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TKR Lesions caused by metal sensitivity

Not aware of what MUA is? Sorry to hear you are having rough time.
 
I guess I am leery because the doctor who originally diagnosed my torn meniscus but who I did not use for the repair surgery later said some very insulting things about me to my son when he brought his girlfriend in for a sprained ankle. Then there was the surgeon who told me to "Get out of his office," after he read my list of allergies. He told me no one would operate on me and that I would be lucky if I could get a teaching hospital to experiment on me. To tell the truth I think most of them have a screw loose after some of the things I have experienced. One of them had to go to anger management classes for kicking a nurse in the head in the operating room. They tend to think they are Gods and their egos simply can't accept rejection and I don't want to ever be the brunt of their fragile ego stuff again. You are right traveling to another city might be a good idea but the problem there is I am alone and don't know how I would get home if I go for a surgery in another city. The truth is I am worn out with this whole knee business. I think I would rather settle for 95 rom permanently than to have to deal with any more doctors. There must be some normal good ones out there. I just haven't experienced any and don't feel like I can take on any more stress. Maybe that is what is wrong. The additional stress in my life has me done in and even simple things seem overwhelming. I should have waited to have the surgery until my life settled down.
 
Maggie, a MUA is a manipulation of the knee to force it to bend. This is done under anesthesia because it would be too painful for the patient to do it while he is awake.
 
Ahhhh......now I understand a bit more about your situation. Thanks for the additional information.

I agree completely with you that the doctors you've described are not for you!!! What dogs both of them have been!!! You can find someone better!

I suggest you give another doctor in a different area a try. At least talk with one or two. If you find one you like, you can work out the issues about travel if you need additional surgery. There is no reason to rush into an MUA either. We have had members who successfully had them done after a year or more. You might want to just try resting, icing and elevating some more to see if that helps you improve. But....I would still talk with another surgeon. Let me see if I have any suggestions for someone in your general area.
 
Here is one choice fairly near you:

broken link removed: https://www.orthopaedicsurgery.uci.edu/faculty/schwarzkopf.html
 
ucsbgal1971 said:
my physical therapist wasn't too enthusiastic about the idea of me having a manipulation
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Allied medical providers should not provide advice that makes a patient conflicted about their care. It's one thing if your PT had observed some steady progress and encouraged you to stay the course, but for a PT to state in any form they don't like MUA is simply unethical, and you see the consequence, which is your losing faith in your ortho. Your working relationship with your ortho is very very important

BTW orthos go by experience and the best information available, and the mainstream thinking about scar tissue is that it matures and hardens over time. Not to defend his position but to say that's standard thinking and try not to hold it against him. As I told another person on this forum, difficult recoveries cause us to doubt our orthos. I know from experience. I got 3 second opinions in all. And when all was said and done, my appreciation for my ortho was greater than ever.

I am sorry to hear about your Sjogren's. Yes, that's a disease to reckon with that isn't helping any. These are challenging days, and relief is not in your immediate future. I had weeks when I didn't know if my leg would ever be OK or if life would return to normal or I would ever be OK again. I felt discouraged every moment except when I comforted myself with a root beer float! However, try to set your sights on a day 2-3 months from now when Spring arrives, your infection is behind you, and your leg is bending normally.
 
I'm sorry, I just saw your exercise question. I learned a lot when I lost the gains of my MUA and needed further intervention. Perhaps that would've happened anyhow. But what a miserable chapter and not one I would wish on anyone. If I had to do it over again, I would ditch the PT I had and I would've limited my physical therapy efforts. I was still under the false impression that I could PT my way out of the situation, or that I wasn't doing it right, or not doing enough. All of those were wrong. You have to work smart, not hard.

Number one: there are only two routines that are important to early progress. I think when you have slow ROM you have to dump all but the essential routines because any exercise at all rekindles inflammation, and inflammation is the source of adhesions and scar tissue, which are the great inhibitors of ROM.

Routine #1: straight leg lifts. 20 a day
Routine #2: ROM, both straightening and bending. Use your favorite method, 20 a day. These should be very slow, very gentle, to the point of discomfort but not pain and held 60 seconds. I've heard of doing 2 an hour all day, which if I'd known about it I would've preferred to what I did, which was two sets of 10 a day. Ice and elevate afterward.
Routine #3: you must get the swelling & inflammation down which means you have to minimize activity, plus ice & elevate.
 
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ucsbgal1971:
When you have a flashlight and the battery wears out, you slide out the old battery, and slide in a new one. Our bodies are NOT like that. We need to give our bodies time to heal, especially after a traumatic surgery such as this one.

I have had multiple surgeries in my lifetime. This TKR of mine has been one of the most traumatic.

Anytime a bone is broken during a surgery, the surgery will be viewed as more traumatic by the body; a surgery in which a bone is broken will be more painful vs. a soft-tissue surgery.

No two recoveries are the same. It is not a good idea to compare them. Even one person with two different surgeries on two different body parts will not have the same outcomes on each leg.

Please see these two Articles by the BoneSmarties in the Library (Library is located at the top of the webpage, in the grey bar.):
ROM: it's worth the wait for ROM
ROM: it's never too late to get more ROM!

It will take approximately a year plus to heal from a TKR - and that is without any complications.

THE hardest thing regarding a TKR is just having to have patience and let your body heal.

Please take care.
 
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ucsbgal1971 said:
Tykey, if they don't do PT in the UK, what do they do? Do the doctors just give you a list of exercises and you are on your own?
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That's almost right, they do a brief bit of training in the ward before we leave, but I did get a home visit once from a physiotherapist just to encourage me and ask if I was doing the exercises, and have a cup of tea. As it turned out, I was doing ok, so he never came back. We can ask for physiotherapy if we really feel the need, but we have to get referred by the GP. It can take a long time for the referral though, and I've never met anyone who bothered.

I think this reflects the current thinking about health in the UK, and if I may parody a US President (Kennedy I think) :
" Ask not what the NHS can do for your health, but ask what YOU can do for your own health". The NHS only wants to do the major things we can't do for ourselves, like operations and curing our diseases.
 
Hi ucsbgal1971,
I can tell you from experience that an MUA after 6 months is fine. I was stuck at 85 degrees but wanted to see if exercise and time would improve it. Nothing happened and I had an MUA at 9 months. I can now bend to 120 degrees. However, bending is still stiff, but not as stiff as it was.

Regarding physiotherapy; the answer is that I got none at all from the hospital, but felt I needed it and
paid for it privately.

By the way, the MUA was a doddle. I got myself well screwed up worrying about whether to have it done or not, but it really was nothing compared to the TKR. I didn't need crutches after, but I did follow the bonesmart mantra of ice, elevate and gentle bending to keep my "new" bend.

You go for it when you are ready and let us know how you get on.

Keep your chin up.
 
Mary, thanks for understanding. The root beer float is the best idea of all. I needed a good laugh. Thanks! I will try that out too. You are right about my PT. When he was hesitant about the MUA I got scared. Actually I really like my doctor and he is an excellent surgeon. His staff is the pits though. The problem is you have to deal with his PA after the surgery and she can be less than responsive.
 
Mary, thanks, I will tryout those routines. Is five months post op still early on? Does it ever get to the point that there is no pain and it is easy to get around? I think I have been experiencing grief over the fact that I think I will never be able to walk again. I was optimistic in the beginning but have lost my optimism after five months of being ill.
 
Nukne4me. I guess you are right. No two people are going to heal the same way. Our bodies are just different. I never even considered that my Sjogrens would pose a problem. I think the stress on my body from the surgery might have caused the flare up of the Sjogrens which caused the stone which caused an infection which resulted in fear that the infection would spread to my knee. My other health issues are probably slowing things down and I just need to recognize that fact and be patient.
 
Sparkle, I am from the USA and have never heard of the term doddle. Does that mean it was easy? Were you able to walk afterward? I live alone and am trying to prepare for what I might need post manipulation. Will I need pain meds afterward? If so, how long does one need to take pain meds? Thanks.
 
ucsbgal1971 said:
His staff is the pits though
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The same was true with my ortho. He had a nurse with, I think, a negative IQ. Oy! Since then he has hired a good RN, and hired a PA with no orthopedic experience so he could "shape" the way the PA practices. I have not been in there since these changes but hear lots of good things. Too bad the hospital there sucks.

Oh I digress. I see you're having a bad day, by the number of posts with questions. Questions are good but I sense a low level panic (and why not?!). I remember scurrying for "answers." I was so so so discouraged.

Honey, it's all going to be OK. And it's OK to feel uncertain and scared right now. Not all of us are good at rolling with the punches. So glad you're on here and getting the support you need and deserve.
 
Yes, Mary, I am very concerned about the infection spreading to my knee. A low level panic is a good way to describe it.
 
I just found out that cpm machines are not paid for by Medicare anymore for knee manipulations.
It will cost $404 to rent one for 14 days. Does anyone know if they are really necessary after a manipulation?
 
Hello again. My OS supplied me with a CPM for 21 days.im 11 days out. My knee is swollen because ive been doing other activities causing much more internal swelling .my plans is to let swelling go down over 24-36 hours . Than use CPM 4 hours a day. Ive been using like 2 hours a day , along with OTHER activities which cause internal swelling. Now CPM is at times a disputed device here on bonesmart. However its been my doctors order. Im a minority that actually enjoys it. Best of luck.
 
I could not beg, borrow or steal a CPM . . . and found one to buy on craigslist. (I since sold it to another BS member out in California!).

My thinking was that anything that would bend my leg passively would encourage range of motion without getting the knee inflamed. I spent 2 hours at a time on it 2-3 times a day until I was bending OK.
 
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