TKR I'm back again

[Dolphin5]

I've just read all your posts. Thank you. I will re-read them again.

My son's visit was a total disaster. He'd texted before coming over and asked how I was. I told him I was still crying so he knew how I was. When he arrived we sat barely talking. He asked about my knee, gave a few suggestions which I said no to. It was awkward. Like a couple who've rowed and not speaking. I eventually asked if he'd take the dogs out and do some shopping. He asked if I was coming and I said no. I went back to bed and cried. When he came back a couple of hours later he came into my room and said he was leaving as he didn't know what to say to me. He didn't even mention the pub lunch we were supposed to have. Could i have been persuaded? I honestly don't know.

When I eventually got up, about 5pm he'd left a Mother's Day card, some chocolates and a scented candle for me. And all the shopping. I was going to get up when he came back. I'd also thought I would ask him to set up my new Tens machine. Later he texted asking if I was definitely, definitely, not going to my pedicure today, if not he'd go home. I just said go home then. He was originally going to stay here til Wednesday. Until my collapse I'd been looking forward to his visit. Walks every day with the dogs, going to the supermarket, the farm shop etc.

My other son is different. He sent me a strong voice note telling me, pleading with me, to be positive. He is on holiday on Thursday but said he'll cancel it unless I can sort myself out. He's been looking forward to it for months and he'll lose his money. He comes back 3 days before my party.

To one question, yes, I felt better on the day I did no exercises, no elevation, no ice packs. Mentally, as it made me feel normal again and I could forget I have a problem. Even the thought of doing exercises again makes me cry more. I've done nothing now since Thursday apart from one ice pack Fri and Saturday morning. I have completely withdrawn into myself and i don't think I can go outside.

My son who came over has gone home. He's quite angry that he had a wasted trip. Before his text last night I'd thought I could perhaps get to my pedicure today, perhaps a short walk first, perhaps some lunch, I don't know, but his text showed he really really didn't want to be with me. And who can blame him in a way.....I'm disappointed though.

A friend has texted me the number for Mental Health Advisory Team on the island. I'm going to ring them. I don't have too much faith in my GP surgery, especially with the GP I've dealt with over the past few weeks.

Normally when I get low I get into the car with the dogs and go for a long, brisk walk, perhaps followed by a coffee and my mood is sorted but obviously I can't do that now.

 

[Dolphin5]

What is OS?

 

[beralc]

“My son who came over has gone home. He's quite angry that he had a wasted trip. Before his text last night I'd thought I could perhaps get to my pedicure today, perhaps a short walk first, perhaps some lunch, I don't know, but his text showed he really really didn't want to be with me. And who can blame him in a way.....I'm disappointed though.“

First off what suggestions did he make that you said no to? Playing devil’s advocate here and clearly we don’t know the relationship between you and your sons but I can see both sides here. I’d imagine your son came to see you with every intention of supporting you in his own way and to be fair, as he can’t offer you medical advice, he was offering the next best thing, moral and physical support in the shape of doing shopping and taking the dogs out etc. if his suggestions about your knee were met with “No”, I can see he may have felt stumped as to where to go in the conversation and as it doesn’t sound like you were offering him any insight into your situation so he had nothing to say.
If he didn’t want to be with you do you really think he’d have come over and plan to stay until Wednesday, but even though you thought you might be able to get to the pedicure and lunch it doesn’t sound as though you gave him that hope.
He has come across a situation that his mum is in, which he presumably hasn’t encountered before. If as you say, being outdoors makes you feel great, that could well be the mum he’s used to seeing and it’s difficult seeing you like this. In my experience few men deal well with women crying.

If this isn’t too personal a question but have you had problems coping in the past, I only ask because of your other son’s reaction suggesting he’d cancel his holiday, unless you can sort yourself out?

“My son who came over has gone home. He's quite angry that he had a wasted trip. Before his text last night I'd thought I could perhaps get to my pedicure today, perhaps a short walk first, perhaps some lunch, I don't know, but his text showed he really really didn't want to be with me. And who can blame him in a way.....I'm disappointed though”.

Again I don’t know the relationship you have with your sons but I would imagine he’s angry at the situation not at you and frustrated that he couldn’t change it or make a difference to you by being there. I know from experience it can make people feel hopeless and useless if they can’t have an impact on a loved one’s situation. You’ve put a lot of the onus on him with regard to “He didn't even mention the pub lunch we were supposed to have. Could I have been persuaded? I honestly don't know”. Is there a reason you didn’t speak up and discuss it with him?

“but his text showed he really really didn't want to be with me”.

I think his text could also be seen as he’d reached a dead end, we can only help people when they allow us. Saying “I just said go home then.” may have been a bit of a blow for him and it sounds as though you’ve left him feeling unwanted, as much as you felt he didn’t want to stick the visit out.

I think today is a “taking stock” day. Work out what you want beyond the obvious and any steps you can take to go about it. Yes seek medical help,but something you can practice in the meantime that may help you is, mindfulness techniques and similar approaches to your situation. You’ll find plenty of great advice about it online. It’s a powerful tool.

My words may like others, feel a bit tough but I hope you can see them in the light they’re given, but sometimes when someone is too in their own head with a problem, it can be very difficult for them to see a clear path out. So tough love is often all that’s left . The important word being love because your son’s desire to help you, is all about love.

The one thing to keep hold of is, this will not last and you will improve.

 

[Dolphin5]

I have just re-read the threads. I've worked out that OS is orthopaedic surgeon? Well he is the one I travelled on one bus, 2 ferrys and 4 taxis to reach but who said I had to take painkillers prior to exercises and that if I didn't then there was nothing more he could do for me. He was unsympathetic and dismissive. I was with him for 15 mins. He also said my op was in December when it was mid January. He wouldn't do another x-ray as he was happy with the one done after the op.

We have GPs on the island. Mine is 3 miles away but they messed up a couple of times delaying my recovery by about a week or so.

I can't remember the things my son suggested but one was, I think, that I get a private PT. I dismissed this as I said I knew what exercises to do. He said something about the exercises but I said I couldn't do them, the thought upset me. I did start crying again when he was sitting there. I couldn't bring myself to ask for much, or say things because of how upset I was.

I wanted him to take charge, tough love if you like, which I do not have a problem with. But he sat, tight lipped and uncomfortable. If he'd been more cheerful, perhaps given me my Mother's Day card and presents instead of just leaving them in the kitchen after, just given me a bit of persuasion.......but I know that men don't deal with women crying very well. He had come to see me expecting to see me as my old self. He left behind a parcel he couldn't deal with as the post office was closed. So he knows that I'm stuck with this and can't take it myself. I'd have hoped he'd have stayed until today to help.....but perhaps I'm expecting too much. All I know is that I had hoped he'd help me emotionally and mentally. Taken charge since I seem unable to cope at present.

I'm not crying much today but it may just be that I'm blocking everything out. Or quiet resignation. Still in bed after another sleep and no will to get up as there's nothing to get up for.

I'm thinking of calling the mental health number but haven't as such. Yes suicide is on my mind but a long way off. I couldn't put my elderly dogs through rehoming. Especially my dog Foxy, 11 years next month, as he was very badly treated before I got him and I couldn't put him through that. I have a specialty affinity with him due to my background. It's surprisingly easy to convince oneself that my sons would be better off without me.

 

[Dolphin5]

It looks like I'm going to be on this forum for many months so after a perceptive comment by Beraic I will give you my background.

My brother, 3 years older than me, had a breakdown when he was 17/18. My breakdown started when I was 16 and lasted a few years, at one stage going into the psychiatric ward of a hospital for 6 weeks from where i eventually ran away. Living at home was stressful. My parents were like chalk and cheese so my brother and I got it from both barrels but in different ways. It would make sense that my mother was mildly autistic. She did nice dinners and kept a clean house but emotionally and mentally there was no love or support. Just constantly being shouted at. I was scared of my father who was very intimidating. I would get stressed the moment he came home from work.

I married a man similar to my father. Divorced him when I was 33. I was stuck with my parents, who divorced when I was 25, until my father died when I was 43, and my mother died when I was 53. Relief on both counts and I never grieved cos I'd obviously stopped loving either of them decades before. The extrovert personality I was born with was suppressed up until I divorced my husband. So I have this ongoing tussle between being extrovert and introvert. I'm more comfortable with being introvert but I'm not happy then.

I brought up my sons from when they were 4 and 2. One of my sons gave me many challenges for several years. It was hard.

When I was 50 I took a serious overdose. I'm probably lucky to be alive. Pre planned for several days and on the morning I posted letters. With hindsight one of the causes was that I was coming off antidepressants. I thought coming off in a month was doing it slowly but I should have taken 2 months to come off them. Also I was on a ridiculous detox programme where I could eat virtually nothing. I've had mini breakdowns in between. Having low blood pressure doesn't help 95/90 over 65/60 as I have less energy than others and keep going at times only one day to wake up exhausted.

When I'm was 38 I started up a social club for single people. We had 30 events each month and there were some 30 weddings (some I didn't know about until years later). Some of these couples are coming to my party. I sold it after 6 years. My father had initially told me I'd never make any money from it, my mother said it would be too much for me, my brother said I was charging too much.

In the 2000s I started up a table tennis club from scratch. When I got others to organise it after 6 years, there were 20-30 people coming every week. A few years later I organised my church's first ever May Fayre. Despite a very small congregation the first year £4,000 was raised. The next two years it was £5,000. Two people told me separately that I had saved the church.

There are other achievements too which I won't go into. But despite everything I still have very wobbly self esteem.

I'm not sure whether I should be taking up so much of everyone's time in reading this but perhaps it'll help you to understand me and help me.

I do generally feel worn out by life and am always seeking peace. Or course peace was achieved by going for lovely walks with my dogs. The fight has gone out of me now. I feel I have nothing left in me. The last nearly 11 weeks has decimated me.

 

[Dolphin5]

PS my ex was a lousy father. My son's deserve better.

 

[Layla]

Dolphin,
I hear you and I am taking your words seriously. If you are feeling this desperate, please reach out to a mental health professional now / today. In an emergency dial 999, or if you need to urgently speak to someone dial 111.
You need to speak with a professional so they are able to help you work through all of this. This is beyond what we're able to help with here.

We are here for you to support you through your TKR recovery and will gladly continue to do so. However, it's heartbreaking to read your words. Please reach out for help both physical and emotional. This is not hopeless.
Prayers for peace and healing.
@Dolphin5

 

[sistersinhim]

I can't remember the things my son suggested but one was, I think, that I get a private PT. I dismissed this as I said I knew what exercises to do. He said something about the exercises but I said I couldn't do them, the thought upset me.

This is one thing that I can help you with. You DON'T have to do PT. You are alone most of the time, as I was. Taking care of your dogs, your house, your yard, and most importantly, your personal needs, are all natural PT and will rehab your knee just fine. You don't have to do painful exercises. Painful exercises cause increased inflammation, swelling, and pain. These are setbacks in your recovery. Use your knee as God made it to be used, not doing repetitive, unnatural movements. Each step you take is PT.

I'm one of those who never took formal PT. Due to birth defects, I've had 12 knee surgeries, 2 of them kneecap removals, and 1 TKR. Even after those, I never took formal PT. But, I didn't just sit around and do nothing, I used my knee as it was intended to be used by walking around to take care of my daily needs along with the necessary house and yard work. As I healed, I was able to do more. Icing and elevation were a huge part of my recovery.

Listen to your knee. It will tell you if you're doing too much by increasing pain and swelling. When that happened to me, I found that resting, icing, and elevating helped. Your knee knows how to rehab itself without being told what to do. Doing too much too soon causes setbacks because your knee has to heal from the inflammation caused by the exercises before it can get back to its normal, after-surgery healing.

 

[Jamie]

@Dolphin5 … none of us here take your words lightly and we are very concerned about you.

I can tell you tried your best to get your son to step in and take charge of helping you, but that doesn’t seem to have worked out well. I know that must make you feel sad, alone, and very much lost. But you don’t have to be by yourself in dealing with your feelings that you’re in a hopeless situation.

There are other excellent options for help if you contact your GP or call a suicide hotline or another emergency number. These agencies have staff just waiting to assist people who have lost their way and believe things cannot ever get better. They CAN!!! You just need a caring someone who can be there physically to guide you through this. Please make a call immediately and get the help you need. You’ve done the first big step. You’ve posted here that you know you need help. Your accomplishments in life tell me that you have the strength to conquer this challenge.

Layla has given you the numbers to call. But here is a link to the website for help on the island. We care about you and want you to find the assistance you want and need. These folks can help you. Please call them now.

Suicide prevention

If you are feeling in despair or are feeling suicidal there are people who you can reach out to

www.iow.gov.uk

 

[Dolphin5]

I meant to call the mental health helpline today but it was easier not to. Easier to bury myself under the bedclothes. I'm still in bed. Will have to get up soon to feed the animals.

Last Thursday I did 10 mins walk outside prior to PT. Another 10 mins walk outside after PT and later another 10 mins walk around the bungalow but the next day the depression set in after virtually no ROM improvement at the PT. No ill effects on the knee from the walking.

I KNOW I should be walking but mentally I've just given up. My brain is at odds with my emotions. I've always had this tendancy, this pull, to be a recluse but my outgoing personality has mostly kept me active. Now the pull is strong. My brother was born introvert and was a recluse, a real recluse. My boys and I will never get over the conditions he was living in. I just feel I can't do this. I know I can walk but I don't want to. Not even strolling round the garden anymore like I was doing and enjoying. Just bed. Hiding from the world and all the hurt.

Whilst thinking of suicide, quite a lot, I'm not close so please do not be concerned about that.

My neighbour, she and her husband are the only ones to have helped me (she had a second complicated TKR last November) has asked twice to come over but I've put her off. Again it's easier to hide under the bedclothes.

I know a lot of this is down to me to make the effort but it's like I just don't want to anymore. I feel I'm finished cos I can't even find the strength to go out or do anything.

 

[Jamie]

@Dolphin5…..I’m glad to hear you have a supportive neighbor. And you know the phone numbers for help. You have to do this for yourself.

We can help you with your knee issues. But while we care about you and your wellbeing, my staff is not able to be of assistance with your mental health concerns. We have provided phone numbers for you to receive that type of help. This is the best we can do. Please make the call to your local assistance agencies. We want to see you get the support you need.

 

[beralc]

@Dolphin5 well done first of all, for going into so much detail, that can’t have been easy to share but is probably a very good thing. “Taking up people’s time” as you put it by posting as you have,was the best thing to have done, because it’s allowed and will allow others to assist you in getting you through this really difficult time in your life and will allow you to be honest with yourself and others close to you, which is vitally important. Everything you’ve described, definitely makes more sense as to why, after your son came and left , you felt so awful and perhaps explains his difficulty with dealing with things.

I can’t put into words how I felt reading all of this. The overriding thing now is to focus on your mental health as @sistersinhim has said normal every day activities will do for your knee for now, but it’s important to get to a place where you can motivate yourself to do them and it sounds like you’re struggling to be at present.

I know you’ve not had the best experiences with your GP always, but if you advise them how you are feeling and the things you’re having they will respond. If necessary remind them about your previous problems and hospital admissions. And do make those necessary calls they are there to help people in exactly your situation.


It makes perfect sense with regards to your present difficulties, the effect your life experiences have had on you. But what’s remarkable is, that despite that, you’ve done some amazing things independently,as well as raising two boys!

I really hope you’re able to contact those who can really start to help you through. And please let us know how you are doing. Sending hugs

 

[Dolphin5]

Thank you.

 

[eaglemom]

I am just reaching out to check on you today. I'm hoping you were able to make that phone call today. I also hope you've been able to at least sit outside with your dogs. They would benefit from it and I know you would also. You can even stay in your robe - I think with just that little change of scenery it will benefited you.

Know you we care about you.

 

[Dolphin5]

Thank you Eaglemum. Unfortunately it was another day spent in bed til 5.30pm. We are having such lovely weather in the UK just now, weather I'd normally love to be out in.

I keep thinking of calling the mental health number but then I don't. I think it's the same reason I can't even think about the exercises, let alone do them, I'm blocking everything out. I can't ring the number as it means facing up to the fact I have a problem. Well problems.

I've now spent virtually 5 days in bed. Knee no worse but obviously stiff and I KNOW I have to do something but with my deep rooted problems I just don't want to be part of life just now (I don't mean in a suicidal way), just need a break from it all.

I've now succeeded in falling out with my son who came on Sunday as I told him he'd abandoned me on Sunday. Red rag to a bull. My other son was virtually cancelling his holiday tomorrow. Said he'd be worrying and miserable. I've now had to promise him I'll be positive and start doing things each day. Whether I keep the promise.....

The other pressure is my party. 10 days away. The caterers will be ringing me any day now to ask for final numbers and for me to pay the balance. If the party was tonight I'd not be able to go, same if it was tomorrow. I just have no idea what to do. My original party was to have been 5 years ago but was one week after the first lockdown so got cancelled.

I so appreciate all the support I've had on this forum. A real lifeline. I feel a lot of the above is not really relevant to the forum helping me with my knee replacement recovery but it helps to get it all off my chest and to receive so much encouragement......I can honestly say that I NEVER had one word of praise, or encouragement, from either of my parents, in all the years I knew them. Not once, so this is sort of a compliment to everyone on here who does show these two emotions. Is that the right word?

Sometimes I also need to be told what to do. The person who said to leave the exercises for now and just concentrate on walking was music to my ears. It's like being given permission. It's so silly. Last Thursday before and after physio, I did two outside walks and one inside walk, totally 30 minutes. No ill effects on my knee. I think it was the huge disappointment of having virtually no improvement that's done it. But it's possible there was some improvement even if it wasn't the ROM. I don't know.

My neighbour/friend is coming over at 10am. She wants to help. She's asked twice to come over but I've said no, me being in recluse mode.

Hopefully she can help me get going again.

 

[Layla]

Good Afternoon, Dolphin

Sometimes I also need to be told what to do.

"Sometimes" you noted.
We can't follow the advice on what to do only if we "like" what's being suggested. In reality, recovery is a challenge, whether we like it or not. It involves effort.

Lying in bed all day and avoiding movement, through exercise and the activities of daily living will impact both your TKR recovery as well as the blues, in a negative way.

It can cause your knee to become stiff, making it more doing difficult to achieve the ROM you're targeting.
Your muscles will weaken without using them, slowing / lengthening the recovery process and making it more difficult to walk properly. Lack of circulation from lying around hinders recovery and can increase pain in the area and cause muscle tightness.

You also put yourself at risk for a (DVT) blood clot which is a serious complication. Moving keeps your blood flowing which is essential in healing.

When dealing with Post Op Blues - Staying in bed will only increase any feelings of isolation and sadness.
As we've all heard, exercise releases endorphins, the "feel good hormones", which helps combat the blues or depression. Isolation does not allow for interactions with others, only feeds the feelings of loneliness if that's an issue.

Getting up and staying up, sitting outdoors, going for walks, doing simple stretches or exercises, routinely, can make a big difference in both your physical recovery and your outlook on full recovery.

Last Thursday before and after physio, I did two outside walks and one inside walk, totally 30 minutes. No ill effects on my knee. I think it was the huge disappointment of having virtually no improvement that's done it.

This recovery lasts a full year and even longer for some. You can not expect daily improvement. Try to look for weekly improvement for now. I suggest you start journaling your walks, exercises, stretches and activities of daily living. You must be doing some things around the home? Prepping meals, doing dishes, doing laundry, tidying up your space. Note all of that along with the difficulty you find in accomplishing each task. If you do this daily and reflect back on it once a week, I believe you will see the improvement you're looking for.

I suggest you get up in the morning and get dressed, signaling to yourself it is the start of a new day. This will get the blood flowing which helps reduce pain, swelling and again, the risk of a blood clot. Staying in bed and in your pajamas reinforces a "sick" mindset and will not improve your mood. A structured day and possibly even one planned the day before will help improve your mood and help you avoid inactivity.

Nutrition Basics

For an average healthy adult, surgery can mean: INCREASED ENERGY NEEDS. Your body burns a lot of energy during and after surgery. A MAJOR WORKOUT. You

bonesmart.org

Fueling your body through healthy nutrition is also beneficial, check out the articles, like the one above, that you have access to as an Insider. In addition, you need to stay adequately hydrated.

You don't have to run a marathon. Tomorrow is a new day and a new chance to begin feeling stronger, one step at a time. We're only halfway through the week. With a little effort you can close it out on a good note.
Best wishes!

 

[Jamie]

If playing the numbers game with a therapist is counterproductive for you (and it sounds like it is), just stop putting yourself in that position. Formal physical therapy is not mandatory. It’s your choice. Many people recover just great by making the therapy that suits them. In your case it sounds as though that might be doing things around your house and walking. As long as a person is engaging in everyday activities and taking time throughout the day to gently bend and stretch your knee to the point that you feel the challenge of mild discomfort, you should be just fine. ROM numbers are not exact. As I mentioned before to you, there can be a variation of degrees depending on how the therapist places the measurement tool on a given day. Focus more on how your knee feels and what you are able to do from week to week (not day to day!) and you should see more positive results. But….I promise you, if you choose to spend large amounts of time in bed, you will not make the progress that you’re capable of. It’s your choice whether you get better or not. Please don’t let feelings of “poor me” overtake the promise of better days and dancing again.

 

[Dolphin5]

Hi Layla and Jamie. Thank you for your posts.

Layla I'm aware of everything you have posted, but appreciate reading it to absorb it more and reinforce it more into my brain.

The last few days haven't been post op blues, but something much more deep rooted. It's hard when you're crying virtually non stop from the moment you awake to when you go to bed, for two whole days, to be rational and even be thinking of what you should be doing. I was in a good structure before seeing the PT. I was getting dressed straight after my breakfast (after I'd shared that I was staying in bed for too long and you advised me on the mental aspect of getting dressed early and the day started - thank you for that). I was doing a mixture of exercises (admittedly very few from when I joined the forum as I was trying not to cause my knee pain, and hoped that the icing/elevating, walking and resting would do the trick). I was icing 10-12 times a day and elevating twice a day for 45-60 minutes.

It's only since last Friday that I sort of mentally collapsed as the above was not, seemingly, working.

I've never been looking for daily improvement. My new 'Forum regime' started (with the above) on Wednesday 12 March. It was two weeks one day later when I saw the PT for the second time and had hoped for some improvement. I knew myself that if any, it wouldn't have been much, but I just wanted a little bit. Having said that the first measurement of 45o was in fact only 9 days earlier with the PT.

Jamie I agree with you about the 'numbers game'. And the variation in measurements. Perhaps there was an improvement up to 47o from the previous 45o.......

My nutrition is good, apart from the last few days when I've eaten very little.

It's not a case of 'poor me' but over the past few days being absolutely overwhelmed with negative feelings and hopelessness. How I've been hasn't really been a conscious choice.

You may be aware of Transcendental meditation. So in each of us is the adult, parent and child. I'm wondering whether when i go into this sort of introvert mood I'm in child mode and therefore wanting to be told what to do. My father controlled me and 'told' me what I could and could not do, so perhaps this is why. I don't know. The brain is so complex.

Thank you for reading so far and I hope I've not caused any offence.

The update is that my neighbour/friend came over yesterday morning and we talked for two hours. She suggested that we go for a 10 minutes walk, which we did. Predictably my knee was very, very stiff, and walking not great. She said to ice pack when I got in which I did. She called for me in the afternoon and we did another 10 mins walk and again I ice packed. This led me to ice pack another 3 times in the evening. I also did some ankle pumps which I'd not done for nearly a week. It may be said that I should've only done the one walk but doing two helped me mentally. I did have to take some extra paracetamol.

This morning she came over again. 10 mins walk followed by ice pack. Walking not great which was to be expected but was nonetheless irritating.

She's coming again this afternoon for another walk. I'm still feeling very fragile mentally but am just trying to get back into everything again, a proper routine. I may be able to do the sit down/stand up exercise later but still cannot face any knee bends/stretches.

I picked up the phone just now to ring the mental health line but realised my phone needed recharging so didn't.

One thing my friend mentioned was possibly having the fluid from the knee drained. She had this done herself, admitted it was very painful but that it actually worked. What are your thoughts on this please?

Thank you for your continued support and encouragement. I don't know what I'd have done without this forum.

 

[Alice Nutter]

I think you did so well by getting up and going for a few walks, with a neighbour who sounds more than precious. And then you did ankle pumps! This is huge, @Dolphin5. I'm sure others will weigh in, but my hunch is that right now try to continue doing the things you can do, maybe increase them a tiny bit, and don't worry about the other exercises. That'll come when you are feeling stronger, and there's plenty of time. Now it's time to build on what you can do, and just put aside that which you cannot do right now. Please be kind to yourself.

 

[Dolphin5]

THANK YOU. I've also just rung Mental Health. A clinician will ring me within 4 hours. I hate being like this mentally. Wouldn't wish it on my worse enemy.