TKR Recovering Great and Then A Loud POP

[Dulcimer Diva]

Maybe it's the retired attorney in me speaking, but I think something more than an apology is owed you!

 

[maryo52]

Really lousy.

 

[Titianlady]

I totally agree with Dulcimer Diva. The rehab clinic did something to cause you grievous harm, and they need to take responsibility. At the least they should be made to pay for any additional medical tests you've needed,and the cost of any and all surgeries you now need to repair the damage they have caused.

Some additional for the pain they have caused is also in order dearone.

 

[Josephine]

How sad for you. But there are a number of reasons for a muscled to tear. The separation most likely occurred at the junction of the muscle and the quads tendon, just as the Achille's tendon usually does at the calf muscle/tendon junction. They can also give way spontaneously for unknown reasons, so while over-enthusiastic PT might have helped it on its way, it's unlikely to have been the primary cause.

I do, however, think that PT owes you an apology.

As a matter of interest, this is why fractures hurt so much, because the muscles go into aggressive spasm without the restraining 'struts' of the bone to keep it out to length.

 

[LonghornNan]

Just want the whole thing to be over....I'll have surgery on Tues morning - July 2 and will be in a brace for 6 weeks. I can't start rehab for my TKR until then. I have had calls from a lot of people connected with the Home Health group - all are sorry that I'm going through this. Yep...me, too.

 

[Celle]

I hope it all goes well for you on Tuesday, Nan.

We'll be thinking of you!

 

[LonghornNan]

I had the tendon repair surgery on Tuesday (July 2) and it was much more painful than the TKR. I was really nervous beforehand and woke from the surgery in tremendous pain. It took several hours to get it under control - may not seem long but it sure as heck seemed an eternity at the time. I have an immobilizing brace from hip to ankle and can't bend for at least six weeks. The brace is a locking brace and stays on all the time which is fine because if you bend your knee it will ruin the repair so the thought of that is pretty terrifying! I had this as outpatient and spent about three hours in recovery. My grandson and husband were with me there and my grandson took this picture. He liked the hubs and I holding hands. I'm glad at his young age he appreciates and recognizes a comforting touch!

 

[bottomshollow]

but this one is more like Lake Superior. So sorry that you are having to go through this. Love the pic your grandson took---wonderful that he has a tender heart.

Please take care of yourself and keep us posted. We care.

 

[hedgep]

Praying for relief from the pain and that healing is quick so you can get back to moving that new knee.
Blessings, hedgep

 

[LonghornNan]

It has been three weeks since my tendon repair and I have definitely had my ups and downs. I'm in the immobilizer brace 24/7 and the day is filled with adjusting and re-adjusting the brace. I have to make that work because the alternative is a cast. I'm walking with a cane and even though I feel as if I can walk without it I'm afraid to because I have felt my quad muscles just give way several times.
I'm really trying to take one day at a time. Looking further down the road causes me to have really awful panic attacks and after that some bouts of depression. The TKR has taken a backseat to the tendon repair. I'll be able to start rehab two weeks from now and while I want to get started I'm really terrified since the tendon tear happened while doing straight legs raises with the physical therapist. Because the tendon tear after tkr replacement is rare there is very little information or research done on it. My doctor has told me that I'll never have the ROM in this knee as I do in my other knee. He say's expect it to be really stiff when I start rehab. I'll be able to do some of the rehab with no brace but will continue to wear it otherwise for up to a year. A year??? That just starts the panic, frustration, depression cycle for me and yes I do get on my pity pot and then I get determined to just get through it. For now it's just mostly doing very little - just rest and let it heal. I'm thinking if I journal this here it may help and possibly a few months from now be able to look back and see some progress that hopefully I'll have made.

 

[maryo52]

If you journal here, you will get on-going TLC and encouragement. That's a great idea.

I had a difficult TKR recovery, but then at two months I started having anxiety. It would come on in the early afternoon. My PCP advised me to take xanax for it. I was already taking xanax for sleep at night. Well long story short, it turned out I had become physically dependent and the afternoon anxiety was my body wanting more drug. I had random withdrawal symptoms for two months before another doctor identified the problem. It took 2 months to wean off and another 2 months for most the neurological withdrawal symptoms to subside. That's about 6 months of daily withdrawal consisting of anxiety most hours, profound insomnia, GI cramps, and derealization. So not the same as rupturing a quad tendon but another example of trial heaped upon trial. It was an unbelievably difficult and dark time. Only close friends and family knew. I went to 12 step meetings for support believing I had become an addict (!!) At least the meetings helped me get through the day. We're here for you.

 

[LonghornNan]

maryo52 Thank you, Mary, for sharing that. I read your thread about how this has changed your life - loved reading some of the responses - knowing others have had similar experiences. I wonder why anti anxiety meds aren't viewed the same as pain meds. If you have pain and really need them you aren't addicted - (maybe dependent for a while just as you're dependent on a cane or walker) and if anxiety is that bad it seems taking something to ease that seems okay to me. I'm still taking pain meds three wks after my second surgery and I think there are some who think that's too long. I have friends who pride themselves on taking nothing ever and I feel "judged" by them. That could be just me, however, because things like that that might have been a tiny irritation is magnified right now. I had a knee replacement 6 yrs ago so I knew what to expect this time. It's the tendon things that has thrown me for a loop. I just don't know what to expect and at times that's okay and others times it's just scary. Thanks for listening.

 

[Celle]

Dear Nan,
Thank you for the updates.
I'm glad the surgery went well and the tendon is repaired. You're over half way through the period of total immobilization of your knee and that's good. It must seem interminable, but it will end.

For now, take care of yourself - try to think of little things that you can pamper yourself with, that you would not do at other times.

Yes, recovery for you will be slow and tedious, but it is going to happen, I'm sure. Patience is going to be your friend, even more so than for most of us.

Don't take any notice of your friends who think you should be cutting back the medication. It's your knee, not theirs, and they haven't had anything like the surgeries you have had.

Like Maryo, I've been to a 12-step programme, (although for a different reason). One of the little saying that I find helpful from those programmes is to approach life "One day at a time". It helps you to not worry over the road ahead, but to just appreciate and deal with where you are now.

Best wishes,
Caryl

 

[maryo52]

I bet you are indeed getting judged. They're comparing you to those who recover well and advertise their success.

The unknown is the worst part. If I had to choose between my saga and yours, I'd pick mine. I think the unknowns about your tendon injury which compounds the TKR issue are daunting.
In fact, people with benzo addiction can go a year or more with withdrawal before full recovery. I was encouraged to accept that it could be 18 months. These drugs are far far more dangerous than painkillers.

 

[hedgep]

As you can see from my list below, I have had quite a time with my right knee and the surgery that was suppose to "give me my life back"!!
I have been where you are with anxiety, panic attacks, depression, pain, you name it. I also have been on and off meds for all of the above for the last 5 years. And, until the surgeon tells me there is nothing else to be done, I will take my meds and ignore what the world has to say about it. I am blessed with a husband who understands and does not judge.
Take what you need to help you deal with what is going on and then when things are getting better, start weaning, SLOWLY, off of everything. Yes there will be bad days, hours, minutes and seconds, but you have already been through the worst, just remember that. And if you are a praying woman, do it. The "peace that passeth all understanding" will see you though this journey in this world.
Meanwhile, I will be praying for you!
Blessings,
hedgep
18 more days till I go back to the 'hack'n'saw man".

 

[LonghornNan]

Three weeks later and I've started rehab! Very, very gentle rehab! It's been 6 weeks today since my quadriceps tendon repair which came 3 weeks after my TKR. As leery as I was about PT I love the place I'm going. They were stunned this had happened and had never seen anyone who had this happen during PT and definitely not after TKR. I am only seeing a physical therapist...no aides...and have only had really gentle massage so far. The leg brace has been unlocked to 40 degrees and I'll add 10 per week. Will also be doing some water therapy eventually. I still sleep in the leg brace but - yay - I can shower without it! It felt wonderful!

Three weeks ago I was so down in the dumps and just feeling like I'm doing something has helped tremendously. I loved hedgep 's advice to take what I need and not to worry because I don't think much about needing any anti-anxiety meds or pain meds much at this point. I'm still taking pain meds at night and my OS always wants to make sure I have what I need.

I am concerned about my other knee (replaced six years ago). It is so sore from carrying the load solo for so long. I've been doing ice cup therapy on both knees plus heat on the right knee and it seems to be helping the tendonitis in that knee.

Finally got my hair color done yesterday by my personal hair colorist aka my husband and Esalon and hopefully tomorrow can get to the real salon for a cut.

 

[Jamie]

What a great report!!! I'm so happy to hear that things are taking a positive spin for you. Hang in there and hopefully this will one day just be a great story to tell over a good cup of coffee with friends! You're doin' GREAT!!!

 

[LonghornNan]

I thought I'd update my progress in case anyone else has a similar experience. My therapy is going great and best of all on my visit to the OS on 8/27 he said I could take the brace off because....tah dah...I'm much farther along than he ever expected! Here's a pic of my leg brace.
(this was the day after 7/2 quadriceps tendon repair. The bandages came off two days later but the brace stayed on until 8/27)

Yea, ME! Wow this has made life sooo much easier!
For the first 5 physical therapy visits the PT did hands on tissue work and carefully moved my leg for me. The next 5 visits she continued with the tissue massage and added some sheet assisted exercises. This week I have started some exercises without the sheet. The therapist has never pushed me to go beyond what is comfortable and in fact cautioned to only do very gentle stretches. The best part - yesterday I started aqua therapy. I exercised with her for 45 minutes and it felt wonderful.

Love this rehab facility! I wish I could just walk around in a water bubble and would recommend aquatic therapy for rehabbing almost any body part! The point I'm getting to is this: basically for 7 weeks after my TKR I didn't move anything and had no therapy. Yet when I did start therapy the swelling was minimal and I had very little scar tissue buildup. So, to me, that just goes along with the theory on Bonesmart that you don't have to put yourself through agony because of the "window of opportunity" to break up scar tissue or get range of motion. My ROM yesterday was 93. I'm not saying that you should spend 6 or 7 weeks immobile but because of the torn quadriceps tendon that required my leg to not bend did not seem to have affected my knee replacement. The rehab I've been doing for the past three weeks for my knee has been fairly pain free and I made tremendous progress in a short amount of time. I think it's true - the knee replacement has its own timeline for recovery! Hope this all makes sense.

 

[Jamie]

Boy, what a perfect testimony to our philosophy!!! While I'm sure there are exceptions, your situation proved that a person CAN be just fine with minimal movement following a TKR. Thanks so much for passing this on to us!!!

Josephine, you think maybe we should put something about Nan's recovery in the Library? It might be nice for others later to read of her experience.

 

[amberpep]

I am so sorry to hear that. It must have scared you half to death when that happened. Please keep us updated on what your doctor says. If it's any comfort, I'm headed back to surgery too, but not for the same reason. Something is bleeding in that knee and my Ortho. Surgeon is going to have to go back in to stop it ... hopefully just scope it, but if not, then open the incision. I'll be praying for you .... do keep us updated on what is happening with you.
abby