TKR Update on Slower Recovery

[Mar]

If I just had one degree of improvement but just nothing. After my PT massage I always feel I can walk better and expect to get better news but no such luck. Taking a much needed vacation in August and I’m worried I’ll be stuck in the hotel because I’m still limping. I guess I can rent one of those scooters but the ones in the stores frighten me. Hopefully a rented one would be a bit more easy to drive, lol. Maybe I should ask for Meloxicam I’ll have to look it up. They haven’t given me anything. I think he was mad at me and just wants to wash his hands of me. Just said I’ll see you in a year Sorry just venting, I figure most of you can understand where as family doesn’t really get it.

 

[Jockette]

At 7 weeks post op in a recovery that takes an average of 52 weeks, you still have a lot of healing to do, as you are still early in recovery. You still have quite a bit of swelling, which inhibits your ROM. The ROM will come as you heal. You said yourself that your other knee did the same thing:

I told him these knees are like twins. Lots of swelling. That at six months my RTKR went to 120.

Try to relax, move around as you’re able, continue to rest and ice.

Go on that vacation in August, just don’t over do while there, take time to rest and try to enjoy yourself. What kind of vacation are you planning?

 

[Mar]

My daughter is turning 21 so we’re going to Las Vegas. My son and sister live 3 hours away. We will stay 3 days in Vegas then leave to stay with my family. Of course my daughter wants to go to the zoo. For sure I would need something for that. Just worried it will be too much.

 

[NightQuilter]

Sounds like a great trip and celebration. As to your bend, it will come - the key is reducing the swelling. What I found useful was finding a trained masseuse who can administer lymphatic and Shiatsu massage. I had a skilled friend who brought her table to me at about 2 weeks post-op - each knee. All I wanted was a high table to stretch on, but she was so good. By my 3 week follow-up, my OS was amazed a how little swelling there was and now recommends it. She focused on gradually working the fluids that collect below the knee up and through the construction site at the knee so they can naturally drain. You are still early in your recovery so just trust that the ROM will increase...on your knee's terms.

 

[Jockette]

When you go on your trip, pace yourself and maybe be ready to not do absolutely everything the others do. If it comes to that, try not to think of it as missing out, but rather giving your knee the rest it needs so it can continue to heal.

I have a suggestion. Buy a portable raised toilet seat and take it with you. I went away for the weekend when I was 4 months post op, and the house we stayed at only had the regular low toilets. I was not healed enough to handle them and it did a lot of damage to the healing soft tissue. I had a lot of pain and swelling, which definitely did not enhance my visit with our friends. That, and trying to keep up with the others. It took a month for me to begin to improve again. I bought my portable raised seat shortly after and had it with me when we traveled for the next year or so. I was especially glad I had it with me at a hotel, where we were supposed to have a handicap bathroom, but the toilet was low, but they had installed a grab bar next to it. That did little to help me, and to me did not define handicap accessible! (and of course we pain extra for the room )

 

[Mar]

Celebrex? Have any of you who had problems with continual swelling taken it and found it effective in reducing inflammation with hopefully a reduction in swelling? Was thinking of calling tomorrow to see if they might prescribe it for me. How long do you need to take to see results? How long do you typically take it for as I know it can be hard on the gut? When you stop say after a month did the swelling return? Just woke up this morning and my whole leg was swollen despite icing and elevating all night

 

[kneeper]

What I’m really confused about is if I slide my foot down a wall I can get pretty close to 90. But if I slide my foot back on a flat surface which is the only way PT measures I’m lucky to get to 70. That is puzzling to me.

This seems to indicate that you have some bend "in there" that is being impeded by swelling.

 

[Celle]

What I’m really confused about is if I slide my foot down a wall I can get pretty close to 90. But if I slide my foot back on a flat surface which is the only way PT measures I’m lucky to get to 70. That is puzzling to me.

Whether your flexion is 70 or 90 degrees is not really important, so try not to worry about it. You know yourself that your knee will bend further than your therapist is measuring it.

What matters most is not the numbers, but what you can do with your knee.

I never found that trying to bend my knee while I was lying down was particularly helpful, or necessary. I chose to assess my bend while sitting on a chair. Doing it that way, you can put a sheet of paper under your foot, so that it slides more easily.

If you find that you can bend your knee further when sitting on a chair, you'll be able to show your surgeon you can bend further than the numbers the PT reports.

Have a look at this article, choose just one way of flexing your knee, and stick with that.
Heel slides and how to do them properly

 

[Mar]

Sudden knee cap pain started about 2 hours ago and hasn’t let up. Kind of like a pulsating nerve pain.. I’ve had these pains on and off but it’s always just a few and then goes away and really not very often. I’m 8 weeks out seems strange for this to happen now getting really annoying and hurting more because I’m tired of it going on so long. Plus I don’t really have many pain pills left so I sparingly take them. I take 3000mg Tylenol daily spread out and one tramadol at night. Haven’t been doing much today or yesterday so not because I’ve over done anything. Any ideas?

 

[Sisterpat]

Nerves just kick in whenever they feel like it! 8 weeks out of 52 isn’t very much. I’m 11 weeks on my last knee and still get various pains and even some in my 5 month knee, too. Don’t worry. Elevate and ice.

 

[Mar]

I’m at 8 weeks and boy do I wish I would turn a corner. My flexion still hasn’t changed since the day I got out of the hospital. My extension is good though. But I’m really starting to worry that this is the best my knee is going to bend. I don’t walk with anything anymore but sometimes I think I should as I do limp. My PT says I’m walking fine. Just started Celebrex as my knee really is still quite swollen doesn’t seem to have gotten any better. I take tramadol at night and Tylenol every 8 hours. Today I started having a constant nerve pain so things just aren’t where I was hoping to be at this point. I fear an MUA is in my future. So don’t feel alone. I wish I had a crystal ball to see where I would be at 6 months from now. It would help me make some decisions that I might need to make soon if things don’t start improving, lol.

 

[FourCats]

@Mar we’re just about the same length of time recuperating and I still have weird aches and pains. Just when I think I might be turning the corner, some message from my knee reminds me this is a long period of recovery. I take Celebrex but don’t think it is really making a difference. I have been able to stop taking acetaminophen as I discovered it was causing constipation (who knew!). I’m just glad to come here and know that others are struggling too. It reminds me that I’m not alone!

 

[Sisterpat]

@Mar, if you are still limping you probably would benefit from using the cane. Also consider Jamie’s offer to Lindalu about joining the One Step program. This is a long recovery and takes time and patience. When your swelling goes down the knee will bend. Are you icing and elevating?

 

[Mar]

Sisterpat, I ice and elevate all the time, starting to think maybe too much, lol. Maybe my knee is so cold it can’t heal. So I stopped my ice machine at night. Just ice before sleep and when I wake up. Then I do stuff for awhile and ice after each time up. I probably ice 6 x day for at least 40-60 min at a time. Just totally frustrated. If I saw just some slight changes I would feel more comfortable with continuing this path but my knee appears to be completely frozen.

 

[Mar]

Sisterpat, What is this One Step Program your talking about and how do you join it? Is that this site or another? I am seeing my OS on the 8th to talk about doing an MUA because today at PT I’m only about 65-70 at best if doing heel slides from laying on a hard surface. PT can get me to 85 after massaging it with my leg over one of those elevation pillows. Needed it with my last knee replacement so maybe it’s just my body and how it recovers from this type of surgery.

 

[Sisterpat]

Jamie will get in touch with you about One Step. It is a program, free for BoneSmart at this time, that helps to analyze and help with gait. Since you are limping, it might be of help to you.

 

[Mar]

I accidentally put this in the wrong thread. I still get confused. I think if I’m on my content it’s my thread then I realize I’m on someone else’s. So I apologize for not figuring this out very well.

Coming to the conclusion I maybe one of the small percentage of people who need an MUA. Despite following Bone Smart I have only deteriorated in flexion. At almost 9 weeks there has been no improvement just a decrease from my 87 at my first PT session.

Plus I finally got the answer to why they measure your flexion while laying on your back verses sitting up. When sitting up your hip can rise allowing you to get back further but you’re not really. Apparently you have to take your hip out of the equation to get a true measurement. So sad to say even though I thought I was getting to 90 I am not. More like 65 -70 at almost 9 weeks.

So I think I am going to go head and and do the MUA. I only go to PT and have massage treatment to try and decrease swelling. I never really did the exercises they wanted me to do. Just heal slides and back and forth on my bike. I ice and elevate all the time, but nothing has changed. If I had just an inkling of improvement I would continue on.

I just recently stopped the on and off all night icing as it was interfering with my sleep. Only take one tramadol at night and 1000mg Tylenol 3 times a day. Pain is 0 - 2. Occasionally I get some worse pains and then take an Oxycodone, but they usually go away with meds.

Still limping if I’m up more then 15 min. I think I gave it my best but it still doesn’t want to bend. I’m tired and frustrated. I have seen a lot of slow progressions on this site with others but no one so far that has mentioned no progression at all but just going backwards after 8 weeks. So maybe I’m in that 2% that get adhesions. I did have to have exploratory surgery once for pelvic pain and they found I had adhesions all wrapped around one of my ovaries. Which was weird since I had never had any previous abdominal surgeries or injuries.

I also ended up with the MUA with my first TKR. So I feel like I’ve hit a block wall. I feel like such a failure. But then realize everyone is different and I guess my body forms adhesions easily. My other knee eventually got better and so will this one. I don’t see the OS until the 8th so who knows maybe it will miraculously improve. I could wait longer but I’m not sure if that’s what’s best, possibly just prolonging the inevitable.

 

[Cabu]

I’m sorry things aren’t going great for you at the moment,I also had my surgery on the same day as you.I’m sorry I don’t have any advise re MUA only that I hope whichever you decide goes well for you.
Please don’t feel like a failure lots of these things are out of our control

I feel your frustration with just being tired of it all,I don’t have much problem with my bend in my everyday getting around and doing things but I have no clue what the numbers are I might be only 80 or 90 . (I only had it measured before surgery and that was a particularly painful day and I measured 109 )but the swelling is ever present.I know I’m improving because I can do so much more but I do think mentally this part of the game is tough because we’re so ready to move on from the constant icing and elevation which I find hard to fit into busy life and then have the added frustration of feeling because I’m not doing those things I’m slowing my progress even more .I also find people expect me to be “all better” at this stage so I don’t even have the luxury of moaning to them anymore

Thank God for the venting machine that is bonesmart

 

[Sisterpat]

Excellent advice, Cabu! Yes, isn’t it amazing that those around us who have never been through this, including doctors and therapists, think we should be “back to normal” in a few weeks? Recently we had a member who had a doctor tell him he would be back golfing in 3 weeks! I still can’t get over that one . Mar, no one is a failure in this long game. The knee will have its own schedule for healing and there is nothing you can do to rush it. Try to relax.

 

[MARYCOOL]

Everyone is different when it comes to the healing process. We had dinner with friends over the weekend (first time since the pandemic ).
One of the men had TKR, he said he used the walker for 1(yes, ONE) day and was back to work a week later!!! I was secretly jealous, but good for him! He is a former physical therapist turned xray tech, and he said the best thing is riding the exercise bike!