The TKR Recovery "Bell Curve"
Posted , 20 users are following.
For the brave of heart and mind, I offer this "conjecture" from a former, old world statistician...
If we look at recovery times as a normal bell curve distribution (not saying it is but humor me), then 95% of us fall within two standard deviations from the mean. For argument's sake, let's say that those two standard deviations run from a 6-month recovery to a 12-month recovery with the mean at 9 months. (Again...conjecture...these numbers could be more or less but probably not by much.) That leaves the other 5% at 3 or more standard deviations from the mean (2.5% lower than 6 months / 2.5% higher than 12 months). These are the "outliers". Every distribution has some.
On the left side, are the 13-week mountain climbers while the 18-month recoveries are at the far right side. All understandable...all part of a normal statistical bell curve distribution. Think...smoking will eventually kill you. Proven fact...but not for everyone. I had a 103-year old great-uncle who smoked his little black cigars every day and never got lung cancer. Outlier.
The thing to remember is that this 5% are the exceptions and NOT THE RULE! The rest of us mortals are stuck in the 95% umbrella and have to deal with real life. I have pity for those at the far right end of the curve...they need to be brave souls...
At the beginning, I mentioned "conjecture". In reality, I don't know of any study done on TKR recovery times and what the mean or standard deviation might be. I'm just throwing this out there because so many people compare themselves to those rare individuals who beat this in a matter of weeks. DON'T DO THAT!!! They are the outliers, the weird individuals who have the built-in DNA to overcome this brutal recovery in seemingly no time at all.
You have seen sooo many of us counsel people not to compare your recovery to that of anyone else. Take that to heart...and know one huge truth...
You will not know where you fell within the bell curve UNTIL YOUR RECOVERY IS OVER!!! You can't see it while you're going through it...only from the outside (post-recovery) looking back in.
Be Zen: "It will be over when it's over." Just like asking your dad on a car ride when you were a kid: "When will we get there?" Remember his answer? "WHEN WE GET THERE!"
10 likes, 35 replies
judy17487 CHICO_MARX
Posted
Chico,
You're so wise. Please help me respond to a friend who had two TKRs, and is in the 5% range. It's almost 6 mos, and I'm still doing PT bc leg won't go beyond 4 without manipulation.
Friend keeps telling me that no one should still be doing PT at my stage. How do I make her understand that it still hurts to walk a lot; descend stairs; giant rubber band; burning pain in calf sometimes; pain during sleep; aching like mad in different places.
I should mention that that I wasted over 2 mos. of rehab with Physio who made me do exercises with weights and only touched my quad when he pushed on it like 50 times in a row at end. He never measured unless I asked, and nothing was happening.
ok I don't mean to hog the floor, but I get sooo discouraged...
TY
CHICO_MARX judy17487
Posted
Discouragement is not an option...
https://patient.info/forums/discuss/tkr-and-ptsd-569521
I fell out of "the bell curve" in October when I developed severe stenosis of L2/L3 in my spine. Think...sciatica down BOTH legs!!! Then you walk bent over to relieve the pain so you put all the stress on the already atrophied quads. Constant leg, butt, hip and back pain. This has not been fun...
But my surgery is this Friday (3/24/17) and we're hoping that it does the trick. One option was to unzip my back, taking out all the L3-S1 hardware, putting a spacer in L2/L3 and re-fusing me L2 through S1. Ten days in the hospital...six months rehab. The second option was to get to my spine from the SIDE and insert an EXPANDABLE spacer. Then they use an Allen wrench to crank it open (like a jack lifting a car) which relieves the pressure on the nerves. Overnight stay...no rehab. Yeah...I think I'll do that one...
Once done, I can then resume my knee rehab and get back all my leg strength. Figure that maybe by summer I'll be fairly normal again. We'll see. I just endure, survive and get past the next obstacle I encounter. No other way...
eileen15268 CHICO_MARX
Posted
CHICO_MARX eileen15268
Posted
No choice...it's the only fix. No drugs, pain shots, therapy, chiropractor... When the nerve roots are compressed in the spine, the only person to see is your neurosurgeon. You can spend years living in pain when the solution is known. Just do it...
june68495 CHICO_MARX
Posted
Prayers to you!!
You are an inspiration!!!
Thank you!
june68495 CHICO_MARX
Posted
I love love love this!!
It's awesome!!
I hope everyone reads this... it's makes me feel hopeful!!
I am 4 months after Tkr and everyday is a new day with ups, downs and everything in between !!
I think the unfortunate part is at least from my experience is the the surgeon gives you unrealistic expectations of what to expect and the time frame in which it can be achieved!!
Makes you feel bad, depressed and defeated!
You have to get past all that and read these comments from real people!!
Thank you
CHICO_MARX june68495
Posted
I took my experience plus everything I read from soooo many people, examined scientific articles and finally applied my very rusty statistician brain to the problem. I wanted to put "recovery time" into a framework that people could understand because, except for people undergoing a second TKR, ...
ALL OF US HAVE EITHER ZERO OR COMPLETELY WRONG EXPECTATIONS OF WHAT THIS WILL BE LIKE!!!
For me, mine were the latter. In the past 17 years, I've had four knee scopes, two shoulder ops, a stomach resection, hip replacement, carpal tunnel and ulnar nerve reposition, double hernia, seven trigger fingers, two wrist operations, an L4/L5 laminectomy, an L3-S1 spinal fusion and more PLUS four kidney stones. I thought this would be a cakewalk like the rest of them. I ALWAYS kicked rehab's a$$ in weeks, not months and bounced back perfect every time. Then came the knee...
Literally unconscious and writhing in pain for the first two months. Threw away the walker and cane pretty quickly but the pain was insane for me as I'm pretty immune to opioids. I just had to bear it day after day, night after night. 10 weeks of PT was brutal but I went from -14 / +84 all the way to -1 / +123. Had sciatica 5 weeks in but a chiro helped with that.
Then 8 months post-op (last October), my recovery stopped when I got stenosis at L2/L3 (like sciatica but down BOTH legs). Had to wait until this past March 24th to get that fixed via a great LLIF op. Now I'm dealing with the post-op nerve pain and have to wait another month to get the surgeon's clearance to hit the gym and finish the knee rehab.
So for me, I'm on the far right side of the curve because of the stenosis. Figure I'll be back to full strength maybe by late summer-early fall...if I don't get hit by a bus. This is not easy...and you have to take it as it comes. No expectations...no guarantees. The expectations are merely Jedi Mind Tricks guaranteed to get you frustrated and depressed. That path only leads to The Dark Side...but the good thing is that they have the best cookies and ice cream over there. RESIST!!!
Click my name and check out my other posts...did 18 of them... Enjoy.
june68495 CHICO_MARX
Posted
I enjoy all your comments!
Very helpful and encouraging !
I'm so glad to have this forum!!!
I have gotten so much information that has been Priceless in my recovery!!
Feel blessed to have this help!!
sooverthis june68495
Posted
I so agree about the time frame! My surgeon gives a manual that says at 6 weeks I can resume golfing, dancing, etc. Not sure who is dancing at 6 weeks, but it ain't me babe! 6 weeks today and I can do all the exercises, but can't bend knee past 103*. Keep pushing, but boy it is a bear! In the pool and swimming 5 laps (slow) and it feels better after that. I fugure everyday is a step in the right direction. I am just so over this project!
marilyn10235 CHICO_MARX
Posted
Hi Chico as usual you hit the nail right on the head!
I have had since 2013, 3 Eye operations at Moorfields Hospital, one of which they bring you round & then finish the op, the last one done under LA urghhh. I had 2 thyroid ops, hemi & completion thyroidectomy. Before 2013, I had a gynae op & the arthroscopy.
NONE of which come anywhere near TKR, I bounced back after all of them with ease. Including the cancer op! But TKR is in another dimension, I admit, now, I went into it with the old rose coloured specs! I thought, couple of weeks rest, do the exercises & 6 weeks back at work! Boy was I wrong in every way!
You really put this into perspective! For some it is not a walk in the park, for some (the minority I think) it is! I fell more into the middle of the bell curve but even that wasn't an easy place to be!
Keep on keeping on Chico. Good luck with the knee rehab when it starts, you'll kick it into touch!!
Marilyn
XX
june68495 sooverthis
Posted
So true!
No dancing here and I'm at 4 months!
It's so nice to get responses from real people going through it and not the surgeon!
Thank you and have a nice weekend!!
sooverthis CHICO_MARX
Posted
I'm going for the 6th month! How about you? Wouldn't mine being an outlier to the left!
Great way to look at it, thanks! MyTKR manuel said I should be able to be playing golf and dancing about 6-12 weeks. Told my doc, it lies!
CHICO_MARX sooverthis
Posted
After you've read hundreds of stories on the forum, you'll realize that the docs and that manual can only be described as "delusional". Look above for the link to my TKR PTSD post...think you'll like it...
helen90430 CHICO_MARX
Posted
Brilliant read Chico. Thanks for the link.
You're a wise owl and give positive advice that keeps me going
Helen
CHICO_MARX helen90430
Posted
I was a statistician many, many years ago. This was my best semi-scientific answer to everyone's question: "It's been five weeks...why am I not further along than this?"
BECAUSE IT'S ONLY BEEN FIVE WEEKS!!!!! Geez...
The biggest problem is that no one, not even your doc, tells you about the level of pain and that it's gonna take a year. Then everyone points to that one in a million person who zips past this in a month with no pain and EXPECTS to be just like that. WRONG!!!
Yeah, there are those who skate but they're at the far left end of the bell curve. Maybe they've got DNA that doesn't grow scar tissue? Who knows... Just be hopeful you don't end up at the far right end. Give up all your expectations and own your recovery. You'll be better when you're meant to be better. No excuses...do the work!!!
You'll be fine. Trust your body to heal and do what's necessary to get to the end of the recovery. Some days, you're the bug...some days, you're the windshield. Be the windshield...