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TKR Cece’s new knee

Six week report.
Reading the forum I feel about right in recovery.

First the tough parts:

Sleeping is harder this week as PT is getting more intense. Aching at night. With only Tylenol for pain there is a delicate balance in too much or to little PT. Slept on the hard floor last night. Weird but it helped.
Pity Pot night last night with crying and being blue. Seems to be a common thread. Lack of sleep does not help this.
Still some coughing. Seeing Doc for followup X-ray tomorrow to check if pneumonia is clear.
Feeling like this will never end
My knee is still stiff.

Okay the good news:

Energy level is slowly increasing.
Gain of 4 pounds from loss of 10
Doing for house activities like laundry and tidying, even cleaned the bathroom.
Shower by myself
Knee is less swollen
Walker use down 50 percent in the House. Walking with no aids in PT
Quad is back, leg lifts doing well. Finally seeing movement in bend,1-2 extension 96 flexion
Walking on our road increasing each day
Mentally doing better, especially being able to be outside.

There is progress. The daily journal is very helpful in seeing the positive improvements. Thanks everyone for being there.
 
I’m really glad you are progressing. But , forgive me for plain speaking, and this is only my opinion, I don’t think you need to to experience the pain following exercise. Your flexion and extension are good, just do your daily life, walk often and keep icing and elevating, do a few stretches if they make your knee feel good. Your knee will recover without all that other stuff. In the UK we mostly manage without intervention and we do fine. When your knee is properly healed at about 3 months , you can gradually do everything you want on it ( I went back to weekly hiking and gym sessions) but the pain and intensity at this stage is not necessary and will be stressing your knee and making it painful. I am only speaking from my own experience, am not trained medically but from my experience and reading on here, this approach seems to work.
 
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@SuperSnapper
Thank you for your response. I wish we had the UK attitude here.
It is normal here to start PT one day post op aggressively bending and flexing the knee. My discharge instructions were 90 degrees by 3 weeks and 116 degrees by 6 weeks. PT is done three times a week with Home PT three times a day. By four weeks my PA was already talking about MUA. Every time I go to PT they give me the numbers.
It is no wonder we are all nuts here and hurting. I find it very upsetting to be so pushed. There is no way we can succeed. I like reading The Forum here as everyone is so patient and kind.
 
The sleepless nights were the worst for me. I love my bed, but hated it during my TKR recovery. It meant a sleepless night. Bu then I figured out a way to sleep on my side! I could lay on my right side with my left leg crossed over my RTKR. It only lasted a few hours, but they were wonderful hours!

Some hospitals and drs in the US are no longer prescribing aggressive PT or PT at all, hopefully it will spread. Have you thought about cutting back on your at home PT time to see if that helps with your pain? I think the walking is the best thing you can do for your knee and you’re already walking a bit every day.
 
@KarriB
Thank you for your reply. After two nights of pain I am only doing the basic flex and extension stretches. Quit the strength exercises. I would rather walk outside. Fortunately there is only one PT appointment this week.
Even on this forum there are different viewpoints. Like yours doing basic ADL and walking. Others say two hours of Home PT per day. In the US there are so many different opinions. I wish there was a world wide Standard Of Practice for TKA. I go to my OS this week. Wonder what opinion he will have.
 
You are also recovering from pneumonia on top of major surgery. That’s a lot for a body to recover from. Even if you are considered recovered from the pneumonia it has not been long since you had it.

Your knee will regain its mobility without painful exercises that prevent you from getting much needed sleep.
 
I’m glad you stopped any strength work because it’s far too early. I did strength work about 4-5 months post op, but still had pain when walking for more than a few minutes. The only thing that helped me was slowly building up my walking by adding a few minutes each week. In retrospect it just made sense to walk because that’s what I want my knee to do. I didn’t want it to push weight as I lay flat or anything else, I wanted to walk painfree. When I have my left knee done my OS and I will have this conversation before hand. I’m not opposed to PT, especially because my second group (yes I left my first PT group) was gentle and gave marvelous massages!
 
Cecelia said:
Sleeping is harder this week as PT is getting more intense. Aching at night.
Click to expand...
That tells me you are doing too much at PT. Cut it back,

Remember that this is your knee and you are the only one with the right to say what happens to it. You can say NO to PT therapy if you wish and the therapists have to respect your wishes:
Saying no to therapy - am I allowed to?
Cecelia said:
I wish we had the UK attitude here.
It is normal here to start PT one day post op aggressively bending and flexing the knee. My discharge instructions were 90 degrees by 3 weeks and 116 degrees by 6 weeks. PT is done three times a week with Home PT three times a day. By four weeks my PA was already talking about MUA. Every time I go to PT they give me the numbers.
It is no wonder we are all nuts here and hurting. I find it very upsetting to be so pushed.
Click to expand...
When it comes to PT, you are the boss, not your therapists and not your doctor. Take charge and speak up on behalf of your knee.

All that PT isn't necessary anyway - 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.

There's no need to rush to get ROM, 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

Cecelia said:
Even on this forum there are different viewpoints. Like yours doing basic ADL and walking. Others say two hours of Home PT per day. In the US there are so many different opinions. I wish there was a world wide Standard Of Practice for TKA. I go to my OS this week. Wonder what opinion he will have.
Click to expand...
I don't think you'll find any of the staff on BoneSmart recommending 2 hours of home PT per day!
Read this again: BoneSmart philosophy for sensible post op therapy

Yes, there are different opinions all over the world, even in the same country. Each surgeon advises what he/she has been taught. It's up to you to choose what you do with your knee.
Remember this:
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
​
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 gentle 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. I think that speaks for itself.
 
Good news. I went to my surgeon at the 6 week mark. The small drainage on the incision is a small suture abscess that will resolve on its own. He said my knee looked great, that many of his patients had a swollen, red, and a hard knee at this point. Mine is normal color with less and less swelling. He was pleased with 0/96 ROM and said he was happy with 90-95. The weird part here is his own PA said I needed 116 ROM at 6 weeks. So even the same office tells you different instructions. He was sympathetic to my having pneumonia and the need to not push recovery. Pain medication was an issue with only Tylenol from week 2-3. For the next TKA he said some ortho docs are using the On Cue Pumps for 3 days after surgery and that might be an option. I felt so much better after the visit. I had been afraid that my progression was behind. His response to possible MUA was, I was never thinking that. Of course his PA said just that.
So happy days. Thanks for listening.
 
Odd, isn’t it, how often the PA wields more of a whip than the OS? Great news that your OS is so enlightened and caring! More should be like him. Also, now you can take on the rest of your recovery knowing he’s expecting only to see you do well, and if you need a replacement for your other knee you can be less stressed about him having unrealistic expectations.

Between you and me, you will probably get better than that 96 flexion down the road. Way better. You’re only six weeks out and have 10 and a half months to go. That’s a lot of healing and getting better.

Thanks for sharing this great report! :flwrysmile:
 
Awesome report!

It makes me angry that some PAs, who are not as knowledgeable as the surgeon, gives us inappropriate information, which in turn upsets and scares us and makes us feel inadequate. Shame on them for feeling the need to show their superiority.
 
Glad you received an excellent report. You will likely continue to improve over the next months, I did with my first knee. By around 5 months I hardly ever thought of it.
 
It's a shame how PA and PT can try and be way too pushy. They think they are encouraging us, but it's the opposite. It's almost like they want us to be scared all the time. Stress slows down healing. The more relaxed we are, the better we'll heal.
 
Week 8 of recovery: positive achievements

Drove my car in the neighborhood
Gave up walker in the house, using walking poles on our road
Increasing length of walks
Only using Tylenol 1000 mg per day times 2
Gaining weight ( this is a good thing )
Gaining more energy, still 2 naps a day but less exhaustion
Doing more about the house

I still think recovery is slow but then I read my diary and every week is getting better.
Rom is 0/90 at PT but I can feel my knee is gaining strength
Complaining less which is huge.

Thanks for being here.
 
Cecelia said:
Even on this forum there are different viewpoints. Like yours doing basic ADL and walking. Others say two hours of Home PT per day. In the US there are so many different opinions. I wish there was a world wide Standard Of Practice for TKA. I go to my OS this week. Wonder what opinion he will have.
Click to expand...

Hi Cecilia. First congratulations on the progress. I wanted to comment on your statement about the different viewpoints in this forum. So far the advice in this forum has been very consistent. The BoneSmart way recommends being gentle on your knee(s). Avoid any exercises that causes pain. PT is not necessary for recovery. Many in this forum have recovered in time just doing ADL, walking, taking meds on schedule, icing, elevating, and resting.

That is what I have found so comforting about this site. The advice is consistent and it works by the experience of those who have gone through this. This unlike many OS and PTs who have never had this traumatic surgery.

Your practice of journaling is a good one. It serves of a reminder of your progress. I don’t journal except posting on BS but my husband reminds me every once in a while of what I’m able to do now as compared to 6 1/2 weeks ago.

Sending well wishes for continued recovery.
 
You have had a very successful week, it sounds like! I bet it felt good to drive. It did for me!
 
Sounds like you’re doing great at 8 weeks! Driving helps gain a little bit of independence. :thumb:
 
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