TKR Two Steps Forward, One Step Back

[nlthomp]

nlthomp, I have changed your thread title as requested.

Thank you very much!!

 

[nlthomp]

Remember what they say on here "THE KNEE IS THE BOSS". If your knee is sore and tired, stop and rest, otherwise you just go backwards a day or two. Don't panic, slow and steady wins this race. It will take time for that tendon to stretch, it's been in an awkward bend for quite sometime.

Hi Jenny--Thanks so much for taking the time to write. Everything you say makes sense. I can't imagine coming home from the hospital with so few pain meds! I really don't know how you got through that first month. I have read so much on this forum that has been useful. My flex is 112 and honestly, I'm very happy with that. I can do everything I need and do have a wonderful PT who isn't pushing. Roy's feedback on extension made a lot of sense, too. It's just a matter of time and patience. I wish you all the best in your continued recovery. Take good care, Nancy

 

[nlthomp]

Hi Tashia--Congratulations on your upcoming 1-year birthday for your LTKR I look so forward to the day when I can wake up and not say "ouch!" As far as meds go, I'm finding every OS to differ in their views. Mine wanted me off ASAP. So, I've been weaning off following Jamie's chart. Down to 1/2 at 8am, 1 for PT and 1/2 at bedtime. When PT ends in another month, I'll cut back to 1/2 followed by 1/4. I actually tried getting my GP to give me another Rx at 6-weeks, but he deferred me back to the OS. So, I had no choice but to switch to Tylenol. How are you feeling overall? Are you still in pain or mostly stiff? Lately, restless leg is driving me crazy at night. Have you ever had that? I wouldn't wish it on anyone!! I wish you continued success and really appreciate your taking the time to write. Keep us posted!! Best, Nancy

 

[Ms.fixit]

Yup, what everyone else said!
I had such aggressive PT that I had a "vaso-vegal"response on the table, which is a pretty way of saying I fainted from pain. I liked my guy, too, but he was under the thumb of my surgeon, who believes in this model ,and in MUA if the aggressive approach doesn't yield results in 6 weeks. I quit therapy since I knew the basic drill, in favor of doing it on my own. I also refused MUA..twice, which made everyone make frowny faces and hem and haw in an ominous way. I told my surgeon and PT guy I'll see them next year and they can se for themselves the results of my approach.
Right now I am closing in on 100 degrees ROM,I left therapy at barely 90..more like 88, and I just got the new ROM this past week..almost 5 months out!
My left leg was shorter than my right all my adult life, because of a bad surgery 42 years ago that left me with poor extension. Part of my rehab challenge is being patient while alllll those shorter tendons,ligaments ,muscles and nerves lengthen. It will not be rushed, but I am making steady slow progress.
It's your body and your knee. If something feels wrong, listen to your intuition and don't be afraid if it goes against conventional wisdom.

 

[kimejen]

Well done Ms.fixit - You seem to be doing very well on your own and following Bonesmart. Would love to be a fly on the wall next year when you go back and show them your achievements. Keep on keeping on. Jenny

 

[jiimbojunk]

You don't actually need a PT. It's perfectly find to do it on your own at your own pace. Here in the UK, we don't have PT like you guys do and I can tell you that our rate of MUA is much, much lower than in the US. You can follow this Home physio (PT) and activity progress: suggestions and do it on your own like we all did.

I would venture to say that the stats are skewed due to the differences in our insurance programs. UK has NHS which might question a procedures necessity. US, unfortunately, does not have NHS...yet...so many doctors will be quick to push a procedure for the insurance money. It's not right, but greed can be evil.

 

[jiimbojunk]

The standard advice is to take your pain control drugs as long as you need them, and not to worry about them. You will stop taking them when you forget to because you're not in pain. You don't have to work at it.

This is not always true. Depending on the individual, it could end up difficult to let go of them.

nlthomp, sounds like you are doing better! I'm 3wks out on my LTKR and my extension is giving me grief! My RTKR extension seemed to go smoother. I know that I shouldn't compare but can't help it when they are both my legs! I do lots of walks on my street which the pt said to do what I could handle. Gets me out of the house! Sounds like you are weaning the meds well too. I'm not quite there yet, although I've dropped them to less than half since surgery.

Hang in there!

 

[Roy Gardiner]

The standard advice is to take your pain control drugs as long as you need them, and not to worry about them. You will stop taking them when you forget to because you're not in pain. You don't have to work at it.

This is not always true. Depending on the individual, it could end up difficult to let go of them.

True.

The reason I said 'standard wisdom' is that it will apply to the vast majority of BoneSmart readers, and that worrying about 'weaning off' should be pretty low on just about everyone's priority list.

 

[nlthomp]

I quit therapy since I knew the basic drill, in favor of doing it on my own. I also refused MUA..twice, which made everyone make frowny faces and hem and haw in an ominous way. I told my surgeon and PT guy I'll see them next year and they can se for themselves the results of my approach.
Right now I am closing in on 100 degrees ROM,I left therapy at barely 90..more like 88, and I just got the new ROM this past week..almost 5 months out!
My left leg was shorter than my right all my adult life, because of a bad surgery 42 years ago that left me with poor extension. Part of my rehab challenge is being patient while alllll those shorter tendons,ligaments ,muscles and nerves lengthen. It will not be rushed, but I am making steady slow progress.
It's your body and your knee. If something feels wrong, listen to your intuition and don't be afraid if it goes against conventional wisdom.

I'm right there with ya, Ms.fixit! My last PT session was on Thursday, and before I knew it my leg was being pushed down so hard, I couldn't catch my breath to say STOP!! Needless to say, the last two days have been miserable. Lots of pain and stiffness. I decided yesterday that I'm going to continue PT at home. As you said, it's a slow and steady process, not something that can be forced.

Many congrats on your progress. Getting your ROM to 100 is a huge achievement! Obviously, you are making the right decisions.

All the best in your continued recovery. I'll be sending positive thoughts your way.

Your feedback is greatly appreciated. Thank you

Best,
Nancy

 

[nlthomp]

Hi there jiimbojunk! Thanks so much for taking the time to write. I'm in awe of you BTKRs!! Can't even imagine going through this twice. Sounds like this knee is a real newbie, at only 3-weeks. I've gotten such good advice here, especially about stretching exercises. Roy Gardiner directed me to his thread, where I found lots of great info on gentle stretching. I've been using a long belt that wraps around the ball of my foot so I can pull forward, with the leg outstretched and toes pointed upward. I do the same with the leg raised and can feel the hamstrings, but not to the point of pain. I think it's been helping especially first thing in the morning when the leg is so stiff. Walking on the treadmill in an over-exaggerated fashion, as if marching, helps a lot with extension and the awkward gait. It's frustrating to have such a gimp that causes other aches and pains.

At 3-weeks I hadn't given a thought to weaning off meds. How are you feeling overall? Are you walking with a cane or walker, or unassisted? I can't imagine having both knees done a month apart. You must be a real trooper

Please keep us updated. I'm very interested in following your progress. Sounds like you're doing remarkably well!!

Best,
Nancy

 

[nlthomp]

Just thought I'd check in on you kimejen. How are you coming along? We're at almost 11-weeks now. Can't believe how time flies. I'm looking forward to continuing my therapy at home, at my own pace. Ms.fixit is truly inspirational! So many strong, smart people on the forum. I'm so happy to have found it and gained so much valuable information.

Hope you're doing great. Keep us posted!!

Best,
Nancy

 

[kimejen]

Hi Nancy. I'm doing well thank you. I still have a few problems with my kneecap. Just a particular movement; foot tilted slightly downwards and when I go to move it, I get pain in my kneecap. That is the same movement that is needed driving. I continue to do my exercises and hope that one of these days it'll be fine. I had a lot of trouble leg lifting and then suddenly it worked for me. Obviously taking a bit of time for me, but I am being patient and taking it as it comes. There's nothing else you can do. I take paracetamol on the rare occasion, but I haven't had any pain for weeks now, which I am very thankful for, as I know many people suffer with pain for a long time. We are all so different in our recoveries. Thankfully we have each other to help us through. Take care. Jenny

 

[jiimbojunk]

Hi nancy!

I'm not using anything to assist walking. I never went to a cane, just walked very slow. Went to dr today for my post op on the LTKR and he said I was doing great and have no restrictions. I swam today which was awesome! PT can be a little trying but not painful...well except the PT did push down on the left and I told him no way can he go to the point past pain! Dr also told me to start getting off the meds. I have been, I'm down to 4.5 a day.

I hope you are doing well!

 

[nlthomp]

Hi jiimbojunk! Thanks for checking in. Boy, you are flying through this recovery. I'm so happy you are doing so well. Sounds like you have a PT that is willing to listen. They can be difficult to find A swim sounds like heaven. How is your scar healing? Good luck weaning off the meds. I'm have no doubt you'll do great. Please keep me posted. You are quite an inspiration!!

Take care,
Nancy

 

[nlthomp]

kimejen Hi Jenny--Great to hear from you. Have you spoken to your OS about the pain in your foot? Funny, these strange aches and pains we get everywhere. My 4th and 5th toes are still partially numb, although the sole of my foot came back to life Glad the leg lifting is working for you now. And even better that you're not experiencing pain. All good news. I took a fall down the stairs two days ago, ending up in the ER. Nothing broken, but I hyper flexed my knee and it hurt like the dickens!! My OS said I'm healing slowly, as well. Extension seems to be getting worse, so I'm spending lots of time stretching and keeping the ankle up on a rolled towel while sitting.

Thanks for keeping me posted. I'm happy to hear you're progressing. This is going to be a long recovery, so no point dwelling on it. The good news is that we're improving and it's all uphill from here

Talk soon,
Nancy

 

[kimejen]

Oh Nancy,, not good about the fall, you poor thing. I had a fall in my second week hom,e, but just in the kitchen. Not a pleasant experience at all. Falling down stairs, OUCH!! No wonder you ended up in the ER. I hope you're doing ok now. Bit of a setback for you. I don't have pain in my foot, it's when I move my foot a certain angle I get pain in my kneecap. Physiotherapist has given me some more exercises, but I feel like I'm in the gym, muscles hurt like crazy. He's trying to get the damn quads stronger so hopefully it'll sort the kneecap out. Anyway, I shall keep perservering. One of these days we'll be kicking up our heels - well a little! I've gone back to work for a few days. It's our own business, so when it really gets busy I go into help. Knee is a little stiff by the end of the day, but nothing a bit of elevation and ice doesn't fix, so all good. I've had issues with my neck in the last few days, very stiff and hard to turn my head. I told hubby he needs to trade me in on a new model!! Take care Nancy, I hope things improve for you. Jenny