TKR New Left Knee . . . Check!!

[Pumpkin]

Niki,
I hear you when you say how hard it is to be inactive. The torn tendons in my foot limit walking, activity, and progressing my exercise program. My OS said you are in a box. Thanks for posting, I have good company on this journey.
Patience is the key,
Chris :happy dance:

 

[Jamie]

I did take some Advil last night with the Tylenol when I went to bed because I had already taken two hydorocodone during the day and didn't want to take more. But I am also taking 7.5 mg of Mobic every day--so not sure I should be taking Advil on top of that. I don't really know that the Mobic does anything for me and maybe I would be better off taking Advil throughout the day with the Tylenol. I did sleep fairly well with the Advil and Tylenol combo last night.

Niki....since both Advil and Mobic are NSAIDs, you need to find out if it is okay to take the two together. I could not tell from the information I saw online. I suggest that you either contact your pharmacist (they many times know more than doctors about this type of thing) or call your doctor. You would be fine if you dropped one or the other too. I'm assuming there is a specific reason you are on the Mobic, though. You could try the Advil/Tylenol combo for a while and see if that worked as well as Mobic. I'm also going to tag Jo to see if she might know about the Mobic. @Josephine:

 

[Josephine]

Oh dear, I missed that. Thanks Jamie.

Niki, I'm sure that being a sensible lass you've already attended to these to two things but
- you shouldn't take two NSAIDs unless under the direction of a doctor
- do make sure the hydrocodone you are taking doesn't have Tylenol (acetaminophen) in it. If it does, be sure to add that to the amount you take extra and see that overall it doesn't exceed the daily maximum.

 

[carousel66]

Niki
first time for me online in a few weeks. Sounds like over all you are doing pretty darn good!
I am back to full time work as of Tuesday and we are at 14 weeks right???
My knee still swells from time to time, and is often stiff after sitting.
I had a very active vacation and am experience more IT band pain and lower back pain. I'm going to check in with PT next week and get back to doing my stretches and get back to my core body work. Today I will be fitted for new orthotics I hope that will also help.
I had to stop taking Tramadol as it make me motion sick when I rode or often even drove in a car. So I'm now on just anti infams with some Vicodin as back up when I need it (1/2 a 5/500 tab) I should try using Tylenol and see if that helps.
Happy new year!

 

[editor98]

Well, I haven't posted anything in more than a week because I just felt like I couldn't come up with anything positive to say. But I have learned some things this past week that I think might be worth sharing.

My regular PT was on vacation last week, so I saw two different PTs. I already told y'all about the PT on Tuesday giving me some new stretches for flexion. On Friday last week, my PT was the owner of the facility. I was nervous when I got there and saw that I would be seeing him because a couple of weeks ago, I saw him really hurting a guy who was about 4 or 5 weeks out from TKR--so much so that they moved into an exam room so that others wouldn't see! So I was all ready with my "you are not going to hurt me" speech when he came to see me. But much to my surprise he looked at my knee, did some very gently touching of the kneecap, and said, "You have got to get this swelling down. This is not what I expected to see." You know how much I have been complaining about feeling like I am not doing anything and always being told I'm doing too much--well, he tells me that I really can't be on my feet for more than about 10 or 15 minutes at a time! Excuse me?? He tells me that I shouldn't be grocery shopping or making dinner--too long on my feet. (About 2 days earlier I had just told my daughter-in-law that I think I can start doing the grocery shopping and making dinner again.) So I came home really feeling dejected (hence, one of the reasons I haven't been posting).

But I thought, okay, I'm going to give this a try and see if there is any improvement. So since last Friday I have really made an effort to stay off of my feet and ice and elevate more. I have not been to the gym at all to ride the bike or get on the elliptical (since that is more standing). The only thing exercise wise that I have done at home is the flexion stretches every two hours (setting my alarm to remind me). And by the way, Jo, you were exactly right--10 reps was too many! That first day I gave up in the evening and didn't do the last two rounds cause it was just too much. So now I am only doing 5 reps every two hours. So that is about all I have done other than stay off my feet. The first couple of days I didn't think there was really much change, but over the course of a week it has made a big difference! The swelling really just looks only slightly better on the outside, but it feels so much better on the inside!

This week my regular PT is back. Today he measured me and my flexion without trying was 105 and with a little help was 110--five degrees better than last week and about 12 degrees better than when I last saw my OS 3 weeks ago when we discussed the MUA and Dynasplint. So today I'm feeling encouraged (upswing on the roller coaster ride). I see my OS next Thursday, the 12th, which is when we are supposed to decide on the MUA/splint. I am feeling better that I'm not going to need either one. 110 degrees is definitely not enough for me though--still having difficulty with going down the stairs without turning slightly to the side. I would think that for all of the things that I would like to get back to doing, I will need about 125 or 130 degrees. I hope that's possible.

So my biggest lesson this week has been LESS IS MORE most definitely. I know everyone has been saying that all along, so I guess the lesson really has been that even though I have felt like I have been doing nothing, I was still doing too much! :rolleyespink:

I also told my PT today that if when I see the doc next week, I don't need the MUA or the splint, then next week is going to be my last week of PT--at least for a while anyway. I just want to try it by myself for a while and see how I do. It literally takes me about 2 days to recover from PT--mostly swelling and stiffness. So maybe things will go more quickly without having to recover every couple of days.

Still "a long row to hoe" for me I think, but at least for today, I'm feeling better about how things are going.
Niki

 

[Mimi]

Niki, this is a blue ribbon day for you, an Epiphany day for sure. When we truly "listen" to our body, it will improve our recovery . You are just beginning to know the meaning of MORE is LESS and LESS is MORE!

Whatever your activity level was before the surgery has to be put out of your mind untill you are fully recovered. And that will be months from now. You are finding out that you can not rush or speed up this recovery, it will come at its own pace and you will follow. :wink1:

I think that you will see the swelling decrease and your ROM increase when it does. You are not controlling these two processes. You are in control of your activity level. As this activity becomes less and you rest the knee more, it will heal and release that swelling and the ROM will be free to increase. This is what I found to be what worked best for me. It took me awhile to "get it" but when I did, things improved well. :yes 4:

At almost 9 months, I just started to work out twice a day on a stationary bike for 10 minutes each time. My goal was 15 min. 3 times a day. BUT, my knee and body said NO to that. So I backed down to 10 min. twice and day. That is all the stamina I have right now and my knee is happy and not swelling. And my ROM just took a big leap.

As for steps they come when the knee is ready to function on the steps. I am just doing steps well and that has taken over a month to get it down well.

Niki, listen to your body and don't push it hard. Gentle and easy will get you healed in time. PATIENCE and TIME are your FRIENDS !

I am so very happy for your breakthrough. Sometimes, it takes getting our minds in the same place that our new bodies are in to see our recovery and progress. [/SIZE]

 

[Dhare63]

Mimi, great advice! You are very wise!

Niki, I stopped going to pt when the OS decided on ordering a splint. That was three weeks ago. The splint didn't arrive until today. During this time, I have been doing gentle stretches, quad sets, and riding my recumbent bike everyday for 30 minutes. I stopped using the cane 2 weeks ago and have been feeling much stronger. I still am missing extension but at least from a functional standpoint, I feel better. I believe that the less is more approach is where it's at. I will try the splint and see where it takes me, but no more heavy pt.

I wish you all the best. Keep the faith and you will get there!

Dawn

 

[Jamie]

Niki.....I'm so happy you have finally embraced the "less is more" concept. I know it's difficult to realize how much activity you're doing each day. It probably does seem small compared to your normal life.

But, as we always say....every knee is different. And now you've discovered what this one needs to improve. I agree that you can probably go forward on your own now.

Good for you!!!! Hope the good news continues!!!

 

[Josephine]

Better late than never! :th_heehee:

 

[editor98]

Better late than never! :th_heehee:

Ha, Josephine, that made me laugh! But I'm sure I will still have issues in the future with this activity level thing. I think Mimi hit it exactly on the head when she said, "Whatever your activity level was before the surgery has to be put out of your mind until you are fully recovered." That is what I am having trouble doing. I think I'm afraid that I may never get back to that activity level.

Dawn,
Good luck with the splint. Is it the Dynasplint that you have? I'll be interested to hear what you think of it since that may still be in my future.

Anyway, I do feel like I kind of turned a corner this week--mentally at least. I appreciate the support and encouragement! Niki

 

[Mimi]

"That is what I am having trouble doing. I think I'm afraid that I may never get back to that activity level."

Niki, you will get back to that level and probably exceed it. However, you have to take care of the business at hand now. This is your healing and recovery time. After a full recovery you will surprise yourself at what you can do. Stop fighting yourself and do what you know is right to heal this knee. Stop setting a time line and you will move forward faster. One day at a time holds so true for these knee recoveries :yes 4:

Today I walked 2 miles on the boardwalk at the beach. We had an unusually warm day here. No pain and no swelling. I am not totally recovered, but my knee is ready to walk for miles! This is something that I could never do prior to surgery. I had months after surgery with quads that did not work at all, and I thought that I may never walk again. PATIENCE and TIME and it will work for you too!

 

[Dhare63]

Niki, sweet picture!

The splint I have is a JAS splint. It's one that is custom fit, it's worn 30 minutes at a time with increasing resistance, a few times a day. I haven't started using it just yet, tomorrow most likely. I will keep you posted. I had the MUA and now the splint, so if you get to this point, I will be a good sounding board. My hope is that you won't need to go that route.

I think with time, you will see improvement. Athletes are used to training to get better, and action relieves anxiety, but in this instance, less really is more. That's my new mantra!

Keep us posted!

Dawn

 

[editor98]

Mimi,
You have been such a mentor for me through this whole thing. I know your recovery was tough--even more so than mine. And look at you now! By the way, love seeing your picture so I can now "know" you a little better. (Beautiful babies!)

Dawn,
Yes, I do remember reading on your thread that it was the JAS device. I'm sure if I have to go that route, I will be picking your brain. My OS seems to be pretty conservative, so I think he would probably go with the splint before the MUA if he thinks I need to do something. Guess I'll find out on Thursday.

On another note--in the "out of the mouths of babes" category. Yesterday I was sitting in the family room wearing some of those nylon mesh athletic pants (my new uniform) with my legs propped up on some pillows on an ottoman. My three and a half year old granddaughter comes over and points to my left knee and says, "Mimi, is that your knee with the boo-boo?" I say, "Yes, it is." She says, "I could tell because look how round it is!" This was through my pants! Do you think I might have a swelling issue???? :hysterical:

 

[Mimi]

Thanks Niki, you have a real cutie too! My grandson is aware of my "boo-boo knee" too. When he wants me on the floor to play, he remembers the reason why it is hard for me to get on the floor and up again..."the boo-boo knee."

 

[Mountain Kat]

On another note--in the "out of the mouths of babes" category. Yesterday I was sitting in the family room wearing some of those nylon mesh athletic pants (my new uniform) with my legs propped up on some pillows on an ottoman. My three and a half year old granddaughter comes over and points to my left knee and says, "Mimi, is that your knee with the boo-boo?" I say, "Yes, it is." She says, "I could tell because look how round it is!" This was through my pants! Do you think I might have a swelling issue???? :hysterical:

I think if a 3 1/2 year old notices your swelling that you have definitely been doing too much! :th_heehee: I am so glad you are beginning to see improvement though, that is great news! You will get there, your path just had a bit of a detour.

 

[editor98]

16 weeks tomorrow. After all of that time I spent in bed with the fracture, it is really hard to believe that I've been walking for 7 weeks already! Things are still pretty slow going. I think I'm getting used to it--or else I'm just resigned to the fact that it's going to be that way.

There are definitely very small signs of progress--up to 22 minutes on the bike and able to peddle fast enough now to keep the bike electronics going ; I am walking my dog to a park to let her run around some, probably about a half-mile round-trip walk; I'm looking more like a normal grown up on the stairs, even going down, I don't really have to turn sideways anymore; muscle strength is good; today I did an ab workout for the first time to at least make myself feel like I'm working out for fitness instead of rehab :hysterical:. I think that's about all of the progress I can think of! ROM is still barely moving along. Still 105 on my own and about 110 with a little push from the PT.

Saw my OS this past Thursday. He agrees the ROM is not great, but he is willing to give me another 4 weeks to see what happens. I was hoping to quit PT, but he wants me to continue until we reevalute when I see him again on Feb. 9th. We are still talking about an MUA or the Dynasplint being a possibility. I asked how far I needed to get in the next 4 weeks to avoid that and he said he thinks 10 degrees would be good. That would take me to 115--and I still don't think that is going to be adequate for my lifestyle. OS said he would be leaning toward the Dynasplint if it comes to that, but I told him I would rather have the MUA because that is over in 5 minutes as opposed to spending weeks using a splint. He is concerned about the fracture though, I know, so we'll see.

My PT was disappointed to hear that we're waiting another 4 weeks. He thinks I need the MUA and just wishes my OS would go ahead and get it over with. He doesn't think my issue is really swelling (though he said there is some, especially in the back of my knee). He thinks there is A LOT of scar tissue and waiting for swelling to subside is not going to make much difference. I think there is definitely quite a bit of swelling, but I also think there is quite a bit of scar tissue. My knee is not puffy like swelling; it is hard and thick like scar tissue.

One funny thing did happen at the doc's office. He was telling me that I should take two hydrocodone before going to PT (I take one), so that my PT can push me a little harder. He was saying that with the PT I can give him feedback about when to stop, but with the MUA I'm out so there is no feedback from me. He's kind of demonstrating the MUA with his hands and he goes, "And I know how to break a leg." I just busted out laughing and said, "I know you do!" I think he forgot who he was talking to!
Niki

 

[Dhare63]

Glad you posted Niki, been hoping to see an update. Your OS and mine approached the rom the same way, mine gave me 4 weeks and said if not better, we would go straight to the MUA. I felt like I had to "perform" and he also suggested the extra meds so the pt could really push me. That was not the answer in my case. I did need the MUA, no question. No amount of pushing would have broken through the scar tissue. The OS said during the procedure there was a very loud pop, and that was the scar tissue giving way. He warned me that he could break my leg but it was highly unlikely. I know you have already been there and done that, but hopefully the OS has the skill to know when to stop pushing.

Let's hope you can find the extra movement. Keep on with the bike, I know it helps keep me freed up. Be cautious with the extra pushing, it will make you swell.

Have you tried massage therapy yet? That might be worth a try, it always helped with my extension.

Funny how quick the OS forgot who he was talking to! Sounds like you have a good relationship with him, and that is great. Keep us posted, hoping you keep seeing improvement!

Dawn

 

[Mimi]

Niki, good to hear from you. Sounds like you are moving forward at your own pace and that is a good thing.

Your ROM is 115 at 4 months, I think that is good. I was 118 at five months when I left PT. I haven't been measured since, but I know the ROM has increased greatly cause I can place my foot way under a chair and even under a rocker and rock away! They are things that my 118 did not allow me to do. When I do that now there is a little tightness but no pain at all. Now this is at 9 months, not 4 months. You to will get there in time. I hope that you don't need a MUA or a dynasplint . You need TIME and PATIENCE and it will all come to you. :yes 4:

One thing that I thought of about your break. Have you been checked for osteoporosis? Have you had a dexa scan of your bones? It just comes to mind to me because I am checked each year because I have had thyroid and parathyroid problems. I would not want to see you go through another break if a MUA is attempted. :skeptical:

Take Care, Mimi

 

[editor98]

Dawn,
I have gotten my PT to do some massage therapy on my knee the last couple of times. I kept asking him why I never get to do any of the stuff that feels good, so he has done some massage the last couple of times. I don't really know if it helps with anything, but that five minutes feels like HEAVEN to me! And I'm with you. I think if I need to do something, I would rather do the MUA and be done with it. What was the recovery from that like? Did you have a lot of swelling, and if so, for how long? I'm still having a swelling issue from the surgery, so don't really know what the MUA will do for that.

Mimi,
Yes, I've had a couple of bone density tests before--maybe 4 or 5 years ago. But with the possibility of an MUA looming, my OS wanted me to have another one. Had it on Friday and got the results today. It is fine. There are no issues at all--so that is not what led to the broken leg. My ROM is at 105 now--definitely not functional for me. He wants me to get to 115 in the next four weeks, but I don't think that will really be functional for me either. We'll see what happens. I am continuing to do my flexion stretches every 2 hours, and riding the bike, but that's all I'm doing at home. I'm also walking a few blocks with my dog every day, but that's it. I've cut back PT from three times a week to twice a week. Still icing and elevating lots.

Overall I think I am feeling less impatient than I have been in past weeks. I'm just realizing that this recovery is going to take a long time and there isn't anything I can do about that. I kind of just feel resigned to taking what comes and not thinking about what might have been. Progress of a sort, I guess.
Niki

 

[Mimi]

Niki, at four months I was just one month into my quads working. Honestly, I could not see past each day at that point. Things were moving in slow motion up until then.

You are making progress, it just isn't what you had in mind. Sometimes our minds are programmed in a different mode than our bodies. You have found this out and you are dealing with it now. You have come a very long way since the break and all those weeks in bed. Everything you are doing will improve your recovery. You are doing a great job