TKR Acceptance and Understanding<

[Needhope]

While sitting with legs straight out on couch, I cannot pick up my left leg using leg strength only. My heel will not come off the couch no matter how hard I try. I can’t recall if this occurred with my right leg after that replacement. My left knee/leg has more bruising and is way more swollen than the Right was.

 

[Jockette]

I couldn’t do that either but eventually I could. Relax, it will definitely come back. Don’t try to force it. All of a sudden it will happen.

 

[kayow11]

I also feel angry at your physician for the pain medication restrictions. It is definitely abusive, and just plain stupid with post surgical patients.
When I was doing PT early on with my first knee, I had a lot more pain, and the Oxycodone didn't seem to help much, but since I changed the PT and stopped doing it, and then only mildly weeks later, everything was so much better and the swelling went way down at that point. I suggest putting PT off for now. It was hard to convince me to do this, too.
And adding an ace wrap for some extra light compression might benefit you too. I did mention that in an earlier post. It sure helped me.

 

[Needhope]

@kayow11 i am very angry with him. Prescribing 20 pills (3 days) worth of medication and expecting me, the patient. To be able to keep up with normal daily use as well as the physical therapy I’m going to have to endure, just seems sooo barbaric. I’m ticked off. I don’t think I can do this. I’m also sleep deprived which isn’t helping me. When that PT guy comes tomorrow morning, I’m going to have to somehow let him know that the condition of my knee and thigh and calf is too painful and too swollen to continue without having any pain relief after the sessions. I hate confrontation but the way I physically feel at this point, I don’t think it’s possible for me at this time.

 

[mlwreader]

I hate confrontation but the way I physically feel at this point, I don’t think it’s possible for me at this time.

@Needhope I don't think you have to have a confrontation. Just cancel the appointment. Or if its too late to do that, just tell him when he comes that you aren't up for any exercise. If he starts to argue with you, just ask him to leave. You don't have to explain and "No" is a complete sentence - lol. They work for you, remember that. You are in charge. Good luck and keep us posted.

 

[Jockette]

I agree with what @mlwreader said.

I’m not confrontational either, but I also really don’t like needless pain. He is not the one feeling your knee pain. Just say no and stick to it.

 

[Jockette]

Picture us in the room with you agreeing with you!

 

[kayow11]

Why do you feel you have to continue with physical therapy? You really don't!

You could just call and cancel that appointment to get that off your shoulders for tomorrow. And then think about the advice that many of us are giving you about canceling all of them for now and maybe starting up in three weeks or so. If at all. It just delays your healing when you keep it flared up like that all the time.

It is your decision but I realized that it was best to not do any of that for at least a month after. And that is what I am doing now with my 13 day old knee.
I know what my doctors and some other people say or recommend, I have tried that way and it just makes things worse. I am the one that has to suffer the pain and I can't stand it, so I will take measures to protect myself. No one else really will.
I also recommend, with info I learned from this site, to ice 45 minutes to 60 minutes instead of 20 minutes. It seems to get deeper and penetrate more into all those areas. I am icing about four times a day at most but the Length is much longer.

 

[kayow11]

Try not to worry about your lack of leg strength and mobility at this time.
It is trying to tell you something so try to listen.
It's being abused and you need to take care of it and let it heal.
The strength will come as the swelling goes down.
I know I was concerned about this too, but it is true, that it returns as the knee becomes happier.
It truly is a slow process getting back to your original strength, and it could even take a year, so try not to fret. I have finally learned the hard way but now I am imparting the same advice to others, and especially you right now, since I know what you're saying and I used to feel some of the same things.
Please try to believe us, this is my third time through this and I have learned a lot!

 

[Josephine]

PT started last night,

Needhope, I really need to know the detail of this please.

 

[Josephine]

1. Usually 2 but if walking around or PT 4-5

If your swelling is 'huge' that alone accounts for at lease 4 points of pain on the 1-10 scale. To me, 4-5 is not severe pain.

2. Acetaminophen 325mg 2tablets every 4 hours needed for mild pain - only took 1 325 tab if I took 2 Hydrocodone.
Been rationing my Hydrocodone because I was only prescribed 20 pills).
Hydrocodone-acetaminophen 7.5-325mg ev 4 hours for moderate pain. Max daily 12 tabs

But you're not getting 'mild' pain, are you? And 325mg is such a very small dose as to be hardly worth the effort of swallowing it! If you're going to take it, take an effective dose which is 1,000mgs but don't forget to add in that which you take in the hydrocodone so you don't end up taking more than 4,000mg in any 24hr period.

3. My knee/leg is moderately huge. I’ve never seen it this big before.

As I said above, that's worth at least 4 points of pain.

4. ROM In hospital it was 85/0 yesterday PT measured 80/0

Not surprising given that you are not even two weeks out yet.

5. Icing 5-6 times daily 20 min.
6. Elevating 4-5 times daily, ½ hour

You accomplish little or nothing in 30 minutes. Ice for at least 40-60mins and as many times a day as you can fit in. All day long that you are sitting and doing other things would be good.
Plus, HOW are you elevating? Is it 'toes above nose'? Here's some examples of good and bad ways to elevate

7. Walking inside house at least once an hour. Don’t stand on it too long it gets uncomfortable

Walk in 'as needed' events such as bathroom visits and getting yourself a drink or a snack. Don't just walk for the sake of it.


Ankle pumps 10x of 3 sets - you only needed to do these when you were immobile. Clearly you are reasonably mobile now so no longer need to do them
Butt clenches 10 sets 2x day - these are a very strange thing to do for a knee! More appropriate for hips!
Heel slides 3 sets 10 2x day - I'd stop doing these for a while. They are clearly causing more swelling and therefore retarding your ROM.

My knee feels like it could explode it’s firm skin, not much room in there to bend it.

Yes, clearly you are doing too much - too much walking, too much exercising and not elevating and icing enough. However, it is early days so you must pay more attention to the things I've said.

But I'd agree with Kawo, you don't need to do exercise nor or later. Many of us here never did any exercises though we were reasonably active otherwise with just the usual activities. But if you are concerned about refusing to do therapy, you need to read this Saying no to therapy - am I allowed to?

 

[Needhope]

@Josephine Ankle pumps repeat 10x hold 1sec perform 3x daily
Quad set with towel under heel repeat 10x hold 5sec perform 3xdaily
Gluten set while lying on back squeeze buttocks hold and repeat 10x hold 3sec perform 3xdaily
Short arc quad place rolled up towel under knee and slowly straighten knee as you raise foot up,
Repeat 10x hold 3 sec perform 3xdaily
Straight leg raise repeat 10x hold 3 sec perform 3x daily
Elastic band supine hip abduction while lying on back slowly bring your leg out to the side keep your
Knee straight the entire time. Repeat10x hold 1 sec perform 3x daily
Heel slides laying on your back repeat 10x hold 3 sec perform 3x daily

 

[Jockette]

I would love to see someone who has NOT just had major surgery 4 days ago do all that 3 times a day. I bet they would be very achy with the effort.

What is the rationale for all this.
It boggles my mind.

 

[kayow11]

Way too much exercise!!!!!! Please stop, and listen to what several of us have said to you, the reasons why, and the consequences if you continue doing them.

We are trying to help you. You do have options and alternative choices that have worked for many of us, or we would not have shared them.

 

[sistersinhim]

Please stop all those exercises. All you are doing is keeping your knee inflamed, swollen and in pain. You are setting your recovery back. Elevate and ice as much as you can. Ice is a good pain killer and the elevating will help the swelling to go down. Cancel all PT until you get your pain under control. Your knee is an infant and needs to be treated as such. I would also make sure to never have that therapist again. He/she does not know how to treat a new TKR!

 

[Needhope]

He’ll be back tomorrow 8am. I’ve gotta grow some balls from now until then. I may request the therapist I had last September. He was very kind, gentile, and never forced me to do anything I wasn’t comfortable with. It’s the same company, so they pretty much know each other. But I don’t like hurting people’s feelings, gosh this is hard.

 

[Celle]

But I don’t like hurting people’s feelings, gosh this is hard.

I know it's hard for you, but you need to speak up on behalf of your knee. Your job right now is to look after your knee and yourself, not your therapist's feelings.

Remember that it's your knee and you are the only one who has the right to say what happens to it. Your PT works for you. You pay his wages, either directly or through your insurance, so you are the boss.
If you say "No. I don't want to do that" he has to obey your wishes. Nobody has any right to do anything to your body that you don't want. NO means NO.
Saying no to therapy - am I allowed to?
CONSENT: what it means and how it can be used

 

[Mutti3]

If you take care of your knee “today”and your knee will reward you! You will not hurt the therapist feeling to stop his visits. But he needs not to hurt you.

 

[kayow11]

At this point with all of your increased symptoms, you don't need ANY EXERCISE for at least 3-4 weeks. Even a more GENTLE PT is still likely too much in your condition.

Try to remember what just happened to you, and what was done during surgery. It's crazy to expect anything from it.

You are causing more harm than good to force your knee to exercise at all, until it settles down a lot, which will probably take several weeks.

 

[Needhope]

I had PT. He measured Rom 89. We did a few exercises but I let him know when I had enough. He gave me another paper with more exercises to add to existing ones. I put it on a pile. I have no plans doing them right now. I called my surgeon for pain meds. Waiting for a call back. The acetaminophen I took this am didn’t do squat for the pain. I’m trying to maintain my composure but it’s getting harder not to let a few tears fly.