TKR 12 months and Strong

[Celle]

@Kiwigirl62
Don't worry about the different protocols - they vary from surgeon to surgeon, as well as from country to country.

My surgeon doesn't allow any PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house.
After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home.
His patients all do well and achieve good ROM, as I did, and he hasn't had to do a manipulation to help with ROM for the past 4 years. I think that speaks for itself.

The most important thing, no matter what protocol your surgeon uses, is not to stress your wounded knee by doing too much, too soon. If you do too much, your knee will stay inflamed and irritated, which will be more painful and could slow down your recovery.

 

[Kiwigirl62]

@Celle
Thanks, i was just curious really. I didn't see my OS as i was conked out before he walked in for surgery. Wont see him til 6 weeks. Although i originally started this process by getting appointment with a top hip and knee man (i stupidly thought i need an athroscope only). He no a replacement.
As i have no insurance i would have to be public. He put me on the list that day.
When hospital rang with date they put me on his list as he overseas ortho unit there and operates one afternoon a week.
Rest of his patients are through private.

So think that is why i have 'flown under radar' re structured PT and limited discharge instructions. But happy with that as have been doing Bonesmart way
Swelling now minor, no offical ROM but on exercycle gently 5mins x 2 daily and other minor stretching and daily living stuff.
Meds now on 2 x panadol 4 times a day.
Pain level mostly 1-2. (Mostly tiny swell and stiffness) Ice for hour blocks 4 times a day.
Am happy with the incremental steps every 2-3 days
PT this week at 3wks PO. ...public system slow but good for me. So happy to date....so do not want to go back to over did it club

 

[Jacimarble]

Hi kiwigirl
1. I didn't have to inject blood thinner, but I did have aspirin for 6 weeks
2. I had compression stockings for 4 weeks. By the 4th week I was sick of them! They gave me dry scaly legs
3. I had my first physio 2 weeks after discharge and have seen him every two to three weeks since. He measures ROM, checks my gait and suggests exercises, and give me some massage on my calf and quad. The next visit will probably be the last. He has never done anything aggressive or that hurts. I'm pretty slack about doing the exercises ( I was better earlier on). Any exercises make my knee swell up.

There does seem to be some differences between protocols and expectations between the different countries. I think we have a pretty good system!!

 

[Kiwigirl62]

3 week update........can't believe it is now 3 weeks. So much better compared to week 1, but so far still go!!!

So had 1st PT today, and got my first measurement 105 / +10. Always had no problems with flex, but because of major thigh brusing from surgery, never did any muscle extention stuff until 10days out. PT not worried and gave me another ease in stretch before extension stretch......so i know its just a matter if time.

I'm going to show my age now - i swear my PT was only about 28yrs....lol. Anyway its a no pressure place...they work with a lot of aged care people and i can go up to 3 times a week, but I am only going to go once a week. Working only at this stage on extentsion, gait and going from 2 crutches to 1 crutch to none. I know this will happen naturally in time.....side note.....was so pleased the other day when i realised i could stand with equal weight on both legs....great feeling .

She also gave me a couple leg muscle exercises....I'm going to do one first for a few days to see any pain outcome before i decide if i will add the other one. I'm going to keep up the cycling to as i enjoy. Basically PT recommended walking as the main form of rehab.

Pain meds are only panadol 1000 x 4 times a day. Still have some oxy in cupboard incase i hit the over-did-it-club....but haven't been there for a week....... haha

Still elevating and icing 4 x 1 hourly each day....love doing this, its really helpful.

Swelling is minor mostly, a bit more after exercise or activities! But ice brings it back in line.

Not due back at work until I'm at 7 week mark, then think i will make the first 2 weeks back on reduced hours so that I'm not battling peak traffic on public transport......I am quite enjoying being 'nice' to myself ....

 

[Kiwigirl62]

4 week update (and another one bites the dust)
ROM 110/+5 (extension better, although flex was same, i can move it better and am able to rotate bike with seat lower than last week
Pain levels 0-2.....its more an ache which icing takes care of and the random zingers
Meds are panadol 3 x 1000 per day although forgot the middle one today so maybe im ready for morning and night only
Sleep still eludes me....very deprived.....still go to bed at night hoping......legs restless in bed. Hit 1 bad night and day with PO blues....lack of sleep doesnt help
Icing and elevating for 60mins x 3-4 times a day
Exercises
* 10 mins x 2 on bike (upping to 15 this coming week)
* Extension stretches (working well shifted from +10 to +5 this week)
* toe /calf raises × 15 (not sure correct term)
* bridges with feet on chair x 10
* IT band stretch (no problems with IT but as read some have problems its a proactive thing.
PT stuff that she gives me...usually about 3-4 new each week. I add one at a time for 2 days before adding the next one....dont know names of them .I'm pretty cautious after reading forum.
BUT she Ms PT who is 27yrs old ) 'made' me try walking unaided between parallel bars. So freaked out, my mind didnt want to let me....finally big breath....and i did it and it was OK.....now walking inside unaided....very slow but finally did that hurdle.
Caught 2 trams home from PT....managed that fine and also had sole charge of 5 yr grandson while daughter overseas for business for 4 days. Managed all ok without going to the ODIC. Had shopping to do so got 5yr decked out with backpack and we slowly wandered to shops, stopped at a seat while he ate treat and i rested. Towards home he desperately needed to go toilet. Only place was small movie theatre....but had to trudge upstairs for that.....still no drama....seems long as i take my time I'm fine. Going to take a train ride tomorrow to visit friend as had 2 x quiet home days. 3 weeks left till work. Forum keeps me sane on sleepless nights an while icing

 

[sistersinhim]

What a good recovery you are having! It sounds like you're listening closely to your knee and resting it when it tells you to. That's a very smart way to nail this long recovery! Continue to do as you're doing and your knee should snap back just fine!

 

[Kiwigirl62]

Well caved in last night after yet going to bed exhasted from lack of sleep at 9pm.
3 hrs later still 'tossing' with a type of RLS, I got up and took an oxycodone, not for pain as had none but to settle legs.

Worked and got 2 x 3.5 hr sleeps. So think while this night restless thing is happening I will try this every 2/3 nights cause i not functioning emotionally with lack of sleep.

Still have about 12 of these pills left over from the early days, so should get me through the next 4-5 weeks until sleep happens.

Any other suggestions out there that are not narcotic related would be really welcome as sleep is my only issue.

I need to get this under control before i go back to work in 3 weeks.

 

[Kiwigirl62]

First full day of walking unaided. Stayed around home but did little walk outside also - maybe 15min return trip. I am SO slow....haha. climbed into bed and knee is good, no pain BUT my leg muscles are so sore....feel like i have tun a marathon. Sprayed the magnesium oil to relax them overnight. Guess ill get up an do it all over again. Much steadier after 3 days of doing this.

 

[NavyGunns]

@Kiwigirl62, sounds like you are doing well. As you’ve just found out, a large part of our recovery is getting the soft tissues to heal and the slowly reconditioned. All of us hit that point where we feel great but then realize later that our activity worked muscles that haven’t seen that level of activity in a long time. Give them a brief rest and you’ll be ready for more.

 

[Softtail]

Kiwi girl, if you check, I ended up changing my thread to TKR recovery and rls. Not surprising oxy helps your rls . Had to deal with it all my life. Augmented on drug requip , and ended up on 10 mgs. Of oxycodone in evening to calm legs, and allow me to get to sleep. For my recovery period I was using it for pain 5 mgs. every4 hours for pain , but now at6 weeks no longer need anything for pain, just back to my 10 mgs. of oxy in evening for RLS. Once I wasAble to adjust my sleeping positions my sleep pattern returned to what it was pre-surgery.. I hope if you didn’t have rls pre surgery ,it goes away down the road cause it’s not a pleasant sensation to deal with. Unfortunately for me it’s something I will always have to manage.

Don’t worry about sleep ,it will come as your knee gets better and you can move it around more without causing you that shot of pain that wakes you up. I would stay with oxy for rls if it works to get you some sleep, and hopefully rls will resolve itself down road

 

[Kiwigirl62]

@NavyGunns , yes i will have quiet one today. But will still walk. It still did surprise me though re leg muscles as right up to surgery day i still rode daily 25kms, did 20mins leg exercises daily and week before op packed an moved my studio carting boxes to downstairs garage. It remarkable the muscle loss that can happen as we get older. Still its a 'good' sore when it means regaining fitness.

@Softtail , thanks, i trawled your thread and saw that you used oxy for rls, hence thought I'd try it. Pre surgery on reflection, i think i had mildly but didnt know as i sleep alone so was able to flick legs around whole bed.

However it was only for 5 mins on settling in bed.....after that used to sleep a solid 7-8 hrs. Did the 1 oxy last night as knew i needed to get legs rested for muscle recovery........wahlaaaaa got 7 hrs straight and no loo break either .

 

[sistersinhim]

7 hours without a potty break is amazing and wonderful! That is a wonderful feat for just a month out of surgery! Keep up that good sleeping!

 

[Kiwigirl62]

I fear it is a one off at the moment as i purposely cut my water intake plus took a heavier med than normal coupled with exhaustion -was the right receipe for one night.
Now is 10.45pm and about to turn off light. Panadol only...hoping asleep by 12am and maybe 4-5 hrs be good.

 

[NavyGunns]

@Kiwigirl62, sleep eludes almost all of us during recovery. My thread is loaded with numerous posts about my frustration with not being able to sleep. Only time seemed to eventually resolve the issue.

 

[Kiwigirl62]

Well had surgical review at hospital. Had to set alarm as it was for 8.45am, had 2 x trains and a bus to catch!! Now home again and icing. But no leg issues with traveling slowly.

Saw OS offsider who assisted with op ( lucky if he not much over 30yrs, but nice guy). Was supposed to be 6 week review but i only still under 5 weeks. Needless he is tickled pink with progress....visually checked ROM ( he assessed at same as last PT measure).

Very happy as it is ahead of their expectations. Showed me op x-rays and discussed good knee - little arthritis but should get another 8-10 yrs out of it. Funny thing is his thought seems to be that whatever ROM at around couple months that is it. I filled him in on what i had learnt here, but could see him skeptical. Going to chart my ROM monthly for 12 months to educate him i think. Next appointment in 12 weeks. Glad their expectations are not high. Seemed to think cause had good leg muscles pre op that helps ROM. I don't see how.

 

[Jockette]

It’s amazing what some surgeons think!

I’m glad he doesn’t pressure you and that he was happy with where you are.

And, 2 trains and a bus, that’s quite the adventure. I’m glad your knee held up well! Good thing it was early in the day!

 

[Softtail]

Kiwi, I am not quite sure by reading your threads if you had RLS presurgery or not. RLS can be brought on by surgical procedures and then can right itself as healing continues. While the Oxy is a great fix for severe RLS cases like mine, it would be a last resort for most people. In my experience with RLS over a long time, mild cases can respond to drugs like Gabapentin ,or Lyrica. Stronger drugs would be Requip or Mirapex. Problem with these drugs is in some it causes augmentation over time where more drug is needed, and lasts less time till you need to stop it. This was case for me that led to Oxy. Just throwing this back out there, and hope it gives you something to talk over with your doctors if the RLS continues.

 

[Kiwigirl62]

5 week update
Where has the time gone and if i think of the progress from week to week it is amazing.
ROM 110/+5
Pain levels 0-1 (mostly general ache and zinger)
Meds - 2 x panadol morning an evening
Ice/Elevate - 3 x 60mins a day (sometimes have to move the gel pads around as it gets too cold).
Exercises usually bout 1 hr x 2 daily, never ever go to pain level

PROS this week, getting stronger walking unaided, this still amazes me.
Able to get up steps OK on old trams
Am comfortable with practising step up
15mins x 2 daily cycle....couple more days and I'll lower the seat again.

Want to focus on extension, IT band and general stretching as walking now has produced new zingers with tight tendons / ligaments. Muscles are ok...sore at night but good to go the next day.

Went to work for a visit yesterday....that was good and the journey a good practise....back in 2.5 weeks. At this stage feel it will be ok.
I work 4 days week so will change day off to mid week. 2 on/ 1 rest /2 on.

Have niece arriving for hol soon so will do a day on and day off with her.

Feeling more positive today but its mostly cause i finally got some decent sleep for 3 nights. Still tired but whole better that 5 days ago.

@Softtail - i think i had very very mild form of rsl pre-op. It seems to have settled back down again. Getting block sleeps now of about 2 x 3.5 hrs hrs which is better. Think the rsl i experienced initially may have been due to surgery as all i could do was lay on back.

Still mostly on back but can relieve now for short bursts on my side.

Loving reading the stories during ice time

 

[Kiwigirl62]

Also forgot...most IMPORTANT..... i am busy looking for my VMO.....haha
Lost it years ago so busy trying to activate when i find it.

 

[Kiwigirl62]

Poked my toe in the ODIC yesterday.
*Did more than normal housecleaning
*Walked 1km to shops and back
*Swept front yard
*Then topped it off with a quick car wash.

Woke at 1am, bad aches, took 2xpanadol (not done for 2 weeks in the night).
Then awake for 2 hrs at 1am
Thankfully got another 3 hrs sleep and feels fine this morning....quiet day in order me thinks.