TKR Its been worse than childbirth! Did I make the right decision?

[Jamie]

I haven't gotten my ROM measured but I think I must be about 100. I'm kinda nervous of my follow up appt in two weeks, because my doctor indicated that if I don't improve, he's considering MUA, which I really don't want.

I know the insurance thing can be a bit nerve wracking, but don't feel pressured into an MUA. As long as you are making progress there is no need to hurry with one just because you haven't reached some number. You are just six weeks out of surgery AND you've been on a major trip. I think you're doing fine. Watch those exercises too so that you are not pushing yourself to the point of pain or overdoing the reps and sets. You really don't need a lot of fancy exercises to get better. Gentle bends and stretches are best at this point.....maybe some time on an exercise bike if you have one.

Here are some exercises for you from the BoneSmart Library:

Knee Exercise Program

 

[mommabarefoot]

I feel your pain and darkness. My primary tkr was 12/13 and was a stryker triathlon knee which failed, I was allergic to nickel and ended up getting grossly infected. I had a total revision with a Smith and Nephew 9/10/14. You're very new timewise. Take your pain meds around the clock right on the nose. I lived in the swollows of pain hell myself, wanting and wishing I would just die (after revision). Be patient. Remember don't stand when you can sit, don't sit when you can lay down, don't stay awake when you can sleep. Elevate, elevate, elevate and ice. ROM will come, don't rush it. We all heal and recover after different rates (lord don't I know this). We are all here for you, anytime any hour. Plz feel free to IM me if you need to. You're not alone. I've seen probably 150 come and go at PT in the 11 months I've been trying to recover. I just remind myself that we are all different. Look for the smallest of changes, even raising up from bed a little easier, don't expect to be like the patient next to you or even on here. Praying for you

 

[appaloosa girl]

Hi @kneegone doing pretty good. Just got back from my dr apt and he is happy with my progress. No MUA. I'm glad I didn't go that way. I was afraid my ROM would be bad but in a couple days I went from 103 to almost 110. Personally I would keep doing the pt and exercise and stretches at home. Be patient with your knee. It's only been 8 weeks.
Dana



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[referee54]

Be patient with your knee. It's only been 8 weeks.

:iagree: Eight weeks sounds like a long time, but, in the grand scheme of recovery, you are in the early times of it. Hang in there!

 

[kneegone]

Thanks @referee54, @appaloosa girl, @mommabarefoot, @Jamie for all the encouragement and feedback.
My first outpatient p/T two days ago, went well. I measured at 111 degrees but he said my leg was not totally straight and in fact my good right knee wasn't totally straight either, so we are going to try to correct both. I really like this p/t, he's gentle but has a firm touch and seems confident. I got hooked up on the electric stimuli thing and I hope it helps. Apparently I have very weak quads?

It was funny, because he asked me what my goals were and I said, to be able to play tennis again, ski, maybe start running? He replied, how about, being able to climb stairs? Oh yeah, it would be great to do stairs first! and he said, "If you didn't run before, now is not a good time to start", lol that made me laugh.

Today, its raining, sleeting, and my knee really hurts. The pain radiates up my thigh bone to my hips. I think its cause I'm walking wrong, with a limp. I'm elevating and need meds now. Tomorrow is Txgiving and luckily I'm invited to a friend's house so, no cooking for me. yahoooo.

Lord, help me get better, make this pain go away, make me able to walk and climb without pain, help me not to wallow in self pity and scrape the bottom, help me get self sufficient and move on. This pain makes you want to just lie there....

 

[appaloosa girl]

Amen @kneegone. Amen!!
Gotta love this weather. Makes most of us all stiff and hurting. I don't even feel like going out today. But I have to later.
Awesome pt report. See your doing fantastic. When you can get a 110 ROM without hurting that's something to be proud of!!
Have a Happy Thanksgiving!!


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[kneegone]

@appaloosa girl, Happy Thanksgiving!

 

[referee54]

It is funny---many folks say that the lousy weather affects their knees---mine did not come with that feature, I guess..

Lord, help me get better, make this pain go away, make me able to walk and climb without pain, help me not to wallow in self pity and scrape the bottom, help me get self sufficient and move on. This pain makes you want to just lie there....

Trust me---you will get there---this recovery takes time (a lot of it) and it is longer than many of us could ever think it to be. It is frustrating, but, in the end, it is worth it!

We will help you get through it all!

 

[Jamie]

If you are hurting, you need to be taking something for the pain. Are you? And icing...that really helps.

It will get better. Honest. It's a slow process sometimes.

I like your therapist's attitude too. And a sense of humor to boot......I got a chuckle when I read your list of goals and then her idea to first climb stairs well. I think you'll do well with this person!

Weak quad muscles are very, very common. It comes from years of compensating for bad knees, but it is definitely something you can fix. The key will be to do it gradually AFTER you've allowed your knee time to recover from the surgery. Remember that you got the weakened muscles gradually over time and that's how you'll get the strength back....over time with activity and maybe some targeted exercises once the healing is done.

I read that you were limping and that's not good. It continues to "teach" your body bad gait habits and can actually make other joints and muscles hurt. Please use a walker, crutches or cane until you have a strong enough gait where you don't limp. As an example...with my TKRs I used a walker for about 6 weeks. I was not good with crutches and a cane didn't give me the support I wanted when I was practice walking (I did use a cane when I went out of the house, though...from about week 4-6). Toward the end of the 6 weeks I only needed the walker at night when I got up to go to the bathroom (safety). I know people want to get off a walker as soon as possible, but it really is an excellent frame for support as you relearn your stride. You don't need to use it all the time necessarily.....just when you want the support to practice walking.

 

[referee54]

I read that you were limping and that's not good. It continues to "teach" your body bad gait habits and can actually make other joints and muscles hurt. Please use a walker, crutches or cane until you have a strong enough gait where you don't limp.

This a very, very valid point.

It is better to use a walking aid such as a walker or crutches a few days longer than necessary rather than abandon them because you want things to move faster.

It is said that "Mechanics is muscle memory." If you are teaching those legs and their muscles bad habits, then you will have to "relearn" everything all over again. I agree---I would make sure that your gait is correct.

 

[dovemck]

It is funny---many folks say that the lousy weather affects their knees---mine did not come with that feature, I guess..

Lucky ducky! I was sensitive before the surgery, now a rainy day is downright misery with a deep bone ache that I can only dull with Tramadol.

 

[mommabarefoot]

Glad to see you are moving along in recovery. Weak quads, I totally understand this. I'm day 82 post op and was just able to do a straight leg lift. Be it 2" off the mat, but I was finally able. It's a slow process, so don't attempt to rush it. You will get there, just keep positive. Happy Holidays

 

[Roy Gardiner]

Walking alot or flexing alot, seems to increase pain and swelling... duh, sounds stupid, doesn't it?

Erm, no; that's what happens if you work a swollen or sensitive knee, it will get worse.

So my natural inclination is to do nothing, but that's not what I'm being told by P/T, dr, friends, etc.

P/T, dr, friends.... are wrong. Don't do anything that hurts or worsens swelling over the next 24 hours

Many on bonesmart, say if it hurts, don't do it?

Yes, we do say that, and we mean it, too,

I'm pressured to progress w. ROM.

Push back! Trying too hard to 'progress' ROM will 'regress' ROM.

I don't want to be stuck here. I wish there was a definitive answer.

There is, pretty much, which you may just have seen already...
- rest, elevate, ice and take your pain meds by the clock, don't overwork.
- If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
- If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it.
- Take note of the BoneSmart view on exercise and how exercise may affect pain and swelling.
- If you won't die if it's not done, don't do it; if you must do it, short and sweet, not hours on your feet.
- Don't stand if you can sit; don't sit if you can lie down, don't stay awake when you can go to sleep

You know my Dr. never told me how hard it was going to be.

It is hard, but (I'm sorry) you're making it harder. Relax, follow your own instincts and do less.

Lord, help me get better, make this pain go away, make me able to walk and climb without pain, help me not to wallow in self pity and scrape the bottom, help me get self sufficient and move on. This pain makes you want to just lie there....

As others have said, please get a prescription for painkillers from your surgeon or normal doctor, and take them by the clock. You won't get addicted.

 

[appaloosa girl]

Hi Judy @ kneegone.
Definitely get your meds. And remember it takes a year to heal and we are both early in this recovery. I know I have to be reminded of it.
Sometimes I think our bodies hit plateaus and our ROM stays the same for awhile. But it does get better after that. So don't get discouraged cos this to shall pass!!


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[kneegone]

@Roy Gardiner, @appaloosa girl. Thank you so much for your words of encouragement! Sometimes, I have to be reminded.... Mornings are so tough, stiff and achy, just want to lie there. I finally got up this morning and couldn't believe it was noon! I took aspirin in addition to Dilaudid last night. I usually take Tylenol, but I thought I'd give Aspirin a try for reducing the inflammation. I think my knee does look a teeny bit less swollen. What do you guys think? I researched online about contradictions w. Dilaudid and didn't find any w. aspirin. After massaging, this morning, I think I felt more "flexy". I have a P/T session later, we'll see how it goes....

 

[referee54]

Sometimes I think our bodies hit plateaus and our ROM stays the same for awhile.

Recovery is full of little victories, then we hit a plateau and stay in the same general ROM for a while---and then, for some reason, we have these little valleys, too. It all adds up, though, to a complete recovery---frustrating, at times, but do not sweat it.

Mornings are so tough, stiff and achy,

Yep, for some, mornings are very tough---just understand that, down the road, things will certainly get easier and brighter!

 

[kneegone]

@referee54, LOL, you sound so sure! I hope you're right. Sometimes, this journey feels so hopeless. The improvements are so miniscule.....

 

[referee54]

Push back! Trying too hard to 'progress' ROM will 'regress' ROM.

Exactly---there is no window for ROM---I am not sure where some of these folks get that idea! ROM can be gained all the way up to a year---and beyond.

Lord, help me get better, make this pain go away, make me able to walk and climb without pain,

Your pain will certainly subside---and, as others have said, I would talk to either your OS or your GP about this.

I was worried about addiction, and I talked to my OS---he said, "Hey, you are taking those pain meds for a reason---you will know when you do not need them anymore."---and he was right.

And, you will be not only able to walk and climb (or descend) stairs---you will be able to do so much more---and do it pain-free---life will be tremendously more enjoyable---but now you just focus on taking it slowly and gently---it is indeed frustrating, but you will get there!

 

[kneegone]

@mommabarefoot, read some of the older posts, and I just wanted to thank you for your kind words! Your TKR revision is about 3 1/2 weeks before me. I had a Smith & Nephew Legion Primary knee. How are you feeling? I saw my friend's father who had both knees done a year ago and he was surprised I'm still "recovering". He had his done in same hospital and recovered in a couple of weeks! He's also 80! He doesn't remember taking all those drugs I was prescribed either. and I don't have any health problems! But he did get the CPM machine at home, which I didn't cause my dr. didn't believe in it at home would make a big difference, plus my insurance did not cover. He got the ice machine, which I did not, money issues again :( Oh, well, at this point, just trying to work with what I have. My hips hurt now cause I'm not walking w. a natural gait, kind of hobbling, because I can't straighten my knee when walking. It does straighten when sitting/laying, albeit, not at 0. I think its weak quads, from years of not straightening? When this is over, I'm going dancing ;)

 

[kneegone]

@referee54, Thanks! I will try to keep up those positive thoughts. Taking my Dilaudid now and going to P/T. Does thinking positive affect the results? I wonder.