TKR And the Marathon Begins<<

[nuttybrunette]

I talked to the pharmacist and he said I could just stop the Percocet since I was down to 2 a day, maybe take just one tonight and then start tomorrow with the Tramadol. So many variations on how to do it. I like that plan tho, as that doesn't leave me without pain meds around the clock for a few days, as is how the Dr. receptionist explained it. Maybe she didn't understand the protocol herself. So......if I come and post on here and I don't seem my "nutty" self lets blame it on Percocet withdrawal and Tramadol use

 

[nuttybrunette]

Had 4th appointment with PT today. I really really like my old pal-this is the one that I've worked with for over 10 years on various body parts. He keeps saying he's not worried about ROM and that he understands that my body doesn't fit in the "box" of average healers, as I've got some weird thing going on that my tissues don't cooperate very quickly and it's been this way for years for me. He is only slightly impressing upon me to work on the extension. Doesn't want me limping forever. Had me try walking on my toes on that leg. OMG! I can't!! Said it would help my calf muscle. Worth trying. He had me do rock back and forth on bike for 10 minutes, quad tightening on the table and short arc leg raises (like 2 inches off the table, and hold for 2 seconds). These, all tho look easy, are not for me, but doable. Then the massaging of my thigh and the miraculous ice cuff. No negativity at all. Love it. The Negative Nellie PT seems to stay out of the room/gym when I'm there. Wonder if she feels bad for being mean to me.

 

[Wilsomasan]

@nuttybrunette My surgeon doesn’t recommend the cpm machine anymore so I have no experience with it. For pain control I just wanna say don’t let anyone shame you for being in pain. If it hurts, it hurts! Try to keep up with your pain meds and don’t let it get out of control. The first few weeks I set a timer to remind me to take them even when I was sleeping, every 4 hours. Glad you have an ice machine. They help a lot don’t they?

 

[VonnieN]

Coming off drugs seems trickier it is amazing how quickly we get use to them in your system.

 

[nuttybrunette]

@Wilsomasan I am about ready to throw that com machine out the window. I think the company wants to pick it up anyway, so it will be good riddance. I did do the 4 hour around the clock alarm thing for pain meds the first 2 1/2 weeks then started noticing I could stretch it. So now I’m switching to Tramadol but yes, I still have no problem saying I need it. I don’t feel the need to be some super hero with the pain. Lol. I love my ice machine, too. Thanks for stopping by. Nice to hear from others. Hope you are doing well.

 

[Celle]

There's no proof that CPM machines make any difference at all to your recovery.
If you don't like it, don't use it. Most surgeons don't use them anyway.

 

[nuttybrunette]

I have read that @Celle I just thought I should as I have history of freezing up quickly after surgery. Not sure what the real term is for that, if there is one. But after using it yesterday AND the gentle PT I ended up in so much pain last night. Like a 10 with big tears. Ended up taking more Percocet than I wanted to as I was going to switch to Tramadol today. So that plan is on hold. I gotta medicate today and pay for my ODIC activities from yesterday.

 

[Jockette]

I have history of freezing up quickly after surgery.

Can you explain this further? What did it feel like, when did it happen and what were you doing before it happened?

 

[Pookie]

How has your switch off of Percocet been going? I had a terrible experience a couple weeks ago when I tried to switch to Norco, so I’d love any input/suggestions, as I’m ready to be on something not as strong!!!

 

[SusieShoes]

He is only slightly impressing upon me to work on the extension. Doesn't want me limping forever. Had me try walking on my toes on that leg. OMG! I can't!! Said it would help my calf muscle. Worth trying. He had me do rock back and forth on bike for 10 minutes, quad tightening on the table and short arc leg raises (like 2 inches off the table, and hold for 2 seconds). These, all tho look easy, are not for me, but doable.

I read this post first and thought, "Oh dear." I remember what those tippy-toe exercises did to me at five weeks. And then the arc raises. Mostly, though, that you did them when your knee/body was already telling you it couldn't.

Also, does your old pal really think you're at risk of limping forever? Because I rather doubt that's what he thinks. He knows you'll get your full extension back with some time and gentle stretching. I don't understand the rush on his part. No need to torture your poor leg to get there.

I ended up in so much pain last night. Like a 10 with big tears.

Been there, done that. Your knee needs a couple of days to recover. Ice and lots of elevation to the rescue!

I gotta medicate today and pay for my ODIC activities from yesterday.

Welcome to the club. We've all been there. It's part of how we learn to listen to our knees! Hope your knee settles down quickly.

 

[nuttybrunette]

I have history of freezing up quickly after surgery.

Can you explain this further? What did it feel like, when did it happen and what were you doing before it happened?

I used the cpm on knee #1 10 years ago. At about the 2 week mark, as far as I recall, the machine could no longer bend my knee. It would move my entire body instead of bending my knee. We tried tying the machine down, tying me down, nothing worked. Then in therapy it was like hitting a brick wall when trying to bend past 80 or 90 for months. It was slow going but eventually I got there. But I have to say, got there, meant A LOT of pushing by the PT. To the point of tears. But I didn’t want MUA, so that’s what we did. So now I have flashbacks and didn’t want to repeat this. This time the cpm has continued to move and stretch my knee. I can only get to 80 and I have to start at 55 every time. It takes me a good hour to work up to 80. But in my head I figured as long as I felt like it was still move my knee and not that brick wall then I was better off and I should use it. I don’t know. What do you think??

 

[nuttybrunette]

I think he isn’t really concerned I’ll limp forever, maybe just saying what happens when legs don’t go straight. I didn’t feel like it was a threat anyway. Or maybe I was being naive. Lol. I GOT IT. I JUST FIGURED OUT WHAT PT STANDS FOR!! Premature Torturist!! Yep, ice and elevation are the only thing on my oh so busy schedule today.

 

[nuttybrunette]

@Pookie how long were you on Percocet before going off? And did you go off slowly or just switch to Norco? I know we all react differently on different meds but Norco makes me waaaay more “drugged up” than Percocet. The only thing perc does to me is pain control. No sleepiness and apparent impairments. So, to answer your question: I haven’t switched yet! It was my plan until I totally overdid it yesterday. So I’m not giving it up today. Then I’ll have to taper off it again before switching. Geesh. One day of activities messed me up for prob a week. Lol. Live and learn.

 

[Jockette]

That experience with the cpm machine sounds awful.

All that pushing on your knee to tears is not necessary. They are wrong when they say it is necessary and many of us believe it. I will not allow that at all next time.

We have all the time in the world to bend better and straighten better, but many medical professionals want to rush it. I don’t know why.

 

[Celle]

I used the cpm on knee #1 10 years ago. At about the 2 week mark, as far as I recall, the machine could no longer bend my knee. It would move my entire body instead of bending my knee. We tried tying the machine down, tying me down, nothing worked. Then in therapy it was like hitting a brick wall when trying to bend past 80 or 90 for months. It was slow going but eventually I got there. But I have to say, got there, meant A LOT of pushing by the PT. To the point of tears. But I didn’t want MUA, so that’s what we did.

It sounds to me as if your knee got very badly swollen, from all the CPM use and the PT pushing on it.
That was all totally unnecessary, as is using the CPM machine this time, too.

Don't make the same mistake again. Instead, concentrate on rest, icing and elevation, to try and decrease the swelling - and cut right back on the PT exercises.
Ice to control pain and swelling
Elevation: the do's and dont's

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.
Just doing your normal activities of daily living is enough exercise for your knee.

It's not even a month yet since you had your TKR, so stop worrying about your ROM.
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

My surgeon doesn't allow any PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house.
After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home.
His patients all do well and achieve good ROM, as I did, and he hasn't had to do a manipulation to help with ROM for the past 4 years, because no one developed adhesions (bad scar tissue). I think that speaks for itself.

 

[kneeper]

My OS doesn't have you use the cpm after 2 weeks. Like you, I took it easy working up the bend. Though I'm not convinced it was helpful or not. If you do keep using it, I wouldn't use it more than 1 hour at a time.
The swelling is usually what holds back the bend. Overworking the knee leads to swelling.

 

[nuttybrunette]

Loving my PT. Like I said before, I’ve known him 10 years, for various ailments. A new guy will be working with me sometimes so my regular one just introduced us and spent a lot of time explaining what he does with me differently than your average because my tissues seem to behave a little differently. Stressed that we weren’t going to push high ROM, that it would come with time. Loved hearing that. Another tkr, one surgery day ahead of me, was on the next table and he was pointing out all the differences between us and how that means you treat differently. Love it!

 

[Jockette]

Another tkr, one surgery day ahead of me, was on the next table and he was pointing out all the differences between us and how that means you treat differently.

I’m curious, what were those differences?

 

[nuttybrunette]

She was on a walker, I’m not. The rest was about how our tissues and muscle tone were very different and how they feel different when you rub/massage them. Some other PT lingo stuff I didn’t catch.

 

[sistersinhim]

It sounds like you have a really good PT team. That's great!