Bilateral TKR Got out of surgery at about 5pm 6/4/2013

[gazelle7777]

Thanks Luisa! I hope you get your headaches under control soon. Hugs to you!

 

[Roy Gardiner]

Roy , I read your suggestions. I can not get down on the floor and up again yet to do the one stretching exercise. I also have not really began a walking regiment.

The 3rd suggestion (pictured in my exercises thread) has pix of how it works -- nothing clever, just leaning on your own leg. Try that one?

 

[gazelle7777]

Thanks Roy, I will look them over again!

 

[gazelle7777]

DAY 42, JULY 15. MONDAY

Good Morning BoneSmart friends. I have had a rough four days since my last PT which was last Thursday. I do not know if I can blame my inflamation and pain on that, but, I have had inflamation, pain and hot to the touch knees every since Thurday last. I did a little work out on Friday thinking it would be good for me, and by Saturday I was miserable! My knees were stiff and painful all weekend. I did not do my exercises the last two days. Pretty much just iced and rested. My PT person is going to ask what I did the last four days... and I am going to have to either tell her the truth or make up a white lie.

So, I guess my question to anyone in the know... What should I be doing going on my 6th week after surgery that will not inflame my knees so bad. I did a lot on Thursday last at PT. I felt good at the time, but, when I got home after going to the store, all I wanted to do was go to bed. What should I tell her today? I feel a bit better this morning. Had to resort to my pain meds last night to sleep. Been taking lots of natural anti inflamatories as well. My right knee feel very tight and uncomfortable....hard to bend and step naturally.

My PT person is kind, but she also lets me know that if I do not get the right leg straight I will never walk normal again. Is it a critical time at the sixth week to be bending and such really well... or do I have time to let it come on its own? I get so confused. I go see the surgeon on the 28th this month, and of course he is going to want to write me off as DONE. I know how they work. If I do not feel I am DONE is there something I ask of him or tell him so that he just does not say see you in a year? What do I tell him about needing pain meds still - I know he is going to want to stop them that week of my appointment with him.( he goes by the books, not the individual it seems) I have never felt well taken care of by this clinic. They do everything so fast and by the clock and the books... not an individual care type of clinic. The Surgeon is good at what he does... surgery... but, has no bedside manner at all. Very clinical.

I am confused at this point... of how I am doing. I am suppose to go back to my retail job in September and I feel no where near ready at this point. I may have to just quit my job. I am tired, stressed and emotional- probably lack of good sleep and the pressure to heal. I am glad I did the surgery, but , my pain and discomfort today is not better or less than prior to surgery.... it is just DIFFERENT. Thanks for listening to my emotional side today.

 

[bottomshollow]

gazelle7777, you need to cut way back on whatever you're doing in PT. Do not take pain meds before PT---it allows your body to go far beyond the stopping point. And you know from being on this site that ROM is something that continues to improve over a long period of time. Causing yourself a lot of pain after PT sessions can lead to chronic tendonitis that is very, very hard to recover from. And that will certainly do you do good whatsoever.

Do not lie to the therapist. Tell her the truth--tell her about the pain and misery you had all week-end as the result of your PT session and tell her enough is enough! It takes time and a considerable amount of it to gain extension. Muscles, tendons, and ligaments have to be stretched out---and it has to be done slowly. Here is a link to our Library article on exercises you can do on your own to increase extension: Extension: exercises for improvement

Please remember that the PT works for you----you do not work for her. You do not have to agree with her point of view, and you have the right to insist that she do it your way or no way. You can always get another therapist. And she is probably NOT the expert she thinks she is.

Well, truthfully, most OSs do the surgery and as long as that goes well, the recovery rehabbing is entirely up to the patient. As a matter of fact, that is exactly what my OS's PA told me---he said that when the surgery was over and there were no problems with the implant, the rest was entirely up to me. When you see your OS, get a prescription for pain meds. If he won't do more for longer than see your GP.

You can do this yourself with a therapist, you know. You just have to make yourself to the exercises in a reasonable way until you reach your goal---0 extension, a perfectly or almost perfectly straight leg. I still lack a couple of degrees on the right leg---but I walk perfectly normally---as a matter of fact when I was -10 degrees, I could walk normally.

STOP beating yourself up----take the bull by the horns and take charge of your own recovery! YOU CAN DO THIS! I believe in you.

 

[Ready]

First of all, sending a hug your way. I remember posting a while back about wanting someone to wrap me in a hug, pat my back, and say "there, there." Secondly, listen to Judy. I like thereapy 2x a week instead of 3x so my leg has time to calm down. I haven't been since Thursday, and today I feel so much better than the past 3 days. I rode my exercise bike for a few minutes each morning, and stretched a bit, but nothing else. Hey, when athletes do strength training, they always take a day off in between. So can you! If you aren't honest with your PT, there is no way she will know how to adjust your therapy and it will be the same old thing. So, as Judy said

take the bull by the horns

or should we say, 'bullheaded PT' by the horns? All the best to you.

 

[gazelle7777]

thank-you Ready and bottomshollo for your input. I am going to talk to her(the PT), I just wish I knew if how my right knee feels is normal since no one can feel it except for me. I hope the tightness and stabing pain when I bend the knee and try to do a normal step goes away. If I walk with a straight knee it feels fine... so my brain tells me not to bend it of course.

 

[MissJ]

Hi Gazelle -
I'm sending more pats on the back and would give you a cup of tea (stiff drink?) if I could.

My knees are still tight, though not AS tight as they were for the first 2 months. However I never had stabbing pain. And though I'd agree that I didn't feel my knees were "better" than before, just different, I did not have stabbing pain. That worries me.

Unfortunately there is no absolute normal when it comes to healing and rehab, and anxiety over being "on track" really ends up being energy better spent resting. I can't remember - are you taking anything short-term like Ativan to sort of manage the anxiety? That also *might* help with sleep.

I'm thinking of you and sending good thoughts toward Seattle!
j

 

[Roy Gardiner]

I am tired, stressed and emotional

Par for the course at the 6 week low point "OMG this has been going on forever, will it NEVER end?!"

What should I be doing going on my 6th week after surgery that will not inflame my knees so bad.

Simple. Don't put force through the knee.

Roy that don't help none, you're just stating the obvious.

OK: any PT, exercise or stretch or indeed anything that HURTS the knee is counter-productive. Don't lie to the PT, tell them exactly what's happened to you and that you are sure that it's the exercises that are doing it, as you get swollen and sore afterwards -- and that you're not going to do anything that hurts any more.

My PT person is kind, but she also lets me know that if I do not get the right leg straight I will never walk normal again.

See my exercise thread for a simple extension stretch.

Another extension exercise needs a partner.

- You sit on the floor, TKR leg out straight.
- Rest the heel on a fairly thick book or similar, to get it may 2" off the ground

- partner kneels at right angles to your leg, placing one hand about 6-9" below the knee, one about 6-9" above.
- gently pushes the leg towards the floor until you feel a good stretch through the back of the leg
- holds for about 20sec
- eases off, waits 30sec, repeats.
- repeat 3 or 4 times.

It's effectively the same as the self-performed exercise pictured in my thread on the subject, but more effective IMO.

Don't do either of these to the point of pain.

Is it a critical time at the sixth week to be bending and such really well... or do I have time to let it come on its own?

Good news, no it isn't there's no critical time, yes you have all the time you need

 

[Lmarshall]

Joan....i hear and feel your frustration. i am at 5 weeks today and am still lacking "perfect" ROM. pain meds continue to bother me and nerve block is quickly wearing off. try to focus on your accomplishments. i KNOW you have many. this is what i do when i start to get anxious and depressed. myleft knee has some sharp pains like you explain but at least now i can pinpoint the pain. last week my entire leg hurt...so here is where i try to feel like even with pain there is some progress. i started more stretching home that seems to help with my extension and it is so passive...no real work. i lie on my stomach and let a portion of my legs hang off the edge for 20-30 seconds ata time.

Whatever you do make sure you tell your pt how much trouble you hadafter the visit. she needs to know you need a gentler regimen. HUGS TO YOU my friend. keep your chin up. we are in this for the long haul and it WILL GET BETTER!

 

[new knee in June]

Dear gazelle,
It sounds like you did to much in therapy last thursday I know exactly how you feel, when I. Have
Therapy I feel like super woman. The next day I pay for it dearly please no " white lies"she needs to
Know how you are feeling.
As for your surgeon are you sure he takes everyone of pain-meds at 8 weeks. I would think a step- down pain
Med would be the next step.
I can see why that would make you anxious......
you feel better in the next few days,
Diana

 

[gazelle7777]

DAY 43 July 16th

Well, I had another hard PT yesterday.I did talk with her about my last one being so hard to come back from. But she had me do the same exercises that caused me the trouble. she said that I have to work hard on getting my stretch on the right knee tendons before we can work in strength exercises. I know she is right, but, I also spent another restless achy night,getting up at 2:30 am again.
,
My right ankle is also swollen and sore...do not know why? Perhaps I am trying to walk better with the right leg and the ankle is not use to the weight or the use?
Next week I go see the surgeon for his "kiss off" as I call it. I feel no where near better...normal...I wish I had a crystal ball to see six months into the future ...perhaps I would feel less down. I think I am just going through a poor little me phase...please bare with!

 

[Roy Gardiner]

Gordon Bennett. You must heal before you can do strength exercises. If you overdo exercise now it will slow or even regress healing. Stretching can be done easily, little and often, without being hard.

 

[skigirl]

Gazelle, first--my surgeon saw me at six weeks, three months , six months and a year. I dont think your surgeon will expect you to be perfect at six weeks, so relax a little about that.

Second, my surgeon also did "step down drugs" too. so, for the first two weeks, I had Percoset one 5/325 and then for the third and fourth week, I had Hydrocodone and finally, I went to Tramadol which is a weaker narcotic.
So, don't worry about being totally cut off from all drugs---I am sure they will listen to you. They can call Tramadol into the drug store-- you don't have to pick up a script.

I also agree that it is a mistake to take a pain med before pt. I never had any pain to speak of during the rehab for two knees. Your pt is pushing you too hard---and she works for you!!! Be the employer and remind her of that--she is NOT in charge of your rehab--you are. Ask for another pt if there is a problem with her listening skills.

It took me almost two months to get to zero extension, so don't worry too much about that. Roy is right, when you begin to walk, that is the exercise that will help you. You don't have to be the Best Knee Patient Ever---just relax---and do some goofing off!! These are your knees, you are in charge of your rehab and too much work makes Jill a dull girl.

It is time to program some fun into your life. Lunch with friends, walks along the ocean or eating clams at one of those wonderful restaurants in Seattle. You don't need painful pt---she HAS to back off. Maybe you need to cut your pain pills in half and take them through the night. Sleep is an issue---I found that the reason that I woke up was pain.

So, I would take half a pill at say 11 pm, when I went to bed. Then, another half at two or three am when I woke up. I kept some grahmn crackers and peanut butter by my bed--had a cracker and read a little when I woke up, but usually drifted back to sleep. Most of all, relax and let your body know that you want to sleep----when I used to get up and be distressed that I was up, it seemed that I stayed awake longer. Sleep is an issue--it makes us crazy when we cannot sleep---are you napping during the day? I decided early in my saga of knee replacement that I wanted seven hours total per day---I would take five at night and two during the day!!

When I was at your stage, my OS told me that for every two hours up, I should be resting with my knees propped up for at least an hour. So give yourself the gift of some rest and some relaxation. It takes a year to recover from bilaterals---I am sure that you will be at zero extension long before the year is out--but you do not have to be there at six weeks!!! Kellt

 

[puffin]

Sorry to hear that you are in so much pain gazelle7777

I agree with the others though - doing too much in PT is causing swelling and pain which is ultimately slowing down your recovery. Perhaps try taking a few days off to give your healing knees a break

 

[Roy Gardiner]

Kelly states the case perfectly

 

[Lmarshall]

Joan, I know how you feel. REALLY I went to see my surgeon today. I made the appt since I had some questions concerns. She didnt nee to see me til somewhere in 8-12 weeks post op. She was very happy with my extension ( I am not at 0 either) and she told me it will come to just keep going to therapy. I mentioned aqua therapy and she thought it would be a great idea. I need to start the process to change PT centers. I mentioned alot of pain on my left leg last night and surgeon explained alot. My problem was valgus on L side, I know you were bowed. The tendons ligaments and muscle shorten on one side after years of walking on not straight legs. When you are "reset" they are being stretched and it HURTS. She said perfectly normal, and swelling makes pain (including nerve pain which i have down to the foot) normal. Sleep continues to elude me also, but it isnt as painful when I wake up as it was before. Im uncomfortable, but am not reaching for pain meds. I think what skigirl said about taking half at sleep time and the other half during the night is a good idea. I know it is so so so hard to be patient...I feel like this is the largest lesson I have ever had to learn in patience. I cry sometimes, moan and groan other times, complain sometimes to the hubby (hes prob so tired of hearing me), but in the end, nothing will change we just need to wait...and wait. Xanax has helped me. Are you on any kind of anti anxiety meds? If not, as your GP for some. My surgeon will only give e one more rx for it, but I hope it will be all I need. I have another weeks worth, and a new rx so 5 more weeks. Im hoping to be in a better place by then. HUGS my friend!

 

[new knee in June]

Dear gazelle,
So sorry you are having such a hard time please take Kelly & the others advice. It sounds like
You need a knee-cation.....please read Toni's thread (a new knee & hot to trot) she did two much in therapy
&it set her back a week. She has been elevating, icing, no p.t,& feels so much better
I think you need a week off from therapy.
Your surgeon will not drop you or take you off pain meds so abruptly, so please don't worry about that
I believe you know what has to be done.......follow the bonesmart mantra & you will feel so much better
Hugs & best wishes coming your way,
Diana

 

[gazelle7777]

Gosh! What wonderful advice from some pretty special people! I feel honored knowing all of you. I will try taking half a pain pill through the nite.. Good idea!. I think attitude is everything and I want to keep looking forward to health and healing. I did my stretching exercise today... The one I do not like. I also got down on the floor and back up for the first time by myself! Progress! Would love a soaking bath....but do not know if I could get out of it yet. Miss my bath!

Thanks again for taking the time to give me your view points and thoughts on my progress! It is so helpful!

 

[skigirl]

You can go in the bath when you scar is completely healed--no scabs, no open spots. Once there is a little straight line, you can bathe. Getting up from the floor is a big achievement. At first, I had to be with both feet and both hands down like a baby!!! Now I get up semi normally!!!