Bilateral TKR Oregon Mom's recovery journey

[WhenImOld]

It's kind of a lonely place to be when you realize that only YOU will know what the best course of action is, and if you aren't tapped into your body's needs intimately, it's going to be a long road.

THIS right here! Yes I know you and you and you (generalized 'you' of course!) all think I should/shouldn't be doing the various things but until I try them or decide not to, I don't know how MY knee will react.

 

[Oregon mom]

Wow! So I emailed my surgeon to see if he could tell me the name of the prostheses he used in my knees because I'm just curious to learn more. He kindly told me the manufacturer and model name and WOW if I didn't immediately find a wealth of information online. The most amazing is a 64 page 'Surgical Procedure' document for surgeons that outlines the prosthesis and step by step instructions for the surgery. It's kind an IKEA instruction manual, but surgery on a human knee instead of a couch. I am amazed at how complex and detailed this surgery is. I have an even greater respect for surgeons. And I've heard that sometimes things can click and clunk, and maybe not feel perfect. But compared to constant pain with every step, that seems so small. It's a long recovery ahead.. But I can understand why now. Just an insane surgery. It's incredibly humbling to get a second chance at mobility.

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[SpaceGirl]

Glad you found yourself some info on your knee! The clicky/clunky sounds I noticed in the beginning but now rarely notice them. I think in time it either goes away or just end up tuning them out because you're too busy living life again!

 

[NewToMe]

@Oregon mom

things can click and clunk,

I have fun making mine clunk. It caused some concern in work colleagues pre-COVID. If I tap my foot up and down picking up my foot with quad, it will clunk.

Keep icing, posting! Tell the hubby it gets better at week 3.

So glad to hear your pain pumps lasted a few days. My knee was outpatient, went home same day but pain pump catheter broke in half..not leak but dosed me first night.

My hubby also had issues with exhaustion the first 3 weeks. Tell yours it gets better for him sooner than for you. Ha ha

 

[Oregon mom]

Steri strips were placed over my dissolving stiches and under the silver dressing.
I was told that the steri strips will just come off on their own and to just leave them be. I can trim the edges as they peel up.
We are told not to scrub our incisions. Do not use any lotions, etc.
Ok.
But under the steri strips is a very sticky glue that is collecting lint. It's kind of gross. The glue will dissolve with an oil based application. I tried a tiny section with a tiny bit of makeup remover on a cotton swab.
I'm not so concerned that I'm going to call my dreaded ortho nurse, but curious if anyone else had this occur. Do I just really leave it alone and collect lint? The lint stays through a shower because I don't scrub the area, I just let the water and soap run over it and pat dry per my instructions.
I am a person who tries to follow the instructions. It's just that no one mentioned the linty Krazy Glue part..

 

[Muldoh]

Hi Oregon mom. I did not have Steri-Strips on my scar but definitely had the glue. But since my surgery was June 30, I could wear shorts and dresses for most of the summer and not worry about any cloth rubbing up against it. I couldn’t even sleep with a sheet/blanket as the feeling of anything against my knee made all the nerves go crazy. I wouldn’t use anything to get the lint off and keep the scar as dry as possible to get it healing. Having it there is probably a common thing,but if you are concerned, I would definitely call your OS and get someone from the office to advise you. That’s what we’re paying them for ;)

And I am 11 weeks out, and still clunking and clicking! When I saw the doc he told me that will continue until all the muscles and tissues around the area get stronger with time. It is such a weird feeling
Best wishes for your recovery!

 

[newlybionic]

I agree, I would give a call. You shouldn’t get anything near your incision such as makeup remover. The remover is not sterile and may get into the incision causing pain or an infection.

 

[Oregon mom]

Right of course! This was far from the incision in a tiny amount. The point was this glue is not water soluble and not likely to just rinse away. It's ok. I was mainly wondering if others had this same issue.

 

[Oregon mom]

I'm *this close* to terminating my PT services. I put PT on hold to start again this Wednesday. I don't see the value in irritating my knee joints all day with a laundry list of exercises and endless repetitions. I did plenty rep counting at the gym prior to surgery and I feel I've earned the right to slow down a little here. I am so confused by the volume and intensity of the program being presented to me.
I think the only thing holding me back from canceling is being perceived as a loser who won't heal properly, someone who squandered their surgical privilege. But honestly, I'm just gobsmacked with how aggressive this seems. I'm a very athletic and motivated person. I can't imagine I'd just let myself turn into a knot of scar tissue without a PT giving me lists of literally irritating exercises to fill my days with.
It's a tough call to make, really.

 

[Murphy2013]

I'm *this close* to terminating my PT services. I put PT on hold to start again this Wednesday. I don't see the value in irritating my knee joints all day with a laundry list of exercises and endless repetitions. I did plenty rep counting at the gym prior to surgery and I feel I've earned the right to slow down a little here. I am so confused by the volume and intensity of the program being presented to me.
I think the only thing holding me back from canceling is being perceived as a loser who won't heal properly, someone who squandered their surgical privilege. But honestly, I'm just gobsmacked with how aggressive this seems. I'm a very athletic and motivated person. I can't imagine I'd just let myself turn into a knot of scar tissue without a PT giving me lists of literally irritating exercises to fill my days with.
It's a tough call to make, really.

I know how you feel! These lists of exercises are designed to protect them in case OS comes back with bad opinion of them because patient isn’t progressing.
I fired my first PT office because of their incessant lists and new purposeless exercises they added each time. A knee replacement patient is in a special class and needs care dialed into their situation. My current pt is spectacular. Very few home exercises (4) in number with easy number of reps done throughout the day 3 times. I have finally made progress with flexion much to my shock. Every time I go in I get a couple of degrees more but it is thrilling and I attribute it to her slow steady program.
The knee is never in a super tormented state going in for care. I also warm it up with a moist heat pad I found on Amazon. It’s like the knee wakes up each day and needs gentle coaxing to get going. Good luck and you are not alone.
As athletes it is super hard emotionally to be classified as a laggard.

 

[newlybionic]

@Oregon mom Can you get a different PT in the group or in another group who isn’t aggressive? Many people had no PT after surgery. I’m one who did. It helped me in the beginning to have PT come to my house. I did do outpatient PT but I decided what we would do. I liked having my leg stretched. It made me feel like my knees were less stiff afterwards.

 

[Oregon mom]

@newlybionic Thank you for caring about me and your questions!
After the first session, I communicated about the breakthrough pain I experienced later that night, and that I needed more time to heal. I was told that the program was "standard" for knee replacements. Even for bilateral patients, I queried? Yes.
I would love to have some gentle therapeutic interaction with a skilled professional. But these sessions are all to be conducted remotely, which means talking to a tiny little therapist on my phone which is propped up on a chair while I perform tricks for her. She even measured my flexion and extension by holding the tool up to her computer screen. The resultant pain is therefore all my fault, right?
Even one of the Ortho PAs told me that I should press down on my thigh to get more extension and that "it should hurt."
I'm just not buying it.

 

[Oregon mom]

Oh and I wanted to add that I am 47 years old and very athletic. I shudder to think about someone who might be in their 70s or 80s and might not be as active being told to participate in this hurtful (my opinion) program.
I'm interested to see what the flex /extend numbers are on Wednesday. Just curious. But otherwise I feel like Wednesday might be the last time I log on for this.
I am deeply confused by how counterintuitive this all is. Is the system that messed up? Has no one studied this?

 

[newlybionic]

Bonesmart has been keeping track of whether to have aggressive PT or not. Some OS are starting to rethink PT post TKR. Some are now advising patients no PT for the first few weeks and no aggressive PT.

Check this article - BoneSmart philosophy for post op therapy

 

[Oregon mom]

@newlybionic I love your screen name so much!
Yes, without a doubt, if it weren't for the information on BoneSmart I would not have the tools or inclination to even question PT. Instead I'd be pushing myself extra hard (which is how I baseline operate, and not at all what I should be doing in this situation) and hurting a whole lot while not healing.
BoneSmart and you absolutely wonderful moderators have saved me so much pain in so many ways. Thank you so much!

 

[Oregon mom]

Very few home exercises (4) in number with easy number of reps done throughout the day 3 times.

I'm curious - Would you mind sharing what your exercises and reps are?

 

[Muldoh]

My OS does not recommend PT for most of his patients. He believes that the knee needs time to heal and that the activities of daily living will be enough for most of us to get back to where we need to be. I was worried about this at first, feeling like I would never get that range of motion again, especially when I would read on this site how many people are pushing themselves through regular PT visits. But at my 11 week visit, he said I was at 0° and almost 140 for range of motion. That’s from just daily activity and using the stationary bike about 15 minutes 4-5 times a week. I’m still not good at steps, but I figure that will come as the leg gets stronger. Part of this may just be luck with the way I healed, but his feeling is that most of his patients will get there, some sooner and some later. He really believes that the no pain, no gain mantra is antiquated and can be downright harmful. So I think you should listen to your body and trust your instincts. If your PT is pushing you too hard, I think you should just tell them that, and if they don’t want to support you maybe you can find one that will! Good luck with your recovery!

 

[Oregon mom]

I've been pacing back and forth in my head all day about PT. I lurked on BoneSmart all day, posted some encouraging words for others, re-read articles about healing and PT and exercise... I paced around some more in my head (because I'm not in a position to really pace at the moment).
Then I finally logged on to my provider's app, opened up my appointments and one by one, canceled all of my weekly PT appointments. I checked the box "Condition Improved" for the reason for cancelation.
It was just so hard to cut the apron strings here. But I think I know in my gut that this isn't the way for me to heal. The awkwardness of doing it remotely made canceling that much easier.
I'm the type of person who usually has a difficult time bucking a system. I'll do it if the system isn't working for me, but I really have to be pushed. So I still kind of feel like I made a mistake... which I didn't...
I've been stretching here and there only as much as it feels pleasant and hurts in a good way, like yoga. And both of my legs can bend 90° now. I take turns putting my weight on each leg. I stretch. I do little mini squats. Everything I'm doing feels nice and helps me wake up my butt that fell asleep, or brings blood to my legs, or stretches out my upper back... I'm not doing anything that I don't just naturally want to do.
This is a very peaceful place to be.

 

[Mrs. Ciz]

@Oregon mom
I don’t know how much value I’d get out of virtual PT either. All the things that really helped me at PT I could not do at home because I don’t have the equipment that they have PT the clinic. Plus my therapist spends at least a quarter or more of each appointment doing massage and stretching with my legs. It’s my favorite part and it can’t be accomplished virtually. If they are just walking you through “home” exercises, you are right - you can do those on your own.

 

[Oregon mom]

@Mrs. Ciz
Oh wow, you get massage? Now that is something I would never cancel!
Thanks for your words of support. I'm so good at second guessing myself.