TKR New Year, New Knee - Jan. 3, 2017<

[kmak81230]

Hope you aren't getting too much rain as Irma spreads out over the entire state. What a great place to elevate! Glad to see you have plenty of the sun screen over the scar

 

[jaschembra]

Yes, @kmak81230 zinc 50 sunscreen everyday! And I try to stay out of sun generally anyway. We have yet to have any rain. Just a little mist here and there today. Wind warning today is all. Booked a backup flight today on Southwest because we can cancel tomorrow morning if our Delta flight is running - but Delta is flying via Atlanta!

@KarriB ? So, everyone talks about how you can continue to get more bend/flex past a year - does the same hold for straightening? I'm not bad. I was 5 when stopping PT way back when... I think once I'm completely straight I will have less discomfort when standing.

 

[Celle]

So, everyone talks about how you can continue to get more bend/flex past a year - does the same hold for straightening? I'm not bad. I was 5 when stopping PT way back when... I think once I'm completely straight I will have less discomfort when standing.

Yes. Both flexion and extension can continue to improve for a long, long time.
Here's an article about extension, with several suggestions for exercises.
One of the best ways of helping extension to increase is to lengthen your stride when you're walking:
Extension: how to estimate it and ways to improve it

 

[KarriB]

What Celle says. I gained in everyway well past a year and I swear it feels like I'm extending farther when I walk now, but that virtually impossible as I'm already in negative numbers.

 

[jaschembra]

I've been getting tempted to see my OS for a visit - if anything just to ease my mind with a set of X-rays to show that everything is okay in there. I'm getting concerned because of how much discomfort/pain I still have when standing or walking (and swelling goes with the territory when I've been up for a bit). I have no pain when sitting. I don't know if it's because I'm having less swelling so I'm feeling more of the mechanics or if I'm just letting this implant freak me out. I keep hoping that one day I will get up and walk and it will feel great. This knee is on my mind with every step I take - not sure how to get rid of that! It's not the same bone/bone pain, but it doesn't feel much better than it did before the TKR - both of my knees are hurting from what seems like inflammation with some bone/bone/popping on the natural knee. I'm definitely not overdoing it as I had the same feelings while on vacation (doing nothing) and was taking the Tylenol 1-2 times a day plus Meloxicam.

I just need to keep on keeping on and be patient, right?! My knee twin and I meet at the pool and have a lot of the same tightness, clamp feeling etc. She just doesn't have the discomfort when walking/standing nor the crepitus when straightening and bending. I said, it's got to be normal right? We can't have the same bad things go wrong, so we must be normal. lol

I am still very grateful that I'm sleeping well during the night. My leg doesn't like to lift the blankets and feels heavier than the other (it is) but when I'm all set, I sleep! With that great "plus" I'm going to sign off and wake up with a better outlook tomorrow.

 

[KarriB]

I was one of those that think about my TKR all the time. If you need reassurance I think it's fine to see your dr. When I went to see my OS a few weeks ago to order my shots for the left knee I was already for him to examine my TKR, but he never looked at it! Guess I still think about it.

 

[DebM]

I still feel 'discomfort' my knees and Am aware of them when up and about. I don't often take Med's anymore, paracetamol at bedtime sometimes, so I can only assume they are still slowly improving. And certainly are much improved since before surgery.
But I do wonder if I will ever get to the stage when I don't think about them.......

 

[jaschembra]

Last week I made an appointment with the OS office. Originally it was Oct. 2 but she checked with his assistant and they called yesterday - now my appointment is Thur. I am praying everything is okay but I'm nervous as I feel like I have slid backwards. My fear and pain has made me more cautious with what I do and how I step, etc. Even today, 15 min. on the bike, with no resistance and I had pain that I didn't have a month ago. Either I've entered a different phase of healing and I just don't understand it or something isn't right. Bottom line is - I can get an X-ray and at least that will provide me the confidence that this implant is secure and as it should be. I do pray that the X-ray is good, but even if it is why do I feel like I do? My emotions are a roller coaster. I think this marathon recovery is taking a toll on my mental health.

 

[sistersinhim]

Oh no, I am so sorry you are having more pain than you were. You have been riding your horse more. Could that be adding to your pain? Is your ROM decreasing or is it the same or better?

 

[jaschembra]

Thanks @sistersinhim I really haven't been riding anymore. In fact, with vacation, actually less. I had been trying to ride 1 day per week and now it's been 1 day per every two weeks and only about 30-40 min. ROM is the same. Just increased pain. I thank God I've still been able to sleep at night.

 

[SusieShoes]

I hope you get some answers when you meet your OS. Having more pain and not knowing why would put anyone into a kind of paralysis. Is it this? Is it that? Will doing Y or Z make things better or worse? Existing in a state of perpetual not knowing is a kind of torture. Even if you find out what isn't the problem, that's better than knowing nothing at all!

I'm sorry to hear you're not riding. That's one of the greatest pleasures and you love it so much. I love to ride but don't have a horse of my own. I have to wait until visits to my brother's farm. I hope you can resume riding soon!

 

[KarriB]

I think it's good the appt was moved up. Now you'll be able to speak to your OS, have an x-ray and hopefully get an answer to your pain.

 

[Pheebs52]

(((@jaschembra))) you've had a long haul. I'm really glad the OS can see you sooner rather than later and I hope the x-ray results and the exam will be totally normal so you can just b-r-e-a-t-he! How incredibly stressful this has been for you and you've really been a trooper throughout. Sending you good wishes and healing prayers.

 

[jaschembra]

Had my OS visit today and this is what he saw (and what I felt as he completely pin-pointed 2 of the prominent painful areas ouch!)

- My bone growth onto/into my implants are completely as he would like to see them. He also compared todays X-ray to mine from April and February. He was very happy and satisfied with what he saw. Thank you God!

- He didn't say it outright, but did concur with the fact that my body is a slow healer with inflammation...

- I have Patellar Tendonitis (he pressed on the exact spot and I said that's the pain I have every time I'm up on my feet walking - whether it's 3 min. or 30 min. and while standing. He has scripted 4 weeks of PT for me. He said one of the things they will do is use ultrasound with a cortisone type gel....

- I also have Iliotibial (IT) Band Syndrome and he included that on the PT script. He showed me a stretch to do and while trying to attempt it, I was in so much pain I had tears so we stopped - but I did say, that is EXACTLY the pain I get and when/where I get it (pain goes half way down the outside of my shin). This area has been the most painful getting up and stepping to the left, or lifting to step over stuff. I had been stretching my IT band on the outer side of my thigh but this is where the IT band goes over the bone and attaches. He confirmed my band is going over bone and not the implant (he said this can irritate the IT band sometimes if it's the implant).

- I am not completely flat yet and I was asking him about that - He said - I would not worry at all about the 1-2 degrees as you are completely functional!

I am so extremely happy that my concerns were put to rest regarding the implants themselves. I can deal with some soft tissue stuff.

My question to the BS folks like @Josephine or others is: With the IT Band Syndrome and the Patellar Tendonitis is there anything I need to watch out for at PT? Things they should NOT have me doing? I just don't always trust those folks. My first visit isn't until Tuesday so I was going to search the library for some information on what I should be trying to do here at home besides rest, ice and elevate (my daily regimen anyway).

 

[Pheebs52]

@jaschembra, your relief is palpable! Though both issues are painful, at least they can be addressed fairly easily; phew! Still, what a piece of bad luck to have both issues simultaneously; aargggh! I'm thrilled to hear your bone is growing into the implant as it should and your extension makes you completely functional; yay! I'll be interested to see what Josephine or one of the other Advisors has to say about treatment for both those issues. I developed IT Band syndrome post THR five years ago, so I can relate to your pain in that area. At that time, the treatment for me was "s-l-o-w", so perhaps things have improved in that regard. I certainly hope so for your sake!

 

[KarriB]

I'm glad all is well with the implant. I'm sure Jo will be by with some advice for you.

 

[Josephine]

With the IT Band Syndrome and the Patellar Tendonitis is there anything I need to watch out for at PT?

Yes, avoid ALL PT!

It's not the exercising that gets you your ROM, it's time. Time to recover, time for swelling and pain to settle and time to heal. One thing that seems to be missing from all the PT's protocols is that all your ROM is there right from the start, just waiting for all that to happen so it can show itself. In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Exercise as in strength training is counter-productive and in the early weeks does more harm than good. Normal activity is the key to success.

 

[jaschembra]

@Josephine I think you may have misunderstood my issue as I didn't spell it out in the question I tagged you on. I am not concerned with ROM and am happy with mine. I'm also not in the "early weeks", I'm approaching 9 months. I am looking forward to PT involving ultra sound and massage techniques to work on the Patellar Tendonitis and IT Band Syndrome - I was just wondering what can be detrimental to a TKR and these issues. For example, while there is pain, they should not be working on strengthening? Or should they at 9 months to help relieve the knee joint? I'm pretty sure this Patellar Tendonitis could have very well started during the early weeks and going to PT! I've had it for several months (at least the same pain) - I just attributed to healing pain and figured it would eventually stop. Thank you.

 

[Josephine]

I'm also not in the "early weeks"

Oh drat! I meant to edit that! Sorry ...

For example, while there is pain, they should not be working on strengthening?

Most definitely not!

Or should they at 9 months to help relieve the knee joint?

They should be doing nothing - nothing in their armamentarium of treatment - to 'treat' your knee. It's much better left to it's own devices.

I'm pretty sure this Patellar Tendinitis could have very well started during the early weeks and going to PT

I totally agree with you!

 

[jaschembra]

@Pheebs52 you mentioned Bakers Cyst on someone's thread... I have them behind both of my knees and yes, my swelling is sitting in it always on my LTKR. I often think that will be the last flex degrees that I'll get - when my swelling finally subsides hopefully sometime in the year 2018, my Bakers Cyst will subside, and I'll gain a couple of flex degrees on top of whatever I gain between now and then!!

Speaking of flex... I had an official measurement Monday when I started back to PT
Natural knee 128 (I had it measured in the spring and it was 131, but a different therapist)
Bionic knee 120 cold and 124 after warmed up and stretched, etc. this is without touching it, just using my hamstrings to bend it on the table. (In March when PT ended, I was at 118, but that was me pulling it up and having some pain while trying to get the numbers). So I am very happy with my bend (even with swelling). Excited that it's nearly equal to my natural knee (although that knee is not a good example since it's so arthritic)

Straightening is another story and one that the therapist believes could be a culprit of my pain of other tendon issues.
Natural knee 1-2
Bionic knee 9 cold and 5 after warmed up and stretching (following visit it was 7 and 5 after stretching). In march when leaving PT it was a 4 at best and that measurement wasn't without me pressing down.
I know that the straighter the knee is, the better my leg feels. And I know there is plenty of time to gain straightness - but if it lessons my pain I would like it sooner reacher than later.

Oh, and PT feels that I may have developed some scar tissue that was affecting my patella tendon area so we've been doing massage on and in the area and the sensitivity has really lessened in just a few days. This area of my incision has burned and hurt since month 2. I think I would take breaking up some scar tissue over tendinitis any day.

So, yes I still have pain and discomfort when up and walking, but mentally I no longer feel like something is wrong. I feel like I'm back on this road to recovery and I'm approaching the 3/4 turn on this marathon journey at a turtles pace! That is, if you base this road as 12 months long lol.