MUA Getting Back in the Saddle

[Josephine]

At only 11 days? You betcha it isn't! The only thing you should be doing right now is resting, icing and elevating! Nothing else at all.

 

[HorseyLady]

Day 13. I have been out A visit to my regular PT at the Sports Injury clinic for his assessment on my knee. He did some very gentle exercises to try and wake up my Quad muscle as I still can't lift my leg. No pain was involved and it really seemed to help. He feels that my swelling is limiting my bending - so also did some soft tissue massage above the knee to try and help move it. Unfortunately this was very painful

When I arrived back home there was a message waiting for me from the hospital. They have given me a date for my gynae operation .... August 2nd!!! This means I will only be 7 weeks after my TKR. Needless to say this has sent me into a meltdown and I don't know if I can cope with another operation so soon or what state my knee will be in Then the sensible part of me kicks in and I start thinking .... while I am rehabbing my knee I can be rehabbing my other bits too - instead of recovering then going backwards again. Josephine what do you think? Am I going to cause any problems with my knee having another operation so soon? Anyone else had to make this decision?

 

[Josephine]

1. obviously they have no idea that you've just had major surgery on your knee
2. you cannot have another surgery so soon
3. you cannot have another major anaesthetic so soon
4. if your gynae op involvs using lithotomy poles (stirrups) that's out of the question too, knee won't like that AT ALL!
5. having another procedure will be detrimental to your knee for many reasons: ambulation, taking pain meds, PT, etc.,
6. you should not be in a ward where the staff have no idea of the care required for TKR (ice, elevate, pain meds)
7. finally, there is the question of you being in the depths of the Energy drain and then having to cope with another major assault on your body and your systems - a very good way to send you into the throes of the post op blues

In other words: NO!

Cancel that date and change it to one about 3 months hence minimum.
(Do you think I stated my opinion with reasonable clarity? )

 

[Josephine]

Unfortunately this was very painful

I think you need another look at some of our mantra and one or two articles
- 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

Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?

 

[HorseyLady]

Thank you Josephine! I thought I was well versed in the Bonesmart mantra and I have read all the articles many times over - but it is amazing how the different opinions of all these PT's and the visiting Rehab team starts to make me waiver and become worried about my ROM. Certainly I have not met one yet who tells me to rest, elevate and ice. The message is always that I need to push my knee in order to get ROM and avoid a MUA.

As for the gynae surgery, I think you are absolutely right (of course!) and I should be delaying it. And yes, you were very clear I guess I am just unsure how good my knee will be in 5 weeks time, whether I would be off pain meds, or walking without crutches etc. Wishful thinking!!

as always for your advice

 

[RICBAK1]

Not enough can be stressed on resting and iceing ,i was one who thought he knew better and was fit enough to get over tkr quickly in my case big mistake.Soon as i started taking it easy things began improving and being from s yorks myself i know i can be stubborn but resting and iceing got me where i am today Living my life hope you have the same.REST ICE AND PAIN TABLETS.

 

[Titianlady]

HorseyLady. Alison!! I finally located your thread!! Oh, my dear, I am soo sorry you had such a terrible time in the hospital! I cannot believe your OS and your PT are trying to push that poor, poor knee so hard. You just keep up with our mantra..that knee of yours has got to get some TLC, not be beat up some more. NO pushing to bend.

I am just beside myself I'm so angry for the way you've been treated. You cancel your other surgery like Josephine recommended..she knows her stuff for sure.

Relax ( hard to do, I know) elevate and ice your knee, and don't let anyone intimidate you. Your knee will come around when it has had time to get over the trauma.

Now that I've found your thread, I'll be looking in on you..please take care...I'm sending big (((((( HUGS )))))))) your way.

 

[new knee in June]

Horsey lady,
You sound like you are doing well...my p.t comes to my house I am at 110-0 yesterday was terrible...
My whole leg was stiff...so I didn't,t do any cpm machine or exercises. I iced, elevated & pain meds. On time
I feel much better today & have decided to take 1 day a week off.
The hardest thing for me is I feel like I should stay loose & not stiff all the time. It seems like I am spending so
Much time icing, elevating & therapy..I should be done ( after 1 month) but it seems like I,m always starting over.
Don,t let p.t hurt you, speak up & say "no"
Thinking of you
All my best...diana

 

[HorseyLady]

Hi Diana. What a great idea - 1 day off a week I think I might do that too as it seems my whole days are filled with exercises, icing, walking, elevating etc.
It's lovely of you to say I am doing well but actually I feel I am not doing well at all! The Rehab team came again today - I was very surprised as I had told myself they wouldn't come on a Sunday Out came the old measurement wheel and lo and behold my ROM is 50! Not surprised at all because there has been no reduction in my swelling and until that huge hot lump moves I am just not going to get much movement. Felt very despondent as they say I am not progressing and I am probably going to need a MUA etc. etc. They didn't hurt me today but they want to try some tissue massage next week which I know is painful so I am going to say NO.

To cheer me up, my lovely friend took me to see my horses this afternoon. My old boy Muffin was so so gentle and had a good sniff at my leg and kept wanting to lick it. Oh how I wish his licks could heal me! We had a lovely cuddle and lots of horsey kisses and I know he has missed me so much. My crutches are now filthy and have bits of carrot on them My younger horse Ruben said a quick hi and then went off to play, he is not so bonded with me as Muffin.

I am paying the price for my little trip out as I am now sore, swollen and in pain - so just taken additional pain meds and having an early night. However, it was worth it and so good for my emotional well being that I feel much happier
Sounds like you are doing great with your ROM but I know how you feel with the stiffness and it is so easy to get down about lack of progress isn't it.

Thank you for thinking of me

Alison

 

[new knee in June]

Allison,
I am so happy you got to see your beloved horses sometimes our emotional needs out weigh our physical needs.
Stay strong with therapy, do only what you want, at your own pace. Maybe gentle massage will do some good
( if it doesn't,t hurt)
I hope your swelling goes down. I only have swelling around my knee, I still hate to bend it.
Tomorrow I tell my p.t just because I can do all the exercises doesn't,t mean I should
I am also only doing cpm 2 times a day instead of 3
It seems like between all the therapy, cpm & exercises my knee wasn't,t
Resting to much.
Thinking of you...all my best....diana

 

[Titianlady]

Ohhh, you sound like you had a wonderful time with your horses. Animals know when we're I'll, or not our best, and they do try to be careful with us. I can imagine how great you felt when you got to see Muffin and the rest of your babies.

Just hang in Allison.. Your knee will come around. Just stretch, and follow the mantra. Time will sort it out.

 

[skigirl]

Sheesh, the last thing you need is your doom and gloom therapist!!! You just had major surgery--you need some time to heal. Right now, you should be spending about 80% of the time resting with your leg elevated with three pillows. Read books, watch movies, but don't do anything to increase the swelling. Right now, you need to spend some time flat on your back so that the swelling is reduced. That is the most important thing to do right now. You don't need anyone pushing your knee or trying to "bend" it for you. Most of all you don't need anyone threatening you with a MUA---just give the knee some time to heal.

 

[Titianlady]

Yes!! What Skigirl said!!

 

[HorseyLady]

Thanks Toni, Diana and SkiGirl. I am trying to do exactly what you say as I know my knee is crying out saying "don't bend me, don't even touch me - just let me rest". it is so hot and swollen with a really hard mass above the knee. Apart from my little trip to my horses I am just trying to ice, elevate and ignore the Rehab team
They are fixated about ROM and numbers

 

[aghiaanna]

Day 13. I have been out A visit to my regular PT at the Sports Injury clinic for his assessment on my knee. He did some very gentle exercises to try and wake up my Quad muscle as I still can't lift my leg. No pain was involved and it really seemed to help. He feels that my swelling is limiting my bending - so also did some soft tissue massage above the knee to try and help move it. Unfortunately this was very painful

When I arrived back home there was a message waiting for me from the hospital. They have given me a date for my gynae operation .... August 2nd!!! This means I will only be 7 weeks after my TKR. Needless to say this has sent me into a meltdown and I don't know if I can cope with another operation so soon or what state my knee will be in Then the sensible part of me kicks in and I start thinking .... while I am rehabbing my knee I can be rehabbing my other bits too - instead of recovering then going backwards again. Josephine what do you think? Am I going to cause any problems with my knee having another operation so soon? Anyone else had to make this decision?

Hi, I'm very new to this forum, i just joined this morning, and like you are having to make a decision whether to have a pelvic floor repair soon after total knee replacement. I had my left knee replaced on March 12th and recovered very quickly, after about 3 weeks I was walking unaided and felt great. My right knee was replaced on 4th June. 4 weeks on tomorrow I'm still suffering with pain and need regular pain relief. I don't think there is anything wrong with my new knee, I can move it well enough , its just stiffer than the other one and i cant walk as well. Maybe I also haven't got quite as much enthusiasm for physio this time round! My pre op for the pelvic floor repair is booked for next week...... I also have a follow up on the same day with my knee surgeon and a physio appointment so plan to decide then whether I'm fit enough to go through with it. I so want to get this over with because I'm suffering with a rectocele and know by putting it off I know i will be miserable. I take on board everything the next post says but I'm wanting to go through with it simply to get all these three operations done quickly. I'm prepared to rest as long as I need then knowing all this surgery is over and done with. I enjoyed reading your experience this morning, you live quite close to where I live over the other side of the Pennines, it's quite comforting to know other women are going through the same as me! All the best to you and enjoy your day

 

[HorseyLady]

Hi aghiaanna. Good to hear from someone in the same situation! My gynae op is for a pelvic prolapse (also rectocele!) and also a TVT. I am keen to get this over with as I know exactly how you feel. However, I certainly do not want to do anything that will be detrimental to my knee, particularly as I still have so much pain and swelling and problems with ROM. I hadn't really thought about the effect of the anaesthetic or assault to my body until Josephine mentioned it but I guess it is a lot to go through in a short space of time. And then there's the stirrups .....

 

[HorseyLady]

Day19 - the saga continues. Today I am of the mindset "why do these things always happen to me". The Rehab team came again this morning and we had the usual discussions about my poor progress and why I need to be force bending my knee every hour and giving myself firm, painful scar massage. I have told them the Bonesmart mantra and today I shouted STOP. This is way way too painful and I am not letting them do it to me. You would all have been proud of me!
The PT was most unhappy and told me that the problem was pain management. She said 2 paracetamol and 2 Tramadol every 4 hours is not enough for me and she wants me to be totally zonked out and pain free - so she can break down this haematoma, stop the "hypersensitivity" and get my knee moving. She then rang my GP surgery and demanded that they write a prescription for something stronger. She told me that if they refused she would ring my OS and get him to write me up for something. But there was no way I could be left with a ROM like this (still 50!)

My GP rang me at lunchtime and told me she would not write me up for anything stronger unless she could see me and take a look at my knee. So my friend took me to see her. Evidently I am running a high temperature and she doesn't like the look of the colour of my knee nor the fact that it is red hot and very swollen with a huge haematoma above the knee. Her view is that I have an infection! She has prescribed a very strong double dose antibiotic and said that the knee should be resting and should not be bent. She would not give me stronger painkillers but if things didn't improve in a few days she would write me up for some morphine.

So there we are. I am totally confused by all this as my scar is healing nicely and is not oozing at all. But my GP felt I should be loads better than what I am "You're nearly 3 weeks out, you should be getting going now" and should not be running a temperature nor experiencing so much pain.

Help! Josephine what is your view on this? I really need your advice and the experience of others on here.

 

[puffin]

Sorry to hear that you may have an infection and I think you should stop the heavy duty PT and rest while this is sorted out - just do gentle heel slides and do not allow the rehab team near your knee until it looks better.

I also had a large swollen hematoma about 4-5 inches/10-12cm above my knee that was very painful and red hot in the early weeks - it was as big as my fist and only in the last 10 days has it started shrinking - it is now around a third of the size but rock hard bruising. I try to give it extra icing

 

[Titianlady]

oh, Alison, I'm so sorry to hear this news. Your OS comments were ridiculous..'you should be getting going now' ..how in the world can you get going if you have an infection and such pain. On top of that poor pain management!! Just hearing all this is frustrating ME!

I sure wish you a resolution to this ASAP. Let's see what Josephine has to say.

HUGE ((((((((( HUGS))))))) for you dearheart. I'll pray all comes out ok Alison.

 

[skigirl]

Alison--if your GP thinks you have an infection, then, I would call the surgery immediately. Your surgeon, tHe OS in this country, will have to know of the infections and will probably want to treat it with IV antibiotics right away.