TKR Am not dead!

[Ms.fixit]

Feeling nervous... I could use some reassurance that I'm doing well, here in week seven.

So! My energy levels are really good and I find myself becoming more active, though I still sleep 2 hours each afternoon and I'm sure to rest often when I do stuff around the house.

I feel like myself again, and I get glimmers of my life to come without arthritis. I am voluntarily tapering down on my Oxycodone, since I hardly need it. Most of my remaining pain is the Sural nerve and Oxy doesn't really help it to begin with. The new knee itself is feeling more at home and my leg muscles are beginning to forgive me for what they had to go through

I do PT on my own each day, and go in for "official"PT once a week(I have a $45 co-pay every time I go so I can't keep going much longer..I'm self employed and haven't been working much in this economy and not at all since before Christmas..).
I am just shy of 90 degrees ROM. That's okay, right, at 7 weeks? I did a Fluidity workout twice this week and can almost bend enough to go down stairs normally. Going up is pretty normal looking. I can stay on my feet without pain for an hour.
I want to be free of Dr. and PT appointments, and I know when I go in today for PT I'll get the song and dance about how slowly I'm going, and MUA would be so great..when I KNOW it's bull.

I keep re-reading the post "it's never too late for more ROM!". But whenever I get to the end of my current range of motion, it feels like I'll never get past that resistance, like the knee will always be stiff. I don't make progress that often.. I remember that my range of motion when I left the hospital was 75 degrees, so I've gained about ten degrees in the time I've been home. So can someone please pat me on the head and "there there" me? Thanks.
I'm a bit angry with myself for letting people cause me to doubt my intuition on this, then I'm like ,'wahhh Mommy, the Doctor is scaring me!.
I think one of my worries is that if I run into problems with my implant down the line, the Dr. and insurance company will say it was my fault for not having MUA. I haz a big nervous.

 

[Recycled]

Ms Fixit,
I commend your bravery for standing up to your Doc. But, try to maintain a open mind on whatever might help your recovery as well. Fear can lock you into a path that could in fact impede your ability to gain the range you want. You talk of the control group..........In my case I did have that comparison. I had my left knee done first and the recovery was typical and uneventful. Through rigorous PT on my part, I was able to achieve excellent rom in an acceptable amount of time. Feeling very relieved, I was looking forward to my right knee TKR just 30 days later. For reasons, still unknown........same Doc, same procedure, same everything......Completely different outcome. Lots and lots of pain, zero ROM, swelling, more pain, etc etc. I tried and tried, fighting the pain, determined to improve mobility......for weeks. All the while the first (left) knee just kept improving, virtually without effort. I tried doing nothing......to ease the swelling.....I tried formal PT......home PT.....ignoring it.....nothing helped. The answers I got were..."It happens sometimes.....we don't know why". So after a couple of months of very slow improvement, I opted for the MUA. I was worried it would put me back to square one and might cause even more scar tissue....(ya know, you dwell on all the negative stories). It went very easy.....In at 9am....done by 10 and in PT at 10:30. The procedure was like a non event. However, I did realize and immediate improvement in ROM. The PT pain was still lingering, but PT continued to accomplish much more improvement. I am at almost two years now post op and I really don't give my knees much thought as I go about my day to day. While my right progressed more slowly than my left, it did eventually catch up and is now fine.
Can I conclusively say the MUA made that possible......No. But would I do it again. Absolutely
My thoughts for you.........keep an open mind. Don't be too quick to write off any options available. Good luck.

 

[Ms.fixit]

Thanks, Bill for the good feedback.. much appreciated.
I replied in mid PT session, but it seems to have vanished.
I got the answer I yearned for in PT today, when my therapist whooped and gave me a huge hug..saying I am at or a bit better than 90 degrees. He now agrees that, not only can I do this without MUA, but he approves of my dropping out of formal PT and continue working on my own,as I have from the start!! I'm going back in in 6 weeks for an assessment, but I am officially finished with PT. He told me he didn't think I would be able to do it in the beginning, but I've gotten far enough for him to tell that the resistance is not from the knee itself and that the adhesions I have are along the front surface of my quad and will yield over the next few months.
I feel like a child that just got out of school for the summer..no more PT appointments. One more folow up visit with the surgeon and I can go back to my life until my one year check up. So glad!

 

[Recycled]

Very good news. You'll find ways to advance the progress on your own anyway. After all, who knows how the knee feels more than you. Short of going in and looking, there is no real way to know what might be causing one issure or another. Only thing you can do it give it time and your best effort. Good luck and I hope you have great progress.

 

[Ms.fixit]

Hi Bill; That's wild..how each of your knees differed so much post-op!

I'm so glad that you are pleased with the outcome of your MUA. Many surgeons here in the Northeast are locked in to a six-week model of recovery. If I told them you waited til week 8 for your MUA, I think their eyes would roll right back in their heads and they'd succumb to the vapors.

Eight weeks, to me, seems far more logical in terms of making a decision about doing a second procedure, but I was told over and over that after 6 weeks it would be nigh on impossible to go any further. But I know from my surgery in 1971, that I can get through the worst adhesions. That time I didn't have a bit of PT for over 2 weeks post op;I was in the hospital, in bed, didn't even put weight on it. Got bedsores! It was criminal, but we didn't know that then. It's lucky I lived. The whole thing was so sketchy.

My particular PT group now is associated with my surgeon, so they all have a panic-stricken response if you get to week six and cannot stick your big toe firmly into your opposite ear. Interestingly, my therapist does not have a computer..which explains his puzzlement when I ran a bunch of numbers from TKR patient studies in different countries with respect to MUA. Things move fast in medicine, so he is pretty much dependent on the surgeon for keeping up to date..and the surgeon is too busy with speaking engagements around the country, plus giving everyone new knees, to learn much either. When I was an EMT with the Fire Department we constantly had to attend seminars to maintain our certification..,so many in fact that I ,as a volunteer, had trouble working them into my schedule, plus still going on calls. If emergency medicine is that way I can only imagine the world of orthopedics! No computer puts a person at such a disadvantage, Doctorate or no.

Anyway..I am quite puffed up and full of myself right now!
Well, not so much that.. as exhilarated by the freedom I'm about to have from the medical world..at least for now. I won't be going for pain management appointments, or consults or post-anything appointments!

 

[Ms.fixit]

Here're a random couple of questions;...How long do people generally continue elevating their knee? I don't have very much swelling at 7 weeks and I get kind of tired of having it up so much. I still routinely ice and elevate when I finish a round of PT. but what about the rest of the time?

Also, I haven't tried taking an outside stroll yet, so I don't know how Mrs Knee is going to react. Should I not do it yet if I'm sore? I could be sore all year and probably will be. I've done short things like the market thus far, but I am hoping I will be able to take some serious walks by June.

I've been doing regular workouts here at home, plus PT.

Finally, how long does it take for the deepest tissues to heal from the surgery? I know in the case of plastic surgery the deep healing can continue for a good 8 months after, so I'm curious.

 

[skigirl]

At seven weeks, when I talked to my pt and OS, they recommended 2 hours up and 1 hour down with ice and elevation.

 

[Ms.fixit]

Good to know..thank you so much,

 

[kneeper]

The naps are completely normal. You'll stop napping so much when your body doesn't need them. Enjoy them while you can.

 

[speccybecky]

I think is amazing that you make therapy x 3 per week!
I didn't see anyone for first 5 weeks and then maybe once every three weeks for a couple of months!...and that was only when I insisted!
I guess that's the difference in this area

 

[Ms.fixit]

So, Nancy..what did you do during your first five weeks? Was it tough to do PT once you got started?

 

[Ms.fixit]

Random observation;I've recently gone back to wearing my compression stocking at night..(actually it has stretched out, so I wear both of them on top of each other)..and it seems to reduce the nighttime aching that's been waking me up.

 

[Ms.fixit]

Whew! Yesterday I went to my surgeon for a follow up..then I drove to the station, took the train to NYC and walked about 7 blocks, for the first time since my surgery. Mrs. Knee is not happy with me today..she is a bit puffy and disgruntled. I haven't had my leg down for so long yet, but overall I'm pleased. I'm just going down the block later to get a few things for my Mom and I'm elevated and iced the rest of the time.
The surgeon is actually happy with me now! He was pleased with the full extension, and says I have "clearly done amazing things" with adhesions by myself in the past..which is true. He is off his MUA kick, and gave me his blessing to just work on my own and check in with him in 2 months! He's a really nice guy, just more into surgery than the nuances of patient relations. When I told him thanks for doing such a wonderful job, he flushed bright pink.

 

[Dewey]

Wow, great news! You must be so pleased!

I have sure read your posts with great interest....I'm 4.5 weeks out and have a ROM that just won't improve no matter what I do! I see my surgeon next Friday, and I just know he's going to insist on a MUA. He's not going to be happy with an 80 at five weeks! I'm scheduled to have knee #2 done in 3 weeks (well, maybe), and I DO NOT want a manipulation yet! I love how you stood up for your beliefs, and I hope I can do the same! Thanks for your encouragement!

 

[Ms.fixit]

Oh, goody! Seriously, don't decide til you read about MUA's here on the site and really, really use your intuition.
It's really early compared to what the practices in the UK consider a decent waiting period, which seems to be around 3 months.. and even then, not everyone does it. Strangely..to me anyway.., outcomes aren't all that different at one year out. Plus, I talked to a guy who had one and he said it was worse than getting the implant. I for sure would have been that person who had a horrible time..I have had both times I've had orthopedic surgery, and I could not take one more bit of pain, so it wasn't too hard to make a firm choice. Don't let them scare you!

 

[Ms.fixit]

Whew..I didn't realize I was still so weak. A one block walk to the grocery and back with a few items and I'm ready to faint from exhaustion. The doorman in Mom's building took one look at me coming up the street..ran and grabbed everything, put it on the elevator and said he expected me to go right upstairs and rest. And I shall.

 

[bottomshollow]

Two months after knee replacement is like two weeks after other surgeries----early, early, early. Still tons of healing going on---your body using most of its energy for that---doesn't leave too much for walking and shopping even a block there and back and just for a few things. Gotta' pace yourself---but we all live and learn with TKR.

Take care and keep us posted. We care.

 

[Ms.fixit]

REALLY??!! Well that explains a lot, doesn't it? Thank you SO much Judy for that comparison..I really had no frame of reference prior to your post and I cannot tell you how helpful you just were. Jeez.
Well, tomorrow evening I leave my Mom's and her Aide returns. I 'm heading straight back to Connecticut with my adopted canary, popping him in his big beautiful flight cage next to my bed, and pronating til further notice.

 

[Ms.fixit]

Oh..hello..I was just rocking to and fro, moaning softly and didn't see you there!

But since you've wandered this way..let me be a cautionary tale about too much too soon.

No huge disasters, but I took my first short walks last week..since last December. Around the block once each day, with an errand along the way as well. I came in from Ct to NYC and did this Friday Saturday and Sunday;I badly needed to tend to my Mom, who has dementia, still lives at home and usually has me for 4 days every month to keep it all running straight with nurses and aides, bills etc. Even while I've been here in bed i get several calls in an evening;Mom wanting to know about how to work the TV or the answering machine or wondering if she has any money in the bank.

. So I went. I thought I'd die from exhaustion any number of times..as thrilled as I was to be outside on my two unaided legs once again..and it WAS thrilling. But just 45 minutes to an hour on my feet and moving required a 2 hour nap; it took everything I had to carry groceries a block and a half!

Sunday late afternoon, I came back to Ct by cab/train/car...and I have been flat on my back ever since. Mrs. Knee is not speaking to me. Sure she looks less like a brisket than she did Sunday, but she is stiff and unbendy and my tibial plateau feels like it's caught in the jaws of a pit bull. This has angered my sural nerve.

So..probably just look at whatever I'm doing, and instead just go lie down..you should be good then!

 

[Ms.fixit]

Hmmmm. I cannot seem to strike the correct balance of activity/PT and rest. My knee is not visibly swollen at 10 weeks, but after PT, it gets SO STIFF. I got a little set of rehab pedals to warm up with and stretch me out,but immediately after I do an exercise session..no pain, easy stuff, the knee just wants to freeze up for the next 24 hours, and I'm back top walking with a hitch in my step. any thoughts or observations?