Revision TKR Sondrals’ Revision

[sondrals]

Are you still going to PT at all?

I just started back this week. Which was maybe bad timing because I started back to work full full time this week. And it's the busiest week of the year, well this and next week. I have a PT appointment today actually. I guess maybe I need to push the "I want to work on walking" thing. They're really focusing on strength which I guess may be my actual issue with walking.

Have you talked to you own doctor about feeling so depressed?

Not really no, I talked to her briefly about anxiety before surgery. She informed me I did not need meds. I feel like I will get the same answer.

Despite regretting it, I'm actually considering having the other one done before the end of the year if possible. It is hurting SO SO bad and PT kept pointing out how "off" it is. I maybe think they're pushing surgery but I'm also well aware of how knock-kneed I am and that I have the same problem I had with this knee as the replaced knee albeit to a lesser extent. It's always been the more painful of knees but this has taken it to a new level. Add in instability and yea, I sometimes wonder if IT isn't the reason I'm having issues walking not the replaced knee.

Part of the issue with my lack of patience is the pressure being put on me by my mom (yes the one who abandoned me like a week after surgery). She just doesn't understand why I'm having such a problem with this. Unless everything is sunshine and roses, she doesn't want to hear it. I've had to really cut back on contact with her because apparently I have an attitude if I don't just lie and tell her I'm 100% recovered and planning on running a marathon next month. Crying is unacceptable, fear is stupid and I just need to suck it up, walk on it and get over it.

 

[sondrals]

I think that feeling as though your knee will collapse, is going to suddenly get a lot better as your knee gets stronger.

Thanks @Carole4815 I REALLY hope this is the case. I felt somewhat "better" yesterday, like walking was a obtainable thing. For some reason my knee just felt more normal. Back to pretty bad again today though, walking seems impossible without a cane. My other knee hurts REALLY bad today, begining to think it's actually the culprit in all this, not my replaced knee.

 

[Jockette]

In my pre op class the nurse told us not to be afraid of putting weight on our new knee, that it would be strong right away. That gave me confidence the very first time I stood up on it a few hours after surgery.

I hope that we can help you have the same confidence.

 

[Jockette]

It is way too early to work on strengthening. If you continue with PT, just ask for help with gait. If they don’t have an encouraging attitude, find another facility, they seem to be everywhere. Interview them over the phone to find out their philosophy. You need a PT who is very understanding.

 

[sondrals]

In my pre op class the nurse told us not to be afraid of putting weight on our new knee, that it would be strong right away.

They told me that too, but as having had two knees that randomly subluxed/dislocated for 35+ years, it may be easier said than done for me. This has opened my eyes to how much I was altering the way I stood, walked, sat, to compensate for my knee(s). I've "let my guard down" before with my knees and ended up subluxing them and hurting myself very badly. I think I really do have some form of PTSD that is making it very difficult mentally to let go and trust it. Also doesn't help that I have an identical knee that I'm still terrified is going to go out and cause a fall and mess up my new knee. And any little pang out of it sends me almost into a panic because I'm sure "it's happening again!"

It is way too early to work on strengthening. If you continue with PT, just ask for help with gait.

Jockette, can you explain a little bit more on why you say that? I guess since surgery I've been told "strengthen your quads!" so kinda curious what exactly you mean? Maybe I phrased it wrong, they're not making me leg press 100lbs or anything crazy, just some basic stuff.

But anyway, I went back to PT today, wanted a nap after. Instead had to go back to work for another 3 hours. Hope this means I'll sleep better tonight! Talked to my physical therapist, she said I'm pretty much the opposite of what they "normally" see. I gained range of motion back really quickly, have struggled with walking, normally it's the opposite. She feel why I'm struggling with my gait is a combination of really weak quad muscles (and muscles in general) making it "feel" like it's giving out and a functional leg length difference due to the valgus in my non-surgery leg.

Had to do measurements for my insurance because they only care about like 3 things, bend, straight and some functional ability form I have to fill out that asks crazy questions like "how difficult is it to run on uneven ground and make sharp turns?" Uh.. Extremely, since..... forever! It doesn't take anything else into consideration but those 3 things which I find weird. But regardless, I have 130/0, which apparently is the "goal" but they think I really probably will end up with more than that as far as bend. I have to say I feel VERY fortunate for how the range of motion stuff has went.

 

[Jockette]

At 6 weeks post op you are still very early in this 52 week (one year) on average recovery. Your soft tissues have not recovered enough to handle strengthening exercises. You are still dealing with your body’s energy drain trying to heal from this surgery. It is better to wait at least 3 months, if not more. Your leg will strengthen naturally as you heal.

Your ROM is fabulous for 6 weeks! The rest will come along in time as you heal.

Had to do measurements for my insurance

Why does your insurance require the measurements ? Does it require PT?

 

[sondrals]

@Jockette Thank you for explaining that! I hadn’t thought about it in quite those terms.

Why does your insurance require the measurements ? Does it require PT?

My insurance requires the measurements to pay the bill. I get 45 visits a year, but they have to be pre-approved. So they dole them out in 3-4 increments and then make you prove you’re getting better. It’s a ploy to not pay for more than they think is necessary

 

[Celle]

Part of the issue with my lack of patience is the pressure being put on me by my mom (yes the one who abandoned me like a week after surgery). She just doesn't understand why I'm having such a problem with this. Unless everything is sunshine and roses, she doesn't want to hear it. I've had to really cut back on contact with her because apparently I have an attitude if I don't just lie and tell her I'm 100% recovered and planning on running a marathon next month. Crying is unacceptable, fear is stupid and I just need to suck it up, walk on it and get over it.

Well, your mother has been unhelpful almost throughout your recovery. She's not going to change now.
You're an adult, and not her "baby girl" any more.

She won't visit, so when she phones, tell her "That's not helpful, Mother. I can't listen to that." And hang up on her. Don't allow her to stress you. She doesn't know enough about recovery from a knee replacement to know what's normal - and your recovery is following a normal path.

 

[sistersinhim]

Tell your mom to watch a 'real-time' total knee replacement on youtube. She needs to see what has happened to your knee. Maybe she'd be a little more understanding then. If she refuses, then refuse to hear her negativity. Your recovery comes first. You are the one you have to please and no one else!

 

[sondrals]

Knee itched today, reached down to scratch.... it did nothing! I can't feel where I'm scratching so how is it even itching? Spent a half hour trying to figure out if it was a "if I touch here, I feel it there" thing. It was not. Stuck with a sort of annoying itch I can't scratch.

My foot on my surgery leg has decided to cramp riiiiiight in the arch. Super fun

Today is the longest day ever at work followed up by a rare occasion I have to work on a Saturday. I hope I don't end up too exhausted

 

[sondrals]

Am I insane for considering having my other knee down before the end of the year?
It’s killing me and really believe it may be what is hindering my walking ability. My surgery knee is getting stronger but I stupidly let PT work me over Tuesday and am still sore. I’m just wondering if the dr will even consider it with me still being on a cane

 

[Jockette]

I’m just wondering if the dr will even consider it with me still being on a cane

I really think you are making too much of the fact that you are still on a cane. I used mine for months. It is very normal at 7 weeks especially since your other knee is so painful.

Please stop worrying about the cane and stop allowing PT to work you over.

I know we’re not supposed to talk about acquaintances, but I saw one today who is 6 weeks post op, and he was using a cane. He didn’t apologize for it.

 

[luvcats]

Am I insane for considering having my other knee down before the end of the year?
It’s killing me and really believe it may be what is hindering my walking ability.

I wouldn't worry about your current ability to walk. It is still early days in your recovery and a cane isn't a big deal.
That said, I did my knees serially as close together as my surgeon would allow. I did it for the usual US reasons of saving on the deductible and also because they were both trashed and I wasn't going to get my life back with just one replacement.

I'm very satisfied with my choices, even though I'm getting a little stir crazy from being an invalid for a whole season.

 

[sondrals]

I really think you are making too much of the fact that you are still on a cane.

I'm REALLY hung up on this, I can't figure out why. I seem to get fixated on things and can't let them go.

Please stop worrying about the cane and stop allowing PT to work you over

I had a case of the oops I over did it. Felt pretty good so I pushed myself probably more than I should have, they said do 20 I did 40, so more MY fault then theirs.

 

[sondrals]

That said, I did my knees serially as close together as my surgeon would allow. I did it for the usual US reasons of saving on the deductible and also because they were both trashed and I wasn't going to get my life back with just one replacement.

My insurance is a huge factor, I have a high out of pocket max so not having to pay that would be a huge bonus. But my other knee is completely messed up, it has been, and I knew it, and I was told about 4 years ago the only thing to fix it was a replacement but I was too young. Then this knee decided to absolutely self-implode so it became the problem child for the time being. The extra use of my once "bad" knee has relegated it back to being the problem child now.

My Dr. requires 12 weeks out, I'm at 7 now? I think, but regardless I thought if I could get it done around Thanksgiving or a little after, we shouldn't be that busy at work. I can work some from home and with Christmas and New Years I'd easily get a month + "off" from work without being too huge of an pain.

And I live in Alaska, having a month or more in the middle of winter where I don't have to go anywhere... uhm yes please? I barely go anywhere in winter besides work anyway because of my knees and me being terrified of falling. Pluuuus maybe by summer I'd be more back to normal-ish or at least mobile enough to enjoy it next summer.

The biggest issue I see is transportation, I'd have to take cabs/Ubers because it would be my right leg this time. But on the plus side, my PT is 1/2 a mile away (if I go), my work is a mile away.

Guess I'm just scared he'll tell me no, for one reason or another. Part of me just wants to "get it over with" so I can get on with my life.

 

[Carole4815]

Am I insane for considering having my other knee down before the end of the year?
It’s killing me and really believe it may be what is hindering my walking ability. My surgery knee is getting stronger but I stupidly let PT work me over Tuesday and am still sore. I’m just wondering if the dr will even consider it with me still being on a cane

I would imagine that the surgeon would do it whenever you want after that 12 weeks, and it will take a while to get all those tests redone, clearances, joint class again, cooking and freezing more meals for the early weeks, and all that other stuff we had to do or wanted to do beforehand, remember all that? I sure do, anyway. Seemed like I was really busy for the 5 weeks before my surgery. So anyway I am thinking that if you started now, 12 weeks would be a nice, early time to have it done. I am going to wait at least until springtime to have my other knee done so that I can see how my second knee does as my new knee improves. Maybe my new knee will be helping it more in a few months, than it is now.

Oh, and BTW, at 9 weeks on Tuesday I am not even on a cane yet; I am using my rollator walker. I really don't give a hoot what other people want to do; we get no merit badges for our progression through walker, cane, etc. My reason for sticking with my rollator right now is for safety. I do not want to risk falling for any reason, at my age, and also it is a nice reassurance to know that I can sit in it if I overdo and need a place to sit. So, I can do more without risking injury. My surgeon is very pleased with my progress and would do my other knee ASAP if I wanted it done soon.

 

[Jockette]

Things will be ok in time. I was stressed out and worried my whole first year. So many expectations that I wasn’t meeting. So many opinions from others coming at me.

I was discharged from PT by 8 weeks and my last appointment with my surgeon was the one year check up. He did not discharge me and told me to make another appointment but I didn’t, i was fed up with him at this point.

After that my mind finally started to relax. No more appointments, no more outside pressure. Comment from others lessened.

I had more functional improvement after this point, and now at 2.5 years post op I am still seeing improvements.

 

[sondrals]

it will take a while to get all those tests redone, clearances, joint class again, cooking and freezing more meals for the early weeks, and all that other stuff we had to do or wanted to do beforehand, remember all that?

I was hoping to avoid double testing I guess, but it's probably not possible. I do know now how I'll do things differently because some of my pre-op testing was a fiasco. I know I'll probably need an MRI of that knee too which takes a bit to book because of my insurance.

I didn't cook and freeze stuff beforehand, I am a notoriously picky eater, especially when not "feeling well" so I couldn't predict what I was going to want. I sorta lived off peanut butter toast on seeded bread, fruit cups, and scrambled eggs. Come to think of it, I'm STILL mostly living off that.

I am using my rollator walker.

I use mine when we go to the store, it gives me more "space" from people, they're less likely to bump into me when I have it, and you're right, it totally gives me a place to sit down if my knee, either one of them, gets tired or starts to hurt. But mostly I use my cane at home, going to/from work, etc.

 

[sondrals]

I was stressed out and worried my whole first year. So many expectations that I wasn’t meeting. So many opinions from others coming at me.

I am a world class worrier. One day I realized I didn't have anything to worry about at that particular moment, so I started worrying about not having anything to worry about!

I get a lot of opinions and everyone knows someone who is doing WAY better than me and I really just want those people to shush. I'm hard enough on myself without anyone's help

 

[Jockette]

I am a worrier, also, and I tend to overthink things and overreact. I’ve learned I have a Highly Sensitive Personalty, HSP for short. You can google “22 signs you are a highly sensitive person.” It was quite the eye opener for me. It explained so much!

I’m sure this had a lot to do with my difficult recovery. My body’s sensitivity, my reaction to my medical team’s treatment of me, feeling so pressured by the comments from my friends and acquaintances, etc.

It’s hard to stop thinking about the things that bother us.