TKR Medan's Recovery

[medan2012]

Yesterday, marked my 16 weeks post-op; almost 4 months post-op. I had my first melt-down since my LTKR......I cried hard for at least 5 minutes...... I am so tired of how my knee is feeling........I realize that it is a long journey to recovery but yesterday; I lost it. I startled my wonderful husband. He actually thought that I had received bad news from someone because of my uncontrollable crying spell.

I felt like I could not take it anymore but what else can a person do?

Sometimes the shadows are just too big and too painful. Extra SUNSHINE may be just what we need! It is true that when I am feeling brave enough, I like to allow myself to live in the sunshine while looking at my SHADOW SELF.


I am looking forward to some sun, fun & relaxation on my upcoming vacation to Puerto Vallarta. That's what I need to help aid my recovery......

I've told my PT after 23-24 PT visits that I am ready to cease the weekly PT & do the exercises & pool therapy on my own. I still have not achieved the 120 degree bend but I am working on the stairs because according to my OS; if I don't achieve the 120 degree flexion;I will have problems with the stairs. I have been focusing on climbing the stairs leg over leg instead of one stair at a time. Yesterday, while climbing up the stairs, I didn't lift my surgery leg up high enough and hit the front part of my foot which resulted in pain. I think that is what started the melt-down......

I've pretty much stopped taking my pain med (HYDROcodone-ACETAMINOPHEN 10-325 but yesterday after hitting surgery leg on the stair; I took one and that helped ease my pain. Most of the time, I take 2 Tylenol Extra Strength as needed.

robynhood, when you say you are easily doing stairs up & down, are you doing the stairs one at a time?

On Tuesday of this week; my flexion was 111 & extension 0 as measured by my PT. When he had me to do my flexion; I got 101.

Anyway, I wish everyone on this Forum a speedy recovery without much complications.

Have a blessed day!!!!

 

[medan2012]

Who was I trying to fool? Today, I went to my OS for follow-up of my knee replacement. My flexion has regressed to 100 degree even though I feel comfortable with my ROM. I still have stiffness in my knee which is very aggravating! I hate this feeling and was told by my OS that my knee would always be stiff if I didn't have the MUA. Apparently, I have a lot of scar tissue that needs to be broken up. I've endured 25 land pt sessions & 3 pool therapy sessions so I guess I will half-heartedly op for the MUA.

I need to be at peace with this MUA procedure so I will be praying, praying that the pain is not too bad. My incision has not gotten any smaller even though I have been using the Vitamin E oil.

We have vacation coming up in a few weeks and I am hoping that I will be okay to travel. My OS thinks I will be okay to travel??????

Oh well................

 

[1ELISEA]

Oh my goodness, talking MUA's?
Let's see if Josephine might have some advice for your situation.

Hope you are doing better soon!

 

[medan2012]

1ELISEA, thank you for your words of encouragement. I have not heard back from Josephine.

I just talked with my PT & he feels that if I have the MUA within the next week; I should be okay to travel. I'm not too concerned about the pain but concerned about my PT. He will show my husband how to do the manipulations while we are on vacation.

 

[Josephine]

My flexion has regressed to 100 degree even though I feel comfortable with my ROM. I still have stiffness in my knee which is very aggravating! I hate this feeling and was told by my OS that my knee would always be stiff if I didn't have the MUA. Apparently, I have a lot of scar tissue that needs to be broken up.

Don't believe him! You got to 120 before so how can you possibly have adhesions (scar tissue) now?
What's happened is this ....

I've pretty much stopped taking my pain med. Most of the time, I take 2 Tylenol Extra Strength as needed.

Some people need to keep taking pain meds for 4-6 months and would certainly need them if they still experience stiffness which is a manifestation of pain which you will know if you had reread the article Pain management: importance of managing pain after a TKR and the pain chart. In my opinion you stopped taking your meds far too soon.

Many members here have reported increase in ROM for as much as a year later and I would imagine the same could be for you.

Another reason why an MUA is not necessary - you are still at 100 which for most surgeons is the cut-off point for MUA anyway.

Plus this happened which will always pull back your ROM but is nothing to do with adhesions!

I started having problems with my IT band which has caused some soreness & a little pain

How is it now, by the way? You should read this ITB (ilio-tibial band) issues and treatments.

I had my first melt-down since my LTKR......I cried hard for at least 5 minutes...... I am so tired of how my knee is feeling........I realize that it is a long journey to recovery but yesterday; I lost it.

Post op blues can hit almost any time so don't be despondent.

OS gave me the prescription and I filled it right away and it is ready to go. Type of knee is irrelevant - he had me do it 10 years ago when I had my hips replaced as well. Reason - our mouths are filled with bacteria and the cleaning usually draws some blood. Thus, the risk of a blood infection is higher. As my OS described it, the infection goes to any new joint.

This issue comes up so often and invariably with so many weird and wonderful explanations, I often wonder if anyone has ever read Infection: peri-prosthetic infection - also known as late onset infection. The comment in bold is not entirely factual. But read the article to find out what I mean. If you read all of the article, you will see there is a new theory that these issues don't actually have anything to do with peri-prosthetic infection anyway.

 

[medan2012]

Josephine, thank you for your response and great information! I've often wondered if it's a con game between PT & OS regarding my ROM. I was appalled to find that my ROM had regressed so much when I am doing the exercises and getting out and about more often. I have been reflecting about my recent OS visit on Thursday. The OS & AS knew that I did not want to have the MUA but the OS came in ready to convince me that it was necessary for my stiff/tight knee. The OS had originally told me that if I did not get the ROM, I would have problems with the stairs. I have been taking the stairs every day pretty much to try and stretch my knee. I have noticed that when I do take the stairs to stretch my knee; I feel the pull on my back. I do have a herniated disk in my back which does flair up from time to time but I have found that with icing, heat & rest; my back feels better.

I have decided that I will not have the MUA (if at all)before I leave for vacation because I have made progress and I do not want to hinder my ability to enjoy my vacation thus far. Yes, I have read some of the posts stating that people have regained a good ROM even after a year and this does give me hope that I will eventually gain more ROM.

It really puzzles me that I have a puffy pocket on the left side of my knee/kneecap and I have massaged it but it will not go down. I've called this to my OS attention twice but have not gotten a positive response. I asked if it was possible that it could be a pocket of fluid and the AS said they don't like to put a needle in a TKR. I have read though some of the postings on here that people have had this happened. I am so put off with this OS/OA that I think I will find another OS to do my right knee when I have my left knee under control. Also think I should find another PT since I had 25 sessions with him and no progress. Perhaps, I need a different technique???

What are your thoughts?????

 

[Brownie51]

Medan I am sorry you have to deal with this. Josephine's advice is always spot on. I hope you can avoid the MUA but it's so difficult have your doctor insist you need something but have your instinct telling you something else! Try gentle techniques to get more bend. I hold my thigh up and let my lower leg relax and it always helps my bend.
Take care!

 

[Pumpkin]

Good luck with the Graston Technique, it will be interesting to see how you feel after a few visits.
I just got a little more ROM and I am 19 months out, .

 

[medan2012]

Pumpkin, thank you. Yes, it will be interesting how the technique helps my ROM. I truly think that my ROM will come; just will take time. Good to hear that you are still getting more ROM at 19 months out!

 

[medan2012]

Well, I endured 2 Graston Techniques before I left for vacation. I really did not see any change...... After each technique and pt exercises, I was left with hip pain & groin spasm. I think the therapists thought that since they were doing the GT that they could push me more for my flexion..... That's why I only went for two visits before we left for vacation. I did not want any new issues flaring up.

We spent 12 awesome & relaxing days in Puerto Vallarta and to my surprise all the walking did not bother my new knee. I used my cane alot for stability since some of the walks are uneven and some of the curbs are high. Of course, I had the support of my darling husband and could hold onto his arm if needed but I mainly used my cane to help me walk faster and more stable. I did experience some swelling and edema in my ankle but elevated my leg every chance I got. I also soaked in the Jacuzzi so all in all; I enjoyed my vacation pain free!!!

At this point, I will hold off on having my TRKR since I did not have problems with this knee. Perhaps I was favoring the new knee more and that is why I did not experience much pain in my right knee????

Anyway, I'm home and now I can get back into some sort of exercise routine. Our pool at our subdivison has opened so I am happy about that! The days I don't go to the recreation center; I can do pool exercises at home.

I think what I am finding is my right leg is not as strong as my new knee leg and it is keeping me from being able to walk and keep a steady balance. Is this normal? I plan to work on my right leg doing quads, hamstrings and straight legs since I am doing them with my new knee leg.

But all in all, I feel blessed and I do not plan on having the MUA!!! I have an appointment with my OS on June 13, 2013. Oh, by the way, while we were in Mexico, I ran into a lady from California who works for an OS & she suggested that I insist on having my OS take a look at my knee using an ultrasound since I still have a pocket of swelling around my knee. If he is not open to this, I plan on seeking a second opinion.

 

[bottomshollow]

update, medan2012! It seems that the best PT for a TKR is a vacation with a great hubby in Puerto Vallarta, Mexico. Wish I'd though of that . Glad you're not having the MUA---sometimes, if we're just PATIENT, TIME takes care of things. Some of us just need more TIME than others. Keep up the good work---things will continue to get better and better down the road.

Take care and keep us updated. We care.

 

[medan2012]

Judy B, thank you for your words of encouragement!!! Yes, I realize that it takes time for some people to recover and I think that I am one of those people.

Have a Blessed Memorial Day.

 

[medan2012]

Wow, I have not been posting lately!!!! Just want to update everyone on my progress.

On June 13, 2013, I went for my 6 months post LTKA. My OS was not happy because I still have not reached the magic 120 flexion. My knee just refused to bend to that degree and I refused to go forward with the MUA!!! I still have the puffy pocket on top of my knee and my OS didn't feel the need to do an ultrasound so I went to another doctor for a second opinion because I really wanted to know what the puffiness was all about.

Before I get to the second opinion visit; I must go back from when I had my 6 months post LTKA. The OS has released me until my one year post LTKA so I won't be seeing him until December 2013. The instructions that he gave me was to continue my squats and stretches and that's it.

I must say, I have slacked off on doing my exercises; focusing more on stretches and doing the stairs. Depending on the stairs; most of the time I can ascend without any problems but depending again on the type of stairs (steep stairs, wide stairs), I have to hold onto the railing/banister when descending the stairs for fear of falling. Whenever I can; I use the stairs and not the handicap ramp because I feel this will help with the stretch. I'm not sure what my flexion is but I have been able to do all of the ADL plus I'm always out and about, driving and just enjoying life. I've even started dancing!!! . Oh, by the way..... for the first time since my LTKA, I have been able to get down on my knee but I do it very carefully. The only reason that I chose to get on my LTKA is because I was trying to retrieve an object that had fallen under my bed. It really felt funny so I hoisted myself up mainly using my right knee.

Now to my second opinion appointment----the OS did not see any need to do any test for the puffiness but he did examine it in detail and stated that it was a fatty pocket and there was nothing to be done. He viewed my post x-rays and stated I did not need to have a RKTA because I still have space and my knee was not bone-on-bone.

My Original OS advised me to have the RTKA. Very interesting...... So, I am not going to have the RTKA until I absolutely have to!!! The second opinion OS stated that he never does TKA unless the person is in a wheelchair, on a walker or having serious problems with their walking. I chose to have my LTKA because my left knee had started catching.

Prior to my second opinion appointment, my LTKA was causing me pain whenever I stepped up or down on the knee and I was also feeling a catching in the side/back of my knee. I have been using Voltaren Gel on my knee and that helped with the pain whenever I stepped up or down whenever using the stairs. The Voltaren Gel has been recommended for inflammation and seems to help and I also use it on my right knee whenever it hurts,

The second opinion OS didn't think that was anything serious since it comes and goes. So, at this point, I guess I will deal with whatever is going on. My knee doesn't get hot anymore and most of the swelling has subsided. Sometimes my knee feels stiff and sometimes it feels loose. I have not used my cane in about a month or so. I do take it with me if I plan to do a lot of walking .

I guess is it for right now but I'm feeling good about my recovery BUT if I had to do it all over again; I would have waited longer!!!!! I can't think of anything else right now.

Blessings to everyone and your recovery.

 

[bottomshollow]

medan2012. Seems that you are doing well and living pain free. Interesting that you would have waited longer---not what most folks say. But considering the second opinion on your other knee, maybe your OS was a bit over eager to do surgery.

Take care and keep us updated. We care.

 

[medan2012]

Judy B, thanks for the endorsement. I would not say that I am pain free because my muscles/tendons etc are still healing and I am diabetic so maybe that is why the healing is taking longer????? I just hate the way my LTKA feels but eventually I know that I will get used to not comparing it to my right knee.

I tend to agree after the Second Opinion that perhaps my original OS was over eager but it is what it is and now I will make the decision when to have my RTKA!!!! I don't see having the RTKA anyways soon because it is not bothering me since I've had the LTKA.

Have a blessed day.

 

[maddimoo]

Just like to say Hi to you all in the Forum, i found BONESMART by accident, i had my TKR late feb,a month later due to unforseen circumstances had to move house 400 miles away,so i had to find a new OS who wasnt very accepting of me, 2 wks after moving i fell and did the ligurmentin my new knee, this was extremly painful, besides the pain i was still having post op,over the last few months slowly the pain has subsided, but still lingering in the day, but i find the nights worst, i cant remember the last time i slept all night, i thought i was on my own until i found this forum, now i know it is normal to belike this post op and not just in my head, i can bend my knee to 120, and im walking better, but what i really want is a good nights sleep, i have recently stopped smoking, so that isnt helping because before when i woke in pain i would go down and have a cigerette, so i would love some advice off you lovely people how to deal with this

 

[medan2012]

Hello All!!!

I haven't been on BS for awhile. Well, I'm now almost 10 months post TKA. I feel that I still have a long ways to go because I still am experiencing soreness in my muscles, tissues, tendons.

My husband and I joined 24 hour fitness a month ago and I have been working with a Personal Trainer for my unachieved ROM. I believe I am between 90-95 ROM. It is very frustrating....... I did not elect to have the MUA. Working with a PT seems to help because he is teaching me what weights and machines I should use. Some of the exercises are familiar from Physical Therapy. Although, I never was given weights when I went to Physical therapy which I think would have helped my rehab.

I was experiencing some catching in the back of my new knee for a while but since I have been using the Leg Extension with weights and Hamstring exercises, it has gotten better. My OS said that it was my Hamstring. On my last visit with him, I also received a cortisone injection for bursitis on the inside of my knee. I still experience pain on the outside of my knee below my kneecap but the OS said it was probably due to my scar tissue and didn't seem concerned so nothing was done about that. I only experience the pain whenever I ascend or descend the stairs.

I can't really complain because even though my ROM is uncomfortable sometimes, I'm still able to do pretty much what I want. We've been on two vacations since my TKA which involved a lot of walking and stairs and I was able to enjoy my vacation. Looking forward to our third vacation the end of the year which will involve more stairs and walking. I try not to take the handicap ramp if I can help it. I prefer to do the stairs because I know this will help my recovery.

Well, this is all for now. Wishing everyone a continued & blessed recovery!!!!!

 

[Brownie51]

Hi Mary Ellen
I think you are doing great! I think you are enjoying your life and doing what makes you happy..but maybe comparing yourself to others too much about the BEND. I have one knee that is almost one year out and the other is 3 1/2 mo. I think that even if don't do tons of PT or special exercises as far out as 10 months, that the knees just continue to improve in someone who is so active as you. I would be willing to bet that by the first day of Spring you will have improved a whole lot.
No real advice from me! Except maybe to keep on appreciating your progress!
xoxox
Marianne

 

[medan2012]

Marianne,

Thank you so much for your encouraging words.

Yes, this BEND is foremost on my mind but I have to keep telling myself, "it is, what it is." My leg feels so tight at times and other times it feels loose???????

Oh well.

Again, thanks for your encouraging words.

Hugs back at you!!!!!!

 

[skigirl]

It sounds like you are living large!! I am jealous. Rom does improve for over a year, so don't loose hope or obsess too much right now. I think you will achieve that 100 mark soon. The leg extension machine is one that I avoid---make sure you do not put a heavy weight on that machine as it is hard on knees. The main difference between a personal trainer and a pt is that the pt approaches exercise with your medical conditions in mind. Leg extension machines are not recommended for folks with bad knees.

You can continue to exercise your hamstring, however---there are lots of other machines and exercises for it.

Also, I have pain on the outside of my knee low down that is because of a tight IT band. Here are the articles that helped me.