Bilateral TKR Ms Blue's recovery

[Rob 68]

I'm 2 weeks out from my second and a little more than that for my first and I feel like I've slapped a wall.. I sit and think will they ever not hurt or not be tight.. Nights are hard.. My pt is good but I'm still with in home but she likes to push it. When she comes back Monday I will not be in tears bc I paid for it this weekend.. You do give me hope... I haven't been out of the house since I got home last Friday.. I can't even imagine going anywhere.. Being home is hard enough... I guess I just hoped it would be easier. But bilateral is not for the faint of heart... But thank you for sharing you give me hope I'll so more soon

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Hang in there and battle that despair bug to its knees. I am in awe of our bilateral sisters and brothers; don't think I could handle it anywhere near as well as you guys. We are definitely in your support corner.

 

[Braunzie]

@Rob 68 - I wish I could hit the "agree" button about 10 times for your comments!!! A single knee replacement is challenging in it's own right..

 

[LHop]

@MsBlue You may be over-doing. Please be kind to yourself! I found really the only thing that helps the stiffness for me is icing and walking. When I walk, which is not long, I try to over emphasize the bending of my knees and the heel to toe movement. Also, take your meds if you have them. I do better staying ahead of the pain than if I'm trying to catch up. I know we've had previous conversations about our pain med "nazis" so I don't know where you are with taking your pain pills.

 

[kneeper]

The PT sounds like one of the "boot campers." Way too much for week 3. Your tissues are injured and my instinct is to say any massage should be fairly gentle, if at all. Squats are my nemesis. I think early squats led to tendonitis in my first tkr so I'm very much against them--especially before 3 months.

 

[Pansy727]

I cry at the thought of squats

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[PolarBear60]

I only do squats in the pool. Not doing them anywhere else. Not until my other knee is done, anyway, and maybe not then.


Jean

LTKR (Stryker Triathlon): 21 April 2015
Right Knee Arthroscopy: 25 July 2006
Left Knee Arthroscopy: 10 February 2005

 

[Celle]

In the pool is the only place i do squats, too. My knees bend better when the water is taking some of my weight.

 

[MsBlue]

I am 4 weeks out today. Still very stiff. However, today's new wrinkle is that I have hives from mid-shin to just above my knees, only on the front of my legs. I think it's related to something we are doing at PT - either the heat pad treatments or the electronic muscle stimulation. I've taken Benadryl, and I am icing - the ice is taking away some of the itch. I noticed that I was having a lot of localized itching around my knees last week, but I thought it was due to the compression socks that I had to wear for 4 weeks. I gave them up early, and stopped wearing them on Monday. However, the rash and itching are worse than ever, so I am thinking it must be those heat treatments.

Has anyone else had an issue like this?

 

[SarahJane]

Sounds uncomfortable! Do you think there might be something in the gels, lotions, etc., or the surface of what appliance or device they are applying to your skin? I know I'm sensitive to some things -- mostly fragrances -- and major surgery has already put a strain on our body's defenses, so we're more susceptible to irritants. Hope you get it sorted out soon.

 

[MsBlue]

The area seems to correspond to where the heat pads are being applied, as opposed to the little conductors for the stimulation treatment. And the heat pads don't involve any lotions, etc, but it is a moist heat. Sometimes they place the heat pads over my yoga pants, and sometimes we pull the pants up and they place a towel between my skin and the heat pads. The heat doesn't bother me, but the pads are heavy. In part, it is a treatment to help my extension reach 0 - the heat of the pads to ease the muscles while the weight of the pads pushes the joint flat. I may ask them to try just using the weighted pad without the heat to see if that keeps me from developing a rash.

 

[Pescara]

@MsBlue I had a lot of itching and the pharmacy suggested Dermoplast or Vitamin E oil. It helped a lot

 

[Braunzie]

@MsBlue - So sorry to hear about the itching! Don't have any experience with that, but hope that you find a resolution quickly!

 

[Celle]

Stop the heat pads and see if that improves your itchy rash.

 

[MsBlue]

Calling my buddies ... brooklyn, LHop, Rob 68 and anyone else who cares to weigh in!

Range of motion - I had my 5 week surgical follow up last week, and my surgeon is not happy with my ROM, particularly on the right. I can get to about 100 unassisted on the Left, and 110 with assist. I can only get to 90 on the Right, and 98 with assist. The surgeon is already talking about MUA. He's basically giving me 4 more weeks to show significant improvement (Sept. 22 appointment to re-evaluate).

I did the week of in-patient PT at rehab, and have done several outpatient sessions in the subsequent weeks. I got the rash (we think from heat treatments, but don't really know), and that has not helped. I had about two weeks where the skin on my kneecaps was so sensitive that it was making things worse - felt the skin pulling anytime I bent. The rash is finally mostly resolved. I am still using prescription topical ointments to keep the rash at bay, but it's much better.

As for the ROM, I have ALWAYS had more trouble on the right since the day of surgery. Even in the first days after surgery, I had a harder time with the right (and it was significantly worse than the left before surgery). Even in the hospital, those first few heel slides, I had a hard time bending on the right. And the pain today is in the same place(s) as it has been along. I have areas to the left slightly above and below the right kneecap and an area on the back of of the right knee to the right side that "stop" me when bending. I just don't feel like it's scar tissue, because I wouldn't have had time to develop scar tissue in the first day or two after surgery. This is where the stress on that knee has been the entire time.

I have started doing lunges and trying to bend and HOLD on our stairs, and I'm using the yoga strap to bend and HOLD a couple of times a day. I dread it. It really hurts, and, of course, I haven't seen any real improvement just yet. (It's only been a couple of days.)

But I am reach out in desperation - does anyone have any ideas? Anything you've picked up in PT that has made a difference in bending range? I'm already freaking out about the possibility of having to have another procedure - and hearing that it's supposedly a pretty painful aftermath. Thanks for any suggestions you may have.

 

[Pescara]

@MsBlue I went to PT today and the stairs one at a time . The other thing was ultrasound and ice. Feel better soon and make sure you ice, elevate and pain meds. They couldn't help me a lot due to pain. Just do what you are comfortable with. Sorry I couldn't help more

 

[jbrooklyn]

Hi, @MsBlue! Glad your rash is resolving, but the ROM limitation is not good news, my friend--sorry to hear about this. No one can force you to have MUA, so if you are not interested in that, take it off the table. I am not a medical person, but do agree that since ROM issue was there right after surgery, that it likely isn't scarring that is impeding your motion. Since I am a big proponent of rest and ice as a path toward greater mobility, I'm wondering if lunges and holding it is the opposite of what you need. Remember, you are in very early days post-op. You mostly need to heal those angry, swelled injured tissues. It takes months. I would be very careful over the next 4 weeks about overdoing anything. Please take it slow, whatever "it" is. (FWIW, my right side was worse going into BTKR, and it's worse in recovery phase, too. I think the ligaments and muscles around the arthritic joint were inflamed, perhaps due to trying to keep a faulty joint stable . . . but whatever the reason, I like you have a noticeable deficit on the right. More pain, more resistance to movement.)

Since your OS is concerned, and you're asking for advice about increasing motion at 6 weeks post-op, perhaps @Josephine could weight in. She has more experience than the rest of us put together, times about 50.

Wishing you luck, and requesting that you keep us posted.

 

[PolarBear60]

Ms Blue, remember, the harder you work the knees, the angrier they will become and the more tantrums they will throw. They are toddlers. Be very careful with the lunges and the yoga strap. They can be helpful, but not if they hurt while you are doing them. Especially the lunges can be hard on your knees.

Your ROM sounds quite good to me for where you are at. I don't think you need to worry (easy for me to say!), and I second the reminder that you need to consent to an MUA.

 

[LHop]

@MsBlue I'm a little surprised that your OS is talking such drastic measures so soon. Your ROM sounds good for 5 weeks, especially since you've been dealing with a rash.

I would echo the thoughts of everyone above. Take it easy and slow. Your ROM can definitely be affected by the swelling and pain. But I also have one knee that is more problematic than the other and the recovery is slower with that one as well. My PT pointed out that everything in that knee is weaker as I have been favoring it for years. It takes time for those muscles, ligaments, etc. to build up the strength and mobility.

The exercises that have helped me are heel slides and stretching. Also, the stationary bike. As I've heard over and over on this forum (and has been echoed by my PT), if it hurts, don't do it. It's okay if it's uncomfortable, but pain is your body's way of saying "whoa nelly".

Sending you hugs and prayers!

 

[Slainte]

Don't hurt yourself. One exercise my home PT taught me was to turn a dining room chair sideways to the table, put a stiff pillow on it to make it a bit taller, then sit down slowly while holding on to the table. If it started to hurt I would stand back up and move my foot a bit farther out and try to sit again. I did not have a bilateral, so was just working on one side. But after sitting for a minute, I would stand back up, move my foot an inch closer to the chair, and sit again. Was surprised how much closer I could get my foot without pain by taking it in very small increments.

 

[SarahJane]

I really wish your PT made cross-continental house calls, @Slainte. The chair sitting exercise is something I'm going to be trying after I get off the computer. Sounds like it's a lot easier than heel slides, at least for me.

@MsBlue, I agree with the advice you've been given. I really shudder at the thought of doing lunges and holding them. Anything that stresses and irritates the knee is likely to lead to an angry, inflamed, and ultimately *less* flexible knee. Please promise you won't do anything where you have to force the knee. Your knees will thank you!