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TKR Zilretta

Hi TinAB, Thank you for reaching out! I was going to PT 3 times a week and did not make the connection between the PT, (which I now realize was too rigorous) and the awful pain, swelling and regression. The really sad part is neither did the surgeon, or the PT. I was sent for and MRI, aspiration and blood tests. No one realized the soft tissue damage was from over doing it. I decided to cut down to 2 days a week and speak up about my needs. Today was the best day I have had since the surgery. I actually fell asleep last night, on my own - no meds. I slept for about 5 hours - the longest stretch since the surgery. I have less pain and swelling today and believe my ROM is greater. I do quad exercises and heal slides at home. If they do not respect my requests this week, I will have to find another PT or do what you have done. I am so happy to hear how well you are doing on your own! That gives me encouragement. Also, I am impressed by your 30 minute walks. I have only done 15-20 minutes. I also have to walk around the house on bad weather days. I have to admit, this has been an awful road. I wish I found this site before the surgery to prepare myself for what to expect. It is great to talk to people like you who have/are going through the same thing. listening to folks like you and to your body is the best medicine! Be well!
 
Good afternoon. I had my best day yet yesterday; little pain and better mobility. Today though, I am in so much pain with swelling. I have been icing and elevating on and off all morning. Question - It is beautiful out and I would like to take a little walk - 10 -15 minutes. Do you think that is a good idea? I did not go out yesterday, did quad sets at home.
Thank you for your help
 
Walking is a very good exercise for rehabbing your knee. You could try it for about 5 minutes and see how you do.

Remember this recovery is a rollercoaster. Sometimes up and sometimes down.
[Bonesmart.org] Zilretta
 
I didn't always walk every day--a lot depended on how I felt. I started with less than I thought I could do (you have to make it back home after all :heehee:) and then added time if that went well. About 5 minute increments.
 
Hi everyone. I cut back on the PT - 3x week to 2x a week and this week I went only once. Last time I was there I really thought I made myself clear. I explained how the knee had to heal, how I am in agony for 2 days after therapy and they need to be gentle. All was going ok until the end when she came at me with a little vibrator, on the scar. I just knew that I should stop her, but I did not. That was Tuesday. Wednesday was awful. I have to decide if I will go next week. I was supposed to see the surgeon today but I could not get out because of the snow. Today I felt a bit better and less swollen. I Iced and elevated all day and took short "walks" around the house. Like clockwork, the awful pain starts each day around 5:30 - 6. I am still not really sleeping and I have a new issue. When I do fall asleep I have awful nightmares about falling. Sometimes I wake up screaming. I know every knee is different but is it "normal" to still be in so much pain? I wonder if the day will ever come when I do not have to think about my knee and be in pain. I am very worried and feel distressed.
 
My knee did not like any vibration, anywhere on my leg. I don’t remember how far along I was when I bought an electric razor. I used it once and my knee threw a fit, and I don’t think I even actually used it on my knee, just my leg.

Please try not to worry, the day will come when your pain will stop. Until then, and even after, guard it carefully so others don’t inadvertently cause it to increase. It’s your knee, not theirs, always listen to your instinct. :console2:
 
Hi everyone. Just checking in. Happy to report that I have had a few nights where I could sleep. I can now find a comfortable position to lay in bed and sleep for a few hours at a time. I take ES Tylenol before I go to sleep. I have not gone to PT in over a week and continue to baby the knee all day. Ice, elevation, light exercises and 10 minute walks around the house. If the ice and snow outside melts, I may go to PT on Thursday, but I am so wary and afraid of getting hurt again. Do you think it's ok NOT to go to PT, continue to do what I am doing and then go back to work on strength when I feel sufficiently "healed"? My stomach is still quite upset. Maybe it is the Voltaren? Does anyone else take it? Does anyone else find that the pain seems to increase in the late afternoon? Starting to feel a bit hopeful, but am afraid to say so - always waiting for the other shoe to drop. Can not wait to be on the other side of this. Very lonely
 
Hello Sharon, I just read your whole thread and had a thought. If someone was cutting or coloring your hair, would it be hard to speak up and say “yuck, this is not what we discussed! I do not want a lime green buzz cut.” But when we are in great distress after a TKR we feel the weakest version of ourselves. I know I did. I am so embarrassed to think of how much pain I had to be in to fire my PT. Speaking of pain, it seemed to have a standing appointment With me to start at 4-5pm during the first 4 months.
My knee just had its .5 year party 4 days ago and I still ice and use some hacks that work for me. Massage CBD balm and then wrap in Saran Wrap before sleep. Use large tens pads after shower under ice pack. My knee likes novel sensations to keep it distracted. You will be on the other side and I can’t wait to read when you do! Best wishes.
 
Hello Murphy,
Thank you for your wise and reassuring words. You are absolutely right - if it were my hair dresser, I would not put up with not being satisfied - I hope so anyway! There were so many times that I cried through therapy. Their reaction was to put me in a private room. I overheard one PT say to another that "she is very reactive. I felt like there was something wrong with me, even though I was working so hard. I know know that all that "work" was counterproductive. Oh how I wish I had stopped the PT or at least spoken up. I use the CBD balm, but have not tried the Saran Wrap. Sounds like a strange sensation, but I will try it. Not sure what tens pads are. I do not think that most people are prepared for the surgery and what to expect after. Congratulations on your 1/2 year milestone! Thank you for your encouragement. It means so much.
 
TKRSharon,
I like your idea of working on your strength a little later. I don’t want to tell you what to do, but if I were you, I would take a break from the PT. I would ice, elevate the leg anytime I’m not doing daily activities and see what happens. When I was about 3 months out, I started slowly working on strength and endurance. I found an exercise machine, called the CardioFit. It really helped me. I can go pretty much go all day now. I was out and about today almost all day today & didn’t feel tired at all. My knees don’t hurt at all now, just have a little stiffness at times. But I’ll take a bit of stiffness compared to the pain I had before the surgeries. Hope you will find what works for you.
Annie
 
You will be fine stopping formal PT, I was discharged from mine at 2 months, and thats where you are now.

This is what @TortiTabby experienced. (Just so you know, ADL means Activities of Daily Living, which means just go about the normal things you do in the course of your day, and not doing a “list of exercises.”)
Just an update for those who are apprehensive about gaining ROM:
It has now been 26 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better. :happydance:
Click to expand...
 
I think how you're functioning is more important than the calendar in terms of PT. I stopped PT at 6 weeks with knee #1 and I think 5 weeks with knee #2. Once you know the exercises and can function pretty well it's just day to day activities that seem to help the most for most people.

I made the mistake of letting them use some tool on supposed "scar tissue" with my first knee. The only effect was needless pain. I can only imagine some vibrating tool feeling even worse.
 
@TKRsharon :flabber: I have just read your entire posts, I think it is shocking what your PT has out you thru. You are healing from a major surgery not a sports accident, you don't need harsh painful PT. My surgeon actually told me it was not necessary and that my daily living activities and the occasional walk was all that I needed, two weeks my surgery after I went to PT out of curiosity as the therapist was a family friend, basically we did a few gentle exercises but nothing like what you have described.
I'm now 1 year post surgery, my knee feels great, it bends well and providing I don't overdo it I have no pain whatsoever, it is so good that I have agreed to get my right knee operated in 2021.
Seriously stand your ground and tell your therapist that you won't tolerate this behaviour or better still do it yourself at home. Good Luck! xxp
 
At two months out from what I read on your post sounds to me that you're doing pretty good. The first couple of months sleeping was an issue for me too. Not so much from pain but from the extreme restless leg that kept me up half of the night. The restless leg went away a few months after surgery but I have to say getting out of bed every hour to stretch my leg drove me up the wall LOL

As far as physical therapy is concerned, if you feel that it's counterproductive then I would think twice and maybe stop for a month and see how you feel. I did go to physical therapy for about six weeks and I made it perfectly clear to the physical therapist I was in charge and my therapist totally agreed with me. I stop going to physical therapy when I tore my LCL.

After my LCL was healed and with the blessings of my OS, the smartest move I made I join the YMCA and used their exercise equipment. The YMCA also offered senior aerobic exercise classes which I was able to set my own pace. Getting out of the house and being around others of my age was a blessing also.

Because of COVID, the YMCA close their doors in March but I got a phone call the other day they will be reopening in January. I am so excited LOL

After my third knee surgery in seven months, every month that went by I can feel my knee getting better and stronger. I went through the doubts, the ups and downs emotionally the first few months but I kept on telling myself give time, time.

I think is fair to say, we all expect to be up and running six weeks after surgery, but the truth is we all heal differently at our own timeline.

Remember, this is a journey, not a race.
 
Hi again TKR Sharon, yes I have the tens machine at home as well and used it around months 4 and 5 instead of extra pain meds. I had to get my husband to lift my right leg onto the couch at that time. Aah the memories!

Now after month 6 I find I like the feel of the the sticky pad surrounding my knee with no stimulation. Go figure. I spent some time as a patient at a Pain Management practice at a teaching hospital and learned to use a variety of tools that would fool my nerves into not thinking of back pain. Tens, k-tape, cold pack, CBD under Saran Wrap, all are worth trying to see what works for you.
 
I did some research into using a TENS unit. and decided it would be a good thing to try. I found out that it is covered by my insurance company. I called the OS for a script. I just got an email from his PA saying the doctor does not prescribe TENS units! I did not like this man before this, but this is insane! What could be his reasoning? Wouldn't it be better to try the TENS so I could stop taking pain meds which are screwing up my stomach? Should I just buy one out of pocket?
 
Hi Sharon, yes I bought mine out of pocket. I got my Auvon unit for $39 on Amazon. It’s been useful over the years. I just use one setting. It is well worth trying because there is zero downside and lots of potential upside.
Honestly when I needed pain pills, I took pain pills. The last time they prescribed them for me they made me take Narcan with it home from the pharmacy. Ridiculous. At two months there is no shame in using the best pain meds you can that do NOT cause stomach upset. Does your OS have an RN or a PA in his office you can work with?
 
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