@Mamie ....the question that is most important for you to ask when you register for Ask the Expert would be something like this:
Revision TKR July 16. Severe pain and swelling causing consistently high blood pressure. Resting highest was 189/119 HR 116. Low ROM. What should I do?
I can tell from your posts that you are trying and that you're fearful of what might lie ahead. But I believe you still are approaching your recovery with the idea that you need to work hard at recovery or something bad will happen. It won't. You are trying too hard and that's contributing to your pain and swelling.
When I've suggested that you need to do gentle bends and stretches several times a day, I mean that literally. No pushing beyond just the mildest of discomfort. And never for 10 minutes at at time.
I recommend that you pick the most comfortable position to do these bends - whether it is lying in bed and doing heel slides, sitting in a chair or on the toilet (that's when I did mine), or standing and leaning into your leg to encourage a bend - and do the GENTLE bends for no more than five minutes three times a day. Rest a majority of the day with ice and elevation. Get up from your resting every hour or two and walk slowly around the house for 5 minutes.
If you have an exercise bike, instead of the 5 minute walk you could do some turns on the bike for 5 minutes or less slowly at no resistance. If you cannot make a full rotation, just rock the pedals back and forth. Eventually you'll be able to go all the way around. An exercise bike used this way is one of the best ways to gently provide motion for your knee. This is it for exercise for now until you have swelling relief.
As you can see, any more causes you to swell again and have pain. You need to keep this low level of exercise up until the swelling has reduced and stays that way. It may be a week. It could be a month or more. It's whatever time your body needs to settle down and no one is going to make it happen any faster by "doing" something. In fact, the more you "do" the more you'll swell and the whole process will take longer.
Contact your GP immediately about your increased blood pressure levels. Only your doctor should be making adjustments in your medication if that's needed to try and keep your BP at reasonable levels. It is not healthy for you to have blood pressure levels and heart rates like you're describing. It could be caused by pain or anxiety or a combination of both, but it is harmful for you to have this going on for days at a time.
I was told that since sitting in a chair and pushing for a good bend degree was too painful to try it differently. So I stood facing the side of my bed and bent my knee as though pushing off for a race. It was not as painful as sitting in a chair but hurt badly after doing it for ten minutes. I had to ice and it was too soon for pain meds. BP spiked and I still have not not stopped hurting.
The type of scarring your surgeon and his PA are talking about breaking up with a Manipulation Under Anesthetic (MUA) does occur, but it is not common. However, studies have shown that a person is more likely to have problems with adhesions if they are exercising too hard and causing inflammation in the knee. The inflammation generates heat in the tissues. Hot tissues become dry and are more likely to stick together instead of sliding freely against each other as they do normally when moist. This is the reason we are focusing on getting your swelling down as soon as possible. Trying too hard with pushing your knee could actually cause you to get the adhesions that you are worried about. Please stop trying so hard.
I am so afraid of what they will say about my progress. I know they will blame it on my therapy at home or me not trying hard enough but they can’t do much with a swollen knee/foot and BP so high. Other than refusing, if he suggest putting me to sleep to force my knee into better range, any suggestions as to how I should respond?
I know it's easier said than done, but try to not worry about things that might happen. You cannot control what your doctor and his staff may say or do. You can only control your reaction to their recommendations. And whatever they say to you is just that - a recommendation. They cannot make you do anything. You are in control of your care and your health. If an MUA is suggested, politely look the person in the eye and say you're not ready for that at this point, you're seeing gradual improvement with the way you are approaching your recovery, and you want to continue working with it on your own for now.
I am curious about this brace. I don’t remember wearing one before. Are they something standard used after revisions? It seems cumbersome and more difficult to exercise with it though set for 90 degrees. I also believe it adds to my pain.
I'm curious about the reason for the brace as well. It is not something that is normally done after a knee replacement or revision, so I encourage to ask questions about it to find out why it has been prescribed, what improvements are expected with your wearing it, and how long it must be worn. You can either call and ask these questions or wait until an appointment.
I am constantly moving my knee in some exercise. I am determined but not winning.
As mentioned above, stop trying to "constantly" work your knee. This is setting you back, not helping. Just do the movements I recommended above and then let your knee rest with ice and elevation.
Our bed sits high off tge floor and I have not been able to lift it on my own getting into or out of bed. I still can’t alone but I am able to get it about one third of the distance coming straight up so my husband does not have to bend clear to tge floor to pick it up. I’m excited!
This is indeed wonderful progress! You need to celebrate. Even these small advances prove that your knee is going to be fine if you can just slow down the "trying" to make it heal. Your body is in charge here and you need to let it heal itself. No amount of working at it will make things happen any faster.
Please don't worry about the time involved. Our main goal is to see you have a successful recovery. We are dedicated to that for all our BoneSmarties and we're always here to listen to your concerns and support you.