Revision TKR To Work or Not to Work?

[sistersinhim]

Sistersinhim: Did it work for you? How long did it take for you to see improvement?

With all 11 knee surgeries I did no PT and I rehabbed my knees just fine. I am divorced, so I had to take care of me, the house, the yard and 13 rescued cats. My ADL was all I needed to get the knees working again.

The first couple of weeks were rough, but after that, things started getting a little easier week by week. When I was seated or laying in bed, I was always icing and elevating. I'd do a little bit of walking to do just one thing, then go back to sitting down. I was down about 4x more than I was up the first month or so. My swelling was no worse than moderate at any time. My ROM came right in with no problem. My extension was a little slower coming in, which is nothing unusual. I achieved good knees' recovery just fine without the agony, time or expense of PT.

 

[JMB]

Sisters, thank you for the inspirational response. I'm no better off now than before my manipulation two weeks ago. My opposite hip has now come into play compensating for walking with a bend in my left leg. It's more painful than my surgical knee. The weekend is here and I plan on resting, elevating and icing. I feel so depressed again, like this stupid knee is never going to heal.

 

[Polkadot]

I think you are on the correct path to attend to your health first and delay the work. What do you teach, and why does it involve standing for 8 hours? I'm a teacher, too, and while a rolling stool might be helpful, I'm wondering about a wheelchair for you? We have had several teachers in our building who have had to use one for a period of time, and one who is permanently in one. Students seem to rise to the occasion and become more helpful, understanding, etc. Others on this site have mentioned that the sight of them unloading a cane or walker from their car tells others to be careful around them--not to knock them over on a crowded street, etc. A rolling stool doesn't send the same message. The right wheelchair also would allow you to raise the new knee a bit, maybe even balance some ice on your knee, whereas a stool is feet down all the time. I find that position challenging, and my knee swells if I spend too much time feet down (as when using my computer), just like when I spend too much time standing. For when you must stand, can you stand mostly in one area? I would suggest getting one of those cushy mats to stand on. I notice quite a big difference to my knee when on marble floors (mall walking) vs sidewalks (a little softer) vs asphalt (starting to feel more comfortable) vs a limed path or a running track (ahhh!)

Think about the biceps-building potential of using a wheelchair! Also, you wouldn't have to be in it every minute--you could let students know that you will be using it when you start to tire, and for going long distances quickly in your school. I think of those long hallways with jostling student bodies, and my new knee quakes.

So while I vote for a delay in your return to work, and maybe when you do, phasing in part-time at first, I also think you can get some equipment that may really help you be successful when you do go back.

 

[Polkadot]

I just don't know what to tell a sub to cover in my absence. I mean I know what I was planning on doing, but it doesn't involve books or preprinted handouts.

Another thing: If you decide to delay going back, why not go all in, rather than doing a sub call day-to-day? It sounds as though you need more time to heal. When I had breast cancer in the middle of the school year, I had to stay home for 6 weeks. My district allowed me to choose a long-term sub who was knowledgeable in my field. She and I met before she started, and I shared my philosophies of teaching with her, what I hoped to accomplish, etc, but I did no lesson plans for her. She stayed in touch during my home stay, and we fine-tuned any problems she encountered. After I went back to work, she even committed to keeping her Fridays free for my chemo days, in case I needed her to come in and sub. It was such a blessing over taking whoever was available each day, but you would have to decide ahead of time how much time you needed to be "out." That would probably be a good thing for you!

BTW, I didn't see "results" immediately from my MUA, either, but it did seem to loosen things up so I could progress in my ROM. I'm in the "slow benders club" so even now I haven't been rocketing along. I can see improvement, though!

 

[JMB]

Well, I am definitely what you call "A slow bender." I am meeting with my department chair this afternoon, and we'll discuss my options when it comes to finding a sub, lesson plans and other details. Part of me still insists I return, while friends and family say otherwise.

 

[sistersinhim]

I think you have made the correct decision.

 

[JMB]

Update: I just returned from a faculty-department summer party. My fellow teachers unanimously agreed that I should not return until I am 100% healthy and able to work a full day. The head of my department informed me that a qualified substitute would be hired and that I need not worry about lesson plans, grades, teacher evaluations, etc. "Just concentrate on getting your mind and body healed." They told me they would take care of any problems in my absence. I'm still uneasy about all this. It's just my nature. I want to go to work! I've never been one to listen to advice before... until now. On Monday I will call my OS to get a note. The next call I make will be to HR to let them know I need more time off. I will take a 25% cut in pay for some of the time off, but we'll manage. That's a load off my mind. Now it's time to heal.

 

[Polkadot]

What a great staff! I'm sure they value your expertise greatly, but they care more about you and your well-being. Cheers to them, and to you for knowing when to take advice and run with it.

 

[JJ65]

That is great news !!! I am happy for you

 

[sistersinhim]

Without going to work, you will be saving the expense of actually working, so hopefully, you won't miss that lower pay. And you just might go into a lower tax bracket! Things will work out for you. You need to worry about healing that knee. Everything else will fall right into place!

 

[JMB]

I never thought about it that way, Sisters. Thank you all for the encouragement. Still many details to work out with the school district next week.

 

[kneeper]

I'm glad you are going to take the extra weeks so that you are more healed and ready to be effective in the classroom. I know it is hard for you but the fact that your colleagues are so supportive should help ease your mind.

 

[JMB]

I'm so depressed today! Why won't this stupid knee straighten or bend all the way?!! I'm getting tired of hobbling on a cane with people staring, too. My hips hurt walking on a bent knee. Ugh! I keep thinking What happens if it never returns to normal? Guess I'll call it a night.

 

[sistersinhim]

Your knee won't bend because its a newborn baby again. It's only a little over 2 weeks since your MUA.

Go on YouTube and look at a real-time video of what was done to your knee during surgery. And look at just the closing: https://bonesmart.org/forum/threads/closing-surgical-wounds-how-is-it-done.4286/#post-90691

Your knee was far from being healed from the tkr, now you're adding in the MUA recovery time. MUAs cause setbacks. Your tissues are inflamed and very angry right now and need time, ice and elevation.

 

[JMB]

Well, school begins next Tuesday without me. I have chosen to stay out until the second quarter- November 13. I have followed the advice here and I must say WOW! I am getting better. We go fairly easy at PT, and I rest on days without it. I can't believe I just left it alone at home to heal, icing and elevating, and it's bending and straightening now! YES I'm not 100% yet- stairs are a real challenge still. I know I have a tough road ahead to get back to work, but I am soooo glad I met all of you here that supported me and encouraged me. God Bless every one of you.

 

[kmak81230]

That's a great report JMB -- glad you have seen some good progress with the rest, ice, and elevation. It's a good idea to wait until November to head back - that is awesome that your school, district, and colleagues have been so supportive. Keep on taking it easy so you can be at your best when you head back to work.

 

[SusieShoes]

You made such a good decision to wait and let your knee do some quality healing. You're blessed with a great group of people to work with, and a situation that will let you take this time off. Many people think it sounds counter-intuitive to "do nothing." But you're not doing nothing, you're doing the right things. You're allowing your knee to heal naturally. I'm so happy you've seen good results so quickly! There's more improvement just around the corner.

 

[sistersinhim]

What a good decision you have made about work! Your knee will thank you over and over! You are more proof that the non aggressive PT is the best way to rehab!

 

[JMB]

So my knee is slowly getting better but no where near what my doctor wants at the 3 month mark. Honestly, sometimes I get discouraged by my lack of complete range of motion- and I still can't do stairs yet. I have 10 weeks left before I return to work in November. That would put me at the 6 th month mark. Does anyone here have advice for a slow healer like me? Sometimes I just don't think I'll ever walk correctly again.

 

[Jordon6]

@JMB l'm in the slow benders club too! I also struggle with gaining ROM. Mine is about 85/90 after 11 weeks. I, too, teach (first grade) and had my knee revision in June and used my 12 weeks off work which went into the first month of school. I am scheduled to return later this week and am nervous. I also felt nervous about using a sub at the beginning of the year. One thing that helped me was I worked along side my sub the first week of school. I came in early and left at lunchtime so that the students could get to know me. I also dropped by during lunchtime every week before I went to my therapy sessions. I felt that I needed to connect with them, and them with me!

I have wonderful co workers-like you but the pressure is still mine to bear about those babies, but they definitely can't thrive if we are not healthy.

Take the time and get healthy. It'll be worth it for you and those precious lives that depend on you!