TKR SeptemberZen's Bionic Journey

[janmont]

To clarify the reference to the posting on my thread, it was the link to consumer reports about Tylenol pm., I copied Josephine so she would be sure to get it. I would do it here as well but I have to sign in to get the article and I am on my I Pad which is harder to do.

 

[SeptemberZen]

Oh, I saw that one! I don't take Tylenol PM; in fact I don't take anything marked "PM". I'm a lifelong chronic insomniac, but I've never been comfortable taking any kind of sleep aids. Eventually it usually straightens itself out.

 

[SeptemberZen]

So -- had my first appointment with the new PT today. Not bad! I was a little wound up before I got there, anticipating that we would not be on the same page but it turned out OK. I took a pain pill about an hour before just in case. The PT started out by putting those electrode thingys on my knee for a few minutes, and then massaging it with some kind of cream. He said the massage would help 'break up' the scar tissue (Not sure that is true, but saw no need to argue the point. ), and then he gave me a long cord and asked me to loop it around my foot. The goal was to stretch my hamstrings by sitting up and pulling on the cord, lifting my leg somewhat and, working my hands down toward my ankle, hold it for 10 seconds, release, repeat, etc. Then I had to press my knee down as far as I could -- although he felt that my extension is pretty close to 0 as it is), and hold that for 10 seconds for several sets. Then he told me to lie on my stomach, looped the cord around the foot again and I had to pull my foot as close to my butt as I could without lifting my hip, hold it for five seconds, release, repeat, etc. At one point, the other PT who was watching said, "That's really good, but now see if you can go a little further. Give the cord a good yank." Um, no. I said, "I will see if I can get it up a little further but I won't be 'yanking' anything!" I said it with a smile; I don't want to appear combative, but I'm not letting anyone push me further than is comfortable for me. I used to be quite the exercise nut once upon a time and found that after my workout, when I did my stretches, I was always able to go a teeny bit further with every stretch so I tried to do the same here.

Overall, we did mostly stretches and leg lifts, and I've gotta say, it really wasn't too bad. And, the PTs were kind of impressed with my ROM. Every time they gave me an exercise, they stood ready to help me lift my leg where they wanted it to go but I barely needed their help. As I said earlier, I walk around the apartment regularly, do light cooking, and go out at least once a week or so for dinner or marketing, so it's not as if I'm just sitting around with my leg up all day. In fact, I find that if I sit too long with my leg up, it really starts to ache and only feels better if I bend it and walk around a little. Even though I have a LOT of stiffness, if I move slowly, I am able to bend my knee pretty far back. At this point, it's really the stiffness and heaviness that is holding me back rather than the pain, and hopefully the PT sessions (and time) will help with that.

 

[Celle]

I'm glad your PT session went well and I'm glad you spoke up against yanking your leg.

Before you go to PT, make sure that your medication schedule is such that you are not due for pain relief close to the time your session ends. You don't want to be desperate for pain relief once the session ends. But, don't take pain medication specifically to dull pain during the PT session - pain is the warning sign that you are doing too much, and you don't want to mask that.

 

[SeptemberZen]

Thanks, Celle.

The session ended at 12:30. I was due for a pain pill at 1:00 pm but didn't take it because I didn't need it then....but I've just started getting some achiness in my hip and thigh so just took the pill.

 

[ConnieJo]

Hi September,
Glad your PT Session went well. I went again myself. In fact I pulled myself out of bed this morning when I so Did not want to get up. Last time I looked at the clock in the middle of the night it was 4:15 and I hadn't had any sleep. I had to force myself to get ready for my 10:00AM appointment, to show up and realize my appointment today wasn't until 2:30 in the afternoon....Gurrr !!
I worked a Lot yesterday and this morning with my leg extensions. I had a girl today and she keep working it and applying pressure and she said she got it straight. I was relieved to hear that. Now I guess I just have to keep working so it will keep getting to that point. The backs of both my knees are just a bit achey tonight, but nothing unbearable.
She was massaging my knee with some sort of salve. She told me to keep working that , to keep from getting one of those raised scars. There was one spot that was a bit tender and she said I really need to work that, because it shouldn't be that tender eight weeks out.
When my husband and I both had our surgeries, they sent us both home with a long cotton strap, with a little loop to put a foot through and then handles to hold onto. They had us pulling on the trap to bring the knee up toward us in a good bending position, hold, release and then repeat. It really works well. She said my ROM was good, and to mainly concentrate on the extensions now. I still do a few of those bends a couple of times a day, just to keep it from getting stiff.
Well, I'm going to try and call it an early night tonight since I'm going on four plus hours sleep...not quite enough. Take care, hope you have a good day tomorrow!
ConnieJo RTkR 1/05/2015

 

[SeptemberZen]

ConnieJo, the strap you described is exactly what I was working with today and my PT also mentioned that the cream he was massaging my knee with would prevent an ugly scar from forming. Guess this is standard procedure! Only thing is, I have most of the feeling back in my knee except for one spot and his rubbing the cream on, over and over, was starting to get irritating. "But that's good, that's great," he kept saying, when I complained. "Some people never get feeling back at all!" LOL - I wanted to smack him!

Sorry about the insomnia! Honestly, this is the one thing I will miss when I give up the Percocet: it has a sedative effect on me. 30 minutes after I take one, if I'm not actively doing something, I get really sleepy.

 

[chestnc]

Hi @SeptemberZen, Great PT report. Sounds like you did well for your first visit. It's good to that you let the PT know that you are ultimately in charge of your own body. Sounds like you are moving right along and progressing nicely. Take care of yourself. My best to you.

 

[praise1989]

Wow! I wish I could get a massage during pt....this will be my 4th visit today and I have yet to experience this massage others speak about. My OS said for me not to put anything directly on scar until after my second post op appt on March 13th and I can't wait to rub some Shea butter on it. I'll be patient ant try not to compare. Great job on your pt

 

[SeptemberZen]

Thanks, Chestnc! The session did go pretty well but I definitely paid for all that stretching later! From hip to calf, I was achy all of yesterday afternoon, but a Percocet and a nap were very helpful!

Praise - I don't understand why you're not allowed to put anything on your incision. As long as you are sure it is completely healed, I wouldn't think shea butter would cause any harm. I didnt put anything on mine for the first month but by then it was completely healed and covered in dry, peeling skin. I just couldn't take it anymore, so I dabbed on some light body oil (Neutrogena sesame oil that I usually use after I shower).

 

[Celle]

It's OK to put creams/oils on your scar, once it is completely healed - no scabs, no open areas. The PT was probably being cautious, which is no bad thing. I used Bio Oil and that helped with the dryness.

It's probably out of season now, with all the cold, wet, snowy weather, but when summer comes, you should remember to put sunscreen on your scar.

 

[kneeper]

You are so right about getting stiff when you are still for a long time. A little walking around is a good thing.
Percocet put me right out I had many good naps in the first couple of weeks when I was on it.

 

[SeptemberZen]

You are so right about getting stiff when you are still for a long time. A little walking around is a good thing.
Percocet put me right out I had many good naps in the first couple of weeks when I was on it.

I heard that! I'm almost going to be sorry when I have to give it up. I generally fall asleep within 30 minutes of taking Percocet. Even though I don't sleep the whole night due to the pain, it usually helps me get between 3-5 hours of uninterrupted sleep.

 

[SeptemberZen]

Discovered something interesting over the last couple of days: Friday morning we went to the supermarket and also did a little shopping at Walmart. Forgot my Percocets, and an hour after we got home, not only was my knee swollen up like a balloon, my ENTIRE LEG was throbbing and achy. I took the Perc but it took awhile to calm down and I was miserable! On Saturday, we went to breakfast and then to the mall. We didn't rush through the meal, just sat enjoying the sunshine (like most of the country, here in the New York area, we've been getting snow almost weekly since January ). I took a Percocet right after breakfast and then we walked around the mall for maybe 30 minutes and did a couple of other errands. I get around OK with my cane but knee is still VERY stiff even though my ROM is pretty good. I had a little discomfort but not too much pain and I iced and elevated my knee as soon as I got home. Surprise, surprise, no throbbing ache!

But nighttime pain has been kind of fierce both nights! I take a Perc before bed, but pain woke me out of a sound sleep on both days. Argh!

 

[kneeper]

I guess you've tested your limits and found them. ;)

 

[SeptemberZen]

Yep!

 

[praise1989]

@SeptemberZen and @Celle
The OS told me at my first post op appt when she took off the covering and added the strips that as the strips fall off DO NOT PUT ANYTHING on the incision....no matter how dry and scaly it looks. I can only allow the shower water to hit it naturally, but no scrubbing or soaking. I wrap in Saran wrap to get moisture so it doesn't look so dry. When I return to second post op this Friday, I will be allowed to soak and put anything I want on the scar. I am so looking forward to pool classes at the rec. it's so funny how different each OS rules are. I did finally take off rest of strips on yesterday and it looks pretty good so I'll just play it safe til Friday...CANT WAIT

 

[SeptemberZen]

I guess a few more days won't make a difference, right? At my first post-op follow up, I was told I could let the shower water trickle down but not to scrub. Got in the tub for the first time last week and had my first soak since the operation. Ahhhhhhh....Felt SO good to sink down and let the warm water flow around my leg!

Worst part was getting out of the tub- LOL! Not so easy to do when you have a very stiff knee and your boyfriend is sound asleep! Ha!

 

[Celle]

@SeptemberZen and @Celle
The OS told me at my first post op appt when she took off the covering and added the strips that as the strips fall off DO NOT PUT ANYTHING on the incision....no matter how dry and scaly it looks. I can only allow the shower water to hit it naturally, but no scrubbing or soaking. I wrap in Saran wrap to get moisture so it doesn't look so dry. When I return to second post op this Friday, I will be allowed to soak and put anything I want on the scar. I am so looking forward to pool classes at the rec. it's so funny how different each OS rules are. I did finally take off rest of strips on yesterday and it looks pretty good so I'll just play it safe til Friday...CANT WAIT

That is correct, which is why I wrote what I did, below.

It's OK to put creams/oils on your scar, once it is completely healed - no scabs, no open areas. The PT was probably being cautious, which is no bad thing. I used Bio Oil and that helped with the dryness.

I don't think the OS's rules about this differ. All agree that you should not put anything on your wound until the incision is completely healed and no infection could get in from the outside.

 

[SeptemberZen]

I've decided to quit going to the PT since I'm not sure I'm getting any benefit from it. Last session we did the thing where you lay on your stomach, loop the strap around your foot, over the shoulder and then pull your foot up to your butt and hold for 10 seconds and repeat. Had a new PT and just like the other PT, she was was very surprised at my ROM. I'm guessing they're surprised because my knee is still quite stiff and swells easily if I overwork it but my extension is nearly at 0, and while I don't exactly know what my flexion is, if I move slowly I can get my leg pretty far back. I do a fair amount of stretching at home along with the daily routine of cooking, doing dishes, going to the bathroom, practicing on the stairs, etc. In addition we either eat out or go shopping every week to make sure I get exercise and fresh air. As an aside, I gotta give credit where it's due: my guy has tons of patience because at nearly 8 weeks, I've reached the "occasionally cranky, occasionally weepy" stage wanting this to be over -- especially when we've been out for awhile and my knee stiffens up and complains.

Anyway, it feels like the PTs aren't really directing me to do anything I can't do on my own. I'm very motivated because I really need to get back to work in 3 weeks, the beginning of April. Boyfriend and I are determined to go back to the gym because he needs it (he's diabetic) and I'd like to start trying to use the exercise bikes, not to mention, we're paying monthly dues anyway!

To be honest, I'm also not entirely happy with the attitude of the PT staff, the typical "you're just being a bad client because you won't let us hurt you, we know best!" attitude. They always apply two kinds of cream to my knee when I go. They apply one by hand and the other which is very cold and is applied using a type of hand held wand. She asked me if I had any feeling in my knee and I told her that except for one small section, I can feel everything, in fact, it's quite tender now that the nerves are regenerating. My scar is slightly raised in that area and super sensitive but she kept mashing down right on that spot! I swear, I'm not a baby, I don't cry easily, and have a pretty high pain threshold, but it seemed like the more I said "Ouch", the harder she pressed, and the more she lingered on the sensitive spot. She kept talking about scar tissue and making sure I had a smooth, flat scar, but you know what? At 7.5 weeks, I ain't all that concerned about it. I'm 61 and look pretty good for my age, but my bikini-wearing days are over! LOL! Heck, I don't even wear shorts outside of the apartment because I'm bottom heavy and feel self-conscious in them!
Anyway, I'm gonna try to take the rest of this rehab journey on my own -- well, not entirely on my own: I have my boyfriend and you guys!
What do you think? Am I nuts?