Bilateral TKR 7wks post op

[KTF]

@chandler Thanks for checking in! How lucky you are to have people willing to try things. I have not found that yet. My left leg is a champ! 122 rom, assorted aches and pains...sometimes night time on outside of knee is ugly...but otherwise, I'm good. The right knee is stopped around 96-100, depending on day, and it is only because of protecting it from that excruciating nerve pain. I just cannot hold it too long it a flexed stretch for fear that it snaps...sometimes by accident I go too far and boing!!! Is your leg stuck? I'm really not attached to it going fast (anymore), I'm just afraid of that pain. Most med professionals agree it is scar tissue around a nerve or whatever that looks like. I'm not getting creative solutions. My OS is reluctantly willing to manipulate it, but he is a lousy communicator, and condescending and does not seem attached to me fixing this. He believes if I am unwilling to push it through this pain and break the scar tissue I should just get used to less than 100 degrees! I will not be going back to see him...but would consider talking to someone else about manipulation. Has anyone suggested it to you? Kris

 

[referee54]

I had a BTKR and my left knee was the angel and the right knee was the juvenile delinquent.

I also had scar tissue in both knees, so I had a choice of doing MUA's or taking care of it myself---and I did the latter.

I would say, though, that, at this time, it is still somewhat early to consider an MUA---I would like to see you get a second opinion about this and get a fresh point of view as to what your options are---not only now, but down the road.

Most med professionals agree it is scar tissue around a nerve

What about seeing a neurologist?


I hope you can find somebody who can give you the correct directions so you can get back to the normalcy in your lilfe that you deserve so much.

 

[KTF]

Tim, how caring you are!!! This site is awesome.
Please tell me how it went for you with your juvenile delinquent. I've said that I'm willing to wait as long as it takes to get better ROM in my right, however, this nerve pain is frightening, it stops me. I wish someone would tell me that it will take care of itself. My doc says that in time it will hurt and I will not get improved ROM if I don't push through this...he's out of his mind!!
Did you get satisfactory ROM? I really am determined to get my rt to be the same as my left (122 so far).
A neurologist, hmmm? I'm about to go see an orthopedist doctor friend who no longer practices in that capacity, but is very caring...I need that.
I seem to get conflicting info on MUA's...some say it is early,and others late????
Thanks for checking in.
Kris

 

[referee54]

Please tell me how it went for you with your juvenile delinquent. I've said that I'm willing to wait as long as it takes to get better ROM in my right,

It took me five months to lose a limp---albeit a little one, but I had my surgery in the first part of November, and it was not until the middle of April when I noticed that the limp had gone bye-bye. I also went back to the classroom too early, and that also slowed down my recovery, too.

Did you get satisfactory ROM? I really am determined to get my rt to be the same as my left (122 so far).

I had scar tissue, and I was told either an MUA on both or that I deal with them myself---and that is what I did. My ROM now is about 130, and I can almost squat down like a catcher---not quite---but my recovery ultimately took eight months or so. Looking back, at six months I was at about 80%-85%---at eight months I was at 90%-95%. It was not until August or so that I could say that I was back to "normal."

I will tag @Josephine and @Jamie to tap into their wisdom---an MUA is not a sign of defeat---some will tell you that it is just another step that some need to take to get to where the want to be---but I think that it is a little early for you to consider it---but I will let Jamie and Josephine weigh in on this.

 

[chandler]

@KTF, when my therapist was working on the spots giving me trouble, it was uncomfortable, but bearable because of the hopes that it would help. He said that a deep tissue massage by a person familiar with knee replacement would be an excellent option, especially because they could take more time than the typical 10 - 15 minutes the therapist can give. They usually have me doing strengthening exercises for about 30 minutes, and then massage and stretching for the last 10 - 15. I am sort of tempted to see about an hour-long session with a local person in our little town who was highly recommended by the therapist.

I believe the surgeon's attitude is that once he finishes and we go to our 6 or 8 week followup, they are done (assuming we don't have a mechanical problem). I think once they turn us over to physical therapy, they pretty much don't want to deal with pain and scar tissue matters, etc.

If you are still doing physical therapy, maybe you could discuss it with them. Otherwise, I would highly recommend you call around and find someone who knows what to do with scar tissue. Again, they shouldn't cause you excessive pain....but if they agree that your problem may be related to scarring, they might be able to break it up for you.

Best of luck! Every time mine snaps, I remember you! And some days, it is pretty often!! lol

 

[Josephine]

I noticed that everyone seemed to remark that I'm doing too much. That is odd for me to hear as I feel like I really am not.

Perhaps if you would be kind enough to respond to the questions I left you in post #38, you might get some answers!

 

[Jamie]

Two months out is early for an MUA. I suggest you give yourself at least another month or so.

It seems as though the fear of getting this pain is limitiing you, though. Could it be that you are babying this knee too much thinking the pain might come? You should still be doing gentle bends and stretches with at least some discomfort several times a day.

Can you tell me the exact site of your pain using this chart?

Having this information plus the answers to Josephine's questions will help her provide a better response to you.

I think at this relatively early stage in your recovery, you will be hard pressed to find another surgeon to give you an opinion. Most are going to tell you to give yourself some more time.

If you opt for an MUA, please do not fear it. You will be asleep and not feel the movement. There can be some pain afterwards that is treated with pain medication, but it is nowhere near what the TKR brought you.

 

[KTF]

Hi @Jamie , no I'm not babying this knee. In my exercises I take it to its limit on stretches, the limit being (hopefully) just before the 'snap' occurs. I will hold it there. I also use stair climbing as a way to take my knee to it discomfort level several times a day. Also cycling will take it to its limit. I am almost at 3 months post op, if that makes a difference. Rf1 at about D is where the snap appears to happen.
@Josephine , I missed this request or thought it was the first time you requested it back in #1 and #2...I will update my answers:

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!

)
During the day my pain ranges 2 -4 depending on activity. At night, when I settle down in bed, I sleep with my legs elevated. I sometimes get pain in my L knee on the outside that hits a #7 or 8...then it settles down. The pain mostly feels like heavy legs and tired if I'm not laying down or sitting.

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?
I am taking a combination of celebrex, tylenol and norco. I take 2 celebrex, 1 in a.m. and 1 at bedtime. I take norco on an as needed basis...usually 1 1/2 at bedtime and 1 mid morning and 1 mid afternoon. I take Tylenol, 625 mg - 1 in morning.
3. how often are you icing your hip and for how long?
I ice when I awake, and before I go to sleep. Also midmorning, mid afternoon. Usually for as long as the packs stay cold, 20+ minutes.
4. are you elevating your leg, how often and for how long?
Yes, usually everytime I ice and while I sleep.
5. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and
My current level of activity is mild activity until about 9 to noon or 1, and as often as possible I lay down all afternoon with my legs elevated and up for a short time around dinner and back down. I do floor stretches in the evening.
6. 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)
I have been doing PT twice a week for 1 hour, cycling, shuffle pushing board and stretches. At home I use a floor cycle for about 10 minutes to loosen up in the morning and the majority of my exercise is walking around house (big house) and up and down stairs (3 story house!).
Thanks.

 

[Josephine]

During the day my pain ranges 2 -4 depending on activity. At night, when I settle down in bed, I sleep with my legs elevated. I sometimes get pain in my L knee on the outside that hits a #7 or 8...then it settles down. The pain mostly feels like heavy legs and tired if I'm not laying down or sitting.

Oh my!

I am taking a combination of celebrex, tylenol and norco. I take 2 celebrex, 1 in a.m. and 1 at bedtime. I take norco on an as needed basis...usually 1 1/2 at bedtime and 1 mid morning and 1 mid afternoon. I take Tylenol, 625 mg - 1 in morning.

I need to know how many mgs and at what times. Sorry to be picky but I cannot help you otherwise - not being a mind reader and all that!

I ice when I awake, and before I go to sleep. Also midmorning, mid afternoon. Usually for as long as the packs stay cold, 20+ minutes. Usually every time I ice and while I sleep.

You get nothing accomplished in 20mins of icing or elevating. Do it longer.

My current level of activity is mild activity until about 9 to noon or 1, and as often as possible I lay down all afternoon with my legs elevated and up for a short time around dinner and back down. I do floor stretches in the evening.

Mild activity like what?

I have been doing PT twice a week for 1 hour, cycling, shuffle pushing board and stretches. At home I use a floor cycle for about 10 minutes to loosen up in the morning and the majority of my exercise is walking around house (big house) and up and down stairs (3 story house!).

Honey, you're telling me nothing! I need to know exactly what you are doing.

Full name or description of exercise and how many reps, set and sessions.Also how many times a day.

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.

 

[KTF]

@chandler, sorry I dropped away for a while! Want to check up on the "Snap" in your leg and let you know where I am with my 'snap'. I finished my formal PT a month ago with 120 on my Lt leg and 95-100 on my Rt leg. My Rt leg had that 'snap' that felt like a knife going through my leg. My PT's were at a loss and suggested a consult with the OS...my OS basically said that if I couldn't PUSH through this pain that I could live with 100 degrees of flexion! I won't see him again! I left Kaiser and went to my Osteopath (outside of my insurance system) and here is where the story changes. One manipulative treatment with the Osteopath and I got up from the table and the pain was GONE and I had an immediate 15 degrees or so more flexion!!!! He manipulated the muscles from the knee to the ankle around the fibula (hurts!) and stretched my hip greatly....HONESTLY....I had instantly more flexion and NO PAIN. I am now able to do all the stretching I couldn't do on my rt leg. I went back to Kaiser PT last week to get measured and to tell them how I was....they were shocked and thrilled. I measured 135 in my Lt leg and 125 in my Rt leg.... I am feeling so amazingly encouraged. I still have a lot of surgical pain and my rt leg still has pain around the knee cap still does not feel as healed as the other, but I am doing so well. Sometimes I seriously overdo because I have so much more energy and so much more hope and I can see the light at the end of the tunnel. I forget how tired I get, how much things can still hurt. I am now at 4 months and filled with hope. I am going to write letters to Kaiser about this and heavily suggest that manipulation be added to the mix of healing when pain and lack of movement is unexplainable and the usual isn't cutting it. Maybe you??? Let me know how you are.
Kris

 

[kneeper]

It's great that this worked for you. Was it tight muscles?