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Thanks Deb. This forum offers incredible support. It's coaching, really. Being human, I'm a slow learner. I need constant reminders. Thanks for reminding me that nature takes care of us.

Re: driving. I've already decided not to care when I drive again. When I signed up for this surgery, I cleared three months out of my life. That certainly gives me plenty of room to follow Jo's advice to let go of expectations.

Best to you!!!
 
I think what someone said once is so right - this is not a race, it's a marathon. You have to pace yourself.

I think you'll be doing just fine, my nursing friend! :wink:
 
Looking back at your posts, you are making wonderful progress! One nurse to another - it's so tough being the patient!:cnsl:
The steady recovery is, as Jo said, a marathon. What a boost when the bruises disappear! And gradually, the swelling subsides. The ice and elevation that help so much after the workouts and muscle strengthening. My issue postop was pain management - didn't want to take too much, etc., etc. However, once I understood that even I, as a nurse, remain human and have these needs for reasonable self care, I was able to approach my pain management differently, and then I made great progress! The advice I received here was wonderful, and it was great to be in touch with others going through similar surgical procedures in the same timeframe. I am 8 months postop and am enjoying life again! Minimal pain - occasional "burning" sensations that respond well to Tylenol after long work days. NOTHING compared to preop!
So, keep up the good work! :thmb: And keep us posted on your progress!
Martha
BTKR 4/7/2010
 
Continue to be scared about the ROM issue. My gentle PT friend is coming over this a.m. and Ill see my orth later. It's like you're on stage and your friends, your family -- everyone -- is asking about your PT, your range of motion, and what's wrong?

Tried to sleep with my husband but it just didn't go so well. Hard to get comfortable, and his movements/sounds woke me. I finally hobbled back to my spot on the living room couch, which is a large sectional and very comfy. My pain at night is controlled via medication but partly via being comfortable, and I'm not ready for the rigors of a normal sleeping situation.

My hope is that my PT and the doc both say something similar to JO . . . that this will take time and with a little patience it will work out.
 
Oh tell'm (nicely) to mind their own business! Truly! It gets a bit boring after a while, doesn't it? And then when you give them an answer, they've always got to have an opinion!

Honestly, Mary - it will get better. Four weeks is still very early days!
 
Post tkr being the roller coast that it is, today was a down day. Had an appointment with my ortho and he basically said he was not as worried about flexion as extension. He was open to proceeding any way I wanted but stated that the painful part of the exercises are the part where the adhesions are broken and this is an inescapable part of the process. He did acknowledge the swelling/inflammation issues. Also, he is not a big fan of manipulation. He's fine with me having 85 degrees at 6 weeks (and said ROM increases for a full year), but as I said, more worried about extension. I had started on the hospital-based physical therapy which I went to twice and stopped because I could not see how I was benefitting and it just plain HURT. Today the ortho threw out other options and actually recommended one person in particular, a private physical therapist. Gonna call there tomorrow.

I do not think it helps, mentally, to be on percocet now for a month. I get discouraged and scared, and confused. My husband is a great guy but he doesn't offer active encouragement. It's just not him. Maybe should find a blow-up cheerleader with little automated messages! Morale a little shaky. :sgh:
 
Mary, I'm so sorry you are having a bad time of it right now. You're wise to recognize that the pain meds can contribute to some of these feelings. They are a necessary evil right now, though.....you need to adequately manage your pain. Just know that things will get better.

Well-meaning family and friends can drive you crazy. Try to have as little contact with the ones who ask all these questions as possible. They just don't understand that recovery for THIS surgery takes a significant amount of time. That's one reason why you have your BoneSmart family to turn to...WE UNDERSTAND!!!

Also, don't hurry back to sleeping with hubby...especially if it's not comfortable for you. Your rest and healing is the most important thing right now. I think your surgeon sounds like a helpful partner in your healing process. He's willing to work with what you feel most comfortable doing and he's absolutely right not to panic about your current ROM. You're just fine!!!

I think your idea of talking to a different therapist is a good one. Some gentle stretches will gradually get you to the ROM you are looking for. You can do them on your own also...but Jo's right....you are still just a short ways away from the starting line of your recovery journey.
 
I love you all to death!!!! Thank you so much Jamie.

I have always been a strong person, stoic, all those things. I had my kids at home, the first time being one of those colorful stories about endurance and pain. Nothing in life compares to this. My ortho (trained in Canada) mentioned that when asking TKR folks if they're happy with their decision, they never ask before the one year anniversary.
 
but stated that the painful part of the exercises are the part where the adhesions are broken and this is an inescapable part of the process
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Well, of course he's seen your knee and I haven't but I would have to contest his assertion that adhesions are an 'inescapable part of the process'. There is not evidence at this stage that you have adhesions as you are getting a moderately decent flexion. I'd see how this new PT can help you. It might be that you need an MUA but not now. You're only just 4 weeks out, for pity's sake!
 
Hi Mary,
Here's hoping tomorrow is a little better for you! These days are tough, I was at work the other day( just a couple of hours) and just stared to cry! Why? Don' know. Leg hurt, I was tired etc. etc. It's nice when people ask how you are doing, but it sometimes does get old. Don't know how to answer, and if they haven't had it done, I really can't explain. My husband has taken up residence in the spare room. We tried to sleep in the same bed a couple of weeks ago, and I kept him up all night!! He said I was rolling and thrashing and pulling the covers. Oh well!! So we take turns, bed, couch, recliner whatever works that night. I hope the new therapist works out really well for you, please let us know, and try to not get discouraged. It's soooo hard not to right now. My mood changes so much day to day, I almost feel bad for the people that always ask how I am. Ha-ha. Please take care.
 
The clearest thinking I've had in days is now at 4 am after being woken by a cluster headache. And yet the only clear observation I have that nothing seems clear to me. I've been dealt an unlucky card in the form of range of motion issues. Me, who biked the week before surgery believing that all that soft tissue health was gonne put me ahead of the game post-surgery.

I am hearing all your messages and wisdom, and hearing the wisdom of my ortho, and it doesn't mesh, quite. You guys are saying ROM comes, on its own, with gentle efforts. Yet my ortho, PT, and actually several people on this forum are saying that ROM gains are painful. Someone mentioned that they got increased in ROM when their PT forced their knee and elicited painless popping noises. I am not having painless anything.

So I've read all the material in the library and have taken all your wisdom very seriously. I want to believe that if a go gently that "it'll come" in a week or two or more." But my hired ortho doesn't see exactly that way. He did say, as an example, that my extension is right there. When he pushes down on my knee it's "rubbery" and not rigid, so it's a matter of working on it every day. But he says that strong stretches Iwhich hurt!) are ecessary to break the adhesions. This concept of adhesions is also not consistently defined in what I've been able to pick up on the internet.

My ortho says he's done a few MUAs and his experience is that much of the gains made during the procedure are quickly lost afterward. Of course I would not pursue this option without a second opinion, and maybe a third.

So tomorrow I will call the newly recommended private PT, who has a pool, I'm told (I would appreciate a PT who does tender loving things to my leg in addition to making demands!). Call the neuro for another dosage change to stop the cluster headaches. Maybe call a counselor to see if I for an attitude readjustment Today I was very very dreary and am not sure whether that was temporary or a new low. Get the xmas tree up (with help of my son). Hubbie's going off xmas shopping and I'm hoping he can come home with Thai takeout. I've also ordered a pedal exerciser that can be placed on the floor or a table.

Sorry for the long, heavy post. Guess I'll try to get back to sleep, though half the island where I live is probably already awake and having breakfast!


 
Right at 8 am I called the PT office my ortho just recommended. The woman on the phone, a PT assistant, said some people's range doesn't shift until 2 or 3 months out which is along the lines of what you guys are saying and this gives me hope. Will go there Monday. She also said, "You've come to the right place." They have a reputation for good results. Will involve an hour's drive but I think at this point I'd drive any distance for help that helps.
 
He did say, as an example, that my extension is right there. When he pushes down on my knee it's "rubbery" and not rigid, so it's a matter of working on it every day. But he says that strong stretches (which hurt!) are necessary to break the adhesions.

My ortho says he's done a few MUAs and his experience is that much of the gains made during the procedure are quickly lost afterward.

This concept of adhesions is also not consistently defined in what I've been able to pick up on the internet.
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And you would be quite right! He is contradicting himself - is the extension there or do you have adhesions? If it's there, then you can't have adhesions. It doesn't make sense to say you have. And if he also admits that his MUAs don't have a lasting effect then I would suggest that the MUAs weren't needed in the first place because flexion was being blocked by swelling and not by adhesions! :doh: What a winner! He sounds like one of those chaps who, when you're scrubbed in with him, has the "don't give me what I ask for, sister, give me what I need" philosophy! Doncha just luv'm - NOT! :rant:
 
Mary....I think you are on the right path with the new PT. But I believe I need to clarify something for you in regard to "gentle" PT. That does not necessarily mean you will have no pain whatsoever. It does frequently feel uncomfortable and hurt to push your knee slightly in a bend or with heel slides. But the key word here is that the action is done GENTLY. And it should never make you cry or bite your lip in pain. Some therapists do just that...thinking that it's okay to cause that much pain. But generally...all a person gets from that heavy-handed pushing is angry and swollen tissue that hides the ROM that is there.

So please don't think that you will have no pain with the recovery process. It's just that we don't want you to have pain to the point of unneeded swelling. It does sound like your new therapist has a grasp of this concept. I especially like that she told you about a more realistic timeframe for achieving the movement you want....2-3 months out.

Granted there are people on the forum who achieve their ROM much faster, but not everyone does that. Some take longer and that in no way means anything is wrong or you are abnormal. It just demonstrates the fact that each of us is a unique individual who heals in our own time.

I hope you can come to terms with this and realize that you are only 1 month out from this most major of surgeries. You have much to be thankful for even at this early stage. It might help if you start a small journal and write how you're doing each day in it...just a short post (you can even do it here on BoneSmart as others have done). If you do this and look back over it a month from now, you'll begin to see how far you have come and that even the small successes with your new knee are really meaningful.

I know talking in terms of months instead of weeks must seem like a very long road to recovery, but it will pass faster than you think. In the scheme of the rest of your life these months spent recovering are just a very small fraction of time out of your life. And the rewards down the road of enjoying active and pain free days will be worth it.
 
Oh Mary I know exactly how you feel. After I had at home pt for 5 weeks and thought I had a Rom of about 110 I had my apt. with my surgeon who informed me I was "borderline at 90". I said how can that be when they measure me I have been getting anywhere from 105 to sometimes 114???? He said sometimes they measure wrong and sometimes they just might be trying to make you feel better. So on that day I went into the doctors office with my chest out and head up high expecting praise and went out the door feeling like a complete failure. It really busted my bubble.:sgh: I then started outpatient pt and after several posts finally listened to Jo, Jamie, Tykey and others who finally got me to understand that my Rom would come in time as my swelling goes down. I am now 12 weeks out (thats right 12 long weeks ) and my Rom is now at 104. I am happy with that. I am still doing all my exercises and have started icing more because I still have swelling even at this point. You are WAY behind me and I think you are doing quite well. I wish I could say something to assure you or even just make you feel a little better. This is a long hard journey. Just try to remember that you will improve in time as I am doing and hopefully will continue to improve. I am sending hugs your way !!!!!!!:cnsl::cnsl:
 
I just had a visit from a friend who explained his second knee replacement was different -- it hurt for two days and he didn't like that too much. Can you imagine? I'm talking about 2 days post op pain, that's it.

One of my sons came home from college, and last night I sat down and explained I was feeling very down but he didn't need to worry. Today he fulfilled my wish to have the tree up and decorated. So tonight when I go to bed alone, with my faithful canine companion still farmed out, I'll be able to take comfort in our little Charlie Brown tree.

Judy, so helpful to have you report first-hand experience so similar to mine.
 
I for the life of me cannot figure out why the knee stiffness. I've tried the gentle approach, the no PT approach, the push it till it hurts approach, and pretty everything has the same result (no change). Part of me wishes they'd draw the extra fluid out to see what my ROM would be with a less swollen joint.

I ordered a pedal exerciser and paid for overnight shipping but somehow it's not coming today. My hope right now rests in trying new things. I was studying up on the JAS Splint and that looked promising and doable. I'd go for it in a heartbeat, and even if my OS wasn't a believer, he's of the attitude to go along with what I want to do (within reason). I wonder with my low grade fevers (99.3 for someone who often is 97 something) -- or is it hot flashes? Whether an occult infection is simmering. I thought maybe I'd just go in and see my primary physician to get my pain meds refilled, run through what I've been doing and what else he might throw out to consider, and maybe he'd be willing to do some blood labs, see how my H&H, inflammation, white cell count, etc. looks. I'm sorry, but there has to be come kind of an explanation for such a stiff knee (OK, I haven't ruled out being a "late bloomer" plus of course the swelling, but everyone has swelling and not necessarily the limited ROM). I felt something was not right from very early on.

Anyhow, anyone with experience or opinions on any of this, please chime in.

There is good news: I'm making progress on normal walking gait (heel to toe, heel to toe!), and the last 24 hours have been on half as much pain med without any problem (except when I try to fully straighten, or flex my knee, which HURTS!) Still keep my box of tissues handy.
 
Mary, do please stop fretting. You are still only 4 weeks and you can't have given 'the gentle approach' enough time to make any difference. If you keep having periods of pushing till it hurts, you're not going to get anywhere.

Plus, as a nurse you must know that the swelling isn't the kind you can draw off with a needle. Oedema is spread about the fat and other tissues.

And why on earth would you want to try new things like a JAS splint? Please have patience. You'll get there. It's such early days and this is a long term venture. Nothing is going to be resolved in a few days. I worry so about you when I see how desperately unhappy you are making yourself.


.
 
Well Josephine you're right. I guess I'm just plain scared.
 
Hi Mary,
Just popped in to say Hi. I keep reading your posts and feel so bad that you are having such a rough time right now. All I want to say is that I am 2 weeks ahead of you and there is a BIG difference from the 4 week time period to the 6 week period. Things WILL start to turn around. You need to allow yourself just a couple more weeks to see how you are doing, I know it sounds like a lot but it isn't after this surgery. I have the tightness and stiffness but it is gradually getting better. Many tissues, frustration, crying etc in the last 6 weeks. Probably many more to come, but that's ok. Do you feel that you are doing anything more in the last couple of days then you were last week? Think about this, have you gone up and down the stairs more often, made a light meal, straightened up your room? I am trying to measure my healing by the little extras I do from day to day and it has made a difference. I went out for a little while today to walmart with my sister. Walmart of all places, it was a zoo, but I wasn't gone long, hung onto the cart as a walker, and actually had some fun. I will be icing and elevating and taking meds the rest of the night but it was worth it. Reward yourself for the small stuff, the other things will come.
 
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