MUA Oct 2017 TKR - Hematoma - MUA - Finally past 90!<

[Celle]

I'm glad my suggestion was helpful. Even when I had taken back most kitchen duties, I found I had to sit on a chair at the sink, while peeling vegetables or doing dishes. Somehow, being able to stand still without pain is one of the slowest accomplishments to return.

 

[sistersinhim]

I, too, am so sorry to hear about your sister. I pray for your comfort, both mentally and physically. God bless you.

 

[Jockette]

My pool therapy was included in my regular PT office, and my Dr prescribed it, so my insurance paid for it. But like I said, I only went once. The water was nicely warm, not anywhere near hot. It was the only good thing about it for me. I am not a water baby either. And it was in a YMCA pool since my PT didn’t have one on site. And there were a lot of people in the pool, at least 20 or more. I was expecting a much smaller group. I couldn’t wait to get out!

 

[funkymuse]

Ok.. I've been reading on other peoples threads about this tight band around the knee. OMG.. it finally hit my knee. So what is this? I think I read that it's some sort of tissue that is working to heal and gets tighter before it loosens up again? I can't remember - (Med haze keeps my memory low).

So... do I push through this band to gain more ROM? It feels so tight. No necessarily painful just darn tight and it makes me afraid to push through it but it stops me from getting past a certain point. I feel my ROM is very low right now and would like to push a little. So is it ok to push into this tight band a little bit?

Other than that I feel that after some walking and a few heel slides that icing is crucial. I'd like to try and do a few more things today like get in the kitchen and attempt to make a protein shake. I'll try to do it. I've read about so many others who had to take care of themselves and that it helped them move forward in recovery. I also am going to wrap this knee in plastic and take a darn shower! I can't stand it! I've had one shower in 20 days due to having to have the 2nd surgery and I'm so tired of sink bathes.

So a couple of BIG activities planned for today! LOL

 

[Jockette]

That tight band is swelling and pushing through it will only make it worse.

Go ahead and make your protein shake, the accomplishment will either make you feel good you did it, or make you think it was an overrated experience. You won’t do any damage to your knee, it doesn’t take long to do, right?

Somehow your going to have to dig down deep for some patience and try to relax. You are in the beginning of a long haul. It will get better, but you are still in very early days.

 

[funkymuse]

That tight band is swelling and pushing through it will only make it worse.

Go ahead and make your protein shake, the accomplishment will either make you feel good you did it, or make you think it was an overrated experience. You won’t do any damage to your knee, it doesn’t take long to do, right?

Somehow your going to have to dig down deep for some patience and try to relax. You are in the beginning of a long haul. It will get better, but you are still in very early days.

Thanks @Jockette ... PATIENCE? Are you kidding?!!! I want it all and now! Seriously this is indeed the universal gift of knee surgery... learning patience. sigh.

Good news is that for the moment I feel like a new Woman! Just wrapped up the leg in that clear WIDE stretchy wrap people use to wrap around their furniture when they move. Hubby thought of it. Then we taped top and bottom and in the shower I went! Ah.. I could have stayed in their for hours letting the warm clean water run over me.

So far today I've had 3 walks to the Living Room and back and each one takes about 3 min.. so not much but a little. Knee very stiff but I'm working on the correct gait and using full weight on the knee but I still can't bend it as much as needed for a smooth continuous movement. I usually ice for an hour or so.. then get up and do a walk and maybe a bit of easy stretching just to get a bit of circulation into this lump that my body is becoming!!!

The ice machine is really something else. I mean it really takes pain away. It's helped me get to where I'm only taking 1-5mg Oxy every 7 hours and 2 Tylenol every 6 and I'll hold it there for awhile.

 

[Celle]

So... do I push through this band to gain more ROM? It feels so tight. No necessarily painful just darn tight and it makes me afraid to push through it but it stops me from getting past a certain point. I feel my ROM is very low right now and would like to push a little. So is it ok to push into this tight band a little bit?

Here's an article about the tight band:
"Tight band" feeling across the front of my knee

No, don't push through it. Never push through things like that - it will cause more problems if you do.
I'm afraid this tight band is going to be with you for a long time yet, although it will gradually become less of a problem.

Yes, patience is going to be your biggest asset. you'll need tons of it, because this is not a quick recovery.

It's still-less than a month since you had this major surgery and it's far too soon to be worried about ROM. Is someone nattering you about that?
There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

And it's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself. So relax and stop worrying about ROM or pushing through anything.

I did no PT exercises at all after my last knee replacement and only minimal PT for the previous ones. Both my knees straighten fully and bend to over 125 degrees. I can do anything I want to with them. I followed my surgeon's protocol.

My surgeon doesn't allow any PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house.
After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home.
His patients all do well and achieve good ROM, as I did, and he hasn't had to do a manipulation to help with ROM for the past 4 years. I think that speaks for itself.

 

[funkymuse]

Well... about the ROM... as far as being nattered about it... I'm like why do ALL these Doc's and PT's and all these people who I've met along the knee surgery route (not on this forum), tell me DO YOUR EXERCISES... MAKE SURE TO DO THE PT... and all the warnings and on and on and on and on! It's overwhelming to say the least. It's drops a gallon of fear in ones gut about just laying here icing and walking around a bit. That's why I keep falling into the trap of thinking I HAVE to do something or I'm doomed! It's all over the place. Every site one goes on in regards to knee surgery, it's always push push push!

If it was not for this site, and the fact that I had a Hematoma that literally stopped me in my tracks for about 2 weeks, I'd be pushing myself like many others I've read about on this forum who have pushed themselves into bouts of pain and being forced to do nothing for a week because of pushing too hard, etc., etc. But because of what I've read and your testimonies I pull back from doing anything near what I would be doing because of my tendency to overdo, and I feel like I'm making good minuscule progress. I'm not sure what my initial PT appt next week will reveal but I am fully prepared to say NO to any pain or pushing too hard!

But if the band stays for such a long time, how is anyone to ever get any real progress made? I've read about people biking a bit and walking and doing gentle heel slides and gaining ROM of 90 and on up and yet they say they also have this BAND. So I wondered if they worked through it regardless of it being there. That's what I really wanted to know.

On the up side, I iced pretty cold for about an hour, then I got up and push dishes in the dishwasher, put bacon in the oven, and cleaned out the fridge (my husband is very helpful but knows nothing of food going bad in the fridge). Of course I was mainly standing on my good leg and not doing any normal movement per se with the recovery knee. I was inspired by many here saying to just do normal activities.

 

[Jockette]

Well that kitchen work was a great example of your daily activities being your PT. Well done. Now sit for a while with your leg up.

I agree about all the outside pressure we get to do our exercises and PT. I think Americans are brainwashed that it’s the only way to recover. That was my biggest shock of recovery, the unrealistic expectations of almost EVERYONE I talked to, especially people who have been through knee replacement. And when I don’t measure up to where they think I should be I get “a look” that says I have failed. It makes me so mad!

I actually isolated myself for a while because I didn’t want people to see that I was still so limited in what I could do, which brought on depression and frustration that I wasn’t doing better.

Thankfully I found Bonesmart but it still took a while to improve my mindset, and just last week I had a meltdown because it’s been over 7 months and, while I am much better than I was last Spring, I am still only where I am.

Oh my. The things we didn’t know before surgery. I do believe that things will get bettter. I have to remind myself about that awful P word ~Patience!

 

[Celle]

I agree that you get a lot of pressure about doing exercises and gaining ROM. The problems is that all these people were taught an old-fashioned idea and they continue to believe it and pass it on. However, very few of them have actually had a knee replacement themselves. If they had, they would be more understanding.

The most important thing for you to remember is that you are in charge of what happens to your knee. Other people (including your surgeon and your PT therapists) can advise, but you can choose whether or not to accept that advice.
Saying no to therapy - am I allowed to?

But if the band stays for such a long time, how is anyone to ever get any real progress made? I've read about people biking a bit and walking and doing gentle heel slides and gaining ROM of 90 and on up and yet they say they also have this BAND. So I wondered if they worked through it regardless of it being there. That's what I really wanted to know.

The fact is that much of what you feel as a band is also some swelling. The swelling should go down gradually, so that your knee becomes easier to bend, even though you still have the tight band feeling. Those people don't push through the band, but find that as their swelling lessens, they can bend more easily.

At the moment, your knee is like a garden hose that is stiff because it's full of water. But, if you let the water out (reduce the swelling) the hose (and your knee) becomes easier to bend.

It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.
So, instead of doing lots of exercise, concentrate instead on reducing the swelling, with lots of rest, elevation and icing.

 

[funkymuse]

Thanks Jockette and Celle!
Well I'm 3 weeks post op TKR and 1 week post op hematoma removal. Although truly it feels like 6 weeks. It's been quite an adjustment. I have no idea how much ROM I have or what the new PT person will be like, but soon I will find out on my first PT appt on Wed.

A few questions:
1) Is it normal for the knee to get tight and stiff after a couple of walks to the living room and back?

2) Also I've been having some nausea and not wanting to eat rich foods at all. In fact even the smell of the foods makes me slightly nauseous. Is this maybe because I'm taking my Oxy and Antibiotic on an empty stomach at times?

3) Today I'm moving my Oxy out by 1 hour to 1-5mg every 8 hours and I will be holding it there. I am also taking the Tylenol 1000 every 6 hours. But at night laying flat out without movement for hours, my body gets restless, my back hurts and my leg gets hot and pains me more. Should I attempt to go ahead and get up and take a walk to get some circulation? I've been sleeping on my back with my leg elevated all night with the ice machine.

Thanks everyone. Every morning I continue to read other peoples threads and gain so much info. I'm beginning to feel so much better about being gentle rather than pushing. It takes awhile to un-do the BRAINWASH of PUSH PUSH PUSH OR YOU'LL BE SORRY.

 

[Celle]

1) Yes, that's normal.

2) Certainly, taking those meds on an empty stomach is going to cause nausea. Always take the pain meds with a bit of food. Some antibiotics do need you to take them on an empty stomach, but if your aren't that sort, do have something to eat with them. It's normal for appetite to be poor in the early days.

3) By all means take a short walk. Don't lie there all uncomfortable. Sometimes, I would even change my sleeping place in the middle of the night, alternating between bed and my recliner.

I know it's hard to stop listening to the people who are telling you to Push, Push, Push, but it will be worth it. The problem is, they were all taught that way and they believe it. Almost none of them have a knee replacement themselves and they've never tried the gentler way to recover.

 

[funkymuse]

My nausea has continued to become totally unbearable. I've read where Cephalexin and Tylenol can both cause nausea. I've got a call into the Nurse.. i'm totally sick. sigh.

 

[Celle]

I hope they give you an anti-nausea medication. Zofran worked for me.
It's probably the Cephalexin. Tylenol doesn't usually cause nausea.

 

[funkymuse]

I hope they give you an anti-nausea medication. Zofran worked for me.
It's probably the Cephalexin. Tylenol doesn't usually cause nausea.

yes she got Zofran prescribed and suggested that I use it sparingly. And then to make sure to eat before I take the Cephalexin.

oh such an awful feeling... with everything else going on, I just reached a limit and started moaning and crying that there's no way I can go through this again with my right knee... i just don't know.

thank God for the comfort of this forum and my husband...

 

[Celle]

Hang in there! All this is going to get better.

 

[funkymuse]

Still waiting for hubby to get home with the Zoloft but soon...

Here's a question.... since I can't take Ibuprofen or any of that anti-inflammatory meds - too hard on tummy - should I try compression stocking for swelling? Just wondering. I read that a person wore them for several weeks for this very purpose. Not just for clotting.

 

[Josephine]

You should also be taking some probiotic yogurt. Nothing like it for calming the stomach.

since I can't take Ibuprofen or any of that anti-inflammatory meds - too hard on tummy

You should not BE taking ibuprofen anyway. Vicious med if you ask me! Medications: acetaminophen (Tylenol, paracetamol) and NSAIDs, differences and dangers

And you can use compression stockings all the time any time.

 

[funkymuse]

You should also be taking some probiotic yogurt. Nothing like it for calming the stomach..

Oh I wish I could. I can't do dairy.. Maybe I'll have my hubby get me some soy yogurt! great idea. Thank you! I do take a good strong probiotic capsule.. maybe I should also up the dose.

You should BE taking ibuprofen anyway. Vicious med if you ask me! Medications: acetaminophen (Tylenol, paracetamol) and NSAIDs, differences and dangers .

And you mean I should NOT be taking Ibuprofen and the like anyway.. right?

And you can use compression stockings all the time any time.

great! maybe I can keep more of this swelling down by using those.. do you recommend a certain type? I'm a dummy when it comes to that!

 

[funkymuse]

Actually @Celle the doc prescribed Ondansetron 4mg. ??? what the heck? They give it to patients before chemo! Also the nurse said to only take as needed... so that's what I'm going to do. I'm still nauseated with that pain in my lower left side, so hopefully I'll feel better soon.