Shaken75 Recovery ACL Replacement 12/9/15

[Josephine]

but I let him do it because he said he had to break through scar tissue that was there.

PTs and sometimes even surgeons, always seem to say this like it's mantra giving them permission to be brutal. But the truth is this:
a) 'scar tissue' as they mean it is actually very rare - the proper terminology is adhesions
b) adhesions are unlikely to form until at least 6-8 weeks and probably longer. Yet they talk about 'scar tissue' within days of surgery!

Though I do have to ask...did any of you with similar experiences have mental/emotional challenges over it?

I can well imagine an experience like that giving one a bout of PTSD.
I almost get it just reading your posts!

 

[shaken75]

Yes, it feels more ptsd than blues. But (thankfully) I feel as though I have kicked into an automatic repair mode of sorts. I feel very detached but yet I am performing a high standard of self-care. I have reached out to a great therapist from my past and while I can't say I "feel hope," it seems logically obvious that I am taking the appropriate courses of action and will get better. Maybe it turned me Vulcan.

 

[Celle]

@shaken75
I think that it's quite normal to be feeling a lot of emotional after-effects of being hurt by that PT. You were hurt badly and unexpectedly, by someone you thought you could trust, and you're entitled to feel just as shaken as if you had been mugged on the street.

 

[newlybionic]

Live long and prosper!

 

[Josephine]

Or better "may the force be with you"!

This should make you chuckle - it's rumoured that when Michael Douglas had his TKR done, he felt it was only right that he should stay awake during the surgery - after all, he had this macho image to live up to, didn't he? Only problem was that afterwards he started having PTSD/nightmares and had to have therapy!

 

[shrdlu]

My surgeon warned me (twice!) with the second knee replacement to NOT get too much bend too fast. He was more than happy with 115 at about where you are now. In fact, at 1 month, he told me to take it easy on bending, as he thought that was going too fast even then. At 2 months, I was at 135, and the surgeon thought that was too much too fast and told me to slow down even more. Tendonitis is a risk when you get too much bend too fast with a knee replacement. (And I suspect with other knee surgeries.) My PT said that tendonitis happens when you push too hard and have pain when doing the bending...in other words, like your PT did. So they do exercises to tightness or discomfort, but not true pain. And I went from 115 to 135 by doing the exercise that I described in my previous post, beginning at week 5. After my (now fired) PT pushed (and she only pushed a little bit, nothing like your trauma), I got my bend doing that exercise, and I did it with very little discomfort. So, since you are at 0 (wonderful! as that is the important number at this point), then you have time to get to 135. In fact, your numbers sound very good for being 5 to 6 weeks post op on a knee.

Work on strengthening, and the rest should come without the trauma of being pushed. You now know that you can bend to 135 (unfortunately it was done in a terrible way), so you don't need to worry about scar tissue/adhesions. As for the emotional after effects, you will be very distrustful of PT from now on. I find myself constantly telling my PT to NOT push and that they need to stop as soon as I say stop, even when they are not touching my leg. Something like that ruins your trust level. So be kind to yourself. Eventually it won't feel as traumatic, but you will be wary with any new person who is doing something to your body. Again, I am sorry that happened to you.

 

[shaken75]

I just want to offer a quick update.

I had my Dr. appt. Tuesday. They were receptive and supportive. I am out of PT and on my own for the next four weeks and I am okay with that now that I feel like I know how to properly work and rehab the injury. And if my progress is not good enough in four weeks, I will go to another location for PT.

Next week I drive to Atlanta for the other kind of therapy. I have reached out and told a couple more friends about what happened and I went out alone today so I am making progress, but my BP is very high for me and interacting with people stresses me out immensely. I had a list of things I needed to get done here on the computer and this is the last one! Everything I needed to get done today IS DONE. De-stress time - thank you again for making this possible...and good night (or good morning as your case may be).

 

[kneeper]

Wow I just read through your thread. Sorry I missed it before. I'm glad to hear you are now on a non-harmful approach to recovery and that you are getting emotional support after that PT assault.

 

[shaken75]

Thanks, kneeper. The knee was doing very well until today. I woke with what seemed like a small ache this morning and took it easy...but not easy enough. It turned into a sharp pain this evening and seems to be related to my toes when I walk. It happens more when my knee bends and I am rolling my foot like a normal gait so for now I have donned and locked my brace.

Does this sound normal ebb and flow of recovery or should I be concerned? I figured I might call the doctor tomorrow depending on how much it improves overnight.

 

[kneeper]

It never hurts to check in with the doc. I don't know about this new pain with an ACL situation.

 

[shaken75]

I called and the nurse did not make it sound unusual. She said it may just be overuse and to take a rest day. If it is actual damage, there is nothing they could do right now about it anyhow.

There was less pain today at least. Back to it tomorrow...

 

[shaken75]

After my "month off" from physical therapy, I had a follow-up appointment with my OS yesterday. He had nothing but good news! He is pleased with my increased ROM and the decrease in muscle atrophy, which was very noticeable last visit. He also said my ACL feels solid as a rock.

My mind is not doing as well, but I will post more on that in the Depression/Post-Op Blues Thread - is that the best way to organize?

My OS does want me back in physical therapy and I am ok with that, but I will be choosing my next facility much more carefully and setting my own rules very clearly, of course after communicating my previous experience with my new provider.

I am very proud of my success this month and I owe it completely to your advice. It is amazing how much my recovery accelerated when I backed off. A big pluff of fluid behind the joint was restricting my ROM as much as anything else. Ice did not reduce it, but decreasing the intensity of my workout did. I do have a burning soreness along the outside of the knee so I am treating it the same as my other mystery pains that seem to come and go - increase ice and rest time; keep exercises light and easy.

He wrote me out of work for the next three months, until my next follow-up appointment. I have a feeling the Worker's Compensation Insurance people will have a problem with that, but I will take it as long as I can. I love that I can view my healing and recovery as a full-time job and I can feel how much faster I am healing just by having the freedom to rest, ice, and exercise whenever she (knee) wants.

 

[Celle]

I'm very glad to hear how much better your knee is getting on.

You've had a long, hard time with this knee and it's a very normal reaction to feel depressed. As you continue to recover, the blues should lift. However, if they don't or it's really getting you down, please consult your own doctor, who can help. You don't have to stay depressed for ever.

 

[newlybionic]

Glad to hear you're doing better. I hope you find a really good PT facility and you continue to heal quickly!

 

[shaken75]

Thank you both! Yes, @Celle, it is already in the works. The post-op depression was under control but after the incident with my physical therapist, it became immediately clear that I needed professional help.

 

[Josephine]

I will post more on that in the Depression/Post-Op Blues Thread - is that the best way to organize?

Oh dear ... I'm sorry to have to tell you that the depressions thread has been removed because new members were using it to post their post-op story instead of starting their own recovery thread. It was getting a bit of a mess so after much discussion amongst staff, it was decided to remove it. So just carry on posting your story in here.

I had a follow-up appointment with my OS yesterday. He had nothing but good news! He is pleased with my increased ROM and the decrease in muscle atrophy, which was very noticeable last visit. He also said my ACL feels solid as a rock. I am very proud of my success this month and I owe it completely to your advice. It is amazing how much my recovery accelerated when I backed off. A big pluff of fluid behind the joint was restricting my ROM as much as anything else. Ice did not reduce it, but decreasing the intensity of my workout did.

That is music to my ears! Everything you've said here is so very, very true. Well done you!

 

[shaken75]

I understand, @Josephine. Everything being so well organized is part of why this site is appealing and easy to use. I hope it is ok for me to copy recent posts from that thread over here in case others wish to continue replying:

=========================================
Clipped from Depression/Post-Op Blues Thread - (4 Posts)
=========================================​

In post: 880761, I said:
My mind is still in a very bad place after being assaulted (it still feels strange to call it that but it is true) by my physical therapist a month ago. I drove to Atlanta to seek treatment from a wonderful clinical psychologist I used to see, but cannot find a similar professional where I live currently so I may try Skype appointments which, while not covered by insurance, he is willing to do for what ever dollar amount I send. He did diagnose me with PTSD which, when combined with post-op anxiety and depression...brings me right here, wherever this place is that I am right now. Let's skip the details for now.

I am trying to think of it much like my knee: There will be good days and bad. Doing a lot one day may leave the injury feeling tired the next. Don't compare my recovery to another's. Give the injury love and patience. After three rock-bottom days in a row, I hate to think how I might feel if I wasn't embracing these thoughts!

There are great posts here. Many of my friends have also fled or seem to when I need something. My stepmother experienced that phenomenon during the last year of her life and I will never forgive her friends for it. It hurt her very badly and @Naomi60 I am glad you confronted your friend directly because, for whatever reason, I don't think people understand it anymore. It has caused me very recently (on my good days) to reach out to people who I know are having health issues, even if we aren't close friends.

Hi@shaken75,
I also have PTSD--not from my knee, but from an incident 7 years ago. I needed a combination of talk therapy, EMDR therapy, yoga, and fluoxetine to get relief from my symptoms. The EMDR is great for controlling the unwanted memories. The fluoxetine really keeps my startle response at a minimal level that I can deal with. The yoga helped me learn to relax again. Just before my TKR surgery I was getting more startle response and some of that someone's about to jump me nervousness. I had hypnosis with my talk therapist and it really helped. I don't know if you want to share experiences with treatment. It has helped me to do this. People don't realize that once you have PTSD, you always have it. But it is very possible to treat the symptoms and become symptom free. I just have to work at keeping my stress level down and take my fluoxetine to deal now.

@shaken75It is very difficult dealing with recovery and all the problems that can arise during it. I have had major depression and other issues for a large part of my life. It is very hard when it seems that friends have abandoned you. I've been through that experience and always try to help others. I even went back to school and became a RN. I try to help anyone that needs help that I can in addition to my job. I take several medications. I also speak to a psychologist weekly. Skype is a very good idea if your psychologist is able to work with you. It's good to have someone you can trust. Talk to whoever you can. Can your psychologist recommend anyone close to you that you can try? There may also be support groups at a local hospital that can help with depression, PTSD or almost other medical problem there is. I hope you start to feel better soon.

In post: 880811, I said:
Thank you both. @jarabas and I are in touch via pm now but for the benefit of others, I will add props for EMDR treatment for PTSD. Even just a couple sessions helped more than I can describe. "Startle response" is a term I had not heard and I am so glad you mentioned it because it was an issue before and is exaggerated terribly now.

@newlybionic - yes, when I needed help before, while living in Atlanta, "shopping" for the right therapist was a terribly difficult process. There is nothing like spilling your story to a stranger while you are at your low only to learn it is not a good fit...over and over again. Once I found this psychologist, I was so relieved. He does not have connections up here, but he told me what to look for based upon why he thinks I like him (clinical psychologist, EMDR practitioner, Ph.D. earned 20+ years ago (what he feels was a key component in his education is no longer emphasized in most programs)). I have not yet found anyone like that around here, but have not searched beyond those covered by my insurance yet. Just another thing on my long list to fall further behind on.

I am (perhaps too) biased against prescription and even OTC drugs - for sure I use them, but only after I have tried behavioral adjustments. I will try drinking water or resting my eyes first for a headache, for example, and I try to play with my diet and exercise when my depression gets bad. I am taking something for anxiety now so be assured I won't refuse, but I hope I don't need to be on something forever...

And yes, I am talking to EVERYONE I can. I have had issues with depression in the past, but I was very private about it. There is something about this that is making me sound the sirens and reach out in all directions, without a care as to whether the subject matter makes people uncomfortable. It frightens me how incapacitated I can become and I know if it happens when I am alone in public...I also have strong fears about long-term effects and how/who I might be after all is said and done. If it does not improve dramatically over how I am now, the rest of my life is going to be pretty rough.

 

[PolarBear60]

Good way to bring your depression recovery discussion back into your thread.


Jean

LTKR (Stryker Triathlon): 21 April 2015
Right Knee Arthroscopy: 25 July 2006
Left Knee Arthroscopy: 10 February 2005

 

[Celle]

@shaken75
I think that your posts about depression could help other people as well as you, so I'm glad you copied them here.
I'm glad you did something about your depression and PTSD and didn't just struggle on without help. Congratulations!

Although mental illness is as real as physical illness, it does still carry a stigma sometimes and it's very often misunderstood.
I have a son with serious mental illness. At first, I didn't tell anyone and I tried to deny to myself that it was so. I've gradually had to adjust my attitude and admit that his illness is real, and be glad for the modern medicine that can alleviate many of his symptoms. He isn't cured and never will be, but he is much better.
There is such a lot of misinformation about his illness and now I speak up and correct false assumptions.

 

[newlybionic]

It is very hard to continue to deal with any illness. You have to bring yourself to believe the PTSD and depression you have is a medical illness. It is the same as having cardiac problems or diabetes for example. It's not a character fault. It needs to be treated just like any other medical problem. You will always continue to be you. Working with your psychologist and possibly a psychiatrist for medications if needed even if just for the short term may help lift you out of your current state of mind. There are many people going hrough the same problems. You are not alone.