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6 weeks after TKR

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lyn

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I am at 6 weeks today and I still feel lousy but my knee seems to be doing well, I can't afford PT with anyone so I do it myself but I wonder if i am doing enough and doing it right, I see folks say they do PT for hours I do like 15 minutes a couple of times a day, my knee bends way back just fine and I really work on the extension, and I walk a couple of times a day, low energy is my biggest problem. I wonder if I am doing enough, my Dr. said when I went to see him at 3 weeks just keep working on extension. all seems well but now i am concerned. Lyn
 
15 mins a day does seem a bit low, lyn. I would have thought at least 2 hrs a day in total.

Now as regards the low energy, you are only 6 weeks! I seem to be continually surprised at you American ladies. It seems like you all expect to bounce back after this op like you've had an ingrown toenail removed! It's a major, major op which perforce, has major, major consequences so far as taking the stuffing out of you goes! It takes a lot of time to recoup from that and 6 weeks is early days! 3 months is early days! You need to up the exercise but also up the rest and relaxation. You still have a lot of healing to do!
 
Dear Josephine--I am at the four week mark, and I am very discouraged. I had my surgery on December 19 and went home on Christmas Day. The first two weeks, my knee and foot were so swollen that it was difficult to move them at all. I had a therapist come to my house three times a week to try to get the knee moving better. During weeks three and four, I went to outpatient physical therapy for one hour every day. I also starting going to the gym everyday, walking around the block, and riding a children's scooter. Next week, I start going to physical therapy 3 days per week. I am working so very hard, but my knee still only bends to about 90 degrees. I do have full extension, but I can't bend my knee enough to sit really comfortably in limited leg space. I can go upstairs somewhat painfully, but going downstairs is out of the question. Does this seem normal for 4 1/2 weeks after surgery? My therapist said that there is a six week window after surgery where improvement is fastest. After that time, scar tissue will build up and make it harder to improve the range of motion of the knee. Is this true? My improvement so far is moving very slowly. Do you think I will ever get to 110 degrees of extension or be able to go downstairs with two feet, instead of like a little kid? How can I make this happen? Some days, I just get so depressed because I'm not seeing much progress, despite a lot of effort. I am 58 years old, and I was in fairly good physical condition before my surgery. I am average weight for my height, and I like to be active.
Am I being unrealistic to expect better than 90 degrees after 4 1/2 weeks?
 
My goodness, you ladies do expect a lot of yourselves! So many have asked this question and expressed disappointment that they are not improving as quickly as they had expected.

I just say this - this is MAJOR surgery you have had. 4½ weeks is nothing! Give yourself a chance to recover and to heal. By all means be active but make sure you intersperse that with plenty of rest, elevation and icing as well. I cannot stress this enough. You can't expect a knee that has been subjected to surgery to cope with all that activity without it.

Sadly, your physio is correct and it may be that you will need a manipulation to break down the excess scar tissue that is preventing better flexion. It's not an uncommon occurrence so don't fret about that. Has it been suggested you use a passive range of movement machine? If you read around the threads here you will find other people telling how beneficial they have been. I believe you can hire them.

So far as the stairs are concerned, I'm afraid that will take a bit more time yet, maybe even a few months. You may find it easier to come down sideways rather than face on.

One other little pearl of wisdom I impart is to tell you how there is always a period - around about now for you! - when you hit this plateau in your progress. You spent weeks looking forward to your surgery, hopes high that you would soon be able to hit the road running. Then the day came and you had lots of attention and everything became very intense. But now you are are on your own, doing the best you can and suddenly realise things aren't quite as you had envisioned. It seems like things have ground to a halt and you're not making any progress. Nothing is happening. But you couldn't be more wrong. There is still a lot of healing taking place. Deep healing of bone and tissue. Your leg and, indeed, your body, is adjusting itself to the realignment of your knee and the bone is healing around the prostheses. This all takes time - around 6-10 weeks minimum - and it's hardly surprising that people tend to get depressed and disappointed. Everyone does get this way at about this point and begin to believe that nothing is happening. But my suggestion is that you keep a journal. Work out a system of grading different things perhaps; a good day be 5 and bad day 1, and so on. Just make brief notes and as you look back, you will be amazed at the progress you are making.
 
I just found this board yesterday and wish I had found it earlier. It really helps to know that other people have the same struggles with recovery that I do. I am 6 weeks and 4 days PO from TKR and I have only 86 degrees flex un-aided. The PT and the doc (and me too for that matter) are concerned and unhappy with my ROM. Therapy is so painful that I yell and the tears roll everyday, but they tell me that is all part of the process. I thought I was a pretty tough guy until I went in for therapy, but this stuff will take every bit of pride and self esteem away from you. I don't really have any advice to offer you because I am struggling with the same problem, but I can tell you that you are not alone. Someone in another thread said they "were not mentally prepared for this surgery and the recovery", neither was I. All I was told by my doc was how good I would be after the surgery, just a 4-6 week recovery and be good as new. Well, if I could turn back time, I would not have had the surgery at all.
 
I came home with a CPM machine. Ask your Doctor for orders to have one at home, or ask your PT about it. I know most insurance companies will cover it. It really helped me with ROM.
Debbi
 
I had the CPM for the first 15 days, but then it had to go back. It wasn't working very well anyway. It wasn't strong enough to bend my knee past 90. The machine would seperate from my leg instead of bending it. I started with a home health agency for the same 15 days and I think that was all wasted time. The therapist I am going to now is MUCH more aggressive but the pain is terrible at this point. I would recommend anyone to go straight to an out-patient therapist and avoid the HH. Thanks for the reply.
 
hi, just knowing we aren't alone in our struggles is reassuring...i'm 4 wks out today and the pain is still so much more than intense.......i ,too, cry like a baby every single day and wonder why i ever did this......but we've got to be strong and get our lives back...i've set my goals and booked a plane tix for April ..... i plan on walking through the airport , on my own, pain free.......i plan on sitting on the beach , drink in hand, watching the sunset....i vision it when i'm crying , and i live it when i wake up 10x every night ftom the pain......we have to do this...there is no choice......life has no do-overs so we can't go back and say no way.....we go fwd and hope that next year at this time the pain is but a distant memory.....(we can hope, can't we?)......
 
I have to remind myself of how badly I hurt prior to the surgery. I have always worked out and practiced various martial arts. This last year or so I sat around and packed weight on Now, it is a different pain but one that I know I will eventually whip...Hopefully I will be able to get back to practicing Kenpo on a limited basis.
 
I'm 5 weeks post op, today. I went back to work today (worked for a half day)...OH MY GOSH it was hard! I'm a bookkeeper and some computer/accounting work and banking HAD to be done. My body has put all of it's energy into healing and has left me with a deficit! My knee has swollen - is throbbing - I can tell I over-did it. I'm lucky that I have an office job!!! People that are up on their feet all day have my deepest sympathies!

Baby Steps, people. We're taking baby steps toward a "pain free walk"...


I'll take some meds....PT.....ICE....cook supper for my boys and get up tomorrow and try it again!
 
Bsassy: I hear you and share in your thoughts. Funny thing about this message board is I seem to be able to relate to everyones situation...I wonder how you guys are when im feeing good, bad or just blah! I think if we all keep our focus on whats ahead, we will be ok!
Thanks,
Chuck
 
.....(we can hope, can't we?)......Yes, we can!!!!!!!!! All we need is a goal and the determination to acheive it. Thats taken from a picture in front of the Treadmill at my PT office. Maybe its there for a reason??
Respects,
Chuck
 
Hi Gatiger and welcome,
I am at 5 weeks, if you have read any of my previous posts, you will know that I was in your boat. I hated therapy I almost decided to stop as every time I went, I felt like it set me back, not helped me. I expected it to have pain, but not overwhelming that I had to break down, I expected my muscles to be sore, haven't used them in 10 years!
But I didn't expect to have a PT ignore the fact that I was so uncomfortable that I couldn't take it. Then my miracle man came along. He works at the PT place, I have mentioned him numerous times, his style is different. He massaged my knee, talked to me about other things while doing it, did stretches that pushed me but not into tears. I am not kidding within 3 days after switching to him as my PT, my back stopped hurting, my knee swelling started to go down, my ROM started to get better. I stopped being so tense. You absolutely cannot get better when you are in so much pain that your body just tenses up at the thought. I can so relate to what you are going through as many of us can. You must do the PT of course, but maybe just maybe you should search for a different one that has a different method. I have far more results this past week than I could have hoped for the week before as I was up all night in pain, worrying about taking so many meds. Rethink it. Who cares if you get up all night, just go with it. Find something to do when you get up. Get out the frozen bag of peas, watch tv, find a comfy spot to rest, maybe your sofa instead of your bed, read, cross stitch, whatever.
Do some stretches on your own, not huge, not painful, little itty bitty ones that help relieve the tension.
You can rest assure that not one of us was prepared for this. The doctor never told me that it would be like this. He said I could drive at 2 weeks (yeah, right if I could bend enough to get into my bonneville) he told me I could go back to work after 2 weeks, yeah right if I could stand, sit, walk without crying or concentrate for 15 minutes without being exhausted just getting into the darn building. Of course it was allowed, so I thought I should feel good doing it...ha ha. You just aren't ready for it and it takes some adjustment emotionally. If I wouldn't have done this one and if I don't get my second one done in a few weeks, I would be talking wheelchair at 54 years old. Now that is depressing. We have a second chance. We don't have a disease that will not allow us to get better. We made the choice to have this done for a better life. It would have helped maybe if the dr could have filled us in a bit more, but I guess if they would many would opt out.
I found improvement when I stopped worrying, when I decided to just take the darn pain meds on schedule, found a better PT and I have decided that if I am walking without pain one year from now, this was all worth every minute.

Good luck and stay with us. We need each other. This site has changed my whole attitude. I found it in the middle of the night, barely able to sit at my desk in so much pain, tears rolling down my face, my husband couldn't help me, I was so depressed and then I found friends. And you can talk, me too much, but peopel read it and listen and understand. We will help you get through this.

Kath
 
Kath, my doctor okayed me for 12 weeks off and I thought he was crazy. I was sure I'd be back in 4... my doctor was right. His assistant had bilateral TKR 18 months ago and she was great at setting my expectations. I knew it would be painful, but I didn't realize how long it would last. I now totally forget to take my pills, then realize I'm in pain and need them. I get frustrated that I'm not totally healed yet and I'm still fairly depressed off and on (doc said probably meds are causing a lot of it). I burst into tears for almost no reason at all. My family has been great tolerating me. They don't understand but they do support me. We'll all get through this. I found this site at about 4 weeks PO and wish I had found it earlier. I passed the URL along to my doctor so he could help others help themselves. It is such a Godsend to know we are not alone in our suffering or in our accomplishments!

Skeet
 
Thanks Kath and Skeet. I went to PT today and showed the web address to the therapist. I told him that maybe it would help some of the other folks that come through. I know exactly what you mean about PT setting you back Kath. Tonight my knee feels as painful as it did my first night home from the hospital. The inner part of my knee feels every heartbeat and burns like I was in a fire. The therapist said it bent further today than it had and he said he was 'encouraged' by that. I really couldn't talk at time as I was sitting on the table crying like a child, but I damn sure hope he is right. Any how thanks for the thoughts.
 
Well, I am at the start of another fun filled up and down night. I bet I check this site 6-8 times a day just to see how everyone is doing.
You know what I just read.
I read about a bunch of folks with determination. Just think of it. You let someone hurt you and you go back for more! I read where if something doesn't work you take a different route but you still keep trying to move ahead. Don't cut yourselves short. I see a tuff bunch of folks. Hang in there folks.
 
Couldn't have put it better myself, Doug! The camaraderie in here is truly awesome! Truly, truly!
 
Thanks Doug. I'm more 'addicted' to this board than I will ever be to the meds. Sometimes I think it helps as much if not more. My knee is as stiff and sore this morning as it has been in the last 4 weeks. Last night I could barely walk after all the 'help' I got at therapy yesterday. But I got up today, and took my half mile walk, a little slower and with a little more than I gotten used to, but I made it. I'm trying to push on today, probably not as strongly as some of you supermen would be doing, but I am determined to not quit. Hell, I've been through too much to quit now.
 
Gatiger,
I had a couple of very good workout sessions yesterday. Everything went great.
I was going to drive to the coast today and play with my new camera I got for Christmas. Too overcast.
I decided to go to the mall and walk for exercise. It was terrible. I didn't think I was going to make it back to my truck. I walked for and embarrassing 12 mins. I was shaking like a leaf. Got home and took two pills and wrapped ice all around the knee. It really surprised me that I couldn't walk more.
So, since we are all pain loving individuals I now have a new goal. I will add mall walking every other day. I got 12 mins. today. Next time I'll go for 13!!
Oh well, I need to stop. The screen is starting to get blurry.
 
Well guys,
Today was a good day, a long tiring day, had to spend 3.5 hours sitting in my car due to running my daughter and her family around due to car problems, really bad weather here in PA, I was so stiff when I finally got home, didn't know if I could get out of the car by myself! But all in all I am doing pretty good. I worked all day too, mostly at my desk but I was working. Only had to take meds 2 times, but no PT today....tomorrow a new day. I think tonight I might be able to sleep, but if not I will be back on this sight with my friends, just hoping someone is up with me.
here's to a few pain free hours for all.
Kath
 
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