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TKR 9 weeks post TKR

@Silvernail02 it sounds like you have your system down and know what works for you. That’s such a great feeling to make progress and it seems your numbers are showing that. Continue to be in charge of your treatment and do what you feel is best for you. Each day is another day toward your goal. Good job!
 
4 weeks and 2 days post op. I had my 3rd PT session. My flexion increased 5 degrees and I am 3 degrees to 0 in extension. I still can't do a straight leg without a little assistance at the lifting part. Therapist wants me to at least one next week when I return. When i try to lift my knee bends, i can't lock it straight because it hurts. I have to work on building my quadriceps still and getting my extension to 0 degrees. Otherwise everything pretty good. I still can't sleep more than an hour and a half without waking up from pain, then I reposition myself. I can lay on either side, but an intense deep ache wakes me up. I have weird clicking noises sometimes, I am told that is normal, but it's weird. I continue to have intense episodes of aching pain in my shin and thigh bone, I hope that goes away soon. I have a desk job but can't tolerate sitting with my feet on the floor for more than hour or so before I have to walk around. I am still needing 1 Norco a day for pain but want to be off them completely by next week.
 
You're really doing incredibly well.
There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

Similarly, there's no deadline for being able to do straight leg raises. If it still hurts too much, don't do them yet. Your knee isn't ready for them and that pain is a warning sign. Your quads will gradually get stronger, but it's still a bit soon for doing strengthening exercises for them. Your knee is still in the early stages of healing, and it's wiser to leave strength training until about 3 months post-op.

I think the pain that disturbs your sleep is a sign that you are doing too much for your knee. Cut back some of the exercises. You have all the time in the world to increase ROM and recover strength. Don't be led into over-exercising in an attempt to meet your PT's requirements. While quick results may look good to her/him, sometimes they aren't so good for your wounded knee.
 
You are 4 weeks into this 52 week, on average, recovery. Your extension will come in time. It’s way too early to worry about it. Actually only 3 degrees from straight is really good, especially at only 4 weeks. Your PT wants perfection and she’s wrong.

Same with the leg lifts. Stop worrying about it and stop trying. It will come when it’s ready. Mine did, and I didn’t “work” on it, daily activities is all I did for it.
 
@Celle , thank you. I am feeling frustrated because I am doing pretty good then I went to PT and he had me put my leg straight and out one hand around my ankle and pushed the knee down to 0 degrees, held it for like 10 seconds. He did it 6 times. It wasn't excruciating but it did hurt. He said working on getting it to 0 will help everything move easier and without pain. Needless to say, I took 1 pain pill before PT and about 2 hours after PT I needed another one cause the pain was too much. I am actually going to cancel next weeks PT session and go the following week. This morning it is quite painful in a way I hadn't had before, I am like 100% confident it is from his pushing it down. It's pretty frustrating because on the one hand I would like to do things the bone smart way, on the other hand in order for my work to continue to approve my short term disability/FMLA past 7 weeks they require my doctor notes and PT notes, so if I show I am non compliant, they can potentially say, ok back to work now. I have a desk job at home, but I don't want to return to that at 7 weeks. My doctor gave me 12 weeks, but my work does independent medical review to determine if I can possibly return to work like 4 hours 3 days a week and increase it. That is stressful cause I just want the full 12 weeks to recover.
 
@Jockette , thank you. See my response to Celle. I am not worrying about the straight leg raises, but for compliance issues with returning/not returning to work, that worries me. So I continue to follow PT instructions, but I modify most if the home PT stuff so that I have no pain with those exercises. It's that once a week, 30 minute PT visit that is painful, and then gives me increased pain that day and next day.
 
I’m so sorry you are locked into a work thing connected to insurance.

Be very honest with this PT about how much pain that last session caused you and ask if there is something different you can do.

You know that pushing down on your leg is bad for it. And, I would think your surgeon is a higher authority than the PT, so maybe ask him to give the PT different orders.

I know it’s a very difficult balancing act when your job makes the rules and controls the payments. :console2:
 
Silvernail02 said:
@Celle , thank you for your response. After reading the myth busting on addiction I would change the wording I used to fear dependency. I think as long as I do the weaning it shouldn't be a problem.
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Same here. I've seen references to that article multiple times, but finally read it today (sooo many good articles on this forum...hard to keep up sometimes). I now realize I was/am afraid of dependency, not addiction. Big difference. While I feel like I probably could take one now or then because of the pain, I feel like I've done without for long enough at this point to just keep that up.

Good luck @Silvernail02
 
@Jockette ,yes it's really pretty unsettling. SDI approved the medical certificate and has me off till 11/25/18, which is awesome. But my work only approved 6 weeks. Plus 1 more week then wants notes. I was like, ok, I am only requesting "time" from work, no PTO, no additional benefits just time and if the state accepts the medical certificate for 12 weeks off and they are paying me, why in the world can't you just approve the 12 weeks short term disability? Well, nope they won't till they see notes and even at that they extend like 2 weeks at a time and want more notes. Totally sucks!
 
Silvernail02 said:
@Rhodyrhody, how long did you take pain medication before you stopped needing it for pain?
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I took it daily from my surgery date of 9/11 until 9/20. Was taking it 3-4 times a day, usually just one (they said I could have two) and varying stretches of time...anywhere from 4 hours to 7 or 8 hours. That night (9/20), I got some kind of stomach bug and was up all night. The next day, I felt like such **** that, I wasn't even thinking about the pain in my knees and didn't take any. But, then THAT night...I had the worst ever case of the sweats. It was like I had taken a shower and couldn't find a towel. My OS ofc told me it was likely my body withdrawing from the oxycodone. I just made the call at that point that I wasn't taking it anymore.

There's been some painful times where it would have helped, but I just decided I didn't want to deal with those.

Would stress that 'everyone is different.' Would also stress that I am no 'pain hero'...(I get all amped up at the thought of just having blood drawn) while "I" feel like I've had some really painful days since...others might not have considered them painful at all. I think I've been pretty fortunate so far (retd to work half days this week - I also work at home). I also think God may have given me some minor illnesses (the aforementioned stomach issue) and the current sinus infection, to make sure I don't get too rhowdy. :wink:

Outpatient PT eval on Monday...we'll see how it goes!
 
@Rhodyrhody , that is awesome you only took pain meds for such a short time. I don't like taking them and the fact that at some point in 24 hours I need a pain pill. I am looking forward to not needing them at all!! Unfortunately for me NSAIDS are a bit if a problem. I had gastric sleeve 5 years ago and they do not recommend taking any NSAIDS because of risk of ulcers and I only have a small sleeve for a stomach. So I am limited for pain control.
 
Silvernail02 said:
@Rhodyrhody , that is awesome you only took pain meds for such a short time. I don't like taking them and the fact that at some point in 24 hours I need a pain pill. I am looking forward to not needing them at all!! Unfortunately for me NSAIDS are a bit if a problem. I had gastric sleeve 5 years ago and they do not recommend taking any NSAIDS because of risk of ulcers and I only have a small sleeve for a stomach. So I am limited for pain control.
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Just my personal opinion, but the oxy is about the only thing that has provided me with pain relief. As the advisers to this board say tho, if you need them, you need them. My personal experiences with Naproxen, ibuprofen, tylenol, etc...have been that they don't seem to really help me. I'm supposed to be taking acetaminophen now "as needed", but I often 'forget', as I don't think they even help.

A this point, I'm kinda taking the approach that as long as I don't do anything to hurt them, they'll likely feel a little better each day (or most days anyway). Hopefully, you're finding an effective solution that makes you comfortable.
 
@Silvernail02 is your TKR a result of a workers comp case? If not and your doctor has you out for 12 weeks, they have to let you out that long. Short term disability can require the things you said but worst case scenario is they decide to stop paying but you still have up to 12 weeks off. It’s your surgeon who decides when you go back to work not short term, they just pay you and your job cant send you back, it’s the surgeon
(Info from my husbands business administrator aka HR person)
 
@InkedMarie , actually it is not work related at all. The state disability already approved me 12 weeks and they are paying me. My work HR has an LOA department. I went on short term disability concurrent with FMLA. The LOA department approved only 7 weeks not the 12 weeks my doctor wrote a medical certificate for. Short term disability LOA from work is just time, they aren't paying me anything, state disability is paying me and already approved 12 weeks. The LOA department said they do their own review with criteria for leave of absence. If they deny it then FMLA is also denied and even though I could choose to stay out the additional time, I would have no protection for my job an then could potentially be terminated. That is if, when they get my notes and feel based on them that I can return to work even less hours to start off, they will deny my request for extension of leave of absence. It's kind of crazy. Like I had mentioned in earlier post, I am only asking my work for short term disability time. They aren't paying me, state disability is paying me.
 
Hi all today is 5 weeks and 3 days! Had my 4th PT session Thursday. I was in a bit of pain going to PT and was limping a bit. My ROM decreased from 110 to 105 and my extension went from 3 to 5. A little setback that I am not concerned with because I was in pain prior to starting PT. So my therapist said I am doing great and added some quad exercises to do every other day. I stand sideways on the stair, bad leg on the stair and hold on to rail.my good leg candles off the stair and I use my bad leg to lower myself down a bit to touch my toe of good leg on floor, then touch my heel to floor. 10 sets to toe 10 sets to heel. Yeah, that evening was horrible quad pain. Not doing that for now. I get this strange tight bandlike feeling across the knee and just below. Not really pain, but it feels like a fat rubber band around it. Feeling a little down because I wasn't limping much weeks 3 to 4, now week 5 limping and more pain. I will elevate, ice and rest more to see if that helps. Frustrated to be going up, then now going down.
 
Silvernail02 said:
My ROM decreased from 110 to 105 and my extension went from 3 to 5. A little setback that I am not concerned with because I was in pain prior to starting PT.
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You're sensible not to worry about your ROM. At only 5 weeks post-op, even 105 is terrific.
Remember, there's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

Silvernail02 said:
I get this strange tight band like feeling across the knee and just below. Not really pain, but it feels like a fat rubber band around it. Feeling a little down because I wasn't limping much weeks 3 to 4, now week 5 limping and more pain. I will elevate, ice and rest more to see if that helps. Frustrated to be going up, then now going down.
Click to expand...
That tight band feeling is pretty normal and I'm afraid it could be with you for quite a while. This article explains:
"Tight band" feeling across the front of my knee

Recovery isn't a straightforward linear progression. It's full of ups and downs, like a roller-coaster, and sometimes you'll feel as if you take 2 steps forward and one step back. That's all normal.

Complete recovery takes a full year, although you'll feel much better long before that.
 
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