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Moving Forward On Two New (Conformis) Knees

@Jajakio, thank you. I understand there will be difficulties with meds because of crossing state lines. I have already met with my primary physician telling her that my surgeon will need for her to handle my med situation. Perhaps she will go ahead and have the meds ordered before I leave town. I could then take them with me for the trip home. I have direct contact through her patient portal. We met last week to finalize pre-op requirements. I still have a bit of time before November but it seems that it will be here before I know it.
 
I printed off the activity progression and had right on my table so I'd be sure to not overdo too much. If I was hurting more than usual, I'd look at the chart and see that I had indeed done more than what I should have!
 
It may be possible to have the nursing staff contact your Family Doctor to update with progress and medications.
That way they can have them ready for you when you arrive.
 
@Jajakio, many thanks. I reached out to my primary after your recommendation. I will work between the two to make sure I have the meds I need to get me home and for the first couple of days at least.
 
Now that I have all of my pre-op surgical blood and paperwork submitted I would like to take these last two months doing what I can to better prepare for recovery.

My current range of motion is limited. I think due to pain I have certainly not pushed flexion. I had an appointment with my surgeon in late July. He is located 3.5 hours away. Upon the physical exam he stated that my flexion is at 70 degrees and that as a result he may need to go back in at my 4 week post-op appointment to break up scar tissue which I certainly hope to avoid.

My job requires that I stand for extended amounts of time and to be honest, flexing my knees afterward is very painful.

I am somewhat confused through reading that my physical therapy activity should be limited at first. The surgeon says he will make a determination based on my therapy outcome as to the need to break up the scar tissue in a day surgery.

How do I move forward with this dilemma in mind?

Many thanks in advance for your response. If there are exercises that will help at this time I am certainly willing to try them. Are heel slides the best activity for me?

best regards,
Sherry
 
You won't know what your post-surgical flexion will be until, well, post-surgery. I too had a very bad knee (my left) that bent very little. Post-surgery its flexion was better than before the operation. I was surprised, but hey... good surprise! If you can, try not to fret about things ahead of any need to fret about them.

Before surgery, I fretted about pain (turned out not to be a problem given the pain killers). I fretted about stairs (turned out to be no problem at all). I fretted about lots of things, and most of them never came close to being a problem.

Physical therapy in the very beginning need only consist of gentle bending (heel slides), ankle pumps (to help prevent blood clots), and getting up to walk to the bathroom or for getting a snack or water. Also you will learn to go up and down stairs, though you won't want to do this more than a couple times a day at first, and get into and out of a car. These are things you need to know how to do, and how best to do them. Otherwise, your knees will need nothing except time and the opportunity to heal.

That will be your job: to give your knees the best possible situation in which to heal. I can only speak from personal experience, but I was conscientious about keeping my knees mobile. I bent them in the recovery room, just to see how well they worked. I did gentle heel slides. Lots of ankle pumps. I walked. The knees do need to move; it's what knees are for, what the joint is built to do, whether original bone and tissue, or with an implant. So I moved them. But I didn't force them.

Knees are pretty good at telling us what works and what doesn't.

Pre-surgery your OS might give you exercises to do. Mine had me do leg lifts (strengthen the quad muscle), pressing the back of my knee into the bed or floor (to stretch my hamstrings for extension), and heel slides. I only learned after surgery, though, that I could have used some strengthening of my upper body too! Would have helped me get up from chairs and toilets. :)
 
Ditto on Susie's suggestions for presurgery exercise. I understand you are limited now with bad knees and pain. You are not going to be able to do some things but try to determine what you can do. I hurt way too bad to walk a lot but I found I could get in my hot tub and do bicycles, stretches, and a few other thing that helped a lot. When I started, I couldn't do 50 bicycle motions, by the the I had surgery 6 months later, I could do a thousand. I was able to pedal a recumbent bike in a week after surgery. I had a physical therapist I was seeing for bursitis help me brainstorm on good hot tub exercises but the Internet is full of pre knee surgery exercises, videos and otherwise. Just concentrate on what you can do. And like Susie says, upper body too.
 
SusieShoes is absolutely right. The first few weeks you shouldn't even take PT. Taking care of your basic needs is enough PT. If you do too much too soon, it just sets your recovery back and slows it down. You will need to concentrate on getting your swelling down. You can barely bend a swollen knee, just like you can't bend a water hose that full of water!
 
Unless you already have scar tissue (by which your surgeon means adhesions) now, you wont have it by 4 weeks post-op. It just doesn't happen so fast or so early. What you probably have now is muscles and tendons that have shrunk. It will take time for them to stretch again and become used to your new knee.
Scar tissue and adhesions - what's the difference?

You'll need to keep your knees moving, but gently. Doing too much PT, or trying to follow an aggressive PT regime will make your wounded tissues hot and irritated - just the conditions to encourage the formation of adhesions.
 
@SusieShoes and @Jajakio, you are two amazing women. Thank you sincerely for your thoughtful responses. @SusieShoes, trying not to fret. The waiting gets to me but it quickly approaches just the same. @Jajakio, I have a desk cycle that I can use. I'll do what I can. Many thanks to you both.
 
You can't tell, but if you haven't had any prior surgery on your knee, than you won't have adhesions.

You will have scar tissue after the surgery. That's what holds your wound together and helps it to heal. Without that normal scar tissue, your wound would split open again.

What makes your knee stiff and difficult to bend in the first couple of months after a knee replacement is usually not adhesions, but simply swelling. The extra fluid in your knee makes your knee stiff, just like a hose pipe that is full of water. But empty out that water and the hose pipe (and your knee) will bend much more easily.

So, after your surgery, do all you can to get rid of the swelling, with lots of rest, ice and elevation.
Ice to control pain and swelling
Elevation: the do's and dont's
 
@Ceele, my parents own a small medical supply business where they produce positioning products for hospital patients. My dad makes a leg positioner that will help with elevation and extension. I told him I will need two. I'll have my surgeries on the 8th and 10th of November. Would you suggest starting PT at three or four weeks post-op? Is this enough time to allow the swelling to diminish?
 
All I can tell you is that my surgeon doesn't allow any PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house.
After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home.
His patients all do well and achieve good ROM, as I did, and he hasn't had to do a manipulation to help with ROM for the past 4 years. I think that speaks for itself.

It's not exercising that gets you your ROM (Range of Motion) - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.
 
@Celle, makes perfect sense to me. Ice, rest, elevation. Amazing how these surgeons request their patients to do different things post-surgery. I plan to take it easy and listen to my knees. Thank you very much.
 
@jeffm1955, best of luck to you tomorrow! Let us know how you are doing. Prayers for a great recovery.
 
I had very gentle PT in-home for the first couple of weeks. I actually appreciated it. A good PT can be a valuable guide and confidence builder who doesn't push you to doing things that cause lots of pain.
Listen to the knee and you'll be ok.
 
I am now just shy of seven weeks from my BTKR. I am beginning to purchase items to help me recover at home. Several people speak of a lounge doctor wedge for elevation. Is the small one be wide enough to elevate both legs or would the wide one be necessary? I'll use it mostly in a recliner chair (I think).

Many thanks,
Sherry
 
Monday morning madness and so frustrated with this knee pain. I jumped up this morning because one of my little dogs was not feeling well and forgot to use my hands taking pressure off my knees which left me with a searing pain in the front of my right knee. I am now sitting in a restaurant alone with crutches beside me. How can I possibly hold out until November? I cooked our staff inventory meal yesterday and am totally exhausted. This pain overshadows every part of my world. Terrible.
 
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