TKR Everything Comes to She Who Waits

[Mutley]

Dorothy, let me tell you right now, you are doing BRILLIANTLY! Bearing in mind what you have going on, with the house sale, sorting out packing arrangements/removals etc AND recovering from the TKR, well I think your great Like Carol, it's still early days you know! I'm sure your putting your thinking skills into the house move while your husband is carrying out those thoughts! It takes two you know! So good to hear that your doing well! Take good care of yourself & that knee! Jaki x

 

[turtle68]

Thank you Jaki, for your kind words. They mean the world to me.

 

[Mutley]

Carol...WHERE ARE YOU???
Hope your doing ok? Hopefully your be back with us soon to post an update. Just to say thinking of you & hope all is well.
Jaki x

 

[patient 99]

Hi Jaki, Bit slow in replying because I haven't been getting email alerts when there's a message for me.

I went to see the OS today. The upshot is that he thinks I am having difficulty walking, and generally being able to get on with my life, because of lack of bend (currently 90 to 100). Because my bend isn't too bad he has given me 6 wks to improve it. If by that stage nothing has changed he will do MUA. As you have had this, I'd be interested to hear your take on it.

I asked him what the tight rubber band sensation actually is. I said I'd heard it was build up of scar tissue or fluid retention. He said it was none of these. It was just a phenomenon of TKR, and the bad news was that for a few people it never goes away!

I also said that I was often very confused when it came to the balance between exercise and rest. He was absolutely adamant that I needed to exercise and work my knee as much as possible. He said it didn't matter if I got a bit of swelling. That only by challenging the knee would I get an improvement in bend and get the knee to do its job properly.

My natural inclination is to come home and work the knee as hard as I can. I will, however, be more sensible - BS has taught me that . But I am going to push a bit harder. I really don't want MUA, and if he says pushing the knee harder, is the way to achieve this, I am going to do as he says. Wouldn't life be easier if there weren't so many different opinions?

Another good thing was that when he talked about MUA I didn't freak out. Even now I am quite calm. That would not have been the case a few months back. I must be toughening up. When I was a teenager and first got my periods, I used sanitary towels. Then a savvy school friend told me about tampax. I was very wary. I held it about 6 feet away from me, and couldn't understand why it wouldn't go in. It took a long time, but I did get there in the end and the trouble was all worth it - sound familiar? xxC

 

[Mutley]

Hi Carol & so good to hear from you
Well, you sound like you've had a fairly good appointment with your surgeon even if the news on your ROM wasn't quite as positive as you or he would have liked. I think the 6 week mark of trying to up the exercise a bit & see what happens is a good call. I would really try & get to the pool as much as you can (with-in reason!) during that time as I think the water really does help, especially in the hydrotherapy pool. At least by giving it another 6 weeks no-one can say you had an MUA way too early! Your ROM isn't horrific by any means and I'm sure more can be gained in the coming months UNLESS you've been told otherwise.
I don't want to put you off by talking about my MUA. Yes, I gained a bit more ROM, going from 80 to 120, but he wasn't able to gain anymore than that due to previous trauma, op's etc & there is no way I will be able to gain anymore either. I'm currently still around the 100 mark ( I think!) Generally I can do most things but sometimes I'm left wishing for a little bit more. The extension is still around the 6 degree mark. This frustrates me MORE than the lack of ROM as I believe it affects my walking. I was watching myself as I walked by some glass fronted shops & I do have a unique walk Some people breeze through an MUA but unfortunately I didn't & I believe I'm still suffering from the after effects some 5 months later. My Dr has also mentioned that the pain's I'm suffering with could be with me for years or even life. Now even to be that is a VERY NEGATIVE train of thought so I just deal with it & mentally tell myself I'll re-address the situation at the one year anniversary.
So, my advice to you is concentrate on the next 6 weeks. Do your exercises religiously, go to the pool, do some walking, rest, ice, elevate, take pain meds if required but satisfy yourself that you have done everything in your power to try & avoid an MUA but if your told you do need one, it won't be because you didn't put the effort in!
Big hugs & thinking of you...but trying to forget about the Tampax story
So glad it's Friday...so glad it's wine time Cheers! Xx

 

[patient 99]

so glad it's wine time

Hi Jaki, I have always been amazed at how much support you offer me, when every now and then you reveal how tough it is for you. I wonder what your previous employment was. If you weren't in the people business I'd be surprised. I'm really pleased you get stuck into the drinks and do unconventional things, otherwise I'd think you were too special for the likes of me. That's not to say I'm a little ****, far from it, but there is definitely room for improvement.

I walked by some glass fronted shops & I do have a unique walk

Me too. But I don't care as much about that as I thought I would. The important thing is walking, and hopefully in time walking without discomfort or pain. Taking each day at a time and not dwelling on how things might be for the rest of your life, has to be the right approach. You know the saying `what doesn't kill you makes you stronger'? I do think the whole TKR experience does have that effect.

I will definitely be doing all the things you mention to avoid MUA. I think I will do pool therapy every day. Quite a nice way to start the day.

Big hugs

Oh shucks. I'm from Newcastle remember. We aren't that demonstrative - at least not when we are sober. Go on then, Big hugs to you too. Carol

 

[turtle68]

Good to hear from you Carol, and I'm glad to hear you're not too upset about that possible MUA. Hopefully your efforts o ve the ext six weeks will help you get more bend. I have been in an outpatient program for depression and to get my meds straightened out. It's going well and, hopefully, will only be a few moe days a its very hard to sit there from 9-3. My knee was doing really good and then yesterday it locked up again. Hopefully, it will be better in few days. Keep in touch, and take care of yourself.

Hugs. Dorothy

 

[Mutley]

You name it, I've done it...well, almost Your right though, I've worked as a learning support assistant in a junior school & as a health care assistant in a rehabilitation hospital. Currently a company secretary but when we move I think I'd like to go back to hospital work.
The trouble with me is I can " Talk the talk" but don't often apply it to myself I can tell ANYONE about dieting, tips, recipes, exercising, whatever is needed to get the best results...but don't follow the advice for myself...HOPELESS!
Now you Carol are MUCH CLEVERER than me! For a start you MANAGED to get an avatar picture up on your profile...all I got was " computer said NO! Too big, resize, step away from the settings facility..."
By the way, I so DON'T do hugging but either getting older or surviving a TKR has possibly mellowed me a little! If a little virtual hug makes a difference to someone's day, I say let there be more hugging
Thinking of Dorothy & I know she will enjoy lots of hugs from us both at the moment so DOROTHY, this one is for you too
Here's to a lovely positive " I'm feeling a bit better than yesterday" day!

 

[patient 99]

Hi Dorothy really pleased to hear your class is working out for you. I have read several books on coping with depression. Not to trivialize it, but I think it can be a little like dieting in the sense that you can start off good, with all the class reinforcement, and then it tails away. If I'm correct you need to adopt an approach that will stop that from happening. This is a little thing, but it has helped me over the years. If I feel down I find a quiet place. I make myself think of something that has made me happy. I rub the palm of my hand to reinforce the thoughts, and I make sure that I smile at the happy memories. Its not rocket science, but it works for me. Some how its hard to be down when you've a smile on your face.

Today I discovered a new ROM exercise. I have loads of exercises given to me by PTs and from books I've bought, but this one I hadn't come across. I find it very good, so just in case its new to you too I thought I'd share it. You lie flat on your bed. Lift the TKR leg into the air. With the leg still in that position let it bend at the knee. Gravity brings the knee down. Once it gets uncomfortable you have to stop. The pluses seem to be that there is no pushing involved, gravity does the work.

The hardest thing for me over the next 6 wks will not be doing the exercises, but getting the balance right so that I don't overdo it.

Have you been back to look at the complex you're moving to? I'd find it hard to stay away. I imagine you can use some of the facilities even though you haven't moved in yet. So that's big hugs from me and big hugs from the other one. xxC

 

[patient 99]

Hi Jaki I would have put money on it that you had worked with children and/or patients - it shouts out of every message. Your talents are wasted as a company secretary. I too have done lots of different jobs, but for the last 20 years I worked as a management consultant. In the end it all seemed a bit pointless. I didn't think I could make a difference - its hard to change the culture in large organisations. So I took early retirement and enjoyed all my free time hugely.

You said you can talk the talk, but don't always apply it to yourself. That's very common. I think that's when a mentor comes in handy. A lot of things are just too difficult to go it alone - hence BS. We do of course have our family and friends, but sometimes they are too close. Believe it or not, but my mentor is my ex husband - who incidentally put my avatar on BS for me. I wanted to take all the credit for that, but the 2 friends hugging each other in your message were looking right at me. I just couldn't fib. x Carol

 

[kneeper]

Finding that balance is a very individual thing. It's really trial and error, I think. I think the PT once said it's ok to be a bit sore after the exercises but if it's more than a couple of hours you probably did too much.

the "gravity" exercise sounds a lot like one they had me do a ways out, only in that one you scoot yourself close to the wall and let your foot slide down the wall.

 

[patient 99]

Hi Kneeper As your right knee was done 2011 you are one of the more experienced around here. I'll have a look at your thread, but just wondered how you are doing. Avoiding MUA is what is top of my list at the moment. The MUA isn't to impove ROM (I'm 90 to 100 and getting better little by little). Its to loosen my knee up a bit so that walking will be easier. 4mths post op means I know a fair amount of the right/wrong things to do. But any tips you can pass on to me would be greatly appreciated. I've got until 18 August to shape up. Carol

 

[Mutley]

...my thoughts on this subject as I was out " attempting" to walk my dogs at 6.30am, what the hell can I do to make my walking easier/ less uncomfortable/painful? Answer to myself??? CHOP THE BLOODY THING OFF Ignore me, bad night therefore will be a bad day!
If your surgeon is only interested in doing the MUA to loosen the knee up, I would definitely say NO! At JUST 4 months out, I would say your problems are just down to your knee taking longer to settle down. I've been lucky in ONE AREA at least, & that is I haven't & don't really suffer with excess swelling. However, my friend Laura in America is a few days behind me post op, so at nearly 7 months she still suffers with swelling. This obviously can make the knee feel tight. It might be worth searching the Internet & finding out about various forms of massage? I think even Dorothy said she had had a couple & felt they had really made a difference. Now before you get carried away dreaming about tall, dark men giving you a full body massage, this idea is purely meant FOR YOUR KNEE Anyway, like I said, it's just an idea.......Wishing you a lovely sunny Sunday in your part of Sussex!

 

[patient 99]

What a little tease you are. Give with one hand, take back with the other. If I saved up my therapy pool money might I not just have one all over massage with a tall, dark man (he doesn't even have to be that tall). We might get cheaper rates if we shared him. In fact I think we are onto something here. Instead of going back to hospital work when you move, how about we set up an agency. There's about 10,000 of us Bonesmarties and they are a game lot.

Bad nights are awful. At least its Sunday so may be you will get more of a chance to rest. I've thought about your idea of chopping your leg off. I think ON BALANCE I would say best not to. As you say to me. Time, just a bit more time and we will get there. We will be stark raving mad, but WE WILL GET THERE.

I never thought I would say this, but I am getting much better at knowing what my knee can cope with, so for the moment I am going to keep doing what I'm doing. Will keep very much in mind what your thoughts are on MUA. x Carol

 

[Josephine]

Oh I agree about the MUA, Pat. That is not a good reason to do it. However, I would imagine it to be unnecessary if you are achieving 100+ as that's the cut-off point for most surgeons. No MUAs required once you've got to 100. You're still only 4 months out so plenty of time to get more. Lots of people find they continue to increase even as late as one year out. I'm sure you'll make it in the end.

 

[patient 99]

Josephine the issue is not the bend (as you say 100 is not too bad at this stage). The problem is the tight rubber band which sits just above and down the sides of my knee. It restricts my WALKING, is very uncomfortable and at times feel worse than in the early days. If it wasn't for that, I would say I am doing well. No pain, very little swelling, nice straight leg and improving on the bend.

My OS says that MUA might help to ease the pressure, making walking easier. He is concerned that it is this bad 4mths post op. I've read your article on the tight rubber band issue. I know it is common. And I've read messages from other Bonesmarties who are experiencing difficulties with it. The impression I've got is that it goes given time. Of course, we might be dealing with something which seems like the tight rubber band phenomenon, but is something else entirely.

I have no reason to believe my OS is over zealous or incompetent. Which results in my being very confused when experts like you and the OS differ. He has suggested leaving it another 6 weeks to see if things improve. I will then be approx. 5 months post op. If its no better by then I wont know what to do for the best. I do not have the knowledge to make the right call.

 

[robynhood]

Hi Carol, i feel your confusion. Here I am 9 months post op and my ROM is still 90. And the most annoying thing is they just keep saying I didnt have enough physio in the early months. And that was not my fault. They signed me off. I didnt know any better and I asked why they signed me off and she couldnt give me any answer to that. She showed me exercises on Friday that I have never seen before which is ridiculous. My extension has been excellent from day one after the op and that has helped with my walking which has improved 100 percent. So now Im back to. Exercise bike 15mins to warm up exercises mostly stretching and walking walking walking. If and when I have the other knee done ( ooo that ones a little bent isnt it she said) the one thing I would change is the physio. First of all to have some and secondly to have it for much longer. Theres even a knee class which I didnt know about. Its so annoying.

 

[Josephine]

Yes, I understand that. But it's all part of the recovery phenomenon. I suffered from that until at least six months out and it was a real beggar and kept me using a crutch for ages!

Question is, are you treating it for what it is - post-op pain? Are you still taking pain meds? If so, what, how much and how often?

 

[patient 99]

Hi Pat, if they hadn't blamed lack of physio, I wonder, would they have found something else. I have had a lot of physio right up to the 12 week stage. I will probably be told I did too much!!! I am now doing pool therapy twice a week. Were any of the new exercises you've been given worth passing on? I seem a bit short on stretching exercises. Your story is so similar to mine. I only found out about the knee classes by talking to a woman in the ladies loo. I forced my way on to them. After a while they said I was too good for the classes and had to leave. There were only 3 other women in the class - what difference did a fourth make?

My OS says that I cannot hurt my knee, that I could play football if I chose. Again very conflicting advice.

I am off to bumble along now, never knowing if what I am doing is right or wrong. Am I challenging my knee enough, not enough etc etc etc. Oh just one more thing to demonstrate my confusion. One PT was worried about swelling below the knee, said go see your GP. GP said its fine. Another PT said the scar looked infected. OS said it wasn't. I've been told all along that I'm doing fine, now there is talk of MUA. Mutley was threatening yesterday to chop her bloody leg off - she might just have the right idea. But pound to a penny there would be 10 different views on how to do it and still stay alive < Pat, in the end you just got to laugh.>

 

[patient 99]

Yes, I understand that. But it's all part of the recovery phenomenon. I suffered from that until at least six months Question is, are you treating it for what it is - post-op pain? Are you still taking pain meds? If so, what, how much and how often?

If its all part of the recovery phenomenon, it still begs the question `why would the OS be considering MUA?'. This is a rhetorical question. It isn't post op pain. I don't have pain. This is why I don't take pain meds. I think you are about to say `it is what we call post op pain, and therefore pain meds are the answer. It doesn't hurt so I can't think of it as pain. What it does do is restrict the movement in my knee, which affects my walking. No doubt there are some real heavy duty drugs that would make me forget the restriction. The walking would still be as poor, I just wouldn't know it. But I don't want to take heavy duty drugs.

Josephine, I know you are trying to help me and I am sorry for being a pain<no pun intended>. I've got 6 weeks before I need to make the MUA decision. So perhaps the answer is just to get on and do the very best I can in that period. Who knows it might all be wonderful by that stage.