TKR I really didn't know what I was getting into!

[Knees4Me]

@KarriB - Thanks, yes, I found that article on my own and it was part of the reason I thought I had IT band syndrome. My physio, who's experienced, agreed. She gave me similar exercises...but they hurt! I'll ice my knee before I go to bed, take Tylenol, rub on Voltaren and hope that tomorrow will finally be the day I wake up without pain!

 

[Arttie]

I'm not that familiar with the Canadian health care system, however if you can't get a referral to a different orthopedic surgeon for a consult, would an office visit to a revision specialist south of the border be possible for you? I know that you would have to pay out of pocket but it could give you an insight to take back to your doctors in Toronto.

I have to say that I have wondered how you were doing but did not want to be a bother by asking. I'm sorry that it has been so difficult for you.

 

[Celle]

I may ask to see my surgeon in September although my one year checkup isn't until January. For my five month checkup I saw only an "advanced care physiotherapist", not the surgeon. She told me to wear a neoprene knee brace, continue physiotherapy to work on my tight hamstring (which I'm doing) and take Tylenol. My flexion was 110 and my extension has always been zero. I may ask to go to the pain clinic. Maybe I'm just a baby!

I think it's time you saw your surgeon, so it's a good idea to make an appointment for September.

And no, you're not a baby! You have pain and you deserve to have it treated.

 

[KarriB]

I agree with Celle, you should make an appointment with your OS. An x-ray and exam can put your mind to rest and he'll be able to let you know if it is an IT problem for sure.

 

[jaschembra]

Just to put your mind to ease, I would be making the appointment sooner if you can. I'm not sure I could wait until September if the IT exercise is not helping.

 

[Knees4Me]

@Celle @KarriB @jaschembra - Thanks, all. You say what I know: an early trip to my surgeon is in my future. We have my sister-in-law and her husband coming to stay with us mid-August, so I don't think I'll be going to see my surgeon until September. But I will go, unless my knee improves dramatically in the next month or so. I'm just afraid she'll disapprove of my failure to exercise my knee into normalcy and she'll criticize my failure to get my weight down to what she said she expects. She's a tough cookie. Sheesh.

@Arttie - Thanks for the suggestion, but I won't be seeing a doc in the States. We're retired and on a fixed income, so I'm not inclined to travel there and pay when health care is perfectly fine and free here in Toronto. Besides, my passport has expired and I have to get a new one! I'll need it for our eventual trip to Hawaii!

 

[kneeper]

It is a tricky position to be in. Often when they don't know what your issue is they tell you to exercise more. But that can just make things worse.

Does your pain feel like it's *in* the knee or *around* the knee? I wound up with what was apparently a chronic quad tendonitis in my first knee I'm sure b/c of being pushed to do strengthening exercises too soon. I felt pain doing stairs, stiffness when standing for a long time or walking a lot etc.
When I complained of lingering pain all they told me was to exercise more. Exactly the wrong thing, imho. I had to stop doing most exercise for a few months and then very gradually increase (mostly through normal daily activities).


On the weight issue--I know I should lose weight for my health (and I'm sure it would be easier for the wear and tear on the artificial joint), but even though I'm heavier than I was before the tkrs I feel good because of the tkrs.

All that said, seeing your actual surgeon (not some kind of assistant) to check things out sounds like the first step.

ETA: many of us continue to gain a bit of ROM over the first year just by normal activities. That was the case for me. I just gradually and gently challenged myself to do more. I probably went from about 110 at the time I left PT to about 115 by the end of the year. (I had years of limited ROM and so wasn't expected to gain past my pre-op 110).

 

[Knees4Me]

@kneeper - Oh, kneeper, you're a keeper! (I'll bet you've heard that before!) I think the pain is in my soft tissue: muscles, tendons, IT band. My current, gentle, physiotherapist agrees.

A few nerves are still firing too...I assume it's as they heal. But I can't be sure what's going on because I don't know knee or leg anatomy or all of the side effects of TKRs. My GP says if there was something wrong with the artificial knee, The pain would be worse. Maybe I have a lower than normal tolerance to pain. I don't know. But I suspect the exercises I was expected to do, starting one week after surgery, in the hospital's aggressive rehab "knee classes" may have caused my continuing grief. As well as pushing our knees to the point of agony in the name of increased flexion, to reach 120 degrees, we were made to do a lot of strengthening exercises. Too soon, in my opinion. Hindsight is 20-20.

I went out today to a hair appointment, parked a couple of blocks away, walked to the bank and then to Starbucks for coffee and on to the supermarket. I didn't even park in a disabled spot, tho' I still have a permit. I took my cane, which I could probably have done without, but my knee is sore from walking. So I iced my knee when I got home - and had a "reviving" gin and tonic," as my Irish brother-in-law calls the drink! That does help dull the pain and stiffness.

I just want to get back to doing normal things like going down stairs, biking and taking long walks without pain!

This forum is a godsend for support, education (that we don't get from most surgeons!) and getting things off my chest that most other people don't understand. Thanks a million fellow Bonesmarties!

 

[sistersinhim]

Did you have any knee surgeries before your tkr? Sometimes previous surgeries add to the healing times.

 

[Knees4Me]

No, nothing. So that's not the prob, apparently. Just advanced arthritis...

 

[liam2015]

hi @Knees4Me. i was wondering what kind of exercises and treatments you had one week after surgery? i was supposed to have physio come to my house and then out-patient physio but they never called me and i didn't follow up because i was too weak and ill with nausea from the narcotics and didn't feel up to it. i had my surgery at William Osler in Brampton, although my surgeon's office is at William Osler in Etobicoke (Etobicoke General), actually the medical clinic adjacent to the hospital. Where did you have your surgery? i finally started physio (paying privately) at 6 weeks post op.

you're right ~ it's nice to come here for support, education and to get things off our chest that other people don't understand. hope your issues improve prior to september when you plan to follow up with your surgeon.

 

[sistersinhim]

The therapists even threatene to phone your surgeon upstairs if a patient was deemed "uncooperative". It happened to me! Beware of this type of unacceptable "therapy." I blame it for my continuing pain at seven months out!!

I think you are absolutely right. Time and time again we have seen aggressive PT cause set back and much slower recovery. BTW, so what if they tell your OS?! What's he going to do? Put you on restriction? Spank you? It sounds so juvenile to hear that. The PT that came into my room at the hospital after my tkr tried to push my foot to get more bend and I flat out told her no. She said she was going to tell on me and I told her to go ahead. After getting home, PT called to set up an appointment, I told them no, that I was doing it myself. They also said they would tell on me for being non-compliant. Again, I said to go ahead.

After having my 3 after surgery visits with my OS, he never said a thing about me not taking PT. All he wanted was to see what my knee would do each time. Don't you worry about them telling on you either. It's your knee and you are in control of what happens to it. Do not let anyone hurt it, including yourself! You will have such a quicker and better recovery if you follow the BS guidelines. They have proven over and over again to work!

 

[Knees4Me]

@liam2015 - I had my surgery at the Orthopedic and Arthritic hospital in downtown Toronto that's part of Sunnybrook Health Sciences Centre. The exercises were the same as the ones in their handout book - and more. I, on the advice of my doc, thought it would be a good idea to sign up for the twice weekly "knee class" at the hospital (for two hours each time), starting one week after my surgery. We stretched our "surgery" knees with a strap, both sitting up and lying on our backs. Then we'd sit on the end of the physio bed and the physiotherapists would come over, hoist up the beds and bend our knees with their hands back under the beds as far as they could until we yelled "uncle," screamed stop or (as some some others did) burst into tears. Then we had to go up and down the stairs in the stair wells, holding on to the banisters. (I still can't go down stairs without pain!), do knee presses and uses therabands (e.g. for "the crab exercise"), practice stepping up and down on a step, practice sitting down and getting up without using our hands, deep knee bends, going up on our toes, balance ball, side leg lifts, recumbent bicycle, etc. They kept me there longer than most others because I wasn't getting to 120 degrees flexion. They finally had to release me after three months at only 110 degrees. Brutal! I wouldn't do it again if I ever get to a stage where I'll agree to have my right knee replaced. The mother of a woman in my book club had the same surgeon as I did, never went to the "knee class" or physio and just did the exercises in the book at home on her own and, apparently, never missed a day. She reached 120 degrees flexion by her six week checkup and was cane-free and walking with no limp or pain shortly after that. But, as this forum proves, all knees - and recoveries - are different! All the best for your recovery! We're in this frustrating situation together!!

 

[liam2015]

omg @Knees4Me ~ i know i could not have done that. you are stronger than me to be able to do all that so soon after surgery. the physio i had the day after surgery, prior to being released just went over the sheet with the home exercises, which they made me do but i couldn't do them very well, then they described to me how to climb the little portable staircase (good foot up, bad foot down) which i was able to do and also they watched me walk with the walker. one last thing they did was describe to me and have me show them how i would get out of bed at home and that was a joke. i couldn't really do it at the time, but they released me anyways. i was in pretty poor shape. i did the hospital exercises in bed for the first week or so but then i stopped due to nausea. i wanted to take care of that first.

yes, every recovery is different and we are in this frustrating situation together. the support here is wonderful. best wishes to you also that you resolve the issues you have.

 

[Knees4Me]

@liam2015 - I only did rehab because I had too! When the sadistic PTs came the day after surgery to my hospital bed, they pushed my knee and said I needed to get 90 degrees flexion before I'd be discharged. I didn't. One physio actually bragged that she'd caused one patient so much pain that she'd passed out. Some physios (but certainly not all - I have a great one now) are sadists! What are your extension and flexion now? Can you walk down stairs without pain! I can't and don't know if I ever will. I always need to hold onto the railings or my cane!

 

[liam2015]

@Knees4Me ~ i am walking very gingerly down the stairs alternate feet putting toe down first and hanging on for dear life to handrails on either side. i don't let it hurt as i'm not putting my foot down quickly, as i accidentally did one day which was painful. there was no talk about degree of r.o.m. in the hospital. i really think they just wanted to go through the recommended exercises so they could say you were ready to be released. i do think it's a good thing because you don't really gain anything staying longer in the hospital; in fact, more of a risk to catch an infection or virus. i guess i was lucky in that way that the physiotherapists didn't insist on a high standard of completing the exercises before releasing me.

at the moment, my flexion on my own with no pushing is 96, i think she said today. with the physio pushing, it was 105. i'm not sure of my extension, but she said my knee was almost flat against the table. i do trust Melissa, my physiotherapist. when she went on vacation, another one took over for her, and i found her a little too aggressive with the manipulation, being as she didn't really know me, although she was probably following Melissa's orders to continue the momentum while she was away. i will probably go until the end of august, and then we hope to go on a vacation to a place we rent on lake ontario, sandbanks beach, near picton. i might even stop sooner than that if i'm not having significant progress. it's hard to know what to do.

p.s. when i went for my 6 week follow up with my surgeon, my r.o.m. was only 76 degrees.

 

[Knees4Me]

@liam2015 - I might stop physio at the end of August too. I'll rest, elevate, ice and do gentle stretches. Other than that, I'll just do everyday things and try to walk a bit farther every day. Maybe that will help to reduce pain and help recovery. Hope so!

I grew up going to the Sandbanks! A high school friend's parents used to rent a place on West Lake nearby. What's the cottage like that you rent? Is it on Lake Ontario? We were just down in Kingston to visit my 90 year old mother and on the way home we stopped off at the Norman Hardie winery, also in Prince Edward County. Nice wine, but expensive! Before my surgery, I thought I'd have my other knee done last month as well and have two good knees by Christmas. We were planning to go to Hawaii in January, but even my first knee won't be ready, unfortunately. Do you need to have your second knee replaced eventually?

 

[liam2015]

we rent a place owned by my hubby's partner's cousins on Salmon Point Road, called The Old Dairy Barn at Sandbanks. it's a 7 minute walk through the woods to the beach (yes it's on Lake Ontario) but with all the rain this year, the beach has receded and the entrance is difficult due to rocks being piled up and the water coming up so high. i'm a little worried that i won't be able to safely get to the beach but even if i don't, it's still a lovely place to recover ~ quiet and lots of land. i think this is just what i need.

at the moment, i don't think i will need the other knee replaced. when they were both x-rayed prior to even being considered for surgery, my right knee was fine, with no arthritis. however, it has been compensating for my operated knee, even before, and i feel it has weakened. that's why i'm trying to use my new knee just as much so i don't overuse my unoperated knee.

well i hope you do get your trip to Hawaii when you're a lot better so you can enjoy. my physiotherapist went there recently as it was less expensive to fly there than to fly across canada. she rented Airbnb's and had great success. she only took a backpack and no shampoo, etc. and they provided it along with sunscreen. were you planning a cruise or renting somewhere there? i've never been.

lucky you grew up going to sandbanks. we only just discovered it around 5 years ago (prince edward county).

 

[Knees4Me]

@liam2015 - That does sound like a lovely place to relax and recover. But I know what you mean about not knowing if you can get safely to the beach. I want to be able to walk on the beaches in Hawaii. If we go, it'll be a once in a lifetime trip with a stop to visit friends in L.A. I've never been to either place. We plan to stay in hotels since we'll be 68 and 71 and need all the "mod cons." I'm not sure about Airbnb's. We may still go to Hawaii next year if my left knee recovers to an acceptable degree in the next few months.

When we went to the Norman Hardie winery, we noticed that many properties were flooded along the Lake Ontario. I've never seen it so high! I feel sorry for the owners! Hope they can get back to normal - and more rain isn't "the new normal!" Enjoy your BBQ this weekend!

 

[KarriB]

@Knees4Me , you really don't need that type of aggressive PT. It's just causing you swelling and pain 6 months post op. There are many docs and hospitals (including Mayo Clinic) that do not require their patients to go to PT because of the aggressive therapy you have experienced. If you're going to stop in August, just stop now and give your knee a rest and live your life. This type of aggressive therapy can lead to chronic pain. Check the link below.

https://bonesmart.org/forum/threads...e-consequences-of-doing-too-much-of-it.26764/