worse off after my manipulation

[duffy]

Had my TKR Dec. 08 and was walking without aid of anything by Dec 20th. My home PT kept me "home" for 7 weeks though I was mobile the second week after surgery. I didn't start out pt therapy till Feb 1st 09. After 4 weeks I wasn't where Pt thought I should be but Dr. said another 4 weeks aggressive therapy. Oh my does the bending and straightening she does kill me! Well after another month Dr said I should have the manilpulation under anesthesia. That was last week and now the knee is so still & swollen... I can't even tolerate the PT to bend it. They want me to use a crank type device that bends the knee.(kind of like the CPM thing I had after TKR) Does any one out there know of this thing? Insurance won't cover it and it will cost me $500. for 2 months. I am wondering if it really helps. It's alot of money but I feel worse now then I did before the MUA.

 

[Jamie]

Oh, Duffy....Welcome to BoneSmart and I'm so sorry to hear you've had such a rough time of it. What is your ROM (flex and extension) at this point? I would discuss with both your surgeon and your therapist what they believe you can achieve in the coming months. And also....do you know what ROM your doctor got during the manipulation and whether or not he thinks you have (or had) a lot of scar tissue?

Are you on pain meds or anti-inflammants for the swelling? You need to be. Plus you should be icing and elevating as much as you can - even when you're sleeping. Swelling can cause things to really tighten up and you just can't achieve adequate ROM under those conditions.

As for the machine, I am not familiar with anything like that, but maybe Josephine (our forum nurse) can provide more information for you there. She will be checking in here soon. I wonder why they just don't prescribe use of a CPM....lots of insurance companies cover that.

Sorry to bombard you with questions, but a little more information would help me understand better where you are in recovery. Try not to get discouraged. It just takes longer and is a bumpier road for some of us - many times through no fault of your own. I do feel like things will improve for you, as long as you have the support of your doctor and therapist that the only problem rests with the current swelling. Hang in there!!! You can always post here and find LOADS of caring people who will support you. Don't hesitate to write any time!!

 

[duffy]

Thanks for answer back, before manipulation the therapist measured with that gauge thing they used and it was 101. I haven't made any headway because of stiffness and swollen. The Dr. said he got good results with the manip. ( I don't remember numbers, as they don't help "me" I only know how far I can "not" bend my knee. )
I should ask about the CPM again.. I had it right after the surgery but need something again.
I have Vicodin to take every 4 hrs... which I had been more so before therapy. It makes me kind of sleepy and then I can't do grocery shopping or other errands, only want to nap. So I haven't had anything in 2 days. Will the tiredness go away eventually?
I need to be more agressive with the bending exercises and the meds every 4 hours would probably help.
Anyway thank God I found you guys! I know just talking with someone who knows about how I feel will help.
Thanks!!!!!!!!

 

[Judles]

Welcome Duffy! Hope you are NOT taking prescription meds while you are out,,,,driving etc! I'm a hippie but I just wanted to let you know you'll have a lot of support here! Good luck!

 

[aussie]

Welcome Duffy,

I'm sorry you have had such a difficult time. I'm about a month ahead of you in recovery, and I was stuck on 90 for the longest time. I gave up concentrating on the numbers and looked at the little things that improved all the time. You know your body and if it's not doing what you need it to do then you need to check in with your OS. I am now only on 110 but I can do so much it's unbelievable, I don't even think about the number just live my life. I'm sure when the swelling goes down a little more you will get better movement. I wish you all the best and keep posting, lots of encouragement here.

Chris

 

[JudyS]

Duffy
Hi from another hippy. Keep icing is my advice
judy

 

[Jamie]

Duffy, there are many different types of pain medication. See if your OS will provide a different prescription for you .... something that won't make you so sleepy. Then take them. You know, right now your most important job is to rest and heal. Maybe you shouldn't be doing quite so many of those errands yourself. Can anyone else help you?

You are just 4 months out from your initial surgery and you had a manipulation. Recovery takes time! Rest, elevating, icing and pain meds are a necessary part of that process along with working on your therapy.

 

[Josephine]

101 isn't so bad. Beats my why your PT's over there make it sound like it's means the operation is a total and complete failure! And improvements can continue for months post op. Doug, one of our long serving members who is now about 14 months post op, said only the other day that his ROM still improving!

It's been 3/4 weeks since the MUA - well, might be that you still have swelling from that but you already said you have pain from it. Well, let me tell you about the vicious circle of pain, swelling and lack of ROM.

Pain causes swelling
Swelling causes pain
Pain and swelling obstructs movement.
Inadequate pain management causes pain and swelling and obstructs movement.

Get the picture? Everything's connected to everything else!

Treatment:
~ get the pain under control with ice and pain meds
~ get the swelling under control with ice, rest and elevation

 

[duffy]

Thanks to all of you!!!! Knowing your there and reading and commenting is just so encouraging!
I have begun using Aleve (last night first time) and the swelling has improved. I did PT this a.m. and could walk on treadmill without much of a limp. 10 minutes @ 2.0 and I was fine. That is better than before. Came home and made lunch... still not tired!
Bending still feels like something in the knee will "pop" if pushed too far. That must be my limitation and I need to keep bending into it? I will try and go alittle further but the pain scares me away from pushing to far.
Appreciate all of you... have a good day!

 

[Josephine]

Bending the knee does hurt, no doubt about it. You've only got to read some of the old posts in here. But the trick is to test it a bit each day and keep trying it at that until you feel you can go a little bit more. As I said previously (you did read that, didn't you?) you don't have to do this all at once and at a few weeks, it's still early days!!! (think I'll have that printed on my forehead!) Nothing is going to go pop and you're not going to break anything. Just keep gritting your teeth and forcing a little bit at a time every day. You'll get there.

 

[maumeefootball]

Duffy

The gadget you are talking about sounds like what my PT calls the flexinator. It has a place to put you foot and a hand crank with a slide rule that it runs along. You sit in the chair and gradually pump the handle and your knee bends more and more. My PT has me do it at the end of each session. I am not sure I would drop $500 on one of these. I have found you can do something called a wall slide and pretty much accomplish the same thing. You lay on your back with your feet on the wall or in your bed against the headboard. You need to be close to the wall. Put both feet on the wall and then use your good foot to gradually slide the bad foot toward the floor. It gives you the exact same feeling as the flexinator. Please ask your PT to show you as I wouldn't want you to to this incorrectly from my scant explanation.

 

[calling_all_angels]

Sharon,
Venting is good for you!!! Vent away!!! Sometimes we just have to get it all out. And we have all had things to vent about. I am starting my 8th week with the LTKR and it is pass being funny. When I see my OS on thursday I have a few questions for him. Can not seem to be able to find the answers on tourniquet pain anywhere. And I think that by now the left knee should not hurt so bad that sleeping is so hard. So I have a few question for him.
^i^
RTKR on Jan 14 2009
LTKR on March 6 2009

 

[Texas]

Don't have much to offer but I don't mind listening to anyone vent. I am only 3 weeks out so aways to go. Still trying to bend and can't . But you all went this far to give up now. You give advise that it will get better, so please take your advise as it will get better, was good advise for me . Hang in there. Just ask your OS all the questions you need. That wall thing are your legs bent or straight. Get etter soon....Kim

 

[Jamie]

I'm also considering Manipulation, I had my TKA, March,3rd. starting on my 9th week.
I still only have a 100-115 bend!!! I still have so much pain, when my weight is on it.
And I guess I'm just getting depressed, and worn out..... No suport system at home. My two 23yr old twin sons, can back to assit with recovery, and I work for my sister, so...I had to go back to work @ 6weeks.......desk job......MAKES IT ALL BETTER, "for her"!
Sorry for the VENT, Thanks for listening.

Sharon....I'm betting part of the problem is that you went back to work TOO SOON!! I know with my knee, there was no way I could have done even a desk job. How are you able to rest, ice and elevate throughout the day when you are at a desk??? Can you scale that back any? Of all people, your very own sister should understand. Are you still in therapy? Maybe you should be. Who is suggesting an MUA? I frankly don't think your ROM is all that bad for 9 weeks....especially considering all you are doing. I bet you have swelling in that knee and ya can't get full bend when you are swollen. Why don't you start a thread of your own and you can get a little more input from people. If you don't know how to do that, let me know and I'll move your post.

 

[Josephine]

Just what I was about to say, Jamie. I don't know of any OS that would consider an MUA when the patient already has a ROM that good!

Just as a thought - did you actually tell your sister that 6 weeks was too soon? I bet you didn't! I am now 6 weeks and I had a stellar recovery with present ROM at 135 but there is no way I'm even contemplating going back to work yet a while. Be kinder to yourself. No wonder you're feeling down in the dumps.

 

[duffy]

Now I seem to be waiting for a device called a Dynasplint for my flexion. The Pt found a place around where I live & insurance will cover it. It looks like a huge leg brace that will bend me.... it sounds like I need to wear it 3 hours a day????? My goodness my life just seems to revolve 24/7 around my knee. I have gone to out pt therapy since 2/1/09 and only missed 1 day in the near 3 months. (3x week)
Oh forgot about the week before my manipulation as therapist was hoping that procedure would start me out like new and it certainly has not! I cut my therapy short today... said I had to come home and wait somemore for brace company to call and deliver the thing. My husband has DR. appt and one of us has to maintain phone.
I am so discouraged by all this. I am beginning to think I'll never be quite as good as I was before all this.... but the one blessing and probably the best is I am not in pain any more... only when I do bend and straighten the leg exercises!!!!!

 

[Jamie]

Duffy, you need to be kinder to yourself. You had major surgery. You had a manipulation, which is also a BIG deal. You need to allow yourself time to recover. It's difficult to be patient and go slow, but in the end it is the best thing to do. You deserve to do this for yourself. Right now, your recovery IS your most important job. It will get better, but you may heal more slowly than some on the forum. But you will heal....honest! You are doing a great job keeping up with therapy. Sometimes when things started to get me down I would write down all the things I could do each week that I couldn't do the week before. Doing that helped me see that I was making progress after all.

We'll be here for whatever support you need. Post any old time.....

 

[Hope810]

I just posted this to Texas and thought it might be a helpful idea... I liked to sit on my shower stool with the warm water running over my knee and gently bend it out and back. I also sat on my recliner and gently pulled my legs into a V. I progressed bit by bit each day, a little at a time. Best wishes to all.

Hope

 

[duffy]

Hi all,
Tomorrow a rep from "Dynasplint" is coming to my house to fit me with this device to help me gain more flexion. Has anyone had one of these before? As I already mentioned (or did I?) it sounds like I have to wear this device 3 hrs a day... even better if I could sleep with it? LOL (lots of luck) We have an air mattress and I don't think this looks to compatible with it.
I am skeptical to say the least about this thing but I have and will continue to do evrything possible to be more like I was before my knee problem.
Thanks to you all!

 

[Jamie]

Duffy, I hope that someone will post with their experiences with this device. So far I don't recall anyone mentioning them. Maybe you'll just have to be our "test case" and report as to how it works (or doesn't). It does seem to me that it might be a bit uncomfortable to wear for long periods. I cannot imagine how I could sleep with one on without lots of drugs! Years ago I was supposed to wear a leg brace 24/7, but was not able to sleep in it. Please let us know how things go!