TKR And the Beat Goes On in Jazzabelle's Recovery

[Jazzabelle]

Okay, @Josephine, here are my answers to your Q's:

1. At the moment my pain level is 3. Most mornings this is true. I have had my immobilizer on all night long and have been elevated and icing most of the night. I elevate and ice most of the day, too. But most nights I peak at about an 8. After PT, too, since I have to get up, dressed, out of the house, and all again in reverse order afterwards.

2. I take Norco (oxy/act) 10-325 mg, 1 tab 4 x day; aspirin 325 mg, 1 tab 2 x day

3. My leg is moderately swollen right now and most of the time as well.

4. flexion 48, extension +6

5. I have a Berg that runs most of the day and night. Any time I am in my hospital bed. Breaks 2-3 x day of up to 2 hours.

6. I am elevated most of the day and night in my hospital bed. On the couch I elevate with pillows.

7. Unless it is something I can do while in bed, I don't do it. ie, folding clothes, stuffing envelops, etc. I walk around the house whenever I get up - every 2 hours or so, I take a lap or two through this level of the house (5 min).

8. Exercises:
Home:
ankle flex with no set time or limitation
ext. sit same
gluteal sets same
heel slides 2-3 x day, x5 reps
sitting heel slide just began, 3 x day, 2-3 reps
hip flex 3 sets or 12, 3 x day

PT: Nothing established yet.

I have tried hard to adhere to the Bonesmart way of thinking around phys activity and pain. I am content with slow and low.


Thank you,
Jazzabelle (aka Laurie)

 

[Josephine]

I live in a state where soothing is legal.

As you can see, discussion this topic is a violation of the forum rules. Besides which I know nothing about it. Sorry

1. At the moment my pain level is 3.

Only 3? The why did you need to discuss with your friends the use of that other substance? At less than 2 weeks out, TKR pain is usually much higher than 3

2. I take Norco (oxy/act) 10-325 mg, 1 tab 4 x day

Okay

3. My leg is moderately swollen right now and most of the time as well.

And did you factor this into your pain score?

4. flexion 48, extension -6

I think you mean +6 don't you? minus 6 means the leg will bend backwards a lot! And with such a low ROM, I would ask you again to reassess your pain score.

5. I have a Berg that runs most of the day and night. Any time I am in my hospital bed. Breaks 2-3 x day of up to 2 hours.

Good

6. I am elevated most of the day and night in my hospital bed. On the couch I elevate with pillows.

Good

7. Unless it is something I can do while in bed, I don't do it. ie, folding clothes, stuffing envelops, etc. I walk around the house whenever I get up - every 2 hours or so, I take a lap or two through this level of the house (5 min).

Good

Exercises:
Home:
ankle flex/ankle extensions with no set time or limitation - these are not actually exercises, just an activity to ward off clots. Once you get more mobile, you can stop these
gluteal sets same - these often contain a variety of exercises so what are you doing?
heel slides 2-3 x day, x5 reps, sitting heel slide just began, 3 x day, 2-3 reps - you don't need two lots of flexion exercises! Chose one and dump the other. As for any kind of heel slide, it's awfully easy to do them badly and these are badly! Read this Heel slides and how to do them properly.
hip flex 3 sets or 12, 3 x day - likewise, these are a hip exercise and therefore unnecessary for a knee!

PT: Nothing established yet - good! I suggest you keep it that way. PT exercises are largely a waste of time anyway. I suggest that, if anyone offers you this, decline their kind offer!

 

[Jazzabelle]

I have made changes to my comments to Josephine's request for answers. My changes are in bold. I also deleted my question about "soothing" for pain relief, in case you notice reference to it in Josephine's reply.

Can anyone tell me why I feel the intense burning, stinging pain to the left, below and above my knee? Is this normal? Should I be at all concerned? I could really use your insight. Thank you.

 

[jakeleg]

@Jazzabelle I have the stinging off and on at 8 1/2 weeks. Mine seems to come with activity.I had it a lot more in earlier weeks. I'm reading posts because I woke up at 3:30 and gave up on going back to sleep.

What I see now is that many of us have worried and do worry about the same things. I never thought I'd quit crying or that the pain would leave. I still have stiffness and fatigue and swelling depending on what I do and how long I'm up. If you can find in my thread where I spoke up to PT, I will tell you I that I have been much more relaxed since then.

Of course, I want to be totally recovered now. That's not the way it works so I trust the advisors completely. I'm debating how much to tell my doctor. I like him a lot. He must be very open-minded, because when I praised my chiropractor to the skies he said. "Bring me some of his cards".

Doctors prefer compliant patients. I ask questions and speak up - not in an argumentative way. He said that I'm a "straight shooter". He may be just trying to appease me and get me out of the exam room. We keep thinking " when, when" and then one day we notice some little thing is better. It's the "when when" times when we need this site.

 

[Jazzabelle]

Thank you, @jakeleg. I am almost always upbeat and optimistic. It has served me well in my life - opens doors, keeps me grounded. So when I'm not, it's alarming to me and everyone around me. This has been a mighty rough ride! I am so grateful for Bonesmart. I have learned so much here reading and asking questions.

I am still less than two weeks from surgery! If I'm impatient and frustrated now, is that going to just get worse as the days and weeks roll by? Yikes! I don't like the prospect at all. But, I kinda don't have a choice now, do I?

I'll go back and read through your story, @jakeleg . Thank goodness we have each other to learn from! Thank you again, J

 

[Jazzabelle]

How many of you have had an experience like this? Yesterday I had my staples removed (15 days post op). The whole thing was nearly pain free, but not event free. When the nurse gently tugged out one staple, a tiny, little fountain of bright red blood shot about three inches into the air. It was really quite fascinatingly! The nurse had never seen anything quite like it, and neither she nor the surgeon were alarmed in the least.

The rest of the recovery part of the story: I am now at barely 60 degrees flexion and 2 extension. Nobody's alarmed by those numbers either. So far, so good. However, after reading of so many others who are at similar numbers being pushed by their OS, I am waiting for that ball to drop. One day at a time!

Merry Christmas everyone!

 

[Celle]

I am still less than two weeks from surgery! If I'm impatient and frustrated now, is that going to just get worse as the days and weeks roll by? Yikes! I don't like the prospect at all. But, I kinda don't have a choice now, do I?

Oh my! You are going to have a problem unless you can tell yourself that this recovery is a marathon, not a sprint. Complete recovery can take as long as a full year, although you will be able to do most things by about 3 months.

Find your store of patience and start to dig deep into it, because nothing you can do is going to speed up this recovery process.

Patience, Grasshopper!

Try not to think of resting as "lying around, doing nothing." Instead, think of it as working hard, to give your knee the best possible chance of healing well.
In other words, when you are icing and elevating and watching TV, you are not 'lazing around' - you are "engaging in a carefully considered, proactively designed, heuristically programmed, dynamically structured recovery programme".

When the nurse gently tugged out one staple, a tiny, little fountain of bright red blood shot about three inches into the air. It was really quite fascinatingly! The nurse had never seen anything quite like it, and neither she nor the surgeon were alarmed in the least.

It sounds as if one end of the staple was resting in a tiny artery and removing it left a little hole. However, your system quickly closed up the hole and the bleeding stopped.

 

[Jazzabelle]

Oh, one other event to add interest to my recovery. It is about 25 degrees outside and we are going on day two of no heat inside. Our furnace has gone kaput. Icing is counter productive in the cold. I have a tiny space heater and a massive pile of blankets, but then wrapping my knee in an ice blanket..? The fun just never ends!

 

[DebM]

in my opinion you are expecting way too much too soon.
I am 10 months post bilateral and my recovery is still progressing and I expect, and according to my OS, it will continue for maybe another 6 months.
Nothing or no-one is going to rush the process, as frustrating as it can be.

 

[pdx]

Just catching up and hope you have heat again. What a bummer.
A lot of times those knee zingers/stingers are the nerves figuring out what happened & healing.

 

[Jazzabelle]

The past few days have been a roller coaster of good times . I fell deeply into the the pit of despair. I had one of those sobby-sad-miserable-pity-party days a couple of days ago. Woke up under a cloud, fell asleep under the cloud, woke up the next morning feeling my normal, happy-go-lucky sun-shiny self. Whew. I didn't like that one bit!

The last two days we have had a flurry of heating and air estimators come through the house to see about getting a new furnace installed. Most have been very nice but unable to get to the project anytime soon. We had decided that the one bid that could be installed the soonest would get our business, despite the price. This morning we had one fella who promised an installation this very afternoon! Sold! My home will be warm once again and I will be able to leave my little hidy-hole room.

My ROM isn't changing, but I attribute that to the cold and not wanting to ice as regularly as I should. That is about to change. Am I right in assuming so?

You all have a wonderful, joyful Christmas! :kittychris: (This looks like my cat, Buster. But if I put a hat on him, he'd take a chunck out of me!)

 

[sistersinhim]

Oh finally , a nice one house! I bet you can be walking around without being all tightened up because of being so cold now. And being more relaxed will be great for your knee. I bet that ROM will improve.

I don't know a cat anywhere that would allow a hat on their head! I'd have 20 scratch marks!

 

[Jazzabelle]

Okay, I will be 4 weeks post op on Christmas day. I would love to get my ROMo (cute, huh?) back for Christmas, please. It hasn't changed in weeks. Still less than 60 degrees! I've just had a stationary bike donated to me, but it is an old fly-wheel type. Is that going to be okay for me? I am able to make it about 1/3 of the way around, back and forth, with a pause at the crest of each swing.

I am also working on my thigh with a rolling pin to work out my knotty muscles, the theory being that the tightness is preventing me from bending. And lastly, pressure point work has been added to my home therapy.

Hiking poles are the best means for support I have found. I have a tendency to lean too much on the walker and cane. With the hiking poles (which are like extensions of my arms, I'm so familiar with them) I find I am able to walk upright and with confidence. Now if I could just pick my leg up more naturally. I am taking laps around the house three or four times a day, up stairs and around both levels. My pace is short and conscientious about heel and toe contact. And despite all my efforts, I am struggling to regain any ROMo.

I'm being a good little Bonesmart girl. I am trying to be very careful not to over-do my PT, and I ice and elevate a LOT. There rarely seems to be excessive swelling or pain. Just a little tightness on occasion.

This is really beginning to bother me now. Do you have suggestions? I could really use your sage advice.

Thank you! :santa sleigh:

 

[Celle]

Yes, I have advice. Stop worrying about ROM - it's only about 4 weeks since you had this major surgery. The bend will come, given time.
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

Don't feel that working at your exercises will help to increase ROM. It won't.
It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.
TKR: work “smarter” and not “harder”
Lose the Work Ethic While You Are Recovering!
TKRs and our fast food society

 

[kneeper]

Just as Celle says, it may seem like a long time but for this recovery timeline you are in very early days. You're doing well. Just let time and the knee do its thing.

 

[Jazzabelle]

Thank you @Celle and @kneeper foor your words of encouragementbans reassurace. I will relax and soak up the love and spitit of the season. I have so much to be grateful for, like an incredible husband who actually gets pleasure out of picking up the slack around here! and for Bonesmart support that keeps me sane! xo

 

[Celle]

That's the right way to do it!

Happy Christmas! :merryx: :treestar: :reindeerlights::reindeersleigh

 

[Jazzabelle]

Well, I wonder what to think/do now? I have one concern and one question that I know you Bonesmart folks can give me sage wisdom about. First the question. How can I find the post that tells of the range of motion "milestones" for those who have recovered ROM very late? I've read it a couple of times, but cannot find them now when I need them.

Which brings me to my concern (the same concern I've had for weeks). I am nearly 6 weeks now, but I have made no progress in my ROM in either direction in all that time. I am at approx. 65 degrees flexion at most, and 10 degrees extension. I go to PT 2-3 times a week with a very sweet, gentle therapist who will not hurt me if I don't let him. He suggests try to get an early visit with my OS (my appt. is the 17th), because I am essentially stuck. Walking is challenging, stairs are a step at a time and SLOWWWW, there is pain behind the patella when I try to flex, above the knee cap when I extend for very long at all, and behind the knee when I stretch too much. I rest, I ice, and I elevate. I do not over do the physio very often at all.

ROM, or that lack there of, is my only big concern at this time. There have to be others out there with the same experience. Did you end up having a MUA? At what point? If not, now long did it take before you turned the corner?

The good: After a slow phase-out, I am nearly through with the narco (one at bedtime and before PT) and my pain is very doable. The chills pass after a few days, btw.

Thank you for any insight you might have for me.

 

[AndyBooth]

Hi Jazzabelle,
I’m now just about 5 weeks after left knee TKR surgery.
Although for me flexion is around 80 degrees when warmed up,
Mine also has not changed much in the last two weeks.
Other posters have mentioned, concrete knee, or rubber band knee,
And i am having similar symptoms.
Very localised swelling around the knee surrounding the patella, with tightness in the attachments
Of the quads above.
Like you, walking is slow, and steps are just getting possible in normal method, but angled to the side a little
Due to restricted ROM.
After extension excercises, then some swelling behind the knee, after heel slides, some additional swelling around the patella, but they go down after elevation and icing.

i recognise all have different symptoms, and that it’ll take as long as it takes, but its frustrating
All the same, I Don’t know how some even think of going back to work at six weeks.

 

[Jockette]

I just have to tell you, your new thread title has that Sonny and Cher song in my head all the time now!

At least I think it was Sonny and Cher, they’re the ones I’m picturing!