TKR Take Two

[Jewlz1]

Thanks Jockette. I'm trying to not be frustrated with myself. It seems like physical therapy is a double edged sword. When I was doing therapy before surgery it was good. Did the pre-hab help me post TKR? I would have to say yes. But I feel duped by the entire physical therapy industry post surgical. Especially after receiving a bill for 15k yesterday. I'm thankful for insurance because I will owe far less. But what a racket!

 

[Jockette]

When I was doing therapy before surgery it was good.

Back then you were not recovering from surgery: from anesthesia, from having 2 bones sawed and drilled into, and metal implants pounded into them.

Post op is a whole different ball game, but too many PTs truly don’t understand what this surgery entails.

 

[sistersinhim]

I am concerned about the strain and also concerned about losing quad and/or hamstring strength if I stop physical therapy all together. Any input will be helpful.

With your injuries, I'd stop all PT and concentrate on healing your strains and from your tkr. You will not lose what you have now and as you heal, will gain more without exercises. I'm proof of that.

Less than a year after my tkr, I fell and broke my ankle/foot on my tkr leg. I was non-weight bearing for 6 weeks. That means my new knee wasn't used at all. It fussed about not being used, but I didn't lose any ROM and just a little strength that came right back after I was back on 2 feet. I never took PT after any of my surgeries or after healing from my breaks. My body, as everybody's body, knows how to rehab itself without PT telling it how. It just comes natural.

Don't inflame your knee anymore than it already is. Let everything heal and it and you will be much happier!

 

[Julia1911]

My brother, like me, has had severe osteoarthritis much of his life. Both my hands are badly affected and I have had surgery on them twice, removal of synovial cysts and cortisone shots.

My brother also had severe wrist arthritis and multiple cysts drained/removed. Due to bone on bone erosion and associated pain, his doctors prescribed gabapentine for the nerve pain in his wrists and hands. He said it helped tremendously, but it gave him strange dreams for the 1st 2 weeks or so. Better than opiods.

My vet has me give it to one of my cats who freaks out and goes nuts for vet visits, nail trims, blood draws, etc. 1 dose every few months. Wears off in about 4 hours. She gives it to dogs and cats (only those who need it) to calm them down a bit before a visit so no one gets injured -- not the pet, vet or tech.

 

[Jewlz1]

Hi @Julia1911 - the Gabapentin has been a lifesaver for me and sleep. I can't take it during the day as it makes me too drowsy. Hope you're having a good day!

 

[Jewlz1]

@Jockette man oh man your explanation of the surgery! That image got thru my stubborn head. Part of PT requirements for graduation should be clinical, observing TKR. My OS said the same thing; it's very rare for a physical therapist to observe the surgery so that really don't understand. But he prescribes the therapy so.....

Thanks for all of your support!

 

[Jewlz1]

@sistersinhim - thank you for sharing your story and your encouragement. That had to be difficult to experience a break on the same leg as your tkr. I hope the day comes when PT is no longer considered a necessity post TKR. Our bodies are pretty darn amazing machines!

 

[Jockette]

I hope the day comes when PT is no longer considered a necessity post TKR

It may be considered a necessity by the medical profession, but you know your own body and have the final say what happens to it. You can do your own rehab at home at your own pace.
Saying no to therapy - am I allowed to?

 

[LD of Michigan]

Yes, she right. I looked at vids of the surgery in parts pre-TKR to learn the mechanics of if all. And the miraculous adaptability of the body considering all of that, with time and patience.

As I said weeks back recovery and PT is a 'paced' process. Not instant. One day at a time. Early on sometimes mine felt 'half-hour- to 'half-hour' at a time...... But it gets better...

@Jockette man oh man your explanation of the surgery! That image got thru my stubborn head.

 

[Jewlz1]

Is it possible for vastus lateralis and retinaculum strain to be a result of surgery or when I flexed my leg too far during my 6 week post-op? I'm fairly confident the strain happened during PT on 2/6 when I was leg pressing 80lbs. But I don't know thatfor sure. I have stopped all PT, but wonder if there should be sonography or MRI done to reveal the degree of tendon/retinaculum strain through imaging. I have new pain on the outside of my thigh radiating to my groin. I'm worried and not sure what to do. I don't want anymore surprises and this strain seems like a set back. Still resting, icing, and elevating. Thank you!

 

[sistersinhim]

Still resting, icing, and elevating.

That is the best thing for you until these strains heal.

 

[Jockette]

don't want anymore surprises and this strain seems like a set back.

This strain is a set back.

Another reason why I will be doing my own rehab at home, next time around

 

[Jewlz1]

@Jockette - me too!
This is so frustrating.
I wish I could make someone accountable for my additional suffering.

 

[Jockette]

You could at least call and tell them what happened, and that’s why you are cancelling the rest of your appointments with them.

 

[Jewlz1]

I am feeling pretty darn good this morning slept straight thru last night about 7 hours.
I'm trying to be vigilant in staying on schedule with Tylenol 2-500's every 6 hours and diclofenac topical which really helps. Icing and elevation 3x daily and at bedtime while I read. Today is the first day I feel almost like myself again even with the quad tendon tear that happened on 2/6 at the hands of an over zealous physical therapist. I haven't been to PT since the 19th of this month and no exercises at home, just daily activities around the house. Heed the advise of Bone Smart on physical therapy. Don't allow a therapist take you to the point of pain. I have a couple of errands to run and am anxious to see how that goes. I'll need to be careful, because I could easily forget that I'm only 9 weeks out from surgery.

 

[Jewlz1]

Well, talk about one extreme to the next. I am in quite a bit of pain today and frustrated. Waiting to hear back from my OS office without much success. I did request medical records from their office and left a message with SERC PT for the same. I'm to the point where I would like an ultrasound or MRI to see what degree of strain my quad tendon has suffered as well as the lateral retinaculum. Which from my research is a group of ligaments that help keep the patella in place and there is also medial retinaculum. Is it too outrageous to ask for ultrasound or MRI?

 

[Jamie]

If your pain is on the outside of your thigh, it is possible that you have inflamed your IT band. Please take a look at this article from our Library and see if it sounds like what you're experiencing.

ITB (ilio-tibial band) issues and treatments

Inflammation of the IT Band is pretty common when a person is overdoing exercises or activity early in recovery.....and you are still very early in the recovery process. It is unfortunate that you were trying to press weights like that at this stage. I suspect you're correct about that being the incident that caused your problem.

Keep pressure on your surgeon's office to get back with you. You may need to just make an appointment to be seen.

 

[Jewlz1]

Thank you @Jamie

 

[Jewlz1]

I was unable to fall asleep last night; yesterday was rough pain wise. I have a tendency to overthink as some have probably figured out about me. So I've been a mess over this tendon strain and really not understanding the healing process. So I took a picture before attempting to sleep and one this morning. I'll leave this open for comments on what you see with your eye and impressions. It will be very helpful to me as I live alone and a second set of eyes is always better. Thank you!
The first one is before bed, second one is shortly after waking up earlier.

 

[sistersinhim]

You are obviously less swollen in the morning, which is normal. Being up and on your feet during the day causes your knee to swell. At night, the fluid can dissipate and since you're resting and not on your feet, it doesn't come back. Then you get up and start moving around. Back comes that swelling.

I was also alone during my recovery. I never took PT because with all the daily activities I did, my knee was getting plenty of exercise. The first four weeks I did mainly the 'must do' things. Gradually, I added one extra thing a day and did just the 'must do' things the next day. If my knee didn't react too badly, I knew it was OK to do that extra thing. Then in a few days, I'd add another extra thing, following the same routine as before. This was a slow process, but I got things done, including yard work.

Letting your knee stay in control will give you a less painful recovery.