5 month birthday of my new right knee!

[MathSci4me]

Three weeks since the surgery. PT came today and still only have about 62 degrees ROM. It's so depressing. He worked the knee pretty hard so I iced it and elevated afterwards. Ended up taking my next pain pill about an hour earlier because the leg was aching so much. PT will be coming back on Thursday for his last home visit and then my follow-up with the OS is next Tuesday. I'm anxious to hear what he has to say and what the next course of action is. With such little progress so far I'm really worried about being able to get back to work when school starts at the end of August. Stressing about it all! Last night I had a dream that I was sitting around talking to friends and I noticed that my right leg was bent comfortably at 90 degrees! I got so excited in the dream that I had 90 degrees ROM!! And then I woke up to reality.... :(

 

[kneeper]

The struggle is that in the first few weeks you likely have a lot of swelling and so bend won't come. If you work it too hard and the knee blows up more...
It's good that you're icing and elevating--do you do that throughout the day?

 

[Roy Gardiner]

Three weeks since the surgery.

3 weeks is early , don't worry.

He worked the knee pretty hard so I iced it and elevated afterwards. Ended up taking my next pain pill about an hour earlier because the leg was aching so much.

Remember the mantra:

- If it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it.

Don't let him 'work hard', it's counter productive.

 

[MathSci4me]

@kneeper, I do ice and elevate throughout the day. However, I don't ice as much as I did in the beginning because my PT said that the swelling was deep in the knee and that the ice would not help it. So after I do exercises, walk, etc. I will ice for about 20 minutes, but I elevate throughout the day as much as I can.

I kind of took today "off" from exercising. I walked to my mailbox twice, but that was it. Otherwise, I had my leg elevated a majority of the day. The home health nurse came today for her last visit. PT's last home visit is Thursday and then I see the OS on Tuesday.

Sleeping at night continues to be a struggle. I've never seen as many late night shows in my entire life as I have in the past 3 weeks!

 

[LisaNHart]

@MathSci4me - I'm fairly new to this forum and just read your thread. You are a week behind me. I had a Right TKR on June 16, 2014. Welcome.

I had one of those long days with lots of swelling, etc. The following day I did nothing but watch movies, iced, elevate, etc. The day after R&R, I felt much better and bending the knee wasn't nearly as bad.

Good luck at PT on Thursday.

 

[Ollie]

I think that a PT telling you that the swelling is 'to deep' for the ice to help is a crime. My PTs would never say anything like that to me - they are all about the ice and elevation, the gentle stretching, and walking. Seriously - Ice and elevation always helps; knees are compact and fibrous, & bony; cold is conducted pretty well into the joint. Heck, my joints feel cold weather and I certainly don't tape or wrap winter days around them!! Just Keep Icing and Elevating; ice for long periods. It makes a difference regardless of what one PT says!!

I am also doing just a bit of heat on my thigh, trying to work that lingering tourniquet stiffness out. It was quite deep and the knots were so painful, but slowly the heat, stretching, and my hydro therapy is getting it loosened. Yeah!! It takes time - lots of time!!


Ollie. LTKR June 10, 2014

 

[kneeper]

I think that a PT telling you that the swelling is 'to deep' for the ice to help is a crime. My PTs would never say anything like that to me - they are all about the ice and elevation,

I even got a super cold ice wrap in PT yesterday to help with the swelling and I'm farther out than you @MathSci4me

 

[MathSci4me]

Thanks! I'm continuing to ice the knee even with what PT says. Even if it may not help with internal swelling (according to the PT), it certainly helps with the aching and the pain! Last home PT visit was this morning. I really like this latest PT guy and I'm going to miss him, but I'm glad to stop having these home visits. I feel like I'm always straightening up my house for someone to visit! Now I have 5 days on my own until I see the OS on Tuesday. My goal for the next 5 days is to ice, elevate and do GENTLE exercises to see if my ROM improves some by Tuesday.

 

[Ollie]

Keep at it!! I still ice and elevate often; have sort of discovered if I start to feel kind of grumpy, that ice calms me and my knee down a lot!!


Ollie. LTKR June 10, 2014

 

[Jozilla]

I think I iced a good part of 24 hours for seven weeks. It was so important to me. The BS mantra is so logical and easy to follow. Ice gets the swelling down and therefore your pain! I was also happy my OS and nurses in my hospital had the same philosophy!

 

[Quasi]

@Ollie
Great point about ice and grumpiness ! So agree!

 

[MathSci4me]

Four week check-up today and first follow-up visit with the OS. I had so many emotions going into this visit - anxious to see what he would have to say about my limited ROM but also dreading it. And I was also worried if I would be able to get into the car today to get to the appointment! I had a friend to drive me to the appointment and I didn't know if I'd be able to get into her front seat or not and I was up last night worrying about it. I was so excited when she got here and I was able to get into her front seat!! I felt like that was a small victory for me and my knee!

Got to my appointment and I remembered to ask to do a new HIPA (sp?) form so I could add more people who could pick up prescriptions for me. I got x-rays taken and it was so strange to see these new parts to my knee! The physician's assistant said it all looked good and the incision was healing nicely and no swelling. He said I definitely need to go to outpatient PT for that ROM. He also went ahead and gave me a refill prescription for my pain meds so I wouldn't have to come back next week for it. Then the doctor came in and expressed his concern for the limited ROM. He suggested that I run a hot bath, take a pain pill and drink a glass of wine and then get in the tub and work that knee. I told him that I read the warnings for the medicine and it said no alcohol and if I had known I could drink alcohol I would have done that weeks ago! He said just make sure I had a way to get out of the tub. He said to come back for a follow-up visit in 4 weeks, but if I wasn't making any progress in PT to get more ROM that I need to come back sooner than 4 weeks. He also said that it was important to get the leg straight - that there were things they could do to improve ROM but there wasn't anything they could do to get the leg straight. I didn't ask him what those "things" were to get more ROM and now I'm wishing I had. It just didn't occur to me at the time.

I was so excited that I could get into my friend's car that when I got home I decided I would see if I could get in my car and drive it out to my road. I live in a rural area so I have a great area to get back into driving without endangering anyone. It hurt but I was able to bend the knee enough to get into the car and drive! I felt like I had been re-energized!

So tomorrow I'll contact the PT place that is right down the road. I really hope we can get this ROM improving! I don't want to know what the doctor's other methods for improving ROM are!

 

[Quasi]

@MathSci4me

Sounds like you had a good report overall! At 4 weeks out my OS was not worried about my R0M as much as he was getting knee straight, but he also wanted me to get my pain under control, it will come, do not worry! It us strange to see something in your body that isn't a real part of it. PT will help you as long as you don't get pushed to much. You drove today?! Good for you, I still have not, I have a long drive to work and still on pain meds, so I am afraid too. But I might try this weekend. After your successful day, it sounds like it would even make my spirits better to just drive down a country road! Keep on doing what your doing, at 4 weeks I was so behind but my ROM is now a little over 120 so persistence , rest and ice have Halle me et there along with the support of so many on this forum,

Keep us in the loop regarding your PT! Best wishes for a good day tomorrow!

 

[Quasi]

@MathSci4me

Forgot to tell you..that thing called sleep....well it can be elusive for quite, some time, so grab it when you can!

 

[Roy Gardiner]

MathSci4me, are you doing your own extension and flexion stretches every day?

 

[MathSci4me]

@Roy Gardiner , I have been doing the exercises and stretches that the home PT had me doing. I can see where my strength is improving, but not where my ROM is improving.

@Quasi, sleep is so elusive! For the time being I've decided not to be so concerned about when I'm getting sleep, just as long as I'm getting it. But I know with school starting up at the end of August, I'm going to need to start trying to establish more normal sleep patterns before then.

Outpatient PT is set to start Friday afternoon. I really hope they can help me increase my ROM in the next couple weeks so I don't have to see what alternative methods the OS has for increasing the ROM. Today I stood in the shower and placed the shower head right on the knee for awhile to try to get that warm water working on the knee. Afterwards I did my exercises and went for a walk. Unfortunately today it was really hot outside so it wasn't a very long walk! Tomorrow I have an early doctor's appointment but when I get back I want to try soaking in a hot bath and working that knee in the water. I may just sit in that tub all afternoon!

 

[Roy Gardiner]

I have been doing the exercises and stretches that the home PT had me doing. I can see where my strength is improving, but not where my ROM is improving.

It's good you're doing stuff at home, many don't!

So I'd ignore strength exercises and concentrate on mobility, see also the BoneSmart view on exercise and how exercise may affect pain and swelling.

 

[Celle]

Hi @MathSci4me

I know I'm coming late to your thread, but I have an article that I think would be a help to you.
Knee recovery - Lose the Work Ethic!!

You see, I think you have somehow been given the idea that you can work on your knee, to make it recover faster. For a recovery from a TKR, that really isn't so. In fact, doing too much can actually slow down your progress.

You'll see in the article I recommend that "No amount of 'working hard' makes recovery happen faster." Your knee will recover and ROM will happen in the knee's own sweet time.

There's also no rush to get ROM, because that story about a "window of opportunity" is just an old myth. It's possible to continue to improve ROM for a year, or even more, after surgery. See this:
Myth busting: the "window of opportunity" in TKR

I do understand the pressure to get back to work, but trying to rush your recovery could be counter-productive.

Oh, and by the way, my surgeon did not allow any formal PT until 4 weeks after my operation. All I was allowed to do was rest, ice, elevate, move around the house, and do a few, gentle exercises (that I was given on a little pamphlet when I was discharged from hospital). My knee is great. I have a ROM of 0 and about 125 degrees.

 

[MathSci4me]

Thanks @Celle! I just feel like I'm so far behind in ROM and it is so frustrating. I've read through several threads on this forum and everyone seems to have had more ROM right after surgery than I have right now 4 weeks after surgery. I don't even think I have 70 degrees ROM right now and to hear that the OS wants 120 degrees or more ROM is overwhelming to me. And when the OS says to come back for my next visit in 4 weeks, BUT to come back sooner than that if my ROM doesn't improve with the outpatient PT is scary. It doesn't seem like 2-3 weeks is very much time to see any sort of great increase in ROM so I'm just going to keep my visit at 4 weeks regardless of what happens in outpatient PT. I had 3 different PT's when I had home PT with varying viewpoints. The 2nd one was trying to scare me into working through the pain by telling me the doctor will do the manipulation on me if I don't have more ROM. I didn't like her very much! I really liked the 3rd/last one because he just said there must be a lot of internal swelling preventing the movement and it was just going to take time for it to go down and my ROM to improve. My first outpatient PT visit is tomorrow afternoon and I'm really anxious about what their viewpoint is going to be.

 

[bottomshollow]

@MathSci4me, cut yourself some slack, girl. You are only 1 month post op---very, very early days. You are 1/12th of the way down recovery road. You still have a long way to go and a lot of time to improve ROM. Right now I'm sure that your knee is still having swelling problems and probably will have for some additional time.

THE SECRET OF SUCCESS with joint replacements is TIME & PATIENCE. We have to have (or find) the PATIENCE to give our knees TIME to heal at their own pace. Nothing else works like these two things and nothing can take their place. But it is a very hard truth to absorb in the beginning of our recoveries.

Recovery is what it is, and it's going to take as long as it's going to take. So be PATIENT and let TIME take care of things with some assistance from you. You're going to have to stop, relax, take a deep breath and go with the slow flow of recovery. You will get there, but it's going to take TIME. The knee is now in full charge of your life. Treat it tenderly or it will make you suffer. Dig deep and find the PATIENCE you need to move slowly but surely toward to goal.

Take care and keep us posted. We care.