TKR Pain and good support system

[Whimsy3]

You are doing good and we are here to be your support. This is a tough surgery and whining is acceptable.

 

[Josephine]

Oh geeze, Louise! What a kerfuffle!

 

[Probertson]

Kerfuffle?? Lmao


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[Josephine]

ker·fuf·fle
Noun: a commotion or fuss.
Synonyms: fuss

 

[Probertson]

Why-O-Why do I do the things I do ?
I haven't been out of the house for weeks but Because I was feeling "OK" I thought I would have my daughter take me to Michaels so I could pick out some yarn...needless to say by the time we got to Michaels and I walked (using my walker ) to the back corner of the store my knee was screaming at me.
As soon as I returned home to my recliner and took some much needed pain meds and ice on my knee, I slept for a couple of hours. But I've been paying for my little trip all day. OMG does my knee and thigh ache. But besides for the discomfort I'm in I did enjoy being out.
I'm also still waiting on my health insurance to approve the increase in the strength of my pain meds, but regardless ...I've only got 2 pills left and might have to pay out of pocket for some much needed relief. Curses on you Healthnet!!



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[morningstar]

To Probertson:
I sorry to hear you had you were in allot of pain and that you have worked out some of the problems.
I agree with everyone about the information and went through some of the same problems you went through
with pain and P.T. and even though I didn't go to walmant to get my meds filled,I had taken a perscription to a drug store near my house that is family owned and I didn't expect and knew I wouldn't get it filled that day,
but I had went througn the same aggervation the week before and the doctor had upped my meds so I could do either exercises and or P.T..
I just saw my Ortho's PA Tuesday,and he had told me that if I couldn't bend my knee more it might seize up or become stiff and they would have to do MUA which is minipulation under ansterstesia,sorry for the spelling, and my P.T. told me that he just wanted to make sure it didn't become stiff and not be able to move.
She said I had good range of motion and keep doing exercises.
Even though I haven't walked in your shoes,I know how you feel.
I had RTKR in September09,2013 and they gave me daludin, and Oxycodone in the hospital,but seem to drop the ball when you come home and expect you to get by on 1 tabled every 4 to 6 hours.
My drug store had called my insurance company because she didn't think they will cover the amounnt of Tylenol,on that pescription and they started in about me being on the Oxycodone with 3 perscriptions and that I was taking too much meds and that they should last 10 days each.
The problem with me is I had already talked to the doctor about my low pain threshold and sometimes they don't get it.
I can understand about your husband even though mine did get stuff for me and cooked supper,.he works steel and felt I should be off the walker and rushing things.
They haven't a clue about what you go through and mine had his hip replaced in May and felt the knee was similar and no way are they in any way the same.
I had my Left knee replaced in June,2010 and someone had told me about bonesmart and I was able to get on the website a few days before I went into the hospital.
This is a great website and the best family you could ever have to help you get through anything to do with knees and hips.
They have a fantastic life saver to me and I tell everyone about them.
josephine is our mother hen and a wonderful person that will help you allot.
I am glad you are doing better and keep on going.
There is always someone on that can help you and I love the encouragement and positive feedback in formation they have to offer.
Hang in there and things will getter.
Knee replacement is the toughest to go through and takes a while to get over.
You are in right place and we are here for each other.Morningstar.

 

[Josephine]

I just saw my Ortho's PA Tuesday,and he had told me that if I couldn't bend my knee more it might seize up or become stiff and they would have to do MUA

You do know that's utter rubbish, don't you?
Myth busting: the "window of opportunity" in TKR
Myth busting: the "window of opportunity" JBJS.

 

[Probertson]

Today is first day of PT. I'd be shakin in my boots if I could get em on. They better not hurt me. Not the boots those PT people...lol


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[Whimsy3]

You are gonna be fine, just breath

 

[Josephine]

It's in your hands - you are their employer and you must tell them NOT to hurt you. Say no and mean it. If they persist in hurting you when you've said not to, that's abuse and you don't have to put up with it. besides which, causing you pain is very counter-productive to your recovery as it only causes you more swelling and pain and delays your recovery. Remember this Myth busting: no pain, no gain.

 

[Probertson]

PT went great! I can do more then I expected. I walked across the room with no walker or cane, that felt weird and scary. My flex is only 70 but I knew that was gonna be low. The therapist was very gentle and did not put me in any unbearable pain. She said that I did really good. Actually the excersizes felt good.
I forgot to ask what it takes to be able to stand for long periods of time. By the time I'm finished with my shower I can't wait to sit down.
And finally my pain meds are straightened out that helps a bunch.
I'm a little sore and tired, so I'm icing and relaxing.
Have a great day!!


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[Whimsy3]

Yeah!!! Told ya so . I think standing a long time just takes time. I remembering taking a shower in the beginning was exhausting. Patience is the key word.

 

[Josephine]

Oh me too! I can remember being in a fearful sweat and trembling while I was drying myself off. Then coming downstairs soooo carefully and dropping into my recliner with a great big sigh of relief! That state of affairs lasted for about a month though it did lessen as time went by of course. Another thing that was a milestone: I had a bath shelf I'd sit on whilst showering and after about 10 days, would try time and again to stand in the bath but just couldn't summon the strength (or was it confidence) to get up off that shelf and onto my feet. The day I did I was so elated! Even though I sat down again quite quickly. But I did it!

 

[Probertson]

PT yesterday ... Went well ... But OMG am I in pain today. ; (


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[Josephine]

Did the PT push on your leg, forcing it to bend? And what kinds of exercises did you do? Squats, lunges, steps?

 

[Probertson]

Recumbent bike: 10 min - obviously can't do a complete rotation so rocked it forward as far as I could and then reversed and told to push as hard as I could and hold for a count of 5 seconds

Large excersize ball: 2 reps of 10- laid flat on my back with both heels on top of ball rolling it forward and back trying to bend knee as far as possible

Sat on side of bed with legs hanging over the side with 2lb weight on my ankle lifted leg 2 reps of 10

Laid down with a medium size ball held between my knees squeezing knees together for 10min

Laying down used a long strap that looped over my foot to aid in lifting my leg to a vertical position (to strengthen the calf and behind my thigh) 2 reps of 10

Butt kicks 2 reps of 10 : standing bending my leg up to get my heel to touch my butt which I can't reach my butt yet ... Lol

Step over a contraption that would represent a curb 2reps of 10

Lay on my side and lift my leg as high as I could kinda like a scissor motion 2 reps of 10

Sit with my back against the wall - leg lifts 2 rep of 10

I think that's it ... I go again in the morning and I push through the exercises but honestly hate what happens before I leave.

Before I leave the therapist has me sit on the end of the bed scootched up on the ledge and asks me to bend my leg back as far as I can, then she measures the bend, I was able to get it to 83 degrees then she used a salve and massaged my knee lightly because my knee is still really tender and holds my knee with both hands on either side and rocks my leg back and forth and pulls down on my leg and then pushes it back further then I was able to do on my own.. She got it to 91 degrees and holds it for a count of 10 and then repeats it one more time.
It does hurt it kinda pinches and pulls but I tolerate it ...Lamaze breathing comes in handy at this point...because I'm pretty sure I'm not gonna get my bend back in my knee without this dreadful part of PT I am a cooperative patient.

I take a pain pill about 1/2 hr before I go but honestly I'm pretty much useless for the rest of the day and part of the next day. I assume this is normal



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[Probertson]

Question - is mua a common procedure because I really don't want to do that. Is it something I shouldn't be afraid of? What would have to be happening or not happening for me to consider having MUA done?


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[Celle]

I think that's far too much PT at this stage and you should not be having weights put on your leg.

Josephine what do you think?

 

[ramblin]

Probertson everything you describe sounds so familiar! My TKR was July 9th, and recovery is a slow process. MInute by minute, day by day, week by week. Take photos of your knee every day or so and as you look back you'll see Oh, yeah, it was much worse and now it's better.
As the pain diminishes [from constant-and-agonizing to every-now-and-then] of course you'll feel better. Just don't get swept up in the overwhelming relief that you're not hurting, and try to do too much! And remember "doing too much" is a relative term, defined by how you are NOW, not pre-op ;-D (I did like you did at Michaels, only for me it was Trader Joe's lol!)

You asked about a stationary bike -- I have a recumbent bike I got from Amazon, it's very handy. I used it to rock back and forth, and was so thrilled the day I got all the way around in a full rotation!
It's the Exerpeutic 400XL Folding Recumbent Bike
https://www.amazon.com/Exerpeutic-400XL-Folding-Recumbent-Bike/dp/B004O6TXVS/?tag=ate362da-20
Your husband can make himself useful in the manly activity of assembling it, LOL! (actually I was able to do it, it's mostly pre-assembled)
Hang in there and Onward!
Ramblin'

 

[Josephine]

Lamaze breathing comes in handy at this point...because I'm pretty sure I'm not gonna get my bend back in my knee without this dreadful part of PT. I take a pain pill about 1/2 hr before I go but honestly I'm pretty much useless for the rest of the day and part of the next day. I assume this is normal

Goof grief! And you're only 6 weeks out! I think even half of all that would be more than enough. Does she have you in training for the Olympics or what? I can promise you this - you are not going to get the bend back with all this dreadful PT!

Did you read the articles I left for you in post #4 of this thread? Did you read this one? Swollen and stiff knee: what causes it? Did you understand what it was saying? All that activity and stress causes swelling - swelling blocks flexion (bend) and as long as your knee is swollen and painful it will be stiff.

It's only normal inasmuch as for some reason there is a 'work'm hard' culture in the US which is totally counter-productive to getting decent functionality in your knee. The other article you should revisit is Myth busting: no pain, no gain. Your answer is to do less of this boot camp stuff, get the swelling and pain under control with the mantra (in post #4) and then be prepared for surprise when you find you have a decent flexion after all. It was just the swelling that was preventing it from showing itself.

Question - is mua a common procedure because I really don't want to do that. Is it something I shouldn't be afraid of?

It's relatively common but not in excess. And no, it's not something you should be afraid of. It's just that your surgeons, in an abundance of legal caution, invariably emphasis the possible (and very rare) complications that are possible.

But do get this - I can, hand on heart, promise you that you do not need an MUA at all. You don't have adhesions, you're just being made to do too much. I know one of the favourite 'warnings' of PTs and surgeons is that there is a "window of opportunity" within which if you don't get to 90 or 100 degrees of flexion then your knee will set like concrete and never move again! These articles I also gave you in my previous post
Myth busting: the "window of opportunity" in TKR
Myth busting: the "window of opportunity" (JBJS)

So did you read these? Is it that you've just forgotten about them? Please read them again and be reassured. Also take charge of your own recovery and simple refuse to do so much. This is not a race, there is no time pressure. We have a saying here, it's not a sprint, it's a marathon. Some people don't get all their ROM back until 6 months out, some report continuing to improve after 12 months! You don't have to do it all by Christmas!

Finally, do remember that you are employing her and have the right to call the shots. It's entirely up to you to dictate what you want to do and when. Okay? I've made some suggestions by crossing out those I believe would be better left till you have a better ROM. They can be added back slowly over a time until by week 16 you are doing them all again.

- Recumbent bike: 10 min - obviously can't do a complete rotation so rocked it forward as far as I could and then reversed and told to push as hard as I could and hold for a count of 5 seconds
- Large exercise ball: 2 reps of 10 - laid flat on my back with both heels on top of ball rolling it forward and back trying to bend knee as far as possible
- sat on side of bed with legs hanging over the side with 2lb weight on my ankle lifted leg 2 reps of 10
- laid down with a medium size ball held between my knees squeezing knees together for 10min
- laying down used a long strap that looped over my foot to aid in lifting my leg to a vertical position (to strengthen the calf and behind my thigh) 2 reps of 10 2 of 5 would be plenty
- butt kicks 2 reps of 10 : standing bending my leg up to get my heel to touch my butt
- step over a contraption that would represent a curb 2reps of 10
- lay on my side and lift my leg as high as I could kinda like a scissor motion 2 reps of 10
- sit with my back against the wall - leg lifts 2 rep of 10 2 of 5 would be plenty
At the end
- the therapist has me bend my leg back as far as I can, then she measures the bend
- then she used a salve and massaged my knee lightly
- holds my knee with both hands on either side and rocks my leg back and forth and pulls down on my leg then - pushes it back further then I was able to do on my own
- got it to 91 degrees and holds it for a count of 10 and then repeats it one more time.