MUA for me...I'm discouraged...and a strange pain

[need2nees]

I know there have been a ton of posts about post op pain, progression of PT, ROM, etc, but I just need to do a reality check here. At best my ROM is 79%..on a good day with pain killers onboard. Then I regress back to 70....the stiffness is constant and SO frustrating. I ice, elevate, sleep, nap, exercise (all of the good mantras) and went on my second 'outing' yesterday to the grocery store with husband while I drove one of those electric carts. Even having my leg down for that time (30-40 min) was terribly painful. Is it still considered 'normal' to have to keep taking pain meds? How about muscle relaxants? I take a small dose 2.5mg flexeril maybe 2-3 times daily when muscles get really tight. I went one day without and really felt I had a setback. I walk with a considerable limp and my PT emphasizes "try to walk without a limp!" yeah...right....

Hurt hurt hurt. Maybe my patience is wearing out, but today I wanted to just crawl back in bed and stay there. Any words of advice/encouragement??? All of you are always so helpful on this site...thank you.

 

[Billy]

I finally reached 125 degrees today after five weeks, so it is very time consuming. I feel your fustration with the knee pain ater standing, even after five weeks it is painful for me after being out and about. Every morning it feels as though it is stuck at 90, so I work it back and forth relentlessly, it will work itself out, just a long, long process, some das better than others, I always tell myself I cannot undo what has been done so I must move forward, I have no option

 

[DogLoverx3]

You're just 3 weeks out, so I would imagine an outing to the grocery store would be a lot. Your ROM will come with time, so please don't worry. We are all more stiff in the morning but that will get better with time. I know it's hard to be patient, but that's what this recovery takes. A lot of patience and A LOT of doing nothing. Yes, pain meds are still the norm at just 3 weeks. I'm almost 9 weeks and just went down to Tylenol only with the random Tramadol thrown in. I wonder if muscle relaxers instead of pain meds is the way to go.

Regarding you limp. Are you walking without any aides? No walker, crutches or cane? If there is even the slightest limp, you need to be using one of the above. The simple task of walking puts enormous stress and pressure on your knee at just 3 short weeks out from your TKR, I think you're pushing yourself. I know it's frustrating and even harder to wrap your head around 'do nothing', but it really is what's best for you knee in the early days.

If you try to push yourself, your knee or your ROM you will only serve to set yourself back by making your knee swell and hurt. As we all know, a swollen knee won't bend. I know it's frustrating, but keep up with the mantras. I promise it WILL get easier!!!

 

[dragonflywoods]

I will be 4 weeks post-op tomorrow. I can understand your frustration, as I have felt it too. Last week, I took a turn for the better. It just seemed like my knee was easier to move around and less pain. I am pretty much off pain meds, except when I go to PT or are feeling sore. PT is getting easier for me, but way far from normal. I was able to get to rom- 110 on Friday, but it was not without a struggle and can be painful. Everyday is a struggle, I feel like I have to start over every morning when I wake up, I think that is the hardest part. I asked if it was going to be like that forever and my PT said expect the stiffness for a least the first year. And the little things seem to wear you out. PT told me it's because your body is trying to heal it's self. Everybody is different and we all do things at different times. Some of the people in the hospital who had their's the same day had better ROM than me and they have 20-30 years on me. I asked the PT last week how I was coming along and she said I had a slow start, but they are seeing progress every time I come. So that gives me hope that I am working hard and getting back to normal, if I can even say that. I wonder what normal will be now? Maybe you are progressing slow too. In the beginning I would try to straighten my knee and then sit in a chair with a dog leash on my foot and pull it back every two hours, as instructed by my PT. It hurt, but I think it has helped me move along. Talk to your Dr or PT person to see if there is anything else they recommend. Maybe your pain meds aren't strong enough? I can remember feeling the same way you do, but it does get better!!! I even wore a pair of jeans today, milestone for me . I hope you get to feeling better!

 

[Nana moon 27]

Hi @need2nees I have to say this to you. We are all different in our recovery. I am now in my 6th week. My rom is 100 and straight is 7. Our recoveries vary because of the condition of deterioration that our knees/muscles were in before the op. How long we'd suffered bone on bone, our lifestyles everything! It all impacts differently! There is no right or wrong in the recovery period. I still walk with a crutch when I go out! I still do not walk far and still have to have someone with me which I find very frustrating. I still cannot drive because I know I couldn't do an emergency stop.

It is best to listen to your own body and do what is right for you personally. I completely agree with @dragonflywoods post too! I find it refreshing that someone else doesn't find it an easy walk in the park either! I respect honest posts.

As hard as it is we all need to stop comparing ourselves and learn to recognise each new thing that we do. @DogLoverx3 taught me that (thank you x) she made me think of three things I can do now that I couldn't before, a couple of weeks after having the surgery done! Boy, it helped immensely. It made me realise just how far I'm starting to travel on the journey to recovery. E.g I can walk up and downstairs without my crutch now - I couldn't do that two weeks ago!

Hard as it is, you have to have patience and do what's right for you. You are doing fine just take it one day at a time as each one will be different at this stage x x x x

Take care now
Nana moon 27

 

[hear_me_roar]

need2nees.

I think you're doing great at 3 weeks. I was about the same. I just kept working on pulling that knee towards me and made it to 130 at 6 weeks. It just takes hard work but you'll get there. Just be patient and do the P/T as hard as it is. Did you have a CPM machine after surgery? I did and I feel like that helped me so much. But not a lot of people get them. I'm a nurse and we've stopped using them at our hospital. Big mistake in my opinion but I have no say.

 

[NuNe4Me]

My OS doesnt use CPM. Personally i think CPM is too agressive for tissues that have just been: sawed, cut, stretched, glued, stitched(?), etc. The best healer is time.

I have had multiple surgeries in my lifetime. The surgeries that involve breaking/cutting bone are the most painful vs. a soft-tissue surgery. This TKR has been one of the most traumatic surgeries i have been through. A traumatic surgery such as this one will take a year plus to recover. There just are no shortcuts.

 

[bettysgone-Sept-5-2013]

Need2knees, how many hours per day did the OS suggest you use the continuous movement machine?
Thanks!
Betty

 

[bettysgone-Sept-5-2013]

Great job with 130 Rom! Congrats!

 

[1ELISEA]

Just be patient and do the P/T as hard as it is.

PT should never ever hurt! Gentleness is the order of the day along with plenty of icing. Pushing past the gentleness limit in PT will delay healing.

@need2nees
I did not even begin PT until week three and my ROM now is 135. Up until week 4, I was healing, and resting, and icing, ....and did I mention healing. Your knee has been through a lot. Imagine having a broken arm or leg; would you be doing PT at 3 weeks and pushing it to bend more? It is still healing and while swollen it won't be bending.

I had the worst limp ever; but really did not work on the limp with my PT for several months. But if you feel the need, practice walking without a limp while using your walker.

And seriously, I could not sit with my legs bent for longer than 10 minutes until about 2 months post surgery. Seems to me that you are right on track and doing fine. Just remember this mantra, "patience and rest, rest and patience".

 

[icep707]

Hang in there. Just got to be patient. Im one week out and have 12 weeks of disability. So I pictured a long recovery. I wont lose my job!! ,Over this ordeal. You have to stay positive . My meds are playing games with my stomach so im figuring this out. Other than that things have been going very well. My expectations where all over the map. And after reading thread after thread I was prepared for the worse. So keep that in mind, it could be worse. Ill be wishing you nothing but good progression. Just dont over do it and sacrifice a few more weeks to rest and to stay home with gentle PT. Nothing else !

 

[maryo52]

You've gotten some helpful replies but I don't see that you've been around to read them.

My response is . . . welcome to the Turtle Club. You will have to be especially vigilant about elevation and not stirring up inflammation. Boy, I had the same problem . . . couldn't stand to have my leg down. It was so big and heavy and hurt like crazy. My ROM never rose above 85 (until intervention). The fact that you fluctuate between 70 and 79 suggests that what's inhibiting your bend is swelling. Swelling involves fluid in between the cells. Imagine, those cells are already packed in next to each other with no space between except for a supply of blood vessels and the lymph system, and so swelling causes all those structures to be crowded and compressed, thus inhibiting blood flow as well as drainage. It's hard for tissues to heal with this kind of congestion going on.

Well, as to the pain med question . . . Replaced knees have a mind of their own. They don't pay attention to our agendas or notions. Gosh, I ended up taking 24/7 pain meds for six months, and don't recommend it, except what else was I supposed to do? I hurt all that time. The pain didn't relent until I stopped my PT routines and went on knee-cation.

Hang in there, girl.

 

[Campervan]

I was also part of the Turtle Club as Mary calls it. I did have 90 on leaving the hospital but made very little progress for months. I didn't gain ROM progressively, it would be stuck on a number for ages and then all of a sudden, WOW, it had moved. Below is my ROM progression list. I'm now over 2 years post op and generally have somewhere between 120 and 125. Would I have liked more? Absolutely! Can I do what I need to do? Absolutely! So I no longer push to get more.

Do take your meds as stiffness is also a type of pain. I only ever needed Voltaren (diclofenac) and paracetemol (Tylenol) and I tried to stop the Voltaren after a couple of weeks as I only had a little pain. But my knee stiffened up more so on Jamie's advice I started on it again. She was spot on as the stiffness then eased off. But I did feel I had tight rubber bands around my knee until about 8 months.

92 - 8 weeks post op
105 - 10 weeks
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr
120 - 1yr 2 months
125 - 1 yr 8 months

 

[maryo52]

@Campervan to the rescue!

 

[need2nees]

WOW...everyone has brought up so many good points that my outlook has improved considerably..even if my ROM has not, yet!

Betty, I was advised to use the CPM 1-3 hours daily (3 hours, really?) but have been using it for a couple of sessions daily, maybe 45 min. each. Not sure of I can say it has made a huge difference, but it does feel good at least until I turn it off and try to stand (ouch).

It is so helpful to know that I am at least in the ballpark of expected recovery...one day at a time never had so much meaning to me until I had this surgery. Maryo, thank you for affirming that just having my leg down is about as painful as walking on it. Even tho my knee doesn't look TOO swollen, (everyone comments, "gee, it looks great!") it sure feels tight and constricted.

I must focus on not being so hard on myself. Also, I have to accept that others (unless they have had a TKR) really really intend well, but tend to set up this agenda of improvement that is way too fast. The first time I heard, "gee, it's been over 2 weeks now, do you really have to keep taking those strong pain meds??" I wanted to deck them. Also, doglover, GOOD point regarding using crutches or other aid for walking. To be honest, I have been ambulating without walker/crutch/cane since I got home from the hospital. No wonder I limp. I just assumed that it was a good thing to push through it.

All of you are the best. Thank you for the sanity check and encouragement. xoxoxox

 

[maryo52]

I learned about well intentioned people from having cluster headaches. As if scripted, they'd say, "Do you think it's stress?" So during TKR recovery I knew now to whine to most people lest I get dumb comments which I was in no mood to deal with!

 

[referee54]

Hurt hurt hurt. Maybe my patience is wearing out, but today I wanted to just crawl back in bed and stay there

As others have said, PT should never hurt---you should never be in pain. PT exercises should never go beyond discomfort---and you have to remember that the PT's work for you, not the other way around.

Set up limits as to what you will do and what hurts and what does not---and if they do not like it or accept it, fire them and move on---find a PT who understands what this recovery gig is all about.

Remember---this is s slow go during recovery, and you are still in the "Dark Days" of recovery---the first four weeks are the toughest.

This recovery is a marathon and not a sprint, and successes are often time measured in tiny increments; your knee is the one that sets up the schedule, so you have to reach deep down inside yourself and find the patience that you do not know that you have---it is there.

Then I regress back to 70....the stiffness is constant and SO frustrating.

This recovery is very much like a roller coaster ride---you will have some good days, some great days, and then, for some unknown reason---you will have some stinkers, too. Just hang in there and ride 'em out.

Focus on today. Recovery can be like boot camp or basic training---do not look ahead---just get through today and let tomorrow take care of itself.

but today I wanted to just crawl back in bed and stay there

Nothing wrong with that---just take it easy and do not try to push the knee---it will push back and "go on strike." The more you try to set a schedule and say"By this time next week I will be..." the more frustrated you will get, and then the vicious circle begins, as you try to overwork your knee.

You also have to understand that the post-op depression is a reality---and most of us went through that, too. I would stand in front of the front window and watch the world go by. Have yo read this article yet?Post op blues is a reality - be prepared for it

Take care and take it easy---do not worry about the roller coaster ride---just strap yourself in (you already have!) and go for the ride---you will indeed reach that point fo being fully recovered, but it can and often does move slower than we would like it to.

 

[need2nees]

I learned about well intentioned people from having cluster headaches. As if scripted, they'd say, "Do you think it's stress?" So during TKR recovery I knew now to whine to most people lest I get dumb comments which I was in no mood to deal with!

oh boy....how right you are!! We should start a thread titled "well intentioned yet off base 'advice/comments' from others"....bet it would be a hoot to read what we have all heard!!

Here's one: "my aunt Susie was a nurse and went back to 12-hour-shift floor nursing in 10 days! Then she didn't have time to think about the pain! Distraction works!"

 

[referee54]

We should start a thread titled "well intentioned yet off base 'advice/comments' from others

Remember---even those OS's have not been through this---so often people are completely clueless as to what it is really like.

We will be here for you to vent---we do kn ow what it is like and will be here to help you and to support you!

 

[need2nees]

Tim c, thank you. I will read your post over and over again....it's full of great advice and encouragement over and over again!!