TKR Back with a question

[sistersinhim]

You are just over 6 weeks from having a major, traumatic surgery. You are only around 1/11 of the way of a healed knee. It is frustrating to not have the energy to do the things you want to do. And if you do too much the knee rebels with swelling and pain. But, each week you will see improvement. It won't be a lot, but it'll be there! Before your tkr, your knee pain would have just gotten worse. Now, it will get better! Try and think about a year from now. Then think of what a year from now with your old knee would have been like. It will get better!

 

[Jockette]

It is very scary to say no to the prescribed therapy. We feel like the PT and the surgeon are a higher authority and in the past we have trusted the medical professionals to know what is best.

From reading on here, that isn’t always the case after knee replacement. It astounds me the things they want us to do when common sense tells us otherwise.

Listen to your body, take care of it, and defend it from treatment that goes against your better judgment. It is your body. They are not the ones who go home at the end of the day in pain, we are, when we continue to do what they tell us even though our bodies are telling us not to.

 

[rubyyarn]

@jakeleg, I think some people return to work because they feel they have to,like they'll lose their job or their medical benefit is expiring. Most would rather stay home and recover.

I am sooo glad I was retired before I had to do this! The pain, the boredom, the drive by depression...eek!

Really, the best answer is what everyone has been saying...

 

[kneeper]

Just like everyone's been saying, you're not even 2 months out from your surgery. That's no time at all.
At six weeks I was just approaching 90 degrees bend; my knee was a ball of swelling (though diminishing); I was doing very short walks; took a nap every afternoon.
Guess what--the knee(s) turned out great in the end. Hang in there--it will be ok.
Ignore the "miracle" stories and just take it one day at a time. TKR is an "individual sport."

 

[Jockette]

@kneeper Your message applies to me, too, at 8.5 months post op! Thanks!

 

[jakeleg]

Finally...found a way to Ice, Elevate and be comfortable on the bed. The healing is taking energy from my brain. I just realized today is Saturday. I have 2 more days to I and E (abbreviations) before I go to PT at 8 am Monday. I am going to write "Gentle!" on the palm of my hand so that I can speak to my therapist with a gesture. I have been sleeping well throughout this 6 weeks, don't really have to do anything I don't want to and discovered Bonesmart --- that's the start of my gratitude list for today. I am, dare I say it?, somewhat optimistic.
Thank you forum advisors for your most recent posts.

 

[jakeleg]

I read a lot of posts today. It's a mistake to compare, I know. So.... I have a question.

Is there an explanation for a person getting ROM of 120 at 4 weeks, doing all other kinds of exercises and PT and not paying a price in pain and swelling? I have taken the advice here and am taking it easy, icing and elevating.

Went to get my prescription several hours ago; walked down one flight of stairs (1st time to do that); then took elevator. Walked around in pharmacy for 15 minutes or so. Came home to ice and elevate more. I probably get up at least once and hour to go to kitchen, bathroom, other little tasks.

Should I forget about ROM? Will I lose ground? I worry that I am a big baby, trying to do everything right and not getting the right results. I continue to be purple and tight a few minutes after I get up. The color and scar look good (to me) when I'm lying down. My knee is warm and tender. (sounds romantic) on the inside. I have had a spot that looks like a bruise for at least 3 weeks, but it is not tender.

I know everyone is different and I obsess a lot. Just remembered - I gently rolled the big ball about 20 times earlier in the day and it felt ok except for tight quad. I wonder if I would worry less if there were some simple things I could do just so I don't feel like a slug.

What can I do to decrease tightness in quad? I feel like I'm supposed to know everything by now.

I could cry if I would let myself.

I thought my knee would reward me for being more relaxed today. Sorry, I hate all of this today. I wake up with a little hope and go to sleep with less hope. Now after writing this I'm embarrassed and dread going to PT. I feel like emphasis on heel slides and bends messed with my mind.

I'll understand if this is an annoying post, but it's me right now. I'm happy for those who are doing well.

 

[rubyyarn]

Alas, I'm afraid there is no explanation. It seems, with knees, 'normal' covers a wide range. Some (like me, relatively speaking), do pretty well. Others suffer the torments of the damned for no good reason. Yet most recover and get on with their lives.

Don't know if it made a difference, but I followed the most uplifting threads I could find (SusieShoes, Pheebs52) and avoided the ones that focused on problems. No need to read about revisions and infections unless you have that problem. Time enough for that when you've turned enough corners to be sure of your own recovery.

Meanwhile, your knee may not reward you for a day off, but it will reward you for a week off. They are like that. About a week ago I blew mine out making muffins (!). It is just recovering.

You might want to ditch the pt for a while. Sounds like it isn't helping right now.

 

[funkymuse]

Oh gosh.. I am so with you on so many points!!! I'm working to trust and move forward with the bone smart suggestions and testimonies. It's so hard not to compare. I will feel much better when I see my surgeon this upcoming Wed when I can find out how he feels I'm doing and where he feels I should be based on my surgeries. Thanks for sharing.

 

[jakeleg]

I agree about reading the positive posts. I do not see doctor until 1/3/18.

I am so vain and discouraged that I don't even want to go any place until I have no tightness. I don't like limping when I am out.I don't mind walking slowly, but limping is hard on my ego.

When I read the super achiever miracle stories I get angry - at whom ? My doctor, myself? What's the point of that?

I want to rest more, but I don't want to lose ROM so I'm hoping what I do at home will bring progress.

I did well after meniscus repair so I thought I'd do well at this. I probably feel worse about my attitude than I do about pain and swelling. I don't mind being alone. I am happy with my cats and visitors. I've always heard that cats prefer to be left alone when they are sick so we're ok here. Watched football today and winced when a player had to have help getting up. Will ice the rest of the evening and pray for progress overnight.

 

[Jockette]

I’m glad to hear you have visitors, and cats are good companions.

 

[rubyyarn]

I think it is a fact of life that this recovery takes For.Ev.Er! It's like the world expects us to bounce right back, like we've had a cold or something.

From what I understand you don't lose ROM unless your knee swells. When the swelling goes away, your bend comes back.

 

[SusieShoes]

The best explanation I can come up with is some people swell more, just as the way their body reacts to trauma, than other people. Someone who doesn’t swell a lot will have less pain and more ROM than the rest of us. But there’s more to it than that, I’m sure, and so no gold-plated way to predict or assure a faster, easier recovery.

The good news is you know what to do to minimize swelling and help it go down faster. The more resting, elevating and icing you do early on, the more your knee will have the opportunity to heal. The more healing it can get done, the faster you get through this ordeal. Just keep in mind your speed of healing will not be the same as @rubyyarn’s or mine, or any other person. You are 100% you, and will heal on your own terms.

And for what it’s worth, I am battling a monster of a cold/flu or something, and I swear I got through my knee recovery less miserably than this thing!

 

[kmak81230]

Hey Jakeleg -- you are still very early in recovery - I called it the "dog days"- not as horrible as those first dark weeks but still feeling like you are not improving, not gonna improve, questioning everything you are doing as you are worried you are gonna screw your knee up forever. You will continue to improve and get better - slowly but surely. I am a Super Sweller - my knee swells up at the least provocation so the ROM has been slow to come. I am currently about 6.5 months out and still have swelling and stiffness but can do many things I could not do when I was at 7 weeks (where you are). On my best day I can get to 125 and I'm still working on getting to 0 extension. At 7 weeks I was still using a cane so that I would use good walking form. I believe that cutting back on any aggressive exercises helped me to negotiate this recovery better, helping my ROM to continue to slowly improve. Hope you have a good day today.

 

[kneeper]

I very quickly got over being self conscious about going out with a walker or a cane as I was recovering. No one really pays any attention. Really, there are tons of people out with walking aids--either from injury or surgery.

Also try not to think about "doing well" in the sense of success or failure. It's up to your knee not your willpower or really much that's under your control. What's under your control is to give yourself time to recover.

 

[Jockette]

I had an interesting experience while out with my walker. We were at a little convenience store that had a side area where they sold ice cream. My husband went into the main area to let them know we wanted ice cream and I waited by the ice cream door for my husband to come back and hold the door open for me. While I waited a boy,who looked about 10, came out of the main door. When he saw me he asked if I needed help. How sweet was that! His parents did a good job teaching him to be helpful. I should have let him open the door for me but the first thing out of my mouth, with a smile, was no thank you, my husband is coming. But he was so sweet. I was so touched!

 

[Celle]

Should I forget about ROM? Will I lose ground? I worry that I am a big baby, trying to do everything right and not getting the right results. I continue to be purple and tight a few minutes after I get up.

Yes, forget about ROM. YOU won't lose ground. ROM will come as your knee heals and the swelling goes down.
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.

I gently rolled the big ball about 20 times earlier in the day and it felt ok except for tight quad. I wonder if I would worry less if there were some simple things I could do just so I don't feel like a slug. What can I do to decrease tightness in quad?

Rest, ice, elevate and take your pain medications on time. Let your activities of daily living be your exercise. You really don't need to do any exercises to increase ROM. Your knee knows what it's doing and ROM will come, with time. Your leg is wounded, not lazy or unfit.

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

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".

Now after writing this I'm embarrassed and dread going to PT. I feel like emphasis on heel slides and bends messed with my mind. I'll understand if this is an annoying post, but it's me right now.

If you feel like that about PT, why not take a holiday from going for a while? I did no PT at all after my last TKR and only minimal PT after the one before that. Both my knees are strong and reliable. They straighten fully and bend to over 125 degrees. I can do anything I want to with them.
Saying no to therapy - am I allowed to?

I am so vain and discouraged that I don't even want to go any place until I have no tightness. I don't like limping when I am out.I don't mind walking slowly, but limping is hard on my ego. When I read the super achiever miracle stories I get angry ___ at whom ? My doctor, myself? What's the point of that? I want to rest more, but I don't want to lose ROM so I'm hoping what I do at home will bring progress.

Try to get over the vanity. You are a wounded warrior. Be proud of how brave you are.
You won't lose ROM if you rest more. You might even find your ROM improves as your swelling decreases.

Some fortunate people do have an easy recovery, but most of us are like you. We struggle, moan about how long it's all taking, wish time would pass more quickly, get depressed, have sleepless nights, grow impatient - and eventually come through it with a new knee that is better than the old knee.
We understand, because we've been there too.

Hang in there. Better times will come.

 

[jakeleg]

Well, I wrote my most recent post before I read the responses to last night's post. I got sidetracked . I love the forum. I have learned so much and it has made me more aware of what to say to people who have other types of problems. We don't like to admit we are afraid. I thank every one of you for the encouragement.

 

[jakeleg]

A new thought - it doesn't pay for me think about how feel. I can have mood swings many times a day. It does take a lot time for all the bonesmart info to stay in my brain. It is a roller coaster and I'm tired of it.

Have been icing and elevating all day. I must have one angry knee!! I have had some very helpful replies to my posts and yet I still want the magic answer. That's when I feel like such a child. I am grateful that I have little or no pain. What happens pretty consistently is that I walk, knee gets dark red, more like red wine than purple color. Then it gets tight and if I stay on my feet, it feels like is going numb down to my foot.

I noticed that when I sit to shave my legs. I wonder if I'm not elevating properly? Does anyone have elevation tips? Is knee supposed to be straight or bent? Her I go obsessing about something else. What's nice about this site is we never know who we're going to hear from. Making new friends all the time.

 

[Jockette]

You do want a little bend in the knee, keeping it totally straight hurts.

I have a foam wedge that my hospital sent home with me to elevate my leg. I didn’t find it comfortable at first but I love it now. I still sleep on it all night at 8 months post op!