before but you must have missed them. Here they are again

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 that 'pain' also includes soreness, burning, stabbing, throbbing, aching, swelling and stiffness)

2. are you still taking any pain medications, if so, what, how much (in mg please) and how often?

3. are you still icing your knee and if so how often and for how long?

4. are you still elevating your knee and if so how high, how often and for how long?

5. what is the detail of your daily activities? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

6. what kind of PT/exercises are you doing? How much and how often? Details would are required!

 

[Jamie]

I hope you can provide answers to Jo's questions as that is the best way for us to help you. My guess is you've cut back too soon on your meds and you're doing a bit too much activity (PT and possibly daily activity) for this stage in your recovery. You are still healing!! This is a long recovery. I know you're feeling that you should be farther along, but not necessarily. So.....let us know some more details, please.

 

[marco4432]

Thanks to everyone who has responded, first in answer to your questions
1.pain 6 to 7 in the morning, 0 to 1 lying on coach elevated and using ice during the day, after 7pm knee seems to tighten up feels like I lose anything I gained after PT still use ice before bed pain to 4/5.
2. Medications ( Opiode tollerant ) morphine er 2 x 50 mg per day ( Just reduced), Oxy er 80 mg 2 x day, Oy IR 30 mg 3 day ( Just reduced) to sleep Restoril 2 x 15 mg and klonopin 2mg 1 or 2 at night.
3. Icing 12 Hours a day
4.Elevating when icing 12 hours a day
5. PT Twice a week, little housework , take my dog out 6 x day 100 to 200 yards only, yesterday went to Walmart had to use push cart BIG STORE, painful, sweating, eausted by the time I got home.
6 PT knee bends, straitining with electrodes attached, knee slides lift feet on wall and let gravity bend knee, Pilates Machine different bending, just starting on bike takes about 20 turns for me to be able to turn the peddle, I have to lift my right thigh to get full turn, lastly PT massage and then he tries to force the knee using resistant example I push up then stop and he tries to bend by force. On days i do not have PT it depends how I feel some days I do nothing but bent while sitting at computer.
Lastly my PT says I should rent a CPM machine I had one from my insurance but I did not use it much as it was rough the first couple of weeks due to my opiode tollerance impacting my pain.
So If I rent I would have to pay out of pocket, I have one more month of Aflac disability due, but after living expences, 50.00 for each PT session and now 350.00 to rent CPM for two weeks, cost me money to live right now, Job terminated me so I have elected Cobra 600.00 a month.
Theres no way I could work in my proffesion walking 8-10 hours a day by the 12 week, I can't manage a 200 yard walk.
Losing my Job is affecting my mind, I'm pretty concerned about the thoughts going thru my mind.

I hope thats not to long and boring, thanks for reading

M

 

[Jamie]

Thanks for providing all the details.

As I've said before, if you are in pain it is no time to be reducing meds. So, as long as you're hurting I suggest you take the full amount of medication that you have been prescribed.

Walking 100-200 yards six times a day is actually a lot of activity. I understand that you must take your dog out, but can you put the dog on a long rope or chain so you don't have to do a lot of walking?

I am concerned about that forced bending that your therapist is doing. That can cause swelling if he pushes beyond just mild discomfort. How does it feel when he does those pushes? If it's hurting, stop him from doing that part of the therapy and just stick to gentle movements.

I don't feel like you would get any benefit from the CPM. It's (as the name implies) a passive motion machine and you can do your own gentle bending and stretching without a machine. Too much of that on a given day can irritate your tender knee anyway, so the idea of spending $350 seems not to be a good one. Just pass on it and don't feel guilty at all. Not having it should not affect your recovery negatively.

Since you're hurting in the morning, are you taking your meds during the night?? If not, you need to do so. And I suggest that you apply ice at night while you're sleeping as well. Put it on both the front and back of your knee. If you use gel packs, you'll probably need to change them out once during the night. Be sure and put a towel between the ice source and your skin so you don't damage it from the cold. Ice is a great pain reliever.

I'm going to tag Josephine so that she sees your response as soon as possible. She is on a business trip right now and it may be a few days before she is back on the forum.

 

[Josephine]

Much of what I say will be a repeat of Jamie's advice.

Yesterday went to Walmart had to use push cart BIG STORE, painful, sweating, eausted by the time I got home.

You're only six weeks out.This is no time to be going to Walmart! Read this Activity progression for TKRs.

PT
knee bends But how many?
slides- lift feet on wall and let gravity bend knee But how many?
Pilates Machine different bending But how many and what?
just starting on bike takes about 20 turns for me to be able to turn the pedal, I have to lift my right thigh to get full turn Stop trying - just rock the pedals back and forth until the rotation happens by itself
PT massages and then tries to force the knee using resistance But how many times? example I push up then stop and he tries to bend by force. And this to what? until you are in pain or to the point of discomfort? If he causes you pain then tell him NOT to do that. You've been hear a while now - you should know the mantra includes this "- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you"
On days I do not have PT it depends how I feel some days I do nothing Quite right - no PT days are days of rest.

Lastly my PT says I should rent a CPM machine

Absolutely not!

Considering your problems with pain meds, you cannot do all this and expect to cope or progress. If your knee is painful then your tissues will be hot and hot tissues are at risk of developing adhesions.

 

[marco4432]

Thanks to everyone for your inputs, at PT all exersises are sets of ten, the knee bending the PT does is massage and then 3 x knee bends , he bends then tells me to push up against his resistance then he slowly bends with force untill I tell him to stop, my flex is max 80 but after he bends and massages he can get to 95, then ice with electrodes, then I leave and even though there is discomfort it feels good to bend, problem is when I get back home and ice with my knee straight and elevated, then it goes back to being stiff. My PT and OS suggested the CPM which arrived today, I don;t know if it will help but I have to try, otherwise, my only option to get back to employment without the luxury of having the funds to wait 12 months, is I assume having an MUA.

My next appoitment with my OS is 12/06/13, If there is no inprovment should I go with an MUA, would appreciate any feedback from anyone who has had an MUA.

Josephine if you read this could you comment on the CPM, as I have my OS and PT saying in might save me from an MUA,( I'm sure that an MUA is painful and would delay my return to work) how I wish I had the funds to not work but I don't, there is nothing I can do about that.

Thanks again

M