TKR New brand new Knee

[leejaa]

knees if you have such a leg length discrepency - have PT measure it and ask them about a shoe lift till you have the other knee done. My in home PT checked me out after the first knee replacement just to make sure I did not limp due to anatomy of my bad knee.

 

[knees]

Thanks leeja I will ask my pt. I have thought about buying heel lift off amazon. Maybe that's an answer. nana yes anti inflamatories would help I'm sure. I also found a heating pad helps too. Nothing really makes it completely go away but it does help.

 

[Mazza]

Really feel for you as I was going through the same torment until only a few days ago. I am just 16 days post surgery and can identify with everything you say - apart from comparing my surgeon with yours!
Everything you can read on here is so true and the best prompt I received was to stop beating myself up and just concentrate on what my body is telling me.
Since doing that I have improved no end. I was impatient to think that I would get through everything without much trouble, but that wasn't the case. I cut back on the PT to just doing what I can and have progressed to walking without sticks in the past couple of days (just around the house). When I'm tired I sit down and elevate my legs.
All our bodies are tailor made differently, we are different ages and have different levels of pre-existing fitness, so how can any surgeon or PT expect the same results from patients. We are all individuals. You will be OK

 

[knees]

Tmwilla I am 5 weeks and I just now am able to bend to 95 with a lot of pt pressing. It's been slow and hard for me. Some of us it just takes awhile. It will come

 

[GraceV61]

I am 7 weeks out and just got to 115. Was stuck at 95 for a few weeks. Was 15 out of surgery! Progressed to 70 within 3 weeks. You will see, things will dramatically change. M MUA usually not done for quite q while if flex is below 70. Hang in there.

 

[referee54]

I am 7 weeks out and just got to 115. Was stuck at 95 for a few weeks.

Yes---there are these "plateaus" that many of us experience---sometimes we then move forward and, on occasion, sometimes, for some unknown reason, we digress a little. Recovery take some time---up to a year, so there is nothing to worry about---but that does not stop us from worrying!

 

[Josephine]

TM, I am probably going to repeated most of what's already been said but bear with me as I will be saying things that are very important.

the orthopedic surgeon examined my range of motion, particularly how far I could bend. (70%). He was very emphatic that my progress was not even close to what it should be and that I should be at least at 120% flexion.

It's very wrong that your surgeon should be so hard on you this early out in your recovery. There is no "should be". At less than three weeks, it's very common and expected that a knee won't be doing much bending for the simple reason that it's swollen. Swollen knees cannot bend. Read this and see why Swollen and stiff knee: what causes it?

emphasized that I needed to stick to a schedule of 1 Norco every four hours despite having little pain for a good part of the morning and afternoon.

In this he is absolutely correct! You may think you have 'little pain' because you are comparing it to the bone-on-bone pain you had before the op. But this is different. Post op pain also includes soreness, burning, stabbing, throbbing, aching, swelling and stiffness and these should be medicated religiously.

He wants to see me in three weeks and if I haven't met my goal for flexion, he wants to do manipulation under anesthesia. He added that I should want to avoid that at all costs because there is a risk of fracture or damage to tendons which would require additional surgery.

A risk certainly but only a theoretical one. I have been present at dozens of MUAs over the years and have never seen anything like this happen - actually never even heard of it happening. A good surgeon would have the skill to manipulate the knee without this. He is just trying to scare you into doing the exercises and being obedient but more on that later!

He repeated several times that "the window" to achieve optimal range of motion is closing quickly and then I will make no further progress.

This is also untrue and has been proven untrue in many studies carried out by experienced knee surgeons. Plus countless BoneSmart members have reported increases in their ROM even a year after surgery. The "window of opportunity" does not exist!

I confess I am afraid of antagonizing my orthopedic doctor but I am really fearful about the manipulation if I don't reach my goal for him.

Now hang on - who's paying whom here? (I trust you are an US citizen - you haven't added that in your profile). But you employed him to do this surgery and now you're going to let him boss you around and bully you? Don't you have any of it!

Another thing you need to bear in mind: he cannot just do this because he thinks he will. He has to have your written consent first. And if you don't want to have this done, there is nothing he can do about it. He can bluster and go red in the face but you are not obliged to sign the consent and he can do nothing about that. If he is so bullish that he is going to behave like this, then clearly you chose the wrong surgeon. That's why they call us the 'caring profession'. We're supposed to be caring!

And a third thing - you are not reaching this goal for him - you're doing it for yourself! Get it?

The therapist and surgeon have both told me I have a very low pain threshold. I didn't know that about myself.

Which by implication means that all this is your fault! Oh please, please don't fall for that one! It is not your fault, it's their fault as they are pushing you - and your knee - much too hard. It's unnecessary and counter-productive and is the cause of everything he is blaming you for. Don't forget that! His fault, not yours!

New question- since surgery my right butt cheek is numb and I have pain in my lower back and thigh on that side which have really added to my inability to find a comfortable position lying down

Take your pain meds! This is all referred pain from your knee, believe it our not.


So now I have some questions to ask you:

1. what are your pain levels right now?
(remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget that 'pain' also includes soreness, burning, stabbing, throbbing, aching, swelling and stiffness)

2. what pain medications are you prescribed, how much are you taking (in mg please) and how often?

3. are you icing your knee and if so, how often and for how long?

4. are you elevating your knee and if so, how high, how often and for how long?

5. what is the detail of your daily activities? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

6. what kind of PT/exercises are you doing? How much and how often? Details would are required!

I'll be back shortly to see your answers!

 

[tmwillia]

Wow,
Thank you all so much. I feel better this afternoon than I did yesterday, and also more hopeful. I appreciate all of the thoughtful advice and I'm going to try really hard to heed it and not let my surgeon dictate the course I take.

I did one 'set' of exercises today, which consist of both standing and seated 'marches' where I draw up my knees one at a time, slow motion lunges, which just seem to be a stretch and standing and sort of (trying to) kick backwards. (The pt wanted me to do three sets a day)
Then I iced while lying in bed using a polar ice machine and elevating my leg on a pillow from my hip. I only iced for about 20 minutes then had to get a sweater and hot coffee to warm up.
For pain I'm taking Norco ( 7.5 mg. hydrocodone-325 mg acetaminophen) every 4 hours. Plus 5 mg. valium every 8 hours.
I am in the US. , Schaumburg, IL to be precise. My surgery was at Alexian Brothers Hospital by Dr. Daniel Koutsis. I picked him because he has literally done thousands and replaced both my dad's knees. My dad bounced back like superman even when he was 80. I'm 57 and feel like a bit of a disappointment.
I walk around the house unassisted, for the last few days and do a little tidying up or put dinner in the oven.

I'm not good at laying around and feel guilty when my family is vacuuming or doing laundry and I'm not, but I'm working at not being an idiot.


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[tmwillia]

Oh my pain is at 0 in the am and by 6:00 in the afternoon its about 8. Thats with taking the pain pills on a schedule.


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[referee54]

'm 57 and feel like a bit of a disappointment.

Don't feel that way. we all heal differently and at differnet schedules, so each person may take longer than others.

Never compare yourself toanybody else, as you are unique, so is your healing.

 

[tmwillia]

New day new misery
So today is three weeks since surgery. My ortho says i need intensive 5-day a week PT. I had an appointment today for a PT evaluation. My flexion is up to 79. I explained at PT that since I am not allowed to drive, I cannot get to outpatient rehab. I have family members available three days a week. The PT lady said that seems fine as long as i really do the rehab on my own on the days i cant get there. The OS' physician assistant had a fit. She insists that i must go 5 days a week. I looked into taking a cab and it would be $60.00 round trip. Multiplied by however many days i don't have a ride. So it simply isn't going to happen.
Then the PT says i need to be doing the exercises every hour all day long. Is she for real? Im so tired I'm in bed already before 8:00 pm. Im just waiting the extra 30minutes till i can take my pills and sleep.



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[referee54]

She insists that i must go 5 days a week.

I honestly believe that five days a week of intense PT is counter-productive. I did two days out-patient after my BTKR, and , along with a light day of stretching, riding the bike, and a sauna (still more stretching) I did just fine.

Then the PT says i need to be doing the exercises every hour all day long. Is she for real?

Real--I think that your PT is really, really too intense. They are expecting you to do too much, too soon.

 

[tmwillia]

I honestly believe that five days a week of intense PT is counter-productive. I did two days out-patient after my BTKR, and , along with a light day of stretching, riding the bike, and a sauna (still more stretching) I did just fine.


Real--I think that your PT is really, really too intense. They are expecting you to do too much, too soon.

I believe you. But i feel so badgered. The OS ordered some kind of fitted knee brace that has a way of bending my knee. I am being measured for it tomorrow. My husband and son are trying hard to be supportive but believe my best interest is doing as the OS says.
At this point, i don't even care if the knee ever bends, i just want to sleep.
I don't think there is any way to stop this roller coaster. I appreciate the opportunity to be a crybaby. Im sure the PT is going to get easier.


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[Tykey]

I believe you. But i feel so badgered.
I don't think there is any way to stop this roller coaster.

Oh yes there is! But it's a decision only you can take.

You've had lots of advice from people on here who have all been through it, you just have to be brave and take it.

Good luck, be assertive and take control, you'll be ok if you still do the exercises, but on your own and gently.

 

[maggie may]

Are these people insane?!? I just found your thread and cannot believe you are being put through this downright torture. Please do yourself a big favor and discharge yourself from this OS.
Go to your GP if you feel comfortable with him or her and he can advise on Meds PT etc.
what you need most now is to rest and heal. Ice and elevate. Perhaps therapeutic massage from a chiropractor or PT for your sore body. Just think how out of balance you have been walking and how that affects your lower back and butt muscles.
Take your time!!!
You are doing great!


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[knees]

Oh my gosh you are only 3 weeks! That is crazy how they are treating you! At 3 weeks I think I was around 80 and now yesterday they got me to 97 and I am 6 weeks now. It just takes time for some of us. I go to pt 2 times a week and do my exercises once or twice a day. I can't believe you are being pressured at only 3 weeks!! I go to my os this Thursday I sure hope he doesn't give me any grief :(

 

[Pjmc]

Two weeks out and your surgeon is wanting more from you . No ! They cut bones what happened to letting bones heal ? Also I actually asked for muscle relaxers and the nurse said my dr would not give them until after three months . Reason was he wanted me to use those muscles not relax them . I have spasms at night . I had som Valium and took one for a few nights just to rest . My legs are painful at night .

 

[tmwillia]

Are these people insane?!? I just found your thread and cannot believe you are being put through this downright torture. Please do yourself a big favor and discharge yourself from this OS.
Go to your GP if you feel comfortable with him or her and he can advise on Meds PT etc.
what you need most now is to rest and heal. Ice and elevate. Perhaps therapeutic massage from a chiropractor or PT for your sore body. Just think how out of balance you have been walking and how that affects your lower back and butt muscles.
Take your time!!!
You are doing great!


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We moved here because of the proximity to the surgeon. He did both my dad's knees and had such a good reputation and seemed so reasonable I thought there could be no doctor better. I have an HMO insurance plan which only allows me to choose a new primary care physician and network of specialists once a year. I don't really know her very well and truthfully she doesn't seem like a doctor who would 'take over' my care from the OS. I'm going to try to work with my OS. I did my exercises at home today. 4 sets, not once an hour as directed, and for the most part I feel like I did pretty well. Also feel a little rebellious...
The representative for the hinged knee brace came and measured me for the brace that should be here in a few days. He told me it needs to be used 30 minutes 3 times a day but only to the point of feeling stretch, not to pain. That sounds more doable than what I had been told about how painful it is. I really want to have a positive attitude about it.
Reading other peoples stories on this forum, about what they've gone through really makes me appreciate that at least I didn't get an infection or have to have multiple operations. I do think I will draw the line at MUA, if the OS brings it up again. I think I will be satisfied with a slower recovery than he will like, or even less flexion than he wants.
Thanks to everyone who has written in with support.


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[leejaa]

Most muscles need some downtime in between exercises and PT to really recover. You cannot push the body constantly without some rest time. This was told to me by my in home PT. I have never been above telling whomever that yes I did it yay often and go my own way to make sure my knee got rest and I had time to ice and elevate and keep the swelling down. Really worked for me. I was told often with the first knee that I must be working really hard and at the end I told them - really not.

 

[maggie may]

Oh, goodness, I didn't mean to sound so hostile. It's just that I feel so bad for you !
Please take care and I know you will do what is best for you.
Just give yourself time to heal, ok?
Best to you!