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Manipulation scheduled. I'm apprehensive.

Posted , 36 users are following.

joansgarden
joansgarden

I saw my surgeon yesterday and he took one look at my bend and said he would manipulate it, but not until I was at 12 weeks so that is in another 3 weeks from now. In the meantime I've stopped physical therapy so that I will still have some left for after the manipulation. I had got to 105 under force, but I think that under my own steam I'm only making about 90. My apprehension comes from the fact that his nurse told me they do it under a general rather than an epidural - because it's such a 'rough' procedure. My heart doesn't do well under general anesthesia.

I'm so tired of all the ups and downs - a big up because I made 105 and then a big down because I couldn't keep it. Feeling up because the medication is working one day and then down because the pain is back the next. And now I don't know whether I should be up or down - up perhaps because it might finally get bent and down because of the anesthesia worry.

I don't really have a question. I just know that you are the only people I can talk to who understand.

5 likes, 140 replies

140 Replies

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  • MCanada
    MCanada joansgarden

    Posted

    I have just read your question and 14 responses and have a little bit to add. I have had 5 reconstructive surgeries on my knees in 37 years and now 2 replacements in 2014. Knee surgeries are painful and the recovery and learning to walk and build functional knees takes a LOT of work and dedication over a lengthy period of time 4-6 months is the minimum time for good recovery and full recovery takes about a year. I DO NOT believe in manipulation under anaesthetic unless there is some extenuating circumstances as you are right back to square one with bruising and major pain. If you are over 90 degree bend by about 10 weeks you are ON TRACK! If you are better than that you are a STAR! Any surgeon who pushes you harder than that has their own agenda. The physiotherapists who guide you will be more honest. If you are progressing and doing the work, you will get there. There are NO shortcuts! Do the work before the MUA or do it after the pain starts again! It is difficult to do the work but the work IS simple. Tbat is my honest advice. If you think you can, you will. If not, you won't. I believe that our mobility is the most important thing we have other than our health. And it IS up to us!
    • joansgarden
      joansgarden MCanada

      Posted

      My physio has given up on me twice already! He's been pushing for manipulation for weeks. It is the surgeon who wanted me to try it for longer, and I will keep trying, but it's very frustrating to hit that point where the bend doesnt change for weeks. From what I can gather from others, once the knee actually starts to bend the progress is reasonably fast after that - not so for me.
    • MCanada
      MCanada joansgarden

      Posted

      Hi Joan, I can't fathom what the physio is thinking when he/she forces the joint past severe pain like some people have reported, nor can I see any benefit to giving up on you! Keep doing the work and pushing yourself a bit farther every day. You may not feel like you are improving fast enough but you will benefit. I hope that you can do it without the severe choice of manipulation. Cheers
    • peter73207
      peter73207 MCanada

      Posted

      Hey MCanada, how are you doing?

      i love your posts and think your right on target.

      you are so right. Where in the world does anyone get off in pushing someone into severe pain? Makes no sense and Its a terrible trap to fall into.

      I'm seeing my surgeon next thurs for assessment. Will be quite interesting to say the least

       

       

    • MCanada
      MCanada peter73207

      Posted

      Hi Peter, thanks for the positive feedback. I will be seeing my surgeon next week too. It will be 11 weeks and I am confident he will be on side with my progress. No, it is not as speedy as knee #1, but it is progressing well. He has seen me recover at my own pace after 5 or 6 surgeries now. We are a team with the physiotherapist and we all know it! I will post after my visit and look forward to reading about your visit too. Cheers.
    • britta217
      britta217 MCanada

      Posted

      hi mcanada ... clearly you have a lot of knee experience, way more than me!  and probably more than joan.  but where do you get the idea from that having a manual manipulation under anesthesia takes you back to square one with bruising and major pain?  is this your experience? or is it what your doctor tell you this?  i question this as this is not my experience at all.  

      joan and i have had a similar experience and our physios and surgeons have worked very closely together.  nobody pushes for another stay in hospital, believe me, but if both the surgeon and physio can feel like the knee is like a concrete wall, with no "give" in it at all, then you have to listen to them and believe their experience.  somebody else mentioned it on here, just like the healing is different for all of us, so is the scar tissue.   and it would appear, my scar tissue does its own thing and completely blocked the move - i loved eileen's comparison with the hoover and hairs!! - of the knee.

      anyhoo, i have made great progress since december when i had it manipulated.  i feel optimistic about my knee and life again and i think that is what joan needs ... the light at the end of the tunnel.  it is tough for us, we don't have 37 years of experience!

       

    • nikki55182
      nikki55182 britta217

      Posted

      Hi Joan,

      I have to agree with britta 110%.. I had my manipulation at 8 weeks and my experience was identical to Britta's. Since I was child I have had 10 ops so sadly I've had plenty of experience. My surgeon and physiotherapist both said sometimes despite hard work you need a manipulation to snap the adhesions. Anyhow I've not looked back, still problems walking but thats to do with a thigh and bottom muscle issue. But I have good bend, dead straight leg and can do 30 mins on a exercise bike and 30 mins on a treadmill with no problems. Last Friday my consultant was thrilled with me and told me he didn't want to see me until sept😁

      So try not worry, you be fine.

      X

    • joansgarden
      joansgarden nikki55182

      Posted

      Thank you Nikki and Britta - just what I needed to hear. If anything my bend is getting less instead of more. I couldn't face the thought of another 12 weeks of this! Now I'm worried that I may not keep the bend after the manipulation since it's taking place on a Friday and my physio won't work on a Sat. This is the third surgery on that knee plus I've had 3 on the other knee so I do have experience, but this time is really getting me down. Got to get my head in the right place and start looking forwards!
    • britta217
      britta217 joansgarden

      Posted

      according to my surgeon, being on a CPM machine for 48 hours after the manipulation is key. i was on it for 60 with minor breaks to eat and shower and such. but actually, i could have done it at home. it was more a precautionary measure i think as my doctor was traumatized (as was i!!) from the previous time. i realize i am repeating myself but try and find a place you can rent such a machine from. it will do you the world of good.
    • joansgarden
      joansgarden britta217

      Posted

      I will look for one. I know of someone else who rented one so it must be possible. I think you're right and it would calm my worry of no physio in those first couple of days. There is also the brace that I mentioned some time ago - still don't have it! But the surgeon says to go through with the whole thing and get it. It has to be approved by Medicare before I can rent it (and have them pay). So far their approval is not back after 5 weeks.....
  • paul57039
    paul57039 joansgarden

    Posted

    Hi all, I am pleased to hear I am not the only one to make a knee goniometer and subsequently buy one on E bay, I wasn't going to admit to it, my wife believes I have become obsessive, but it is my new knee and I will play with it if I want totwisted. My physio said 120 was a good bend and I achieved that and I was very happy and that where it stayed for a week but I continued my exercises and then it started to improve again and now its at 130. Now I don't know what to do as the surgeon said about there were limitations imposed by a tkr and I don't know if I should stop now or just carry on regardless. Every morning for the first 5 minutes of walking there is no pain but it feels like the knee has been filled very heavy gear oil, is that normal? I don't see the the surgeon again for another 3 weeks, any ideas anyone?

    Regard Paul

    • CazDesmond
      CazDesmond paul57039

      Posted

      This makes me wonder why they don't just sell them to us TKR peeps, or give them to us. I'm sure it would encourage us to exercise more.

      Caz x

  • britta217
    britta217 joansgarden

    Posted

    hi joan -- bless your heart, i can totally understand you being worried.  as caz reminded you, i was so wound up on the day i was really tearful and jittery.  but really - and i am being totally honest - i shouldn't have worried.  first of all, you are only under for 5-10 minutes so the dose of anesthesia is very, very small.  i really don't think it will affect your heart but as somebody else said, absolutely mention it to your doctor.  in my case there was NO swelling and NO additional pain so there was also no steps back.  remember, there is not cutting, it is more like how you feel when you haven't done any exercise for a long time and you go to a power bootcamp class.  the next day your muscles are screaming.  same thing.

    if there is any way you can rent a CPM machine for a couple of weeks, that would be amazing.  this will not replace physio, but really helps your confidence as it shows you what you can do.  stay on it for as long as you like.  i have only just given mine back a couple of weeks ago and i really, really miss it confused

    thinking of you and sending good vibes.

    • joansgarden
      joansgarden britta217

      Posted

      Thank you Britta! So good to hear those details. I'm going to stop worrying. I don't normally worry like this but tkr has turned me into some kind of shrinking violet. I wonder if it's not just all the medications that are messing with my head. Other people have mentioned that they have lost confidence and I can easily see how that can happen.
    • britta217
      britta217 joansgarden

      Posted

      confidence or the lack thereof is a killer, isn't it? that's why i recommended you get a CPM machine. when you can see - black on white - that you are bending the leg at 130° and are having no pain, you can hardly believe it. or that's how i felt. but you need to see it to believe it as it then helps you with other things you cannot do now, such as walking down steep stairs. i would remember being on the machine and would tell myself, if i can do it on the machine, i can do it walking down stairs. the feeling is one of elation! just like when i got on the bike at the physio last week and happily pedaled away. i was very apprehensive but once i was on it, i wondered what had stopped me until now. that damned pain memory! all will be well, joan.
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