Bilateral TKR Scheduled February 2016

[KarriB]

No part of this is particularly easy. I truly tried to nap or sleep as much as I could, watched mindless tv (reruns of any type of Law and Order), Netflix was handy also. It was a few months before I could concentrate enough to read and if I needed to do some work for school, such as entering grades in a computer program, I had to time my meds just so. My advice, don't fight it, that's when I got weepy and mean.
I did try to do a few things to feel helpful, folding clothes while I sat and a month or more later dusting a different room every few hours.
This will pass and another phase will come along.

 

[KayeKaye]

Just got the threatening MUA call from the doctor. He had expected me to be at 90 ROM by now, day 20. Said if I don't get there we will be looking at doing MUA. Is this even reasonable? From what I have read here on bonesmart it's nothing to consider unless it's been 12 weeks, so that's just about "90 days for 90 degrees of ROM" (@Josephine hmm sounds like a catchy phrase for a graphic).

Honestly I am just so tired right now I can't even think of doing all this work. I know I have to but wow, what fight, I think I will rest instead just for now.

 

[KayeKaye]

newlybionic, I have never been a crier but watch out now, just weepy at the dumbest things. Today I watched a "Father Knows Best Reunion" show and weeped all the way through. Just stupid. All the tv shows are doing this to me now. My daughter went away on spring break, she did watch the house and pets while we were gone at the hospital for a week so kudos to her, but wish she was here doting on me.

@KarriB thanks, I will try not to fight it and give up trying to focus, I just can't for now.

 

[Celle]

Your OS is expecting too much, too soon. My surgeon doesn't expect 90 degrees until 6 weeks after surgery.
Don't be frightened by the threat of a MUA - lots of surgeons and PTs threaten this (which I think is wrong and unprofessional) but no one can do anything without your consent.
Next time someone mentions it, just tell them that you want to wait a little longer and see how it goes. They're your knees and you have the final say.

Don't be misled into thinking that you have to work hard to improve ROM either. Just a little exercise and lots of rest, ice and elevation are all you need. As the swelling goes down, your ROM will improve, all by itself.

These articles might help:
TKR: work “smarter” and not “harder”
Life in the slow lane
Knee recovery - Lose the Work Ethic!!

 

[KayeKaye]

@Celle Thanks so much. I think I have a fear of being put on a non compliant list and being refused service if something should go wrong in the future. I think I will send the doctor these articles. Can't hurt.

 

[Pumpkin]

KayeKaye,
You can say NO to a MUA, it is to soon for you. I suspect you still have swelling that is blocking your ROM like a hose full of water. A MUA could even be counter productive, it is too early to develop scar tissue.
Here are some articles about MUA and ROM.

MUA (Manipulation under Anaesthetic) and Adhesions
MUA for Stiffness Following TKR
MUA: the ineffectiveness of early MUA (JBJS)
ROM: it's worth the wait for ROM
ROM: it's never too late to get more ROM!
ROM (range of motion) information

Best thing you can do is Heel slides and how to do them, and follow the Bonesmart Mantra,
and medicate on schedule as prescribed. Do a little .

 

[kneeper]

I wouldn't bother to send the doctor anything. Just say you'd like to wait and see. 'You are doing fine. Just keep on with the gentle exercise and lots of ice, elevation and rest. I know it took me well over a month to get to 90, but I did once the swelling decreased.

 

[KayeKaye]

I don't seem to have any swelling. The PT and the nurses agreed that there was no swelling. My husband says my legs look the same. But it must be swollen, if not just inside. Don't know why the swelling is not showing, but glad.

 

[Celle]

I think I will send the doctor these articles.

No, don't do that. You won't change his mind. Better to just quietly tell him what you would like to do.

 

[Celle]

I don't seem to have any swelling. The PT and the nurses agreed that there was no swelling. My husband says my legs look the same. But it must be swollen, if not just inside. Don't know why the swelling is not showing, but glad.

It's possible to still have swelling inside your knee, even if nothing shows on the outside. Your knee joint is such a small, tight space that even the smallest amount of swelling affects it.

 

[Josephine]

I have a fear of being put on a non compliant list and being refused service if something should go wrong in the future.

They don't do that. It's more than their jobs are worth! They're just trying to hurry you up so they can discharge you and register you as a good outcome! They're not really interested in you at all.

I think I will send the doctor these articles. Can't hurt.

Oooooh no! He will react with disdain at the very least. You see, our 'softly, softly' approach really does go against their years of training. They cant' take it on board and it makes them !

But it must be swollen, if not just inside.

There is plenty of room for excess tissue fluid to build up in the inner compartments of your knee and your leg. It doesn't always show on the outside.

 

[KayeKaye]

Ok I will not be confrontational. Will try to go under the radar. It was just so irritating to listen to the the doctor trying to be stern and gruff threatening me. The PT people are better in that respect.

 

[KayeKaye]

I am really slow and tired today. Did my arm exercises still have to do some heel glides. But I did get out on my deck and to my surprise my deck chairs are very easy to get out with no help. Beautiful day here so got some Vitamin D sun on my skin to help with bone healing

 

[KayeKaye]

The ice packs I am using are great but I think they are feeling really heavy. It seems to hurt from the weight as much as it helps from the ice. Anyone run into ice packs being too heavy? I was thinking that maybe some nerves are waking up or something. But I have to switch to smaller lighter ice packs now.

 

[newlybionic]

The weight of the ic packs did hurt my knee too early on. The pain slowly dissipate and I was able to pack it in ice for much longer times and over my knee without problems.

 

[KayeKaye]

The night was pretty bad. I don't know if I overdid it or if new nerves are waking up bring new pain with it. My knees were aching and zinging pains shooting through them. So the ice packs added to the trouble, good to know @newlybionic that it too will pass. Had trouble sleeping, which is normal but this was something more, so gave in and took an oxy. Woke with more pain in knee but could walk and it lessened. Can't sit, my butt hurts from sitting all the time. Have to stand more, but that makes me wonder if it will hurt the healing. Doesn't help that I can't sleep in my own bed. After we took off our 4" memory foam we discovered a completely shot mattress. Will buy a new 2" memory foam to see if that helps short term. The 4" was like laying in a marshmallow and couldn't move an inch at all in it. Sorry, complain complain complain.

Doesn't help that there are all kinds of other crappy stuff going on in my life right now, in-laws in very bad health and life changing decisions underway, which really is hurting my husband; my church of many decades is closing this week due to infighting and poor management, so sad. What are the odds of all this happening at once! So here I sit just crying at any little provocation.

Having another in-home Pt today.

 

[newlybionic]

I'm so sorry to hear that you have all those things going on at once. Sometimes it feels like we are getting overwhelmed with all types of problems that are totally out of control. On top of it all you just had a major surgery. Try to pick something that you can take care of and do that. I've found that even if I can pick out one little thing that I can get off my mind it starts to make me feel a little more upbeat. You can start with the bed or even start with making your chair more comfortable by adding a pillow or inflatable 'donut' so you are comfortable there. Sleep is a tough one so I slept whenever and wherever I could. You migh want to take a pain med at night and then set an alarm to take the next one. It always seemed I had more pain at night and for me I thought it was because there was nothing else to distract me. The last thing is go ahead and cry. It does help. Hang in there!

 

[Celle]

I'm sorry you have so many things going on in your life right now, all at a time when you are dealing with a long recovery yourself.

It's not making it any easier that you probably have a dose of the post-op blues, which makes your emotions unstable too. Easy tears, quick anger - they are all part of this recovery journey. They will pass, but it takes time.
Post op blues is a reality - be prepared for it

You can't do anything to help your in-laws or your church right now, except offer sympathetic words, but you will be able to before long. Concentrate on your own recovery now and you'll be able to help more effectively later on.

About that night pain: It's still very early in your recovery and many people at that stage are still taking regular pain medications. I see nothing wrong at all in taking a pain medication routinely at bed time - it sounds as if you still need it.

 

[KayeKaye]

Thanks Celle and newlybionic. I guess I need the help to sleep no use pretending I don't. I've never been a crier, it's so weird for me to end up doing that, but there is nothing else to do. Donut, will try that on my chair.

PT came today and it well very well. I was extremely tired but still got up and did the paces. Walking, getting in and out chairs, some exercises. It was all very gentle. I tried the floor pedal machine and as I was rocking back and forth I just went around with no trouble. Did that for a few more minutes, all the way around both directions back and forth. She was very surprised as was I. No pain. That's encouraging. ROM increased as well, 78 L 82 R. But by the end of the session the R backed off a couple degrees, no doubt due to my hip hurting from yesterdays car ride.

 

[Creation]

If I am in pain, I am a cranky old ..... And I am no fun to be around with.
I noticed that I get cranky when the meds efficiency is at its end. My leg starts hurting, I have no patience and I slowly am no longer able to focus on anything. Now that I understand my self a bit more I do not wait to get into that state, when I start fidgeting meaning : putting the leg up, turning left, then right, than down, then ice, then change the pillow...not this one....I then look at the clock...there it is I am 30 minutes overdue for my next dose.