TKR Journey of a slow healer

[JusticeRider]

she agreed to gentle PT. Win!

Good for you Tentcamper. No one knows your body like you do. We are each unique and we have to fight sometimes to protect our bodies, especially if they don’t fit the ‘timeline’ the medical professionals want.

I have seen significant improvement again recently in my ROM, now at almost 11 months post op. I think it may be from doing more hiking downhill lately. Going down stairs feels much more comfortable the last week or so (it has always felt a bit tight), and I also noticed I’m beginning to curl up more on my side in bed sometimes, which is nice. I’m absolutely a long term ROM improvement story

You are doing just fine! Some of us just take a while. You have a good attitude, and with regular visits from the patience fairy I have faith you will just keep moving forward and see that knee gradually relax and bend. Wishing you well, TC

 

[Layla]

Hi Tentcamper,
Happy One Month Anniversary!
I hope you have a great holiday weekend!
@Tentcamper

 

[Tentcamper]

Can someone tell me where I would have adhesions if I did have them? I've looked on the internet and it seems they would be on the top of the knee rather than the sides, mid-knee. And no, I don't think I have any. Just marshaling info for a discussion with my OS.

 

[Tentcamper]

Can someone tell me how the heck I can change the title when I ask a new question? It's driving me crackers!

 

[sistersinhim]

The staff can change the title for you. Just let us know what you would like for it to say.

 

[Tentcamper]

So when Doccuke posted with the title of 'update' he asked you to make the change? If so could you change mine to Adhesions? Thanks.

 

[sistersinhim]

I changed it for you.

 

[Jamie]

Adhesions are a rare complication from some types of surgery. They are many times misnamed as “scar tissue.” But in reality, they occur when surfaces of soft tissue get hot and dry and no longer glide smoothly across one another. This can happen when tissue is inflamed, as the heat contributes to dryness. When the tissues don’t move properly over one another, they can stick together and “adhere” to one another, restricting movement. I seriously doubt this is what is going on in your knee. Swelling can take a long time to resolve sometimes…especially if you are pushing your activity a bit.

Some thoughts as I read your thread….

You mention you are not using any type of walking aid around the house. This is okay as long as you are not limping or grabbing on to things for support as you move about. If you are doing either of these (especially the limping), it means it’s too soon to stop using a cane or walker for support. There are no prizes given for tossing these aids early in your recovery. It’s much better to continue to use whatever works best so that your body has time to develop strength to walk with a good, long stride. Gait is very important and it’s something you can discuss with your therapist. Many are trained in gait therapy and can help with that.

Be sure you are getting plenty of protein each day. This is the most critical food for good recovery as it contributes to healing and development of new tissue. It’s great to supplement food with high-protein products such as Ensure, Boost, or Glucerna.

I’m sorry both your surgeon and therapist are telling you that your knee might get “stuck” at a certain ROM if you don’t push yourself. As long as you are not couch-bound all day and are moving around routinely, this will not happen. Some people just take longer to heal than others. Our bodies are all unique and totally in control of this recovery. The best we can do is to give it the tools it needs to do its job (like good nutrition and plenty of water) and allow it the time needed to get the job done. I’m glad you are listening to your own body and responding to these comments accordingly. No one knows your body better than you. We have tens of thousands of BoneSmarties here who will tell you the more gentle approach to recovery worked well for them.

I think you’re doing just fine. You are still very early in this recovery process. It is a marathon and not a sprint that can take a year or more before you realize all the benefits of having your knee replaced.

 

[Tentcamper]

@Jamie Thank you so much for all the info. It puts my mind at ease to tell my surgeon to back off. I see him again in a couple weeks and will politely refuse an MUA.

I am slacking on drinking water and will get back to my previous level of 80 oz a day. I eat a lot of protein but will add a smoothie in the morning.

I'm doing well walking unassisted...no furniture surfing. I have to remind myself to walk like a human and not a stiff leg or pirate.

I live alone so get about two hours a day of ADL. I take a 1/4 mile walk a day using my trekking poles. The rest of the time is on the couch, elevated and icing.

I had no idea how long this endeavor would take and am learning patience. I'm so glad to have found this forum and all the support.

 

[BionicMama]

It's just so frustrating to see no real change in the swelling since I came home from the hospital. My ice machine and I regularly commune four times a day and I elevate as much as possible. I have almost no bend (flexion?) at all...maybe 5 degrees. Add to that, my knee collapsing this morning and I'm headed down the depression trail for the day. I'm not worried about the collapse. I was told I have to get the muscles holding my knee back up to strength, but there are times it feels like nothing is healing. The good news is that I'm not in any pain and I did get five hours of solid sleep last night. I just had higher expectations of healing by now. Boy is this hard sometimes.

It’s hard when you feel like you’re not making progress. I’ve felt that way many times so far and I have to remind myself it’s still early. My knee can flex to 95 and extend to 5 but every time I stand up it’s painful and my muscles gather into knots. I’m at 4.5 weeks and really expected to be almost back to normal which I’m realizing was not at all realistic from what most others experience seems to be. Hopefully we can keep moving forward and start to see some significant progress soon!

 

[JusticeRider]

I see him again in a couple weeks and will politely refuse an MUA.

Hey Tentcamper, I know it can be difficult to refuse a treatment your dr is pressing you to do. It was stressful for me leading up to that appointment at a few months post op. When I was there the PA told me I needed to do a MUA or I would never get more ROM. I asked a few questions, then told him I would think about it. A few days later, I messaged him and said “I’m not inclined to do a MUA at this point.” And that was that!

 

[Tentcamper]

@JusticeRider Brilliant solution? Now I don't have to look like I know more than he does, or that I'm throwing a temper tantrum

 

[Rain Dancer]

I’m rooting for you! It takes courage to resist the pressure. My surgeon told me that I was his first patient who refused an MUA. I’m glad I refused because we later found out that my flexion issue was caused by the implant impinging on the popliteus tendon. During arthroscopic surgery to release the popliteus, the surgeon found no adhesions.

 

[sistersinhim]

My surgeon told me that I was his first patient who refused an MUA.

WHAT??!!! This is absolutely crazy. I would run fast from this surgeon. Bending just takes time and forcing it does more harm than good for the vast majority.

 

[Tentcamper]

The great acupuncture episode is over! I had five sessions and here are the results. The first picture is before I started, the second is after the last treatment and the third is this morning. The second picture shows the cupping marks. I look like an octopus got me.

I know there doesn't look like there is a lot of difference but the huge part is now my swelling is soft to the touch and not hard as a rock. I walk without feeling like there is a tight band around my knee. I don't think it improved my ROM but at this point I'll take what I can get. Now to get that residual muscle swelling down. Yeah, patience. And yes, I would do this again if needed.

 

[mendogal]

The great acupuncture episode is over! I had five sessions and here are the results. The first picture is before I started, the second is after the last treatment and the third is this morning. The second picture shows the cupping marks. I look like an octopus got me

Oh this is great progress!

 

[Rain Dancer]

My surgeon told me that I was his first patient who refused an MUA.

WHAT??!!! This is absolutely crazy. I would run fast from this surgeon. Bending just takes time and forcing it does more harm than good for the vast majority.

I was also the first patient to walk into his office with an article from a medical journal and tell him that I had diagnosed myself and needed to have the popliteus released! In his defense, he listened, and got me to a sports medicine surgeon in his practice who agreed to do the surgery. They are using me as a test case because there are other patients who presented with similar symptoms.

I probably have one of the best knee replacement surgeons in my area for the actual replacement surgery; however, the only tool in his toolbox after surgery for ROM issues is an MUA. And he believes that an MUA must be done in the first 12 weeks to avoid injury. This seems to be a common theme on Bonesmart. We have to advocate for ourselves and trust our instincts.

Frankly, the state of care after knee replacement surgery is scandalous. There are so many long haulers on this site who are struggling to find answers after being told that the x-rays look fine, and they should just live with the results.

 

[WFD]

Frankly, the state of care after knee replacement surgery is scandalous.

So true. Post-op care gets maybe 1% of the effort and technical sophistication that the surgery does. If as much research as has been done on surgical techniques and equipment were applied to post-op recovery, it would be a different world.

 

[Frustrated !!!]

Frankly, the state of care after knee replacement surgery is scandalous.

So true. Post-op care gets maybe 1% of the effort and technical sophistication that the surgery does. If as much research as has been done on surgical techniques and equipment were applied to post-op recovery, it would be a different world.

I totally agree. Most surgeons are extremely receptive and have time to talk pre-surgery, but as soon as they are done sawing off your bones, they barely have time to acknowledge you. My OS is always over-booked, and for all of my post-op visits, I had to bide my time in the waiting room for over an hour each time, then barely got to see him for 5 minutes during the actual post-op evaluation. I guess it's not cost-effective for them to spend too much time on post-op care, and it seems like they just want to move on the next patient ASAP. I consulted with a different surgeon regarding my left knee, which has Stage 4 OA as well, and he seemed to be about the same.... rushed and over-booked. If I find a decent OS who has time to listen to patients post-op, I will definitely post his name on here!

 

[JusticeRider]

I absolutely agree. I saw my surgeon for an appointment once before the surgery, and then once in the recovery room directly after the surgery (when I was still foggy from anesthesia). That’s it. Every other time it was his PA. There was very little guidance for after care, and they pressured me to muscle through the pain to the point of agony to force my very swollen knee to bend. They seemed to give up on me after I passed on the MUA. I think he was a skilled surgeon but that’s where his talents began and ended. Unfortunately, that seems to be a common experience ): I wish they would actually invest time, care, and research into after care, as @WFD pointed out.