Good morning new friends
- Thread starter maryo52
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OP
OP
I guess this a.m. I had one of those bursts of depression that seem to be part of the process. For the first time, though, yesterday's PT made me feel better. Last night I was supposed to wake at midnight and 4 a.m. to take a pain pill. Either an alarm or my body wakes me. But I slept right through from midnight until 6:30. Wahoo!
Have scrounged up a place with a pool and hot tub to expand my PT efforts.
Happy New Year All! Anyone from Holland on here? Gelukkig Nieuw Jaar
Have scrounged up a place with a pool and hot tub to expand my PT efforts.
Happy New Year All! Anyone from Holland on here? Gelukkig Nieuw Jaar
Wow, Mary....we've never had anyone join the forum from Holland, but I sure wish we would. I think it is such a beautiful country and I'd like to learn more about it.
OP
OP
Am 7 weeks post-op. Refilled my percocet today on my way home from PT. My husband still plays chaffeur since I'm on 24/7 narcotics and my leg is not bending well enough to drive. Long-legged people need even more flexion to function!
Anyhow, a question. What's holding up my stretches in PT is pain. In other words, at the point where I cannot tolerate any more bend, my PT is feeling no resistance. He said he could go a lot further. I did try allowing some greater bends but they were so painful I became light-headed. Plus the whole area over the knee cap feels like a hard shell.
Is this part and parcel with the "angry tissue" phase?
I have tried doubling pain med before PT. I'm on anti-inflammatories. I'm icing and elevating. I'm doing gentle exercises at home (pedal exerciser). I'm walking OK. My muscles are strong. My PT suspects poor early pain management may be the culprit.
Ideas? :th_scratch:
Anyhow, a question. What's holding up my stretches in PT is pain. In other words, at the point where I cannot tolerate any more bend, my PT is feeling no resistance. He said he could go a lot further. I did try allowing some greater bends but they were so painful I became light-headed. Plus the whole area over the knee cap feels like a hard shell.
Is this part and parcel with the "angry tissue" phase?
I have tried doubling pain med before PT. I'm on anti-inflammatories. I'm icing and elevating. I'm doing gentle exercises at home (pedal exerciser). I'm walking OK. My muscles are strong. My PT suspects poor early pain management may be the culprit.
Ideas? :th_scratch:
OP
OP
I thought it hurt because the knee wouldn't bend more. But they're telling me that these past three weeks the stretches have been limited by my pain. Between that and the swelling, it's hard to tell what I'm capable of doing. Golly!
brs0660
supremo
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I suppose poor early pain management is water over the bridge. Now you will have to work with your OS and PT to keep your pain under control now! Not an easy job!
Josephine
NURSE DIRECTOR EMERITA
I think if you read back, that's what we've all been telling you! :whis:
quote:
it's not so much that pain causes swelling but that the after effects of surgery is swelling as the after effects of any trauma to the tissues is swelling. So you have a double causative effect (otherwise known as a vicious circle!) going on: the surgery causes pain and swelling; the swelling causes compression and stiffness which results in more pain; the increase in pain causes more swelling and stiffness - what David so eloquently described as "angry tissues"! Then along comes the PT and starts doing indescribable things to the joint which causes more swelling and therefore more pain, etc., etc.
All of this hinders recovery not healing, as the swelling ends up acting like a splint, prevents the knee from moving very well if at all. Then the patient gets frantic that they're not making progress and instead of cutting back on the exercise and activity, try even harder to get that elusive ROM which just makes matters worse. This anxiety results in the over production of adrenaline and cortico-steroids which cause more anxiety and even depression. It is indeed the ultimate vicious circle.
From: The importance of managing pain after a TKR and the pain chart
OP
OP
This recovery is a little confusing from where I sit. My surgeon who has a superb track record says push the PT. The PT says he's had good success with his approach and presumably we have a trusting relationship. My body says "Ugh!" And you guys say give it a rest. It would be wonderful beyond my wildest dreams to hear from some folks -- or read old posts -- where someone who was < 90 degrees at 7 weeks gained ROM via rest. But then we're all unique in our recovery. I don't mean to be dense or stubborn, but I'm just trying to make sense of it all and do the best that I can. Believe me, I've studied in the BoneSmart Library more than once. I very much appreciate all the information and support.
On the up side I can say that I'm walking pretty well, walking is not painful, and PT has made me stronger and improved my stamina. Who knows, I may turn out to be my surgeon's 1:100 MUA, and don't feel too bad about that because of the article on this website, thank you very much! Thanks too for being a sounding board.
On the up side I can say that I'm walking pretty well, walking is not painful, and PT has made me stronger and improved my stamina. Who knows, I may turn out to be my surgeon's 1:100 MUA, and don't feel too bad about that because of the article on this website, thank you very much! Thanks too for being a sounding board.
leenie60
graduate
I'm in the same boat. My OS expects 3 hours of home PT over and above whatever other PT I'm doing. 3 hours! I went to outpatient PT yesterday for an hour and worked very hard. After I got home if I had lunch, laid down for a bit and was up and down and maybe I did another 30 mins of stretching etc. I understand you have to work hard, and I've worked hard with all of my surgeries, but 3 hours???? I've posted about this before and if it were not the middle of the winter perhaps I'd achieve more time, but I'm not so sure about it. I am confident I will achieve full recovery and ROM and extension, but I doubt very much it will be because I've dedicated so much time to it. I'll work hard it just won't amount to the type of time that he expects, I believe.
Aileen
Aileen
OP
OP
Thank you Eileen and Maggie for your understanding. Feeling understood is a great way to start the day. Plus the sun is flooding into our passive solar house making it toasty warm and cheery. And Sammy the lab is at my feet.
The only reason my surgeon is pushing my PT efforts is he wants to see me avoid a manipulation under anesthesia. He generally does not prescribe PT unless the patient is lagging in some area. He does 1 or 2 MUAs for every 100 patients, which speaks well of his TKA results. Plus his experience is that while the legs bends nicely during the procedure, the aftermath involves some ROM loss, swelling, pain, etc. The only person I have talked to who has had this problem and had a MUA ended up with an ultimate flexion of only 95 degrees.
Without this forum I would feel profoundly lonely and depressed. Thank you so much for being there.:flwr:
The only reason my surgeon is pushing my PT efforts is he wants to see me avoid a manipulation under anesthesia. He generally does not prescribe PT unless the patient is lagging in some area. He does 1 or 2 MUAs for every 100 patients, which speaks well of his TKA results. Plus his experience is that while the legs bends nicely during the procedure, the aftermath involves some ROM loss, swelling, pain, etc. The only person I have talked to who has had this problem and had a MUA ended up with an ultimate flexion of only 95 degrees.
Without this forum I would feel profoundly lonely and depressed. Thank you so much for being there.:flwr:
greeneyedsis425
junior member
I am 4 weeks post RKNR today. My OS had me on the CPM daily, initially 3 to 4 hours, and after 2 weeks it was 2-1 hour sessions. That ended 2 days ago. (insurance allows 21 days I guess!)
I have migraines and cannot take Vicodin, as it gives me more migraines, so I can relate to your cluster headaches! I also had the rash and severe itching post surgery which my Tylenol 3 seemed to aggravate. I was switched to Tramadol and Percocet. When the percs ran out, I didnt call for refill as my OS PA was all nervous about addiction. After dealing with more pain etc for at least a week, emotionally breaking down frequently, I did call and get the percocet refilled yesterday. This forum has been a lifesaver for me!! My OS wants me to do the simple exercises 2x a day, and then we will talk at 8 weeks about if I need PT or not. He has found that most of his patients, especially we "younger" ones, dont need it. However, I am really looking forward to that 8 week mark, as I can get back in the pool at that point! I just want to get in that warm pool and walk....ahhhhh! And TYKEY....I want a Tshirt!! lol
I have migraines and cannot take Vicodin, as it gives me more migraines, so I can relate to your cluster headaches! I also had the rash and severe itching post surgery which my Tylenol 3 seemed to aggravate. I was switched to Tramadol and Percocet. When the percs ran out, I didnt call for refill as my OS PA was all nervous about addiction. After dealing with more pain etc for at least a week, emotionally breaking down frequently, I did call and get the percocet refilled yesterday. This forum has been a lifesaver for me!! My OS wants me to do the simple exercises 2x a day, and then we will talk at 8 weeks about if I need PT or not. He has found that most of his patients, especially we "younger" ones, dont need it. However, I am really looking forward to that 8 week mark, as I can get back in the pool at that point! I just want to get in that warm pool and walk....ahhhhh! And TYKEY....I want a Tshirt!! lol
Bees Knees
senior
Hi Mary,
I am sorry you are having such a challenging recovery. I understand your confusion. I have felt confused also when my knee was hurting more than usual. I question "Did I over do?"
I have been lucky in P.T. The therapists give me guidance with the stretches and exercises but I have always controlled the amount of stretch. Exercises that feel good include riding the recumbent bike without resistance and stretching my leg over a small therapy ball. I still get tired very easily and feel sore after exercise or stretching.
I love labs.:dogkiss:
I am sorry you are having such a challenging recovery. I understand your confusion. I have felt confused also when my knee was hurting more than usual. I question "Did I over do?"
I have been lucky in P.T. The therapists give me guidance with the stretches and exercises but I have always controlled the amount of stretch. Exercises that feel good include riding the recumbent bike without resistance and stretching my leg over a small therapy ball. I still get tired very easily and feel sore after exercise or stretching.
I love labs.:dogkiss:
leenie60
graduate
I let my therapist stretch me until I say "WHEN" and she backs off. Aside from the stretching I can and do pretty much all of the exercises at home so I'm not sure why I'm going because it is incurring an expense and duplicates what I'm already doing. I'm going to go for at least another week or so and see if I make any more progress at PT than simply doing them at home. Part of it is a social thing to and I tend to work harder when someone is monitoring. Anyone else feel this way?
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