TKR liam2015: 1 Year Anniversary, Life Goes On!

[sistersinhim]

Yes, it is normal to have heat. Heat is a sign that it's healing. You are doing so good now. Don't let pt mess that up! As much as you are already doing, you don't even need pt. Doing laundry, up and down stairs, walking outside, all that is pt. Why go when you're already doing it! Just make sure they do not cause you any pain at all. A little discomfort is OK, but nothing more than that!

I had to use a food tray to keep my laptop off of my knee. Any weight at all on it was painful. It was ages before I could sleep on my tummy after my surgery, so any weight on it being painful is normal. I recommend you look for a lap tray. They come in very handy.

 

[liam2015]

thank you sistersinhim, good to know the heat means it's healing and great idea about a food tray. maybe i can get it at the dollar store. i really haven't been doing anything very physical up until today going up and down the stairs twice for the laundry, but you're right, now i've started, i'll probably be expected to keep it up, especially since hubby has started the "tough love" phase lol.

i have been pressured since day 1 about how important it is to go to physio and the nausea has been my excuse for not pursuing it. the one thing i'm looking forward to at the physio is the use of the modalities they have, such as the ice machine, which a lot of you have been using (i have to switch ice packs regularly and some of them are so small, i have to continuously move them around) and also the tens machine, which i was reading about through a link someone posted on this site, maybe even massage. my first goal is to get the swelling down which is probably more a matter of time than any modality can fix. i am terrified if i get pushed too far and have more pain, since i will not go back to the narcotic pain reliever (Oxycocet). we'll see how the assessment goes and a session.

i have to get this first session in before i have my next appointment with the surgeon on june 6. he has no idea that the in home physio that he ordered for me (free) never phoned and i never pursued. i like him, i'm sure he did a fine job, but he's young and he is like others, wanting his patients to have a certain r.o.m. within a time period. i'm going to try to be strong and speak up if the therapist disrespects my concerns. if it weren't for BoneSmart, i would have just gone along with everything i was being told.

p.s. sistersinhim ~ i hope you're doing better.

 

[sistersinhim]

Thank you, @liam2015. Today has been a rough day with all the traveling and hopping. But, I feel wonderfully blessed that I don't have to have surgery on my ankle!

My OS gave me a prescription for therapy which I never used and never told him I didn't go. He just looked at my ROM and extension and was satisfied. You don't have to tell him you're not going, if you decide not to. As long as you're progressing is what's important to him. But, again, be strong and don't let anyone hurt that infant knee of yours. It is not worth it and will set back your recovery with swelling and pain! We care what happens to you!

 

[mechellec]

I think you are doing great! I don't like confrontation either but this site helps you feel good about standing up for what your are comfortable with. Remember it is your knee and you call the shots.

Yes mine is still warm all the time too! Keep up the good healing!

 

[liam2015]

thanks for your support mechellec. good to know the heat around my knee is normal. i will update after my first physio appointment on thursday. keep up your good healing too.

 

[Celle]

When you go to PT on Thursday, make sure you tell them from the outset that you will not allow any pushing on your knee, or anything that hurts or seems excessive. It's your knee and you have the right to say how it will be treated.
If they can work with that, well and good. If not, find another PT facility.

 

[liam2015]

My first physio appointment at 6 weeks, 1 day: It went well. The young woman physiotherapist was very knowledgeable about knee replacements. Before i would sign the consent form i asked her if she would let me know before she touched or moved my knee, and she said "yes" and that she would stop whenever i said "enough". She measured around both knees in 3 different places and also measured my r.o.m., which was about what i expected: 70 degree flexion and -20 extension (that surprised me because i thought i straightened my leg moreso than that). She talked about scar tissue and the importance of r.o.m. exercises ~ i just nodded my head and said "uh huh"!

Next, she massaged my thigh above the incision and my calf below the incision for quite awhile, maybe 15 or 20 minutes. It felt okay, but could have been gentler; however, i wasn't sure how it should feel. During the massage she explained about what modalities they have and what she would recommend for me in the future. After the massage i had a few minutes of laser therapy and then 20 minutes of the "tens" machine with an ice pack below my knee and on my knee. The ice packs felt great as they were quite big and completely covered and surrounded my knee, unlike the little ice packs i have at home. After the "tens" machine, she lifted up my leg, cradled it in her arms and gently flexed to see if the flexion had improved, although she didn't measure it. I think it did improve a little and i told her when to stop as i felt slight pain.

To end the session, she had me demonstrate some of the exercises she wants me to do; 3 of them the same as in the hospital, in bed and 2 more standing exercises. She told me i could try my bicycle which is set up on stands and in future i could try the stationary bike in the gym at the clinic. I made another appointment for one week from today, next Thursday. At the reception desk, i noticed they had displayed some ice bags/heat bags, large like the one used earlier, with a soft cover. I think i might buy one next time if not too expensive. My surgeon appointment is for next Tuesday, June 6. I have a feeling he won't be happy with me, except for the fact that i will walk in nicely with no devices...lol! I will tell him i didn't pursue physio before because i was too ill with nausea and other side effects from the Oxycocet.

My question for today: Since i stopped the Oxycocet 3 weeks ago and ran out of Celebrex and i have been moving around more, feeling better, eating better, doing more light chores around the house, i've been having more achiness in and around my knee. I've been taking two 325 mg. Tylenol 4 times a day (last night i took 2 more at 3 a.m. when i woke up) [i can't take the extra-strength as they are too big for me to swallow, even if cut in half], but i still have the achiness whenever i sit and elevate and when i go to bed. The ice pack helps more than anything. I was wondering, for those that take Tramadol, does it completely alleviate the pain? I'm not sure i want to start another medication that would play havoc on my tummy.

Thanks for listening. It was nice to get outside today as i've been mostly housebound for the last 6 weeks.

 

[Celle]

I never found that the Tramadol took away the pain completely, but it did tone it right down.
Since you're still feeling a bit achey around your knees, it would be a good idea to cut back the household chores a bit. The house will keep, but your knees need the gentle treatment now.

 

[sistersinhim]

Tramadol is a great step-down medication for many of us. It dulls the pain without that spacey feeling. Some people don't like it, but a did. It wouldn't hurt to try a small prescription of it. If it works they OS can always prescribe some more.

 

[flyaway79]

I use Tramadol during the day and find it does take the edge off the achiness.

 

[liam2015]

thank you for the replies. if this achiness doesn't subside by next tuesday when i see the surgeon, i will ask him for a prescription, but maybe just get a few pills filled to try and make sure no harsh side effects.

 

[sistersinhim]

I have no side effects at all with Tramadol! I hope it's the same for you.

 

[Celle]

One word of warning: If you take Tramadol, be surer to wean off it slowly. Some people who stopped taking it too quickly have reported withdrawal symptoms.

 

[liam2015]

thank you @Celle and @sistersinhim and @flyaway79 . i will keep those points in mind. have a great weekend wherever you are.

 

[Pheebs52]

@liam2015, I just read your entire journal to date and all I can say is you've had a really rough ride with all the gastric issues; good grief! Other than that, it sounds as though you are doing very well with walking and other activities and that's so gratifying to hear! I'm curious as to how things went with the physio? I know you stated that your ROM isn't very good, but....look at all you can do! According to the chart here, you wouldn't even be able to do the stairs if your ROM was too low, so it must be better than you think. Here's to a prolonged period of uncomplicated recovery for you!

 

[liam2015]

@Pheebs52, thank you for the encouragement. i detailed my physio appt. around 7 posts above. to summarize, i had 3 treatments: massage of thigh and shin; laser treatment and tens machine, then she went over some exercises with me to make sure i was doing them right. after the treatments she very gently cradled my leg and slowly bent my knee until i said "enough" and i think it might have bent slightly more than when she first measured me at 70 degrees flexion and 20 degrees extension. the physiotherapist is a young woman, very knowledgeable about knee replacements, but she has the same "old fashioned" philosophy (i think) about needing to exercise to break up the scar tissue and gain r.o.m. i just said "uh huh". she also said i could add 1 lb. weights to my exercises ~ again i said "uh huh" lol. of course i won't. she agreed to not push me through pain and to let me know when she was going to touch me. i'm glad i waited 6 weeks before starting physio, which gave me time to learn through BoneSmart what i should and shouldn't do. i do like the treatments and look forward to trying the stationary bicycle. i have my own bicycle set up on stands here but haven't tried it yet.

now my next hurdle will be seeing the surgeon as i know he won't be happy with my progress (same old-fashioned set goals); however, this weekend, i'm going to practise walking mindfully, in the hopes that he will think i'm doing quite well and steady without using any device when i walk in. btw, i'm just doing the one-step stair routine, down with the bad and up with the good, although today i walked foot over foot up a hill and down and that went well. i saw a really nice, big softly covered ice/heat pack at the physio i might buy, which totally covers the knee and sides, unlike my little ones that i have to move around...sigh!

i'm still struggling with that achey pain in and around my knee, as most of us are, but i am so relieved to not have the gastric issues. hope you and the others are having a good weekend.

 

[kneeper]

Getting one (or two) of those large gel packs is a great idea. I had a couple of large ones that covered a lot of the knee and I'd have one on while the other was in the freezer chilling.

 

[Pheebs52]

@liam2015, I don't know how I missed your prior post about PT; duh! Must be the Oxycodone effect along with insomnia. Thanks for giving me the recap! It sounds as though you have a pretty good PT person, so let's hope that continues to go well for you.

 

[liam2015]

today was the dreaded surgeon appointment and it went as i anticipated! my sister took me and we had to take along my 6 y.o. granddaughter who was sent home sick from school today and yesterday, right after my hubby dropped her off. (she sure didn't seem sick, singing all the songs from "sound of music" in the car lol!) and tonight she's sleeping over and staying home with me for the day because there would be no one to pick her up if she was sent home sick again, since hubby has meetings downtown and her dad in boston on business and mom works downtown.

first thing he asked about was physio and when i said i just started on thursday, he was alarmed and rhymed off all the rhetoric that others have described: time line approaching for the minimum 90 degree r.o.m. and if not reached then he would have to have me in for another surgery (m.u.a.), although he didn't name it, thanks to Bonesmart i knew what he was talking about; said that if i didn't get the r.o.m. i would be stuck at where it is; that even twice a week physio wouldn't be enough, i would have to have someone push me every day to bend my knee further and he said he wanted to see me in a week and talk to my husband. i told him that i had been very sick for the first 3 weeks, and another 2 weeks before the nausea subsided, but he wasn't impressed. he asked me what i was doing if i wasn't doing physio or exercises and i said i was walking around the house, doing chores, etc. and he said i could have been doing the exercises with the nausea if i could walk around.

he did lift my knee and pushed on it back and forth. it did hurt but it was fine afterwards. he said because of the pain i would not be able to get the r.o.m. myself; in other words, i think he meant that someone would have to do the pushing, a little more each time...ugh! he suggested that i take 1/2 an oxycocet pill as well as an aleve (or something similar) to deal with the pain, since the tylenol wasn't helping. i did that tonight at 7 p.m. and within 40 minutes, i noticed the pain was gone, so i did the 2nd set of physio exercises, and yes, they still hurt to do. i tried my street bicycle which is on stands and i could only rock the pedals back and forth. as i was leaving, at the reception desk, he said i need 90 degrees to climb stairs unless i wanted to be a peg leg...lol. my sister was there and we laughed at that and now hubby is telling granddaughter to call me "pirate nanny"...hehe.

i go back to physio on thursday and will make an appointment for monday to see if my r.o.m. can be improved. if it's not, i think i might cancel the surgeon appointment for next week as i don't need to hear anymore; hubby can't make it anyways and i think the surgeon will want to tell him he has to be tough and push me. i realize my surgeon has the same protocol as many others, including physio, but i do appreciate that he did a good job on the surgery and that, even if i disagree with him, he cares enough to want what he believes is the best for me. it was quite a day explaining this to hubby; of course, we knew it would go down this way. i kept trying to reassure the surgeon that i would be fine but he wouldn't hear of it...sigh! luckily, i'm not worried ~ i believe i will get the r.o.m. in due time.

 

[Celle]

Well, your surgeon told you the same things that he was taught. We know from experience that they aren't true, though.

Please just carry on being gentle with your knee and let it improve on its own schedule. Don't let anyone push on your knee or encourage you to "push through the pain." That's old-fashioned thinking dan it doesn't work.
ROM can continue to increase for a year or more after a TKR and there's no "window of opportunity".