TKR Stress

[60mom]

Well I am 3 months and I had an MUA at 5 1/2 wks. I would have waited a bit longer but my insurance was running out so I had to make a decision and decided to go ahead with it. My flexion was decreasing as well. So I had it and immediately was at 122 flexion. But 2 days later I was down to 90. Over the course of the next 7 wks I regained that flexion back so I am 120+. Not sure exactly because I am no longer in PT but it was 120 last week and a I think I have gained a little more. The one thing that changed after for me is that tight band feeling left. My OS said he did brake up scar tissue. I am prone to developing it. Had to have scar tissue removed from my ovaries. But on the other hand you shouldn't develop it that quickly and I have heard that aggressive PT can cause it or a lot of swelling making it difficult to bend. After the manipulation I changed to a less aggressive PT. So how do I know which has helped. Probably never will or maybe it was a combination of both. Can't tell you what to do but my suggestion would be to wait a bit. While waiting really decrease anything that makes it swell. Do your bending but be very gentle about it. Try that for 2 wks and see if anything changes. If it gets better continue to do a wait and see. If not then go ahead with the MUA. I don't really see a reason for you to rush this decision unless you have insurance issues or something like that. The one problem I did have was an increase in pain after the MUA. Much worse then right after my surgery. My pain was also not managed so that did not help. Sounds like your OS would not let that happen. I don't think an increase in pain is typical though. I just was unlucky. But I am doing fairly well now and am able to do just about anything I want the only thing I can't do quite yet is ride my outdoor bike I can rotate ok but it hurts. My exercise bike is fine. I also still have a bit more pain then I would like and am seeing a pain specialist on Tuesday. Keep in mind we are all different and what we experience will vary. Prayers you soon get the pain relief and mobility you desire.

 

[Kelsie Lou]

@SadKnee and 60mom thank you for sharing your personal experiences, that is exactly what I was hoping to get... other perspectives. There are so many factors that I need to take into consideration, including who does what with kiddos after the procedure. I appreciate you input.​

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Hope you are getting a peaceful night's sleep. Unfortunately, sandman has not found me yet... 2 AM. Oh boy!!!!​

 

[Mutley]

Hi Kel! Well you already know my view on the matter! Like 60mom I was in AGONY after my MUA. WORSE pain than the original operation I think if I had retained what my surgeon managed to achieve for me (120 degrees) I would have felt it had all been worthwhile...but I didn't. Also, he was unable to straighten my leg fully which is rather annoying too.
Just remember that if you do decide to go ahead with it, your recovery date then STARTS from when you had the MUA NOT from your original op date that has taken me the last 6 weeks to accept this very IMPORTANT piece of information!
Hopefully Josephine will be along soon to give you some good, NO NONSENSE advice! Big hugs to you my friend!

 

[Josephine]

A week and half ago, my ROM was at 70 degrees. This past Thursday it was measured at 58 degrees. This was disappointing to all of us. So not only have I struggled with bending my knee, but my progress has gone backwards

Exactly what is to be expected at 5 weeks out. Especially considering this

There have been many stressful things going in my life as well as an active, crazy household. I have always put everything and everyone else first. I am making a conscious effort to put me first.

If you are still trying to be mum to your household, then I would strongly argue that your FM is only a small part of the problem with your ROM.

Now here is the reason that I like members to stick to one recovery thread - in your other thread you were given some articles to read, one of which is about a swollen and stiff knee . Did you read that article? Because it explains precisely why you need to follow the advice given and not try to be mom of the year when you are recovering from this surgery. In fact, that whole thread is filled with really good examples of what not to do: an aggressive PT, excessive stress, an unsympathetic husband and family, inadequate pain med regimen, I'm sure there is more you haven't shared.

So who is helping you? Doing your housework, preparing meals for you never mind the kids, doing the laundry? Or are you doing all of that too?

What pain meds are your prescribed, how much are you taking (mgs) and how often?7
How much are you resting, elevating and icing, how many times a day and for how long?

I believe I have built up a tolerance to the meds that I am taking.

Sadly that may well be so but there are ways to get around it using the multimodal approach. You need to discuss this with your GP or a good pain clinic (meaning one that's not all hung up about addiction - if you can find such a place!)

Doc suggested that I meet with a rheumatologist to get the fibro under control, schedule a MUA, and have a femoral nerve catheter put in the week after the MUA to help control the pain. He believes the fibro has slowed my progress.

I don't know, seems a bit like taking a sledgehammer to crack a walnut to me. Have you told him about your family circumstances, all the stress you have with errant step kids and your thoughtless husband? Have you told him how much housework, etc., you are really doing?

Fact is that early MUA is well documented to have negative results both actually and psychologically. You are very depressed, frustrated and disappointed right now because of your low ROM, you have cited more than one very good reason for this (the FM). Now he is going to render you unconscious and then gleefully tell you in recovery how he (easily) got your knee to about 90 degrees or more. Only shortly after that, your knee will blow up like a balloon and you may not even get what you had before, that plus a huge amount of pain which you cannot manage because of your medication history.

Personally I've never known or heard of a femoral nerve block to be used in this situation though that doesn't necessarily mean a lot but it seems a bit excessive to me. If the procedure is going to cause that much pain, it inevitably is going to cause that much swelling as well. So is the idea that the PT can be as aggressive as s/he likes because your leg is numb? I really don't like the idea of that. Numb or not, it's still going to produce a considerable degree of swelling which itself will be both painful and obstructive.

However, I am sure all this has now confused you no end! But the principle thought I want to leave you with is that this is your knee and your choice whether you accept this procedure or not. Don't feel pressured or bullied into it. Don't think that because your surgeon has said that in his opinion it needs to be done, you therefore have have to comply - it may well need to be done but not necessarily right now - later will be just as effective. You are perfectly at liberty to say to your surgeon that you'd sooner wait a few more weeks to see if things settle down and improve on their own. There is no rush to get it done and waiting until week 10 or even 12 won't make an MUA any less effective. It's entirely up to you.

 

[Fernie]

Hi kel wow, what a lot going on for you .

My OS told me that younger TKR patients, like us, often expect miracles and super quick recoveries, fantastic rom etc, but we hav to e realistic. It's major stuff here. If you check my thread you'll see I've been through all the ups and downs and bad meds, no sleep, Young child to care for, But I've been pretty good at icing and resting regularly, which I believe has helped massively and I'm just under 6 weeks now and feel more human the past few days, but boy, it's been a tough few weeks and I really underestimated the whole early recovery process.

I hope you work out What's best regarding MUA and meanwhile, the others are right, you need to rest up big time and give yourself chance here. .

Take care, Fernie

 

[kneeper]

Do you see a rheumy for the fibro? I also wonder if your docs have tried you on Cymbalta? My mom had great luck on it for her disk disease nerve pain. I also think it might help with the fibro. The good news is when your knee heals up you'll be able to be a bit more active which can also help a bit with the fibro. I know I've been able to be more active since my tkr (though my other knee which needs tkr limits me) and that's helped a little bit with energy levels.

 

[Kelsie Lou]

kneeper Thanks for your response. I was taking Cymbalta years ago for anxiety but stopped for some reason - I can't recall. I wasn't taking it for fibro though.... I will have to check into that. Yes, the rheumatologist will be for fibro. That's the route my OS suggested I take for treatment..

Fernie Sleep has been hit or miss for me. There are some days when I am so exhausted that I just crash but most days I rely on my pain meds to help the muscles relax enough to get comfortable. I am looking forward to the day when I can just snoooooze....... As far as recovery... oh boy!! This is not at all what I expected. I know now not to compare myself to others, but I was thinking my recovery was going to be picture perfect like the stories that I have heard.

Mutley I truly appreciate all the advice and guidance you have given me. You have become a good friend.

 

[Mutley]

Kel, you are more than welcome I never thought I'd get to the point I'm at today, but can now, 15 odd weeks LATER just see the turn in the corner so to speak! It feels so much longer but now that I can feel some improvements & have more positive moments, I'm starting to think actually I've not done bad at less than 4 months post op! Unfortunately you are still very early in your recovery & as much as we hate it, there is NOTHING we can do to make it happen quicker or better , but by accepting this could be like it for quite some time to come, it will make it less stressful. Big hugs my friend & hope that you start to feel some of those positive moments too!

 

[Kelsie Lou]

Josephine Thank you for all the information. I did read the articles, but I am revisiting them. Thank you. There is definitely a lot to think about!
I know I am trying to do too much in my day to day life. I really hoped the 5 children especially the 14 and 16 year olds would have stepped up to the plate and pitched in. It is truly surprising how people can watch someone living in their own home, struggling with every step and not be internally motivated enough to clean up after themselves. They frustrate me! The 10 y.o. is very willing to help me but she gets distracted easily. She has a huge heart though and if she sees me struggling, she's right there. The 8 y.o. boy will help out if it doesn't put him out too much... typical boy. The 5 y.o. is my buddy! We have developed an awesome relationship. Being a kindergarten teacher, and her being that same age, we have a lot we can relate to together. She will do ANYTHING I ask of her (within the limitations of a small child).

I have really slacked off on my duties over the course of my recovery. The first couple weeks, I tried to do anything within what I thought was reasonable. I believe it was last week that I really started to listen to my body. The kids had gone back to their mother on March 8 and that's when the couch and my Ice/compression machine became my best friend. My husband helped more last week while it was just the two of us. This week unfortunately, he his making messes like everyone else. I am walking away from all small messes, I don't want to fuss over it. I create so much more stress for myself when I get worked up about the small stuff. I am working on it!!

Some housework just isn't getting done. Floors and bathrooms need to be cleaned... but not by me!!! Dinners are generally made by my hubby but I do help where I can. I hate not contributing and unfortunately, the more the older 2 see me not doing things, the more they sit out. Their dad will delegate when he's upset but ordinarily the kids just don't do anything. I will tell them to do things but if their dad isn't directly backing me up, they get around to it when they get around to it, (Actually they do that to him too, unless he's mad). I've been trying to call him on idle threats and following through on what is asked. He's a pushover and just wants to make them happy which means they are spoiled brats. I do feel sorry for them but if hubby won't support me, there is no way I can help change things. I just remove myself and let him deal with more and more on his own.

I am taking 1-2 Percocet every 4 hours. I believe my OS has realized that I am building up a tolerance and that is why we are going to try the catheter. I am going to an Advanced Pain Management clinic for that. They hope the injections will help control the pain, the cortisone will help with the swelling. I ice and elevate much more often on the weeks we don't have kids. Last Friday, 3/15 they came back to us. I have noticed more swelling again. Definitely a direct correlation. Yesterday and today I am home alone for small stretches of time so I am icing more often for about 30 mins each time.

I think that's it in a nutshell. Now it's time for a siesta.
~Kel

 

[Josephine]

Okay - you can only do your best

 

[Kelsie Lou]

Happy Wednesday. I had the MUA done today. As of now I feel physically and mentally that it is what I needed to do. Doc said before he did the procedure I was at 45 degrees and after breaking all the scar tissue it was at 130. He said it was "like a brick wall". It does make me feel better to know that it wasn't all in my head! I was starting to wonder..........

Anyway, I had the procedure, went to PT, received the CPM machine. It's been quite the day. I have spent hours icing and elevating. I got another mini lecture at PT, this is my chance to get this knee right! After today, I believe it. I don't want to do this again. I'll do everything I can to achieve success.

Have a good night!!

 

[bottomshollow]

I do sincerely hope, Kel, that the MUA will continue to be successful for you. Please do a lot of elevating and icing for long, long periods of time until the swelling is reduced and stays that way most of the time. Just remember not to force bending on your knee while it is swollen--just gentle easy bends to discomfort only---don't cause pain---that leads to more swelling---which keeps the knee from bending.

Take care and keep us posted. We care.

 

[Kelsie Lou]

bottomshollow Thank you very much!!! I truly plan to do exactly as you said.

 

[Toothfairy]

Hi Kelsie-Lou I am pleased your MUA went well yesterday.
Take it gently and enjoy those soothing ice packs. I hope you are not too sore and swollen today.
I hope this will let you get the ROM you need and get your recovery back on track,
Hugs, Toothfairy x

 

[Kelsie Lou]

Good morning Toothfairy, My knee is not tooooo swollen today. Of course it has some.... I have been up for a couple of hours now. Still sleepy. It's time for me to go back to bed to ice, elevate, and rest! Have a great day!

 

[Fernie]

Hello Kel - was wondering how you were getting on. Wow, MUA all done now. At least you know the capabilities of your knee now when the swelling has gone down and you can your PT programme.

keep resting up and taking it very easy for now. Take care, Fernie x

 

[Toothfairy]

Great news Kel,
Glad you are not too swollen and sore today. Keep,up with that icing and resting and onwards to great but gentle progress,
Hugs, Toothfairy x

 

[Kelsie Lou]

Toothfairy, I like that... "onwards to great but gentle progress". I will be doing just that.

 

[Kelsie Lou]

I continue to be cautiously optimistic. I realize this is only 2 days after the MUA but today at PT I got to 98. I was soooo excited I could have jumped out of my skin! I have been trying to be super cautious in what I do here at home but yet super smart. I am doing my exercises religiously and successfully. It is so unlike the last 5 weeks.

I am home to relax and ice now. Happy Friday!

 

[Toothfairy]

That is wonderful news. I am so pleased for you.
Toothfairy x