TKR beth1954's Recovery Thread

[beth1954]

It's closest to DLF3, but along the bottom border of that square and toward the inside of my knee more than the middle or the outside. It's kind of intermittent. When it happens, there will be 5-7 separate pains and then they go away for awhile. It happens standing up AND sitting down. I just remembered that when I was doing some leg lifts while contracting my quad I got almost that same pain (I was at PT at the time.) When I told her it hurt she told me to quit. Type of pain: stabbing with a throb at the end but it doesn't linger long.

 

[Josephine]

Like this?

I'd say that, given your description of how it started, you have tendinitis in that area. That spot is where the patellar tendon (part of the quads structure) is attached to the tibia.

So the the solutions are
1. to stop doing the leg lifts and anything else that causes the pain for a few weeks, probably 3 or 4
2. take pain killers - Tylenol should do
3. ice the area
4. massage it like this Acupressure massage

 

[beth1954]

Yes that is the spot that hurts. I (stupidly) did a leg lift to see if it still hurt during a leg lift and guess what?? It did!! So next I will try to massage it as you suggested. I will tell my therapist on Monday how it has been hurting. I will also ice that area. Hopefully that will help out this newest problem. News flash: My entire surgical knee area is still very swollen. Even from the back side of my leg......very very swollen. It rarely gets much better. On average my left knee is about 2 inches bigger around than my right knee.

 

[saltyal]

That reminds me an old joke: Guy goes into the doctor's with a couple of big lumps on his forehead and says "Doc, my head hurts from walking into the doorframe, can you help me?" Doctor replies "Yes, I can advise you to watch where you're going!"

 

[Josephine]

News flash: My entire surgical knee area is still very swollen. Even from the back side of my leg......very very swollen. It rarely gets much better.

Well, you're only 8 weeks out - you surely didn't expect this to all be done and dusted by now? You did read the articles, specially the one about TKR recovery periods? Where it says recovery can last up to 4-6 months and possibly even more? That includes swelling!

 

[beth1954]

I haven't written much lately because I don't have anything good to say, plus I guess I'm just embarrassed or ashamed--i don't know which.
I'm probably known as the drama queen here because I do react strongly to everything. But I have to say first off that I have had major depression most of my adult life along with anxiety and probably a few other undiagnosed conditions! Everything seems out of control.
So my physical therapy started out pretty good. But now she is very concentrated on the "numbers." The first measurement there was 59. Yesterday's measurement was 85. I have for sure made some improvement but she pushed me too far to get that 85. I am doing the best I can at PT. I can go up to a very uncomfortable stretch but it very quickly goes into a painful stretch. She was concerned yesterday because I couldn't tolerate much of anything. I don't know why. It just seemed like everything hurt! I cried almost the entire hour. Sometimes because of pain, sometimes just frustration. She talked to me about my depression meds. I don't blame her. I must have looked like a real nut job.
Now I just don't want to go back.
On top of everything else I have a bad situation brewing at work that has me all kinds of crazy.
I'm just so tired of crying and feeling this way. The psychiatrist I was going to is no longer on my ins plan and she referred me to a couple of others but they are so far away. I probably at the very least need an adjustment on my meds.
Feeling pretty hopeless........

 

[Jozilla]

Hi Beth - we are all here to support you. Quit the PT! my OS had me stop after four weeks outpatient and he never was concerned with my ROM! You need to take some pressure off yourself and everything will start to fall into place. You are still having a lot of swelling so just ice, ice and elevate. If you don't hurt yourself at PT you will be able to recover.

I know what depression is like and understand the frustration you are experiencing. Is there any way your GP could adjust your medication? How about psychologists that may be closer? My GP works with them to prescribe the correct medication so his patients do not always need a psychiatrist.

I agree it is early on recovery and it is difficult at times to see any light. I do think your stopping PT would be your best option at this time. You can always return if you want down the road a bit.

Please take care!

JoAnne

 

[Josephine]

In no way are you considered to be a drama queen. I wouldn't stand for anyone saying that to any one else!
You are depressed and feeling lost with your recovery which is understandable, especially with a PT like that. It's like she is judging you and being over critical. You are still only 8 weeks out and doing well as far as I can see. Don't beat yourself up about this. Good ROM can take months to acquire.

I agree with Jozilla, quit the PT and do it on your own. You know what you need to do and I'm not just referring to the exercises! Your leg is probably very swollen too which will hinder your progress no end. Get rid of the swelling (by resting, icing and elevating) and you will find you have all the ROM you dreamed of, just waiting for the chance to show itself.

As for your meds, can your GP not help with that? And what about your pain meds? Are you still able to get refills? Because pain can cause depression too, you know.

 

[beth1954]

In the U.S., quitting PT is like being the biggest failure! I just don't know what to do. I do know that she has been pushing me too much though. There are certain things she has me do that are fine, and I feel like they are beneficial, but she really wants to get that good "number" and when I have gone as far as I can, she will push it to get that extra 2 or 3 degrees. She pushes ever so gently, but it ends up leaving me in horrible pain. She seems to think when I say I am having alot of pain that it means (to her) that I am getting a good stretch. NO! I know the difference! I feel like I have been very cooperative and have done everything I can.

I think that if I do gentle stretches at home and get on the bike and just rock it back and forth until I can make a full rotation, (which might be a long time) that I will do ok. I'm still worried about quitting PT though. I did wall slides at PT and I thought that was beneficial. I could get to the big stretch and just a tiny bit more. She also put a belt on my foot, had me lay on my stomach and pull my foot toward my bottom..........also seemed like a good way to get a stretch w/o tons of pain. When they measure for ROM, she has me lay on my back and then lift my leg straight up in the air, grasp my thigh and then let my foot drop. For some reason, that causes a lot of pain just about my knee. (My quad?) I told her there must be a less painful way of measuring that! We tried it while I was sitting in a chair one time, but the numbers weren't as good as she wanted.

I thought I was going to have a nervous breakdown yesterday. I just couldn't stop crying. I left there and the crying just continued on through the night. I was exhausted this morning. I almost didn't go to work, but I thought it might be good for me. Except that I have to deal with my "temp." This lady, a temp, came in to handle my job while I was gone. Well, turns out she basically evaluated my job and everything that it entailed and MORE. She made many suggestions to my boss, so now I have to change up a lot of things that I do. I have been here for almost 30 years, and now I am having to do what someone tells me to do that is a temp.

 

[Josephine]

In the U.S., quitting PT is like being the biggest failure!

In whose opinion? Her opinion? You know what - it only matters if YOU let it matter. You are so busy trying not to earn her disapproval, and seemingly terrified of doing so, that you are missing the big issue here - YOU! You are in charge, you pay her to treat you, you are not in thrall to her and don't need her approval or anything else. You have the right to remove yourself from her care.That doesn't mean you are quitting PT. You can either do it on your own (thousands do, me included) or find another PT who will be gentler. She's a bully and unprofessional.

She seems to think when I say I am having a lot of pain that it means (to her) that I am getting a good stretch. NO! I know the difference! She pushes ever so gently, but it ends up leaving me in horrible pain.

Then she's not being 'ever so gentle'. That's tantamount to an assault.

Let me put this into context for you - just suppose you walked up to a person in the street and did something like that to her. What do you think would happen? I would expect you'd be in the custody of the law in no time flat! Just because these people have a 'professional' standing does not give them carte blanche to cause you pain in any way they deem fit, particularly as you have clearly objected and denied them the freedom to do it. In legal terms, that is an assault. If she persists in behaving in this way, complain to the facility manager/owner and ask for different PT or leave and find somewhere else that is going to show you some respect.

When they measure for ROM, she has me lay on my back and then lift my leg straight up in the air, grasp my thigh and then let my foot drop. For some reason, that causes a lot of pain just about my knee. (My quad?)

No, it's much more basic than that. You are only 8 weeks out from major surgery. Things in there are still freshly injured and tender and considerable reverberation is caused when she lets your lower leg drop. More, because it is reverberating, the shock waves continue on for some time and cause that excessive pain. It's probably okay to do that with a healthy leg but with a leg that is so recently out of major surgery it is totally outrageous! It's hurtful, unnecessary, disrespectful and unprofessional. And another jolly good reason for you to not let her put hands on you again.

I thought I was going to have a nervous breakdown yesterday. I just couldn't stop crying. I left there and the crying just continued on through the night.

I am not at all surprised! Honey, you need to get out of her hands. She is doing you more harm than good, not only to your knee but to you emotionally, psychologically and in your self respect. Claim yourself back while you still can.

 

[beth1954]

Thank you everyone for being patient with me. I am obviously not very stable. I am trying to get a hold of someone who can adjust my psyche meds.
I talked to my surgeon's assistant today. She told me to double up on my Celebrex for ten days. That will bring me right up to a couple of days before my appt with the doc. She said that my ROM isn't great but not hopeless. She said the doc will decide if they need to do something more aggressive. I think we all know what that means.
I will go to PT next week (I cancelled today) but she told me not to let them measure my ROM. it's just not necessary and that is when she hurts me. The assistant told me to do whatever I can that doesn't cause me pain. (Gee haven't I heard that somewhere before?) She also said to ICE AND ELEVATE!! I've heard that somewhere before too. So hopefully with a lot of praying and lots of ice, elevating, Celebrex and luck.......maybe things will get better.
Two problems if doc wants to do the MUA. One problem is I don't want it. The other problem is I just don't have any money left. Period.

 

[kneeper]

My 2 cents for what it's worth:

1. You have been making progress in ROM. If you do the things in your last post there is a good chance the swelling will get under control and your ROM will continue to improve.

2. PT seems to have been too aggressive. I bet if you do your exercises at home as you say, you will keep the knee moving but not overdo like the PT and rebound into more pain and swelling.

3. You may need your meds adjusted--what a bummer that you have to switch docs due to insurance plans though.
But also, you are just like all of us in having frustration and being emotional--particularly when the PT pushes you so hard.

It sounds like the surgeon's assistant (PA?) is on the right track.
Hang in there. We're here for you.

 

[Jozilla]

Sounds like you received great advice from PA. I agree with kneeper and think you will continue to see improvements. We are here for you! I am sending cyber hugs your way and hope you feel better soon.

I don't know if you take any supplements but in my case i found a B Complex vitamin helpful. Though they take a few weeks to get into your system they help me with healing the nervous system. You can search google or go to a health food store where they should be able to advise you.

Take care!

 

[Josephine]

I talked to my surgeon's assistant today. She said that my ROM isn't great but not hopeless.

Exactly! Remember that. You're only 8 weeks out yet. Far too early to be making assumptions that 'all is lost'!

Two problems if doc wants to do the MUA. One problem is I don't want it. The other problem is I just don't have any money left.

I'll add these options:
1. you don't have to have anything you don't want to
2. remember that the requirement for consent is a legal requirement, they cannot touch you without it
3. if needed, an MUA can wait several months before it needs to be done.
4. Read this - the author had hers done ONE YEAR later It's never too late to get more ROM!

 

[beth1954]

Went to PT yesterday. She didn't hurt me, but she acted like she was a bit angry that I didn't go in last week. I also talked to her boss about a few things, so she wasn't very happy. I let her measure me MY WAY......it didn't hurt at all (just uncomfortable because I was trying to get a good measurement w/o hurting myself).....it was 84. The other day when she measured me and hurt me REALLY bad, it was 85. So I felt pretty good about that!

 

[beth1954]

I had my post op visit with my surgeon yesterday. He is not happy. I am at about 85 on a REAL GOOD day. He didn't even measure me, he just looked at my flexion as I was sitting in a chair. He said "You have to get that moving. You have to work harder." At one point he actually said in a singy-songy voice, "Don't make me mad." What the heck does that mean????? Then after the full 45 seconds I had with him, on the way out he said he wanted to see me in 6 weeks and that I needed to be at 110. He started to walk out, then stuck his head back in and said "I'm not kidding." I don't know how I can make it bend any more than it does!!! Total frustration again!

Along with my knee frustrations, I have been having major problems at work!!! Problems so bad that I'm going to retire. I wanted to stay 2 more years so that my social security/medicare would kick in, but my mental health cannot take this any more. My boss is a monster. Once she decides on something, it's gonna be her way. Basically I think she has decided she doesn't want me here any more and she's going to make my life miserable until I leave. I give up. I'm not happy here anyway, and I can't wait to get out.

I still have not found a psychiatrist. I thought I had found one, then they sent me a letter that he is not taking new patients. Back to square one.

 

[2hips2knees]

Wow! I can't believe your surgeon acted that way. I am further behind than you are (and I am at 10 weeks), and my surgeon has been nothing but understanding. He has never indicated in any way that the lack of bend is my fault. I'm so sorry he spoke to you that way. Wishing you a much better day today.

 

[Jamie]

Beth.....I'm so sorry you had to endure that poor behavior from your surgeon. We can only hope that one day HE has a bi-lateral knee replacement and gets a good dose of recovery!!! Please don't let him bully you. As you know from being a BoneSmartie, "trying harder" will only make things worse when you are dealing with an angry, swollen knee. Keep doing gentle exercises, icing, elevating and things should continue to improve....even if it's slow, it's still forward!! Do you have access to a pool for some water therapy? That might help you and still be gentle on your knee.

And don't feel at all guilty if you decide to stop the therapy. It is your choice to go in or to do it on your own at home. If you choose the latter, ask for a printout of the exercises for you to take with you. You need not offer any explanations as to why other than it's what you prefer. You have paid for everything you receive and you have every right to be in the driver's seat as far as therapy is concerned. I'm always amazed at how these folks frequently don't seem to get that YOU are the customer.

 

[beth1954]

Yes, and I stupidly DID "try harder" yesterday and my knee is very stiff this morning. I guess I'll never learn. I'm not really a "bone smartie."

 

[new knee in June]

Hello Beth,
I was reading your thread & would like to reply about " Ripping Velcro feeling"
At least that's what I call it I am almost 9 months out, with a very good recovery.
I believe this is very common. I think it has to do with the nerves regenerating & also
The soft tissue. It is your knee getting better.
I try to ignore it, it does go away. But, I think it is a form of pain ( more irritating than anything )
So, continue to ice, elevate, pain meds. On time
Sorry your O.S. Treated you so badly
You are a "Bonesmartie" & we are here for you
Sincerely,
Diana