TKR New Left Knee . . . Check!!

[carousel66]

Hang in there Niki
I find that recovering from this surgery there are many ups and downs it is not a slow steady incline of recovery it is full of jagged peaks and valley's of progress than back sliding, sometimes there seems like great leaps fwd are followed by falling back then slow progress forward, then stalling then all of a sudden big leaps forward. :biggrin:
And then you have taken one of the most unique paths through TKR :skeptical: - one I know you didn't choose!!!!!
I keep thinking that your body is going to come through for you. You have only been walking for a short time and your body is trying to catch up. Swelling makes a huge impact on our ability to flex. A good and bad day for me can change my measure by 10 degrees. (related to swelling)
I hope you have good news from your doctor. If I do not get online on thursday I will try to catch up on Monday or Tuesday.
I'm very glad to see an update! thanks!

 

[editor98]

Saw my OS today for the first time in 4 weeks. The last time he saw me I still was not walking and rode into his office in a wheelchair. Today I walked in without any assistance! Had some more xrays (I think I will soon be glowing in the dark!). My fracture looks very different than it did on the xrays 4 weeks ago. There are areas that you can no longer see. I did ask to see the previous xrays cause I just didn't remember the fracture being as big as it looked on the last xrays. So he showed me the xray that was taken in the hospital the day of my surgery, and the fracture was the same size back then. I guess I was too drugged to notice how long it actually was! It is probably about 3 to 4 inches, where I thought it was only about an inch and a half in the beginning. At any rate, the fracture is fine.

We discussed my ROM and how concerned my PT is about my flexion. We talked about the Dynasplint and about an MUA. He is not ruling out those possibilities at this point. But he said he wants to give it another 4 weeks and see how it goes. He feels confident that I'll be able to get there without those interventions. So he gave me an order for 4 more weeks of PT. He also told me to take a hydrocodone before PT. He said that the more relaxed I'm able to be when my PT is stretching me, the better the results will be. So he thought the hydrocodone before PT instead of later that night would be a better plan.

I asked him if after four weeks I haven't made much progression, which way would he be leaning--the splint or an MUA. He said he would probably recommend the splint because he really doesn't want to be applying torque to my leg since I've had the fracture. Although he did say he would feel better about doing an MUA a month from now rather than now. My thought is that if I haven't made sufficient progress by then I would rather have the MUA (which is over in a heartbeat) rather than wear the Dynasplint for 4 to 6 hours a day for a month or more. I just spent 9 weeks in bed--there is no way I can be confined to a device for 6 hours a day for another month or more! I mean come on!

I felt okay after the appointment. At least he wants to give me a few more weeks to see how far I can progress with the ROM. One other thing we did discuss is that my surgical leg (my entire leg not just my knee) is still very red and hot compared to my other leg. He said there is still quite a lot of inflammation, so he gave me a 6-day steroid pack that he said should help.

So I am just continuing on with one day at a time. It is sometimes hard to realize how much progress I've made when I still have so far to go. But the difference between today and even two weeks ago is HUGE! I have to try to remember that.
Niki

 

[tyncam]

Hope you see continued progress here - have you tried a couple of Mint Milanos or Cool Mint Oreos before pt - really feel these are the key to increased range of motion.

 

[Mountain Kat]

Niki, it is good to hear the your doctor expects everything to continue to improve! He understands what you have been through and knows it is just going to take time! It does seem like a good idea to take pain meds before PT to allow you to get the most out of it rather than just after as a reaction to it. I can definitely understand how you feel about not wanting to be confined again, but I don't think it will come to it! You are really just beginning this process even though your surgery was in September.

I do like tyncam's idea though - I'm sure that chocolate would help ROM!! :yes 4: In fact, I may have to try that tomorrow!!

 

[carousel66]

Niki
all and all this sounds really good, you are more like 4 weeks out than 11 :rolleyespink:

I know it means little but my gut feeling is in line with your Doc - that you are going to get there!
I will try to catch up with you again in a few days but I'm happy to hear about a good report!
Hang in there and have a great weekend! (btw I STILL take some sort of pain meds prior to PT)

 

[rubysue]

Hi, Niki - it seems like you are making progress, although I'm sure it seems so frustrating sometimes. I think you will probably be able to improve even more in the next four weeks and hopefully avoid the Dynasplint.

Good luck with your short steroid treatment. I've been on low doses of prednisone for several years for my RA and I believe it was a factor in helping with swelling and and heat in my new knee. Watch out, though, you will definitely be raiding the refrigerator! :wink1:

 

[Pumpkin]

You are making excellent progress, your ROM will come with time.

 

[karmigirl]

Niki,

Sounds like a pretty report to me. Just keep doing what you are doing, take the med before PT and I would bet the farm that in four weeks you will have improved greatly. Looks like the DR. must have seen inflammation (swelling,lack of ROM) and that is why he gave you the steroids, wouldn't be surprised if you don't see great improvment soon, that stuff works really quick.
Might be why he wants to give it more time also.

I know how frustating it can be when you either do not progress much or have a good set back. Going thru the set back myself ever since I twisted my knee and calf about a week and a half ago. I was doing so well and then on my 6mos anniversay I go and do something stupid. Well I guess in time this too will heal.

We are all here pulling for your recovery.

 

[Mimi]

Niki, what a great report from the Dr. He is listening to you and allowing you healing time and sees progress in your recovery

I had the very hot knee too. I think that the more trauma and swelling the knee has the hotter it gets. I think of it as a place where a lot of healing and repair is going on and that creates a lot of energy. With energy comes a release of heat! Well, that is just my thoughts. It will cool down when it is healed. Mine has been better the last few months. But in PT it would melt my ice downs :rolleyespink: It is a good indication of telling me I have done too much. When I over do, the knee screams heat at me to settle down and ice, elevate, and rest :hissyfit:

And I took the steroid for inflammation and it helped greatly. I am on another round of it now for stubborn inflammation behind my knee.

Remember that healing takes place when you are at rest. Allow your body to heal and be patient. That is the hardest part. Taking meds an hour before PT was an order by my PT guy and it did help. You are progressing beautifully and the bits and pieces that are slower to obey your command will progress in their time. The knee rules and we follow:wink1:

 

[Jazyb]

That sounds such a positive report Niki. I'm so pleased your OS is going to wait another 4 weeks and then take another view point. I bet in that time you will have moved on to a different level again as 4 weeks is a long time in healing power. Wishing you loads and loads of good wishes

 

[editor98]

Okay....so far I have only taken three of the steroid pills, and seriously, my leg looks better! It is less red and less hot. Is this my imagination, or could they really help that quickly?

Today I took one hydrocodone about 30 minutes before PT--and WHAT A DIFFERENCE!! I had almost no stiffness throughout my almost hour and a half workout. I am feeling stiff now (and icing and elevating), but truly my knee felt sooooo good during PT. I think it actually was bending more (but maybe that really was my imagination)!

I feel like a yo-yo....one day I'm down and depressed about how things are going, and the next I'm feeling optimistic because my knee is giving me small glimpses of possibly being normal at some point in the future. :biggrin:

Thank you so much for all of the encouragement. What a wild ride this is.....Niki

 

[editor98]

Hope you see continued progress here - have you tried a couple of Mint Milanos or Cool Mint Oreos before pt - really feel these are the key to increased range of motion.

Dale,
That made me laugh out loud! I LOVE Mint Milanos, but I have never tried Cool Mint Oreos. Adding those to my grocery list as we speak! Niki

 

[karmigirl]

Niki,

From what I know yes the prednisone can act that fast. That is why PT was so much easier because the pred was taking care of the swelling. You are probably right that your bend was better also. Less swelling=more flexion.

When you are done with the pred you may want to ask you Dr for some type of anti-inflammatory, so your swelling stays in check.:xmasmore:
I have a problem with swelling for what ever reason so they had me on anti-inflammatories as soon as I was done with the blood thinners, and I really could tell a big difference right away. Now I just take Advill twice a day and that seems to do the trick.

 

[tyncam]

Dale,
That made me laugh out loud! I LOVE Mint Milanos, but I have never tried Cool Mint Oreos. Adding those to my grocery list as we speak! Niki

Hope you enjoy them - we purchased a Keurig for the holidays last year and enjoy the Mint Milanos with hot chocolate topped off with whipped cream - it's my official "pre-workout" meal.

 

[Mimi]

Niki, so glad to hear you are feeling better.:happy dance:
I think you may be trying to play catch-up since you had to lay low for so long. I say this cause I think that I was doing the same thing. When my quads did not work for 3 months, I thought will I ever walk again as a "normal" person. That made me work harder than I should some days and I now feel that was a detriment to my recovery .I know all recoveries are different, but I feel that rest is a better healer than over doing the physical aspects of recovery.

Things ( ROM, pain, stiffness, swelling) did not greatly improve for me till all my 5 months of PT was over. About 2 weeks later my swelling went down so much I thought my knee was a prune. And with that the pain was gone one day and I did not even notice it was gone! Cause I was just so used to it always being there.

Your day is coming soon Niki, just don't overdo things. Slow and easy wins this race! :yes 4:

 

[goodasnew]

Glad to hear you're feeling more positive Niki, you certainly had a slow start but things will improve! Glad the meds are reducing your swelling and PT was easier this week. Your OS sounds good - he's not pushing you at least, and I'm sure another 4 weeks will make a big difference. Keep working smarter not harder!:santawave:

 

[carousel66]

Hi Niki
how are you doing!?
I'm taking lots of tramadol today - iced my knee 3 times today!
but loving being on vacation. Did the thing I was MOST looking fwd to on vacation a bit over 1 mile walk this morning with my dogs and this afternoon almost 3 mile walk in the desert with my dogs! The desert walk was about a mile more than I planned to? but it was WORTH IT.
I'm 12 weeks out today, meaning you are 12 weeks out in the morning!
looking fwd to hearing an update! your posts sound pretty good and I'm a big fan of pain meds prior to PT! Also thrilled to hear the steroids are helping!

 

[Dhare63]

Hi Niki,

Good report, sounds like you have a very practical surgeon who is being cautious but steady. I think you will benefit from the additional 4 weeks before taking any additional action to increase ROM.

I do understand the roller coaster analogy. Its very hard when you are up one day and down the next. I will also say its been challenging for me to manage expectations of the people around me. I spoke with my boss this afternoon and told him there may be another procedure coming up to help with my extension. He said since he saw me last week getting around so well at our meeting, he thought that I was doing a lot better. Thats code for, why can't you get back to normal and do your job 60-70 hours a week like before the TKR. Maybe thats an exaggeration, but thats how it came off. IN the end he gave me the "do what you need to do" talk and we left it at that. Grrr, super irritating. I hope that time off over the holiday will improve my attitude!

Keep us posted and good luck with the PT. I always take meds before PT and it does help a lot! I also agree with everyone else, chocolate is very under prescribed as a remedy for TKR pain!

Cheers, Dawn

 

[srn]

It's funny about the chocolate. When I was in hospital after my TKR I was feeling very down because my pain was not properly controlled and my knee was so hot and swollen it made me feel ill. My son brought me in a 'Crunchie', I ate it when he had gone and within minutes I felt like a new woman!!!!

 

[editor98]

I am making PROGRESS!!!!
PT as he's bending my knee: "Hey, that is looking better. I'm going to measure you today." Me, frowning: "Really? Oh man, you're just going to disappoint me." So he measures me at 100 with no assistance--and then with him helping/hurting :rolleyespink: me I got to 105! Really made my day cause that is 10 degrees better than the last time he measured me about 10 days or so ago. So instead of being disappointed I feel greatly encouraged. And you know, I think it really is all a swelling issue. My swelling has gone down slightly recently--instead of that "cannonball" look, I actually have a little bit of contour in a few areas of my knee now. Still can't tell I have a kneecap in there yet, but hey, I'll take a little bit of "definition." I am actually letting myself believe that I might not need an MUA or the dreaded Dynasplint after all. I have another 3 weeks before I see my OS again to reassess.

Another bit of progress--yesterday I did the grocery shopping all by myself. I went to the grocery store about 3 weeks ago for the first time, but my husband went with me and actually pushed me in the kiddie cart. This time I went alone and walked pushing the cart. The first 45 minutes felt fine. After that it got tougher and by the time I was headed out to the car I was really wishing I had someone with me to help. Door to door, round trip, it was about 2 hours on my feet. I felt stiff and more sore than usual for the rest of the day, so I iced and elevated a lot. Was still feeling kind of stiff this morning so that's why the flexion measurement this morning really took me by surprise. I didn't expect to see any improvement.

So for today, I'm feeling good and encouraged and seeing some small light at the end of the tunnel. Merry Christmas!!
Niki