New here & 2 weeks after TTO and don't know what I can or cant do

[lululocket]

Don't worry too much about the bending- there is no point worrying about whether it will hurt or not until you get there! I've found that bending is painful right near the limit, but actually going from straight to a few degrees off the limit and back again was actually quite NICE, and I liked getting some movement in it! I did heel slides on my own at home, using my hands to help. I also got my mum to help based on my physio's instructions.

Have you started any heel slides yet? http://www.kneeguru.co.uk/KNEEnotes/node/1142 It would be good to take your brace off and have a little try before you get to the physio as you'll be able to use the time more constructively. I was allowed to do this 4 or 5 days after surgery, using my hands to move my leg carefully.

The scar tissue and swelling can limit bending, so if your knee is still swollen (probably is) then keep using ice for 30 minutes a few times a day, wrapped with a cloth to protect the skin.

When you reach the bending limit, your physiotherapist will assist you in bending it a little more - pushing to break up the edge of any scar/tight bits a little bit. This can hurt with a bad physiotherapist. However, it is all about communication - my physiotherapist is GREAT (and my fifth in two years, so I know the good from the bad, trust me). The reason he is so good is that he explains to me what he is doing and why it may hurt, but why we need to get through it. That makes me motivated to get the treatment done, even if it hurts. Then, he asks me the whole time how much pain I'm in, and makes it clear that he will stop if I want. He aims to get up to a 6/10 in pain, so quite a lot but bearable. I now say it's a 'brave 6', meaning it is very painful but keep going as I'm feeling brave, or a 'bad 6' meaning it hurts and I am not coping so well.

[Fogie]

My OS told me that Im to keep my brace on full time for another 3 weeks & it is then I will be bending my knee & he said he will bend it 30 degrees in another type of brace which is called the dunbar, I think thats what he called it, it sounds something like it anyway.  No he didn't get me to do any heel slides yet & I won't be meeting physio till I'm 6 weeks post op.  I seem to be doing way less physio & progression than ye are but hopefully when I start I won't be long catching up.  Keep up the good work with the physio!

[lululocket]

It will probably be a brace like mine below, which has a joint in the centre which you can set a limit on, so it will be able to bend up to 30 degrees. Fun! 
http://www.donjoy.com/index.asp/fuseaction/products.detail/cat/2/id/40

[Fogie]

Thanks Lululocket, I can't wait    It feel like I am progressing to the next step of my recovery   

[Fogie]

Hi Lululocket, I was just wandering how long were you wearing your donjoy brace for & how many hours during the day did you have to wear it & did you have to wear it in bed

[lululocket]

Well, below you'll see that I've given you my timeline. BUT, this is my second TTT, so I know the drill pretty well. So far, I've made a much better recovery than last time, and I wasn't so afraid as last time. I'm healing much more quickly, and have got out of the brace more quickly. Thinking of last time, I'd increase everything by 50% (so 1 week becomes 1.5 weeks, 6 weeks becomes about 9 weeks, I'm not kidding...). Also, there are lots of variations of the surgery, so you may need more or less protection than me, so don't get too obsessed by comparing everything against others as we're very unlikely to be identical.

Having said that....I do personally think that within two weeks of surgery you should take your immobiliser off whilst sat on a nice sofa with your leg out straight, and do some foot pumps and some facilitated heel slides. Remember, this is just a little bit of bending using your hands to support everything whilst sat on a sofa, it's very different from bending 30 degrees whilst up and about on crutches, which I would expect to come much later. I realise that your OS hasn't particularly recommended it, but 6 weeks is aaaages to go without bending your leg at all. If you leave it that long, then it probably will hurt    I would contact his office, tell him you really want to try some heel slides, and ask him if there is any medical reason NOT to do that. Unless you've had some other surgery done than a TTT, physios would have you doing heel slides fairly soon.

I've checked back over my diary at
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=58973.15
First few days I wore it all the time, locked straight (so the same as your immobiliser).

After a few days I was allowed to take it off to do facilitated heel slides only (I started on day 6, and headed slowly up towards ~4 times a day to keep it moving). I also started seeing my physiotherapist after one week, and would take the brace off for the sessions with him.

After two weeks had passed, I had my stitches out, and was allowed to take the brace off to have a shower (being careful!), and also allowed to take it off when I was just sitting still in bed or on a sofa and wanted to be a little more comfortable. When walking around the house with crutches it was still to be worn locked straight, but I was encouraged to put up to 20kg weight through my leg (my physio had me practice with weighing scales). I was allowed to sleep without the brace at that point if I really wanted to and 'wedged my leg in with a pillow' (OS's words), but I ended up still wearing the brace to sleep in case I moved until about the three week mark I think.

At the four week mark the brace was unlocked to 60 degrees bend. It was scary, but after about two days I got the hang of it.

At the six week mark, I had an xray that showed...well it actually showed the bone hadn't completely healed, but apparently it was almost done, and good enough to walk on (full weight bearing). We ditched the brace completely at that point. I happily got back in the car without it!

[Fogie]

Thanks very much lululocket, this is great.  It really helps alot. I am so thankful.  I actually took the brace off, I mean immobilizer & stocking for 5 mins last night &  the night before it seems to be driving me mad sometimes & I feel my leg needs to breathe.  So I think I will ask the nurses about leaving it off when I sitting on couch or bed & about heel slides, when I see them next day coz find it alot easier to talk to them. 

I was a bit down again yesterday feeling sorry for myself especially being in pain & not being able to do much.  But thank god the Sun was shining today & my husband set up the sun lounger while I watched him play football with the lads, he has been wonderful doing the cleaning & cooking, I don't think I would have managed only for him, you do need alot of help after this op.  The pain seems to come &  go & I am still on painkillers. One other  thing I do know for next time when I get my other knee done   ask more questions, bring a nightdress, not a pj's.

A friend of mine, brought me a lovely maxi dress & has offered to turn it up for me to have for my next appointment instead of wearing tracksuits  : )  Meeting nurses tuesday so I'm hoping my wound is ok !

[mrschandrad]

Have you been doing the quad strengthen or a SLR?
That's something I was doing on my own before going into PT...only because I knew they were going to have me do them and I wanted a head start.
I would suggesting doing them as "hard" as they will make you but start. I was doing quad strengthening 2 session a day 10 times per session holding for 5 seconds...just so that I wouldn't lose all muscle strength.
The SLR I would just do randomly throughout the day. Not raised very high and I would hold for 5 seconds, doing about 5 or 6 each time.

When are you going to start PT? We had our surgeries about a week apart I think...

Chandra

[Fogie]

Hi Chandra,  I was operated on the 17th April, I have been doing quad strengthening from around about 2 weeks post op even though I have done much the last 2 days because I have been quite sore & as for SLR I can't seem to rise my leg yet  when I try doing lying down putting my other foot under to give it a head start I seem to be pulling a little on my back muscles.  They are starting PT 6 weeks post op 29th May, I am so looking forward to them & he is putting me on a Dunjoy brace & bending my knees 30 degrees then.  I seem to be on a less aggressive pt at the moment but I reckon when I start it will be full force ahead.

The last couple of days I seem to be very sore around the knee, I reckon thats from the travelling in the car to appointments.  I am in the front seat as the lads are in the back.  I talked to the doc & nurses at my last visit on tuesday  & they said I am not to be doing any Pt only for the squeezing the quad muscles & to try & do SLR which I am finding impossible at the moment.  I have hired out a wheel chair with a leg support for the concert & I will be sitting in the back seat to keep my leg raised with plenty of pillows so hoping the journey won't be too painful. My leg is still very bruised & swollen & I still have bandages on under my stocking & immobolizer brace but they said my wound is healing very well    I was trying to wean off my painkillers but I have gone back to stronger painkillers today because leg was even getting too sore to my quad clenching pushing knee back against surface.  So I am doing 20 clenches five times a day of the quad muscles & I always try & do an SLR once every morning.

[Fogie]

Yesterday, I went to the concert, hired out a leg support wheelchair.  I travelled in the back seat with my feet up with a few cushions for added comfort, for a change as we had none of the lads with us.  It was alot more comfortable than sitting in the front with my leg down.  My leg started getting uncomfortable during show so took extra painkillers so that I could enjoy the show.  The show just rocked & I enjoyed the rest of the night.  The staff at the venue were so helpful which was great because I was dreading the journey & the concert itself incase any one might trip over my leg, there was a different exit for people in wheelchairs which was fantastic & we just avoided the crowds outside.  My leg started getting sore again on the way home again : ( but was able to sleep when I got home as I didn't get to bed till 5.30 a.m. in the morning and was wrecked.  My husband got up for the lads, he has been fantastic.  Today got sick I reckon it was probably from extra painkillers from night before & I am still not feeling the best.  My leg is stinging like mad today too although I have it up all day.  Don't feel a thing when I am icing leg but when ice is gone it starts to sting again so taking it easy & I am also taking painkillers.  Hopefully it will settle down tomorrow.  I have cancelled the holiday, because I reckon it will be too much.  Going to have an early night tonight.

[Fogie]

4 weeks & 5 days post op

I am feeling fairly frustrated today because it seems to be such a slow process.  I am still doing quad clenches 20 times repeating that 5 times a day & pumping my foot also.  Every morning & after lunch I try to do SLR's but no, nothing happens & sometimes it feels like that something is dripping in my knee.  I am afraid if I can't do SLR's before my next OS appointment he will think I am not trying.   

[lululocket]

I thought this might make you feel better, quoting from my diary

Day 30

Well today I kept my brace off all day (didn't really go anywhere). I should probably put it back on tomorrow and do some walking with my partial weight bearing to practice.

But right now I just want to say ARGH I AM BORED OF PHYSIOTHERAPY WHY WON'T MY LEG LIFT GET EVEN WHEN I PULL A SILLY FACE

Ahem. Well, my physio did say I needed to get angry. One more session left today why oh why.

My point is, even though we were more aggressive, so I should have been a teensy bit ahead of you, and at that point I was meant to be putting 20kg through my leg as I crutched around, I still couldn't do an SLR. In fact, I think it was just barely before the 6 week mark that I managed the first one. So don't worry too much!

I'm so sorry you're frustrated. I don't want to just say keep trying, but you know it's true.... And we've all be there. How about a half day off? I have 3 or 4 physio sets a day now (10.5 weeks now!), but I still often take a day or a half day off a week in order to stay SANE, and my physio says that's ok.

Oh, and tips and tricks for SLRs in the next few weeks - try them lying down as they are a little easier (you can cheat a little with your stomach muscles getting involved). Also, try hooking something around your toes like a belt so you can pull a little with your hands, so it's assisted a bit.

PS, Sorry to hear about the holiday, but hopefully that means you can go on one later when you can walk really well and it will be GREAT!

[Fogie]

Hi Lulu,

Thanks very much for your kind words of wisdom & support, it really does help alot.  Today I am feeling a bit better I actually took a half day off doing my physio & I hate to say I didn't try doing the SLR yet but I will try later.  I will definitely keep trying the SLR's & I will try out your tips, thanks.   Last night I thought to myself tomorrow is a new day & I am going to start afresh, so I decided to take some time out from physio & to have a break from the house.  My husband drove me to my local toddler group which is only around 3 miles over the road and it was just what I needed, to feel some bit of normality.  I sat down with my leg resting on the couch.  I brought my belt from my robe with me.  I carry that with me always so that I can lift & lower my own leg.  I had a  cup of tea & some nice lemon icing cake while my little boy went playing with the other little children.  It was great. 

I also now have started learning french, as we are planning a holiday hopefully next year to Disneyland, Paris, please God everything going well.  My knee still stings, it just comes & goes & it swelled up alot last night.  There is also alot bruising still on the back of my knee.  Nothing more to report.

Take Care,
Fogie

[Lorikeet]

It's good to hear you are getting out and about a bit now. I have found life is feeling a lot more normal now that I'm able to drive again and can go about some of my normal activities. I'm still feeling like I'm moving in slow motion at times though.

Sorry you are having the stinging and swollen knee still. I'm still getting swelling quite a bit now at seven weeks so I think some of us are just more prone to it than others.

[Fogie]

Thanks Lorikeet.

5 weeks & 1 day post op

Today have been a good day     After two weeks, I finally was able to do 2 or 3 SLR's today, using your tip lulu, thanks.  I looped my robe belt around my toes to lift, feeling pressure in my knee so I knew I was working some muscle then last night I lifted my leg again with belt & let the belt drop & have my husband have his hands underneath my leg & it dropped.  So this morning I lifted leg again with belt, I dropped the belt & was able to keep my leg in the air for a sec or two, yeah !  So I decided to do it again without belt & yes I lifted my leg twice without belt.  It felt like I won the marathon ha ha !  I was sweating afterwards & have tried since but can't seem to get it up again but its a start in the right direction.  I do feel a bit of pressure on my knee when lifting & it does sting a little bit afterwards.  Oh I can't seem to do the SLR lying down only sitting up with my other knee bent & I have my hands wrapped around that knee.  I have cut back on my medication again just taking 2 difene tablets & 4 paracetomal.  How long does it take for the swelling to finally go, coz when I am at home, my feet are constantly up.  Tomorrow I am 15 years married, so I am hoping to give the husband breakfast in bed for a change with the help of my eldest boy who is 7, he normally gets up very early, thank god so I won't have to wake him.  I have also invited two friends to call over, who is bringing wine & snacks with her.  He thinks I have forgotten so he will be in for a nice suprise!