PKR JusticeRider’s rehab adventure

[JusticeRider]

Time for a little update. This past week I tried to approach improvement from every angle. I took the week off pt and canceled all my other appointments except my massages. I’m getting 2/wk from an LMP who specializes in orthopedic massage. She is so good (thank you insurance!!) and fortunately only 20 minutes away. So I only had 80 minutes of driving this whole week as opposed to about 80 min per DAY. That seems to be the thing my knee likes least, so I thought I’d minimize it for a week and see what happened. My massage therapist was able to go a little deeper on me now that I’m past 6 weeks, and she suddenly got my quad to release! It felt like it just came back to life, like it was waking up and wanting to have a good stretch!

Stretching my quad is something I haven’t been able to do in two years though, because I haven’t been able to flex my knee enough to get any kind of stretch. Well, I found a way! The arms of my couch are really wide and flat, like the kind you could set a drink on. It’s a very deep couch, so the arm is long. Luckily I’m petite, because I can lay on my back on the arm of the couch and let my lower leg dangle off the end so my foot isn’t quite touching the ground. If I stretch my arms over my head and then pull my heel back as far as I can toward the couch (around 90•), I can feel a real stretch on my quad!! It works! And as a bonus, it also stretches my hip flexors on my operated hip I have been doing that several times a day for the last few days and it seems like it’s actually helping my walking. Maybe some of the pain I’m having in my stride is from tight quads?

Another thing that has been helpful just in general, is Tramadol. I have reacted badly to it in the past and did not want to try it again because I never wanted to feel that sick and disoriented again. But my surgeon really wanted me to give it another try. He mentioned it at my 2 wk appointment and I said no, and he mentioned it again at my 6 wk last week and I said I’d think about it. Before when I took it, I was taking 50 or 100 mg every 6 hrs, as prescribed. This time he had me try just half of a tablet (25 mg). I have been able to tolerate 25 mg, 3x/day. So a total of 75/day. A fraction of what I took before! But I have had some mild pain relief from it. I also noticed my mood lifted considerably! Like a lot! Well…it turns out Tramadol actually has significant anti depressive properties. I had no idea! I actually googled it because my mood was night and day after I started taking it, and what do you know? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7737323/#abstract-1title
So that was a happy side effect! I had been having some pretty dark days. This is helping!

I feel like I’ve made some progress this week and I hope it continues. I appreciate all the support from this forum as I navigate these sometimes extreme ups and downs. These joint replacements are not for the faint of heart!

 

[JusticeRider]

I haven’t posted on my own thread for a while because my last post was so optimistic and I hoped to have more good news to share. But the truth is, I’m a bit lost. I feel like I’m in one of those dreams where I’m trying to run but my legs are too heavy and no matter what I do I can’t break free.

Something is wrong with my walking that I can’t figure out and my pt can’t figure out and my surgeon’s PA doesn’t seem to understand. Ever since that ONE DAY a full month ago, I have had a horrible squeezing, pinching pain during this one part of my stride. It makes walking absolutely miserable. It causes me to walk like Frankenstein on my operated leg. It is extremely uncomfortable, but also embarrassing in front of other people, and it can’t be good for the rest of my body. Especially my hip, which has suffered two surgeries of its own. If I try to force my body to walk normally, that nasty pain rears up and makes me want to cry. It seems to go along with the swelling that keeps plaguing me. It will improve a bit for a few days, then get worse again for a few days. But it never totally eases up. Yesterday my leg felt like a huge water balloon. Today seems like it may be the same, but I don’t know because I’ve gone back to bed rather than face it. I had a really nice dream last night that I was running down the street just for fun, and it felt so natural and free. I just want to back to sleep so I can feel like that again.

My activity has been much the same every day. It’s like Groundhog Day. I have continued to elevate and ice dutifully several times a day. Doing my basic adl’s, gentle stretches, and short walks in my house. I wish I could walk more, but the more I walk the more painful it seems to be. I can’t even walk a block without paying the price. I don’t know what else to do. I’ve read 6 books, watched countless silly movies and TV shows, tried to write but can’t concentrate on it.

And it just doesn’t make sense. Weight bearing on that leg is not a problem. I can stand on one foot on my operated leg with no pain. My flexion is not great, but I can bend into the 80’s if I’m doing heel slides or hanging my legs. I can even do a mini squat comfortably as I do occasionally to pick something up off the ground or pet my tiny dog when she’s lying in her bed. I can get full extension, and that part of my stride feels fine. It’s just the moment where my operated leg is lifting off behind me and starting to bend and swing forward. That’s where it grabs me and I just lift my toes and hitch that leg forward without bending it any more.

I feel like I am not going to be able to progress until I can walk more. But no one can explain what’s wrong. My knee just keeps swelling and my walk doesn’t work and my mental health suffers. I used to walk 20 miles a day over mountains and now I can’t walk a block. Feeling very low.

 

[sistersinhim]

Have you thought about seeing another OS? Something doesn't sound quite right with your knee. I can understand your feeling down. I would, too. Has your current doctor seen you and run Xrays?

 

[JusticeRider]

I haven’t seen my surgeon in person since my surgery. At my 6 wk check up (week before last) I saw the PA. I shared my concerns then, but it happened to be on a day when the swelling was less (of course!) and he thought it was a little too swollen but nothing alarming. I think he assumed my issues with walking stemmed from ROM limitations. He didn’t even watch me walk. He was mainly interested in talking about my lack of flexion and threatening MUA. He thought everything else looked good. I had X rays done and they looked good too. I really think that by zeroing in so much on ROM numbers, we’re missing something else.

 

[sistersinhim]

He was mainly interested in talking about my lack of flexion and threatening MUA.

For some reason, many doctors love doing an MUA when the majority of them aren't necessary. Most of them just need time and even some of the MUAs cause more setbacks than improvements.

 

[Jockette]

At only 2 months post op, you are in the early months of this year long recovery. Try to relax and try to be patient with yourself. You still have months of healing to do. Lots of things we worry about at this stage do resolve on their own.

 

[JusticeRider]

Jockette, I hope you are right. This difficulty walking is really demoralizing. And that’s on top of my stalled ROM. I am trying to focus on the positives but my mood has been pretty low. And I’m going stir crazy!

 

[JusticeRider]

Just as an aside, does anyone else get irrationally enraged with jealousy seeing ordinary people just out walking down the street? Just skipping along on two good knees without a care in the world? Like, they have no idea how good they have it??

 

[Jockette]

I wouldn’t say I react that strongly, but yes, I notice. I also found when my husband had a football game on TV, and a player would fall on his knee, I’d think, oh no, there’s a TKR in that guy’s future!

 

[kiwicurls]

@JusticeRider , I don’t get irrationally jealous but I do have a friend and her husband, both 70 years old, who climb mountains, run marathons and cycle competitively. They are the exception, I know, but sometimes I feel a teeny pang of envy.

 

[sistersinhim]

I really don't get jealous but do notice when someone has knee problems just by the way they walk. I was frequently teased about my 'funny' walking and I wonder if they have gone through the same thing. If I get into a conversation with them I will tell them how successful a knee replacement can be. Maybe never pain-free, but oh, so much better than it was before having the surgery.

 

[JusticeRider]

I know I am just cranky and frustrated. Walking is such a big piece of who I am. Before my surgery, a lot of things hurt my knee. But one thing that didn’t hurt (much) was walking slowly on flat, even ground. I could do that for miles, and so I did. I was walking 3 or 4 miles every day. It helped keep me sane. I miss trail running, hiking, backpacking, snowshoeing, and riding my horse. But most of all I just miss the feeling of walking naturally. I miss enjoying it and letting it take me away from my worries.

 

[Jockette]

You will get back to it. Try to remember, recovery is temporary.

 

[JusticeRider]

@Jockette, thank you

 

[Cheleigh]

[Just skipping along on two good knees without a care in the world? Like, they have no idea how good they have it??
I used to walk so fast… Now I’m hobbling along. When I see the fast walkers whizzing by me, I smile and tell them to be so thankful they can walk fast and bend those knees. It gives them perspective and something to be grateful for. Our stories are so similar. I hope you’re feeling good today. I hope im replying right… still figuring out this forum.

 

[Layla]

does anyone else get irrationally enraged with jealousy seeing ordinary people just out walking down the street? Just skipping along on two good knees without a care in the world? Like, they have no idea how good they have it??

But...maybe they don't have it as good as you're thinking. Possibly they have issues or conflicts in their lives that far outweigh deteriorating or healing knees. That's what I try to keep in mind as none of us move through life without physical or emotional pain. I think you'll get back to all the things you love s-l-o-w-l-y, but surely.
Smell the roses along the way. Happy Weekend to you!

 

[JusticeRider]

A lot of good positivity here! Thanks all.

The last few days have been better. I’ve been having massages done 2x/week by a really skilled therapist who specializes in orthopedic massage. Last Monday, I was really upset about the trouble I’ve been having with my walk and she asked me some questions, poked and prodded a bit and said she thought she had it narrowed down to a few key problem muscles. She’s very knowledgeable and I understood almost none of what she said (scientific medical names of different muscle groups, etc) but she worked on the back of my leg and found some extremely tight, angry muscles. She got some things to release and woo-whee did I feel a lot better when she was done! It’s the most relaxed that left leg has been since I don’t know when. My pain and swelling was reduced all evening, but the by next day my leg swelled up like a balloon! It wasn’t sore actually, just really really swollen.

That was alarming, so when I went back to see her on Wednesday I was like, whaaat…? She said that by getting some things to open up we probably released a bunch of backed up lymph fluid that needed to be moved along. So she did an hour of lymphatic drainage, after which I felt strange and groggy and just wanted to go to bed. I did as she said and took it easy and drank a whole bunch of water and used the bathroom a lot too! But lo and behold, I woke up Thursday to the least amount of swelling I’ve had in weeks! I am still limping but noticeably less! There is significantly less pain and stiffness.

As you can imagine, this brings an improvement to my mental state too. It’s astounding how closely my mood is tied to the state of my knee. I am trying to enjoy this without getting carried away and trying to do MORE. You all know how that goes, right? You feel better! So you do more! And then you feel worse and regret it. So I’m trying not to change anything for now and just see if this improvement lasts.

And I am continually appreciative of all of you, and the camaraderie and support here at BoneSmart. I honestly can’t imagine what I would have done had I not found this forum. The adventure continues…

 

[panammaniac]

@JusticeRider It’s amazing what a good massage therapist can do. I own a spa and have 15 MTs on my staff. Not all of them can do the high end orthopedic massage and lymphatic draining that you described. They are all good at different things, so for anyone considering massage therapy make sure you get a therapist who is a fit for your needs.

 

[JusticeRider]

@panammaniac, I agree. A good massage therapist is worth their weight in gold! I’m really lucky to have found this one. So cool that you own a spa…you probably have access to some wonderful healing modalities!

 

[panammaniac]

@panammaniac, I agree. A good massage therapist is worth their weight in gold! I’m really lucky to have found this one. So cool that you own a spa…you probably have access to some wonderful healing modalities!

Ownership definitely has its benefits. Massage therapists are kind of a bizarre group of people to manage. Anyone who’s ever run a spa will tell you that. Some of them get very uncomfortable when they are asked to massage the boss, like they think they’re being evaluated or something. But yes, for sure, there are a lot of amazing healing modalities out there, and a good MT who’s a good fit for the individual can make all the difference in the world. I’ll be getting weekly massages as soon as I’m physically able to.