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

Thank you @Jamie, good suggestions. It said tendinosis so I guess that's tendinitis. Thank you and everyone for being patient with me. The aggressive PT was before the MRI; my surgeon agreed to order it after numerous requests. Pain at walking up steps came as a surprise, though those three flights last month didn't help. The surgeon I'm seeing Monday is one of very few in my area who does knee replacement surgery now that hospitals combined with medical groups. His practice told me only specialized surgeons can offer second opinions. Early last year I saw him to ask about aspirating my knee as it was very heavy; he said there was no need. I like to get a second opinion prior to surgery; my surgeon aspirated my knee several times between last spring and early fall 2023. I love to walk and am hoping to resume once the weather turns warm. My limit is three miles yet to me that's exercise.
 
dubloosh said:
It said tendinosis so I guess that's tendinitis.
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There is a difference between the two and it's important to know which one you have since the treatment differs.

I found the following information on the Cleveland Clinic's website:

"Tendinitis is a more acute injury caused by inflammation. Tendinosis, on the other hand, is the result of degeneration over time and usually takes longer to resolve. "

Diagnosis is generally done by ultrasound.
"If the ultrasound shows tendinitis, a corticosteroid injection may be the right treatment to decrease the inflammation and relieve the condition. Because tendinosis is the result of degeneration, the recovery process tends to be longer. In addition to rest and over-the-counter pain relief, physical therapy can help stretch the tendon and strengthen surrounding muscles."

Hope this information is helpful.
 
Hi @benne68, this is very helpful, and thank you. I'm not athletic. The most I do is walk, maybe one or two miles, three miles at the most though less as I got closer to surgery time. The report said "TENDONS: Mild patellar tendon thickening with slight increase in signal is present consistent with tendinosis." Until that aggressive PT session at about three months post op, during which I did half squats, my replacement was starting to feel like a real knee, no pain when walking up steps. So best not to pull my knee to my chest, even when I have no pain, as that may aggravate the condition. I'll certainly ask the second opinion surgeon Monday when I see him. Thank you again.
 
I’m sorry I misread your post. There is a difference between the conditions as Deb posted above. If you have tendenosis, it would be a good idea to discuss this with your doctors to learn what options for treatment you have. I’m glad you plan to do that. If therapy is recommended, be sure to ask specific questions of any therapist you are considering to make certain they have dealt with this problem successfully before you have any sessions.
 
@Jamie, my surgeon didn't mention tendinosis. I saw a copy of the MRI report and picked up on it. He told me - before I saw the report - that the MRI is OK, and that it takes one year to heal. That's not an answer and disturbs me. He told me to stop PT so I don't know if the condition began before PT or is a result of it. I'm thinking it's a result of PT as I never had pain at the bottom of my patella prior to surgery; I was too busy managing my poor knee while awaiting surgery. I don't know what to make of this and am disappointed he glossed over it. Changing surgeons at this point might be tricky as any second surgeon may wonder why my original surgeon isn't treating me. I also wonder why. He just wrote back and said he hoped I'd be medically better within one year. I hope the second surgeon, who is not in the same practice, can advise me.
 
That was poor form for the surgeon not to advise you of the full results of the MRI. When you see your new surgeon, you don’t have to go into a lot of details about what happened. You can just say something like, “We didn’t communicate well.” or “He didn’t seem to have any answers for me about my pain.” From your description of the letter he sent you, it definitely sounds like he’s washing his hands of your case. Very sad, really. I’m sorry this happened to you. There are many great surgeons out there. You will find one…..
 
Thank you @Jamie I'm disappointed as I know him a long time. He didn't send me a letter; we've been emailing each other via the medical site's portal. He's always been upfront. All he had to do was tell me there's something on the MRI report, and this is how we resolve/take care of it.
 
What Jamie said! Some surgeons are just "craftsmen" and have no interest in human beings or soft tissue complications. You will surely do better elsewhere!
 
You may be right @mendogal as he is very competent; I think he may be overworked, too, as the medical center books him four patients per hour - and sometimes double-books. Who can focus with that schedule?
 
I hate that a good number of our medical clinics are now run by accountants in the hospitals or insurance organizations. If he’s seeing 4 patients for every hour he’s in the office, that poor man is definitely overworked. It’s difficult to give quality care to anyone under those conditions.
 
Happy Valentine's Day! Thank you everyone for guiding me and for your suggestions. Interesting that today my knee is not painful yet my quad has swelling. Armed with conviction I emailed my surgeon and asked for a prescription for PT at another facility that treats patellar tendonitis. I hope it takes my insurance. My surgeon wrote back and said he’d hold off PT as it's been three months since my surgery (October 13). I reminded him I didn't begin outpatient PT until end of December as we were focusing on healing the infection at the top of my scar. I told him I want to address this now - no strong exercises, no working to increase ROM - since once I resume working I'll have less time to ice and elevate, not to mention added time on my feet. I don't understand his resistance and had to ask several times for an MRI until he finally ordered one. I rescheduled my appointment for Monday morning and see new surgeon that afternoon.
 
Good morning, and happy Thursday! The laundry is done so the day is off to a good start. Sunny and crisp outside, which means leg slides were painless . . . until I remembered I had no bread yesterday. Feeling better so attempting to cut back on pain meds. I've a glimmer of hope that maybe the op knee is slowly getting back to where it was prior to the PT session that set me back. Yesterday I answered numerous job ads so today I'm home babying my knee. Hope this closer-to-normal feeling continues. Wishing you a wonderful day.
 
Happy Saturday from snowy New York, take two and much less than a few days ago. Mid-afternoon yesterday I received a call in response to one of the resumes I sent and arranged a phone interview a short time later. That made my day. Because I was busy all day and paid little attention to my knee it was a log last night. To compensate I elevated it with a heating pad around it and read. This morning to my surprise my knee bent easily when I did leg slides. Have to remember this when night comes or when I'm having a rough day: my knee can bend and did bend and will again. Wish I wasn't so obsessed with this. The job would be office work preparing for a local summer camp: three or four hours in the afternoon and five weeks of full time office work during camp in July and one week in August.
 
Good luck on the job. It’s good news about your knee, too. I agree that if you can find distractions so you don’t focus on your knee constantly, it will help you. Are there hobbies, reading, friends who could come by, or other possibilities to keep your mind occupied?
 
Thank you. The job sounds like fun and will be a good way to meet people and learn some new skills. The knee is surprising because (shh), I had bread yesterday. When it doesn't bother me I don't think about it, just take notice of it. My scar is getting lighter so maybe that's healing? Afternoons I seek out events at the library or one of the community centers here. My friends work so we sometimes get together on weekends. If this job materializes, then I'll be able to relax and joint the local Y to swim. Plan to ask my surgeon Monday if this would be OK as the incision is closed. I'd like to be more active yet am afraid of overdoing and backsliding.
 
Sunday morning, and the knee is not happy. Last night I watched the CNN documentary about Navalny. This is not political post. I'm fixated on a scene where a woman on his team walked into a hallway, leaned against the wall and sat on the floor. She bent her knees until her feet touched her backside. Ouch. I said "Wow" out loud and again when she stood up. My knee today is not as cooperative as the previous days. Nevertheless, I'm optimistic about tomorrow - seeing my surgeon and, later, the new surgeon - and happy to be indoors icing and elevating while I have time. Peanut butter and apples today as I froze the bread.

Something I remember from years ago when I was a reporter I wrote about a man who, among writing and painting, was a forager. He'd take leaves and plants (safe ones as he knew how to spot things like poison ivy, etc.) and make salves. One time he gave me a tiny bit of comfrey salve for my mom, who had knee pain after a partial knee replacement (the non-replaced side hurt). She said not long after she applied it her knee felt so much better. I ordered a small container of comfrey salve off Amazon to see if it works.
 
oops posted twice.
 
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Nay Nay said:
Wow, let me know if that comfrey salve works. I am willing to try just about anything to help with knee pain!
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I shall (it's due Tuesday) and hope you feel better. When was your surgery? I've tried so many products that seem to work temporarily or for something else. Lidocaine was OK yet short-lived, Arnicare is great for shoulder pain yet did nothing for the pain behind my calf; castor oil was said to help yet I returned it to Amazon as it was too greasy and didn't help. I found the link to the story; the editor moved the web host and didn't move the pictures. Hope this is OK to post; if not, then I'll remove it.

rocklandtimes.com

CREATING MAGIC WITH NATURE: Meet the Rockland Forager Paul Tappenden | Rockland County Times Newspaper: Real News Since 1888

BY JANIE ROSMAN Within South Nyack is an unmapped location called Hobbit Halls where Mason jars containing herbs, flavorings, oils and what looks like magical potions are created. “I do a lot of preparation here,” Paul Tappenden smiled, leading the way to his basement (dubbed by his daughter)...
rocklandtimes.com rocklandtimes.com
 
dubloosh said:
All it took was an aggressive PT session to set me back
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Just don't agree to aggressive PT.
It's important not to be coerced into things that are really not good for us.
I am over a year out now but I still have to be careful in group yoga or pilates classes. There is a wish to fit in and just follow what is happening around us. I can do most things but some twisty exercises, high kneeling or balancing on one knee poses will probably never be fully possible again. I have to listen to my body and back off if it warns me to stop.
Don't let an aggressive PT person or peer pressure push you past what is good for your rehab.
 
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