5 month birthday of my new right knee!

[tiredwife]

@71Beetle The hospital just remodled and added on. It turned all the rooms private. It isn't that big of a town, but we have lots of small towns around that also use it and a military base and college, so it is a pretty big hospital for the area. His room had a couch that made a bed, a recliner and a private bathroom with a shower big enough for a wheel chair. It was reallly nice.

 

[71Beetle]

Sounds nicer than my apartment in college!

 

[MathSci4me]

I dithered about asking you these but I'm going to ask you these questions anyway!
It would be very helpful if you would answer each one individually 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 compare this with the bone-on-bone pain you had before surgery!

)

I would say 3-4 most of the time.

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

1-2 pills of oxycodone (5-10 mg) every 4 hours (they said "as needed" but I'm taking every 4 hours on schedule now)
I can take up to 4 g of Tylenol daily
1 Xarelto at noon (which I only have to take for 2 more days now)

3. how often are you icing your knee and for how long?
I'm icing it about 4-6 times a day for at least 30 minutes. I try to use the ice machine in the morning and at night for longer periods. I take some ice packs up to my bedroom with me in a cooler to use for those 2 AM times when I wake up aching.

4. are you elevating your leg, how often and for how long?
I elevate at night when I'm sleeping and during the day when I'm icing.

5. What is your ROM - that's flexion (bend) and extension (straightness)
Not much. It's so depressing. The PT said today I had about 60 degree bend and was 10 degrees off of straightness.

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and
Nothing too major. I do well getting around even with my knee not bending. I have not been out of the house because I don't really need to go anywhere. I do some light housework and cooking is basically warming up stuff because I prepared meals ahead of time.

7. what kind of PT/exercises are you doing? How much and how often? (and detailed details would be appreciated, please! Reps, sets and session and all that)
Try to do 10 reps of following 3x a day, but if it is a day with a rough PT session it is probably just twice.
Heels slides sitting on couch or bed
Heel kicks sitting on couch with pillow under knee or sitting in chair.
Stretches for hamstring
Use my steps to put foot on first step and try to work knee into bend and hold.
Sit in chair and move foot back as much as can and hold.



Note:
If you're not familiar with this, it goes like so:
1 lift of a 500kg bell bar = 1 rep or repetition.
Doing 5 reps and then a brief rest = 1 set of 5.
And doing 5 sets and finishing = a session.

 

[MathSci4me]

As far as picking up prescription, I had to have a letter authorizing my friend to pick up the paper prescription from my doctor since I did not put her down on my HIPA (sp?) form. I only put down my next-of-kin on that form before surgery. If I had realized that prescriptions couldn't get called in and that I would need people to pick up paper prescriptions for me, I would have put a lot more people on that form!

 

[MathSci4me]

PT is so depressing. The physical therapist said today if I don't make a lot more progress within the next week, I'm going to have to go have to be put under and have my knee manipulated by the doctor so that it will have more range of motion. She said that I need to just work through the pain. I'm trying to do that (and it should help now that I have my pain meds refilled and don't have to worry about running out of them the next few days), but now I'm really concerned that I may already have so much scar tissue or whatever built up already that it is going to be impossible to get enough range of motion to prevent having that procedure.

 

[71Beetle]

You will hear this from a lot of people on the forum. You should not be thinking of an MUA this early. My god it has been a week! PTs with their scare tactics make me soooo angry! There are people who have had an MUA and have had success but I don't imagine it was that early.

I was at 75 degrees at my 3 week check and my OS said he would consider an MUA if I was still there at 6 weeks. I was 102 at six weeks and he never mentioned it. I will let him know when he operates on my right knee on Thursday that he can manipulate the left knee if he wants as I will be under anyway.

Did you PT mention what your flexion and extension was?

 

[MathSci4me]

Did you PT mention what your flexion and extension was?

Flexion is how much it bends, right? She said that was about 60 degrees today. And if extension is how straight, she said I was about 10 degrees off there. She did some massaging and pressing on my knee while I was laying flat to see if she could get my leg any straighter and it didn't help that much.

She's coming back on Thursday. She's been very busy seeing patients because the person she shares the territory with has been out sick, but she said I was a priority so she'd definitely be here on Thursday. I guess I'm a priority because I can't bend much!

 

[71Beetle]

I am not the expert but I do know that both of these will get better. Be kind to yourself. Rest, elevate and ice and medicate. You will see improvements soon enough.

 

[tiredwife]

@MathSci4me If your knee is swollen it won't bend or straighten very much. Your ROM will change all the time, some times a step backwards some times forward. If they push on your leg enough to cause pain it will cause more swelling and less ROM. 10 isn't bad for a week, my husband's was about 8. You will get there.

 

[referee54]

The physical therapist said today if I don't make a lot more progress within the next week, I'm going to have to go have to be put under and have my knee manipulated by the doctor so that it will have more range of motion.

You have got to be kidding! You are not even ten days removed from very traumatic surgery and they are already threatening you with an MUA? #1---it is way too early to even begin to think of that, and #2---nobdoy can do anything to you without your consent.

She said that I need to just work through the pain.

Tell her that you will not work through the pain---that you will go to the point of discomfort and no further.

You have to remember that the PT works for you, not vice versa. You set the ground rules up front, and if the PT does not like it, then find another PT.

but now I'm really concerned that I may already have so much scar tissue or whatever built up already that it is going to be impossible to get enough range of motion to prevent having that procedure.

Very few people get scar tissue---and it has nothing to do with the lack of PT or the lack of activity or the lack of ROM---it is rare.

The harder you work your knee, the more swollen it will become---and the more swollen it gets, the less ROM you will have---take it gently, take it slowly, and ice and elevate, and you will see better progress.

 

[referee54]

This PT person has to understand that you have had a very traumatic surgery---and this is not an athletic injury. He cannot treat you like an athlete rehabbing an ACL. Recovery from a TKR can take quite some time, and you are still in the "Dark Days" of recovery---so what is the rush?

There is no "window of opportunity" when it comes to ROM---ROm can be gained up to a year and beyond!

Stand your ground and let the PT know what is acceptable and what is not---and do not let them frighten you!

 

[54andfighting]

I had my right knee replaced last Monday (today is Sunday). I've been a little down because I can't bend my knee very much and I wake up in the middle of the night from the pain. Finally decided to see what I could find online about recovery and came across this site. What a blessing!!! I've been reading over many of the threads and feel so much more positive about the future. Thank you for all the great info!! Wish I had known about this place before I had surgery!

We are on the same schedule! Had mine done on the 23rd as well. Welcome to the group. So much helpful info and helpful people here. I've been posting everything I can think of that have helped me so far and might help someone along the way as well, and been lurking and bouncing around on many threads. Time now, though for some reps and sets! Heave ho and up I go....

 

[referee54]

Time and patience are the key here. You cannot rush a TKR or a BTKR recovery---the schedule is set up by the surgical knee or knees, and that schedule is not up for debate.

You have to resist the urge to work hard and to try to speed things up---the more you work on it, the slower your recovery will be---and more frustrating, too.

 

[midwest girl]

One of the things my PT said that helps with extension is doing the quad strengthening exercise - where you squeeze & hold your quad muscle. You could try that. I've also heard that you could put a light weight on your knee while your leg is extended. All I ever did was put a rolled up towel under my ankle and let gravity do it's job. @71Beetle I also had a private room which I knew my insurance doesn't cover. But this hospital just remodeled their Surgery-Medical floor and all the rooms are private. And my room was actually in the oncology wing so it was a huge room - and very quiet. I'm blessed that my insurance covered the room. Wishing you the best in your recovery @MathSci4me. It's a long recovery that requires a lot of patience.

 

[zlady]

Hi @MathSci4me, oh my gosh it sounds like PT was tough! Take heed to the advice on this site as it makes so much sense. One of the things that took a while to sink in for me was that it will take time for your knee to heal; this is something that can't be rushed. I have cried many days thinking I wasn't healing quick enough & that this would NEVER be over but as I've said before you will improve. Keep yourself positive & I hope your next appt goes smoother.

Gina

 

[susie09]

Hi @MathSci4me - I'm amazed at the number of PT who seem to think it's appropriate to threaten a patient with their own doctor. I quit one therapist who,after one week, was doing a pretty good job of destroying my self-confidence. My OS, who knew how well I had been doing, totally approved and supported me. If your PT dares to threaten you again, I think it would be so empowering for you if you could whip out your cell phone and say something like, "Dr. X has never said anything to me about doing an MUA so early. Let me call his office right now and see if I can get him on the phone." It would be so worth it to make her squirm!

 

[kneeper]

I agree with what's been said above. You are barely out of surgery and have time to improve. The key thing is to see progress little by little. It will be slow while your knee is swollen and overworking it just brings more swelling. Don't let this PT scare you.
Manipulation is an option for people who truly get "stuck" but it shouldn't be considered a "threat" and from my experience here is not typical.

Just keep doing your exercises to the point of discomfort (not bad pain), rest, ice and elevate.

 

[MathSci4me]

Thanks for all the encouraging words! I get so down about my progress and when I read the postings here, I have so much more hope. And then PT comes.... Sitting here icing my knee and dreading that PT will be here in 2 hours. At least I have a 3-day weekend away from the PT due to the July 4th holiday weekend.

 

[MathSci4me]

Happy Independence Day! Eleven days since my surgery. I have focused today on resting, elevating and icing! I've got this one particular area just at bottom or below knee cap that is particularly swollen and I am hoping to get that area's swelling down. I'm hoping that will really help with increasing my range of motion, but we'll see.

PT yesterday was exhausting! We did some new exercises to try to stretch out my knee and my flexion and extension were a little better than the previous visit. However, I noticed later that night that my left knee (the one that didn't have surgery) was sore and I'm wondering if it is from the squats she had me do (holding on to kitchen sink and squatting as much as I could) of if it was from this exercise she had me do where I put my right knee on the 2nd step and tried to squat/bend that knee as much as I could. In that latter exercise, I could hear my left knee popping and clicking so I think that might have been what did it. I worried all night about my left knee being injured because it has had to take up the slack of getting my big body up from chairs, etc. so I iced my left knee some today.

I took my last Xarelto yesterday! Happy to get off at least some medication. I'm finding that I'm OK with extending the time between my oxycodone during the day, but at night I need it to stop my leg aching enough so I can get to sleep. I take a pill before I go to bed, but I also have to take one during the middle of the night.

I'm using the cane instead of the walker now. The PT said I could and it is much easier to get around and not run into things.

Hope everyone is doing well! Time to get some more ice!

 

[MathSci4me]

It is so frustrating to not be able to get much sleep at night! I take a pain med before I go up to bed, bring some ice packs for the night and get my leg positioned on pillows. For some reason, even if I haven't been in pain throughout the day, the pain starts at night. I then spend my time icing and massaging my leg to make it feel better until the time comes that I can take another dosage of pain med. Then about an hour later I fall asleep. So I end up with just a couple hours total of sleep for the night. I would love to have a normal or close-to-normal night's sleep!