will be 29 days since tkr,swelling,tightness ect....

tiggpooh · #1 February 8th, 2010, 07:24 PM

Hello, I had tkr on my left knee Jan 12,2010 and had my first pt appointment today 2-8.

My pt guy says that I am only at 60 degrees rom.

Had to single step stairs could not bend it completely and the arthritis and scar tissue over the years resulted in bone on bone, hence the need for tkr.

Am I in trouble as far as my flexibility? Should I be in a panic? Should I just breath and relax?

**Josephine** · #2 February 9th, 2010, 01:46 AM

Hello, tiggpoo, and welcome to BoneSmart! Do I spy a Winnie the Pooh fan? I so love those characters, especially Eeyor!

Well, you have a classic case of doing too much too soon! You shouldn't be walking with nothing yet, even around home as your knee needs support. And driving is not usually recommended before 6 weeks have elapsed. Driving whilst on drugs is also ill-advised for obvious reasons!

I can tell you that your ROM is probably restricted due to swelling and the swelling is probably excessive because you have been doing too much, on your feet too long, not managing your pain enough and aren't icing and elevating enough!

29 days is way too soon to be back to 'normal' as you are. Swelling is often the biggest cause of flexion problems so the sooner you get the swelling down, the sooner you can get some improvement there. PTs always seem to be 'Eeyors' when it comes to these things. Don't know why they feel the need to scare the bejeebers out of people like that!

I need a answers to a few questions though:
Have you been taking pain meds all along?
If so, were you taking them regularly or just when you were in bad pain?
Have you been icing and elevating?
What kind of exercises have you been doing at home and how much/often?
When did you start doing housework again?
How well are you sleeping?

When I have this info I can answer in more detail.

ship4 · #3 February 9th, 2010, 03:31 AM

Tiggpoo,
Welcome to the forum! Have you inquired about HOME Physical Therapy? My insurance covered having the PT person come 3 days/week for a month to my home! Call and inquire ASAP! As Jo said taking medication and driving are not a good idea this early in recovery. I was not to drive for 6 weeks!
Are you in the city or a suburb, or a rural area of NY? See if the any local agency could provide transportation for you if PT can not come to you....
Just some suggestions.

Dtman44 · #4 February 9th, 2010, 04:25 AM

Hi Tig,

I was able to take my CPM machine home with me and it was a big help with ROM when I was still very swollen. I would work my way gradually to 90 degrees. Once I got there I would increase it by 2 degrees, but would only let it go down to about 80, stop, then return back to 92, then back to 80, back to 94 etc...

Does that make sense? It enabled me to get to 100 while still very swollen without an inordinate amount of pain.

tiggpooh · #5 February 9th, 2010, 07:38 AM

Thank you so much for you help!

I am resting,resting,resting.

I have not driven on meds, I only take oxycodone at night to help me sleep and pt is 35 min from my house. Driving is not a problem. That will be the only time I do drive. I have basic exercises I try to do at home. I have found so much comfort and info from all you folks.

Hugs.....Tigg

**Josephine** · #6 February 9th, 2010, 09:25 AM

I need a answers to a few questions though:
Have you been taking pain meds all along?
If so, were you taking them regularly or just when you were in bad pain?
What kind of exercises have you been doing at home and how much/often?
When did you start doing housework again?
How well are you sleeping?

**Josephine** · #7 February 9th, 2010, 11:45 AM

You're not taking enough pain meds. At your stage you need 100mgs Tramadol and you could add two Tylenol extra to that as well for really good coverage. It should be enough for you not to need the oxycodone as well but if it works, whatever!

You also shouldn't be cooking dinner for everyone and cleaning this early - not every day, anyway. Isn't there someone in the family that can take this over for you? I couldn't have managed that until 6 weeks at the earliest.

It's no wonder your leg is so swollen you cannot get a decent flexion. With that schedule of exercising and everything else, you overdoing it way too much. Go easier on yourself. Let the house get dirty if you must. It's not a crime! This won't last forever and then the house can be cleaned!

**Jamie** · #8 February 9th, 2010, 12:34 PM

Hi, Tiggpooh....welcome to the forum! I'll most certainly second what Jo has written. You need to slow down on the activity. It's no doubt causing at least some of the swelling that is inhibiting your progress in recovery.

You say you aren't driving while taking pain meds, but you SHOULD be taking a dose of pain medication about an hour before your therapy. It will help you do a better job of it and reduce the chance of swelling afterwards. You need to ice, rest and elevate immediately when therapy has ended for the same reason. So, to me....if you don't have someone to drive you there at this stage, home therapy might be a good option for you. Could you rely on a friend or relative? It's okay to ask for and accept help from others while you are in the early stages of recovery.

Another question I have at this early stage when you are experiencing swelling....why do you need to be "out and about" with hubby???? This is the time for him to take care of YOU!

Also, if you are experiencing swelling, don't use heat on your knee. It will just make the swelling worse. Ice is your friend!!!

**Josephine** · #9 February 9th, 2010, 12:51 PM

Oh my gosh! I missed the comment about heat!

**Josephine** · #10 February 9th, 2010, 01:49 PM

Oh no! We're only saying this because we care about your recovery. Sorry if we're coming on a bit heavy.

calling_all_angels · #11 February 9th, 2010, 02:23 PM

Tigg,
So sorry if you feel picked on. Honestly Jo and Jamie are only trying to help you. Please do not be upset It was not the intention of anyone here to make you uncomfortable. Sometimes things just are easy to take one way when it was meant another. Please stay.

**Jamie** · #12 February 9th, 2010, 02:41 PM

Tigg, I'm so sorry if I made you feel like I was picking on you. Please forgive me. I DO care about you. Please accept my apology!

I'm glad you have the support of your husband. It is so very important and he sounds like he is supporting you. It was nice to hear that...so many spouses just don't understand what this recovery involves.

**Jamie** · #13 February 9th, 2010, 03:38 PM

((((HUGS)))) to you, Tiggpooh......we'll look forward to hearing from you again whenever you are ready. We'll be here if you need us. BoneSmart really can be a large, extended family who understands the ups and downs of recovery.

**Josephine** · #14 February 9th, 2010, 04:22 PM

Indeed - we've all been where you are. We know what it's like. Remember that.

Ginnibug · #15 February 26th, 2010, 02:32 AM

Hiya Tigg, I'm so happy to see you here and it seems that you and I have so much in common with our knees and recovery, please hang in here with me as I feel we may be able to assist one another.

My very first knee injury/surgery was at the age of 12, long story wont go there lol. My second surgery was about 11 years ago and a fall on a concrete floor is what prompted the surgery. I was told then that I needed a replacement but because of my age at the time, it wasn't an option. June of 2009 I was getting up from a seated position while at work and my knee simply decided it had had enough.

The MRI revealed that my ACL was completely destroyed and my MCL and PCL were both torn. My meniscus had cross tears in 3 places, I had runners knee, burscitis, the possibility of a Bakers cyst as well as degenerative rhumatoid arthritis and Of course I was bone on bone. My knee was a mess!

I know you are wondering why I'm telling you all this but please just hang in here with me!

12/30/09 I had my replacement surgery and the very next day I got myself out of the hosp bed and felt as if I was ready to walk for miles and miles (a morphine drip works wonders lol) Of course the medical staff had a fit to see me up and about and quickly put a stop to it as I wasn't moving properly, with the proper support needed for my new knee.

I started my therapy in the hospital, it was a joke and really didn't do a thing for me. I was released to go home after 4 days and the following day home therapy started, it was a joke as well. 3 weeks of home therapy that did nothing more than keep the muscles moving a bit. I had no pain in moving around the house so of course I was up and doing what I wanted to once everyone cleared out. I took my pain meds when I started to feel pain (not a smart move) and my whole leg was swollen and continued to swell until it was elevated and this was usually after going to bed at night. I was up and about so I thought I was on my way to a perfect knee.

My wake up call came when I started my outpatient therapy. when measured my ROM was 60 and I was floored, the pain to get to 60 was nauseating. After listening to the history of my knee my therapist then started his pep talk. with a knee as bad as mine (no flexability for so long) the surrounding muscles and tendons were suffering from so much atrophy that it would take time and so much effort to get everything working together to enjoy the benefits of my new knee.

We worked for 2 weeks and finally got my ROM to between 85 & 90 and believe me I then was taking my meds as prescribed because the pain in getting that ROM was excruciating. Due to the scar tissue I then had a MUA to break it up and that helped but I'm still working very hard to keep my ROM at 110. But that is just a number, at almost 8 weeks out I have seen such an amazing improvement of what I can do.

The reason for sharing all this with you is to say regardless of how you have progressed thus far, regardless of any mistakes that may have been made with your recovery, it's not too late to rehabilitate your knee! We are all different with different circumstances and decisions that we must make. Do the best you can, work hard in therapy and please come here for support, you will get there Sweetie!!!

Did you say that you fell at work? If so, did you file for Workers Compensation? This could open up a new world for you and the future of your knee!!!

Take Care Tigg and hang in there!!!

Smooches,
Ginger

Ginnibug · #16 February 26th, 2010, 07:35 AM

That is excellent news, I simply want to assist you and learn from your recovery as well Sweetie that's all!

Have an AWESOME day and hopefully the snow storm isn't pounding you too hard!

Ginger

**Jamie** · #17 February 26th, 2010, 07:39 AM

Ginger, that's quite a story! But your postive attitude and determination come through loud an clear, so I know you will be okay. Plus....I think your experiences will help many others here on BoneSmart.

When these things happen to people, they sometimes feel like they are the ONLY ones in the whole world who have had such difficulty. It can be a weight because you may not be able to see yourself coming back from the adversity. Friends and family care and would like to help, but it's difficult for them because they have not experienced what you are feeling. And, sometimes, they frankly just shut it all out because they can't "fix" it and it's too difficult to deal with.

So....I hope you continue to post here and let some of your spark rub off on our other members. I know you can certainly make ME smile!

Ginnibug · #18 February 26th, 2010, 08:51 AM

Jamie, thanks so much for your kindness, you are one smart, perceptive young lady! Believe me, seeing your post at this point is something I needed

You are so correct, friends and family sometimes can't understand that our surgeons and therapists are fixing us physically and that we need them (friends and family) for emotional support as well as to help do things that at the time we just can't do.

I remember day 1 after my replacement and after the morphine drip was removed, there was a mix up concerning my oral pain management meds. I went half the day without anything for pain and all I could do was cry. Tony (hubby) was doing everything possible to straighten it out with the medical staff and looking back he was so pitiful as his hands were tied and he couldn't fix the pain for me. I remember asking him to crawl into the hosp. bed with me, just to hold me. He looked at me and said "honey, that will not take your pain away, let me demand again to speak with the doc" and I told him that it would not fix my pain but it would bring joy to my heart.
He turned right around and managed to get into that tiny bed with me to console me as I cried and cried. It did help a great deal and from then on we have been clear that my knee wasn't the only past of me that needed healing attention.

Some people want to reach out for help but are so scared and so down that once help arrives they are too blind to receive it. As a giver though, I will always continue to share, to assist until I'm simply told to go away and even then through my hard headedness lol I may make one last effort

Thanks again Jamie for listening to me ramble, I know everyone must be thinking that that Ginger girl sure is long winded and I agree, I am. TeeeHeee

Have a MARVELOUS day Sweetie Pie!

Ginger

**Josephine** · #19 February 26th, 2010, 11:48 AM

Ginger - I hate to hear that happening to anyone, that they have even a short period when they have no pain meds. It happens all too frequently and is why I am soon going national with my Pain Management Survey. I am determined to highlight this, even if it is only in the UK.

Ginnibug · #20 February 26th, 2010, 12:52 PM

Thanks so much Ms. Jo and I wish you the best of luck with that!!! what happened with me was so odds to me.....I have an allergy to tylox and the medication that my OS prescribed for me (hydrocodone) has some of the same ingredients as tylox so the hosp pharmacist would not dispense it. This is what I was told anyway lol The nurse on duty with me who was pregnant and absolutely clueless simply did not give a **** and was not acting on my behalf as she should have been. ( I had her removed from my care and demanded that she not return to my room) When my OS made his rounds he had no idea of what had happened and instantly started morphine straight into my IV port. I asked him since when was a pharmacist allowed to not dispense his meds without speaking with him to resolve the problem, he shook his head and had no answer for me. Ironically enough, I have been on hydrocodone since day 3 and have had no problems at all. Who was at fault here? The point is mute I guess, I made it through it.

Bless you for being the type of person to see things through and to make a difference in getting things done properly!

(((HUGGS)))
Ginger

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