TKR Second TKR Done, but still not very patient

[leejaa]

Ellen, sending you . Hang in there. I am sorry you are feeling so down. I can tell you it is quite normal but that will not help right now. Sometimes letting yourself cry it out might help -lets out the stress. A recumbent exercise bike might be easier to start out on - easier to get on and move back and forth if not full revolutions right away. Anyone in the family you can swap cars with so you have an automatic and might be able to get yourself to the gym- sounds like this would really lift your spirits.

You did not fail in not returning to work at this time. As I have written, if I had a choice I would have stayed home longer just to help with stamina and have the time to work on strengthening. You are doing a good thing in waiting so that when you return to work you are actually more productive and able to deal with the job instead of just feeling knee pain.

I hope today is a good day for you. Lee

 

[Josephine]

would you mind please changing the name of my thread to "Patience is not my strong point'". Many thanks.

Done!

Still need to lean on my walker to get in and out of the shower and first thing in the morning until everything wakes up and becomes less stiff

That's okay - you're still only 6 weeks out. Don't fret about it.

I put off my return to work, for good and valid reasons, but somehow I feel like I have "failed" in some way by not being able to go back when originally planned.

Actually, you've succeeded in taking charge of things!

watching the dogs look at me with longing in their eyes because they desperately want to go for a walk and I can't take them - we used to have such lovely walks together

And you will again! This is just temporary and they will get over it.

I just want to cry, but I won't let myself because I don't think I would stop for ages.

Sounds like you need to have a really good howl! When you are on your own, get a nice big box of tissues and a big cushion to hug and bawl your eyes out! It's healing and very, very good for you. Human beings are designed to release emotions with tears so don't ever bottle them up because that's where we end up suffering from things like panic attacks and depression! Let'm flow, I say!

purely on a medical basis Josephine do you think there would be any correlation between drains not being used after surgery and the fact that my swelling is so severe?

I wouldn't like to go that far but there might be a correlation in that the accumulation of loose fluid immediately post-op has set up a tendency to swelling in your knee. But people who have had drains also get persistent swelling so

 

[leejaa]

Ellen, I forgot to say that I did not have drains and did not suffer from excessive swelling- though icing/elevation was my life. I also did not have a CPM machine or compression stockings.

Also,both times my PT in home was more insistent that I had a good gait with my walker before using a cane. Neither one thought there was a time to go to cane - it was all about my gait. Also, both of them said to progress to cane slowly- middle of the night I always used walker and first thing in morning till I got moving and after I had my shower. Once I was more awake and more mobile after getting out of bed - I would use the cane inside the house for middle of the day but anytime I woke up from nap or whatever I would first see how I felt (steady or unsteady due to whatever knee, meds, just general feeling) before either grabbing the cane or the walker - both were near by for a few weeks while I figured out what would be safest. Like recovery there is no timeline for when to go to cane.

Lee

 

[Jozilla]

Hi Ellen - sorry you are feeling so down. My surgery is in one week and I certainly have looked forward to reading your posts. I think having such an athletic life probably makes the recovery and patience harder for you. You are doing fabulous and have certainly made lots of progress from my perspective. I agree that crying is good for the soul! Indulge yourself. Now hopefully I can remember these words in a couple of weeks . . .


Sent from my iPhone using BoneSmart®

 

[kneeper]

 

[GimpyGal]

Ellen, I've been following your posts since you are about a month ahead of me. I'm sorry you are so discouraged. I'm fighting that myself as I approach six weeks. When I asked my surgeon about recovery, his simple answer was that I could expect '3 weeks on a walker, then 3 weeks on a cane.' And after that he said I could do whatever I wanted including golf.

So, I assumed at six weeks this journey would be over.

Well, we all know that at six weeks there's still a ton of recovery ahead. I can't imagine getting back to normal in just one more week. I may be allowed to golf and hike, but I can't fathom doing that yet. I understand about the dogs - I have a six month old puppy I've yet to walk which has bothered me greatly - but we'll both get there.

I really like my surgeon but I wish he would have painted a more realistic picture of recovery. Or that I had discovered this site sooner!

As far as tears, I've been there, too. I spent an entire day last week watching tear jerker movies, one after another, and sobbed my way through. I seriously felt so much better afterwards.

 

[NetballKnees]

Hello All ... Thank you so much for paying me a visit and sending words of encouragement and support - leejaa Josephine kneeper Jozilla GimpyGal
I do so appreciate your words. I got up this morning with a different mindset and decided to do an exercise I had done while participating in this year's 12-week gym challenge. My biggest problem is that I have always expected much more of myself than I do of anyone else and I had this problem doing exercise at the gym as well. I was the oldest in the team, had two bone-on-bone knees which restricted what I could do and was the heaviest in the team and still I compared myself to what 20 or 30 year younger, already fit members could do; got frustrated when I couldn't do what they were doing and got in quite a state about it.
The trainer for our team in the Challenge (and also my Food Coach) sat me down and got me to tell her what I COULD do, rather than what I couldn't do. I couldn't spend long on the treadmill, but I COULD ride a bike faster, harder and for much longer than most people ; my upper body strength was amazing and anything involving lifting, pushing or pulling had me at the head of the pack; I had really good stamina; was determined to finish anything I started and apart from being hard on myself; never, ever complained at what I was asked to do.
So this morning I thought I would do the same thing with my knee, so I re-read a lot of posts to see what problems other TKR-ers had. I have discovered that although I have not much bend, I DO have great leg lift and I haven't needed to be helped into bed since the 3rd night after the op - I was able to lift my leg from that stage and swing it on and off the bed with ease - others aren't so lucky.
While I don't sleep all night, and wake every 1-1/2 to 2 hours for a bathroom visit, I DO go back to sleep quite easily and can move from side to side without much trouble (using a pillow under the TKR) - others have a lot of trouble with sleeping.
Although I had, and still have, swelling, stiffness and that awful tight band feeling, I think I have NOT had the level of actual, acute pain that some others have.
Oh, and I have never had any problem with my appetite, but perhaps that is not quite such a good thing????
I have had the additional "hurdle" of have a medial collateral ligament strain in the non-surgical knee (which GP now thinks is an actual tear given that it is so painful and healing so slowly) and this is hindering recovery of the TKR. But there are those who have bilateral TKRs and who probably face greater limits and pain that I am experiencing.
So all in all, I am not doing too badly.
I am a bit ashamed of yesterday's "outburst" given what some other TKR-ers have to face, but I think it was a sort of cartharsis for maybe being a bit easier on myself and accepting things as they come - I will try anyway.

Jozilla - My hope for you is that you have nothing to cry about, but I realise that is probably a bit unrealistic given what a TKR recovery is. But I will certainly be available for you to vent to whenever you need to, as will this forum. I will make sure I visit before the op.

Lee - I appreciate your kind words and advice regarding walker/cane/gait. I think our physio over here is a bit different. My physio has never mentioned gait - just told me to practise walking with the cane at home. I hope you are feeling a bit stronger and work is not tiring you as much.

Josephine - thanks for addressing different points and showing that I have actually/am doing the right thing.

kneeper - thanks for the . Hope everything is going okay for you.

GimpyGal - I am actually 11 days ahead of you and I do hope your recovery is going well, with not many speed bumps. You are right - my surgeon was certainly not very realistic about the time needed for recovery. I am afraid I would rather know all the "what ifs" than believe that life will be a golden road afterwards. What sort of puppy do you have? I do love dogs. I have a cat too and adore her, but the dogs have the lion's share of the heart.
So once again, and after the War and Peace of posts, thank you all again I certainly hope this new attitude of mine sticks around.

Have a great day/night everyone and hope your lives are going well.
Ellen

 

[Josephine]

That's the ticket! Much better to be a 'glass half full' than a 'glass half empty' kind of person!

 

[leejaa]

Your food coach and trainer sounds awesome. Wow for your arm strength and at 3 days lifting your leg without assistance.

I ,unfortunately, have a lot of weight to loose (more since last year when the lt. knee got so bad I could barely walk with a cane) and unfortunately my appetite though not great in recovery was still there and with less activity put on more weight. One would think that with having the mind set of going through two knee replacements and recovery could manage weight loss easily - not so between genetics and my own eating when stressing it is not my forte. I guess we all have different weaknesses. On the bright side I rode my recumbent 5 miles in 26m at level 3 yesterday which made my leg (thigh) feel a little tight but good and it went away. I have a hard time making time for me around the work and home schedule when tired. I think you are awesome for your previous weight loss and fitness regimen and recovery now. You will get back to the gym and get even better. I am going to use your past regimen to try to propel me to do more and get this weight off- I refuse to buy clothes right now since I need just 20# off to fit in more of what I have and it is too discouraging to buy larger right now- I was large enough already.

Thank you for sharing about your weight loss and exercising even with bad knees as it will help me. Lee

 

[NetballKnees]

Thanks Josephine

Lee, I too have a lot of weight to lose again. Even when I lost 18kg in the challenge, I still had a lot to lose and as desperate as I am to get back to exercising, I still can't seem to stop eating at the moment. You sound a bit like me - I eat when I am sad, when I am stressed and when I am depressed. Oh, let's face it - I eat just because the day ends in 'y'. My personal trainer used to say that in weight loss, exercise was 20% of the equation and diet 80%, but I think that exercise is 20%, diet 30% and mindset at least 50%. One day you will get the mind to act with the body and it will all happen for you. I keep telling myself that I will diet properly again and lose the weight once I can exercise properly. It might be too late then. I really need to start doing something now.

Yesterday I got out the Christmas tree and assembled it and decorated it. Before that though I needed to rearrange some of the lounge room furniture. I could not believe that moving a few chairs, assembling and decorating a Christmas tree would take the entire day. I kept stopping to elevate and ice for a while and then start again. But the tree looks lovely. My LTKR has been tight and swollen today, so it looks like the timetable may be, have a day of doing stuff and then the next day elevating and icing. The old rubber band feeling around the leg today feels like someone put a stick in the band and twisted it (like a tourniquet). One look at the twinkling lights on the tree makes me feel better though.

I am making tea tonight - spaghetti - yummo. I have a little trick of putting some cream in the sauce before serving and it makes it absolutely delicious.

Take Care everyone ...
Ellen

 

[leejaa]

The tree sounds lovely and cheering - well worth the icing and elevating. I will have to try the cream in the sauce trick.

Have a lovely day enjoying the sparkling lights. Lee

 

[NetballKnees]

Needing some advice please fellow Bonesmarties. Yesterday at physio, my physio commented that my "bend" had lessened from the week before. I believed her as I had felt the same in the last few days. I feel I can cope with that though - I am used to not having good bend.

However, when she was massaging the leg, she also commented on something else I had noticed - in the last few days when I have been massaging Bio-Oil into the scar, I felt the beginnings of lumps up and down the scar line, not on top of the scar but right beside it on the outside of the knee. The physio said "you are very bumpy this week". This has only started to happen in the last few days and already the "lumps" have increased in size. I am a bit confused by the difference between scar tissue and adhesions. What would these be? And is there anything I can have done about them? Or are they destined to stay unless I have a clear-op or MUA?

Hopefully someone can give me some advice on these, especially Josephine Jamie @!bottomshollow leejaa or anyone else.

I am over 7 weeks now and have been trying to walk a bit more, with the effect that the rubber band effect is heightened. I am so tired of sitting around all day on the recliner, elevating and icing, or lying on the bed and elevating and icing but we do what we have to do.

Thanks for any advice I receive about the "bumps".

Have a great day/night everyone and take care ...
Ellen

 

[Josephine]

Scarring is a complicated thing as there are several different types of it. Basically, 'scar' is a fibrous material which the body develops when there has been an injury or wound in the skin and/or deeper tissues. At its most basic, it is the matrix of new cells that binds the edges of a cut together. Once it's done it's job and sealed the wound, it settles down into a fine, thin line which is pliable and almost invisible.

Then you get the kind of scarring where and ordinary scar just goes on growing. It doesn't attach itself to anything but just grows like a bunch of grapes in odd places, varying in size from peanuts to grapes though mostly they are quite small. They're little more than nuisance value as a rule though if they get big, they can be unsightly.

Another abnormality that can occur in scars is the development of a keloid scar where instead of staying a nice fine almost invisible line, the scar develops into a dark brown and rather prominent bulging mass of tissue. This is more common in the Afro-Carribean populaltion but it does sometimes occur in other groups.

Adhesions are quite a different kind of thing. I have explained the how and why of it in detail in this article MUA (manipulation under anaesthetic) and adhesions. It's where structures like muscles and tendons that should be easily gliding past one another get stuck together and has nothing to do with the surgical scar.

something else I had noticed - in the last few days when I have been massaging Bio-Oil into the scar, I felt the beginnings of lumps up and down the scar line,

I would venture to suggest that your bumps have actually been caused by your massaging - there is no need to massage scars as the body is usually very capable of dealing with them on its own. It's quite possible that the friction has caused an overgrowth of the fibrous tissue resulting in these nodules. I recommend you leave it well alone.

I am over 7 weeks now and have been trying to walk a bit more, with the effect that the rubber band effect is heightened.

7 weeks is prime time for the rubber band syndrome. Mine lasted well into the 5th month so be warned! I trust you taking pain meds for it?

 

[leejaa]

Ellen, sorry to say I have nothing to offer on your lumps and bumps. I wish I did. I am sorry you have them and that you seem to have lost some bend. You are having quite a difficult road on your recovery. I see though you have been encouraging and supporting others on the forum which is a wonderful thing. You have a great way of phrasing in your posts. Lee

 

[NetballKnees]

Thanks Josephine for your explanations for me. The scar itself looks great, with just a tiny pucker at the bottom - not sure whether it might be first or last stitch. I am hoping it will flatten itself out over time, but if it doesn't, it is so small it's not really worth worrying about. The lumps are under the skin, close beside the scar, but if you think it may be caused by my attempts at massaging the oil in, I will stop and see if they reduce in size at all. I do not actually take painkillers any more - not the Endone anyway. I take Panadol Osteo when necessary, not regularly. The OS was not prepared to give any more strong painkillers and the GP said he would only give me the one extra script for Endone last time I was there a few weeks ago. This is all gone now.

Thanks leejaa for your visit. Thanks for the cat and dog hugs (it is lovely and very calming to stroke the animals) and the consoling hug. I do seem to be going backward a little bit but have not been posting it much because I really would rather post positive affirming posts.

Today ex-husband took me to Big W because I was looking for one of those bed rest pillows (the kind that you can sit up against, with arms). Also managed to snag a couple of Christmas pressies and tableware for Christmas Day. The good thing is that all these things were either on, or just off the one aisle, so I really didn't have to walk too far around the store. Then it was a wait in line to pay and back out to the car and home. The problem was that when I got back to the car, I was crying with pain. I can count on two figures the number of times I have cried from pain since the op. I have cried from frustration, cried from feeling down, but not from pain. I have actually walked further around the Chemist Warehouse when down there without the pain, stiffness and tightness I experienced today. To top it off, my right knee (the medial collateral ligament strain) was also stiff - extremely stiff and so painful and trying to get back in the car was such an effort. It took me back a bit because it wasn't a step backward, it was about 3 weeks backward. So very frustrating.

Thank you for your kind words about my visits to other threads. I find it so much easier to be encouraging and positive to others. I am actually following your lead in this as your supportive, friendly and encouraging posts are all over the forum, so thanks for the example.

I hope work is getting easier for you Lee and you are not so tired and worn out at night. I am so glad I put off going back to work - the idea of working all day does not appeal at the moment at all.

Take Care ...
Ellen

 

[Josephine]

The scar itself looks great, with just a tiny pucker at the bottom - not sure whether it might be first or last stitch. I am hoping it will flatten itself out over time

Oh it will! It's just where the surgeon gathered up a rather large bit of tissue into the stitch. It will even out in time.

The lumps are under the skin, close beside the scar, but if you think it may be caused by my attempts at massaging the oil in, I will stop and see if they reduce in size at all.

They may not reduce in size or if they do, it will only be over a period of months. Maybe even a year. Nothing happens quickly with such things!

The OS was not prepared to give any more strong painkillers and the GP said he would only give me the one extra script for Endone last time I was there a few weeks ago. This is all gone now.

That's very cruel of them - I was still taking those meds for 3 full months and you are only 7 weeks out! At that point I was actually getting some of my worst pain.

 

[GimpyGal]

Hi, Ellen!

I'm wondering if you are more comfortable now and have recovered from your outing. I had a similar meltdown after spending nearly 4 hours on my feet, getting ready for our trip. By the time I settled into the car I was sobbing and my husband suggested we call it all off.

THAT went over well!

Good for you getting your tree up, though! I've been tempted to just cancel decorating, but I imagine having it up makes life seem a bit more normal. Yesterday, I went out and bought just a little table top tree and that's my compromise. Whether or not it actually gets decorated remains to be seen.

How are you doing now that your doctors refuse to prescribe pain meds? Do you feel like you still need them? That's a fear of mine as I have my 6 week post-op this week. There are times I do okay without them, and times I don't and I want to be the one to decide my own pain level.

I'm sorry you are dealing with a 'bad good knee' on top of your surgery. That's what my mom had to deal with, too. She said the second knee was a piece of cake because her previous TKR was strong and she had faith in it.

 

[NetballKnees]

Hi Josephine and GimpyGal ... Thanks for your posts. I actually had just written a really large post and it disappeared into cyberspace somewhere. One day all those lost things up there are going to come crashing down on top of everyone.

Because we were speaking of not being able to get the stronger pain meds any more, I thought I would share with you the conversation with the doctor when I first when for a renewal of the Endone script.

Doc: Why is your knee so swollen? (This was as I was walking in and I was wearing a long dress - that's how swollen it is).
Me: I had a knee replacement remember?
Doc: Oh, that's right. I suppose you have come in to get stitches / staples out?
Me: No - there were none to take out. I have come for a renewal of the script for Endone.
Doc: (look on his face) Endone? That's morphine you know.
Me: Yes, I know, but that's what they sent me home from hospital with.
Doc: What do you take? 3 tablets a day?
Me: No, the box said 2 tablets 3 times a day?
Doc: That's 6 a day!!!!!! That's Endone. That's morphine you know. It's very addictive you know.
Me: Well, I haven't been going on heists to local pharmacies yet, so I think I am safe so far.
Doc: I will give you a script but it is the last one I will give you. The sooner you are off those things the better. It will only be 1 tablet 3 times a day and as soon as you can, only 1 at night and soon after that, none.
-------------------------------------------------------
I don't know what doctors take when they are in a lot of pain or discomfort, but they are very anti morphine derivatives.

On a positive note, there seems to have been some progress - just a little. I can get in and out of all sorts of cars now AND in the front seat like a real person.

Last night a friend came to take me over to another friend and her husband's place as it was the second anniversary of the passing of the husband's brother from a brain tumour and we were all getting together to remember him and have a bite to eat. We all spent time together in Fiji in October 2011 and had such a lovely time, even though we were there mainly as his last request for a holiday. He passed just 6 weeks after coming back. But I digress ... when I got there I had to go up 5 stairs at the front. I have only ever done 3 stairs up and down since coming home because I have a low set house. I managed the 5 at the front fairly easily using the rail and the cane and two feet on each step. When we got inside we realised that the main group were downstairs. The back is higher than the front, so then I had to go down 14 stairs. Managed this quite well too except the rail ended before the last 2 stairs and I actually stumbled down them and wrenched the non-surgical knee. Then to have dinner, I went back up the 14 stairs - much easier than going down and then down the 5 stairs to go home. All in all, not too bad and left me feeling a bit more confident that there is light at the end of the tunnel and it is not the express hurtling through.

Today I had the pleasure of being taken to see Sebastian, my 2 year old grandson, having his swimming lesson and then looked after him for a couple of hours. (Mum is still having root canal surgery). Such a joy. Ex husband then took me to a discount shop to pick up a few Christmassy things and went to Woolies to pick up groceries. Must admit it was a bit much and have taken Ibuprofen and am icing, icing, icing and elevating at the moment, but the feeling of desperation that I will always be like this has gone.

GG - do you have tinsel in the house? Maybe you could drape some around your table tree to make it sparkle and shine. I can't believe you were on your feet for 4 hours. I think you were entitled to person. I think you will know when you need to stop taking the strong painkillers, or at least cut down. If you still feel that you need them some of the time, I hope your doctor will give another script at least until a few months are up. Hope you are doing well and recovery is ticking along well.

Take Care ...
Ellen :ereindeer: (How long have these Chrissy emoticons been here? I have just noticed them. I will have to pay more attention)

 

[GimpyGal]

Ellen, that conversation with your doctor really disturbs me. Others posters report similar situations - it's just so wrong! I'm glad you used your sense of humor and were assertive enough to get what you needed.

At my 2 week post-op appt I was still taking morphine. My OS mentioned the 'sooner I could move on to something else, the better' because it was more addictive than other options but didn't force the issue - perhaps because I can't tolerate most other narcotics. It makes me feel fortunate I could be on it as long as it was necessary, which was over 4 weeks.

How's your pain level now?

I'm not sure what the signs of dependence are, but at four weeks I sure didn't 'crave' the pills for anything other than pain relief. I did laugh at your pharmacy comment!

And how on earth does your dr not know whether or not you have staples? Do you see a different doctor post op than your surgeon?

Still not sure about the decorating here. If I postpone much longer I guess that will make the decision for me! I'm dealing with a 6 month old puppy (a Brittany who is only now just starting to have enough self control to 'Leave it!' . . . when it suits him. . . . if I have a treat in my hand . . . and if the item's not wonderfully enticing!)

He really is the perfect excuse to keep it simple this year.

BTW, I finally looked up netball! Never heard of it here - I think it's awesome you played it for so long!

 

[Josephine]

You doctor sounds like a real pillock! But try suggesting to him that he prescribe you Tramadol instead. He 'just' might go for that as an alternative.

How long have these Chrissy emoticons been here? I have just noticed them.

I put them up yesterday. There is an announcement in the Announcements Forum!