TKR TRKR 10/13/23 - Moving Forward with Many Detours

[mendogal]

A zisse Chanukah to you and yours!!!

I am SO proud of you for advocating for safe and sane PT!

Slowly relaxing and deep breathing into discomfort is way different from being put into pain. There is no good that comes from the latter.

 

[dubloosh]

Thank you @mendogal for your encouragement and Chanukah wishes. Next week I have an evaluation at another facility and shall see what happens. My surgeon told me I've reached the maximum potential for my knee, which I understood. Maybe it only needs to slowly heal from being poked and prodded.

 

[dubloosh]

Good Sunday morning. Last night I made a New Year's resolution to be healthier, first by stopping NSAIDs. I've been taking meloxicam and ibuprofen (not on the same day and in the allotted doses) since January 2023, when my right knee began to accumulate fluid. That's two years. The last time I took NSAIDs for any length of time was after my left hip was replaced, and then it was for a few months.

Yesterday I put comfrey salve on the lower area and outside of my knee and covered it in plastic wrap, didn't apply heat. The numbness on the lateral side might be permanent, my surgeon told me; I hope the tender areas under the incisions will eventually heal. Though the plastic crinkled faintly when I bent my knee walking, I felt no pain doing errands. Changed the plastic and applied more salve later, then removed both before I went to sleep. Months ago I tried castor oil, which didn't help, maybe because of the scar tissue. I'm willing to try it again. This morning I looked at the ibuprofen and went for the comfrey salve instead.

I'm interested in hearing if you used a knee support and if it was helpful. Sometimes the top of my knee, lower quad, is tight on the right side, and sometimes not. This tightness is different form what I felt earlier. Thank you in advance.

Wishing everyone a relaxing and painfree day.

 

[mendogal]

Hi @dubloosh !

Yes, various changing experiences of tightness are common as we go through the healing and recovery process.

Personally, my body hates the compression of common knee or other joint supports. I know some members have liked them for the secure feeling it gives and the reminder to exercise caution.

While topical comfrey has been shown to contain effective anti inflammatories, please be careful with not using the comfrey too many consecutive days. And I hope you're not applying it to any open areas.

According to this article from Mt Sinai's website, even topical use can cause toxic levels to accumulate, so they recommend not using more than 10 days at a time, and over the course of a year not more than a total of 4-6 weeks worth of days.

I use herbals. But I'm well aware that many medicines come from plants (digitalis, aspirin, quinine), but they are often substances that are created for the plants' self defence, so are toxic at certain doses - being a plant product doesn't mean it's necessarily safer than a laboratory product.

 

[dubloosh]

Hi @mendogal, and thank you for this information. I haven't used the comfrey since showering so used it once today. Thought it was safe because I learned of it years ago from someone who foraged for natural remedies and am sure I reached my yearly limit. I looked up herbals and almost forgot about black cohosh and evening primrose for PMS back in the day. Thank you again.

I also hope I haven't traded one pain - the stiffness from adhesions even with a good ROM - for stiffness after the adhesions were removed. Trying to be resourceful, I pulled out the knee high open toe compression hose I bought after my hip was replaced. It's 20-30 mmHg and very tight so I ordered the next lower compression, 15-20 mmHg. While I don't know how wearing it helped my hip, I figure it might help my knee.

The other fun thing (sarcasm) about surgery is anesthesia and hair loss. Maybe it will grow back quickly.

 

[mendogal]

The primary uses of compression hose are for people with peripheral vascular or heart disease (blood pooling in the little veins of the lower leg, or edema - fluid retention in the feet and legs) and right after surgery for a few weeks for post op blood clot prevention.

Some of our post op members have had their surgeons also recommend them for air travel as feet and legs often swell then. And some members use them longer term post op to reduce chronic swelling.

I don't see them as being helpful for post op stiffness unless there's visible swelling through the lower leg.

Does the tightness have a pattern? For many of us it lasts for long months, worse with prolonged sitting or standing, or overnight if sleeping well and not moving about!

 

[dubloosh]

Hi @mendogal, the knee is stiff over my kneecap and has been since the replacement last year. It's sore around the two tiny incisions near the bottom of my kneecap and feels tight when I stand, not when I sit or lay down. There is no swelling down my leg, and my shoes and socks fit. I hope I made the right decision though it's too late now. Twice I had meniscus repair and never had pain or stiffness after those procedures.

I traded the tight band feeling for tightness on the right side of my knee, mostly at night (now). Cancelled the compression hose and ordered castor oil so I can wrap my leg with plastic wrap overnight. May I ask which herbals you use? Thank you.

 

[mendogal]

Everything you describe sounds like soft tissue that needs rest, gentle stretching, and perhaps gentle myofascial release.

Right side of R knee is both the lateral portion of the quads and the IT band. I have chronic issues in my R knee (June 2023) as well - tightness and aching with prolonged flexion (accumulated sitting during the day, plus if I sleep on my side too long with knees bent). It's annoying and not disabling in my case.

In terms of the tiny incision sites, they are still healing from your arthroscopy. Remember too, with your history of fibromyalgia, any surgery can be more uncomfortable and take longer to come back from. "Tincture of time" (aka patience) is your ally here.

I don't rely on herbals for anything but do use them as adjunctive supports for specific issues - I buy commercially available teas from trusted sources like Traditional Medicinals and Celestial Seasonings, and source a couple of topicals from a local Farmers Market grower/processor of salves.

 

[dubloosh]

I'm sorry you have pain in your knee @mendogal. Since my hip replacement nearly seven years ago, I've been sleeping on my back. Might that alleviate some of the discomfort?

I like your phrase "Tincture of Time" and wrote it down for my bulletin board. Thank you for sharing the brands you use; I also use Celestial Seasonings and have heard frankincense oil may help when mixed with castor oil.

In between starting this post and finishing, Burke called to discuss my concerns. The therapist (not the one I had) apologized my needs weren't met and said she can't speak for the person who worked with me, she said, yet will talk with him when he comes in. My surgeon's prescription said strengthening was one of the goals; I said there were many others. Seems therapists focus on what they think is good and not what is good for each person.

Thursday is my evaluation at the new facility. I'll ask about myofascial release and stretching. No machines except bicycle.

 

[dubloosh]

Good morning! About an hour ago I realized I needed to add money to my laundry card and walked down four flights of steps - 14 steps between floors and seven steps between landings - to the laundry room in the basement. I felt like Rocky Balboa after he ran up the steps of the Philadelphia Museum of Art. This is a small miracle for me. I no longer have stiffness at the top of my knee though I do have some at the bottom of my knee near the two incisions. My surgeon told me to massage the area; I've been doing that. This afternoon I have an evaluation at a different facility and shall ask about myofascial release and massage for this area. The staff provides warm, moist heat to the area prior to each session and ice after the session, and I look forward to that. The castor oil I've been applying may have helped stiffness on top of my knee and am curious about today's evaluation. No need to work on ROM; stiffness on the bottom of my knee is the focus.

 

[sistersinhim]

Wow! 4 flights of stairs at your early stage after your surgery. I'd say that you are doing quite well! I hope you will be happy with your new PT this afternoon. Be sure and let them know that you are boss, not them!

 

[dubloosh]

Thank you @sistersinhim. Getting ready now. The facility and therapists are familiar - I've been there before - and am going to stress gentle. I'll post again later today.

 

[Jamie]

A major milestone!!! Those steps are a real accomplishment. Just have some caution still as it is possible to have a reaction to a good workout like that for up to 48 hours later. If nothing happens during that time, you are golden! At any rate, you are making progress and that’s great.

 

[dubloosh]

Thank you @Jamie. Not sure if the steps or PT is making the bottom of my kneecap angry. I think it was the day as I did a lot. Went to PT; it was gentle and included moist heat to start, some tests to see where I am (i.e., I cannot sit to stand or vice versa), bicycle, massage and laser treatment, then ice. Now I'm sitting and feel fine. The soft tissue on the lower part of my knee, though, is not happy so I'm icing it again.

 

[dubloosh]

Good morning, everyone. I've positive news to share. Forgetting I put castor oil (day three) on my op knee and covered it with plastic wrap, I tried sitting on my feet to see how far my op knee would bend. It hurts the top of my feet as I'm not a toe ballerina yet I was about five inches (thumb-to-index finger measurement) of succeeding. My op knee felt slippery, and I figured it was due to scar tissue removal. Then I remembered the plastic wrap and removed it. Silly me. While on the floor I got up leaning first on my non op knee and then on my op knee. Shock that I was able to do both. Months earlier I was contorting to get off the floor without support from an available table or chair.

 

[sistersinhim]

That is really good news about your improvement! Maybe more of us can try out the oil and Saran Wrap. We have to make sure there are no scabs at all. We don't want to introduce any bacteria into the knee joint.

 

[dubloosh]

That is really good news about your improvement! Maybe more of us can try out the oil and Saran Wrap. We have to make sure there are no scabs at all. We don't want to introduce any bacteria into the knee joint.

Thank you. I hadn't said anything yet as I wanted to be sure it worked, and I'm sorry I didn't sooner. I hope it's helpful for others; it's cold-pressed castor oil that comes in a dark bottle. I bought the 4 oz. size which is really too much as it's thick, and a tiny bit goes a long way on the knee. This is an experiment. I'd prefer to keep use comfrey yet am heeding @mendogal about being careful not to use it too many consecutive days.

My incisions are closed. It seems the stiffness moves around my knee, staying away from the top of my incision. I was surprised it's sore after the second procedure as everything I read says it's an option and is effective. I would love to hear how castor oil works for others. A heating pad can be used to warm the knee (put a towel over the plastic wrap).

 

[dubloosh]

Realized it's Tuesday, and I haven't posted in a few days. How is everyone doing? I'm sitting here with a heating pad on my op knee and feeling annoyed. I went to PT earlier and started with moist heat, then gentle exercises, 10 minutes on the bicycle at my usual gentle pace, then an exercise to stretch my calf muscle that felt good. The therapist came over to do myofascial release with cream; however, she asked me to bend my knee and held my foot for 30 seconds. I told her it hurt and to stop; she said it's good for my ROM. I'm too polite to curse, but WHAT was she doing? I finally got my foot free and told her not to do that again, at which point she rubbed my knee really hard, and again I told her it hurt. She gave me ice after the session; I see her Thursday and am not letting that happen again. She caught me by surprise and knows my ROM is 135, and that I'll never get my heel to my butt. I don't want to. I hope I didn't ruin the implant. The soft tissue hurts. Next to me was the same lady who I saw last week; she'd had her knee replaced in September, and in December had scar tissue removed. She told me she was in a lot of pain since the two surgeries on the same knee were three months apart. She has the same therapist I did so I wonder if she caused the pain. Couldn't ask as the therapist was standing there. After all the times BoneSmart advises not to let therapists hurt during sessions, this happened to me.

 

[Jockette]

After all the times BoneSmart advises not to let therapists hurt during sessions, this happened to me.

I’m so sorry this happened, and yes, they catch us by surprise, and yes it’s hard to really make our point with them. Been there, done that. You’ll know next time, don’t even let her touch you. The “massage” was not worth it. Maybe ask for a different PT, or find another office? Or, do your own rehab at home, which many of our members have done, quite successfully.

 

[Jamie]

I agree that the next time you see this therapist (if you go back), you need to establish firm rules for the sessions that make it plain you will not tolerate her continuing anything when you ask her to stop. You may even want to advise the clinic manager that she continued to do things that hurt you when you requested that she stop.