Revision TKR Third and final surgery all done

[kayow11]

Liam, just read your post and realized you had your surgery two months before I had my first one. I am happy to hear what you discovered. Hopefully that will be me also within a couple months.

I do believe all things will get better and return to more normal function and much less swelling but I really think for me it is going to take several months. If I was retired I wouldn't care as much but the work problem remains.

I guess things could be worse though. And I am glad I am not younger, due to the health insurance problem, and now being closer to Medicare eligible. That is one reason I had both knees done so close together is because of good health insurance coverage, and because both knees were so bowed, I felt it was better for my hips and legs to be even on both sides. If you're going to be laid up, and you know the other knee is eventually going to need replacement also, why not Get the misery done together? Kind of crazy thinking though right?

Does your health insurance pay for that relaxing leg massage along with your PT exercise routine? Mine doesn't so I am out of luck there. But I know it could be helpful for me.
I completely understand how ice and elevation and rest seems to do nothing for the swelling. But if I walk too much or do anything too much, it swells up even more for me at this point. It is on it's own timetable and I am trying to accept that.

 

[Celle]

You are right that CELLE's response was comforting but I just don't naturally have that kind of mindset, plus everyone around me including the therapist and family, coworkers, feel I should be able to do more, and why am I not healing faster? And that I definitely need to keep doing my exercises only possibly more vigorously to get ahead. I already tried that and it backfired.

It's very hard not to feel pressured when everyone you know keeps telling you that you "should be . . . "
I think the best solution is not to discuss your knee with them. They mean well, but it's your knee, not theirs, and every knee is different. Comparing knees is just a sure-fire road to worry and disappointment.
Just ell them that your knees are healing on their own schedule and they know what they're doing.
There's no need to worry or rush, since this is a year-long recovery. NO matter how much you want to, there's nothing you can do to speed that up.

I'm glad you've realised that working harder at exercises isn't the right thing to do.

One of my biggest troublesome factors is that my work expects me to be back before December 18 or I will have to resign from my 20 year position. My short-term disability also Ends. It wouldn't be the end of the world if that happened but it wasn't our plan yet.

OK. That's putting pressure on you, too.
But December 18 is almost 2 months away. Your knees aren't going to be the same by the time December rolls around as they are now. They're still a work in progress . A lot could happen in that time.
There's every chance that you will be able to return to work by then. Your second knee will be 3 months old and that is about the time we recommend you take off work. Your firs knee will be 6 months old, and much improved by then.

With as slow as I am going with the first knee, I don't see how I can be ready to go back to work at the three month mark past my second knee surgery, and of course there is the health insurance problem where as at work that is a non-issue because I have good coverage. Not old enough for Medicare so that puts me in a bad spot.

Your first knee is almost doing double duty right now, being the main support for your second knee. That's going to slow it down a bit. However, make sure that you rest, elevate and ice both knees. That should help your first knee as well.

It's normal for swelling to persist, to a lesser or greater extent, for at least 6 months, so try not to worry about it.

I should have added this to my last post just a moment ago, but have any of you tried massage for swollen legs, or lymphatic drainage massage for this problem?

Lymphatic drainage can help, as long as it's not painful. As SusieShoes says, don't try it on your second knee - it's much too soon for that knee.

I wonder if reading these article would help you to feel less anxious about letting your knees take their time to heal?
Life in the slow lane
TKRs and our fast food society

 

[SusieShoes]

That's why walking feels so good... we spend weeks on our backs or behinds!

 

[kayow11]

Celle, thanks for your timely words and response. It is slowly beginning to sink into my skull about what I am really dealing with here.
I did read the two articles you recommended at the end of your post, but the second one stressed being passionate about doing PT, to gain success. These are the things that get me confused because that is what I already tried but it failed me. And that is still what I want to do but I am afraid to do it for fear of failure there again for setting me back.
I know that it works for some, in fact probably for most, but I surely would be doing it if there was a good chance to help me. I love to exercise and get strong and make things better. That was my goal from the very start. And now I have to take the little winding road through the unknown forest to get to my destination. I have to say I don't like it, but I feel it is my only choice right now. I hope and pray that the reward is coming at the end.

 

[RadioGal]

Hi @kayow11 where do I begin? So much wisdom in the replies here! I'm learning and being encouraged along with you.

But @SusieShoes pegged it with the whole acceptance thing! Yes, yes, yes. Despite my recent successful MUA, I ran right smack dab into a major hurdle this past week with PT and my doc trying to get me to gain extension. I'd sooner try to jump that hurdle than how they're going about it, pushing on my poor knee in an attempt to relax the muscles and gain extension. Whee, what fun! And yes, causing more swelling and a pain that I haven't felt since the first couple of weeks after surgery. BUT, acceptance that this is part of the process (no worries, I do speak my mind in PT, it's not a knee-bash free for all) and that I WILL get better. @KarriB is a great example of that. Look at all she tried to do early on, I mean who wouldn't want to go see Wicked? Yet, she paid the price thinking she'd be a-okay to go from Dec. to January. Now, years later she can tell the tale and encourage others, especially newbies like you and me.

You have something I don't have, time! Take advantage of it. I only took one month off from work and though I do a mix of freelance and (real) part time work, I sit in the car in traffic both ways, dangle my leg from a stool @ work and then ice it like crazy @ night to make it all go away...as if that would work

Accept that you're going to be like this for a while, but also accept and expect that you're going to get better just like @Celle

We have much to look forward to!

Oh, and as for exercises, well, shhh, don't tell my PT but I rarely do the @ home assignments. Life and its everyday activities along with short walks are my exercise. I'm also letting gravity do its thing to get more extension, heel on half wedge and holding, or laying on my stomach on bed with knee over the edge.

Lastly, don't compare your ROM or progress to anyone else's. My BF went through this and said "I didn't have any pain after leaving the hospital." What? We're all different and while my MUA greatly improved my flexion, the extension is taking much longer. However, good news on that front too, I've gone from a -20, to a -12 to a -6. The knee tends to hover around -10 on average, but PT and my home extensions is helping me get there.

 

[Celle]

I did read the two articles you recommended at the end of your post, but the second one stressed being passionate about doing PT, to gain success.

I think you might have misunderstood the message in that article. Yes, it said being passionate about your recovery is the way to success, but it didn't recommend being passionate about PT. It meant being passionate for success, and choosing luxury food, not the fast-food menu - in other words, good things take time. Don't settle for the takeaway fast food, when a bit more patience and a slower recovery will give you the luxury food. It doesn't say anywhere that you need to be passionate about doing PT.

 

[OJ2]

The mental game is just as hard as the physical rehab. The exhaustion can get you down, which then affects your mind. I find that reading BoneSmart helps me keep a more realistic view of my recovery and where I am at. We all heal at a different rate, but knowing others are in your boat seems to help. Keep up the good work and non-work.

 

[Fire wolf]

"if you keep your head up, and keep working hard through the PT, you will regain your life."
"You have to be passionate about your PT and your rehab."

These are direct quotes from the Fast Food Society post. I certainly understand how this would create the confusion, @kayow11

 

[Jockette]

In the 7th paragraph it also says you have to be passionate about your PT and rehab.

I misunderstood that, also.

I discounted it when I read it earlier as I know that is not what Bonesmart promotes. But it can be misleading as many of us have PT's telling us to do things Bonesmart says not to.

I do know I've read on here that in regards to working hard, it was said to work hard at resting, icing and elevating, which gives us a work ethic mindset in the right direction, instead of feeling like we are doing nothing, when in fact we are doing something very important for our new knees.

 

[SusieShoes]

I also see how that post could cause confusion, though I understand that when it says to be "passionate about your PT" it means your PT, your way of rehabbing your knee.

I was certainly passionate about my PT. I wanted my knees to get stronger. No one was more passionate about getting in her daily walks -- short walks though they were at first -- or doing her bends and stretches. They were gentle bends and stretches, but I was fierce about them. I blew off PT as soon as my OS would let me, because what my therapist continually tried to get me to do (leg presses, heavy ankle weights) was contrary to what my OS wanted and I knew would be good for me. My knees were my project, and I gave them my all. I was the most passionate walker on the planet, I think.

Passionate about PT doesn't necessarily mean professional PT or what therapists want us to do. But I can see that most readers might take it that way.

 

[OJ2]

I like the comparison to a long, windy road. But it can also be the scenic route. Each of us has a different healing time and we each have different pain tolerances. And why continue to beat your knee up through painful activities while it is so valiantly trying to heal. Your knee will tell you when it is time to try more, and that time is different for each of us. The best thing is time passes at the same speed for all of us, and we don't need to do anything to make it pass. And as time passes, your knee will get better.

 

[Polkadot]

Maybe if you give yourself a break and let your knees "be" for a while, you'll find that by December 18, your knees can handle the work. They may not be back to where you want them to be, but your newest knee will likely (just from reading general progression info on this site) achieve similar flexion, at least to where your first knee is now. You can do many things with 90 degree flexion. So you may not be able to go foot-over-foot up and down stairs, ride your bike to work yet, or run a marathon. You may still need to rest, ice, and elevate (possibly both knees!) at that time, and you may need to do some of this at work. You will probably by then be able to sit comfortably, walk a fair distance, carry small loads without pain, and hopefully do most work tasks without too much discomfort. (Unless you have a very demanding job? What will you have to do?)

No one can know what twists and turns this journey will take. I've learned a few hard truths along the way: I can wish, hope, and even strive mightily to get out of the Slow-Benders Club, but my knee has other ideas--and the knee rules. The more I strive, the more I set myself back. My brain can be my enemy: always "shoulding" on me, worrrying and borrowing trouble. I can worry, plan, and force myself to do more than my knee wants me to all that I want. That won't change my future. It probably won't change yours.

 

[Polkadot]

My health insurance doesn't pay for therapeutic massage. I choose to spend my money on it because it seems to help. One tip: The stated minimum for massage is an hour where I go. The massage therapist is willing to do a targeted massage for 30 minutes instead. I can afford $30 a week right now for this; I probably would have had to go to an every-other-week massage if I had had to schedule 60-minute massages. BTW, In our area, a dollar a minute is standard for therapeutic or spa massage. You may want to check around to see if you can get a targeted massage or a better deal than the $1.00/minute thing.

I didn't start massage until about 10 weeks, and at first it was gentle. Now the therapist does "dig into" places like the IT band and the juncture where several tendons and muscles meet. However, I would be very careful and judicious about the type of massage and when to start it.

My PT did some lymphatic massage because I swell a lot. She also used athletic tape in a certain way to encourage lymphatic drainage. In my opinion, icing and elevating did more for the swelling than any of this.

 

[OJ2]

Definitely different types of massage depending on where you are in this journey.

 

[Celle]

I can see how the confusion has arisen. I think SusieShoes explained what the writer meant.

However, I have asked to have that article modified, so that it's not so confusing.

 

[Jockette]

Thanks, @Celle! Great idea!

 

[skigirl]

One way to look at your knee is to think that the soft tissues need time to
Heal. I spent the first two weeks in bed, with ice and elevating the knee. After that, I began to feel better, but your knee is not ready to support your joint, if u do too much exercise or stand or move around too much, your joint will react with pain and swelling, so take it easy, allow the knee to heal and get stronger,

 

[Celle]

The article that caused confusion has been edited, to remove the confusing part.

 

[kayow11]

Thanks everyone for your input on the last several posts since my last one.
I did see my surgeon today for my two week post op appointment. He said he is not at all worried about my progress or lack bending, and knows I will get there eventually, because I know what to do and how to listen to my body. That was greatly encouraging to me to hear that come from his mouth. He has always been in my court though, not like most other people including PT, and coworkers.
They all care about me but just have a different mindset and truly believe I need to push it to get results. I am learning my knee boundaries slowly such as I can only walk five minutes with this new knee. I guess I need to stay in the house to limit myself on this because if I go outside, it ends up being too much or mad because of the hard pavement. And no exercises. Period.
My old knee is not happy either since it has seemingly regressed. It is acting like the spoiled older sibling that is jealous of the new baby but again, they win, not me. I have to listen and go with it.
I do have one big concern though, my new knee looks like it was over corrected and my surgeon thinks that most of that is because of the extreme swelling I have in my whole leg and especially the joint. He will see me again in one month to look at this and he feels that as the swelling decreases, things will look much more normal. I am used to being bowed and now I almost look knock knee with the newest knee. The other one looks nice and straight.
I asked my surgeon if he felt massage could be helpful and he said sometimes it helps, but of course not near the incision. I will forego the lymphatic massage for now though. He will order it along with my PT and will see how that goes. I have cancelled 2 PT appointments and have only gone twice since my second surgery. I am currently not doing any exercises at home either. Of course my PT wants me to come 2 times per week but I don't see the point in that.
The last few days I have been just resting and icing and elevating a lot. I have been doing this right along these last two weeks since surgery. I hope and believe it is helping me but don't see any signs or change yet from it. But again, patience, patience.
I might be able to phase back to work to some degree, but I have to be able to do my job which is moderately physical. There are no Jobs with restrictions. But I can't worry about that either. My job now is just to take care of myself and the healing will happen as fast as it can on its own. Will see about work stuff by mid November. I doubt Very much that I would be able to start any job stuff before the first week or so of December. I can't start too early or I will just be set back again.
My biggest problem is how to progress myself as I am healing and am starting to feel better. Even going slow, I feel I get burned every time. So that will be quite a challenge, to learn what to try next and for how long. Most everything seems to show up an hour later or even a little more and then punish me for two or three days from it. It is quite a dilemma!
Thanks all for reading another chapter in my book I do seem to send long posts but that is the detail and specifics part of me that won't change.

 

[KarriB]

I think taking it super easy for the first 4-6 weeks is the way to go! You are likely to not see improvement in swelling during the first month, so yes patience is necessary.