Hanging legs over edge of bed to regaining ROM?

[fitnesskitty]

Hi Tanya,

I posted this in the other thread we are posting in, but thought I would paste it here in case you or Chris missed it in the other thread. :-)

I am able to get around with a bit less pain today.  I can work my CPM up to 100 degrees with some pain.  My surgeon said to push hard, that I could not hurt it now, and that getting ROM back is crucial and that I get it ASAP.  He gave me pictures of my knee from during the surgery, showed me the scar tissue, etc.  He also said I have some damage to my patella that we would deal with after this injury is healed and all, but I am scared it is serious and might need more surgery.  I am hoping that if it does, it will be something I need later in life, not right away since I do not engage in contact sports or anything, just low impact cardio on ellipticals and stationary and recumbent bikes when I am healthy.  I think it had something to do with cartilage under my patella, or lack thereof?  He showed me my normal meniscus, ACL, MCL and PCL, so I guess that is good at least.  If anyone has thoughts, please let me know, and wish me luck on getting my ROM back quickly.  My other issue is that I emailed with my employer's HR manager today.  She says I need to be back at work on the 19th because my job protection runs out then, and that they would be happy to accomodate me if I have crutches, etc. In the US we have job protection under the Family Medical Leave Act for 12 weeks, and mine is up at the end of next week.  Do you think I will be reasonably healed in a couple of weeks?  It is only a three day week.  I guess it would be a good way to get back into the swing of things.  I was able to get in the front seat of the car today and I was comfortable and I feel strong enough to drive.  Maybe I will test it out around the neighborhood later on this week.  Hmm.  Anyway, that is where I am at.  Also, I have asked for a modified schedule that would allow me to work the full week but still allow me to come home, take my narcotic before therapy, give it time to kick in and then go to the session.  We will see what happens.  I am trying to get to 105 or so on the CPM machine by the end of the evening!

Take care and hugs!

Sarah

[ChrisC]

Sarah
You are doing great with the CPM and leaving me behind in the "ROM race", although I did get to 92 degrees with my left leg yesterday. How did you do this evening? Do you watch TV or play games while on the CPM to take your mind off the pain? People laugh when I say my Game Boy is a great painkiller!
You need to get your OS to clarify what the remaining problem with your patella is and how they intend to deal with it. Perhaps they could do a temporary fix with keyhole surgery and monitor it in case it needs something more permanent later in your life. You have been through so much recently I think you could do with a break to get on with your life for a while. I am trying not to think about having my new knees replaced in 10 or 15 years time. I can only hope that things will have improved by that time to make it easier next time round.
It's impossible to predict whether you will be fit to go back to work in two weeks as I don't have the same underlying problem as you. If you only work three days then perhaps you could do Mon/Wed/Fri in order to have a day's rest in between. If it's too tough could you take a week's annual leave to give you longer to recover?
Best wishes
Chris

[fitnesskitty]

Hi Chris,

Good work!  I am glad to hear you have made some progress.  Slow but sure works great!  I wish you the best.  I hope that it continues to come back for you.  I've thought about the vacation time.  I might be able to take one day each week for a few weeks even to allow for three day weekends in between working.  I am not sure how I will work it.  I am sure I will figure out something, since I really have to anyway; otherwise, I could lose my job.  I hate all those job protection things because sometimes 12 weeks isn't enough time and after that, they do not have to protect your job any more.  How annoying.  As you well know, sometimes it take a long time to recover from an injury and/or surgeries.

Okay, I will stop complaining now.  Wish me luck at PT tomorrow.  Hopefully I will get a lot more degrees.  Sometimes I get more on the CPM machine than when they are cranking on my leg at PT.  I am hoping she is able to measure at least 90 if not 95.  I will post after the session which is late afternoon tomorrow.  I was so excited that I was finally able to sit in the front seat of the car today for the first time in months.  I cannot wait to drive and walk normally again.  Once my knee is less sore, I am going to try to ditch the crutches one at a time.  Right now I am icing my knee down.  I have been on my CPM machine for 18-20 hours daily.  I think I could use a bit of a break! :-)  The OS said it is crucial that I push for my ROM as quickly as I can so I spend as much time working on it as is possible, stopping only to ice and use the bathroom, etc. 

I hope you are having a great evening.  Keep up the hard work!!  What are you doing at home to work on ROM?  Have you had a lot of pain when your PT is working on your ROM?

Best of luck!

Sarah

[fitnesskitty]

Hi all,

Here is my update.  Chris, your 92 is leading right now!!  I just got back from PT a little less than an hour ago.  I got 90 degrees today.  The CPM allows you to get more at home as you are relaxed and lying in your bed and also they can be inaccurate, but my measurement was still great!  It is 10 degrees more than I got last Friday.  My therapist says most people do really well once they get to 90, that it is a huge milestone, so I am pretty proud of that.  I hope to get 95 or better on Thursday!  Wish me luck.  I got down my steps without my stupid old brace today and I can ride in the front of the car now.  Tonight I am going to try a regular shower, except seated on a stool!  Yay!  Little victories are nice, keep us motivated!  I am not going to be sad because I got more ROM on the machine because I know I tense up a bit at therapy, and it is still 10 whole degrees more than I got last Friday!  I have a sore tendon or muscle in my thigh that hinders my ROM some too, so once that is less sore, I am sure I will move forward even faster. There is also some swelling.   I am so looking forward to riding the bike again soon!!!! 

Anyway I am off to the shower!  Have a nice evening and I will be on tomorrow!

Take care!  Hugs!!

Sarah

[ChrisC]

Sarah, I am no longer leading the ROM race as I only got 90 today (in both legs). My left knee was sore and swollen this morning for no apparent reason, so I massaged first, then dangled for 15 minutes, then pulled up on the board and measured. I was a bit disappointed but just keeping my fingers crossed that I will get more tomorrow when the PT measures, which is the only one that really counts.
I am able to sit in the car comfortably now for about half an hour which is great and increases the number of places I can go to. I haven't tried driving yet but am hoping the PT will say it's okay when I see him tomorrow. He wanted to check with my OS before giving me the go-ahead. He is also checking whether I can ditch one of my crutches, as the OS said it would be two months but the PT thought I was ready. It's hard to know what's going on when you get different advice from everyone!
Being able to shower is great, this week I had my first standing up showers. My shower is over my bath and since coming out of hospital I have had to sit on the bath board and get my partner to hold the shower head and hose me down. I still need help getting in and out but it's a step closer to independence. What I am really looking forward to is my first bath in 3 years but I'm not ready for that yet as I don't think I could get out once I got in.
To work on my ROM I use a combination of different methods. I dangle for as long as is comfortable (increased today from 10 mins to 15 mins); I get my partner to bend my legs gradually while I lie on my back with my legs over the edge of the bed (staying in each position for a count of 10, then 15, then 20, then further in for 10 etc); I sit on the bed with my legs out in front of me and slide them towards me the same way the PT measures them. I play a game and try to hold my leg in tight for one level of the game, then change to the other leg for the next level. By the way, these exercises are know in our house as "dangly leg", "bendy leg" and "slidey board" respectively. The other thing I do is use the minibike, varying from 2 sessions of 300 up to 3 sessions of 500 depending on how I feel. You might find this a good substitute for the CPM when you have to give it back.
Good luck with your measurement at the PT tomorrow. I am going tomorrow too so will report in and compare notes.
Best wishes,
Chris

[tanyap]

Hi Chris,
I love your dangly leg, bendy leg and slidey board names!!!! Youre working very hard, I really hope you get good news off your PT about the driving, itd make all the difference to you.
Getting in and out of the bath is a difficult one but actually I find standing in the shower scarier - maybe cos Im so dislocatey, Id be afraid Ill skid on the shower floor on my gammy one.
I mostly used to use my upper body strength to get in and out of the bath, Id sit on the edge, gingerly lift my leg in, and then hold the sides with my hands to lower myself. I can step in and out now, but I still compensate getting up from the seated position in it.
Good luck with your PT appointment!
xx
Tanya

[ChrisC]

My PT appointment for today has been cancelled and rearranged for Monday 19th so that gives me plenty of time to make some improvement. As for the driving I am going to phone the OS's secretary and try to get an answer that way. My car is an automatic so I only need my right leg to drive it.
I think I could get myself into a bath but it is the getting out again that worries me. When I only had one sore leg (before the meniscus tear) I used to tuck my left leg in as tight as possible then haul up on the handgrips. Now I can't tuck either leg in tight and because I have changed my bathroom I don't have any grips to get hold of. My partner's aunt has a hoist in her bath because she had a leg amputated, she keeps asking us to go and stay with her and it might be worth the 400 mile round trip just to have a bath! There is a whole list of things that I haven't been able to do for years and want to get back to, but having a bath is number two on the list! Number one is riding my motorbike which I hope to do in the spring.
What things are all of you looking forward to most?
Best wishes
Chris

[tanyap]

wearing high heels!!!

[fitnesskitty]

Hello All,

The bath thing presents me with the same challenges as you, Chris, so I sit on a little stool to shower.  I think once I get more muscle in my leg I will take regular standing showers and once I get 120 degrees of flexion, I think taking a bath will be more feasible for me. 

Chris, you and I have opposite views of PT.  You see the week away as a chance to improve whereas I am desperate to go and see where I am at.  I want to go and get measured even though I will not likely have a huge improvement since I was just there on Tuesday and I will likely feel discouraged if I don't get more ROM.  My big fear is getting less ROM because of how I was before my scope and MUA.  I am afraid of scar tissue.  I also wonder how much time per day exactly I should spend working on ROM...I am in the CPM machine all night and of the day, probably around 16-20 hours and I am starting to sit at the table and push my bad leg with my good leg and a couple other exercises for ROM, plus strength exercises.  My fear of getting scar tissue is immense and I am afraid to rest much.  If anyone has any thoughts on how much rest is okay, that would be great. I ice 2-3 times per day for 20-30 minutes to help with swelling.

Anyway, thanks for listening to my neurotic whining! :-)

Hugs!!!!

Sarah

[fitnesskitty]

Hi All,

I just got back from PT a bit ago and I want to chew off my leg.  Boy was that painful.  Lots of stretching today.  I know it will be worth it in the end.  Right now though, it kills.  I got 92 degrees before we did any exercises with some pain.  Then we did some stuff in the gym and she stretched me some more (OWWWW) where I swore a couple times, but she didn't measure but figured I was around 95 or 96.  I go again tomorrow.  Wow I actually felt nauseous after so I now get what you were saying Tanya.  It is awful.  I didn't barf thankfully but it hurt a lot.  I just icec it and have it elevated.  I am going back to my CPM in a bit but boy do I hurt right now.  OW.

Okay, I will stop ranting and whining now.  Thanks for listening. 

Hugs!

Sarah

[ChrisC]

Sarah, do you ever wonder whether you need to have a sadistic streak to become a PT? I wonder what the interviews are like? Maybe they have to do a multiple choice aptitude test to see whether they are mean enough to do the job. Maybe some get a rejection letter afterwards saying "We regret to advise that you have not been successful in your application because you are too nice. Perhaps you should take up nursing instead."
Re your pain, hope it passes soon and keep up the ice. Here's a tip: if you have two different types of painkillers (ie with different active ingredients) you can take both at the same time. I have Tramadol and Co-codamol and in times of desperation take both either together or about an hour apart. I know I'm not supposed to take anything anti-inflammatory but on the odd occasion take a couple of Ibuprofen to top up the other painkillers. Just make sure you're not combining paracetomol with co-codamol as this also contains paracetamol.
I am concentrating on the minibike for the next few days. My partner is away till Sunday so I can't do "bendy leg" and my daughter is coming to stay tomorrow so I won't be able to do "dangly leg" because it's only the spare bed which is high enough for this (I've got long legs). I've done 400 + 500 revs so far today and hope to get another couple of sessions in later along with some dangling. I will get him to measure me on Monday and see whether it's done any good.
Have a good weekend (as far as you can on the CPM!).
Best wishes
Chris

[fitnesskitty]

Hi All,

I've caught a nasty flu and have been sick since late Thursday night, and will catch up with you all when I am feeling better.  Hope you are all doing well.

Hugs!  Take care!

Sarah

[fitnesskitty]

Hi Chris,

You're so funny!  That sadistic thing made me laugh!  I think it actually takes a strong will to help people recover to be a PT.  I would think it is hard to watch people suffer when they are inflicting the pain.  It takes a strong person to be able to overcome that and remind themselves they are helping us through our problems and are getting us back to real life.  I would imagine it can be stressful work.  However, when they are making me cry and swear with pain, I too think they are sadistic!  For those minutes of my session, I hate my PT.  Other times, I think she is wonderful.  I am hoping for full ROM in the next few weeks so that the pain will be over soon.  I sometimes have no idea how I will get through it.  It is so hard!!!!  I still don't know how I will get through these painful sessions.  I am sure I will but I don't know how.  How do you get through it?  My vicodin does nothing for the pain during PT but seems to help a little after.  I come home and immediately ice my knee for a bit and elevate it.  Then later, I try to work on ROM some more before bed although I don't often get far.  I use the CPM now but don't know how I will be after they take it from me on the 21st.  I hope I don't loos ROM and do really well.  I am scared to be without it but I guess I should not rely on it forever.  Is your knee stiff in the morning?  What do you do to warm it up?  Oh and I got 92 last Thursday before exercises, then 95ish after exercises at PT.  I was supposed to go Friday but was so sick, I could not and I feel guilty about that.  Next session is Tuesday!

I have to see my rude OS tomorrow, and am nervous.  He is never happy with progress and always makes me feel bad, but my PT says I am making progress, so I am trying to not let him get to me.  They get cocky and forget that everyone recovers differently.  THey want you to get ROM on their time frame.  SOme of us do not gain as quickly as they would like.  I think they sometimes take it personally and that is the reason for the attitude.  I will not let him get to me.  I will beat this thing and be better than new, I tell myself!  He is taking out the stitches tomorrow.  I hear that doesn't hurt.

I will stop here for now.

I hope you are all having a great day!  Take care and write soon! :-)

Hugs!

Sarah

[ChrisC]

One of the things I do to deal with pain at the PT is to take two types of pain killers: Tramadol and Co-codamol, with an hour or so between. Because they are not the same active ingredient it's okay to do this from time to time. I also take ice with me in the car so that I can start icing on the way home. I use the wine cooler packs and take them in an insulated lunchbox wrapped around a solid freezer block (the blue plastic type). I also keep this next to my bed in case I need to ice during the night if the pain is particularly bad.
When they take your CPM I would really recommend getting a minibike. Just cycle slowly on it and it will have a similar effect to the CPM. You adjust the angle by moving it slightly closer to you. I usually do about 400 revs per session, but have done up to 600 before now. It doesn't take up nearly as much space as a normal exercise bike.
I am always stiff in the mornings but manage to get going by walking to the bathroom and back, then doing my quad exercises and straight leg raises, then I massage my knees with Emu oil, starting with my thumbs and then using my knuckles. Then I have a quick dangle before attempting to get down the stairs. I am lucky in getting breakfast in bed and don't normally come downstairs till just before 10 when my favourite TV show is on. Then I cycle during the show for 400 revs.
Hope your OS appointment goes better than you expect. Let us know how you get on.
All the best,
Chris

[fitnesskitty]

Hi Chris,

Thank you for the advice.  Where did you get the minibike?  Are they expensive?  I would really like to order one before they come to get my CPM machine.  I am going to try sleeping tonight without my CPM machine.  I don't sleep well with it and need to get some rest.  I am SO exhausted.  Any tips on comfortable sleeping positions?  I hate to sleep on my back but cannot get comfortable on my side.  I was about 95 at therapy last week.  I am hoping to get to 100 tomorrow though the pain is unbearable.  I am scared to take ibuprofen to boost the painkiller effects because I was not allowed before surgery and I don't want to risk getting more scar tissue.  I find that my vicodin does nothing during the stretching parts of therapy but I hear this is a common complaint, that most people don't have luck with painkillers during therapy.

My appointment went very well, to my great surprise, he was nice to me and said I would likely regain full ROM.  He was pleased to see me sitting with legs over the edge of the table and I dangle at nearly 90 degrees now.  Oh I have one more question...how much time do you spend on ROM and strength each day?  Also, does the minibike turn on a smaller revolution than the regular bike?  I can't turn a revolution on the stationery at PT.  I got a work release for Monday, they 19th.  I am excited and scared but had to see if I could go back because I don't have any more job protection left.  This is my last week.  It is sort of bittersweet.  Now that I am starting to get better, I can't be home to enjoy it.  I can't wait to be fully recovered.  I am hoping to be in great shape by Christmas as I want to take the week between Christmas and New Year's off.  When do you go back to work?  I wish I could be home to enjoy the holidays!  I am envious!  I should be much better by the end of December I would think?

Anyway, I am off for now.  I need a little nap after the night of no sleep on my CPM machine.  Have a great day!

Take care!  Hugs!

Sarah