MUA So much contraction over my incision!

[KarriB]

Resting that knee will help new adhesions to not grow, so baby that knee as much as possible.

 

[katpkatp]

I’m devastated, but resigned to try the rest and relaxation approach. The pain management part is difficult.

I’ve used oxycodone (no more than 2,5mg /day)
and flexeril ( no more than 3, 5mg/day) and lots of Tylenol.
Celebrex (2, 200 mg/day) for the last 2 months has been changed to 75 mg volaren/2 Times per day. Haven’t started this yet.
Tramadol will replace the oxycodone very soon.
Scar tissue hurts as it grows. It hurts as it pulls across my knee when I walk.
Doc wants pain to stop, so inflammation will stop, so scar tissue will stop growing.

 

[sistersinhim]

It sounds like your OS is up to date on how to rehab a TKR while your PT wasn't. Now, you know you are to baby that baby knee and you have every reason to do just that.

 

[tabbykit]

@katpkatp sorry to hear you didn't have better news today. Sounds like you are getting good advice though re no forced flexion, and less exercise. You will get through this.

 

[katpkatp]

Ok, now that I have the diagnosis of aggressive arthrofibrosis, does anyone have tips for dealing with the constant pulling and pain of the ever tightening scar tissue? I can live with Not being able to flex my knee. These sensations of pulling and tugging, even ripping, are incredible. Doc says, if something hurts, don’t do it. And any tips to work on swelling? Ice and elevate I got. I can not have the arthroscopy until the swelling goes away. Thoughts on that? Still a mess in PA.

 

[Jockette]

Rest a lot, just give your knee some gentle mobility movements, in addition to ice and elevate.

 

[Jamie]

@katpkatp .... you are going to need to alter your thought processes about recovery. Your surgeon has advised you to take things easier and so have the folks here who've worked with lots of recovery patients or experienced similar problems themselves.

You cannot "work on" swelling. There are no tips other than to ice, elevate and stop doing a lot of activity for weeks....at least 2-3 weeks. You can do some lymphatic massage that may help to some degree. I'll tag our newest Forum Advisor, @CricketHip, who has a background in this. But what your surgeon told you is true. The arthrofibrosis will not stop until your tissue becomes less angry. That requires that you stop pushing yourself with movements and activity. Rest, ice, elevate and do gentle bends and stretches and a little walking around the house every hour or so to try and keep your knee limbered up. But that should be it.

 

[katpkatp]

I shall listen, but it is so hard especially since the last 9 weeks have been a brain washing of “work, work, work or else your knee will never work properly”. I look forward to hearing about the massage. I want to run to another doctor for a second opinion. Scar tissue feels like an alien taking over my body. Thanks again, k

 

[Jockette]

Scar tissue feels like an alien taking over my body. Thanks again, k

This also describes what swelling feels like.

You are right, it seems many of us are brainwashed to work hard in this recovery no matter how much it hurts. Frankly, some people do manage that type of rehab, but I think they do in spite if it rather than because of it.

SusieShoes is one of our advisors, and here’s her recovery thread:
https://bonesmart.org/forum/threads/susieshoes-new-knees.41339/
She did minimal exercises and concentrated her rehab on gradually increasing her walking. She has a way with words and I think you’ll enjoy reading about her recovery. She is proof that we don’t have to “work really hard” at this recovery.

 

[KarriB]

I understand how it feels to go against everything you’ve been working at for a while. I experienced an infection 4 weeks after TKR and after surgery my OS said no bending. He even put me in an immbolizer for a month to be sure I didn’t bend. After working to bend, bend, bend, it was hard to change my mindset to rest, rest, rest, but I as a type A personality I follow drs orders to a T. So I wore the immbolizer 24/7 and followed my OS orders for non-aggressive PT after the immbolizer came off. You can do this, just look at resting as if it’s your job and work at that.

 

[Jockette]

You can do this, just look at resting as if it’s your job and work at that.

Exactly! Don’t think of it as doing nothing, think of it as giving your knee the best circumstance in which to heal.

 

[katpkatp]

Morning, good remains to be seen. This will be my first day back to PT after a 7 day rest. I’ve asked my doc to specifically send his recommendations for no pain PT, but I have my doubts that he did. I will have to stand up for myself. If I come away from the session with bad feelings, I am switching!

I’m beginning the ‘second opinion crusade’. After a few days to accept my diagnosis as aggressive arthrofibrosis, I think I am ready to begin the next step. If anyone has experience with this, please tell me. I have some doctor’s names. The first is in the same nearby area so convenience is a plus and another at a hospital near Philadelphia, about an hour away. I must check with Medicare about second opinions.

I get so worried that my leg will be entirely consumed by scar tissue if I wait for the 6 months until arthroscopy. Doc's office told me it’s actually 6 months from initial surgery, so it would be 4 months. I can feel scar tissue increasing daily. PT should be a barrel of monkeys. I’ll let you know how it goes today. Wish for pleasant surprises!

 

[Jockette]

I can feel scar tissue increasing daily

What you are feeling is swelling.

At PT today tell them you just want massage to address the swelling. Do not let them manipulate your knee.

If my leg felt like you described I would not even go to PT today. I would stay home and elevate my leg and do some gentle walks around the house.

I think getting a different PT facility is a great idea. Make some phone calls and ask how what their approach is and find a group who is gentle.

 

[Pumpkin]

I agree with Jockette, skip PT and/or find another clinic.

 

[Josephine]

I get so worried that my leg will be entirely consumed by scar tissue if I wait for the 6 months until arthroscopy. I can feel scar tissue increasing daily.

Who on earth has given you this load of nonsense?

1. scar tissue - more correctly called adhesions - is not a very common thing
2. what you are experiencing is swelling. That does develop on an almost daily basis
3. no knee/leg would ever be in the remotest danger of being 'entirely consumed by adhesions​

Please stop panicking and relax. Having only 7 days off PT is worse than useless. You need to stop it for at least 4 months and even longer. Swelling takes an age to settle down even with rest.

 

[katpkatp]

Me, again. Heading into 10 week anniversary. I am back at pt, only 2 times per week and doing NO pain producing activities. I guess I really made my point by taking the doctor’s comments from my last appointment. They are treating me very differently. I was ready to leave.

I am resting, icing, elevating. I have been prescribed a dyna splint;I got it yesterday. I wore it to sleep for 6 hours. I began on setting 2, that’s close to straight legged. The man who brought it to my home said it should not hurt. It woke me up at 4 am. I took it off and slept till 6. I have no idea how I will progress, but I will post weekly.

And, I DROVE TO PT! It is so wonderful to have some control of my life. I figured out a way to reach the pedals by raising the seat and also pulling it forward. My leg hurts a tad, but not enough to distract me. This certainly is a journey.

Still would like to hear from anyone on the subject of second opinions. Best to you all.

 

[katpkatp]

Checking in approaching week 11. Nothing much has changed except the dynamic brace is now at level 4. This means the flexion pressure has increased a bit. I wear it for about 5 hours each day, off and on. My pt flexion measures 60 and it still disappears as I walk out the door. I got a used stationary bike and use it about 2-3x per day, just to push back and forth. A doc appt coming up next Friday. Doc ordered blood tests: CRP , sed rate and CBC. I think it’s cya, if you get my drift. I also did get up the courage to make a ‘second opinion’ appt. that’s not till August 30. I’m trying to stay busy, but falling asleep is the most miserable time of my day. Ideas? Thanks.

 

[sistersinhim]

Sleeping is unfortunately a common problem. Many times pain at night is a sign that you are doing too much during the day. Try cutting down some and see if that helps. Also, sleep everywhere and anywhere you can. Any sleep is a help.

 

[tabbykit]

Hi @katpkatp, just read your thread and hope you are doing well. I sympathise as I had a similar experience, TKR 4 years ago, but it was never right and never got halfway decent ROM. I knew the only option was a full revision, but put it off until this year. OS said he removed a lot of adhesions, and I am afraid of the same thing happening again. Now at 11 weeks, ROM is around 65-70 bend, and follwing the BS way of ice, elevate and ADLs. So far the recovery is a bit easier than before, but am anxiously awaiting seeing my OS in about 3 weeks.
What happened at your second opinion appointment?