TKR Toni Lee Recovery Thread

[Celle]

Molly59 now has her own recovery thread, here:
https://bonesmart.org/forum/threads/molly59s-recovery-thread.57667/

Please follow her progress there.

 

[tlfiore]

Thank you everybody. Yeah...I've got to wrap my brain around this whole PT thing. I initially felt good about the whole process after I did my Intake last Wednesday and more so, after my first full session last Friday.

Seems like the PT therapists are NEVER pleased with anyone's progress. I wonder if there's something about the ego, or culture within the discipline. That is, the PT feels achieved if their patients make the most progress in the shortest period of time. I mean, the PT therapists are like disciples of an art & science...it's kinda weird. They all sorta walk around lean & buffed up...it's a few steps removed from being gym rats...uggghhh.

 

[Sara61]

CrikeyI'm nearly at 8 weeks post op - have PT twice a week and do not EVER do half of that, I don't take pain meds before as there is never any need to do so, my PT says we get enough exercise at home (everyday living) this stage of recovery- you are several weeks behind me. Seriously ask about a replacement PT he isn't doing you any favours at all.
I'm now almost living a normal life (off all pain meds )& slowly everything is getting where it should be xxx

 

[sistersinhim]

There's a tendon, or some type of band that he's gotta break through that's holding things up (?), if not I will have problems, blah, blah."

Nope, he is so wrong. Aggressive PT causing swelling is what's holding things up.

Again, today I accomplished:
-5 minutes stretching & flexion after heat applied
-8 minutes Nu-Step recumbent step machine
-8 minutes recumbent bike, forward & backwards
-8 minutes on treadmill
-15 repetitions on step blocks
-15 repetitions quad strengthening
-15 minutes icing

Oh my gosh! This is insane. Does he think you're training for the Super Bowl or something? He obviously has not been trained in joint replacement therapy. Run away from him as fast as you can.

I'll pre-medicate for my next PT session come Wednesday. I'm still having some nighttime pain, which does either keep me awake and/or waken me every few hours

It's wrong to pre-medicate before PT. You need to feel the pain so you'll know that your knee isn't ready to do that type of PT. You would be much better off finding someone who works on getting your swelling down and your gait. Not taking PT at all would be much better that what you are doing now. Besides, just walking around in your house, taking care of your daily needs, is all your knee needs to recovery nicely.

 

[Helizabug]

This work is for your healing, not the PT’s portfolio. If your knee is crying out for help, listen to it. If your PT is crying out for affirmation, that’s what their paycheck is for. (Is there a ‘drop the mic’ emoji?)

Ugh. Honestly, they shouldn’t be putting you on the defense. It’s unfair, and you’ve got other work to do. They should be easing your pain, helping you progress at a sustainable pace, and giving you encouragement.

 

[tlfiore]

@Helizabug ..."drop the mic emoji"...you made me laugh. Thank you.

Well, I've not updated in a few days but as others who follow me have mentioned in their Recovery Threads, I do feel alright, albeit a bit "stalled." Again, if not for BoneSmart and all the wonderful folks out here, I'd really feel discouraged, which I do not feel...really discouraged.

Same ol', same ol' at PT. Therapist was a bit more pleased with my movement, blah, blah. I almost canceled my session on Wednesday but decided not to do so. As I've mentioned, SOME of the PT does seem to help a bit. But yes...after Wednesday's session, I could see I was more fatigued, in a bit more pain on Wednesday evening. Truthfully, Wednesday night was not good. Even my dear friend Barbara, who has driven me to my four outpatient PT appointments said to me (as she kept me company), "OMG...enough with this recumbent bike, stair up and all...you've got to be getting tired and fatigued," etc (as my right leg/knee fell from the recumbent bike pedal)

Uggggghhhhhhh...and yes for me, sleep & nighttime...the WORST! I dread nighttime 'cause I cannot get comfortable at all to fall off to sleep. Icing STILL helps me a whole lot. Seems like I pass a certain pain "threshold" whereby icing goes from feeling irritating to being extremely comforting. So, I'll try and I keep trying.

Then of course, there's the early morning, few times a morning "waking" with the fatigue, tiredness and knee stiffness. Thank you insomnia.

I have this sorta grooved, side pillow thing arriving any day now that is supposed to help me elevate and cradle my right leg/knee...hopefully this might diminish some nighttime pain.

Good news is like many of you, there are several, small victories! I'm fine with XS Tylenol 1300 every 8 hours during the day. I'm taking oxycodone and Tramadol at nighttime, once only (most nights). I still elevate & ice a lot, which my knee seems to enjoy. I'm definitely getting around better with my cane. I'm completing a few more errands with my neighbor graciously driving. Foolishly, I made my husband a rather arduous dinner (??) before and after returning home from PT on Wednesday...lesson learned. I will not be doing that again...arduous dinner (or any dinner) on PT days.

A few longer walks with Ernie. The list goes on. I guess I'm feeling a bit impatient with the pace of my recovery right now. Yet, I'm thankful and grateful my surgery & progress have been so uneventful.

Please stay well and hopeful, friends. More updates and stories to follow.

Thanks for reading!

 

[Macknit]

Hello @tlfiore I miss your postings!!! How are you doing? I too have been posting a bit less, but it is the time of year ! Right??

I hope all is well with you and life's busy-ness has just gotten in your way of writing.

Take care!

 

[tlfiore]

@Macknit you are so kind to check in on me! I still jump on BoneSmart every day and I read a lot. I am posting less 'cause there's little to report. I look forward to following your updates. I am so happy you are managing as well as you are.

Well, today is not a great day, for whatever reasons. I've not posted in about one week. I am anxious to see my OS this Tuesday the 17th for my 6-week follow up. I just CRIED my way around the block while walking my Ernie. I've been weeping all morning...not exactly sure why. Guess I didn't expect this much pain & discomfort at 6-weeks post-op. I keep telling myself, "It's only BEEN 6-weeks" but I guess I expected to be further along.

I've been attending PT but cancelled on Friday...just couldn't bring myself to going. It's the same ol' stuff. Not sure why I cannot mimic various movements here at home. I guess the theory is one will not push "hard" enough for improvement. What a joke. Of course, I can SEE I still have swelling and edema all around my knee and upper thigh. I understand it takes months for the knee to return to normal, which includes WNL flexion and ROM. Gonna ask my OS on Tuesday about opting out of PT.

I guess it's difficult to have an objective measure about progress 'cause the progress is slow and aside from the physical therapists, NO ONE monitors our progress closely. Such a different recovery. It's not a linear process. So, it's hard to know what's normal or not. I think I'll feel reassured after I see my OS this Tuesday. Either way, progress or not, it will be a relief to have OS re-evaluate me.

Not sure what I'm doing right/wrong but nothing seems to help the pain come nighttime. I just ordered a thigh cuff for my Air Cast Cryo Cuff 'cause I cannot tolerate the knee cuff (never could) and I can no longer tolerate the hard ice freezer packs against my knee...so I've been icing less. Undoubtedly, less icing is contributing to more pain. The thigh cuff will cover my knee more evenly. That item should arrive here come Tuesday.

I'm just taking XS Tylenol 2 tabs q8 hrs during the day for pain. Wish I could take ibuprofen on a more regular basis but due to bariatric surgery, I cannot. Tired of taking oxycodone and Tramadol at night...

Guess I'm just feeling discouraged today. Going to get my mind off of this.

THANK YOU Macknit for caring. Your thoughts about me already made me feel better. Thank you!

 

[Suz]

I care too @tlfiore! You've been such an inspiration to me and many others here. Our temps are dropping steadily here today and my knee is 'over the top' unhappy about it!

We WILL survive this!

 

[Helizabug]

You’ve got reason to weep, of course. This is a long hard haul your going through. Do mention it to your doctor, and don’t play it down. Sometimes we need help getting through these times.

 

[Celle]

Not sure what I'm doing right/wrong but nothing seems to help the pain come nighttime.

There are usually two main reasons for night-time pain:

1. Under-medication.
2. Over-activity.

1. Under-medication

I'm just taking XS Tylenol 2 tabs q8 hrs during the day for pain. Wish I could take ibuprofen on a more regular basis but due to bariatric surgery, I cannot. Tired of taking oxycodone and Tramadol at night..

Ibuprofen really isn't a very good painkiller, because it's primarily an anti-inflammatory. Besides which, it can cause bleeding from your stomach, so please don't even think about taking it more often.

Have you considered taking the Tramadol-Tylenol combination that we recommend? The second table, for six-hourly doses, is probably more suitable for you.

To get these doses right, you'll need to switch from the Tylenol Arthritis tablets, which each contain 650 mg and last for 8 hours, to the Extra-strength Tylenol containing 500 mg per tablet and lasting 4-6 hours.

The most effective way to take Tylenol is 2 x 500 mg tablets 6-hourly, to a total of 4,000 mg (4 doses) in 24 hours. You need to take it regularly, to keep up the levels in your bloodstream. If you just take the odd dose now and then, it's far less effective.

Check all other medications you're taking, to make sure there is no Tylenol/Acetaminophen/Paracetamol in them. If there is, scale back one or two of your regular doses, so you stay within that safe 24 hour limit of 4,000 mg.

2. Over-activity

I just CRIED my way around the block while walking my Ernie. I've been weeping all morning...not exactly sure why. Guess I didn't expect this much pain & discomfort at 6-weeks post-op.

Not sure why I cannot mimic various movements here at home. I guess the theory is one will not push "hard" enough for improvement. What a joke. Of course, I can SEE I still have swelling and edema all around my knee and upper thigh. I understand it takes months for the knee to return to normal, which includes WNL flexion and ROM. Gonna ask my OS on Tuesday about opting out of PT.

At only 6 weeks post-op, just walking your dog, combined with you other activities of daily living, is plenty of exercise for your wounded knee. PT on top of that is just too much for such a new knee.

It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. You don't have to strive and work hard to rehab your knee, or to increase ROM. That will happen naturally, as your knee heals.

You already know that your therapist is pushing you too much, so stop going to PT.
You don't need your surgeon's permission to do that. You're a responsible adult and it's your knee. No one but you has the right to say what happens to it. While others, like your surgeon and your PT, may advise, you have the right to choose whether or not to accept that advice.
Saying no to therapy - am I allowed to?

Your knee knows what it's doing, Listen to the messages it's sending you. It's telling you "Mom, you're making me do too much, too early in recovery, and that's why I hurt so much at night. Please don't ask so much of me."

 

[Macknit]

It's interesting how people can meet through letters or forums and connect on something so difficult and stressing as this knee recovery! I truly care, you are a very strong and educated lady who is just facing a tough time. As DH said to me one day around 6 weeks also (I was in a puddle of tears) "You are doing fine, you're just having a bad day..." That actually helped me feel better too. So hang in there, I do care how you are and just know all of us have been right where you are!

I really appreciate @Celle's advice! Both the medication and the over-activity part. I have used the tramadol after a couple of surgeries and it really worked well for me when combined with Tylenol.

As for the tears, you are so very normal and some of us (oh yes, I cry quite easily) are of a more sensitive nature, so the slow recovery and non-linear progress makes the tears flow a bit easier! We will get through this..(I'm Icing and elevating, yet again!) Keep up a hopeful spirit!

Peace and Joy

 

[flacie1]

@tlfiore I have been wondering how you have been doing as well. I jump on daily, but don’t post as often either since I don’t feel I have much to report either. You’re so right about this recovery. It stinks that it’s different for everyone and there isn’t one set path. I am highly jealous that you are able to get out and walk Ernie. I can’t wait to get out and walk Blue. Are you able to walk unassisted already? I have returned to work and even though I’m tired (I’m there from 8 to whenever I need to leave, which is around 2) and even though it’s ONLY been 6 weeks I’m so glad I’m back to work. I think that returning to work is helping me with my recovery. It gets me out of the house, I sit all day at work and my job is very low stress. I try to get up every hour and walk around to stretch. I’m going to PT 1x a week, and my therapist was pleased with my progress the past week. Sleep is another thing. I can’t find a comfortable spot. Even when I’m sitting on the couch it’s frustrating that I can’t just curl up and get comfortable. It doesn’t help that my 58 lb poodle likes to sleep long ways across the bed! Lol. DH has been sleeping on the couch in order to let me sleep in bed without worry of him kicking me. (That happened early in my recovery, he felt really bad).

Hope your OS appointment goes well. I see mine again on 12/31. Sending healing vibes your way, look how far we have already come in ONLY six weeks. I’m still at a point where I can’t say I’m happy I had the surgery, but I think one day we will be there.

 

[tlfiore]

Thank you everyone for your kind words and for caring. I, too have a fondness for those of you who have followed my recover, as I've followed yours! I have your profiles marked as "follow," so I get to read all your posts & updates, no matter how frequent or infrequent they might be.

@Suz thanks for the kind words and the words of encouragement. I recognize you just had surgery and I will go in a re-read your recovery notes. BoneSmart helps so much, it really does. I have you marked as "follow," so this will make it easier for me to track your progress and posts!

@Macknit you are always so encouraging, positive and kind. I smile when I read about you and your family. You are obviously such a loving, kind and MUCH LOVED person...and I can see why. I am on a second marriage, no children, no grandchildren, no step-children. I have a sister in NJ, who I rarely speak to (long story) and one niece (this sister's daughter) with whom I am very close...along with my niece's 6 year old son. It's lonely and difficult at times but I've always managed somehow. I try not to over-rely on my husband (or anyone), so reaching out is hard for me. I've always been industrious, independent and self-sufficient. I realize there are times I MUST reach out and rely on the kindness of strangers...hard for me to do.

@flacie1 thank you for commenting and for checking in. I've been wondering about you, too. As I woke this morning, I actually thought about YOU and a few other folks who have already returned to work at 6 weeks. Yes, there is so much therapeutic about work and returning to that routine, a place where we find satisfaction, purpose and socialization. Yet, it's GOTTA BE HARD to sleep restlessly, wake with pain and move on with a routine. You also care for your son and family...you are a strong one, woman.

@Helizabug thank you for understanding! I appreciate it a whole lot.

@Celle thank you for once again taking the time to post. I've read your information and I am taking heed. Thank you.

So, as I wait for the Air Cast Thigh Cuff to arrive, I decided to give the thing another whirl with the Knee Cuff. I freeze three x 2-cup plastic containers with water and I take those frozen blocks, smash the last one up, fit all the ice in the canister and top the canister off with water )to the fill line) and some additional crushed ice. Saves us from having to fetch bags of ice from a local store 'cause we do not have an ice-maker. I re-position the knee cuff where it feels most comfortable and I place a ripped t-shirt piece under it all, as a barrier to my skin. Yes, icing DEFINITELY helps.

I definitely need to rest, ice & elevate more regularly and take acetaminophen on a regular basis.

I am not ambulating without the assistance of my cane. Haven't used my walker in several weeks, though. But my gait is still off, so I require the assistance of a cane to walk.

Yesterday was a bad day but today is better. It's up 'n down but we'll make it.

Cannot thank everyone enough for posting & caring.

 

[Sara61]

It seems as we all progress we tend to post less on our own threads but more on others to offer words of encouragement, as we are all more or less at similar stages in recovery, what I notice most on everyone's post is the hated "nights I'm sooo looking forward to going to sleep without a pillow stuck between my knees and the constant shifting of position so that my knees doesn't get stiff or stuck on waking and also my husband moving back into our bedroom as I fear the longer I leave it the more accustomed I get to having the whole bed to myself
We all have great days and days when we think "why on earth did I do this" but look at our Bonesmarties superiors mostc 1-2 years ahead and enjoying pain free knees- this is my mantra when I wake up in a turmoil cross at the world and all in it - thankfully I have a caring husband who assures me tomorrow will be a better day.
But like you I'm fiercely independent and feel frustrated how slowly this recovery takes.
But we will all get there in the end ...knowing my luck as soon as Mr. Leftie is perfect I will be starting all over again with Mr. Righty haha.
Keep Smiling - big healing hugs to you xx

 

[sistersinhim]

Yesterday was a bad day but today is better. It's up 'n down but we'll make it.

Yep, that's the rollercoaster ride that everyone goes through. On the days we feel better we tend to overdo, then we pay for it the next day. Frustrating. You will find that the good days will soon outnumber the bad days. That's surely a time for a celebration.

 

[caredFL]

Guess I didn't expect this much pain & discomfort at 6-weeks post-op. I keep telling myself, "It's only BEEN 6-weeks" but I guess I expected to be further along.

Like you I don't post a lot as not much daily progress to report. I feel exactly the same way regarding progress. Really thought the pain would be gone at this point except for when I did too much etc.. I know that was unrealistic expectation but I was basing that on my sister's recovery a few years ago. I think she was an exception as I have found we are all different and progress at different rates. Nights are the hardest for me as well, as I have difficulty getting comfortable without medicating. Some days and nights much better than others for sure! I'll be traveling to Baltimore Friday and I'm not looking forward to holiday travel, but at least it's a direct flight. Just looking forward to the day I don't I am living life not thinking of my knee. We will get there!

 

[tlfiore]

Hi everyone. It's taken me a few days to post because I've been uncompsed. Cannot believe the stuff that's happening.

One phrase from follow-up with OS: Improve by next visit or it's a MUA.

Me: WHAT???? You've gotta be kidding me...why?
OS: I'm not pleased with your progress. You've made zero ROM progress in 4 weeks.
Me: What? Why? I don't get it.
OS: You're at 6.5 weeks post-op and your flexion is barely 100º...maybe 101º
Me: But I feel I'm progressing. Yes, I still have pain, tightness, etc but I thought it was part of the healing process. I'm walking better, doing more...I don't understand (crying now).
OS: I'll see you again on January 7th. If you're not at 120º flexion or greater, we'll schedule a MUA.

Suffice to say, I've been devastated, discouraged and hysterical. I thought I was doing well.

My PT/friend Dave is confused and perplexed, as is my husband and my neighbor/friend Barbara, who has been helping me throughout this process.

Feeling anxious, frightened, confused, discouraged, bewildered, ANGRY. I don't get it.

I DO NOT WANT A MUA under any circumstances. I'm afraid if I decline the MUA, I'll end up with a permanent horrible contracture.

I KNOW what you all are going to say but I'm conflicted. I am so downtrodden.

 

[sistersinhim]

You're at 6.5 weeks post-op and your flexion is barely 100º...maybe 101º

The majority of OSs would like 90 degrees at 6 weeks and you are 10 degrees better than that! Your doctor is being unreasonable.

I DO NOT WANT A MUA under any circumstances. I'm afraid if I decline the MUA, I'll end up with a permanent horrible contracture.

You are the boss, not your doctor. You are doing amazingly for 6 weeks out. Don't let him depress you. He needs to go to recovery training school for a knee replacement. Where you are today is not where your knee is going to end up. All your knee needs is time and your doctor needs to have more patience.

 

[Celle]

Your knee is doing well. It's already ahead of the game as far as Flexion is concerned. That shows that there's very little likelihood of you ending up with a permanent contracture.

If your surgeon chooses to be unhappy, that's his problem not yours. If he wants to do an MUA unnecessarily, that's also his problem, because you can refuse to have it.

No one can do anything to your knee without your consent. It's your knee and you are the only one with the right to say what happens to it. While your surgeon can advise, he cannot make you have something you don't want. You have the right to choose whether or not to accept his advice.
CONSENT: what it means and how it can be used
Saying no to therapy - am I allowed to?