MUA Ruby's Tuesday--July 11th, 2017<

[rubyyarn]

@VW54, you might also wear a short skirt so the scar shows...

 

[SusieShoes]

I carry my cane when walking sometimes, and it's interesting how differently people react. They recognize the cane as meaning I'm either less able, or rehabbing something. A few ask, "Hip? Or knee?" So there's that. If I don't carry the cane, people don't have a clue I've had my knees replaced... unless I wear shorts, or a skirt, and with the latter mostly when I sit down. Then the scars are visible--but most people never seem to notice them. Perhaps they're being polite. Almost everyone seems to notice the cane.

 

[Ruby9297]

I'll be bringing my walker, cane, and wheelchair, considering the ceremony is outside in a vineyard and the reception is in a cave where the wines are stored. I'm bringing all because I'm not exactly sure what I'll need until I get there. ive decided to just let it go. I'll get there in a nice dress, but it won't be red carpet formal; it'll be sensible for someone recovering from a TKR. I'll stay as long as I can, and if I start to get fatigued or if the pain increases, I'll leave. They will understand, or not, but I will have made my healing a priority. What else can I do?

 

[Ruby9297]

Well, I'm 6 weeks and 1 day out from Surgery. Recovery has been much slower than I expected, but I am making progress --I posted pictures on the scar thread 3 weeks and 6 weeks, which Showa a vast improvement. The annoying part of this is that since about 2 days ago, my other knee actually hurts more than the knee that was operated on. My OS has told Me that the other knee needs to be done as well, but I just don't think I can go through this again so soon, both because of the pain I've just been through, plus the amount of time I can take off work . Such a dilemma.

 

[Ruby9297]

I know recovery has its ups and downs, but I had really begun to think that I had turned a corner in my healing, and over all, I think I have. But the last day has been painful again. I was down to needing about 2 norco and zero diazepam a day, but today, I'm probably going to end up needing 3 or 4 norco and 1/2 a diazepam, which is still way better than up to earlier this week when I was takin as many as 7 per day and as many as 3 diazapams in 1/2 tablet doses. Getting the narcotics out of my system has had the added bonus of moving my digestive system back in gear, do instead of not being able to "go" more than once every 3-5 days, I'm "going" 5-6 times per DAY! Good lord! I never knew a person could have that much stuff backed up in their system! I've felt rather depressed today: my leg is hurting lots again, I want to feel like I'm making steady progress so I can do simple things like eat dinner with my family at the table, drive to the grocery store, sleep in my own bed instead of the recliner. Feeling weepy and discouraged.

 

[Fire wolf]

I know it's hard, but try not to lose hope. Just because we don't always see the progress doesn't mean that it isn't happening. Unfortunately for us, we are dealing with a recovery in which progress is not evident in a linear manner, but instead takes a meandering route through challenging terrain away from a gps signal, so sometimes our knees get lost, go in circles, stop to figure out what side of the tree tbe moss is supposed to grow on, ooooh a squirrel! Wait, no, where was I? Oh yes, I remember, so try not to get too discouraged, oooh a pretty flower, know that healing is happening even though it's hidden, and that we will all come out better than before! Ooooh, look at the butterfly, maybe let's follow it and see where it goes! Most importantly, we are here for you!

 

[Ruby9297]

@Fire wolf , now you went and made me cry again. Good tears, though! Thanks for your kind words of encouragement.

 

[Lil Cyborg]

@Ruby9297 Take heart and keep the faith! You will get through this, and you will be stronger than ever. I definitely agree with @Fire wolf that our recovery process is not linear. I have experienced this myself, and sometimes it makes me very frustrated and upset, although I know intellectually it is just the way it is. Sometimes we all need a good cry, also. Sending you healing and encouraging thoughts.

 

[Happydale]

You will feel so much better once you wean yourself off the narcotics. It probably seems just the opposite, since they do their job to address the pain in the short term. Congrats on cutting back already. Hang in there, and try more Tylenol. I have never found it helpful for other types of pain (like arthritis), but I find it really does help my knee surgical pain.

 

[Lil Cyborg]

I totally agree with you @Happydale about feeling much better when you are no longer taking opioids. I have not needed or taken
Oxycodone in several days, and have only taken some Tylenol. My head is clearer and my innards are getting back to normal and my body just feels better. They served their purpose and I really appreciate having been able to use pharmaceuticals for my pain relief. I do agree that we should address and control the pain, stay ahead of it, and not tough it out. In the past, I always tended to tough out the pain, but I must say, this knee experience showed me that my body and mind
really like being comfortable and not suffering.

 

[Fire wolf]

Well making you cry certainly wasn't my goal! I hope that you have found your hope and encoragement again! Eventually you knee will find the nice well worn path that leads it back home! In the meantime, I guess we all just try to enjoy the scenery!

 

[Jajakio]

I agree with Happydale, at least in my case. I took percoset for a couple of weeks full time, then another week at night only. I thought it would be a cinch to come off, but it was not. I tapered down like I was supposed to but when I got to the none part, it was tougher than I thought. I honestly think in that short of a time, my body got used to it and did not want to let go. I spent 3 days of virtually no sleep and my mind kept telling me I needed it. When I really examined it, it wasn't the pain. Another 4 days of less craving but still little to no sleep and the occasional "pain" which was different than my usual surgical pain . I dont know how to explain how, it was just different and much better when it was gone even though i still have normal surgical pain at times. I know many people on here say it was easy for them to give up opiods when they were ready. Maybe so, but for a few of us it might not work that way. I know after my week of what i dont know any other word for but withdrawal, I turned a corner and started feeling better overall. Narcotics may be necessary for a while but it's nicer for me to be off them. I feel more like myself and more in control of my recovery. I still take tylenol and I still hurt sometimes but I'm moving in the right direction now. Everyone has to make their own choices as to how long to keep taking opiods and I'm sure many people will not go through what I did.

 

[Lil Cyborg]

@Jajakio I agree that people have to make their own choices. What may be good for one is not necessarily good for another. The best thing to do, I think, is to be as informed as possible about everything, then carefully choose what we think is best for us. It is not always easy, but there is a sense of freedom in knowing that we control, to the extent possible, what we are doing or, what is being done to us. I am happy to hear you feel you are moving in the right direction. Keep it up! I know it will just get better and better for you.

 

[Ruby9297]

For the record: This post is in no way my attempt to give medical advice. I'm simply sharing my experiences and observations since I began my TKR journey.

Thanks all for your caring and insightful responses. I certainly agree that there is a definite increase in general wellbeing when off of opioids; that said, I'm glad they exist for when I've needed them. Without casting judgment though, how people get addicted to them is besides me. I for one hate to feel constipated all the time and I don't like feeling groggy; it's depressing to me after a while. In my efforts to get off opioids, I have done my best to truly cut down and to look to more natural methods of dealing with my pain, such as acupuncture, massage, meditation, reiki, and Ayurvedic herbs in the form of salves and edible pastes that taste foul, but really help with pain and sleep. In one day after starting Ayurveda, I went from using 7-9 Norcos to 2-3. I was able to have bowel movements for the first time in five days, and every day since. I was also able to get my brain back. That's all positive!

Looking back on the past few days, I think I have a theory as to why I had a setback: Wednesday I had an amazing acupuncture treatment and received my Ayurvedic herbs. For the first time since even before surgery I had my best night's sleep ever! Thursday morning I felt great! The only thing was that my leg felt stiffer than usual, but that's been normal when I first wake up.

My PT came over at 9:00, but he usually comes at 11:00, which has always given me a couple of hours to loosen up a little. So the first thing I told him when he got here was that my leg felt so stiff that I felt like my incision would split open if we pushed too hard. He said that what I was feeling was scar tissue under the skin, and we needed to break it up, then he pushed me harder than ever. I really felt he had me overdo my session.

When it came to Measuring my ROM, I had gone from 76 at last measurement to 74. I reiterated to him that today that my knee felt extra-stiff, like the incision would tear if we pushed it too hard. He pushed my knee back again this time further and I begged him to stop because it was hurting me. He measured my ROM again, it was 78-- he could go back to his supervisor and report my improved ROM. I truly don't think he thinks he's doing damage. He's firmly planted in the "no pain no gain" philosophy.

He left. I immediately elevated, rubbed in some of the Ayurvedic salve, and iced because my knee had already begun to swell up and it hurt. There is a small area at the end of my incision that is a bit redder than the rest. I think it did tear a little ad a result of getting my knee pushed back further than it could go.

Thursday night Some salve got into the tear and burned like throwing salt on a wound. Additionally, my calf and thigh muscles went into spasms. My tibia ached unmercifully directly under my knee, like it never had before. I think This was due to the leg lifts--straight and bent, that I had to hold to a count of 5 and do 12 times

Suffice it to say I had no sleep Thursday night, I sat in my recliner yesterday with a high level of pain, and slept poorly last night. This morning, I finally started to feel a little better. I showered, took the car for a practice drive, then came home and slept from 2:00-6:30 when my phone rang. This was sleep with no meds inside me except the Norco that I took at 6:00 this morning. It was total fatigue!

I am bothered that I'm just sleeping my life away on a recliner all day, but it's part of the journey. There have been ups and downs for me on this journey, I am learning from mistakes, and doing my best to get better.

 

[Celle]

My PT came over at 9:00, but he usually comes at 11:00, which has always given me a couple of hours to loosen up a little. So the first thing I told him when he got here was that my leg felt so stiff that I felt like my incision would split open if we pushed too hard. He said that what I was feeling was scar tissue under the skin, and we needed to break it up, then he pushed me harder than ever. I really felt he had me overdo my session. When it came to Measuring my ROM, I had gone from 76 at last measurement to 74. I reiterated to him that today that my Knee felt extra-stiff , like the incision would tear if we pushed it too hard. He pushed my knee back again this time further and I begged him to stop because it was hurting me. He measured my ROM again, it was 78-- he could go back to his supervisor and report my improved ROM. I truly don't think he thinks he's doing damage. He's firmly planted in the "no pain no gain" philosophy.

Dear Ruby. Yes, he is doing harm. There is absolutely no need at all for him to try to massage away "Scar tissue". Yes, you do have some scar tissue, but it is the normal sort and it is helping your knee to heal. It's what's holding your wound together. Without it, the incision would open up again.

Please take control of this. Stop begging him to stop, and tell him. Tell him to keep his hands off your knee. There is no need for him to touch it at all.
It's your knee and you are the only person who can say what will happen to it. If you tell him to stop and he continues to do something, he will be committing an assault.
Saying no to therapy - am I allowed to?
In this instance, you are the boss. He works for you and has to please you, not the other way round.

He left. I immediately elevated, rubbed in some of the Ayurvedic salve, and iced because my knee had already begun to swell up and it hurt. There is a small area at the end of my incision that is a bit redder than the rest. I think it did tear a little ad a result of getting my knee pushed back further than it could go.

Thursday night Some salve got into the tear and burned like throwing salt on a wound. Additionally, my calf and thigh muscles went into spasms. My tibia ached unmercifully directly under my knee, like it never had before. I think This was due to the leg lifts--straight and bent, that I had to hold to a count of 5 and do 12 times

You see, he did do some damage - causing your wound to open a little.
And there is no need at all to keep on doing those straight leg lifts. Once you can do them, you don't have to do them any more. Doing exercise to the point of making your knee swell and get stiffer is going to slow down your recovery.
Did you read this article, in the post-op reading list we gave you?
BoneSmart philosophy for sensible post op therapy

In any case, 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.

I'm glad that the Ayurvedic herbs are helping you, but please don't rub any lotions, creams or pastes, including those, on your incision. By doing so, you are running the risk of introducing infection. It's not good that some of the herb got into the little break in your skin.

I am bothered that I'm just sleeping my life away on a recliner all day, but it's part of the journey. There have been ups and downs for me on this journey, I am learning from mistakes, and doing my best to get better.

Sweetheart, you're not sleeping your life away. You're working hard at giving your knee the best chance to recover. It isn't lazy, needing exercise. It's wounded, trying to recover from a huge operation that caused lots of trauma. It needs time, rest, and gentle treatment, to help it to heal.

 

[Pumpkin]

I truly don't think he thinks he's doing damage. He's firmly planted in the "no pain no gain" philosophy.

Ruby when you told him to stop and he continued pushing on your knee it was an assault. What he is doing is setting back your recovery, by causing pain and swelling.
You need to tell him to stop, or better yet call the agency and tell them to send someone else. The ROM numbers you are getting are all with in the margin of error, no gains are being made.

You are over 6 weeks out from recovery, your incision should be fully healed and will only open up if someone pushes or shoves to hard. Time to tell them to STOP.
Saying no to therapy - am I allowed to?

If you can get in and out of bed, go to the bathroom, bathe, go up and down the steps or stairs in your home, prepare a simple meal, do some light pick up and dishes, you do not need any therapy.
You can do these two gentle activities.
Heel slides and how to do them and Extension: how to estimate it and ways to improve it .

The walking you do around your house, resting, icing, elevating, and medicating on schedule as prescribed is what will get you ROM.
Time to let your knee heal, we cannot rush recovery, but we can set it back by doing too much, or allowing someone else to push us too much.

You have taken control of your pain meds and found something that works for you. Time to to the same with your recovery, take control and say no to anything or any one that is going to continue to irritate your poor soft tissues, give them a half a chance to heal.

We have had members who allowed their PT's to push them too much.
PT: the seriously grave consequences of doing too much of it

Myth busting: no pain, no gain
TKR: Ceasing aggressive physical therapy after surgery

 

[imjustme62]

When it came to Measuring my ROM, I had gone from 76 at last measurement to 74. I reiterated to him that today that my Knee felt extra-stiff , like the incision would tear if we pushed it too hard. He pushed my knee back again this time further and I begged him to stop because it was hurting me. He measured my ROM again, it was 78-- he could go back to his supervisor and report my improved ROM. I truly don't think he thinks he's doing damage. He's firmly planted in the "no pain no gain" philosophy.

The whole no pain no gain theory is rubbish! You tell him TO BACK OFF and NOT to touch you!

You are in charge not anyone else!

I am bothered that I'm just sleeping my life away on a recliner all day, but it's part of the journey. There have been ups and downs for me on this journey, I am learning from mistakes, and doing my best to get better.

Honey, you are doing what is needed for your recovery. Rest is a great thing and your body needs it. You have to remember what you had done to you, it's major surgery and there is a lot of trauma that was done. Rest! Ice! and elevation!
I'm just a day behind you, and yes I have gotten much better. Each of us are different, we heal differently. You'll do it, it just takes time and a lot of patients!
Hang in there and YOU be in control of your PT You have made victories in your recovery by driving, taking a shower. Those little things are awesome! You're doing it and will continue to do so.

 

[Lil Cyborg]

@Ruby 9297 My heart goes out to you. I know sometimes it is so hard to know what to do, and we want to try anything and everything to make us better. I have to agree with @Celle and @pumpkin that you should not let anyone hurt you in the name of physical therapy. It is your body, your knee, and you are in control. Please feel better, and take good care of yourself and your knee. Resting a lot now is the trade-off for all that you will be able to do later when your knee is all better. Think of all the wonderful things you will be able to do when your knee is no longer painful. I bet you will become so active and do so much that it will make up for, an far outweigh, the extra time you spent resting. You will get there!!

 

[Josephine]

He said that what I was feeling was scar tissue under the skin, and we needed to break it up

Absolute tosh! He couldn't possibly have 'felt' adhesions and even if he could, there is no call to 'break it up'. That's old wives tales and much more likely to do more harm than good as these two points later your post proves.....

1. I think it did tear a little ad a result of getting my knee pushed back further than it could go.
2. my calf and thigh muscles went into spasms. My tibia ached unmercifully directly under my knee, like it never had before.

Geeze, is that's not proof positive of harm and damage done.

Suffice it to say I had no sleep Thursday night, I sat in my recliner yesterday with a high level of pain, and slept poorly last nigh

And these are the absolute proof of my philosophy that was born out of this article PT: the seriously grave consequences of doing too much of it

Ayurveda,

In case anyone wondered, this is

Ayurvedic medicine (“Ayurveda” for short) is one of the world's oldest holistic (“whole-body”) healing systems. It was developed more than 3,000 years ago in India. It's based on the belief that health and wellness depend on a delicate balance between the mind, body, and spirit.

 

[Josephine]

try more Tylenol. I have never taken it for pain, but I find it really does help my knee.

@Happydale I am puzzled by this comment. If you never take it for pain, for what purpose did you take it for your knee?