MUA ValleyGirl Recovery

[BBCG]

Hi @ValleyGirl... I totally agree with Jockette and Jacey: each of our knees has its OWN healing timeline. My two TKRs were completely different. My first took a looong time to heal, partly because of aggressive PT which I didn't yet know was aggressive; I just thought that was what it was supposed to be like! But, then I found Bonesmart, and I finally took time away from PT, cancelled a week of it, then finally began to see the internal swelling recede. This time, 8 months ago, I followed the Bonesmart way and everything went way better! In almost every category, my healing took far less time this time, because I was not doing lots of PT to aggravate it, I was gentler on myself, I avoided the oxy drugs that don't actually work for me, etc. Plus, I got a puppy at 3 months out and he helped my recovery, too, since I had to walk him and resist his pulling me, train him, etc. So, even on one person, two knees can be very different. (His head is in my lap right now, as I'm at my computer, in fact!)

No bad thing will occur if you skip PT for a week or two; but I bet you good things will happen! Less swelling internally, less inflammation, less pain, and all that goes with a gentler healing process.

I'm very glad you found Bonesmart, as I was when I found it, too, and DO go and read other people' stories. At the very least, you'll say, "Gosh! I'm glad THAT didn't happen to me!" at some of the issues that have arisen for others! But, you'll also see how well lots of us do when we take a break from the assertiveness of some medical practices and their "one size fits all" approach!

Happy New Year's too!

 

[ValleyGirl]

Got 2nd opinion from another ortho doc last week. He is sending me to a better pain mgmt doc, appt is on 18th, for CRPS eval and lumbar block consideration. He also said to continue PT to see how far we can increase ROM on our own. Then I have follow up with OS the week after next. Am afraid my OS will be ticked I got 2nd opinion..but I had to since I will not let the pain doc at my OS practice touch me again.

My floor measurements show almost 6" improvement since my worst foot position after the MUA. 90 degree flexion is the best so far...I told PT I want 91 next. I focus most on getting my right foot to the same position as my left, after sitting down, then I hold the position as long as I can. My right foot is getting closer and closer to the same place my left foot falls. My family says my gait on the cane is much improved as well. I do hobble about a bit without my cane too.

I still love the NuStep at PT. I am at the top of the movement in seat position 6, so am moving up to position 5 next. I can also use the small exercise pedaler my neighbor loaned me.

I am seeing a pulmonologist tomorrow due to the pain in my lungs/chest from the blood clots. I hope he helps!

What does everyone do for sitting at a work desk and leg rest? Has anyone tried a leg rest or a foot hammock? I will have to return to work soon and am looking for suggestions!

Thank you everyone for your support...I hang on all your feedback!

 

[Jockette]

What does everyone do for sitting at a work desk and leg rest? Has anyone tried a leg rest or a foot hammock? I will have to return to work soon and am looking for suggestions!

I did not have a job to return to, but when I sat at my computer desk at home I put a small box to rest my foot on, giving it more height than just the floor. It wasn’t much, but it helped. It allowed my knee to not have to bend as much as if my foot was on the floor.

At the suggestion of a friend who had a TKR a few months before me, I also kept a small pillow on the floor of the front seat of our car (passenger side!) for the same reason. It was very helpful.

 

[WFD]

Sitting at my work desk (which is in my home) I experimented with various inflatable foot stools from Amazon - they worked well but all went flat within a week or two.

Then I discovered that an old roll-around carry-on suitcase that I have and which is built very rigidly, was the perfect height. I have a rolled-up towel on top under my knee and it is very comfortable. In fact I am using it right now as I type this. Plus it is easy to move around as it is on wheels.

In addition, for when I want to put my foot on the floor, I have a half-round foam thing that I also got on Amazon, that I can put my feet on to prevent me from extending my foot (which shortens the calf and is painful.) I need to do this because I don't have the flexion to put my surgical foot flat on the floor under my chair like I can with my good leg.

I recommend experimenting with different boxes and crates until you find something that works. You can adjust its height with pads and towels, and adjust your chair height as well to fine tune it. You can even make a custom box my modifying one with a knife and packaging tape. That's what I was going to do until I stumbled on this suitcase.

 

[ValleyGirl]

@WFD How tall is the rolling luggage you use? I am going to go through our luggage too! Thanks so much.

 

[BBCG]

I’m so glad to hear you have a 2nd opinion in now, with a possible 3rd? Your poor baby knee has really taken a lot of abuse, and good fir you to do what you feel led to do by getting other opinions! Very smart to do… I do hope these new docs will prove far more supportive of your healing process and will be more understanding that yours is an individual journey through recovery… and that your size is your size, not some imaginary ideal! I’m glad to hear you are trying to buck the one-size-fits-all model! It sure as heck wasn’t working for me, either!!

 

[hawk2go]

@ValleyGirl I'm glad your working with the health team to get some relief. Your doctor's disappointment in you getting a 2nd opinion is not something you should worry about. He should be worried that you felt the need to get a 2nd opinion because he/his team/the practice could not help with your pain.

I use an adjustable foot stool under my work desk. I can change the height and angle fairly quickly as the day goes on. I also used my ice machine when I first started working and a higher box when I needed to really elevate. I find that the longer I stay in a position, any position, the knee complains. So for me, the key is to change position often.

 

[WFD]

@WFD How tall is the rolling luggage you use? I am going to go through our luggage too! Thanks so much.

Not including the rolled-up towel on top for my knee, the suitcase is 18 inches high. The chair I am using is about 21.5 inches high, including the seat pad I added to it, so the luggage is 3.5 inches lower than the chair.

 

[ValleyGirl]

2nd MUA is tomorrow, Feb 14. Am only at 90° ROM active-assisted. Am very scared. Am staying on blood thinners which is the norm. Didnt stay on thinners last MUA and got lung embolisms. Now I am afraid about excessive bleeding after the procedure.

I just want to walk without pain and with good knee motion again...is it too much to ask? Been off work since mid-Sept 2021...I want to get back to work. Started meds and therapy for my depression and anxiety caused by my TKR circumstances and meds. Feeling a bit better and hope to be much better after the 2nd MUA.

Please pray for me. I am very scared.

 

[Jcx]

Hope my help you. Jcx

 

[Jcx]

Prayers

 

[Jockette]

Sending hugs and prayers.

Is your original OS doing the MUA tomorrow?

Have you been going to PT since your original surgery?

 

[Roy Gardiner]

From your previous MUA:

At home after MUA procedure. Hubby didn't even have time to go to the restroom after they took me back before OS called him to say it was over and that it went very well. OS reported getting to 130 degrees off my <70 degree leg

Right at the beginning, he got 130 degrees, showing that it IS possible

Did one round of exercises that I promised PT I would do. Ouch! Ended up back in bed icing

This time, please do not hurt yourself. No 'exercise' just gentle movement

Some days with the OS and PT being so down on my progress, I get scared and worried about the future for my knee

It strikes me that you've come under huge pressure from your doctor and PT to do stuff that's not, in the end, helped you. This is unfair and (to put it gently) unkind of them.

Does anyone have advice on MUA recovery? How long before the swelling is gone that might affect the ROM? Should we expect to be at 90° by 2 weeks? Should we expect ROM improvement to move at the same pace as post-TKR?

Treat the MUA as Day 0 in your recovery. Everything before is cancelled, you are starting again.

The exercise you need is gentle movement of your knee. No pressure, no exertion and above all no pain. Do not press for more ROM. Your knee will be swollen and traumatised by MUA, but you know that 130 is possible, the surgeon did it the first time around.

Relax, rest, watch telly, ice and be calm. The ROM is there, you know this, you just have to let the knee heal, swelling to go down, and it will happen.

Try and do knee movement that is non weight bearing. Here is an example

There is no force going through the knee, I'm just gently pulling the skateboard towards me.

 

[Carol Anna]

I am seeing a pulmonologist tomorrow due to the pain in my lungs/chest from the blood clots. I hope he helps!

I also suffered a pulmonary embolism 4 weeks ago (13 weeks after knee op). I still suffer some chest discomfort and get a bit short of breath if I go at something a bit too fast but I am told this is part of the recovery as the blood clots don't go immediately you have to wait for you body to break them down. Anyway just wanted to say 'you are not alone' and I get the fear but we will come through this. God Bless Carol Anna xxx

 

[Sara61]

Hoping your surgery went well today, sending you gently healing hugs xx

 

[ValleyGirl]

@Carol Anna Thank you for your note about the PEs. 2 months later and i still have chest pain. I think some of the pain is muscular due to use of cane. I use lidocaine patches when the pain is especially bothersome. It is frightening when the pain pops up fast and takes my breath away. I am still not driving and am fearful of having a lung pain when I drive. Life has become very fearful for me. I truly am fighting fear every day and doing things to build my confidence.

 

[ValleyGirl]

Is your original OS doing the MUA tomorrow?

Have you been going to PT since your original surgery

Hi @Jockette,

Thank you for the well wishes. Yes my original OS did both MUAs. I have been going to PT since my original surgery. Am posting MUA update in a moment.

Patty

 

[ValleyGirl]

2nd MUA completed yesterday. Much easier post-procedure. They put in a catheter in my thigh with a medication delivery system to numb the area 2-5 days. No seizing or guarding of the leg. Leg didn't really work well the first day, probably from meds they injected for the procedure. Leg is more engaged today.

Leg has some numb feeling from the catheter med. I can feel the back of my knee hurting when I straighten it, they probably did some scar breaking for extension. Will have PT tonight and get an idea on flexion. Dr. said there was much less scarring this time compared to 1st MUA

Haven't taken any oxy this a.m., trying to see how long I can go without it. Have catheter on lowest setting so med will last longest it can.

So nice to have knee move more freely and without the usual pain and stiffness! Dear God, help me keep this feeling!

Patty

 

[Roy Gardiner]

Dr. said there was much less scarring this time compared to 1st MUA

The BoneSmart view is that it's adhesions that cause ROM to stall, not scarring. All wounds have scars, but it's quite rare for soft tissues to stick together and thus need to be separated by MUA.

So nice to have knee move more freely and without the usual pain and stiffness!

The anaesthesia will have something to do with that of course, but the HUGE take-away is that you can get ROM. Be confident, please!

Will have PT tonight and get an idea on flexion

There is little you need to do now. Please don't push or endure any pain. Don't push at all because the anaesthetic will dull or kill the pain, that does not mean it's safe. It means you can push on and cause damage where pain would otherwise stop you.

Recovery will work. Having your knee move freely proves that. You don't need to gain more right now, just be gentle and careful to conserve what you have.

 

[Jockette]

It will work. Having your knee move freely proves that. You don't need to gain more right now, just be gentle and careful to conserve what you have.

I agree with Roy. Please do a very gentle rehab going forward. Your knee has been through a lot, more than the average knee replacement, with almost 5 months of PT, and 2 MUAs.

Here are two articles from our Recovery Guidelines that I suggest you read again:

From mobility to strength with your new knee

Post-operative exercise – the BoneSmart view Post-op exercises target the gaining (or regaining) of - Mobility and range of motion (ROM)*, during and after healing - Strength and fitness, after healing is complete The exercises required for these are quite different, and it is essential...

bonesmart.org

BoneSmart philosophy for sensible post op therapy

You will have noticed there is a significant opinion here about the potential hazards of PT. You may feel that your therapists are experts and know what you should be doing. However, over the last several years I've been here, I have observed that the more intensive the regimen of exercising...

bonesmart.org