Help, I need advice

[Motherofmany]

Hello all, I'm so thankful my daughter found this site for me. I am a 43 year old mother of 8+3 grandchildren living at home; 9 1/2 weeks post-op from RTKR due to OA and injuries. I'm recovering very slowly and would like some advice.

Just a little history about me. Had code blue 1st night due to pain med. Then possible infection/blood clot (neither happened) that lead to minimal therapy in hospital. Allergic reaction to sulfa antibiotic for possible infection that caused seizures and blood pressure to drop 50-60 points when standing and would black out, so discontinued. Aggressive home therapy for 4+ weeks, including CPM 3 weeks. Injured left knee 5 weeks ago (day before last home therapy) walking out back door. Dr. thinks I either tore the miniscus or remaining cartiledge. LTKR needed as soon as right is healthy according to surgeon.

Dr. says as long as I'm progressing, I'm okay. My problem is I'm stuck at -10/ext even using board 2-3x day for 10 min at time and 78-84/flex. Able to drive and walk up/down most stairs normal. Stay busy home educating 7, feed 20 horses 2x week, church, running children to activities, grocery shopping, etc. Icing and resting to compensate for activity. Husband took 3 weeks off, but had to return. Children help with housework, laundry and cooking.

I dread PT because they have creative yet painful ways to TRY to bend it. Even with pain med, I am in tears trying to endure and perform for 1+ hours of PT 2x week. Have seen post on MUAs and am wondering if this is something I should do? Help! I need answers from others who have been here before.

Any suggestions would also be welcome as my PT says I have increased strength and endurance but will have a permanent limp if I can't get to -2/-3 on ext and above 100 on flex. Have tried to force it on my own and my husband and daughter help with bending, but neither can stand causing pain and don't want to hurt me. I tell them they aren't hurting me, pain is just a part of the process.

I realize my value is not in what I do, but who I am, however I often feel like a failure and push myself to do normal activities to the rebuke of my family because it makes me feel useful. Realize I'm rabbling, so I'll quit and hope for some encouragement/answers.
Blessings,
Rose aka Motherormany

 

[Texas]

Hi Rose. I am 9 weeks as well. I was only able to bend about 65 when I was 4 weeks. And I was not progressing at all, I was stuck. If you are making head way and gaining then maybe keep trying. If you feel like you are stuck and cant go anymore then I would just speak with your OS. He might say keep trying or do the manipulation. When I had mine I was SORE, nothing like the replacement. In a few days the sore parts were gone and I was able to bend about 90. Kept pushing and now my last measure was 117. I was very happy I had it done, because PT wasnt that painfull because I was able to bend alot more...I would still maybe talk with your OS and see what he says. The manipulation is really not that bad, just sore...but well worth it. Please Post any others questions you might have. Hope you feel better soon.............

 

[Jamie]

Welcome to BoneSmart. We're glad you found us and hope the forum can provide the help and support you need to get you through this rough spot.

Since your surgeon said things were fine as long as you're progressing and it doesn't sound like you ARE progressing at this time, it would seem like a good idea to talk with him again. Specifically talk about what a manipulation might be able to do for you. The key to a successful surgery is being able to do the things you want to afterwards. It doesn't sound like you are at that point and your doctor needs to give you advice about what he would like to do to get you there.

 

[Nursepair]

Welcome Rose, I was terrified about having an MUA but glad I had it done. It wasn't very painful after and my flexion improved after, that was after 7 months too.

Talk to your surgeon again. Hope all goes well for you. Sue

 

[Sticker Lady]

Ro
Welcome to BoneSmart! Everyone here will give you the benefit of thier experiences--they are the best people in the world! Be sure that you take the time to be good to yourself--not easy when you're the mom, I know.
Blessings,
Irene

 

[FrogFeathers]

I cried only once during my ten-days post-op PT in the hospital (they do rehab in the hospital where I was). But in the outpatient PT, I cried every single time I had a session for the first three weeks. It did get easier. And if your PT is any kind of good (and I've yet to meet one who wasn't), they won't get mad at you for crying.

I'm frustrated that I'm not walking "normal" yet and still using a cane (I'm 2 1/2 months out from my surgery) and I have to keep reminding myself that this is MAJOR surgery! Our progress is completely normal, everyone heals differently and our bodies deal with it all differently. Its hard not to get down on ourselves because we feel like we should be doing more. I've had to learn how to say: "I can't do this..." and "It hurts if I [do/try/etc]..." Just keep reminding yourself that it DOES get better! Just a few weeks ago, I didn't think I'd be able to walk from my computer desk to the kitchen without my cane. And I am now... and soon, I'll be able to take my dogs out all at once instead of making each one wait in turn (we don't have a fenced yard). And soon... I'll be back to walking for exercising!

By the way, I'm 39 years old and have three kids, I'm glad to see I'm not "too young" for this- as I've been constantly told by people I meet. My husband is disabled as well and his disability doesn't cause him pain (he had a stroke 14 years ago). He doesn't express emotions properly and gets angry at me when I complain about pain. (its from his frustration of not being able to do anything about it).

 

[Josephine]

Well, mother, you have got yourself into an anxious state! With the unfortunate experiences you have had it's hardly surprising you are a little behind schedule although I would urge you to remember that at 9½ weeks, you're still very early and there is yet time to make up the slack. It may well be a manipulation will help some but that's for the surgeon to decide.

One other thing ... you said you are stuck at -10 degress extension! Gosh, there aren't many without knee problems that can achieve that! But later you say it's -2/3 which in my book is pretty ok. However, I'm assuming the first figure was a typo!

Now the pts are telling you for certain that you'll have a limp for ever?! No way! People on here have report that their flexion continues to improve even as long as 12 months later! Don't let them scare you into this anxiety. It's not for man to know what will and will not be. And many have managed quite well, thank you very much, even with a bit of a limp. Total perfection is not always attainable.

You also seem to be doing quite well regardless - my goodness! All you do at 10 weeks and I'm still barely just walking around! You should be PROUD of yourself, dear lady! Very proud! So one more question - you manage all that and walk up and downstairs (almost) normally - what are you panicking about? Some extra flexion would be nice but seriously, if you didn't get it all, would it ruin your life?

I think not. Give it time, stop trying to rush the fence all in one go.

 

[backbay38]

I can't imagine how you do all you do -- manage allthose kids and feed the horses etc only a few months out from TKR. You sound like you've made more progress than you give yourself credit for!. it really is a process which is different for all of us. And I have read elsewhere on this forum that it is - apparently - more difficult for younger people to recover. Seems strange but maybe because many younger people are more active than those in their 60's and 70's. (and many aren't so again --generalizations don't work!!!)
As for the PT hurting etc -- do you stillhve some swelling? There mayb e interal tissue swelling you can't acvtuallys ee which makes your knee feel very tight and would get int he way of bending more. That's all for your surgeon to say. But I would think you can ask him that and also about any possible need for a manipulation. My surgeon made it clear from the start I could call and ask questions any time I had them. He calls me back at the end of his day usually.
It also sounds like perhaps you are just so overloaded with work and childcare etc that you may just need to pull back and rest a bit more. I know that's easy to say from here but it IS your knee and your life and you do want to take enough time to recover so you can forget about your knee and just live. is there anyone who might be able to help you ?

 

[JudyS]

Hi and Welcome,
I have to second the rest more advice. Soomehow it has to be possible. Is there someone who might like to feed the animals for a while? Help in any way. Just think of sitting and icing, there must be some things that will survive without your care. Housework for example. I have had a lot of surgery and other stuff recently and have to let a lot of things go, life still goes on just fine. I actually have felt I have got closer to my teenagers as I am sitting and able to talk more to them.
My body decided rest was needed, seriously, I started sleeping from 10pm to around 12 the next day. Just crazy for me, but my body kind of put it's foot down and demanded. I am such a light sleeper and was surprised today that is was 11:30 when I woke up!!!!

Please try so hard to get yourself some needed rest so more healing can take place, it really matters. Of course as Jo said, you are doing great and it is still very early.
judy

 

[Motherofmany]

Thanks and more questions

I consider it a priviledge that each of you took the time to read my post and respond. Thank you for all the wonderful encouragement and advice. I am grateful for the input from others who are TKR survivors. My OS and PT tell me statistics, but only those who have been through this process have personal experience.

I am so blessed and really should not complain, so please forgive my venting. My frustration and disappointment with my somewhat slow recovery stems from unrealistic, self-imposed expectations I have for what I can and can't do and when. I didn't know what to expect from this surgery, but have had a reality check over the last 10+ weeks.

I don't do 'still' very well at all. Unfortunately rest and icing are the only ways to reduce the excess swelling I am having in my knees. My PT agrees with you all on that one. He told me I can do activities with my children/grandchildren, but limit the time at the barn to 1 hour at a time and not to piggyback activities. Because I have always been very active, I have difficulty pacing myself and staying within my limitations, then suffer needlessly.

Therapy was excrusiating on Monday because of the excess swelling. I regressed on both my flex and ext, but I passed my strength test. He wanted me to be able to lift 100lbs. with my right leg alone on the leg press. I was able to lift 130lbs.:wahey: It's great to have even a small victory!

I took your advice and limited my excercise type activities to one per day. I had been doing barn duty the same day as pt. I found out the hard way how foolish that was! I have also spent more time in bed with my leg elevated and icing/heating as needed. It's taking a while to reduce the swelling.

Thursday's pt went better. I adjusted the seat myself on the bike and was able to get the pedal all the way around by sliding my right foot a little. I told him I was cheating, but he said I was doing fine. I was also able to walk faster on the threadmill and balance better. My flex and ext seemed a little better, however he didn't measure. Figures!

I have therapy 2x next week and the week after then I return to my OS on June 29th. We will discuss what needs to be done for the left knee and if I will do a MUA then.

Have any of you ever heard of them doing a MUA during the second TKR? I don't think it would be the best idea since I will need a functioning right leg to support me while recooperating, but was hoping not to have to be back under again due to problems the first time around.

I'm hoping to try some aquatic therapy to see if that helps over the next few weeks. Any words of wisdom on activities to do in the pool?

Also was wondering at what point the tenderness on the outside of the knee subsides? It is still tender to the touch and often hurts like I've overstretched the ligaments. Most of my surgical pain is gone. Praise the Lord!

I am still walking with my cane (or crutch on rainy days) when I go out. In the house I hobble around pretty well without them. Only when I first wake up or if I've sat too long do I need to use something for support. Also, I can tell when I've spent too much time standing because I have stabbing pain where the metal attaches to the bone on both the upper and lower leg. Heat seems to help dull the pain some. Is this normal? I'm still trying to figure this out.

Thanks again for your encouraging words. I really needed to hear them. I think we all struggle with feelings of failure and uncertainty. Would appreciate any wisdom you can share.

This has been a difficult time, but I have found trials and tribulation bring forth proven character. I guess the Lord isn't through working on me yet!

Blessings,
Rose
aka Motherofmany
RTKR 3/31/09

 

[Texas]

Wow I dont think that is a small victory....lol. That is fantastic.........Thats alot of weight to me.....I am 9 weeks and still figuring things out , thats ok........We appreciate you posting...........

 

[Jamie]

Rose, it is quite common to do an MUA during the second TKR. It is not an invasive procedure and you will not have the same level of recovery pain as with the surgery. You'll be fine - especially with that STRONG leg you've got going there (130 lbs!!!). Also, the pains you are experiencing are quite normal as the muscles, ligaments and tendons all get used to working together properly again. Jo always says they are just getting reacquainted with each other!

You are doing fantastic for this stage of recovery. Pat yourself on the back, keep SLOWLY doing things for a while, and allow rests when you feel tired. You will be dramatically improved in the coming months!

 

[Texas]

Hi I got the knee sleeve thinggy and it works great it does slide down sometimes but it slides right over the knee and covers the whole knee around. It is good when I sit or lay I dont have to worry about it sliding around. If you order it runs small so order accordingly...Just thought I would let ya know........hope your doing well............Have a good night...........

 

[Judles]

Kim! The thingie falls down? Oh no!!!! Doesn't it come with something that wraps around and sticks to your leg like velcro?

 

[Texas]

No just gets larger...Haha this is getting funny if you think about it...lol................no it just fits to your leg...I cant stop laughing writing this,............No really it just fits on your leg you slide it on. But atleast when I sit or lay its doesnt fall off. Its pretty good, fits all around the knee so its nice....It was worth it...It doesnt slide all the time when I walk....

 

[Judles]

Hmmmmm!!! It DOES sound rather funny!!! Just hope it HELPS!!!

 

[Texas]

Yes it really does help! Thanks!!!!!!!!!

 

[Motherofmany]

Thanks Kim,

I've done a little research on it and it seems to be highly recommended. Wasn't sure if it was just paid advertisement, so I'm glad to hear a true testimonial. I would use it while elevating on my leg wedge. I was able to order one like they use at my pt locally. Only problem was the price was higher when it arrived. Catalog was out of date, so they say. :skp: Even so it was worth the money.

On another note, I went back to pt today after 10 days off. Ouch!!! Didn't make it last week because of teaching VBS. Boy am I sore tonight!

Doesn't help that I slipped on the ceramic tile in the bathroom last night and wretched my TKR knee. Double Owee!! Bruised immediately even though it never hit the floor. Then to add insult to injury I tripped on the cat this morning when getting into the shower and twisted it some more. Told my pt it feels like when you roll your ankle. He didn't take pity on me and still made me work 1 hour. Would have thought I could have gained some sympathy since he himself was limping with an injury to the knee.

I'm still stuck at 78 on flex and 11 on ext. I have 1 more session on Wed. before heading to OS on Monday. Pretty sure he will do a MUA. Pt thinks so too. He was happy that I hadn't lost any more with the injury to the knee. I wasn't though.

Get discouraged when I work so hard and make no progress. I shouldn't complain though, I am truly blessed. When I read of others on here and what they go through, I am thankful that I am mobile even if I'm stiff.

Thanks again for letting me know about the ice sleeve.

 

[Texas]

Hi Rose wow dont fall you dont need that.....I know the feet get to going and sometimes we cant stop them...lol...Sorry your sore tonight just take it easy.... Relax take medicine if you need it....About the MAU I did have one I was stuck at 65 , wasnt fun, but once they did the MAU I went up to 90-100 and I was a lil sore for a couple days and thats it. Well worth it. Please let us know what the Dr says......... It will be ok though.......Take care of yourself...

 

[skigirl]

Dear Rose,

I love the pool, just walking around frontwards, backwards and then sideways feels good---you can move faster in the pool. I have a kickboard and will float on my back while holding it and then kick my legs in a straight leg kick for a while too. I swim now often for 30 minutes, am going to try a water aerobics class tomorrow. (I am almost six weeks out)

The pain on the outside of your knee--and the stabbing pains in your knee sound like me---I also have trouble sitting still and often overdo the knee. But, I have tried lately to be more sensible---if you are doing too much---making the knee swell and causing pain, then you are not helping the healing at all--in fact, you are slowing everything down.

the pain on the outside of my knee was partially caused by a tight IT band. My pt massages it every time I go--3x a week. I also have a weekly 1/2 hour massage of my hip and it band by a massage therapist which has helped a lot with the pain there.

For swelling, I think you have to get your knee above your heart and ice it. It is summer, so I think school can be relaxed a little--it is more important to get that leg up. When I went into urgent care, the nurse told me to keep the leg up 15 min for every hour that I stood. I think you can ask the little ones for help--they need to play quietly nearby while you ice the knee four or five times a day to address the swelling. I saw a difference after two or three days.

Finally---I would question the use of the treadmill in pt---I use a stationery bike, a rowing machine and just lately, the elliptical trainer. I am very active and strong---but the treadmill makes my knee swell too. If your gait is not perfect--and your extension is not 0, then walking on the treadmill is just making everything worse. An elliptical trainer is so much more knee friendly, but a bike is the best since it is non weight bearing. If you have swelling, then you need less weightbearing exercise.

I spend a lot of time on the table with three sets of quad straight leg lifts, lifting while my leg is on a coffee can for full extension and side leg lifts--all helping to regain quad strength while keeping the weight off my knee.

I will be at six weeks on Wed---do have 0 extension--which is very important. If less than 0, your quad does not fire properly while you are walking. so, if your extension is less than 0 and you are walking on a treadmill, you are punishing your knee and the poor quad is struggling along not firing properly.

Children are great helpers when you need them. Explain to yours that you need help to rest your leg more for the next week or so---use lots of ice, elevate the knee and get off the treadmill. You can easily read to the children while you are resting and elevating---and, helping you is educational in itself. Even little ones can fold laundry, dust and help with the food---make it a game for them. Being educated to have compassion, to take care of someone who needs help, to take care of their bodies is as important as learning to spell. good luck. Kelly