TKR Milosnanna's Recovery Thread<

[Milosnanna]

Haven't written for a couple of days. Been in a lot of pain both with knee and then because of trying to get comfortable with my back. It is hard to say which is worse. I think I was doing well, even though I didn't think so at the time. I now realise I was but now my back has gone and it is far far worse. I can't continue with my walking - back won't let me so I'm stuck.

Went to see OS yesterday, first appointment since surgery. I went there on crutches I had planned on walking in, couldn't do it then. Appointment was delayed by 1½ hrs. Had to sit there waiting. Got up a few times with crutches to walk around as foot goes tight and red when down for too long.

Saw my consultant. He said he was pleased with progress but my extension could be a lot better. He told me to push it back to the point of pain and through pain and hold it for 10 seconds and do it several times an hour ugh. As fast as extension he held my leg and told me to push down. I did and he said it needs to be on a rolled up towel every hour again several times a day pushing down. It hurt. I asked him about water therapy he said it wouldn't help at all.

As we were leaving I told him about my walking when my back was good. I said I had been using the heel to toe method he asked me to show him and said NO, stop that you are walking like a duck stand up and walk walk fast, don't think about it - to my surprise (even with a bad back) I stood up straight and walked out of his office through all the people who had seen me hobbling in on crutches - with no crutches! I just kept going to my husbands amazement and walked all the way through hospital and back to car where I collapsed. I guess it's a mind over matter or something it shocked me, haven't done it since.

I am so confused now what do. Do I follow his advice re extension or will it just come anyway, I must be honest I have relied on the walking alone for extension.

I also asked him about when I awoke from surgery he said to me we gave you your own kneecap back - he said they had indeed given my old kneecap back as he believed, although it will be more painful there is less chance of complications @Josephine is this right?

Asked him about zingers, he said "what are they" explained shooting pains he said totally natural it will be 3 months before I see any improvement and more like 6-8 months to see greater improvement. He is the head orthopaedic surgeon and also teaches ortho.

 

[Jajakio]

Milosnanna,
I'm not quite two weeks ahead of you and my back has been acting up too, not in the beginning, just the last 3 weeks or so. My doctor says he thinks it just a result of getting more active. He says give it time and if it doesn't clear up we can go to steroid shots. I'm reluctant to do that so have started back exercises twice a day hoping to strengthen muscles. Who knows if it will work?

I don't have much advice on extension, since it hasn't been a problem for me. But there is an article here on it with some more gentle exercises. I feel for you and your pain and hope you can find a balance between overdoing and hurting yourself and doing what you need to to move forward. My ROM was stuck for a few weeks at the same level, and nothing seemed to make much difference at the time but gentle exercise and bike time eventually resolved it. I hope you can find a path to continue to improve.

 

[Pheebs52]

First, huge congratulations on being able to attend the wedding, especially for going there prepared with the wheelchair and ice! Yay!

What did your doc say about your infection and red foot? I'm sorry to hear he is advocating painful exercises for you, but bear in mind, you don't have to do them. Personally, I've followed the Bonesmart mantra when it comes to exercise and have gone out of my way to avoid anything that causes pain. That seems to be working well for the most part. Thankfully, my PT agrees that pain just equals more swelling and pain; phew!

Glad to see your sleep seems to be improving a bit; whoohoo!

 

[Polkadot]

Hello, Milosnanna,
Ouch, ouch, ouch! And do I hear another ouch? Oh, yes, I do! Back pain is just the worst--I had an injury in my 20s that just keeps on giving periodically, so I do know a bit of what you are exeriencing. And to think that you have to deal with back pain on top of all the pain and discomfort you've been managing with your TKR--well, that's just unfair! Try icing your lower back. It does help. I used to go to sleep lying on an ice pack (appropriately wrapped) when the pain was bad. I also used a fanny-pack type sling with an ice pack in it around my waist at work.

Regarding extension, do you sit in a recliner? Here's what I do to encourage extension while watching TV: Take part of the doc's suggestion, and roll up a towel to put under your ankle. That raises your leg just enough so that the knee is slightly suspended, rather than resting on the chair. Every so often, while sitting there, flex your foot (point it at the ceiling). You should feel a little stretch in the back of your knee, and your kneecap will go down a little. Hold it for a few beats. Relax. Do it again. Eventually, you will be able to sit with towel under ankle, foot flexed, and knee straightened, for several minutes at a time. You are gently helping your extension when you do that. If you stop feeling the stretch when you straighten your knee and point your toe, you can always add a little gentle pressure by putting your hand on your knee and helping your kneecap lower a little more. This is a gentle version of the knee hang (chair to stool) that many people do.

Here's hoping you can put that negative doctor visit behind you. Mind over matter, indeed! You are a strong woman!

PS. I wish for that doc to experience a few zingers so he can be a bit more sensitive to his patients!

 

[Milosnanna]

@Jajakio - thank you so icy, hubby just came in with a bike for me so I will wait until back Is a bit better and try that xx
@Pheebs52 - mentioned infection he said it wasn't an infection just body trying to get rid of stitch, he explained it like having a splinter in your hand and how everything goes there to try and get it out and it will go red/green and eventually "pop" I wore a dress to is and it rubbed that part of my lef when I got home nothing there the head of it had gone and it's all nice and pink now so perhaps he was right, as far as foot he said its natural with all the pulling around that has gone on all the trauma etc it will goin time?
@Polkadot - I Have used heat today my ice pads I can put in the microwave tried this morning and have done it constantly and to be honest it works, it feels some have easier, not gone but easier, I had a 1 1/2 hr nap went to sleep and woke up in same position with head pad on my side holding it on with my hand - felt great that I had actually had a sleep I agree I do t like the knee hang but will try the recliner method tomorrow when back it hopefully a bit better, been really lazy today only up to get heat pads, but it is the first day that I have had "off"
Hubby got the little broke for me will try that too.

Thank you all so much for being there you are all absolutely amazing and I love your dedication to helping others xxxxx

 

[Josephine]

Saw my consultant. He said he was pleased with progress but my extension could be a lot better. He told me to push it back to the point of pain and through pain and hold it for 10 seconds and do it several times an hour ugh. As fast as extension he held my leg and told me to push down. I did and he said it needs to be on a rolled up towel every hour again several times a day pushing down. It hurt.

So what is your extension? Without that information, I really cannot comment. But overall, I really don't agree with trying to obtain extension with force like that. In my experience, it causes more swelling which in turn obstructs the extension. It only takes a bit of swelling to do that.

I said I had been using the heel to toe method he asked me to show him and said NO, stop that you are walking like a duck stand up and walk - to my surprise (even with a bad back) I stood up straight and walked out of his office

Well that's the problem with the internet - we cannot actually see you walking and gait is everything. So seems like he did you a big favour there! Actually I did exactly the same thing after my first arthroscopy - my knee was dreadfully painful so I popped in to see the physio who had me walk up and down and pronounced that my gait was awful! She instructed me on a better gait and I almost left there skipping!

I guess it's a mind over matter or something it shocked me, haven't done it since.

Why haven't you done it since? He's just shown you the correct way to walk - why wouldn't you carry on doing it that way? Or have I misunderstood what you said?

I asked him about water therapy he said it wouldn't help at all.

I tend to agree with him.

I am so confused now what do. Do I follow his advice re extension or will it just come anyway, I must be honest I have relied on the walking alone for extension.

Well it won't if your walking was out of whack. That's a certainty. But no-one can make this decision for you. We can advise but that's it. However, do remember this Saying no to therapy - am I allowed to?.

I also asked him about when I awoke from surgery he said to me we gave you your own kneecap back - he said they had indeed given my old kneecap back as he believed, although it will be more painful there is less chance of complications @Josephine is this right?

Eh? NO idea what he is talking about!

Asked him about zingers, he said "what are they" explained shooting pains he said totally natural it will be 3 months before I see any improvement

This is the funny thing about us patients - we develop a language which is all our own and then expect our doctors to understand it! Zingers is not a medical term!

As for his opinion, it depends where these 'zingers' occur.

Here's the chart - you can tell me where. With any luck, maybe I can explain ..

 

[sistersinhim]

For me, the extension was the last to come in. At my 1 month checkup, my OS was very gentle with me and said that it wasn't there yet, but would come in after a while. He was right. I 'worked on' it a few days by laying on my tummy with my thighs on the edge of the bed and my feel and legs hanging over, letting gravity work on it. After that, I just increased my walking stride while holding on to my walker. It was a few months, but it came in all by itself!

 

[Milosnanna]

@Josephine the reason I haven't done the walk since is my back I have been treating all day with heat I think I slept awkward due to pain or should I say napped I do t sleep.

D Rf2. Zingers
And to be honest all the way up the back of my leg at various points like lightning
Oh and extension he didn't give me any numbers just held my leg up and when he did the rom pushing my leg back he said he would be happy with another 5 ?

 

[Celle]

Extension: how to estimate it and ways to improve it

 

[liam2015]

hi Milosnanna ~ you're not alone with the extension being slower to get back to normal. i was shocked when i sat on the floor with my legs straight out and i could put my whole hand in a fist under my operated knee. i had never noticed it was that bad before. i think it's around 10 degrees from being straight. i have swelling, so i'm just trying to be patient, doing a variety of simple exercises for flexion and extension. we'll get there. sorry about your back. i find if i happen to doze off in the evening watching t.v. in an uncomfortable position, i get aches where i never had them before. hope you will resolve your back issues.

 

[Milosnanna]

Using lots of heat seems to be easing my back so far it's just so frustrating, I now appreciate I was actually getting somewhere it's funny what it takes to make you realise that at least I could walk. Now with back issues I am held up a few more days - hopefully days not weeks. Thanks for all replies and advice xx

 

[sistersinhim]

I think with our knew knees the back is affected from the different walking. Try to concentrate on walking the way your OS told you to. I think if you are consistent with it, not only will your back be better, but your over all body.

 

[SusieShoes]

You've gotten good ideas on how to improve extension. Extension is the last thing that came to me, too. In addition to lots of walking, I did the "press the back of the knee down against the bed/ottoman/floor" exercise. It's easy to do some of these while sitting and watching TV. But extension takes a while, no matter what exercises you do, so you might as well find one you don't mind doing and stick with that one.

 

[Milosnanna]

Had 100% sleep last night according to my sleep ap -wonder what tonight holds, bought stick on ice patches, they were very good stayed on all night and helped a lot maybe contributed to my sleep, try again tonight.

 

[kmak81230]

Excellent! Very happy for you Milosnana

 

[JJ65]

@Milosnanna I like putting a rolled up towel under my ankle for the extension... exercise. I can do it while I am in the recliner or have my leg stretched out on the sofa. Make sure and engage your quad, it helps to push the knee down a bit.

 

[Milosnanna]

Good news today I drove to local restaurant had a nice meal then went to local supermarket, left after about 15 minutes knew my knee (gipetto) had had enough I named him that because that's what it feels like someone with a little hammer hammering away at the side of my knee. It definitely seems stronger my bad back has he,d me back about 4 days but using heat patches and cool patches on knee they seem to work as I am sleeping much better even with bad back.

 

[sistersinhim]

@Milosnanna, you are coming along so well! I love reading of your improvements!

 

[Canada35]

Good for you! A lunch outing is perfect for testing your new knee's abilities! Glad you enjoyed it!

 

[JJ65]

@Milosnanna I love reading your updates on how you are doing and all. I also love the picture is that your doggie? It is cute... I have not named my knee, guess I should consider it. lol I love that you named yours.