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Bilateral TKR 15month update....finally normal

The wedding was beautiful and I am so happy that I was able to go. In total, I was out of the house for 4 hours. The wheelchair was an absolute must - I would have really struggled without it. All of the chairs were the standard white wood folding chairs. I find those uncomfortable on a good day.

The ceremony was outdoor on a golf course. We had to walk across grass (mostly level) to get to the ceremony. Husband pushed me in the wheelchair and parked me in the outside aisle of the back row. This gave me room to take my feet off of the foot rests and move my legs. I had to keep my legs constantly moving (ankle pumps, bending and straightening...) otherwise they started to ache.

The reception was at the same venue and started immediately after. We removed the chair at my place at the table and I sat in my wheelchair. The table had a bar under it that was about 10" off the ground. During the meal I rested my feet on that bar to elevate them a little. Had to move legs quite a bit and stand up and march in place a few time to keep the circulation going and stop muscle spasms. I took a pain pill about an hour earlier than scheduled, which allowed me to stay a bit longer. Made it through the toasts and cake cutting, then said my goodbyes.

Got home, changed clothes, then plopped on the bed to rest, ice, and elevate. Rested for about 2 hours and then got ready to go to bed for the night. Woke up this morning and legs are slightly achy (elevating and icing them right now) but don't seem too bad.

Overall, I'm happy with my decision to go and share the day with my friend, her family, and our mutual friends.
 
You are very brave to have a bilateral... I can't imagine. Don't know what I would have done without my "good leg". Did you make it to the wedding?
 
I'm glad you found a solution to the wedding, @Want2hike and aren't feeling the effects too much today. It sounds like you were able to enjoy yourself and not put your knees through too much.

@silty1 have you begun a thread for yourself? We'd love to get to know you in this way and any questions you have could be answered there. It would also be helpful for you to create a signature with your knee history.

https://bonesmart.org/forum/threads/how-to-create-a-signature.14728/
 
I'm glad you managed to attend your friend's wedding. It sounds as if you were very sensible in the things you did.
Well done!
 
@referee54 is so right... it's early days for a bilateral. Take time, take ice, take meds. Healing will come. I am four months out of my Bilateral and I want you to know everything takes longer than we think.. but you will get there. I wondered how far I would be able to go on the journey of recovery - things really are very good. My sleep, eating, walking, exercise were all out of 'whack'... but it does come back. I hope you enjoyed the wedding... life will come back to you. You just wait and see. xx
 
I'm feeling really frustrated today. I know everyone recovers at their own pace, but I feel so far behind in ROM. I'm nearly 4 weeks post surgery.

I just had my last in-home PT appointment (outpatient starts next week) and these were the measurements
Left: ROM 75 on my own (105 in CPM) extension= -5
Right: ROM 60 on my own (90 in CPM) extension= -3

I have strength, I have stability, but I just can't get my knees to bend. It feels like I have a giant ace bandage wrapped very tightly around my knees and I can't overcome the tightness.

My legs/knees have minimal swelling (the left is swollen slightly more than the right). My pain at rest, when walking, or when doing most exercises is 0-1, but jumps to 4-5 when getting to my maximum ROM with heel slides.
 
Want2hike said:
I'm feeling really frustrated today. I know everyone recovers at their own pace, but I feel so far behind in ROM. I'm nearly 4 weeks post surgery.
Click to expand...
You are correct in that everybody recovers at their own pace. But you are exactly where you should be---never, ever compare yourself to others---somebody will always be recovering faster than you---and somebody will be recovering more slowly than you---take it from somebody who has been where you are---my recovery was slow, as well----but you are not behind in your recovery---your surgical knees set the schedule, and you just go along with it.

You are not behind----you are exactly where you are supposed to be.

Yes, this recovery does really challenge our patience, but you will get to your destination of being fully recovered---but it is on your knees' schedule, not yours----again, I can commiserate with you----but you will be fully recovered one day, and you will be able to look back at these frustrating times and say, "It was certainly worth it."
 
Please don't be discouraged, remember how early you are in this recovery, not even a month yet. Your soft tissue is still recovering from surgery. When I was 3 weeks we hadn't even measured my ROM yet. It will come when the swelling goes down, continue to ice, elevate and follow the activity progression chart.

https://bonesmart.org/forum/threads/activity-progression-for-tkrs.14334/
 
Want2hike said:
I'm feeling really frustrated today. I know everyone recovers at their own pace, but I feel so far behind in ROM. I'm nearly 4 weeks post surgery.
Click to expand...
You're not behind in ROM at all, so don't listen to whoever has been telling you that. Actually, you are just right, and even a little ahead of some people.
My surgeon only expects 90 degrees by about 6 weeks, so he'd say you are doing well.

Your knees know what they're doing. They are on their own recovery schedule, not your therapist's, or yours. As long as they are making progress, no matter how slow it seems to you, they are doing OK.

It really annoys me to hear how some therapists get obsessed with ROM numbers, to the extent that they make their patients feel like a failure. It's unkind and unnecessary.
Want2hike said:
My legs/knees have minimal swelling (the left is swollen slightly more than the right). My pain at rest, when walking, or when doing most exercises is 0-1, but jumps to 4-5 when getting to my maximum ROM with heel slides.
Click to expand...
It's possible to still have swelling inside your knees, even when not much is obvious externally. It's a pretty tight space inside your knee compartment and it only takes a little bit of extra fluid to "gum up the works" , so to speak.

Do make sure that you're not being too keen with the heel slides - do them only to discomfort, not to pain.
Heel slides and how to do them properly
You don't have to do all the sorts of heel slides in the article. Just choose one or two that you like, and do them gently. Once a day is often enough.
 
Right knee finally loosened up and can now bend about the same as left. Yeah! Both need to increase ROM but I feel better about them being close.

Prior to surgery, my right knee used to lock (in a straight leg position). I compensated when walking by raising my right hip, sitting down while keeping that leg straight, etc. following surgery, I continued this compensatory behavior because the knee wasn't bending much. My PT called me out on it but it was hard to change when the knee still wasn't bending much. Now that it is bending more, I find myself needing to really focus on learning how to bend the knee more when I walk, when I sit, etc. Other than walking in front of a mirror so I can see if I'm still using bad habits, does anyone have suggestions on how to retrain myself to walk and sit correctly?
 
I don't have any tips for you, as I have the same issues. I catch myself when going up and down stairs, lifting my hip and not bending my knees. Also sometimes when walking I have to tell myself to bend my knees not walk on my toes. I walked on my toes really bad before surgery so it is a habit I have to break! I told my husband to watch for it and call me out if he sees me doing it!


Sent from my iPhone using BoneSmart Forum
 
Hi Want2hike (and Lene), I'm in the same boat: I tend to hip-lift my TKR leg too, and have been doing it for some 20 years, following a ski injury!

So, to begin to undo twenty years of bad habit, my PT-exercise person has me do several exercises to help, and one is to walk really slowly thinking through each millimeter of my walking movement. It's as if I'm to break the process down like an Eadweard Muybridge photo! (Fascinating photos of various critters' movement, including humans, done by English photographer-scientist.)
Then, I'm to do sink rear leg lifts: stand facing sink, hold on, lift each leg up in back slowly 10 times, activating your core, keeping your shoulders back. Get as close as you're able to get your knee to touch your bottom.
Another one: stand with side against wall, lift leg closest to wall upwards to 90 degrees while holding in your core, shoulders back; ten times each leg/direction.
Oh, and when walking, focus on having the outside of your foot parallel to floor, with foot turned in enough to give you good parallel stride... those are just a few. This PT is a sports physiologist, so is very knowlegable about body mechanics... she played professional basketball in Europe...
More recently, she set me to do sink squats, but not until I was at 3 months. Again, stand facing sink, begin to "sit" down part-way, while holding onto your core and keep your shoulders back...though that's hard to do when you're doing this!
 
I would throw my foot out to keep my knee from bending too much (and now do it with my left) while walking. In the beginning my PT would stand behind me, watching and coaching while I walked. Later (4 months) I got on the treadmill to practice a better gait for about 5 minutes at a time on a very slow setting. It just takes concentration and practice not to go back to those bad habits as we're walking.
 
I had a PT assistant that actually pointed out to me that I wasn't walking correctly. She helped me to adjust my stride so it was closed to what the norm is. In the beginning it felt so strange and I had to really concentrate to walk correctly. At that point I went to a store that caters to runners to get a pair of sneakers that would help me now that my leg was straight ( it wasn't preop.)
 
Want2hike said:
but I feel so far behind in ROM
Click to expand...
Never compare, it's not a race, you are progressing just fine.
Want2hike said:
My pain at rest, when walking, or when doing most exercises is 0-1, but jumps to 4-5 when getting to my maximum ROM with heel slides.
Click to expand...
Don't do it. Pain in exercising is counterproductive, it's just worsening the damage. Exercises are for mobility, not training.
Want2hike said:
does anyone have suggestions on how to retrain myself to walk and sit correctly?
Click to expand...
Practice, practice, practice :)

It's one of the best uses of a physiotherapist, to point out where you are going wrong and how to improve.

But just walking consciously correctly, noting where your body wants to compensate and not doing it, should help. It helped me, anyway...
 
I, too walked wrong for so many years that it's easy to slip back into the bad habit with the knew knee. Unfortunately, the old one makes that side walk funny if I don't watch out for it, too. So, last it was said earlier, it takes concentration to walk correctly!
 
Getting tired of my right knee lagging behind my left...
Had a 40 minute drive (I rode, not drove) to relatives for dinner last night. Left leg did fine and was comfortable. Right leg started aching (quads area) after 15 minutes. Felt fine once I was out of the car and standing/walking. Went into the house and hogged the recliner so I could elevate. No pain. Sat down at the table for dinner and again within 15 minutes started aching in the quads (left leg was fine). During dessert and post desert chatting, had to move my leg from under the table and fully extend it out to the side. That reduced most of the throbbing/aching. Same issue after 15 minutes on the drive back home.

Any ideas why that leg aches when it is in a sitting position (knee bent at about 60 degrees).
I see my OS next week for my 6 week follow up.
 
That is completely normal. When the leg is down, the swelling increases. Even now, after almost 6 months I can't sit for long with my legs bent. My recliner and ice are my best friends!
 
I tried to keep my leg propped or elevated as much as possible for 3 months. Anytime I went out to eat I made sure I was in a booth so I could prop my leg up beside me. You're just about 6 weeks, so don't be surprised if the swelling continues, especially when the legs are left down for any length of time.
 
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