PKR My Drama Queen Patellofemoral Knee
- Thread starter Jockette
- Start date
United Kingdom
OP
OP
Something to think about. Thanks, Josephine.
I usually over think things and all through this recovery I've worried about every pain and sensation and inability to do things that my friends, who had tkr's after me are able to do and I'm just plain scared that something is wrong with it and I will have to have it revised and I really don't want to do this again. I know I've read many times here not to compare ourselves to other's surgeries, but it's hard.
I wonder if I've babied the knee too much and just been too sensitive about every sensation/discomfort and held myself back.
@Pheebs52
I'm already worried about my 7 month October appointment, that my surgeon will not be happy with my rom. He wasn't too happy at my 4 month appointment, he (and I stress he) could only get me to 124, when he'd gotten me to 128 at my 10 week appointment. Are those 4 degrees so different? Especially since there was 8 weeks between appointments, I guess I can see his concern. But aren't those really good rom numbers? I know many on here would love to have them, but it didn't seem good enough for him.
I'm in the middle of a set back right now and I think my rom is only 90/95. It was much better before we went away for the weekend in July where I really stressed the knee. But I can't seem to recover from it. Celle suggested I spend time resting icing and elevating to see if I can get swelling down since that is most likely why my rom has been so poor since our trip, so that is what I'm doing.
Even though I didn't get the 128 and 124 myself, surely it indicates that I will eventually get there on my own, doesn't it?
I usually over think things and all through this recovery I've worried about every pain and sensation and inability to do things that my friends, who had tkr's after me are able to do and I'm just plain scared that something is wrong with it and I will have to have it revised and I really don't want to do this again. I know I've read many times here not to compare ourselves to other's surgeries, but it's hard.
I wonder if I've babied the knee too much and just been too sensitive about every sensation/discomfort and held myself back.
@Pheebs52
I'm already worried about my 7 month October appointment, that my surgeon will not be happy with my rom. He wasn't too happy at my 4 month appointment, he (and I stress he) could only get me to 124, when he'd gotten me to 128 at my 10 week appointment. Are those 4 degrees so different? Especially since there was 8 weeks between appointments, I guess I can see his concern. But aren't those really good rom numbers? I know many on here would love to have them, but it didn't seem good enough for him.
I'm in the middle of a set back right now and I think my rom is only 90/95. It was much better before we went away for the weekend in July where I really stressed the knee. But I can't seem to recover from it. Celle suggested I spend time resting icing and elevating to see if I can get swelling down since that is most likely why my rom has been so poor since our trip, so that is what I'm doing.
Even though I didn't get the 128 and 124 myself, surely it indicates that I will eventually get there on my own, doesn't it?
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I agree that if you achieved the ROM of 128, that it's in there and will come back. But, remember, you can not force it to come back. If you try, you just make it worse. It needs to heal and to get that swelling out. It can't bend much if it's swollen.
OP
OP
I'm not trying to force it, I'm counting on the Bonesmart way that it will take care of itself. I just wish my surgeon would admit that.
It's frustrating that it must be all inner swelling as I can't see much of it on the outside. Just the same 2 small spots that have always been there since the surgery.
Patience, right?
It's frustrating that it must be all inner swelling as I can't see much of it on the outside. Just the same 2 small spots that have always been there since the surgery.
Patience, right?
There's very little difference between 124 and 128, as you suspected. And achieving either of those numbers is perfectly OK. In fact, anything over 120 is a bonus.
I'm sure you'll get back to somewhere close to those numbers as soon as your knee settles down again.
Remember that ROM can continue to improve for a year, or even much longer, after a knee replacement, so there's no need to rush.
Once you've passed about 100 degrees, the numbers are relatively unimportant. What you can do with your knee is far more important. Function trumps the numbers every time.
Remember that you're in charge of your knee. Your surgeon may advise and even express his discontent, but it's your choice whether or not you accept the advice - and no one can do anything to your knee without your consent.
Saying no to therapy - am I allowed to?
In any case, you don't have to please your surgeon. You're paying him, either directly or indirectly through your insurance, so really you're employing him.
Your knee knows what it's doing and it's on its own agenda for recovery, not your surgeon's agenda.
I'm sure you'll get back to somewhere close to those numbers as soon as your knee settles down again.
Remember that ROM can continue to improve for a year, or even much longer, after a knee replacement, so there's no need to rush.
Once you've passed about 100 degrees, the numbers are relatively unimportant. What you can do with your knee is far more important. Function trumps the numbers every time.
Remember that you're in charge of your knee. Your surgeon may advise and even express his discontent, but it's your choice whether or not you accept the advice - and no one can do anything to your knee without your consent.
Saying no to therapy - am I allowed to?
In any case, you don't have to please your surgeon. You're paying him, either directly or indirectly through your insurance, so really you're employing him.
Your knee knows what it's doing and it's on its own agenda for recovery, not your surgeon's agenda.
SusieShoes
Former BoneSmart staff member
Your flexion is good, and what Celle is saying about function is dead on also. Is there a reason your surgeon is hung up on you attaining greater flexion? I'm curious, because my OS was thrilled with my flexion of 120. He said I would likely get more when I had fully healed and he saw me again in a year, but he didn't appear at all concerned.
The long recovery is frustrating, to be sure. The swelling can last a long time. I still have some and wonder if it will ever go away. Every person I know who has had knee surgery tells me it will. The waiting really is the pits, though.
The long recovery is frustrating, to be sure. The swelling can last a long time. I still have some and wonder if it will ever go away. Every person I know who has had knee surgery tells me it will. The waiting really is the pits, though.
OP
OP
At one of my appointments he measured my other leg and said it was 146. I guess he's hoping for that with my new knee.
I guess his concern was that in his opinion I had not progressed in 8 weeks since the last appointment. But he doesn't ask what I can do, just takes X-rays and puts my leg to an uncomfortable place and measures.
Doesn't he know that this process takes time.???
Oh, and at that 4 month appointment he happily told me I could go in the ocean. (He's big on boating.). Well, my incision may be healed enough to handle ocean water, but there's no way at this point my knee can handle trudging through the sand to get to the ocean. And the beach we go to has a fair sized sand dune to get over before reaching the sand. I had read a while back on here that sand can be very bad for a new knee. He told me that without asking how I was or what I could do.
These are some of my frustrations with my surgeon.
I guess his concern was that in his opinion I had not progressed in 8 weeks since the last appointment. But he doesn't ask what I can do, just takes X-rays and puts my leg to an uncomfortable place and measures.
Doesn't he know that this process takes time.???
Oh, and at that 4 month appointment he happily told me I could go in the ocean. (He's big on boating.). Well, my incision may be healed enough to handle ocean water, but there's no way at this point my knee can handle trudging through the sand to get to the ocean. And the beach we go to has a fair sized sand dune to get over before reaching the sand. I had read a while back on here that sand can be very bad for a new knee. He told me that without asking how I was or what I could do.
These are some of my frustrations with my surgeon.
kmak81230
post-grad
Good morning @Jockette. I have decided to think of my surgeon as a good mechanic who doesn't really have a clue about the latest thinking and methods in recovery for TKR - plus he has never had one so does not have that personal experience. I am fortunate to have good PTs who I have much more faith in for helping me in recovery. One of my PTs, after a frustrating surgeon visit, encouraged me to listen to the doc, take in what's relevant, and discard his admonitions about the need for painful hard work. I expect to have this surgeon for knee #2 and am confident he is good at putting in the implant so am maintaining a good relationship but to his recovery advice I now say "Phooey." Perhaps when I am done with #2 I will encourage him to learn more about the BoneSmart method of recovery for TKR. Some folks on here have been fortunate to have both great surgeon and PT who are on the same page in terms of gentle recovery. For the rest of us it is frustrating and confusing to get conflicting advice from so many people. I found Bone Smart about 4 weeks after my surgery when things were not going so well for me and it has made a positive difference in my recovery. And yes, I think sand and ocean waves would be something you would have to work up to - it's like lifting weights. 
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You also have to worry about the waves hitting your knee, besides the sand walking. I think it's way too early for that!
OP
OP
Yes, I thought of that, too, and even just standing at the edge of the water, when the water goes back out, the sand under your feet shifts, I'm sure I'd be in a lot if pain if I attempt to go in the ocean. Thankfully I don't like the beach so I wasn't even tempted.
But it's comments like this from him that has seriously affected my trust in him.
Everything I need to know about knee replacement I've learned at Bonesmart!
But it's comments like this from him that has seriously affected my trust in him.
Everything I need to know about knee replacement I've learned at Bonesmart!
Me, too!
Josephine
NURSE DIRECTOR EMERITA
You absolutely cannot baby your knee too much!
Well you've got to be assertive and not allow him to bully you about it. 4 degrees is nothing. Even a normal knee can change 5-6 degrees over a day.
Well, you'd hope so, wouldn't you? But it's one of those things "all evidence to the contrary"!
exACTLY!!
OP
OP
Oh Josephine, thank you for the reassurance that I'm not babying the knee too much. I fear I don't do enough activity to help it progress. But when I started taking walks in my neighborhood my knee didn't like it.
My knee didn't seem to mind the bowling I did in June and July, I don't bend the knee when I bowl, and my ball is very light and I thought the activity twice a week was good.
I am taking a break right now from bowling to see if my knee and rom will improve.
Last night when I put ice on my knee when I went to bed, it actually caused some pain on the knee so I took it off. Is there such a thing as too much ice? And I have to be careful of the ice pack itself, as some are too hard or a bit too heavy and even at 6 months my knee is still very sensitive as to the weight of an ice pack or a quilt. It's different from the previous burning of the incision. Is that par for the course at this point?
My knee didn't seem to mind the bowling I did in June and July, I don't bend the knee when I bowl, and my ball is very light and I thought the activity twice a week was good.
I am taking a break right now from bowling to see if my knee and rom will improve.
Last night when I put ice on my knee when I went to bed, it actually caused some pain on the knee so I took it off. Is there such a thing as too much ice? And I have to be careful of the ice pack itself, as some are too hard or a bit too heavy and even at 6 months my knee is still very sensitive as to the weight of an ice pack or a quilt. It's different from the previous burning of the incision. Is that par for the course at this point?
Josephine
NURSE DIRECTOR EMERITA
OP
OP
It's interesting that my knee doesn't mind if I'm walking in a grocery store. But there, the floor is smooth and I'm pushing a cart (incognito walker?!).
Keep listening to your knee and your own instincts, @Jockette , and do what feels right for your knee. You know your own body best and your knee knows what it's doing.
You've got a good, functional ROM and there's still plenty of time for it to improve.
It's still only 6 months since your surgery and complete recovery takes a full year, so you're only half way there. Your knee is still a work in progress, not the finished result.
I honestly think that surgeons have no idea about the long, slow, frustrating process that is recovery. They do a good, technical job of repairing your knee and then seem to feel "I've done my part."
Time is on your side.
So what if one of your knees bends a little less than the other? You'll still be able to function well, and that's what's important.
I think one of my knees bends about 5 degrees less than the other, but I never notice that in my daily life. I use them both equally well.
You've got a good, functional ROM and there's still plenty of time for it to improve.
It's still only 6 months since your surgery and complete recovery takes a full year, so you're only half way there. Your knee is still a work in progress, not the finished result.
I honestly think that surgeons have no idea about the long, slow, frustrating process that is recovery. They do a good, technical job of repairing your knee and then seem to feel "I've done my part."
Time is on your side.
So what if one of your knees bends a little less than the other? You'll still be able to function well, and that's what's important.
I think one of my knees bends about 5 degrees less than the other, but I never notice that in my daily life. I use them both equally well.
OP
OP
@Celle Ive been icing my knee for the last week for an hour, 3-4 times a day and going to bed at night with an ice pack and the knee seems to be rebelling, it actually hurts a bit when I put ice on it now. Is it possible I'm doing it to much at this point? It's not like that early post surgery swelling that took over but I think more the inner tight band type.
With my calf being a bit tight recently I attempted a heating pad on the back of it this afternoon. I realized that it was also touching the back of my knee so I moved it down. I only had it against my calf for about 15 minutes, and not even 5 touching the back of the knee, and oh my, my knee didn't like it at all! It started to ache and even my foot felt weird. I won't do that again!! I thought it might loosen up the calf a bit.
With my calf being a bit tight recently I attempted a heating pad on the back of it this afternoon. I realized that it was also touching the back of my knee so I moved it down. I only had it against my calf for about 15 minutes, and not even 5 touching the back of the knee, and oh my, my knee didn't like it at all! It started to ache and even my foot felt weird. I won't do that again!! I thought it might loosen up the calf a bit.
It's 6 months into your recovery and I think you could stop icing, since your knee is telling you it doesn't like it any more. Keep on elevating, if you can.
OP
OP
Alright, thank you for your advice and support, I really appreciate it! I will still take it easy and elevate for another 2 weeks like you suggested and then add activity back in slowly.
I think I should name my knee Drama Queen!
I think I should name my knee Drama Queen!
OP
OP
@Josephine I saw my chiropractor yesterday and she did some kind of pressure point release around the back of my knee, and oh my, I walked out of her office a different person, my knee felt so much freer! I think it must be similar to what yours did with you. I know I read a post the other night where you mentioned it but can't remember which post it was.
Anyway, I am so excited, it's the first light at the end of the tunnel I've seen in a long time. While I did not have an immediate drastic improvement in rom, I didn't expect to, but I am very encouraged. I expect it will take a few more times for her to do this but I think we are on the right track.
She is such an awesome chiropractor and she calls me her "less is more girl" as I respond best to her gentler treatments. That theory coresponds well with all Bonesmart stands for!
Anyway, I am so excited, it's the first light at the end of the tunnel I've seen in a long time. While I did not have an immediate drastic improvement in rom, I didn't expect to, but I am very encouraged. I expect it will take a few more times for her to do this but I think we are on the right track.
She is such an awesome chiropractor and she calls me her "less is more girl" as I respond best to her gentler treatments. That theory coresponds well with all Bonesmart stands for!
