TKR Ok, home & less delirous:) staples anyone?

[Josephine]

Josephine...... I think I'm lost? Is this the right place to post??

You're doing it perfectly! Just stop quoting people and it will be even better!

ironically, if I feel so good am I not doing enough??

People often say and think that. They've been told so often by others that one has to work hard for ROM and that if they don't, the knee will seize up and they'll never walk again. Of course this is preposterous.

if we are continually stretching the scar tissue, how can it not hurt.. we're pulling on it to have it stretch.. right?

As others have said, this is nothing to do with scar tissue. The term is used incorrectly. We have to have scars, they are what hold our wounds closed! We wouldn't want to walk around with our wounds hanging open, would we?! What they are talking about it more properly called adhesions. I loved how Chihuahuan put it - spot on!

One is to maintain/develop "glidability" of tissues as they develop or heal. It's about making sure that tissues are viscous enough to slide over one another. Make sure you drink enough fluids. I think of it as lining-up and lubing!

The problem we face after a TKR is not adhesions - they are actually not that common - but swelling and pain. That's what blocks our flexion. Manage tat and your ROM will be revealed because you know what - it's there all the time. It just can't show itself because of the swelling. Read this article Swollen and stiff knee: what causes it?. So what makes swelling worse? Doing too much exercising! But more, doing it so it hurts!

A couple of things to remember
a) you are only 8 weeks out.
b) when the PTs try to insist you do something you don't feel comfortable doing because it hurts too much, you have the absolute right to say no! Exercise it!


I'm now going to ask you some questions and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

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 compare this with the bone-on-bone pain you had before surgery!

)

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

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

4. are you elevating your leg, how often and for how long?

5. What is your ROM - that's flexion (bend) and extension (straightness)

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. what kind of PT/exercises are you doing? How much and how often? (and detailed details would be appreciated, please! Reps, sets and session and all that)

Note:
If you're not familiar with this, it goes like so:
1 lift of a 500kg bell bar = 1 rep or repetition.
Doing 5 reps and then a brief rest = 1 set of 5.
And doing 5 sets and finishing = a session.

 

[Josephine]

Almost forgot - you need to read these as well

First are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

Next is a FAQ (Frequently Asked Questions) thread.

And here are some very crucial articles
The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Activity progression for TKRs

Healing: how long does it take?
Chart representation of TKR recovery
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling

Home physio (PT) and activity progress: suggestions
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

And then some wise words from members who have shared their experiences ...
Where are you in recovery?? (TKR)
Five “P’s” of knee recovery
TKR: work “smarter” and not “harder”
Recovering a knee - from one who knows!
It's never too late to get more ROM!
It's worth the wait for ROM

 

[kneeper]

I would say at this point it is good to try steps, but if you still need a cane or need to only do a few at a time so be it. You will get there gradually.

 

[tiredwife]

Hi, thought I would stop by and see if you are okay!

 

[Nana moon 27]

Hello @Dosbichons

I thought I pop in and say hi! I'm sorry you're suffering but it will get easier as time goes by as regards exercise. I have to say I loved the response from @Pumpkln with the list of degrees necessary for certain movements. That's very useful xxx

I've missed seeing you on my thread.

Love Nana moon 27 xoxox

 

[Josephine]

Yeah, and waddya think - those articles have been in the Library for years!

 

[Nana moon 27]

Hi @Dosbichons I'm so sorry I missed some of your posts in here. When you tag someone in to chat, always remember to put @ before their user name eg @Nana moon 27 etc. That way we get alerts off you. When you post it the @ whoever should turn blue xxx

Just take your time and follow the good advice you're being given on here. Most of all, please don't ever let a PT bully you into pain. That achieves nothing. Remember, I've said this before to you. We are all individual, all different and our recoveries like ourselves are individual to ourselves. You will get people who recover quickly, you will have others who take a good twelve months plus. Don't worry about rom. It constantly improves and exercising even a little will help xxx

I look forward to chatting with you again soon.
Love Nana moon 27 xoxox

 

[tiredwife]

@Dosbichons Hope you are doing okay?

 

[tiredwife]

@Dosbichons Still hoping to hear how you are doing!

 

[Dosbichons]

Well. dunno if I am in the right thread. It's been a long time since I've visited & posted and need to catch up reading what others have said. I had the replacement 7/21. Now I am walking. Still not far and not really able to do enough stairs to be able to use NYC subways. Too many stairs for me to use a train for transportation. So in the past, seeing PT and Drs. cost me soo much money taking cabs. NYC has gone through some winter >. OMG. Some wind chill factors bring temps to 10/20 below.. not the average - who knows maybe it is and if snow I'm afraid to walk.

My life has changed drastically. During my recovery, my husband showed his true colors.. he's totally selfish, refusing to help me even get a glass of water or ice for my knee after the operation. So we fight all the time. I'm really depressed, not being the active person I used to be, not working. Used to be very very social, out with business acquaintances all the time, hitting most of the "in" places to dine in NY. I worked long hours and after work met my "bar" pals for a few drinks/jokes and just hanging out.

I'm looking at life as half empty. Yes, I resent my knee replacement, not being able to wear all those shoes/heels/boots I purchased, clogs and sneakers.

My disappointment in human nature does put a damper on things, like an injured animal. If I have my cane showing/at my side some "steals" the cab from me. If I hide it (the cane) behind me I can catch the cab.. some world huh??

In addition, being home and watching the news ..OMG who isn't down .. ISIS, people just shooting others all the time. Even politicians being arrested, portion of congress contacts IRAN informing them (going around our President Obama) that the President can't strike a deal with them. WOW.. so what is good? I've gained a lot of weight.. BUT I have little or no pain.

 

[Jamie]

@Dosbichons ... I have moved your post to your own recovery thread. An update is more appropriate here than in someone else's recovery thread.

So sorry to hear you're not feeling well, but after the winter you guys have had, I'm sure that's at least part of the problem. Spring is just around the corner and hopefully that will allow you to get out more.

You say you have no pain with your new knee. That's a great thing! So what happens when you try to walk outside a bit for exercise? Do you have some stairs where you live where you can go practice to get stamina back?

I'm also sorry to hear about your marital problems. Difficult as it is, these things happen sometimes. In the end we can only be responsible for ourselves and our own behavior. Have you considered obtaining some marital counseling with your husband? If he won't go, make an appointment for yourself and take the first step to becoming more in charge of your situation. It will help you.

 

[Josephine]

I agree with Jamie. Seems like your hubby is putting on his parts and not stepping up to his responsibilities in the "in sickness and in health" bit of the contract! I'm pretty sure if it had been him with the hot knee, you would have been fussing round him like a good'n! Not fair these blokes can feel free to opt out just when it suits them.