Manipulation Questions

[Nursepair]

Cathy, Newwoman, I know you had a manipulation done earlier. I may be having one soon too, I see my surgeon on Tuesday. How many weeks PO were you? You had your's done the same day as me, I believe you also had a Zimmer Gender the same as me. Funny that. I think Skeet had a Gender too and hers is fine.

1) What was your ROM at the time?
2) What is it now? Did it work?
3) Did you have gas or epidural?
4) How long did it take to stop hurting after?
5) Was your knee still swollen at the time and did it swell much more after?
6) How many weeks PO were you?

Sorry for all the questions, I really don't fancy this, but need the extra ROM. Mine is 87-90 and has been for weeks. Thanks. Sue

 

[Newwoman]

How many weeks PO were you? You had your's done the same day as me, I believe you also had a Zimmer Gender the same as me. Funny that. I think Skeet had a Gender too and hers is fine.

1) What was your ROM at the time?
2) What is it now? Did it work?
3) Did you have gas or epidural?
4) How long did it take to stop hurting after?
5) Was your knee still swollen at the time and did it swell much more after?
6) How many weeks PO were you?

Here you go Sue,
I had my surgery on Jan. 9, 2008 and had my manipulation on Feb. 21, 2008 at the time of manipulation I was 52 degrees and now I am 92 degrees. It did work and I am still increasing my bend little by little but am not hitting that wall like I use to.
I had gas because they tried to do the IV but botched that up bad so I was awake when they put the mask over my mouth and told me to breath deeply and slowly. What idiots I was scared to death and it was everything in me not to jump okay slither off that table and run but I didn't and after the 4 breath I don't remember anything until I woke up in recovery.
It hurt like h?ll for about 12 hours and then started to subside.
My knee is always swollen so I don't know if that made much difference because I went directly from the procedure to my physical therapy.
I am now 12 weeks post op as of Wednesday.
Hang in there Sue, we didn't go through all this cr?p to only be able to bend to 90 so you probably have no choice in the matter. I am here for you all the way and you can ask me anything and I will do my best to answer or just listen if that's what you need. I have huge shoulders for crying on and am great at nurturing so don't hesitate to use me.
Cath

 

[Skeet]

Yes I have a Zimmer gender knee. My knees prior to surgery had like 130+ on both legs. My surgery was due to an athletic injury, so only one knee was impacted. I did a lot of exercise to prep for the surgery and was at 90+ before I even left the hospital. I'm at around 120+ today and it was flat at 0 or more from day one. I am currently at almost 16 weeks. Wish you all were having better results early on, but hang in there and it will come, probably with manipulation, but you do want a successful result.

 

[Nursepair]

Thanks so much for the info Cath, I really appreciate it. I am actually using your shoulder now:( Thank you.

It sounds as if you are doing really well now, that is a 40 degree increase. What was your ROM shortly after the manipulation? What degree does your PT expect of you.?

MIne thinks I will probably get about 115, my other knee isn't much more than that it seems. As long as I can get up the stairs and ride the bike properly I think I will be happy, and most importantly we have no more pre surgery pain.

I have started Aquafit as well now, so I am still pushing it, but it just wont budge. I am also going for a massage for Lymph Drainage tomorrow to see if I can get rid of any more of the swelling. Have you tried it from the charts Beachcomber sent out? It is lovely getting that done, soothing and relaxing. My hubby has been doing it for me.

Thanks again, ((((((((HUGS))))))))))) Sue

 

[Newwoman]

My physical therapist says 110 is plenty for most people and I looked on my paperwork and 8 days I increased by 10 degrees so it will come just hang in there.
We will get through this you and me. My surgeon said 110 also so don't sweat it I want what you want no pain eventually and to be able to climb stairs and cross my legs.
Cath

 

[Nursepair]

Skeet thanks for your post too. I think the state of the knee before the op must be a factor in this ROM thing. I had started Aquafit a couple of months before surgery, once I knew I was having it done. I also swam, but I don't think it was long enough to strengthen it in time. I also managed to slip and twist my knee in the pool just before Christmas so it was painful and swollen then too.

I am so pleased for you that it is working so well for you. Take care, and good night, my brain is swimming now, the pills cut in ages ago, I just hate to sign off. ((((HUGS)))) Sue

 

[JenniferG]

Sue, just wanted to say hello and good morning. I know you feel really overwhelmed and maybe even scared about this manipulation thing. Try not to. (easy for me to say, right?) I remember how scared I was toget this surgery to begin with. One of the biggest things I had ever done in my life. But now, it's done and I am glad. Some days I still can't believe it, but we did it. And you can do this if you have to. all you have to do is show up. after it is done you have no choice by to heal and get better, and you will heal and get better. And you know you can show up because you've done that for bigger and scarier. Aw heck, you let some guy cut your leg open, saw your bones and glue a thing in. You're a strong woman to show up for that. Just imagine what you can do when you get good/full ROM. OoooHHhh Watch out!

 

[Nursepair]

Thanks for your encouragement you guys, I am crying again, but this time because I feel so fortunate to have found such loving and caring people Have to "run" now, I am meeting another friend for coffee soon and I am still not showered. It is so great to be driving (short distances so far) again and not totally relying on everyone else. Talk later. Enjoy your morning all. Love and hugs, Sue xoxoxo

 

[Josephine]

Sue - do not fuss about having a GA. It's so brief a procedure that messing around with a spinal just isn't worth it. You are asleep, have the MUA and being wakened up again so quickly, it shouldn't take more than 10 mins from the point of injection to being awake.

 

[elcammeno]

I had my TKR surgery 4 wks ago. My bend lately has been 93-94. Am so afraid I may have to have manipulation. How & when do they decide that manipulation has to be done.I have heard some have had a phyisical therapist do it & others have had the surgeon do it. Which is best? Is there any one exercise that is best to do to get the rom higher? Also, I still have that tight band feeling around the front of my knee & a burning pain at times. Am wondering how long to expect that. I can get so discouraged with all this. Like my Mother used to say "This too shall pass."

 

[Nursepair]

I don't know yet Jo whether I would get the epidural or gas, I would rather have gas.

The first time I had my wrist manipulated, right after I broke and disclocated it, (I have photos of the wrist and the x-rays), they didn't really put me out. They gave me a sedative and a shot to forget the pain? I don't remember the pain, but apperently I did curse a bit. (That was in an emergency room in a hospital far up north, I had been on an island when I fell on rocks). The second and third time (in my normal hospital) they pulled it without anything, never let them do that again!! Final time the gave me gas, my hubby demanded it for me as he couldn't see me go through that again.

Ecclammeno, you sound as if you are doing well with your ROM at only 4 weeks. I am at 12 weeks and only 87-90. That's why they are considering doing mine. If you did need it done, the OS should do it, he has the means to put you out!!

 

[Jamie]

Elcammeno, I agree that you are doing just fine for 4 weeks. If you have a bike at home, try that "rocking" thing described in another thread. I did it two times each day and my ROM improved every day. Do push yourself with it...not to the point of extreme pain, but just the beginning of the hurt. Eventually you will just magically go all the way around and be on your way to more movement. Best of luck, hugs, and keep us posted on your progress.

 

[Josephine]

I had my TKR surgery 4 wks ago. My bend lately has been 93-94. Am so afraid I may have to have manipulation. How & when do they decide that manipulation has to be done.I have heard some have had a phyisical therapist do it & others have had the surgeon do it. Which is best? Is there any one exercise that is best to do to get the rom higher? Also, I still have that tight band feeling around the front of my knee & a burning pain at times. Am wondering how long to expect that. I can get so discouraged with all this. Like my Mother used to say "This too shall pass."

I'll say it yet again, friend - 4 weeks is FAR, FAR too early to be worrying about that. So long as you are putting all you have into the physio, you should be fine.

As to how and when they decide about a manipulation, that is a very variable thing. It depends upon a whole load of things and varies from surgeon to surgeon and patient to patient. Basically, the surgeon will be looking at the rate of progress, what it was like pre-op, where it is at now, how he judges the patient's ability to commit themselves to the physio, be it poor or good, and what he would judge the outcome to be. In other words, it's one of those 'how long is a piece of string' questions, I'm afraid!

As for whether the surgeon or the physio does it, personally I'd prefer the surgeon but I know the physiotherapists are a different breed from the ones I worked with so I would have to say I wouldn't really think that there is a 'best'. The whole procedure is just mechanical process anyway so I suppose one could be tempted to opine that a surgeon would be somewhat over-qualified to do it!

As for which exercise, I'll have to leave that to our compatriots here. Personal experience is always best.

 

[Doug]

For flexing the knee. The best has to be the bike. low intensity, and just keep lowering the seat every few minutes..
For extension..get in a very hot bath and soak it. Then just straighten that sucker out and bend. Then ice.
A mindless technique is using an ottoman or chair while watching t.v. Place your heel on it and slowly relax the leg..Keep your toe up though.

 

[elcammeno]

Thank you all for your encouragement & replys to my questions about riding the bike & manipulation. I got on the bike rather hesitatingly this morning & had the surprise of my life!! On the first try I was able to go full circle with my knee!!! I tried it again this afternoon & was able to do it 30 times which was when I felt I had had enough. I will increase it as I can. I was also able to sleep in my bed last night for 6 hrs comfortably for the first time since my TKR on March 5. I got up & took a pain pill & felt like I needed to elevate my leg in the recliner & slept well there for a couple hrs. I am rejoicing today & so very thankful.

 

[beachcomber]

Great news! You did it!

Be sure to get back on again soon and keep it flexible. Don't let it decide to stick again..... you are over the big hump now.

You can start working on more flex by lowering the seat and other "fun" exercises. Keep up the good work!

 

[Jamie]

Great job, elcammeno!!! Doesn't it feel fabulous to accomplish these small (but really VERY large) tasks!!! You're on a roll now!!!

 

[Nursepair]

That's fantastic elcammeno, that is one huge step in your getting back to normal progress. Keep it up.