Extreme pain 5 month post op

[scaredinCA]

I feel conflicted. BoneSmart is teaching us that the numbers don't matter that much. Reading these posts, I see the same thing, numbers don't matter all that much. But when in physical therapy and in the doctor office it seems that the numbers are all that matters because if you didn't reach a certain number then you need a MUA. I tend to believe that numbers shouldn't matter, the only thing that should matter is how you feel and what you are able to do now that you couldn't do before. But it doesn't matter what I think or believe, its still all about numbers. I see my surgeon next Friday and am scared of what he will say, or worse, what he may do to my legs because of those damned numbers.

 

[Nomorepain67]

Hi ScaredinCA
I also see my OS for the first time next Friday specifically related to ROM and I will be at 4-weeks post-op. I am uneasy as well because quite honestly I never asked him before surgery what his perspective was related to aggressive ROM or slow and steady. It was his PA who recommended PT 5x per week when I had my staples out week two. I am hoping with all I have learned from BS that we can have an honest conversation and that I can tell him "NO" if his preference is to be more aggressive. As others have said, I'm paying him so I believe my preferences should be considered. Good luck next Friday - we'll have to compare visits.
Stacie

 

[Celle]

Dear scaredinCA, please don't worry any more about those numbers, or about what you think your surgeon will do. Why? Because it's your knee and you have the right to tell both the PTs and the surgeon that you will not allow them to hurt you. You do not have to fear what the surgeon will do, because you have the right to tell him STOP! You truly don't have to allow him to do what you fear. They can't do anything to you without your permission.

Many surgeons have a belief that, if you don't reach a certain ROM by a certain date, a MUA is necessary. In this, too, you have the right to decline, to say "I understand, but I would like to give this a little more time first and think about a MUA later." There is no absolutely critical time within which a MUA must be done, so all is not lost if you defer it for a bit. Your surgeon can't force you to have a MUA - he won't come to your house and drag you to the hospital for it.

Do you have someone you can take to the surgeon's appointment with you, to help you speak up for yourself? A bit of moral support could help, if you feel overwhelmed.

Best wishes,
Caryl

 

[scaredinCA]

Stacy we will compare visits! And Celle thank you for reminding me that I'm in charge of my knees. Last week at pt I told the therapist to stop, and she did, but I should have told her sooner because my knees were swollen for three days afterwards. So far in recovery I haven't had swelling problems, so I know exactly where last weeks swelling came from!!
Its just so hard to stand up to these therapists that have been trained a certain way and they honestly believe their way is right! Very frustrating to say the least. My daughter will be with me, but even she finds it hard to buck the system. We want to be good girls.

 

[Celle]

Unfortunately, we do seem to be programmed to want to please authority figures. I'm sure that you do want to be "good girls", but please don't let that desire impact on your rights and on your knees.

It might help if you and your daughter have a talk before you visit your surgeon. Plan together what you will say and keep practicing it. Think about it like this: If he says this. . . , I will say "I understand, but . . . " Prime your daughter to say something like "My mother doesn't want you to do that, so please stop."

 

[Grammy211]

ScaredinCA,
I am right there with you. I am leaving for my doctor appt in a few minutes and am scared out of my head because I know what's coming! Even though everyone says not to worry about the rom numbers, I do because they seem to be so important to the doctor and therapist. If I'm not where I should be with the doctor (and I'm not) then he calls my therapist and tells them to be more aggressive. He's done this twice already. Today I am going to take a towel with me to hold in my mouth to try and subdue my screams. I've asked him before if we could stop now and he said no a little bit more. He swears that I will love him in another month but if I'm so afraid of going to see him, what good am I doing myself?

BTW, may I ask how long it took for most of you to feel better than you did before surgery? I know being almost 7 weeks post op is early but I'm just curious. When I was able to begin pedaling my stationary bike all the way around last week, I was so excited that I felt like shouting it from the mountain tops! That's how I want to feel about each and every little bit of progress I make instead of constantly worrying about what the doctor says.

Well, thanks everyone for letting me vent - it does help tremendously to share with others who understand.

 

[scaredinCA]

I'm at 8 weeks and do feel better all the time. I can *slowly* go up or down stairs the normal way which I think is almost a miracle. I haven't been able to use stairs in a couple years! I can walk up a steep ramp and back down again which was unheard of before surgery.
I feel I am making slow but steady progress even though my ROM isn't that great yet. I'm 105 and 94 with bad extensions of -5 and -12. I hate being measured for a couple of reasons. I'm always afraid I won't be up to par with the rest of the class. And I don't like the physical therapists that are all business, no emotion. And I'm always afraid that my rom has slipped back instead of moving forward, etc. I still can't peddle my stationary bike which is upsetting. But overall I believe I have improved anyhow.
How did your doctor appointment go?

 

[Grammy211]

Actually my doctor visit wasn't too bad today. I told him right away that I haven't had therapy for 2 weeks and why and he was so upset over that that he didn't push me too hard. He even apologized when I started to moan! He immediately called the therapist to have her push my insurance company to get therapy going and boy did it his phone call do the trick! Everything got approved and set up for me to start tomorrow! I see him again in 2 weeks and hopefully I will made enough progress to make him happy.

 

[Celle]

I'm so glad your OS visit went well.

 

[maryo52]

The reason I worry about the numbers is because they report these numbers to the surgeons, and then the pt's get in trouble if our numbers aren't good enough. The surgeons expect a certain set of numbers by a certain time or they start talking about MUA.

Neither recovery nor the patient-doctor relationship should be fear driven. All of your care should be patient-centered. Your efforts are to make your KNEE happy, not your surgeon. He is your employee by the way.

For the record, PT is not necessary. But by all means pursue it if you derive benefit and support. PT will not prevent MUA, though. A simple set of home exercises is all you need. Those who have MUA have adhesions, which are not caused by the lack of PT and in fact are made worse by aggressive PT.

 

[Celle]

Mary, you said it better than I could!

 

[Grammy211]

Thank you Mary and others for your encouragement! My therapist is complete opposite of my OS and i really like her! She believes in gently exercising and stretches and won't allow me to be in pain. I actually did increase my ROM during the 2 weeks I was exercising on my own so that was a huge encouragement! I will see how my next doctor appt goes (Sept. 10) and if he's still too aggressive I will make it my last!

 

[maryo52]

Great to hear about those gentle, supportive PT!

I think our orthos are ethically and legally "married" to our knees. Yes some of us need move on when we have an ortho who totally is not working for us. However, your ortho is responsible, at least in the first year, for seeing your knee to its anniversary. He will contact you even further down the road to monitor the knee's progress. So if you can make it work, that's best. Of course your self care comes first. But when we advocate for ourselves, and decide for ourselves what is right rather than taking their word, we help make them better doctors. Plenty of people on here (lots!) have proved their doctor wrong by saying no initially to MUA and then gaining good ROM through our approach. Just think of what a valuable learning that was for their orthos! My ortho claims his best learning is from his patients.

 

[Carolina girl]

I am at eight weeks and I cannot pedal all around. I am not worried about it and no one is stressing over it! You should not fear visiting your doctor. Only you can put a stop to it!

 

[kneeper]

Sounds like a good pt. I know it's hard not to focus on the numbers but the main things I found were--can I do more than I could before? Can I move the leg more easily?
that progress continued for many months.

 

[Bionic woman2]

I have noticed a huge difference in my ability to bend my knee while sitting in a chair verses laying on the floor or doctor's table.

I noticed this today. When I sit with my back against the wall it's greater and easier to achieve. I haven't been measured in a while, so I'm using my "good" to compare it to. Today I manage to bend past it. I'm having surgery on it in a few weeks so that's no surprise. It's tired of being the good leg. I've been measured and stretched past my comfort zone a few times, and the last time was one time too many.

I think true ROM is that which you can achieve yourself, with little discomfort. Otherwise it's like squeezing into a pair of jeans to be a certain size, only splatter all over the place once you take them off.

 

[Grammy211]

I feel as though whenever I'm on this site, all I do is whine and complain but I think this is the only place I can come where someone really understands the recovery journey of my left TKR. So please feel free to stop reading, I completely understand!

I'd like to know at what point most of you felt as though the tkr was really worth it and your pain level became less than it was prior to surgery? I am 7 weeks post op and perhaps just a little too anxious to get a pain free lifestyle back. Today it is hot, very humid, and rainy outside and both my knees are hurting! I am trying to work through my exercises plus get some housework and cooking done for company tomorrow but I feel like I just want to curl up in bed and cry. I've noticed that humid, damp weather does bother my surgical knee but between that and the soreness from doing my exercises and stretches, it is so draining. I cannot take any ibuprofen due to having blood clots after surgery so I can only take Tylenol which does absolutely nothing to alleviate the pain. I do ice a couple times a day also.

Eventually I will probably need my other knee replaced also but at this point I am saying emphatically, "No Way!" Am I being too much of a baby? I've always prided myself in having a high tolerance for pain but it certainly doesn't seem that way with the knee replacement.

So, I'm wondering when most of you got to the point of saying, it was totally worth it!

 

[Grammy211]

Thanks again, I really appreciate all your input!

 

[bottomshollow]

lalyfa, I have merged your multiple recovery threads.​

We prefer that you keep everything about your recovery in one thread as we have all your information in one area. This makes it much easier to answer questions or discuss concerns about your situation. If you want to be sure a question is answered, just tag an admin or a a mod and you will get a response. Thanks for your cooperation. If you'd like a title change to your thread, just tag one of us and let us know what you want and we'll be happy to make the change.​

​

Right now, sweetie, you are doing TOO MUCH, and you are not taking pain meds. Tylenol may not be enough this early out. I did not stop my Percocet until the end of the 3rd month post op. You are only 1/6 of the way through a 12 month recovery. Your knee needs a lot of TLC. And housework, cooking for company, doing exercises is just more than it can cope with----and that's why it swells and hurts. It is telling you to STOP and to SLOW DOWN. But you are not listening.​

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I have some reading for you! The first set is essential reading, the second and third are useful and the fourth is just good information, but you will need it all.

Group A
The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Progression of activity for TKRs

Group B
How Long Does Healing Take ......
Chart representation of TKR recovery
Energy drain for TKRs
Elevating your leg to control swelling and pain
Using ice
Constipation and stool softeners
Sleep deprivation is pretty much inevitable - but what causes it?

Group C
Knee Replacement - Where Am I in Recovery?
So What Is It Going to Take? The Five “P’s” of Knee Recovery
Work “Smarter” and not “Harder”
About recovering a knee - from one who knows!
Some suggestions for home physio (PT) and activity progress
Myth busting: The "window of opportunity"

Group D
MUA (manipulation under anaesthetic) and adhesions
It's never too late to get more ROM!
It's Worth the Wait for ROM
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it

Please don't be overwhelmed by the list. The articles are not lengthy and contain information that will answer many questions and help you make your recovery much easier on your knee and on you.

I also want to share the BoneSmart mantra with you. Following it to the letter will assure you of the best possible recovery.

- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!

We are here to help in any way we can: answering questions and concerns; supporting and encouraging you from start to finish; giving you a place to vent, whine, complain if you need to; sharing experiences with one another; and having fun and some laughs along the way.

Take care and keep us posted. We care.

 

[Grammy211]

Thank you so much bottomshollow! I didn't realize that I should keep my posts in the same thread but now I understand! Also thank you so much for your encouragement and the reading material. I will start reading the articles asap!