TKR Montecresto’s Recovery

[Montecresto]

It is easy to get frustrated in the early weeks, where you are now. My best advice would be, IF you go to PT make it crystal clear that you refuse to push through any pain and if they’re okay with that, proceed, doing only what you’re comfortable doing, no more. You are the one that has to recover from the pain afterward, not them. Ice preventatively afterward also.

Feeling conflicted is understandable when you have well meaning friends, family, us, coming at you from different sides. Let your body be your guide. You‘re working to heal and you are healing, just allow yourself the TLC you deserve. Enough of my ramblings for now.
@Montecresto

Thanks for your time and advice, everything I get everywhere is appreciated….and yes my wife is doing a great job with me, but everyone has their limitations. She sets on the back porch and cries when I’m at those points where I’m writhing in pain, whimpering and crying out. It’s got to be very hard to watch someone suffer when you’re helpless to do anything……

I did tell my PT that I won’t be there this week. My wife called a new PT clinic and talked to a guy who is “very nice and knowledgeable, knows all about working with people who have excessive swelling as I do and has worked with my doctor, known him for years and I’ve had the best ortho in Arkansas, in fact in the country, he will have done the best procedure possible so I’m going to be golden” and so my wife made me an appointment with him tomorrow. She’s sold and my skepticism ruffled her feathers and now she’s crying and mad at me…..She said my OS office told her that I CANNOT go a week without PT…….

The anxiety I’m feeling right now is overwhelming. Scared to move, scared not to move. Oh, and 48 hours now without eating anything except for a few bites last night due to chronic or acute constipation, whichever would be the correct term at this point…..

Remember my very first comment to you in the op………….”this is a way bigger deal than I ever expected”…….

 

[sistersinhim]

I have the ice machine on with 20 minutes on and 40 minutes off.

I iced and elevated the whole time I was sitting or laying down for the first couple of months. This kept my swelling and pain level down and narcotic consumption less than if I didn't ice. At night I'd set up my ice water circulating machine and normally slept for about 4 hours. That's when all the ice was melted and the water got warmer. I'll refill it with my frozen water bottles and some loose ice and water and go back to bed and right back to sleep after a few minutes. I'm living proof that you can't over ice as long as you have a cloth between your skin and the ice source.

She said my OS office told her that I CANNOT go a week without PT…….

I have to disagree with her. I had 5 previous knee surgeries on this right knee and never took PT, not even after my sixth one, the TKR. I did my own thing at home and never let it go beyond pain. I also had 6 surgeries on the left knee and never took PT. The key for me was to do my daily activities, always resting, icing, and elevating after doing something. As I healed I was able to do more, and always continued to follow the RIE routine until I was more healed. As I said earlier, it was a constant thing for at least 2 months. I am single and had to recover mostly alone, so I know what can work with this recovery.

 

[InkedMarie]

Have you tried the Smooth Move tea? Give your wife a break. Give her some cash for lunch out. Regarding PT....you don’t owe anyone an explanation. You can just cancel any appointments you want to. Think about Covid. Many people had TKR’s right before and PT wasn’t an option.

I think talking to a new PT is a great idea. Tell him your issues. Ask him what will he do if you say “stop”. If his answer is “stop”, you’ll be good to go! Let us know how tomorrow’s meeting goes!

Marie

 

[Layla]

Oh gosh, I’m sorry.

She sets on the back porch and cries when I’m at those points where I’m writhing in pain, whimpering and crying out. It’s got to be very hard to watch someone suffer when you’re helpless to do anything……

Yes, I’m sure it’s difficult for her to see you so vulnerable and to feel helpless in relieving your pain. Go tomorrow and see how you feel about it, doing the bare minimum.

Oh, and 48 hours now without eating anything except for a few bites last night due to chronic or acute constipation,

Does drinking coffee help? Or how about a protein smoothie, for some nutrition. If packed with some fruit or veggies it may help.

I am going to tag my colleague @CricketHip as she’s not on the forum right now and share some knowledge from both, Jamie, from Admin as well as an exercise CricketHip has shared that may help with the swelling. Possibly CricketHip will have more to add when she responds to the tag.

Jamie from admin once explained that It is our lymph system that rids the body of fluid (swelling). So you want to get the fluid to the lymph nodes in your torso area so your body can more quickly process it. The lymph system works rather slowly on its own and much more efficiently with the assistance of gravity. The fluid isn’t draining into the hips, but contained with the lymph system and moving to the torso and lymph nodes located there.

BoneSmart FA, CricketHip, is involved in Therapeutic Massage and has shared this exercise to assist in manual lymph drainage. This gentle, yet effective therapy will help prime your lymphatic system to move fluid and inflammation away from your leg, which in turn will help your range of motion and pain - you may want to give it a try and tag her if you have any questions.

While lying supine, take deep breaths...deep, as in breathing in to a count of 5, 4, or 3 seconds, whatever is most comfortable for you. Hold that breath for another count of 5, 4, 3 then blow out completely, still using the count that's comfortable for you. A series of at least 6 reps may help get the excess swelling to move. To ensure you are taking proper deep breaths, place your hand on your naval and watch while taking in your breath, if doing this properly you should see your hand move up. Repeat this whenever you feel up to it during the day or night. Lying flat (supine) is best as the lymph nodes seated in your groin are less restricted, allowing for better lymph flow.

In addition, after the breathing exercise, place your hands lightly on your upper thigh, at the crease in your groin and lightly stroke upwards towards your naval.
Be patient because it can take the body time to respond.

I read this also today - After a sports injury or surgery, lymph vessels can become overwhelmed with the demand placed on them. When tissues are swollen, deep tissue techniques may actually cause damage to the lymph vessels and surrounding structures. Lymphatic massage is often the treatment of choice, because it helps the body remove proteins and waste products from the affected area and reduce the swelling. This helps reduce pressure on cells and allows them to reproduce faster to heal the body.

Hopefully this is not information overload, but it sounds like both you and your wife are feeling a bit overwhelmed today. I hope things ease as the day progresses.

 

[Jockette]

As for PT, I have to say that I’m catching a WHOLE LOT of grief from friends and family over my decision as it is. Receiving all manner of links from people on the warnings of not doing PT and testimonials from people who skipped it and are now suffering bad results because of

So this is very hard, fear and anxiety of going to PT, fear and anxiety of not going to PT, pressure and information for and against PT from all sides.

I know just how you feel, I went through this also. It’s shocking how many people out there believe we can’t recover without formal PT. After 5 years of reading Bonesmart, which means literally hundreds of member’s experiences, I have confidence that my opinion of no formal PT is the right one for me.

She said my OS office told her that I CANNOT go a week without PT…….

I have to disagree with her.

I also disagree with this, we have members to prove this not true.

Try to relax, all this anxiety over conflicting opinions is not helping your recovery. Just remember, it’s your knee, not ours, not theirs, only yours. You have the right to choose how you will rehab it.

 

[Montecresto]

I have the ice machine on with 20 minutes on and 40 minutes off.

I iced and elevated the whole time I was sitting or laying down for the first couple of months. This kept my swelling and pain level down and narcotic consumption less than if I didn't ice. At night I'd set up my ice water circulating machine and normally slept for about 4 hours. That's when all the ice was melted and the water got warmer. I'll refill it with my frozen water bottles and some loose ice and water and go back to bed and right back to sleep after a few minutes. I'm living proof that you can't over ice as long as you have a cloth between your skin and the ice source.

She said my OS office told her that I CANNOT go a week without PT…….

I have to disagree with her. I had 5 previous knee surgeries on this right knee and never took PT, not even after my sixth one, the TKR. I did my own thing at home and never let it go beyond pain. I also had 6 surgeries on the left knee and never took PT. The key for me was to do my daily activities, always resting, icing, and elevating after doing something. As I healed I was able to do more, and always continued to follow the RIE routine until I was more healed. As I said earlier, it was a constant thing for at least 2 months. I am single and had to recover mostly alone, so I know what can work with this recovery.

Some would probably insist it took 6 surgery’s because you didn’t do PT…These are the kinds of horror stories to be found all over the internet….so darn frustrating…
It’s very apparent to me however that there’s a lot of TKR veterans here that are anti PT…..
I’m listening to all sides and trying to make a decision on what to do for myself, as with every opinion I receive I’m told the decision is ultimately mine and the burden of making it is upon me, as I’m the one that’s going to live with it…..
I’ve got the ice machine on at the closest intervals I can stand right now. It’s much colder and much more effective than the ice packs. I’m glad I can use it now….
Thank you so much for your input sister…..

 

[Montecresto]

Have you tried the Smooth Move tea? Give your wife a break. Give her some cash for lunch out.

Lol, I’m not being hard on her…..
And she goes out every day to get a break. And I don’t dole out the cash, she’s always able to do as she needs and wants…..

She ordered us some Smooth Tea, thanks for the recommendation……

I’ll certainly be inquiring of the new PT instructor of how things will go when I need to stop….

Thanks Marie for your input……

 

[InkedMarie]

Have you tried the Smooth Move tea? Give your wife a break. Give her some cash for lunch out.

Lol, I’m not being hard on her…..
And she goes out every day to get a break. And I don’t dole out the cash, she’s always able to do as she needs and wants…..

She ordered us some Smooth Tea, thanks for the recommendation……

I’ll certainly be inquiring of the new PT instructor of how things will go when I need to stop….

Thanks Marie for your input……

I meant a break because you said she cries on the porch.

 

[Montecresto]

I know just how you feel, I went through this also. It’s shocking how many people out there believe we can’t recover without formal PT. After 5 years of reading Bonesmart, which means literally hundreds of member’s experiences, I have confidence that my opinion of no formal PT is the right one for me.

Well, that’s a fair point that your opinion of no PT is the right one for you. I can’t imagine anyone disagreeing with that….

 

[Montecresto]

Have you tried the Smooth Move tea? Give your wife a break. Give her some cash for lunch out.

Lol, I’m not being hard on her…..
And she goes out every day to get a break. And I don’t dole out the cash, she’s always able to do as she needs and wants…..

She ordered us some Smooth Tea, thanks for the recommendation……

I’ll certainly be inquiring of the new PT instructor of how things will go when I need to stop….

Thanks Marie for your input……

I meant a break because you said she cries on the porch.

I don’t know how I can give her a break. But the good news right now, is that today, in terms of my pain, I’m having the best post op day yet..

One reason I’m scared to go back to PT tomorrow. But I’m going to in order to keep the peace. But my wife at least agrees with me that I don’t have to engage to the point that I’m suffering as I had last week…..

 

[Montecresto]

Oh gosh, I’m sorry.

She sets on the back porch and cries when I’m at those points where I’m writhing in pain, whimpering and crying out. It’s got to be very hard to watch someone suffer when you’re helpless to do anything……

Yes, I’m sure it’s difficult for her to see you so vulnerable and to feel helpless in relieving your pain. Go tomorrow and see how you feel about it, doing the bare minimum.

Oh, and 48 hours now without eating anything except for a few bites last night due to chronic or acute constipation,

Does drinking coffee help? Or how about a protein smoothie, for some nutrition. If packed with some fruit or veggies it may help.

I am going to tag my colleague @CricketHip as she’s not on the forum right now and share some knowledge from both, Jamie, from Admin as well as an exercise CricketHip has shared that may help with the swelling. Possibly CricketHip will have more to add when she responds to the tag.

Jamie from admin once explained that It is our lymph system that rids the body of fluid (swelling). So you want to get the fluid to the lymph nodes in your torso area so your body can more quickly process it. The lymph system works rather slowly on its own and much more efficiently with the assistance of gravity. The fluid isn’t draining into the hips, but contained with the lymph system and moving to the torso and lymph nodes located there.

BoneSmart FA, CricketHip, is involved in Therapeutic Massage and has shared this exercise to assist in manual lymph drainage. This gentle, yet effective therapy will help prime your lymphatic system to move fluid and inflammation away from your leg, which in turn will help your range of motion and pain - you may want to give it a try and tag her if you have any questions.

While lying supine, take deep breaths...deep, as in breathing in to a count of 5, 4, or 3 seconds, whatever is most comfortable for you. Hold that breath for another count of 5, 4, 3 then blow out completely, still using the count that's comfortable for you. A series of at least 6 reps may help get the excess swelling to move. To ensure you are taking proper deep breaths, place your hand on your naval and watch while taking in your breath, if doing this properly you should see your hand move up. Repeat this whenever you feel up to it during the day or night. Lying flat (supine) is best as the lymph nodes seated in your groin are less restricted, allowing for better lymph flow.

In addition, after the breathing exercise, place your hands lightly on your upper thigh, at the crease in your groin and lightly stroke upwards towards your naval.
Be patient because it can take the body time to respond.

I read this also today - After a sports injury or surgery, lymph vessels can become overwhelmed with the demand placed on them. When tissues are swollen, deep tissue techniques may actually cause damage to the lymph vessels and surrounding structures. Lymphatic massage is often the treatment of choice, because it helps the body remove proteins and waste products from the affected area and reduce the swelling. This helps reduce pressure on cells and allows them to reproduce faster to heal the body.

Hopefully this is not information overload, but it sounds like both you and your wife are feeling a bit overwhelmed today. I hope things ease as the day progresses.

Thank you for all the valued information. The breathing technique is a trusted one that’s been shared with me by others!!!!!!

I’m drinking coffee every morning with Miralax in it. Hopefully it’s helping….

As for any food, I can’t seem to do anything my stomach is so upset….

 

[sistersinhim]

Some would probably insist it took 6 surgery’s because you didn’t do PT

Well, those people that would say that have no idea about my knees. I was born with birth defects in both knees. See how everyone's surgery and recovery are different.

I don’t know how I can give her a break. But the good news right now, is that today, in terms of my pain, I’m having the best post op day.

What wonderful news that you are feeling better! Yay! That's what we all want to hear.

my wife made me an appointment with him tomorrow.

Please be in control of your movements tomorrow. Good luck.

 

[Samsrf]

@Montecresto I know how hard this recovery is! Just about 14 weeks out. For what it’s worth I went through 3 PT (4 total) and was in tears nearly every session with “the good one”. At 4 weeks I had to return to driving children and taking care of my household. After PT it would be a struggle just to function, let alone fulfill my responsibilities for 2 days (when I had another session) so It just wasn’t working (and I was totally stressed!!!) I stopped PT (in dramatic walk out in the middle of a session) after “doing what I was suppose to” and being told it “wasn’t good enough” my recover speeded right along. Follow your instincts. You are in charge of your own body. I became way more active without the pain and swelling of PT. I focused on my gait, stairs, getting in & out of chairs etc. if it doesn’t feel right, say no.

 

[Montecresto]

Well, those people that would say that have no idea about my knees. I was born with birth defects in both knees. See how everyone's surgery and recovery are different.

Very unfortunate for you. Hope you’re done, and won’t have to endure anymore.
Yeah, people would still insist that PT would have delivered better results, without the need for more surgery’s….I’m still getting all the scary anecdotal reports from friends and family of the horrors of not doing PT.

I will report what tomorrow’s experience is like. But I assure you that I’ll not be doing any of the reps that are accompanied by immediate pain. I know which ones those are. The ones I can perform with nothing more than slight discomfort is all I’ll be doing….

Thank you again Sister, and good luck to you….

 

[Montecresto]

Been hitting my knee with the ice machine very aggressively and have swelling down better than ever. Of course I’m going to PT at 1:00 pm…….

 

[Layla]

Of course I’m going to PT at 1:00 pm…….

Well….please tell….was he a good witch, or a bad witch….just as Glinda asked, Dorothy in the Wizard of Oz.
Hopefully the appointment went well, the PT was gentle on you and you’re now chillin on ice.
We’ll wait for the report.

 

[lovetocookandsew]

IMHO, the best way to decide whether or not to do PT is how your knee reacts, both during and after. If your knee is a happy camper during or after any PT or other activity, then it's likely fine. But, if your knee has hissy fits, such as yours did, that's a strong signal that your knee is not tolerating the activity, exercise, etc.

Know this; just because your doctor operated on your knee does not mean he now owns said knee. It is your knee, your decision and only your decision. You can listen to others, but in the end, only you can decide what works best for your knee and your recovery. Period. No one, not your surgeon, not a PT, friends, relatives or Joe Jones on the internet, can make that decision for you. Only you have the right to decide what you want your recovery path to consist of, and that depends on you listening to your knee. If it sails through an activity, with no problems, other than mild discomfort, then it's okay with that activity. Sometimes it'll be fine with something that the next day, or next week, it balks at. Listening to your knee and acting accordingly is the very best way to recover.

Doctors, more so the older ones than the younger ones IME, were taught that hard PT is the be all and end all of recovery from a TKR. But over time they have come to realize that heavy PT can be more harmful than helpful. My OS told me it's a balancing act for them as some patients will not get off the couch and move enough, and they don't know which ones will be motivated enough to move around vs the ones who will become couch potatoes. Plus, it's often hard for many doctors to deviate from their training to allow for new methods. We don't want anyone to become a couch potato; moving around more and more as time passes is the best rehab for a knee replacement recovery. But, hard and heavy PT is not the best route, as we've seen over and over.

Take charge of your recovery, based on your knee and how it does at any given time, and your knee will thank you in the end. But remember, this recovery takes, on average, a full year, and sometimes more, although many people feel much better around three months, but their knees still have recovery ahead.

 

[WFD]

My OS told me it's a balancing act for them as some patients will not get off the couch and move enough, and they don't know which ones will be motivated enough to move around vs the ones who will become couch potatoes.

My last PT said much the same thing. He said one of the reasons PTs push and push is just to get their patients to do something, anything. So many patients don't do their exercises and then lie about it, or just don't show up for their appointments.

For the record, this guy was one of the good PTs, and worked with me the way I wanted to, without any of his ego involved. Like others have mentioned, he is young (30 or so).

 

[Montecresto]

Of course I’m going to PT at 1:00 pm…….

Well….please tell….was he a good witch, or a bad witch….just as Glinda asked, Dorothy in the Wizard of Oz.
Hopefully the appointment went well, the PT was gentle on you and you’re now chillin on ice.
We’ll wait for the report.

Sorry for the delay, I had a bad couple of days, not because of PT, but bowel issues. In desperation I took too many laxatives lol. I’m ok now, but it was intense. Had a vagovagal response that got so bad, my wife thought I was going into anaphylactic shock again. I became clammy, sweaty, lost all color, was tingling all over. Felt like I was going to curl on the ground and die….

We live rural, I was outside when it hit, setting in the car with the AC on waiting for the ambulance when suddenly I had to get to the bathroom. My wife helped me and I barely made it but had the long awaited “break through” moment. Paramedic from the local volunteer fire department arrived first. He got me to the bed, checked vitals, helped me get my breathing under control, and by the time EMT’s arrived I was much improved.

In the meantime I decided to have my wife call my gastroenterologist and sure enough, he prescribed a full bottle of Miralax to a 64oz bottle of Gatorade followed by an enema, twice, four hours apart. And he called me in a prescription of Linzess to be taken once every morning which he said would keep me going….

Saw my OS’s PA Friday and he took X-rays and
said everything looks exactly as it should, he allowed that the incision is healing perfectly and said that there’s no more danger of deep vein thrombosis. He also said I need to start taking my pain meds as prescribed around the clock so I can stay out of pain in order to make progress with home exercise and PT. He also wrote me a script for a Medrol dose pack.

So, I am on the pain meds every 5-6 hours, even setting the alarm in the night to stay on schedule. The result of ALL THAT is that I am now mostly pain free, I’m doing the home exercises that I could not do at all before, and I’m going to PT and doing well with it. My new PT is awesome, caring, gentle, very hands on with my leg, massaging, with gentle maneuvers, electro therapy with simultaneous icing, infra red therapy, and lots of explanations along the way of everything we’re doing, why and the goal, along with regular and copious amounts of encouragement.

The result of that is that my anxiety level is significantly reduced and I see light at the end of the tunnel finally.

Got out yesterday for some light activity, and this morning walked from the bed to the bathroom without the walker for another first, and today my wife is picking up a cane as I anticipate that another week or so and I should be able to use that more….

 

[Montecresto]

My OS told me it's a balancing act for them as some patients will not get off the couch and move enough, and they don't know which ones will be motivated enough to move around vs the ones who will become couch potatoes.

My last PT said much the same thing. He said one of the reasons PTs push and push is just to get their patients to do something, anything. So many patients don't do their exercises and then lie about it, or just don't show up for their appointments.

For the record, this guy was one of the good PTs, and worked with me the way I wanted to, without any of his ego involved. Like others have mentioned, he is young (30 or so).

Nice, I’ve got me a good one now too…..