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TKR 15 week update

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Wow, I thought my recovery was going well, which it is, but I'm jealous that you're walking a half mile and doing stairs after seven weeks. I too had my right knee replaced (revision) on May 18th and endured a one-hour ride home. I'm still walking with a cane most of the time, especially outside, and I've had trouble with stairs since my knee surgery in 2012...darn quads. I'm concentrating on quads in PT and at home but seem to be getting nowhere fast even though my quads feel stronger. I just made the one-hour trek again today to see my OS for a follow-up visit. He's pleased with recovery and ROM of 0/120 and reminded me recovery is not a race. So glad I found this forum the other day--it's so inspiring to read stories like yours and all the other people who keep toughing it out to get their lives back to normal...helps keep me working on those pesky stairs. Take care and keep getting better every day.
 
@swank913 - if I knew where my posts were after my LTKR a year ago I'd tell you to read them & see how different my 2 recoveries are. I am beyond ecstatic with how I'm doing now, but believe me a year ago I didn't walk a 1/2 mile for at least 12 weeks. I know what you mean about the quads - I was totally shocked by how weak mine were - I expected the hamstrings to be a problem but not the quads.

One thing I did this recovery that was VERY different from last year is that I barely did any organized PT for the 1st 3 - 4 weeks. Oh, I did the heels slides & leg lifts but didn't kill myself. Even my PT focused on the soft tissue stuff - the muscles & tendons, the IT band, etc. and I do think it made a difference. Took me till my last joint to get it figured out, but better late than never! Don't be disheartened - it all will come!
 
MB-just read your thread from your first knee and it sounded just like mine.. The dilaudid the silver dressing the 50cc blood loss yet my hct dropped from 41 to 31- where did all that blood go? In my knee! Did you have your knee done in boston? Maybe we have the same OS. I have 4 1/2 wks left then back to work as a nurse again- 12 hr shifts ( I think I might do 3 eights for the first month I'm back.
 
@bluejuju - yes, I had my knee done at Baptist by Dave Mattingly. He replaced all 4 of my joints and I think he's one of the best. He's a tad conservative, totally unflappable, and has super outcomes. There are many, many excellent OS's in Boston - where did you have your knee done? Where are you working? In all honesty, I think your plan of 3-8's is the right one. I think that even with a stellar recovery being on your feet for 12 hours would be a challenge? I'm so glad I'm retired and don't have to worry about a return to work!
 
I had mine done at BI since I work there in OB. The Baptist is the place for anything ortho, but I have my insurance through BI. Aberdeen did my surgery- I think she did her residency at the Baptist cause our surgery sounded identical with the dressing and all.
 
@Celle thanks for the link to Mary Beth's first knee surgery; I read the whole thread. Mary Beth, you had quite a ride the first time out. I was lucky with my first TKRs 15 years ago. Looking back they seem not so bad. I think it's like giving birth--once you're feeling good again you're so happy with the outcome that you forget about the pain.

You mentioned that this time around you waited 3 to 4 weeks to start regular PT, and I think waiting does make a difference for the better. Three years ago when I had my left knee revision, my OS had me wait five weeks to start regular PT because my incision was so fragile from having my leg opened up three times over a five-month period (removed infected knee, try unsuccessfully to replace knee several weeks later, and finally replace it five months after removal) that the skin would tear when I bent my knee, so I had to wait. Normally my OS would've had me start PT after having the staples removed two weeks after surgery. Even though I had been laid up for five months after my infected knee was removed, I think PT was easier than it has been this time around--maybe the extra rest before starting PT made a difference.

I hope all is still going well for you in your recovery this time around. :yahoo:
 
swank913 said:
You mentioned that this time around you waited 3 to 4 weeks to start regular PT, and I think waiting does make a difference for the better. Three years ago when I had my left knee revision, my OS had me wait five weeks to start regular PT because my incision was so fragile from having my leg opened up three times over a five-month period (removed infected knee, try unsuccessfully to replace knee several weeks later, and finally replace it five months after removal) that the skin would tear when I bent my knee, so I had to wait. Normally my OS would've had me start PT after having the staples removed two weeks after surgery. Even though I had been laid up for five months after my infected knee was removed, I think PT was easier than it has been this time around--maybe the extra rest before starting PT made a difference.
Click to expand...
My surgeon has a policy whereby none of his patients start formal PT until 4 weeks after surgery. He says the knee needs that time to start its job of healing. We just do a few ankle pumps and heel slides, and walk around the house a bit. We do a lot of resting, icing and elevating of the leg.
All his patients do well and he has a very low incidence of needing to do MUAs.
 
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Wow this is awesome. I wish mine would been like that. We had pt 2 days after the Hospt discharge as nurse is there 4 visits before discharge to regular pt.


FaithMitchmommy
PKR December.1,2014
TKREV MARCH.2,2015
 
It hard to think of another sugury. I'm there with ya. I am seeing another doc. And it's a mess. I do wish you the best.


FaithMitchmommy
PKR December.1,2014
TKREV MARCH.2,2015
 
@Celle - your experience is exactly why I took control & told the PT we would only do light PT, only measure my flexion when she had to for insurance reporting & instead focus on the soft tissue stuff - the muscles, ligaments 7 tendons. Worked like a charm - I could see I was improving without pushing it. This recovery is so totally different I cannot even believe I had the same surgery!
 
I'm thinking of waiting at least a week before starting in home PT after my next knee. The first week seemed like a waste of my skilled PT's time as they stood and watched me to very basic stuff. They were great to talk to, but other than that, it wasted both our time. The second week, when a different PT showed up, I'd started to get the tight band feeling, and my PT began gentle massage that really helped. That was worth my time, even though she did all the work. Also, for the right knee, I won't be able to drive as soon, so I'd rather have a little bit longer time with the in home PT so my husband doesn't have to drive me. Also, when I started out patient PT, they went really easy on me for the first week or two, which made me think it was a little early for what THEY could do.
 
@PolarBear60 - Looking back to three years ago I'm convinced that waiting a couple weeks longer to start PT makes a lot of sense. My PT experience three years ago was definitely less stressful than the current PT and the PT I did 15 years ago. If I'd put two and two together and realized why it was less stressful last time, I would've talked to my OS about waiting a couple more weeks to start PT this time. Mary Beth and others sure voice this opinion. Don't you love the way Mary Beth advocates for herself when it comes to her PT?

My current PT has gone pretty well but stressful in the beginning. I do have a very hard time with stairs, so my PT's main focus is stairs and strengthening my quads, which have never fully recovered from three years ago. Most of that problem is my own fault because I didn't keep working at it very hard once I was done with PT. I just wanted to get back to work where I sat at a desk for 9-10 hours a day--not good for strengthening anything--but now I'm retired and I have the time to work at it. I've learned my lesson and this time I'm working diligently on my quads and glutes--oh heck, everything from my waist down--and my muscles let me know it. They're screaming at me right now (I had PT today), so I'm heading for the freezer for more ice. I think I'm going to need a lot of it.:snow dig: Have a happy weekend!
 
I love being retired. I got my first chance to work out in a pool today, and I worked very hard on squats. I don't typically do them out of water, but I felt very comfortable doing them in water.


Jean

LTKR (Stryker Triathlon): 21 April 2015
Right Knee Arthroscopy: 25 July 2006
Left Knee Arthroscopy: 10 February 2005
 
OMG. I just re read the entire thread for my 1st TKR from last May. Thank god I didn't do that before this TKR or I would have cancelled for sure. Time does dull memories till I went back & revisted how incredibly miserable I was for such a long time. The swelling I had a year ago was truly outrageous and I think has impacted my left knee for the rest of my life. Already my "new" knee feels way better & normal compared to the left knee. Yet when I compare my progress, in some areas I had faster improvements last year. So very true no 2 knees are alike.

I attribute my improved experience to 2 things - First my OS gave me steroids intraop & post op to try to deal with the swelling post op. And my swelling was way less than last year. I wonder why, if swelling is such an issue for practically everyone, this isn't a standard protocol? Does anyone have any ideas? I know steroids have side effects but I didn't get a big dose and only got it twice over 2 days. And second, my avoidance of aggressive PT for 4 weeks helped the knee settled down before stressing it again. I think I'll ask both those questions when I go back to see him in Sept. I must admit tho, my OS is not a fan of aggressive PT and says that directly to you - but unfortunately the PTs don't hear that. So I do feel the need to be quite assertive but I have been very lucky with all my various PTs except for the outpt one last year.

Maybe I need to go find my posts from my BTHR - and cut myself some slack. 3 major surgeries in 2/12 years is a bit much!
 
@Celle would you please change the name of this post to "15 week update"? Thanks muchly!
 
I can't believe I'm at 15 weeks post op - and realize I haven't updated my post in a while. I have a story of 2 knees - 1 year apart.

First, my 15 week old knee - I'm still stiff and have to watch my gait, especially when I'm tired. No real pain but I'm still very numb and that area feels very heavy like I have weight in the bottom right quadrant, so I'm always aware of the knee. I will take 1000 mgs of Tylenol 2-3 times a day when I am active or after the gym. I can shop for a couple of hours until the knee starts to feel tight, I do the stairs normally unless I'm carrying something heavy & then it's back to one at a time. I still can't get down on the floor or kneel on the knee which always gives me pause from the perspective of falling & not being able to get up. Incision looks great and is still a bit purple on the upper third, which according to my OS means there's still "stuff" going on around the knee. I really feel like I've hit a plateau in my progress which is OK, but disappointing. I cannot complain, my flexion is great, last measured around 128, and my extension is at zero.

I made it back to the gym and have worked my way up to 25 minutes on the bike - but only at level 2 at about 75 RPMs. Then I do some general weight work & focused glute & quad work. Just trying to get back into shape without setting my self back - so I'm constantly in a testing pattern to see how much my knee will tolerate. And I always ice after working out. And I only go to the gym every other day - and when I do go I sleep well that night, and when I don't go, my sleep is very fractured. Stamina & endurance is still a work in progress.

I just finished outpatient PT - My PT thought I didn't even need to go, but I kept on going because he was excellent - 30 minute session focused mainly on what I should/could be doing to strengthen the glues & quads. he gave me tons of good info & exercises that I like to do. Then he would massage around the knee with a technique that was new to me - it's called Gua Sha and uses some type of flat tool that he said would help decrease scar tissue. I'm not too sure of the long term outcomes, but it sure made my knee feel good in the short term.

I'm off shortly to go out West - so that's about 8 hours of air travel & then we'll be driving quite a bit. It will be interesting to see how my knee reacts. And when I look back to last year's trip & the last knee, I'm in a way better place for this trip - but I'm still using a wheelchair in the Atlanta airport!

Now as for knee #1, which is 15 months old - I'm afraid this knee will never feel like a "normal" knee. I'm still quite numb over a large area which I notice all the time, altho I do think it is lightening up a bit. The knee is still quite stiff and I feel like I am constantly stretching the soft tissue when I bend or move the knee. When its bent it feels fine, but then whenever I move it that sensation comes back again. It also feels very tight & heavy from the bottom of the knee, around the left side and up to the top of the knee. My OS suggested it was permanent soft tissue damage at my 1 year visit and didn't have much to offer me. I had massive swelling post op so that might have contributed. If anyone has any ideas I would love to hear them.

My "good" knee is my new knee -and the "bad" knee is the 1st knee. Can I live with this - yes - but it does limit some of my activity, and I am uncomfortable pretty regularly. So I was asked why I was brave enough to have the 2nd knee done - and my response was that the pain was worse than the discomfort from the 1st TKR. So I've had 4 total joints in 2 1/2 years - I'm kinda done with these surgeries. I still have some months of recovery ahead of me but I see the light at the end of the tunnel!
 
@dtmbf so glad to hear things are going well for you too. I too had my second RTKR on May 18th, so I like seeing how you're doing in comparison to myself.

I'm finally done with outpatient PT and doing pretty well, though stairs will probably be a problem for me the rest of my life. I can do them but only with two hand railings or one railing and my cane, but I'm so glad to be out and about and taking care of myself again that I can live with that minor problem.

A good night's sleep is now again possible about 98 percent of the time, and that has really improved my outlook on life. Grocery shopping takes a toll, and I usually need a nap after I get home and put things away (could be recovery, old age or both); but generally my energy level is improving. All in all, things are pretty good. I can get around in the yard again, though I do use my cane then just for safety's sake.

I am having a problem with my right leg still feeling longer than my left leg. I saw my OS two weeks ago and he said my knees are level and showed me on the x-rays that had just been taken that they are definitely at the same height. He said it could take several more months for my muscles/tendons/ligaments to readjust, because I had been walking around for almost three years with a loose knee joint that threw everything out of kilter. We'll see.

I too have numbness and a feeling of heaviness on my left knee, which was replaced for the second time 3 years ago, but mine is in the upper left quadrant and covers an area about the size of my hand. I think it will always be there, but I've grown accustomed to it and don't notice it most of the time. The only time it really bothers me is when I stand in one place for more than a few minutes.

You're lucky that you can kneel down. I've tried but even with knee pads it hurts. Actually, the OS that did my original knee replacements 15 years ago, told me I should never kneel on my new knees. I don't sit on the ground anymore either--it's too hard to get back up without having something to push myself up on. It's not the worst thing in the world, but sometimes it's those little things that bother me the most sometimes.

Even with all the pain and recovery from six knee operations, it was well worth it to have knees that are no longer painful, and I can live a relatively normal life again. I may not be able to do everything I did when I was younger, but I can do most of what I want to do now at the age of almost 65 years.

I hope you have a fun trip out west. Good idea about the wheelchair in Atlanta...it's always better not to overdo it.
 
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