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TKR Braunzie's Journey on "The Other Side"?

Day 6 - woke up this AM and while my husband was still sleeping, starting coming up with all these questions in my head.. I was going to write a list and post a second thread.. Then I got this brilliant idea to read the FAQs on this site (and some of the other links) again and lo and behold! I got most my answers!! :P
Emotions are pretty thin today too. In my head I know everything is going well, and though I have relatively little pain (up to a 3-4 at times) it just gets to me.. In my head I know my family is here to help, but it is just so hard to have to depend on everyone else for so much. I'm telling myself to just get used to it, it's necessary, it won't last forever... but then my other voice jumps in and reminds me it will last quite a long time.. :good-bad:Blech...

I'm up to 88 on my CPM machine. Doc wants me to be at 100 by the end of the week.. Not sure I'll make it (since that's tomorrow), but I don't see him until the 29th anyway, so I'm not really stressing about that. It is hard for me to get to the 0 extension - not really "painful" in a way that I feel I'm doing harm or that I should stop, but it does feel like the machine is stretching my leg away from my hip (with my knee in the middle, of course). I told my 18 year old daughter I feel like I'm being "drawn and quartered".. She didn't know what I was talking about. ??? What are they teaching kids these days??? :loll: Earlier today, I was using the CPM machine and was trying to use my laptop at the same time. Made a comment to my husband that I wish I could get the heal of my good leg not to keep slipping, as I had it bent, supporting the laptop. He gave me this "look", walked over and folded a pillow and stuck it under the knee of my good leg.. (Duh..... ).. I'm going to chalk that one up to the pain meds.. I can do that, right?? :snork:

As I keep telling myself, this is a "process".. And I do know there is a light at the end of the tunnel..

Thanks to everyone here for your continued support and encouragement.. (directly and indirectly). I feel very fortunate to have found this site! I can't imagine what I would be going through without it.. It's kind of like a security blanket, actually... Never thought about it that way before, but it's great to know you have a whole bunch of people who can relate to what you're going through and share their experiences, and lessons learned along the way... So, again... thanks! :chillpill:
 
@Braunzie I've had those emotional days too. Sometimes I let myself wallow for a bit, but then I try and get myself out of it. Yesterday was not great for me, but today I'm all bright and shiny. So every day can make a difference. Wishing you a bright and shiny day today!! :SUNsmile:
 
Hi all -
I'm supposed to wear thigh high compression stocking for 6 weeks. (I originally thought it was only 24 hours - so imagine my disappointment when I was talking to my surgeon's assistant after I had taken them off (gleefully) and found out I needed to put them back on.) They have been driving me nuts because the tops keep rolling down and I have to keep pulling them back up only for them NOT to stay. When they are down, they feel like they are cutting off circulation. So, the good news is that I was whining about it to my newly graduated RN and she suggested trying to use 2 inch medical tape to hold them up and the fold about 2 inches of the tops over the medical tape. (I asked her if they taught her that in school, and she said she just made it up.. haha! That's my girl!)

She wrapped the medical tape around the top of my thigh holding up the top of the stocking and again, we folded the top elastic of the stocking down over the medical tape. It has made all the difference in the world! My stockings stay up and I don't feel they are cutting off my circulation anymore. Thought I would share in case anyone else is having a similar issue. Hope this helps!! :yes!:
 
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The dreaded TEDs! Well done on finding a solution. Many before you have given up! :heehee:
 
Braunzie said:
I'm up to 88 on my CPM machine. Doc wants me to be at 100 by the end of the week..
Click to expand...
In the first 2-3 weeks I liked the cpm machine because it kept my leg moving and I found that comforting. I didn't find the machine terribly effective in increasing ROM. When it got to the point of maximum extension or flexion, there always seemed to be something that didn't work quite right. What was effective for me were heel slides for flexion and flexing the quad with my leg extended to push the knee down for extension. I did these many times throughout the day (practically every time I thought of it), only to the point of mild discomfort and only for a few seconds. I saw dramatic improvement in both flexion and extension in just 2-3 days. I don't think this aspect of recovery is rocket science. If I encounter stiffness and pain, I just keep pushing on the stiffness (to the point of mild discomfort) like a dog or cat licking a wound. This becomes a habit and the problem solves itself. I hope I'm not sounding smug. This might not work for everyone, and I recognize that I'm learning like everyone else.
 
You may notice that I have merged your two recovery threads. We like to keep our members' recovery posts all in a single thread. That way it's easy for us to go back and read your history before responding to a question or concern. In addition, the thread becomes a journal of your recovery for those who come along later and want to read about you. So, please post in this thread from now on when you want to give an update or ask a question. If you decide you'd like a different thread title at any point, you can change it by using the Thread Tools button at the top right of your screen or just post what you want here and we'll get it changed for you.
 
@Jamie - sorry, couldn't find the Thread Tools Button.. could you please change this thread back to Braunzie's Journey on "The Other Side"? thanks. :)
 
Day 7 - Woke up today and my knee was not happy with me.. :bricks: Trying to figure out why. I did 4 sets of PT yesterday, walked a bit (really not much at all), took my meds, iced, elevated, used the CPM Machine. So - could it be the PT is too much? These include:
Ankle Pumps (throughout the day)
Antiemboli Isometric (hold 3 seconds, 20 sets hourly)
Self-Mobilization: Seated Knee Flexion /Extension Stretch (hold 10 seconds, repeat 10 times, 5 sets a day)
Heel Slides (hold 3 seconds, repeat 10 times, 5 sets a day)
Towel Calf Stretch (hold 10 seconds, repeat 10 times, 5 sets daily)
Quad Set in Slight Flexion (hold 3 seconds, repeat 20 times, 5 sets daily)
PROM:Knee Flexion with towel (hold 10 seconds, repeat 10 times, 5 sets daily)
Strenthening: Standing Knee Flexion (repeat 30 times, 5 sets daily)

I've been using the CPM for extended periods of time (up to 3.5 hours at a time - thought keeping movement going would be good. ) Could that be too much of a good thing?

Elevating with 2 pillows.. perhaps not "elevated" enough?

Icing often - when not in the CPM machine

Today I added a 3rd pillow to elevation. Started to try PT and my knee was so stiff and painful that I didn't feel I should strain to do it. Pain was between 5-6 when moving between CPM and elevation or walking.. Seems high for keeping up on pain meds. Reduced usage of CPM machine to an hour each time - only 3 times.

Any thoughts? Or maybe I'm not doing anything wrong and my knee is just doing what it wants to do? I'm really trying to do this right.. :sorry:
 
I changed your thread title back to the original one for you.

Please, please slow down your activity!!! You are just a week out from your TKR --- major, major surgery. You are attempting far too much activity for this soon and that is why you are swelling and hurting.

My suggestions are:

* Cut back on the CPM to 2 hours a day, 1 hour in the morning; 1 in the afternoon. Ice while you are on the CPM.

* Elevate so that your toes are above your nose and ice while doing that.

* Do no more than one set of those exercises a day. On days the therapist comes, that's your exercise.

* Ankle pumps, gentle bends and stretches are good any time throughout the day and night as long as you don't go past the level of mild discomfort.

* Walking should be just getting from place to place (kitchen, bathroom, bedroom) around the house. Use your walker or whatever walking aid keeps you from limping.

You absolutely can do too much in these early days. Please don't do that to yourself. Your knee needs time to heal.
 
@Jamie - Thanks for changing back my title.. I'll know better next time.. :)

Also.. thanks so much for the feedback on my activity. I thought I WAS "taking it easy".. but I guess I'm learning a new meaning to the words. So glad I found this site.. I knew I would get good information back..
I will do much better from here, I'm sure.. :doh: I'm going to take a :chillpill:
 
Good for you!!! It's really easy to overdo things with this surgery. Sometimes we get therapists who push. But most people "guilt" themselves into thinking they should heal faster and get back to normal within a few weeks. It just doesn't work that way with knee replacements. I hope you have read those articles posted for your earlier in your thread (post # 2). Pay special attention to the energy drain and length of recovery time described in them. It's real and your best bet is to let your body guide you as to how much activity you're ready for at any given time. If it is painful, causes swelling or wears you out, that's the signal to stop and regroup for a bit.
 
@Jamie - Yes, I've read them all - a number of times. :yes: I really think I didn't get that I was doing too much. But because I read them, I backed WAY off today and I can tell already that it's making a difference. What I don't understand is why I got instructions to do 5 sets of the PT everyday, with no conditions.. like.. work up to it over 3-4 weeks.. etc.. I will ask tomorrow when I see the PT at the office for the first time. Again, thank you SOO much! :friends:
 
What Jamie said.

How about setting a noncompetive goal of x number of pain free days in a row?
 
Braunzie said:
Day 7 - Woke up today and my knee was not happy with me.. :bricks: Trying to figure out why. I did 4 sets of PT yesterday, walked a bit (really not much at all), took my meds, iced, elevated, used the CPM Machine. So - could it be the PT is too much? These include:
Ankle Pumps (throughout the day)
Antiemboli Isometric (hold 3 seconds, 20 sets hourly)
Self-Mobilization: Seated Knee Flexion /Extension Stretch (hold 10 seconds, repeat 10 times, 5 sets a day)
Heel Slides (hold 3 seconds, repeat 10 times, 5 sets a day)
Towel Calf Stretch (hold 10 seconds, repeat 10 times, 5 sets daily)
Quad Set in Slight Flexion (hold 3 seconds, repeat 20 times, 5 sets daily)
PROM:Knee Flexion with towel (hold 10 seconds, repeat 10 times, 5 sets daily)
Strenthening: Standing Knee Flexion (repeat 30 times, 5 sets daily)

I've been using the CPM for extended periods of time (up to 3.5 hours at a time - thought keeping movement going would be good. ) Could that be too much of a good thing?

Elevating with 2 pillows.. perhaps not "elevated" enough?

Icing often - when not in the CPM machine

Today I added a 3rd pillow to elevation. Started to try PT and my knee was so stiff and painful that I didn't feel I should strain to do it. Pain was between 5-6 when moving between CPM and elevation or walking.. Seems high for keeping up on pain meds. Reduced usage of CPM machine to an hour each time - only 3 times.

Any thoughts? Or maybe I'm not doing anything wrong and my knee is just doing what it wants to do? I'm really trying to do this right.. :sorry:
Click to expand...
Great report. Does seem like a lot of activity for your knee, especially that early. I'm 2 weeks out today, and my PT doesn't put me through half that much. I do envy your use of the CPM; I got to use one 6 hours the one night I was in the hospital, and the night nurse wanted to stop it after 3 hours. Wish my doc would prescribe one for me, but he cites the studies on effectiveness, etc., when I ask for one. Seeing him tomorrow, and I'm sure he'll be disappointed at my flexion, which is stuck in the 70s after an initial measurement of 86. Maybe that will improve when his staff takes the bandage off.

My knee is slowly waking up; I feel things going on down there that are encouraging and frightening at the same time. Good news is no really bad pain yet.

Hang in there and slow down a bit, as others here have advised. I'm cutting my home PT to just those activities that work on ROM; the other stuff I can do at the PT place.
 
I only did my exercises twice a day and that seemed like plenty. I didn't even do all of them at once.....I just made sure they were all done twice. Having had a very minimally-invasive procedure done, and having glue and not staples, made it a little more comfortable for me to walk around a bit. I figured walking was exercise, too, and therefore didn't stress about any exercises. I also didn't have a CPM machine. You might cut back on it's use and see if that makes a difference. If you don't notice any change and you like it, go back to using it as before.


Sent from my iPad using BoneSmart®
 
When I started outpatient PT, my therapist gave me three exercises to do. He said, "I could give you twenty, but you probably wouldn't do them,would you?" I grinned and said, "Probably not."

Take it easy. Spread the exercises out throughout the day. Rest, elevate, and ice. Using the bathroom, getting up to eat, and refreshing ice are all exercise and ensures regular gentle movement.


Jean

LTKR (Stryker Triathlon): 21 April 2015
Right Knee Arthroscopy: 25 July 2006
Left Knee Arthroscopy: 10 February 2005

My comments on this website are provided for informational purposes only and are not a substitute for advice from your personal physician or surgeon.
 
Braunzie said:
What I don't understand is why I got instructions to do 5 sets of the PT everyday, with no conditions.. like.. work up to it over 3-4 weeks.. etc..
Click to expand...
If we had the answer to this question, we'd know one of the major secrets of the Universe!!! For some reason some therapists obviously have been taught that a fairly heavy dose of exercise is needed after joint replacement surgery. It may work for a small few, but most people do not respond well to a lot of exercise in the first weeks and months after surgery. Gentle and slow is better. Just nod sweetly at your therapist and then do what works best for you. If you're hurting, swelling, limping or having any problems like this, it's not the time to be pushing.

I only did my exercises on the two days a week my therapist came....with the exception of the hang-the-leg-off-the-bed extension "exercise." On my first knee I needed to do that one every day. Otherwise, gentle bends and stretches throughout the day, maybe 5 minutes on the exercise bike, and walking from room to room was what worked for me.
 
Day 9 Post Op -
Spent the day elevating and icing, mostly. Used the CPM machine twice - for less than 2 hours total. Feeling much better than yesterday. Can actually get out of bed and stand up to use the walker without feeling intense pain and tightening of my knee (up to pain 6-7). That's what I was feeling by the time I got home to my first "official" physical therapy session. At the session itself, I didn't feel like they pushed my to do anything that caused pain - so that was good, but given the fact I was already trying to recover from doing too much myself and they pushed me a bit further, my knee was definitely not happy yesterday. It was definitely using strong communication techniques to let me know.. :heehee:

When I went in, they measured me at 85 flexion and 11 extension (or should that be -11?) "Well, we'll have to work on that". Didn't make me think that was such a great number.. Then I was told about the "6-week window of opportunity".. Ok.. I knew that was coming.

The gal then proceeded to take off my surgical bandage that was supposed to stay on until my post op with my surgeon (special waterproof, impressive 12 bandage that protects the wound from getting exposed to germs, etc..) I told her she shouldn't and she said, "No, we need to make sure it's not infected".. sigh. NOT.. I followed up afterwards with my surgeons assistant and she reinforced they shouldn't have taken it off.. (Nice communication between the two offices. I specifically chose the PT group associated with my surgeons office because I assumed they would be "aligned".. )I was assured they would be informed at that will help people coming after me. I guess no on before me ever communicated what they were doing?

I also stopped by the OS' office to get a refill prescription for my oxycodone, as I didn't want to run out. No problem getting the prescription. Took it to the pharmacist and he refused to fill it because the dosage my surgeon prescribed was more than my insurance would allow. :sad: But the pharmacist was very helpful and said if I got a prescription for Percocet instead (that has the same dosage of oxycodone in it), the insurance company would approve it and then he could fill it. (Brilliant.. I love that insurance companies can dictate this stuff.. obviously there is logic behind that.. ) ... Just one more thing to take care of...

Anyway, came home (coming up the stairs was REALLY hard using crutches and then the banister and a crutch).. I was hurting and exhausted. (Yes.. I shed a few tears and my poor husband felt so bad for me.. ) Got home at about 5:00, changed into my nightgown, painfully got into bed and started elevating and icing. Did that through the night.... and like I said, took it easy all day today. I read LOTS of the threads here in the forum and that in itself was very therapeutic. Called the doc's office, got a different prescription which my husband picked up for me this evening at the pharmacy. Getting out of bed feels like I'm getting back on track to where I was 4-5 days out before I tried doing too much PT..

Using the CMP machine today, I backed up to setting it at 80 degrees just to get some gentle movement.. That worked OK. Later in the day, just trying to get it to 85 again, felt like it was really pulling at my staples, which I hadn't felt before even when I had gotten up to 90. (That was before the surgical bandage was removed.. not sure if that is a factor or not..) But anyway.. cut that session a bit short and will try again tomorrow with something that is reasonable. And I will try some of my PT exercises again.. but NOT TOO MANY!

My husband went back to work today - I think he got a rest from his around the clock care he's been providing.. He's definitely been a trooper! This week I still have pretty much full coverage between two of my daughters (one is a newly graduated RN and one is a CNA) - still in very capable hands! I am so fortunate!!

Tomorrow is another day.. I think I'm back on track.. but I'm sure I'll discover another "learning opportunity" before too long.. :yes:
 
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