TKR Summer2020 recovery thread (RTKR 1/13/20)

[Jewlz1]

Hi @Summer2020 - I cringed when I read your PT put a weight on your knee. That had to hurt like heck. No wonder you were feeling uneasy about going back the next day. My experience has been good and not so good with my LTKR. My surgery was 12/18. I did PT before surgery for 4 weeks and felt strong physically and mentally for surgery. The day of surgery went well, my pain was well controlled and the nursing staff was stellar. I was released within 23 hours later to home. My in home PT was for 2 weeks and I started outpatient PT on 1/8 for 4 weeks. During my 2nd week of outpatient PT I started doing leg presses that increased progressively until I was pressing 80lbs. I trusted the therapist to know what they were doing. On 2/6, I was on the leg press and something happened to my surgical knee and I could barely complete the rest of my exercises. To make this long story shorter on 2/18 I went to see my surgeon and I had suffered a quad tendon and retinaculum strain during that leg press on 2/6. I guess I'm sharing all of this history with you because I don't want you or anyone to experience what I have. I am resting my leg to give the strain time to heal. I'm icing routinely and elevating when my knee gets achey. I live by myself and so I take care of running the household. Because of that I know I'm getting enough movement through my ADL's. I miss exercising but won't consider going back to it for at least a couple more weeks. I've gotten long winded here. Hopefully you've been able to cut loose from PT and can follow the gentler bone smart approach to your recovery. I'm confident that you'll be having a great time on the dance floor in August celebrating your wedding!!

 

[Summer2020]

Oh @Jewlz1 leg pressing 80lbs? Holy moly! No wonder you hurt yourself! I am scheduled for PT again on Monday. After last Monday, and the riding the bike for 5 minutes and she wouldn’t let me stop and on Tuesday some new pains I had never had came on like a vengeance, I cancelled my PT for the rest of the week. I’ve had a real hard time controlling this new pain I’m having.

I’ve decided to go to PT on Monday but my therapist and I are going to have a talk and anything that puts me in pain is out! Anything that I want to stop we stop! And no one will take my cane away from me and refuse to give it back to me ever again! If he won’t agree to these terms I’m done with their structured PT and I’ll do my own on my own.
I’m so sorry you are going through this painful setback. PT is not suppose to hurt us it’s suppose to help us. Having a TKR is hard enough to recover from, adding injuries to it sure doesn’t help a thing! I hope you feel better soon

 

[Summer2020]

Those sharp pains....having them tonight. Litlke electric shocks or pinpricks !!! Occasionally a deep bone throb. Whats that?

I know exactly what you’re talking about. I’m sitting here at 2 am not being able to sleep because of it!

I have my theories but they may or may not be right or even apply to you. I had multiple nerve blocks and I also had what they call cryotherapy injections. A week before my surgery they did the cryotherapy with an injection of nitrous oxide to freeze the peripheral nerves around my knee. In a few months the nerves regenerate and it wears off. I think the last of my nerves are coming back to life and causing the tingling and zapping pains. That’s my theory. I could be completely wrong tho lol . All I know is that hydrocodone barely touches the pain if at all. Thus why I’m awake at 2 am for the last 2 hours.
But if you didn’t have any nerve blocks or the cryotherapy injections that kinda throws my theory out the window. @valgriff2 did you have anything like that?

 

[Summer2020]

@Summer2020 I am so sorry the PT still has you in this much pain at 6-7 weeks post-op. I noticed a few things in your original post, and also in your additional posts....

1) My surgeon is a Reconstruction and Revision specialist for both knees and hips, so he has seen it ALL---the good, the bad, the odd, the ugly, the younger patients, the older patients, and the super weird!!!! This means he's also seen many knees rehabbed in various ways. Based on his 20+ yrs of experience, he told me to never let a PT force your knee to bend or straighten, nor to let them put weights on it to straighten it. All of these things literally "force" your knee to go further than it can at the time, increasing inflammation--that leads to increased swelling (additional fluid in the knee, causing a rebound effect)----meaning tomorrow you will be more swollen due to their harsh treatment of your leg. My surgeon hates seeing this chronic cycle of pain/inflammation in patients around the 6-8 week point when the pain and swelling should be going DOWN, not up. For this reason, he is very strict about the length and type of PT following a TKR. He would say your PT is only creating more problems and not solving ANYTHING.

2) I'm also VERY surprised your Dr is disappointed in your recovery. This just seems odd to me. Your ROM is actually very good and normal for 6-7 wks post-op. 120 is VERY good flexion for this point (mine was 94), and your extension of -4 is pretty decent too, as the swelling is keeping the leg from straightening completely. Mine was -6 at 6-7 wks and didn't reach 0 until the 13-15 week point (I'd have to look it up to be precise). I swell A LOT after every knee surgery, so I was prepared ahead of time for a slow go in getting ROM back. As for reaching an extension better than 0, there's no need. Some people are more flexible than others, regardless of whether they have good knees or bad knees. Just because some knees can extend past zero doesn't mean they NEED to.

3) Lastly, this is totally my opinion----but I think you are being done a big disservice by your PT and your Dr right now. There is no window of opportunity to gain your range of motion back. I've had knee operations where it took 5 weeks and some where it took 6 MONTHS. I even have one knee that behaves differently than the other, regardless of having the exact same type of surgery. Righty just LOVES to swell----LEFTY, not so much! There's literally no rhyme or reason to it.

4) I think you need to stop trying so hard to please the surgeon and PT. As others here have stated, you don't work for them---THEY work for YOU!!!!! You have the right to say no to any treatment that is harming you, and from what you listed above, it IS harming you and delaying your recovery. I was lucky to have a surgeon that would NOT give me more PT visits though PT said I needed it. He gets tired of PT creating problems he's trying to solve-----like eliminating pain and getting us back to regular life.

Hang in there and keep reading and asking questions. The people here are wonderful. Also, the more recovery threads you read, the more you'll see no 2 people recover the same or in the same time frame. Unfortunately many medical professionals prefer we all fit the same mold.

Thank you @Rockgirl4. So much of what you said really validates the feelings I have been having lately. Thank you for that boost in confidence. Yes I’m having a talk with my PT on Monday and if they don’t agree I will be pulling the plug on my scheduled PT and doing it on my own. I work in billing at the hospital where I’m doing my PT. I have access to the PT facilities before 8 am and after 5:30 pm. So if I want to I can go use the equipment there on my own.
Thanks again for what you said. This forum has helped me so much to see my recovery in a way that makes sense to me. Instead of just relying on the surgeon and PT to know what’s best.

 

[Jewlz1]

Right on @Summer2020 !! Physical therapists, at least in my experience with this one that pushed me so hard can be tricky! Good luck tomorrow!

 

[sistersinhim]

riding the bike for 5 minutes and she wouldn’t let me stop

The PT works for YOU, you don't work for them. If you want to stop, take control and stop.

If he won’t agree to these terms I’m done with their structured PT and I’ll do my own on my own.

Stick to those terms and you'll do fine. Even if you do you pt on your own, you're be fine.

 

[Summer2020]

Well I didn’t get to PT yesterday and have my talk with them as planned

my fiancé’s brother fell off a payloader. My fiance had the day off yesterday so we drove about 1 1/2 hours to the hospital he is in.Ends up he broke his sternum and 1st rib so glad it wasn’t worse.

so now my next PT is Wednesday and now they are probably going to chew me out for missing my last 2 appointments.

I did quite a bit of walking yesterday with my cane. Put ice on it after we got home yesterday. But this morning it feels real swollen, tight, and it tingles all around my knee cap. Is that just from swelling?. I did take Aleve the last 2 days and it seems to help with the pain better than Tylenol. Wondering if most of my lingering pain is from swelling? I remember my OS telling me after my surgery that I had a lot of red and inflamed tissue in my knee. Is that just not healing? So I’ve got swelling and that is what is impeding my ROM?

 

[sistersinhim]

so now my next PT is Wednesday and now they are probably going to chew me out for missing my last 2 appointments.

I did quite a bit of walking yesterday with my cane. Put ice on it after we got home yesterday. But this morning it feels real swollen, tight, and it tingles all around my knee cap. Is that just from swelling?

You have been doing PT with all this walking you've been doing. Walking is what your knee was created to do and it's the best PT you can do for it. If they chew you out, run from them. They don't care about you, they care about you being there. You don't even need to go, you're doing plenty without adding PT. And yes, your swelling is causing all this tightness and pain.

I remember my OS telling me after my surgery that I had a lot of red and inflamed tissue in my knee. Is that just not healing? So I’ve got swelling and that is what is impeding my ROM?

You are healing, but it takes up to a year to be totally healed. That swelling is most definitely impeding your ROM. Can you bend a water hose that is full of water? That's what your knee is like. Get the swelling down and the ROM improves. It's common sense. Less swelling=better ROM.

 

[Josie1054]

@valgriff2 : I have the same though they are diminishing the last week or so, will take your breath away for a second. The therapist told me that was nerves waking up and/or regenerating. She said as time goes by it’ll be minimal.

 

[Summer2020]

Well as much as I didn’t want to I went to PT yesterday. This time I had my normal therapist that I’ve had all along. Right away I told him I missed last weeks Thursday appt out of choice. That my knee swelled way up and I had lots of pain for at least 3 days. And that it started the day after my Monday PT with a different therapist. I told him that the biggest thing we did different was her making me ride the bike and not letting me stop when I told her I was hurting. Then I told him not letting me stop something when I’m in pain will NOT happen again! He agreed and apologized. My PT was good. He didn’t take my cane away from me. Just said ‘try not to use it but if you feel you need it then of course use it.’ I did all the exercises the previous therapist took my cane away for without using my cane except for the walking a tightrope one. I used it for balance then. He said if riding a bike hurts and at your stage in the healing process it often does then no bike! We did do stairs and I walked down and up a flight of stairs normally for the first time in probably 20-30 years. That was exciting! And it only caused some discomfort no real pain. We did do the weight on the knee to straighten it BUT he said if you have pain just tell me and we’re done. We’ll shoot for 45 seconds, last time you did 1 minute, but if you want to stop before 45 seconds then just say the word. I made it 30 seconds and said. ‘Ok enough’. He took the weight off immediately and said ‘no problem, good job’.
So my PT was basically pain free!
He also commented ‘have you been doing stuff at home cuz you’re much better with your walking, stretching and strength’ . I said ‘not anything structured just normal daily stuff and resting and icing it. And he said ‘huh. Well it seems to have helped’ and I said ‘well I’ve learned that too much exercise aggravates it and causes swelling, and angriness in my knee. So normal day to day in moderation with ice and rest seems to work better than all this structured exercises. Sorry’.
He said back. ‘ yes and we’ll watch the pain level better I promise, and then joked with me . But don’t make me lose my job!’

much better session and I love the nustep machine and getting out of the house. So I think I’ll still keep going.

 

[sistersinhim]

What a good PT you had today. You maintained control and it worked! Yay!

 

[Jockette]

I’m glad things were better this time, but please decline that weight on the knee for straightening, it is not necessary. You pushed it a bit to go to 30 seconds. No one ever had me do that and my extension came along fine.

 

[Summer2020]

So I have about 3 weeks before I have to go back to work.
The biggest things that are bothering me right now are
1. Swelling. My knee feels huge and very tight. I take time almost everyday and when I go to sleep to ice it. I’ve been taking Aleve twice a day for almost a week ( I can’t seem to take ibuprofen without my stomach hurting). No matter what I seem to do I can’t get that swelling down. My surgeon said when he went in my tissue was very red and inflamed so seems swelling is my norm. But now it’s even worse. What do you all do for swelling? Maybe there is something I haven’t tried?
2. This is probably caused by the swelling. But I can’t straighten my knee enough to walk straight. This causes a lot of back pain if I walk a lot or stand a lot and during some of my PT exercises. Anyone have any advice on how to get my posture straighter? Looking forward to going back to work but so not ready to deal with knee issues while working

 

[Summer2020]

Have had a rough past week. When they say depression can hit you with these types of surgeries they are so right. Between the lack of good sleep, the pain, the frustration of not being able to do things that you want to do, the pain medications themselves this surgery is sure messing with my mental/emotional stability.

My son. last Tuesday night. Moved out. Now he is 25 years old so in a lot of ways it is a good thing. But what bothers me is that he left in a huge puff. We have been arguing the last couple weeks about just stupid stuff and he knows it, but he just wouldn't quit. I won't bore you all with all the details but it was rough. real rough. He ended up moving out Tuesday night, and now won't talk to me. I have text him once to check on him and no response. I have no idea where he went, but he yelled something about he wouldn't even be in the state after that night. So I have my suspicions of where he went, but not completely sure.

I won't go into all the details. But this has been so hard for me to handle. The pain meds made it to where I couldn't remember one conversation from each day to the next. I couldn't follow what he was saying completely because he was talking so fast. He kept screaming at me about my reactions to what he said. Yet I couldn't even fully comprehend everything he was saying.

This has been tough to deal with. I cry at the tip of a hat. I can't stop it. I am anxious and it makes it hard for me to sleep at night. I wonder how much of this is because of the stress of my surgery and everything that goes with it, or just me being a cry baby as he said.

Rough!

 

[Jockette]

I’m so sorry you had such a big argument with your son. I hope that things will settle down and he will call you.

I found that I was extra emotional after my surgery, even as far out as 5 monument post op. It’s just hard to cope with everything after such a major surgery as this one.

Post op blues is a reality - be prepared for it

Post op blues is feeling depressed, weepy, nervy, shaky, fearful of the future, anxious, overwhelmed by what is happening to you, convinced it's never going to get any better and finally, uttering that most intense of all cries "I wish I never had this done!" It arises out of a variety of...

bonesmart.org

 

[sistersinhim]

I'm so sorry about your fight with your son. I hope he'll soon realize what you are going through and will give you a call or a text. For him to leave like that was really juvenile. Being away for a few weeks should open his eyes to the truth. In the meantime, take extra time to care for yourself. Baby that knee and cry all you need and want to. Crying is cleansing. Come to Bonesmart whenever you need to 'talk'. Someone is always here that understands what you are going through.

 

[Seatides]

@Summer2020, I am so sorry that you're having to deal with a family problem that would be difficult and emotionally challenging for a loving parent at any time; to be hit with this now, while you're working on recovering from major surgery, must feel overwhelming. I agree that sobbing your heart out can be cathartic. Don't hold it inside. We're all here thinking of you, and those of us who pray are praying for you too!

 

[Summer2020]

So on Monday It’ll be 8 weeks since my RTKR surgery. I’m actually doing ok. If ya told me a month ago I’d feel this good I would have never believed you.

there’s only one lingering thing that is bugging me. More annoying than anything but sometimes there’s pain with it to. I don’t know how to describe it but here goes. It feels like a tight band that goes around my knee cap. Sometimes it has a tingly feeling, sometimes it feels like it’s bruised when I rub it. It’s a thicker band on the bottom front of my knee more than on the top front. I’ve been working on my extension a lot at home and I’d say I’m right there to 100%. But I can feel that the bottom part of it is impeding me from going more than that. I still walk with a limp which really bums me out. My PT says it’s swelling of the soft tissues getting use to the metal in there , but no matter how much I ice it it doesn’t go away. It also feels sometimes like it’s moving which is a really weird feeling. Almost like my knee is about to dislocate even though I know it’s not.

Could this be scar tissue? or is it just specific tissue swelling? Is it eventually going to go away? If I could just get rid of this limp I’d be happy.

 

[Summer2020]

@Summer2020, I am so sorry that you're having to deal with a family problem that would be difficult and emotionally challenging for a loving parent at any time; to be hit with this now, while you're working on recovering from major surgery, must feel overwhelming. I agree that sobbing your heart out can be cathartic. Don't hold it inside. We're all here thinking of you, and those of us who pray are praying for you too!

thank you @Seatides for your prayers. My son is still gone. I’ve heard from him once in response to a text I sent him telling him I was thinking about him and hoped he was doing well. He responded with “haven’t figured out where I’m going but I’m doing good”. I responded with ‘thank you for letting me know. I think about you every single day, I love you and stay safe’ that was on Monday . I have reasons to believe he went to the Seattle area. I hope he finds what he’s looking for , I just wish he wasn’t mad at me to do it.

 

[Qdogpa]

Summer, I experience exactly what you describe..and it prevents the knee from completely flexing...I will say the numbsess / tightness has lessened on the exterior side of knee, while bottom and medial side is still numb and tight...I also feel a bruise like condition on the medial side as well....icing has not done anything for this...best of luck...