TKR Zena831’s Road to Recovery

[CricketHip]

I just read through your recovery thread and am wondering if you have considered scheduling with a Manual Lymphatic Drainage Therapist? (MLD therapist)
There are Licensed Massage Therapists that take extra certifications for this modality and it is very helpful with helping to ease inflammation, pain and swelling.
It is a very gentle yet effective massage and I think this could be very helpful to you.

In case you'd like to try a little on yourself, I can leave an example of some easy techniques to do whenever you are elevating and resting.

Also for what it's worth, I think you are progressing very well for being less than 8 weeks post op.

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Take deep breaths.. deep, as in breathing in to the
count of 3 or 4, whatever is best for you. hold it for another count of 3-4, then blow out completely, still using the count that's comfortable for you. A series of at least 6 of these could help get your excess swelling to move. To ensure you are taking proper deep breaths, place your hand on your naval and watch while taking in your breath, if doing this properly you should see your hand move up.

Then, as you slowly breath out, to the same count of either 3, 4 or 5 gently press down and slightly upwards with the palm of your hand.
Do this whenever you feel up to it during the day or night. The more supine that you can get in the recliner or bed, the more effective this can be.. you have lymph nodes located in your groin and sitting up too much can cause a restriction of the lymph flow.

You can, after the breathing, place your hands lightly on your upper thigh, right where the crease is in your groin and lightly stroke upwards towards your naval.
I did this quite a bit post op and while it takes a while for the body to wake up and respond, it will and it will help get the swelling moving.
The reason this can help is because many of our lymph nodes are located in our abdomen and in our groin area.

Our breathing combined with moderate pressure over our naval can help to "prime" our lymph system.

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Additional notes: you can reach down to your knee and lightly stroke upwards your groin after doing the steps above. Then lastly, gently pump the back of your knee in a rolling, upward motion towards the trunk of your body, using all 4 fingers of your hand and NO fingertips pressing in..

This can be effective if done daily.. use light pressure, no deep pushing. This isn't a no pain no gain thing.

I hope this helps!!

****

 

[Zena831]

Honestly, I would rather not go to PT. However, what I’m truly afraid of is that IF for some reason, I have to go back in for a 2nd surgery..if I left PT before the script was over, that insurance would not cover it. That is the only reason.

I’ll go this next week to PT once I am on the steroids and see if there is any change or any additional exercises to do. Any thoughts about that?

 

[mendogal]

Yep... maybe check in with your insurance company about this? They may be happy to pay for less PT now and more willing to cover it later?
I totally get it if you decide "nah, not even gonna go there...."

 

[Zena831]

Well, shoot.
not sure why my response didn’t post.

I respect the questions about continuing PT. So, I’m totally afraid that if I don’t finish out now that they wrote another 4 weeks of PT, that if I have to go back in for a 2nd surgery that insurance would not pay for it…finding some excuse that I didn’t follow what the doctor prescribed. Believe me, the PT people don’t know what else to try to get this knee extended.

I’m open to anything…ok, almost anything at this point.

My knee honestly feels like a basketball inside a tennis ball skin…if you can imagine that.

 

[Zena831]

This can be effective if done daily.. use light pressure, no deep pushing. This isn't a no pain no gain thing.

I hope this helps!!

Thank you for this information. I am going to try.

 

[Layla]

Hi Zena,

So, I’m totally afraid that if I don’t finish out now that they wrote another 4 weeks of PT, that if I have to go back in for a 2nd surgery that insurance would not pay for it…finding some excuse that I didn’t follow what the doctor prescribed

I am not trying to persuade you either way. The decision is yours and I respect that. Just wanted to share this article that I remembered we have in our Library, if you care to read it.
Wishing you only the best!

Saying no to therapy - am I allowed to?

 

[JusticeRider]

My knee honestly feels like a basketball inside a tennis ball skin…if you can imagine that.

Yes, I totally understand. Mine felt just like that. Like it was going to just burst. It limited my ROM too but once it finally went down things improved. Hang in there, you are doing great healing yourself

 

[Layla]

Happy Two Month Anniversary, Zena
I hope your week is off to a good start.
Take good care and stay in touch.
@Zena831

 

[Zena831]

Hi all, so much going on with work that I haven’t had time to think. It is truly hard to believe that I am over two months post-op.

Well, I am still in PT No have 2 visits this week due to my schedule with other appointments. I go back to the doctor on Friday morning. I did request to see the doctor instead of his PA. I just want to make sure he knows what’s been going on and can explain to me how we move forward.

I am literally at a plateau. No additional flexion or straightening over the last month. I am able to get the recumbent bike all the way around instead of the half pedal forward and backward. However, the pain i excruciating sometimes when I get to a bend of 113. There is a certain place on the inside of my knee that feels like a knife is stabbing when I get to the flexion point. My gait is a better but nothing like I think should be.

I’m at a loss and feel like I am just not where I should be at this point in time. My husband is my biggest cheerleader and reminds me that everyone heals differently and the fact that I am eaten up with arthritis along with having autoimmune issues.

I haven’t been the most pleasant to be around since I have gone through the depression phase of this. Lord, something has to give.

 

[MSuki]

Sorry you are having a hard time. Are you still having swelling? Sounds to me like you may be pushing too hard. If you are pushing the bend into excruciating pain, you are likely injuring the soft tissue. Two months isn’t long in this recovery so you may need to slow down and heal some more in order to make progress. I know it’s frustrating but you can’t speed up the process by pushing harder.

 

[mendogal]

I'm sorry you're having the blues. It's a common side effect of TKA.

I agree with @MSuki ... You're likely over doing things and so the swelling won't go down, so your knee won't bend as you'd like. Yet.... two months is 1/6 of a year long recovery. These are very early days, your muscles are barely healing; the tendons.and ligaments and bone are slower to heal and to adjust to their new structure.

Perspective...
I couldn't get a full turn on the recumbent bike at 8 weeks either.
At 9 weeks I just managed a few turns but the seat needed to be so far back I pedaled with my tippytoes, terrible posture, and it hurt the knee! I returned at 10 weeks, did a few minutes, still tippytoe though. At 11 weeks I had overdone so many things that I decided my knee needed to quiet down and I put the bike on hold and then at 16 weeks I could actually get on the bike with the seat placed properly and after some slow turns to loosen the muscles slowly pedalled ten minutes without resistance.

The hardest muscle to exercise, and most important in this rehab process, is the patience muscle. Hang in there. We know you'll pedal when the knee is ready!

 

[Layla]

I am sorry you're struggling, Zena.
Post Op Blues is common which is cold comfort, but you're not alone. Thankfully it sounds like you're beyond the depression, but ongoing pain isn't pleasant either. Consider skipping PT which is likely aggravating healing soft tissue and ice / elevate as time allows. Let us know how your appointment with the surgeon goes on Friday. I wish you all the best and hope today is a good day.
@Zena831

 

[Zena831]

Thank you all for the encouragement. I am glad to have the perspective of others.

Maybe it’s the PT people. They keep telling me I should be further along than I am. However, that’s why I wanted to see my Dr and not the PA. I want to hear it for myself.

I went to PT today and I think I’m going to take advice and sit out, even if the Dr tells me to return. I do feel like I have come a long way but still have a ways to go. Honestly, I believe that no PT for a week or may help with some of the healing.

I do appreciate you all. My attitude has been better this week as I’m not so edgy. Or want to bite anyone’s head off.

We’ll see what the Dr says tomorrow. Praying for some relief and healing.

 

[mendogal]

Hang in there.
Tincture of time, walking, gentle stretching, and daily routine activities are your ally.

 

[Layla]

Honestly, I believe that no PT for a week or may help with some of the healing.

Please try it and see...you've nothing to lose but the pain.
Best Wishes for your appointment tomorrow. Stay in touch, we're here for support always.

 

[MSuki]

I am taking a week off this week and feeling pretty good about it. You can always go back afterward if you want.

 

[Zena831]

Well, today I did see the Dr and he measured, read the PT notes and then we talked about a lot. About PT, how I feel among other things.

He told me that I have a ton of scar tissue building up and right around the 3 month post-op period is when he decides if he needs to go in and do a manipulation to break it apart and also try to help with some straightening.

He wanted to give me 2 more weeks of trying the flexion and straightening but if I am no better, he feels the manipulation is the best thing. We were afraid of scar tissue build up. I went in for the right knee meniscus in March 2023. The Dr (partner to this surgeon) fixed the tear but also tried to clean up the knee as much as possible as he saw that I was definitely going to need the replacement. So, the belief is the manipulation wil be the best thing for me really.

We went ahead and scheduled me to go back in to have that done but I have 2 weeks to try and get passed this on my own. We can always cancel the additional surgery.

So, I have until Fri, 16th to get passed this plateau or I’ll have the manipulation done on Fri, 23rd and be in my immobilizer at night for 6-8 more weeks.

Also, he isn‘t too happy with my incision as it looks to be keloiding. This is literally the first incision after my many surgeries that has done that.

I really hope I didn’t make the mistake of having the knee replacement done. I was in so much pain for years but now….

Oh, and his belief is that when the my knee was shoved early on by PT, they could have damaged something then causing some of the additional issues which has prohibited me from getting better.

 

[mendogal]

This must have shaken you up quite a bit.

We see the good and bad side of MUA here: There are people who heal very slowly, probably don't have adhesions, and long term do very well without a MUA despite surgeon's dire predictions. There are people who have an innate tendency to form adhesions and despite the minor setback of a MUA derive benefits quite quickly and have great outcomes.

This link is to our Nurse Director Emeritus' excellent article on adhesions and MUAs.

We always support our members on their individual journeys and I know you'll end up making your best decision in consultation with your medical/surgical team.

 

[MSuki]

Hope it goes well whichever route you go!

 

[Layla]

I hope you're not feeling too much pressure with the scheduled timeline. I don't know that you made a mistake in having the TKR, but certainly are dealing with more than you hoped for. Living in pain with limited mobility interfere with out quality of life. Whatever you decide, we'll be here for you. Best Wishes!
@Zena831