TKR Everything Comes to She Who Waits

[patient 99]

Hi All Josephine, I am preparing my list of questions for when I go to see the OS on the 16 August. I thought I'd run them past my BS chums just in case I've missed anything. I have met this man on 2 previous occasions and he rushes me a bit. So wanted to be prepared.

Brief background. No pain.No longer taking medication. Fully load bearing. Extension O Flexsion 90-120. Very little visible swelling. The swelling that there is is just below my knee. Able to walk for a couple of hours before it becomes very uncomfortable (stiffens up). The MAIN downside is the tight rubber band syndrome. I don't have much freedom of movement. Knee feels like a parcel - all tied up. Last time I saw the OS (6 weeks ago), he said if there really wasn't any improvement when next he saw me the only thing he could try would be MUA. There has been improvement, but quite small. If I don't try to do too much eg, go on long journeys, dance, stay out late, then its all manageable.

Questions for OS:

1. How do you tell the difference between normal scar tissue, which goes away in time, and scar tissue called adhesions, which doesn't go away and requires MUA?

2. Why is MUA being considered when Ext 0 and Flex 90-120?

3. Is the tight band syndrome normal at 5.5 months?

4. If MUA is recommended how will I prevent the recurrence of scar tissue post MUA?

5. What are the dangers associated with MUA?

6. If MUA is not recommended what should I do to continue to help my knee improve?

7. At some stage is there a good chance that I will be able to do most of the things I want to eg, go dancing, do gardening

Thank you for taking the time to read this. Carol

 

[Knee pain]

I agree with all the above, your just doing so much, I cant believe how I would feel if I tried to keep up with you. OUCH...DOUBLE OUCH. Take care look forward to our journey together. Look after you first.XO

 

[patient 99]

Knee pain Hi Knee pain. Don't think your above message was for me. Its not a problem. I mention it only so that you know your message hasn't gone where you thought it had. If I can help please let me know. Otherwise one of the moderators will assist. Good luck with your recovery. Carol

 

[patient 99]

Hi Knee pain. There's a thread in social room regarding how few Australians there are using BS. So pleased you made your way here. Carol

 

[Mutley]

I know EXACTLY what your surgeon will say! He will say all is on track for 5.5 months & just GIVE IT MORE TIME
Must admit I went with my long list when I saw my surgeon but as he had squeezed me in an appt during his fracture clinic, it was so busy that I felt I couldn't just reel off all my questions I wish now that I had just given him the piece of paper & say, " Here, read THIS"!!!

 

[patient 99]

Hi Jaki

Its a broken record isn't it. Just give it more time. Eventually the problem goes away because you die of old age. I will have my questions typed up and hand him the bit of paper. Perhaps I should put a p.s. on the bottom of the sheet "reply to each question in full or I will break your knees".

Did you exchange contracts?

 

[Mutley]

No but our solicitor has now received some info from sellers solicitors so at least they are talking
Apparently they are now going to get underway with the searches...watch this space!
I was in rather a lot of discomfort...oh bum, I'm lying! I was in bloody agony this morning so risked taking a tablet that has previously made me very ill. It did make me rather muzzy headed but not quite" the worst ferry crossing in the world having drank 10 pints of Stella"! It seemed to just take the edge off my symptoms so as I was having to do the 2nd dog walk as well this afternoon I thought I'd take another one...BIG MISTAKE How I made it round the woods without bringing up my earlier consumed boiled eggs & toast I do not know! Now laying on the sofa FEELING like I've drank the 10 pints of Stella!
You know I think I would give him your list & just say, " I value this appointment with yourself so much that I couldn't risk missing any answers to my questions "!!!

 

[patient 99]

I am a betting person. If they are doing the searches the odds are now extremely high in your favour.

In agony! oh Jaki. How often does it get that bad? Would you consider going back to see your regular doctor (not the locum)? I think I can hear you shouting NO, NO, NO. But you might have to. We use words on BS like pain, hurt, discomfort, aches but AGONY is a different ball game.

I would give him your list & just say, " I value this appointment with yourself so much that I couldn't risk missing any answers to my questions "!!!

I'm sure you're right, but diplomacy isn't my strong point. No, its threatening to break his bloody knees or nothing. What have I got to lose? The worst that could happen is I'd end up doing TIME and I am getting jolly good at that.

 

[Mutley]

Well,I'm feeling slightly more optimistic that this will be our house...eventually but like my OH says, only believe it's yours when you put the key in the door
No, not going back to the Doctor! Completely sick to the back teeth of them & feel very let down Having said that, if I get to the point of trying to learn how to tie knots, well, I WILL go back & see my regular Doctor Just trying to deal with it on my own, as I have a feeling this is going to be with me for quite some time to come......
It's not bad all the time & for that I'm extremely grateful. A bit like you when you say I have no pain & don't take any medication but I have this horrible tight band feeling. It's just annoying....

 

[turtle68]

Hi Carol, Hope you're feeling better by now. It sounds like your sister knows how to push your buttons. I know that tight band feeling must drive you crazy as it inhibits your movement, and I do hope the OS has some answers for you next week. Are you still doing the water therapy? Just busy her in the throes of moving. Or at least my husband is. I can't wait until this part is over, and we can relax, start going to some movies, and keep an eye on our house as it is being built. Have a goodweekend.

Dorothy

 

[Josephine]

Is the tight band syndrome normal at 5.5 months?
If MUA is not recommended what should I do to continue to help my knee improve?

Yes, perfectly normal. Mine lasted for almost a year! (getting less and less as time went on). I've said it before, but this is a form of post-op pain and you need to take pain killers to help with it. Just paracetamol or otc co-codamol will do and just now and again. Perhaps before you do a big walk, that kind of thing.

Why is MUA being considered when Ext 0 and Flex 90-120?

No surgeon would reasonably consider an MUA with flexion at 120, much less with extension of 0! My guess is that he's suggesting it because you seem so unhappy about things and he's at his wit's end to know what to do. But there are plenty of people who would be DELighted to have a ROM that good at 5 months!

At some stage is there a good chance that I will be able to do most of the things I want to eg, go dancing, do gardening

Every chance but not at 5 months! Overall recovery can take up to a year.

 

[patient 99]

Josephine

Yes, perfectly normal. Mine lasted for almost a year! (getting less and less as time went on)

Sometimes I feel a bit embarrassed that I don't seem to take things in at the first telling. It has to be hammered home repeatedly. I'm sure you have told me before that the tight band syndrome is quite normal at 5.5 months. But not until now, when you've said that yours lasted almost a year, have I really heard you.

My guess is that he's suggesting it because you seem so unhappy about things and he's at his wit's end to know what to do.

If that is the case I think its inexcusable. I better not appear unhappy when I see him on the 16th or he might suggest breaking my arm as well as manipulating my leg just to put a smile on my face. Carol

 

[patient 99]

Hi Jaki and Dorothy Seems like next week is going to be a biggy for all 3 of us. Jaki should get some definite news on the new house. Dorothy will move out and I will see the OS. Watch this space. Bugs C.

ps: Dorothy, I've stopped pool therapy. Down to just my pedal exercises twice a day and usual living. Had a little triumph this morning. I was in the shower and for the first time since my op I realised I was standing still for several minutes and it wasn't uncomfortable. Yipee.

 

[Josephine]

No, not inexcusable but understandable. I've heard many surgeons at conferences say they were 'at their wit's end' (or similar phrases) when asking the assembly what they did for patients with such-and-such a set of symptoms or who said they were unhappy/in pain/otherwise dissatisfied with their surgery outcome. Very often one of the speakers would reply that they would and had even done a revision in extreme circumstances for no other reason and that it seemed to work. So whatever it was that ailed the patient that they were unable to identify, a redo fixed it.

This may seem extreme to you but from their point of view if the patient genuinely appears unhappy with their outcome, they are pushed into a corner and may well offer to do something that might well produce a result even though there is no clinical evidence to support that decision. In other words, they're not gifted with second sight and there comes a time when they have to concede that they don't know everything and sometimes have to just wing it!

 

[patient 99]

Dorothy, I was just about to message saying what are you doing up so late when I remembered its not 9.30pm where you are. But look at me sitting at my desk, eyes wide open. Impressed?

 

[turtle68]

No, it's only 3:40 - what are you doing up so late? I haven't eve had a shower yet today. Must get busy.

Have a good weekend.

Dorothy

 

[patient 99]

that they would and had even done a revision in extreme circumstances for no other reason and that it seemed to work. So whatever it was that ailed the patient that they were unable to identify, a redo fixed it.

Josephine, I am amazed. But in my case all he had to say was what you have said ie, TKR is good, tight band syndrome normal for 5.5 mths. MUA totally unnecessary. Go home and get on with your life. I would have smiled all the way out of the hospital.

What I take from this is when I see him next Friday I will choose my words carefully so that he doesn't feel backed into a corner. Carol

 

[patient 99]

Dorothy, I am seeing what it feels like to be a grown up. Its dark outside and I am not in bed. Wow.

 

[Knee pain]

I really enjoyed readying about your tight band around your knee, this seems to be the biggest problem I am having at the moment, being at 7 weeks, I must be patient by the sound of it. My bend is at 115, so I guess this is OK also. It really puts your mind at rest when you read some thing you a thinking about. Have a great day.
Regards Leonie.

 

[patient 99]

Hi Leonie, there does seem to be 2 things to attend to after the op. One is, of course, your TKR. The other is your HEAD. We are given pain meds and exercises for the knee but absolutely nothing for the head. Finding BS is what has helped my head. We all crave reassurance. The PTs offer some, but they have never had a TKR. The OS you get to see rarely and he probably hasn't had a TKR either. So that leaves you and me and all the other BoneSmarties to help each other.

The tight band syndrome is tough but apparently very common and very normal. Josephine's message above said it took her a year to lose it. So I am taking strength from that. 115 at 7 weeks is absolutely great. Hope you aren't having too much pain at this stage. Keep me posted. As they say `its good to talk'. Carol
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