MUA Bunion forming

[Poof]

Laurie,
I am having a MUA on my knee next Thursday. I will be posting the outcome on my thread, Vickie's Knee Recovery. I totally understand how you feel. I've also started getting pain in my hip and leg because I can't walk correctly from the ROM. It is making me miserable!

I agree that everyone does want you to tell them that you are doing "great" and look disappointed when you answer truthfully. I know that everyone is getting tired of this long recovery, but not as much as we are! I am so ready to move on with my life. I can hardly wait!

Vickie

 

[Gamera]

I am laying in bed with my new best friend (the continuous passive motion machine) gently bending my leg. I had my MUA on Monday, April 22nd. My OS achieved a bend of 125, but warned me that it would not stay due to the swelling. At my first P.T. Appointment yesterday I was able to bend to almost 90 with much less pain than ever before. Of course, I'm on stronger pain meds (percocet).

For now, I'm off work until at least Tuesday when I go back to my OS to see how I'm doing. I am icing, elevating, doing some ROM exercises and using this machine. I love the CPM machine. My OS wants it set from 0 to 90 for now. I have found that if I start at 0 to 70 and work my way up slowly there is very little pain. Once I'm up to 90, I keep it set there for a long time. I don't know if the machine is as good as my bending exercise but I think it helps.

It is too early to tell how things will progress. I still have back pain like Vickie does (I have been following her thread) and am icing my back too. I do lose the bend I get from exercise quickly after I stop. I know I have a lot of swelling that needs to heal first.

I am keeping my fingers crossed. I would love some tips and advice.

Laurie

 

[Poof]

Hi Laurie,
I had a MUA on April 11th, due to scar tissue. I went directly from the MUA to a therapy session to continue bending the knee. I had PT for 5 days in a row (with the exception of the weekend that interrupted it). Those were a very long 5 days. I was so glad when it was over. It felt like all I did was exercise. My knee did exactly what I expected. It was bending great and then the swelling and soreness set in and I was so sad. For the next week, I was convinced that the manipulation did not work and was going to have to be done again.

I just looked at my calendar to confirm that it has only been 2 weeks ago. It seems like at least a month! Anyway, I am doing well now. I am dealing with some back pain that I have developed from not walking properly, but it appears that the MUA did help. The therapists and doctors are no longer worried about the ROM. Once the therapist got it to 110, the doctor said that the rest will come gradually on its own. He feels that 120 will allow me to do anything that I want. I am still going to PT, working on getting the leg straight and also back stretches.

Good luck with your MUA. If you want to compare notes, just let me know. Don't get discouraged. Remember that we will have up and down days for a while. We are still healing and now we have made our knees a little angry once again!

Sending you hugs!

 

[Gamera]

Thank you for your response, Vicki. I hope the cortisone shot goes well on Tuesday. I had a shot in my knee last summer and it gave me huge relief. I hope you will get the same result!

I am finding that my knee responds better to my CPM machine than physical therapy. As of today both are giving me An ROM of 90, but the machine is much gentler causing me very little pain. I do my exercises first and then the machine. It doesn't seem to increase the swelling like PT does and my leg doesn't freeze up as quickly afterwards.

I am very tired of taking pain meds. I understand taking them for comfort level, but taking extra so I can push myself harder at therapy to increase my ROM doesn't make sense to me. My knee only swells more. Then the next time I need to push even harder because of the new swelling hence more pain meds. Is this the only way to stop scar tissue forming?

I am not sure what to do about a vacation planned for May 18th. Last December my brothers, sister and I rented a beach house in South Carolina for a week in May. When we made the plans I never thought I would still be recovering from the knee surgery I had in January in May. Right now it would be very painful to sit on a plane for 3 hours. I wonder if the trip will put me back in my recovery or end up being no fun because I couldn't keep up. Has anyone ever had to make this decision?

Vickie, thank you again for your support and the hugs! I will keep checking your thread for updates on the shot.

 

[bottomshollow]

Taking extra pain meds to push through pain during PT is a big NO NO. Kelly (aka skigirl) who had surgery to have scar tissue removed---her doctor's view is that aggressive PT causes more scar tissue and that one should take it easy until the soft tissue is adequately healed before starting any PT and no PT should be aggressive or painful.

Since you need to start counting your recovery time from the date of your MUA, I suspect that you will not be able to enjoy the vacation along with others---you will not be able to keep up with them and their activities. You could go, but you would still need to rest, elevate and ice, and NOT overdo things. A decision you alone can make.

Please take care and keep us posted. We care.

 

[Gamera]

Oh thank you so much for the advice!!! I have been planning to ask my OS if I can quit physical therapy and do my own thing - exercise and CPM machine. (ice and elevate too, of course) I feel like the PT is headed in the wrong direction and will not be swayed. I do think if I can show my doctor that I can do just as well on my own, he won't fight me. It would probably be good for him to see how the Bonesmart way works! I want to work with my body not against it!

I am on my way out the door (car appt). But I wanted to express my thanks. I am at that teetering point when I doubt myself and you gave me confidence!

Laurie

 

[bottomshollow]

Laurie. Here is a link to Library articles on exercises you can do on your own to improve ROM: Exercises for TKRs: do-it-yourself exercises from basic to advanced

And please always remember that you are the customer---that means that you get to make the demands and decisions---your OS is great at the surgery---but not so much when it comes to recovery. He's never had a TKR---he has no first had experience with recovering. And PT is suppose to be helpful not hurtful---and since you (or your insurance company) pay the bill---you have the say-so.

Both my hubby and I have had TKRs---one on each knee done 2 days apart. We both have followed the BoneSmart mantra, and it works!!!!!

 

[Gamera]

Can anyone tell me how to find a physical therapist that follows the BoneSmart program? I was doing well with my therapist. When I saw her after I last wrote, we found the perfect balance and things were going well. She even lectured me on doing too much!

Unfortunately she does not work on Mondays. Which means I need to see another therapist at the clinic on her day off. This past Monday the other therapist pushed my knee, hurt me and caused it to swell up even bigger. I know have swelling where there was no swelling and my ROM is way down because of it. I don't know if I should change clinics (where to go?) or maybe just ignore doctors orders and go twice a week instead of 3 times. Any thoughts?

And Maryo52, I feel like I am following the same path you were on. Before Monday, I was gaining ROM, but very very slowly. My leg does not bend at all in the normal course of the day. Only when I am exercising it. As soon as I stop it freezes up again. The ROM does not stay.
Is this what you encountered?

Thank you all. Laurie

 

[maryo52]

Laurie, No I did not have fluctuating ROM. It was what's called a "hard stop" due to scar tissue tethering one thing to another. Yours is a question of swelling and getting over the trauma of MUA. If you gain even one degree a week, that is progress and, think of it, over 20 weeks that's 20 degrees. I know, simplistic, but any gain at all indicates that you are moving in the right direction. But you have to put your foot down with the unhelpful PT. I never figure out how to do that in the moment so have your approach worked out in your head before.

I was having this devil's advocate thought that you should go in next Monday and state matter-of-factly that your leg swelled after your session with that PT, the bend decreased, and for the sake of improvement s/he must stop or you'll choose to stay home.

Doctor's orders prevail upon their underlings but not upon patients. Well, yes, they ARE intended for patients. But patients don't have a legal obligation to follow.

PT issues seem to be a neverending theme in TKR world. Some day things will change, I'm sure, but it's never soon enough.

 

[Gamera]

I solved my worry over next Monday's physical therapy appointment by cancelling it. Besides my concern over what another therapist might want to do to my knee, I have also become concerned about the increased swelling.

I thought my appointment yesterday morning went well with lots of massage and little pain, but later in the day my knee puffed up in a new spot. My knee has been swollen since my original surgery January 21st. After my manipulation the swelling went down and was only in the upper part of my knee. The tight band feeling went away. Tonight there is that old numbness returning and the new swelling is still there. By cancelling Mondays appointment I now have 4 days to concentrate on icing and resting. (Well mostly resting.... I did start back to work part time yesterday after 17 days off after the manipulation).

My ROM has gone backwards since the bad therapy on Monday. My regular therapist today said we still may see improvement again but also mentioned possibility of athroscopic surgery. She thinks my vacation the week of May 18th may be just what I need. I am anticipating spending time relaxing with my family in a beach house on Myrtle Beach. No cleaning. Sleeping late... And long. I am bringing my gel wrap for icing and my sister and I are going to sit with our feet up reading all day.

Right now I feel like I don't fit in the world anymore. I can't do things I used to do at home. I can't babysit my new 6 month old granddaughter because I can't safely lift her. I have spent so little time at work that I feel Like an outsider. Sometimes I have to do things I shouldn't because I have no one to help me anymore. People imagine I should be able to get along fine by now. I have gained 35 pounds in the past year because I have been so inactive and eat more sitting around. I was so optimistic after the manipulation. I thought things were turning around. Tonight I am depressed and hopeless and very whiney. Thanks for letting me vent.

Maryo, thank you for the note! I appreciate your advice. I read a lot of past threads and find your comments to people are always helpful to me.

And yours too, Judy.

Laurie

 

[maryo52]

Laurie, so glad you cancelled that appt. Smart girl!

You mention a new area of swelling. If you have pouch-like swelling around your knee, it could very well be an effusion, which is excess joint fluid. Probably no one knows for sure the issues inside your knee, but in my case the adhesions were accompanied by a thickened, inflamed synovium which causes excess fluid. I'm guessing that pushy PT session may have irritated your synovium. I have more than hinted to many MUA folks on here to limit PT to gentle stretching only after MUA because anything more can stir up formation of adhesions, and stories like yours supports my theory.

Anyhow, I can SO relate to your venting paragraph. OMG. I felt so so low during my recovery duldrums trying to get past whatever was inhibiting my ROM. When I look at photos of myself from that time, it shows on my face. I looked sallow and worn.

BTW I'd go out and park myself outside on the lawn under a nice tree and let the 6 month old find me that way. I know that getting up and down is challenging but if you have a chair and someone to hold it, you can use it to get yourself up and down.

 

[Gamera]

Maryo, that is it exactly! A pouch like swelling which feels fluidy. Will icing help heal this effusion? I have been icing like mad.

Is this still a good game plan? Should I add or delete anything? -

I want to be as kind to my knee as possible without going backwards. I was thinking lots and lots of icing and elevation, some careful bike riding (which is still just a back and forth motion), my CPM machine but only with a low ROM, massage, and some of the less aggressive exercises. I am also planning to put my next P.T. Appointments (Wed. And Fri.) on hold. If my knee is still as swollen and painful, I will cancel them. And, lastly i will keep taking the dreaded pain meds...oxycodine with ibuprofen.

Should I limit my walking now because of the new pain? It was coming along well. There hasn't been any bend really but my gait was straighter with a good heel to toe.

Thank you for hanging in here with me, Maryo. It is wonderful to feel understood.

Thanks to all the people on this site that take their time to help others. I don't know where I would be without you.

 

[Meezermom]

Gamera At least you are in the right place for recovrry. I am now 15 weeks out. Still have pain, at 8 weeks had a 2nd surgery to close two small spots on my incision that didnt close . Oh yea the os thought he would do me a favor and do a MUA I was at 100 ROM. After he was done I was bsck to 85. I'm now back t
O 110. Istill have stiffness, swelling and a tight knee. Don't be discouraged. Some of us just heal slower. I am still on pain meds ehrn I have psin.. still everday. You canlook at my thread. I thought I would never dtop crying and bring depressed. At 15 weeks I finally got over that hump. This site was my life line and still is. I am going to grt one of those rollers. Itruly want this to be 100% over. Hang in there, keep reading, I am still learning. Thank God for Josephine.

 

[maryo52]

Even the "adhesion pros" (Steadman Clinic, Colorado) say to stop and rest/ice a knee that swells and gets hot. It was because of their article on this that I went for stretching only in the first four weeks after the scar tissue was removed, plus the CPM machine. I set the CPM to the greatest numbers I could easily tolerate. I walked everyday because I have a dog. But I didn't do any strengthening those first four weeks. For a week, maybe, go for a "knee-cation" with only gentle stretching to keep your ROM. Then slowly introduce your routines

I would encourage you to trust yourself and your judgement as to what your knee can handle. Err on the side of caution, continue to set limits as you have learned to do so beautifully. NSAIDs should help if used regularly. I know some orthos will inject cortisone. My ortho would not because (a) an injection can introduce bacteria and (b) cortisone increase the risk of infection because it suppressed immunity.

 

[Gamera]

I never thought I'd be thankful for a cold, rainy (and snowy) spring, but YAY Minnesota. It is a beautiful sunny day here but my desire to be outside gardening is once again squelched by the cold and wind! If your knee needs to rest, this is the place and year to do it. No temptations.

I am on "Knee-cation". My big plans for the day are to ice and elevate. I can't get out of going to work this evening or doing the dishes, but the rest of the day will be low key.

Thank you for your thoughts and inspiration, Maryo. My knee hasn't changed, but my mood has.

 

[Meezermom]

Hang in there girl. I am so sorry this is a slow process. I just never thought I would stillbe hsving knee issues at this point. My ltkr was Jan 22. Iam flying to Texas vor granddaughter grad. OnMay 29. Only two more weeks to get my knee in shape. I am going easy and slow. I see my OS tomorrow. One day at a time and remember. ?.Be kind to your knee.

 

[Meezermom]

Cleared by OS for tske off on May 29 ROM WAS 115 with knee not being warmed up. He said if he had pushed it hecould have got 120. He was happy. Told him about bonesmart. He is checking it out..

 

[maryo52]

Wahoo!!

 

[Gamera]

Whoo, whoo! Texas here you come! That is Wonderful news, Meezermom. I am thrilled that you are Doing so well.

I am still planning on heading to Myrtle Beach Saturday morning. It is probably not the best plan for me. My knee is still stiff, swollen, painful and just doesn't bend except when I exercise it. My brother was diagnosed with cancer in February. He thinks this vacation may be the last time we can all be together. I hope he is wrong, but I cannot take a chance. So I am going! It will be fine once I am there. The plane trip will be the hard part. But good news is: US Air is letting my sister sit next to me in the seats between first class and tourist where there is more leg room. (Meezermom, call your airline and ask about this. There is no extra charge if you have a medical problem.)

I have cancelled all my P.T. Appointments and am doing only light stretching and lots of icing and elevating. I know I have lost ROM. I don't know what is ahead but I am trusting all the advice I have gotten from this site and trying not to worry. One day I hope I will be looking back on this and using my experience to encourage others.

 

[SadKnee]

Hi Laurie, I had read through your thread before but never really knew what to really say as I was having the same issues. (((Hugs)))

I think this vacation is just what you need and I am glad you are going. Enjoy your time and try to not think about your knee other than taking care of it when it cries out of course .

i am amazed you went back to work so soon but I know we all have to do what we have to. I am sure my coworkers are not happy with me but honestly I would not have made it back to work after 8 weeks so kudos to you on this feat!

I will say a prayer for your brother! It is good you can go and see him. I am overdue on a trip to see my 93 old Grandmother in Chicago who is not doing well as I could not imagine flying alone and getting through the airport but I may just make that trip now. Thanks for the info on the airlines that was very helpful!

Take care and enjoy your trip!