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Mayberry

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Jo. I am 5 weeks and 3 days post knee. At PT today they measured ROM. My flextion was 109 and extension was minus 10. Wondering, considering my setbacks with my graceful falls do you feel I am still on a good pace? My pain has not been below a 6 and I live with ice strapped to my knee it is my best friend and am staying on a good schedule with my pain meds to make sure I dont get break through pain, and that was a life saver learning that from you. We are working on stretching my IT band which is causing me alot of grief. Do you have any suggestions of what I can do to stretch this band and home.

Thanks for your support and advice,

mayberry
 

Jamie

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Mayberry.....I'm not Jo but I want to tell you that I think you ARE doing just fine. Five weeks is really not much in terms of the whole recovery process. And you did have that fall.....so you will have a little extra to come back from. Please don't try to hurry yourself too fast!!! This recovery takes a good bit of time and, frankly, you are just beginning. Be happy and celebrate the things you CAN do now that you couldn't do before. All of it will come in time. I'm over a year out and I STILL find that I'm suddenly able to do new things.
 

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Mayberry

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Thanks Jaimie, As usual you have made me feel better once again. I keep telling myself I dont have to push so hard but PT keeps telling me that I have to get to like milestones in the first two to three months or I am going to have problems. So thank you and I am not going to push myself.
 

Texas

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Ask PT if they had a tkr before? no really my PT who helped me prior to surgery wanted to sit in on my surgery Dr ok'ed, and she watched. And now she is rehabing me . That is who I am seeing now but she has a whole different outlook on it now. She pushes but understands as well....Hope you feel better.......Dont push to hard...You will still have milestones..........
 
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Mayberry

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Thanks Texas I wish I could do that. I think because where I go for therapy they see mainly people in their 60s and hee I am 45 she thinks I should be doing more than they are. The point I tried to make to make to her is everybody heals at their own pace just because I am 45 and a Firefighter/EMT doesnt mean I hurt anymore or anyless than anyone else. She just doesnt get it.

Mayberry
 

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Jo. I am 5 weeks and 3 days post knee. At PT today they measured ROM. My flextion was 109 and extension was minus 10. Wondering, considering my setbacks with my graceful falls do you feel I am still on a good pace? My pain has not been below a 6 and I live with ice strapped to my knee it is my best friend and am staying on a good schedule with my pain meds to make sure I dont get break through pain, and that was a life saver learning that from you.
I was reading this and thinking to myself "Wow, she's doing great!" but then I got to "my pain has not been below 6" followed by "I'm staying on a good schedule with my pain meds to make sure I don't get breakthrough pain".

I do hope this isn't so. If I had a pain of 6 I'd be hammering on my doctor's door wanting something different! Don't think mine was ever much more than 4. Are you sure it's a 6? The scale is supposed to be 0 = pain free to 10 = the worst pain you can imagine.
 

Jamie

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Mayberry, if after talking with your therapist about your pain and progress you still don't think she "gets it," how about asking to switch to another person? I know that might seem a little awkward, but a good professional will understand the need to "click" with the person guiding you in recovery. And if she doesn't understand....too bad....because YOU are the most important person in this partnership!! Do what is right for YOU...ALWAYS!!!
 

Simon

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Mayberry

This is my own theory but given the posts on Bonesmart and I think it has some merit.

I think the younger you have a TKR the more difficulty and time it will take to recovery ROM and muscle strength. The reason being that if you have to have surgery in your 40's or 50's you most like had a accident, some kind of injury, a long time problem due to biomechanics or played some serious sports (think football players) or even a heavy duty hiker, runner along with a family OA history. Now with any of these situations you most likely also suffered ligament, tendon, cartilage, muscle damage and to manage the knee pain/problem your body adapts some weird walking habits which further damage all those other structures. Then if you needed surgery to correct any of those problems you have just added more stress to the entire joint. As a firefighter you certainly have a career with major knee joint ware and tear.

Compare that to someone in their late 60's or 70's who had none of the above but just developed run of the mill OA as they aged. Most people as they age are not as active so even with the OA developing they are not doing as much damage to the joint and most of that damage will just involve the bones and the articular cartilage covering them.

Now after my BTKR, I went to inpatient rehab. My first roommate was in her early 70's and came in 3 days postop BTKR and already add ROM of 108 (even the PT could not figure out what she went to rehab other than some home care issue). She was getting in and out of bed by herself (though she wasn't cleared to) and moving just fine. Now the last time my knees bent over 100 was probably 25 years ago. She stayed about 3 days and left with ROM about 115 and 0 extension. A day later came roommate #2 and she to have ROM over 100. Within 2 days she was cleared to get out of bed my herself and take walks alone. Now I had been in rehab about 6 days at that point and they would not let me get out of bed myself or going strolling and I was probably at least 24 years younger than either of them. When I left rehab after 11 days we had the left one at 104 with alot of pushing and the right barely over 100 and extension on the right still at -12. Now I had problems starting in my teens, 9 major surgeries and a slight break in the tibia due to the BTKR and surgery that went 2 1/2 times longer than planned because the OS had an awful time trying to get the implant into the right knee.

I had a great PT who looked at the entire history and knew it was going to be a long haul. He said he wanted to make sure that we had a good outcome and no complications. I really admired his patience.

Now as soon as I heard the milestone statement from the PT all my bells went off. Yes, you want to get that ROM moving to prevent scar tissue forming which can lead to a manipulation but at the same time pushing too hard causes more swelling and pain and that slows down rehab. After my first surgery I was at a PT clinic that used all these milestone markers even though I kept telling them something was wrong. The end result was a second surgery as the plica got caught under the tendon during surgery so no matter how much they pushed the knee was not going to bend. What was worse was that if they and kept going (the only thing that stopped them was the knee size increased about 4 times in less than 3 weeks) they would have probably rupture some tendons.

Well, this was a bit long winded but the bottom line is that if the PT is not listening and you don't feel comfortable with her, find someone else -- is your body and you know it better than anyone.

Good luck

SImon
 
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Simon,
Your story just blows me away!! You have really been through the old ringer!!!
But you made it through and are now doing so well it just amazing.
^i^
RTKR on Jan 14 2009
LTKR on March 6 2009
 
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Mayberry

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Simon, wow you hit the nail on the head. I have been active in sports and yes I am a Firefighter/EMT. I have demanded alot from my poor knee. Also I have had 2 previous surgery's on the same knee. I have walked with a slight limp and havent been able to straighten this leg for years. My OS says I will probaly never get it straight all the way and that is ok by me I am used to it. I also feel that it is probaly why my pain number is a little high because it has been atleast 3 for along time and to me 6 isnt so terrible. Thanks so much for your input I will take your advice and make some changes.

Mayberry
 

Rowdy66

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I'm with Jo, how do you stand the pain at a steady level of 6? I fell a week ago and have banged myself up pretty good and have a pain level of about 6 at times and it is enough to keep me awake and unable to go back to sleep. I hurt my arm pretty good and have to have it re-xrayed tomorrow. Don't think anything is broken just that I fell on cement and landed on my arm and hand really hard. Swelling is down and I have to say these knees of mine are doing great. I am so impressed with the toughness of them, WOW!!! Anyway, if your pain is at a steady 6 you need to get with your doctor and get some relief. Good luck. Rowdy
 

lakelover

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Mayberry, sounds like you and I had surgery on almost the exact day ( March 18th?). I had a few exercises that were so bad they caused me to break out in a cold sweat. My PT is very kind and doesn't push me---I push myslef thanks to my AA personality and the fact I have a hard time sitting still.I agree with others. Get a consultation with another PT maybe at a different location with a different philosophy. Then make up your mind.
 

Simon

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Rowdy

You adjust to the pain. I spent many, many years with pain in the 5 to 6 range and when rain storms would come in more like 7. I always worried about becoming addicted to pain meds so I never took them and even post op would try to keep the level low. Now I did learn after all those previous surgeries that not controlling the pain was counterproductive and slowed rehab so for the BTKR I took enough. I would just increase the aspirin (until the ears started ringing), used heat or ice or played little mind games with myself. I have developed a very very high pain tolerance (don't use anything at the dentist even had crowns and a root canal done with nothing). I guess over time I have probably rewired the brain. All in a day. The only problem with this is trying to communicate with professionals as what I think is a 3 most people think is a 7 or 8.

Simon

Still taking aspirin as the knees still swell, I guess it is just the osteoarthritis
 

Josephine

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I have developed a very very high pain tolerance (don't use anything at the dentist even had crowns and a root canal done with nothing).
ai21.photobucket.com_albums_b286_flagady15_smilies_smilieyikes.jpg
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ai21.photobucket.com_albums_b286_flagady15_smilies_swoon_1.jpg
 
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