TKR Hello! TKR April 18th

[sistersinhim]

I’m at 6 weeks now and 101.

Wow, that is quite good! Most doctors are looking for 90 at 6 weeks and you have exceeded that! As time goes on that will even get better. Swelling inhibits ROM, so as your swelling goes down your bend will be even better. But, there is no time limit for that to happen. Many improve into their second and even third years, so there is no worry.

 

[Samsrf]

I’m at 6 weeks now and 101. I’m worried because I was told that 6 weeks the scar tissue is laying down and there will be little progress.

I relate! I was told this too- and I was only 90 at 6 weeks. I am now 9.5 weeks and can firmly attest my ROM keeps getting better. From 6-7.5 weeks I went from 90 to 105. And since I didn’t stop improving after 6 (I did point this out) the PT said “ it only gets harder from here” but it hasn’t!!! Since stopping PT my ROM has only gotten better. (I do stretch and move frequently) Hang in there and don’t buy the hype. Listen to you body and you will get there! Slow and steady.

 

[Knitgirl]

Since stopping PT my ROM has only gotten better. (I do stretch and move frequently

Wow! That sure is good news! If I may ask, what kind of exercises do you do n a daily basis? Thank you for the response. KG

 

[Samsrf]

what kind of exercises do you do n a daily basis?

Honestly, I do what feels good. I try to hop on a stationary bike for 10 min at least (up to 20 min) a day to let the blood flowing to the area. I still do 0 resistance- but I will be bumping it up soon I feel. And I have stairs in my house so by default I take the stairs minimum of 4 times a day (I go slow and focus on proper alignment and pushing through my sugucal side glute.) I do hamstring stretch because it feels good I do some yoga poses like warrior 1 and 2. Hip flexor and sartorius stretches. I do quad stretch where I am standing for balance and my Rt foot is on a rolling chair I slowly pull it forward so my quads are parallel (when I started this I held the door jam for balance- this may not be for everyone) I just started making stretches up that felt good. I use the foam roller to roll out my quad, adductors and IT band 2 or 3 times a day. And I went back to pilates reformer classes 2x week on a light resistance. It sounds like a lot all put together, but I literally do 5 min of stretching every hour to 90 min (about 30 in morning and 30 before bed) among my daily activities. I also still ice every 2- 3 hours and often strap an ice pack on while driving because it’s more comfortable (surgical leg is right leg) besides stretch and ice breaks, my ADL are pretty much back to pre surgery. It is my exercise and workout activities that I replace with all the stretching and Ice. But I am building in cardio like waking and swimming- but no more than 30 min at a VERY slow pace otherwise I don’t have the energy to get through the day.

 

[Knitgirl]

Yay( I think)! I have been approved for more PT, which makes me feel a little safer, if that makes sense. The post-op blues and anxiety have gotten the better of me. Plus, I had a death in the family last week, so that doesn’t help.
I know when I go back to the doctor next week for my second checkup my Dr. Is most likely going to be very disappointed in me and recommend an MUA. He said he was going to do it if I wasn’t at least at 110. My question to y’all is… isn’t there a way they can tell if scar tissue or adhesions are an issue? Do they just do an MUA “just because” you aren’t progressing without knowing what the real issue is? Sorry to be such a sad sack. I’m just really worried about what the Dr. is going to say and I’m feeling a little powerless.
I’m not pushing myself. I do about 20 min, 3 times a day on my peddler because it feels good. I don’t use the harsh therapy band anymore, just bending the knee gently on its own power and gentle calf stretches. Icing and resting several times a day and doing my daily activities.
Thanks

 

[Cbet]

Plus, I had a death in the family last week, so that doesn’t help.

So sorry for your loss.

 

[Jockette]

My question to y’all is… isn’t there a way they can tell if scar tissue or adhesions are an issue?

Not that I’m aware of. True adhesions are actually rare, usually the issue is swelling, and the need for more healing, especially at less than 2 months post op. Too many surgeons have a cookie cutter protocol for recovery and if we don’t fall into that, they want to do an MUA. They must have missed the class on individual timelines for recovery.

And, I’m sorry, too, for the loss of your family member. That never helps anything.

 

[hawk2go]

@Knitgirl, I'm sorry you've lost a loved one. It's also unfortunate you're dealing with the anxiety your healthcare team is promoting. In addition to missing the class on individual recovery timelines, they must have missed the one on caring for the whole person.

You have the right to refuse the MUA, if recommended by your doctor. As long as you aren't lying around all day eating bon bons, you are working that knee and your ROM will very likely improve (according to NIH studies, ~3-6% of TKA patients develop adhesions that cause decreased range of motion). Visualize trying to bend a garden hose that is on full blast. Now visualize bending the same garden hose when the water is turned off. It's more likely, at this point in your recovery, that swelling is causing your decreased flexion, not adhesions. Unfortunately, your PT may be increasing the chance of even more swelling. Do they ever measure your swelling when measuring your ROM? I insisted on it so my caretaker would understand that it was swelling not laziness or lack of motivation that prevented the flex or extension. ADLs plus your (reasonable for you) exercise regimen will get you there.

With the first knee, my blues often visited while I was on the PT table. Being a goal oriented person, I lamented not being able to achieve the goals set for me. I cried often and freely as my PT pushed and pulled my leg. With my 2nd knee, I didn't allow the aggressive exercises. I sure ticked off more than 1 therapist as I searched for the person who would work with ME the person (not the TKR coming in at 10:00am). I was an athlete when I was much younger but at this point in life, I just wanted a chance to take a lovely walk without pain. I have gotten so much more with these new knees. I needed to: practice patience; be committed to what worked for me; listen to the knee; and seek the support of Bonesmarties who had gone through it, too.

​

 

[Knitgirl]

I am truly thankful for all of your advice. Now I just need to arm myself with questions and arguments so that I don’t just melt into a pile of tears when the Dr. Lays into me next week.

 

[sistersinhim]

He said he was going to do it if I wasn’t at least at 110

You are the boss, not your doctor. You have every right to refuse to do the MUA. You can tell him that you would like more time to increase your bend the gentle way. You don't even have to do any exercises, just get the swelling down. That will improve your bend. But, remember it doesn't happen overnight. Be patient. It will come. If after a few months your bend isn't improving, then you can consider that MUA.

Do they just do an MUA “just because” you aren’t progressing without knowing what the real issue is?

I hate to say it, but I think the answer is yes. It's a quick thing for the surgeon, in and out of the OR in just a few minutes. He/she has no idea if it'll work or not, but they want to try it anyway.

 

[Jockette]

I was a bit intimidated by my surgeon also, but after almost 5 years on Bonesmart, that is no longer the case. If he mentions MUA, just tell him you prefer to give yourself more time to heal. He cannot do an MUA without your consent.
Saying no to therapy - am I allowed to?

 

[Knitgirl]

As long as you aren't lying around all day eating bon bons

Uh oh

 

[Knitgirl]

10 weeks now and what a huge difference! I took 2 weeks off of PT and did just gentle exercises, stretching and ADL. I iced and elevated, went on short walks and basically took it easy. When I went back to PT this week, my flexion was at 117!!!I went to the Dr. This morning and he was happy with my progress and congratulated me on all of my hard work. Side note: Dr. had me on 4 weeks of prednisone for the swelling. I had never been in steroids for any length of time, so I didn’t know how terrible they could be. Sleep disruption, night sweat, major anxiety, heart palpitations, not fun. Glad to be off of those bad boys.
All is well for the time being and I’ll give an update in a few weeks.

 

[sistersinhim]

I took 2 weeks off of PT and did just gentle exercises, stretching and ADL. I iced and elevated, went on short walks and basically took it easy. When I went back to PT this week, my flexion was at 117!!!

It really does work, doesn't it? What wonderful news that you are doing so well and that your OS is pleased.

Unfortunately, meds can have side effects that are almost as bad as what they're used for.

 

[hawk2go]

When I went back to PT this week, my flexion was at 117!!

That's awesome news. Now don't let your PT push you so hard that all that swelling returns. We're rooting for you!

 

[Knitgirl]

Well well well, I thought that I was in the home stretch, but then I went back to work 2 weeks ago. I work at a wild bird seed store and although I don’t have to lift or carry anything, I do have to stand and walk for several hours. The severe pain has returned, especially at night, and flexibility has gone back down to 106. I do need the work badly, but I’m not sure that I can even do this the 3 short days a week they have me on the schedule. Has anyone else seen a setback like this? I’m taking 6 Tylenol and 6 Ibuprofen a day, and it does help, but I feel like I should be past taking that much OTC medication. Just had to vent, this is difficult

 

[Jockette]

Yes, been there done that, and my huge setback was at 4 months, and again at 5 months. ( long story, somewhere in my recovery thread!)

Rest as much as you can at home, and especially elevate, to recover from your work days.

 

[Knitgirl]

Thanks

 

[InkedMarie]

Sorry @Knitgirl . With my first knee, I went back to work at 4.5 months. It was a new job, doing a 1:1 at a school so I was up & down during the seven hour shift. I don’t remember being anything other than ready to work.

I’m going back to work this time at about the same timeframe, last Monday in August. Different job, this one as kitchen manager at a school. I’ll be on my own again this year, on my feet for 6-7 hours. Unless I have some miraculous healing.... I can’t imagine being ready to go back.

Marie

 

[Knitgirl]

It’s rough, @InkedMarie. I hope all goes well with going back to work. Be kind to yourself.