TKR Grace's (CAdesgirl) recovery

[CAdesgirl]

I went to the doctor yesterday and got released to go back to work WITH NO RESTRICTIONS. I went back today. I meant to only work 4 hours but ended up working 7. Everyone kept trying to keep me at my desk. I had to explain that I have to get up to walk every hour or so in order to keep from stiffening up too much. All in all, it went well although my staff had been holding onto some issues for me to get back so there were some uncomfortable conversations. I'm home icing/elevating and I may take a nap.

The doctor wasn't thrilled with my ROM but just told me to keep working on it because I'll be able to do more if I get my flexion to at least 120 and my extension to 0. I know he just wants me to be able to do the things that a 50ish woman should be able to do so I left in a good mood.

 

[CAdesgirl]

Update: I went back to work on March 7th and it's gone really well. I have kept my walking to a minimum on most days with yesterday being an exception. I've been working 6-8 hours and not icing as much as I should. I make up for it by coming home and icing for an average of 2 hours. The swelling gets up there during the day but the pain hasn't been bad from work. It's already less painful than it was prior to surgery.

My ROM isn't great. My doctor is sending me back to PT to try to get my extension better because I'm still struggling. I think it's because of the muscle flap surgery where they took 1/3 of my calf muscle and wrapped it around the front of my leg. I probably should have done PT after that surgery but, because of the MRSA infection, I didn't. Because I'm working so much, I'm not exercising regularly. I do the exercise bike for about 5 minutes in the morning because it helps with the stiffness and do stretching exercises all day long concentrating on the hamstrings.

I did take a walk of about a mile last Saturday. I was talking on the phone with my youngest son and just walking along not paying attention. I made it about 80% of the way back to the house before I called Mike to come pick me up.

The great news is, I've started planning things. Before my surgery, Mike bought tickets to Elton John's Farewell tour as something I could look forward to and last night we got tickets to Billy Joel in August. We're going to fly out to Denver (from CA) to see him and spend 5 days there. There goes my Caribbean vacation I've been dreaming about. I know that you all know the joy that comes with being able to plan things that will have a lot of walking involved without fear (okay, maybe a smidgen of fear that I won't be ready yet).

 

[Lindylee]

It's a real sign of progress when you can plan something like that. Good to hear your return to work is going well. It helps to get out of the house and back to some level of normality. Great news!

 

[Lilli215]

@CAdesgirl, your knee will be fine on your trip. I had my first tkr on 30th Jan 2017 and on 1st Sept 2017 hubs and I flew to USA to have a holiday in Cape Cod with friends. My knee was absolutely fine by then, no stiffness on flight and no problem with lovely long walks on those Cape Cod beaches

 

[CAdesgirl]

Question - how long did you all wait until you drove for several hours? I ask because I drove about 85 miles each way for a lunch meeting on Friday which ended up being 3 hours each way. I have another trip scheduled in two weeks (driving up on Sunday and back on Thursday) and I'm wondering if there's any tricks to skipping the muscle pain that lasted for 2 days. I did stop once each direction to get out to stretch.

 

[CAdesgirl]

I had xrays done for my followup with the O/S on Friday. I'm pretty sure the doctor showed me xrays at my first postop appt but I was still pretty medicated. I look at these and think of what they had to do to get them in and am surprised that the pain wasn't worse (not that it wasn't bad but... geesh).

 

[sistersinhim]

It's already less painful than it was prior to surgery.

That's what every one of us strive for!

I'm wondering if there's any tricks to skipping the muscle pain that lasted for 2 days. I did stop once each direction to get out to stretch.

I took ice packs and strapped them to my knee. I also got out and walked around every hour. It's adds time to the trip, but the knee reacts much better.

 

[CAdesgirl]

@sistersinhim I did take an ice pack and strapped it on for the drive up but it melted and I didn't refill it for the drive back. I just wanted to be home. I think my drive up will be okay on the 14th because I shouldn't hit traffic. I'll keep in mind your advice to stop every hour for the trip back. I'm just close enough that I can't fly in for the meeting.

 

[JDinCT]

@CAdesgirl Awesome to hear about your continued successful recovery! I too have strapped ice packs to my leg for driving... and carried a cooler with fresh ice packs. I've found that these ice packs last a lot longer and are easier to wrap around my leg. Got them at CVS...called CryoMax…

 

[CAdesgirl]

@JDinCT Well, that looks interesting particularly since I just had another work trip scheduled for the week of the 22nd and it's a 5 hour drive. Mike is actually taking the week off so he can drive me up and back. Well, it's also the central coast of CA which happens to be a happy spot for us.

With that, I'll do another update. It's a "stuck" one. I haven't really had any progress for the past few weeks. My range of motion still isn't great 101/+5. It's the extension that bugs me. It's super painful to the IT band when I passively stretch it. Even sitting on the floor with the leg straight and just relaxing hurts like the dickens. I have no pain from the knee itself. My only complaint is still the IT band. It hurts from the hip to the knee to the point that I can't lay on that side to sleep. Trying to get them to address it in PT is like spitting in the wind. That's not what I'm there for so they don't want to hear it. I go to the OS on Friday and I'm going to talk to him about it. Maybe it's because of the HMO guidelines. I also go see my PCP next week.

 

[NavyGunns]

@CAdesgirl, I say fire your PT then. Issues with the IT band are directly related to your knee surgery. My PT had no issues and I find it hard to believe it has to do with your HMO. If so, they only need to contact your OS and get an expansion of the prescription scope. If it were me, I’d tell them to either get with the program or I’ll find someone else who will.

 

[JDinCT]

@CAdesgirl I'm in total agreement with NavyGunns here.... my PT usually rolls my IT band during at least every other visit... from my glutes to my knee...

 

[Celle]

I agree with the others. You are in charge of what happens at PT. If your therapists won;t give you what you need - which is help with your IT band - the go to a PT clinic that will consider your individual needs.

Here's an article about IT band issues:
ITB (ilio-tibial band) issues and treatments

 

[tylermit]

I agree with the others. I had IT band issues after my last surgery. It became a focus with the PT because is was causing problems with my recovery. For me the only way to keep it from getting angry with me was to back off on the walking and exercises. At its worst it would cause the knee to kind of lock up with pain. My OS is going to do a IT band release when he does my TKR. Your PT should treat this because it is painful and will interfere with your recovery. If not find one that will.

 

[CAdesgirl]

Thank you all for your support. I have an appointment with my OS tomorrow and will discuss this with him. I know that the IT band is interfering with my recovery.

 

[CAdesgirl]

Update - I went to see the OS today and he was very receptive. I talked with him about my symptoms and he thinks, besides the IT band issue, that I might have an issue with my LCL based on the location of the tenderness. He gave me a cortisone shot to see if that was helpful and I have to go back in 8 weeks. He wrote new orders for the PT to work on the IT band, too.

I went to work but only worked 6 hours and now I'm home icing and elevating because the location of the cortisone shot hurts like . I'm really hopeful that the shot helps. I did realize that some of the pain, probably the ligament, has been there before the surgery. The arthritis pain was so bad that I didn't really notice it, though.

I'm feeling really sad which is probably a combination of this and a disappointing day at the office. I'm happy that it's Friday so I can rest and relax. The only thing I have to do is get ready for my step-daughters 17th birthday party tomorrow night. It's just a family event so I won't have to do much except some last minute shopping and wrapping her gifts.

 

[JDinCT]

@CAdesgirl Best of luck with your new PT instructions. I did not realize that one could get a cortisone shot so soon after TKR. For me pre-op.... the cortisone shots always gave me great relief...

 

[CAdesgirl]

I've never received much relief from the cortisone shots in the knee joint. The one I got yesterday might have done some good. The knee seems less swollen than it has been and there is improvement in the pain on the outside of my knee. Whether it helps long-term, we'll have to see. My doc is pretty conservative. He's one that wants prophylactic antibiotics forever after having dental work done. I trust that he knows what he's doing.

I was a bit nervous that he was going to get on me because my ROM is still basically the same as it was last month. He didn't and was instead looking for a solution.

 

[sistersinhim]

I was a bit nervous that he was going to get on me because my ROM is still basically the same as it was last month. He didn't and was instead looking for a solution.

That sounds very encouraging. Many doctors are way too concerned with the numbers and imply that we are doing wrong if those numbers don't improve. It sounds like you have a good doctor there.

 

[Jockette]

One of our members, Bertschb, kept a record of his ROM process. He agreed for us to post it for those of you that are afraid you're stuck. The key is to have patience! Bertschb says:

“I'm 12 months out from my surgery and have some advice based on my experience:
1- Stop going to PT (all it will do is make your knee swell and reduce ROM)
2- Don't worry about your ROM
3- Be patient - VERY patient!!!

Here is my ROM history (more or less):

1 month - 60 degrees
2 months - 80 degrees
3 months - 85 degrees
4 months - 90 degrees
5 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
11 months - 140 degrees
12 months - 140 degrees

I spent waaaaay too much time worrying about ROM. I thought I'd be riding my bike a couple months after surgery but it took SIX months! Looking back on my surgery, if I knew then what I know now, I wouldn't have wasted my time with PT and I wouldn't have worried about ROM.”