Gail,
I don't know if this perspective will help or not. If I remember rightly you have both Crohn's Disease and fibromyaligia. Crohn's is an autoimmune disease and fibromyalgia is not well understood but possibly is the result of irregularities in the immune system. But both are highly inflammatory diseases and respond severely to stress. So even pre-TKR your body had a lot of inflammation going on. I know some people with fibro can hardly stand even light massage. So you went into TKR inflamed and are now even more inflamed and the whole surgical process is stressful both physically and mentally. I am not saying this to make you feel bad but to help you improve your arsenal of things with which to reduce inflammation and reduce stress, which may help your PT. If you go into PT, worrying about hurting and that your ROM won't improve that will make you stressed and tense; neither of which will help. So some of the following might help you reduce the inflammation in your body as a whole and bring your stress level down and that might make you more comfortable over all and better able to do the PT.
I don't know if you practice any of these things or if they interest you but the following might help you over the long term (none are short term solutions):
- Meditating to help with pain and to calm yourself; you might do this just before PT as well as other times of the day (this is not a substitute for your pain meds), but the calmer and more relaxed you are before PT the easier it will be
- Progressive relaxation exercises might help before PT. This is where you tighten and relax each muscle group in the body. Start at your feet and work your way up to your head. There are CDs out there that you can get that take you through a progressive relaxation program. I do this at night and it helps me fall asleep as it is deeply relaxing.
- I know your diet has to be bland for the Crohn's disease and I really don't know what you can eat, but eliminating the foods that tend to cause inflammation in the body might give you some overall relief from inflammation. Particularly, all forms of sugar, white flour and white flour products, highly processed foods, artificial sweeteners, red meat, saturated fats. If you can only get rid of some of these it might help calm the inflammatory response that is going on in your body.
- Have you ever had your C reactive protein (cardio-CRP test) measured? That shows you how much inflammation is going on in your body. Once you are less inflamed in your knee you might want to see what that number is. A good functional medicine or integrative medicine doctor could help you design a holistic program to bring that number down.
- A good supplement that might be worth looking into is L-Glutamine. It is very useful for calming inflammation in the intestines. I started taking this for leaky gut several months ago and I cut my cardio-CRP by 50%.
These are just my thoughts. I know when you are trying really hard and want something badly, that sometimes it makes it more elusive. I don't know how knowledgeable your PT is about the medical conditions that you have, but you might want to discuss the fact that they are both conditions that are inflammatory and responsive to stress and she if she has any thoughts of how to make PT more doable. You guys may have to brainstorm some and "think outside the box" to come up with something that works for you. But you will make progress and it may come on a day you least expect it. So don't lose heart.
One more thing. Both water walking and lymphatic drainage massage are excellent for reducing swelling. I found a massage therapist who practiced that modality and had one massage a week and it helped phenomally with the swelling; my PTs were thrilled. The pressure of the pool water also acts as a lymph massage too and that is why it helps with swelling too. Water exercise might aggravate your knee less than some of the other things you are doing.
United States
