Bilateral TKR 2 years out and facing up to facts

[Ghostpipe]

I am nearly 9 weeks post ops, and have not had the smooth and steady ride that I expected, and am so grateful that I found this forum. Now I realise that I am no different from anyone else, not the Superwoman that I thought I was!
I came out of hospital on day 6, walking steadily with no aids at all, and with flexion achieved with the benefit of of epidural top ups of 130/120. Ha! I thought, after 6 weeks I will be well on the way to normal life. A week of sleepless nights on, I seemed to be going backwards, but persevered with walking circuits around the garden, leg lifts, and trying to push my legs back to my former flexion. Then I started working on trips up and down the stairs, normally. Doing calf lifts, and using the exercise bike. Ended up stiffer than ever and ROM getting worse, sleeping even worse. Then I found BoneSmart and came back down to earth. Stopped expecting too much of myself, cut out the painful exercise and relaxing into healing. Now I understand that recovery is a slow process and can’t be speeded up.
Doing fine now, accepting the tiny improvements and measuring successes achieved by weeks rather than days. Things are starting to look up.

 

[Sisterpat]

Wonderful news, Ghostpipe! It’s a lesson we all have to learn, tough as it sometimes is. Happy for you!

 

[Celle]

Hi @Ghostpipe ,
I'm glad you've started your own thread.

It's good to read that BoneSmart's advice has helped you.

Even though it's been 9 weeks, I'll give you our recovery guidelines - there's still plenty here to help you.

Knee Recovery: The Guidelines

People are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart are here to help, but YOU are the final judge as to the recovery approach you choose.

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary.

2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

3. Do what you want to do BUT

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. Try to follow this

Activity progression for TKRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications​

Wound Care In Hospital​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[Ghostpipe]

Had a really good day yesterday. Increased my static cycling from 6 minutes twice per day to 10 mins x 3. Did two short stretches of gardening, a bit of housework, a load of washing, pottered around the house a bit, cooked a meal. Then had a bath for the first time, after a dry run which proved that I could get in and out of it. But... painful, restless night, ended up taking a sleeping pill, and sore today.
Lesson learned, even if you feel good enough to keep going nearly all day, don’t do it!

 

[Jaycey]

Increase in exercise plus increase in activities of daily living (ADLs) = pain and discomfort. Please baby those new knees. Slow and steady is the best approach.

 

[Roy Gardiner]

Increased my static cycling from 6 minutes twice per day to 10 mins x 3

This level of riding is training rather than using the bike for mobility exercises. You can get better mobility outcome with less effort.

• Set the bike to zero resistance
• Set the saddle low enough so that a single rotation is a challenge; difficult but not painful. When a rotation becomes easy right from the start, lower the saddle a max of 1cm.
• Gently turn the pedals, through discomfort but without pain.
• Continue until the knee is 'warmed up' and the rotation is now easy, or for 2 minutes, whichever is the shorter time.
• Repeat several/many times a day, but don't go mad. Diminishing returns will apply; my guess is that half a dozen reps would be enough
• Do not pedal fast or for more than 2 minutes, this is a stretching exercise, not training.
• And if you get any pain or swelling in the 24 hours after doing this, cut it down until you don't

Here is a bit more chat and some pix and how 'healing' and 'training' are different

 

[sistersinhim]

Lesson learned, even if you feel good enough to keep going nearly all day, don’t do it!

Oh yes, this is so true. I learned to do only one new thing a day and then rest twice the amount of time it took to do it. Then I'd take the next day off if my knee complained that night. It's a trial and error recovery that your knee will teach you.

 

[Ghostpipe]

Do you still have your posterior cruciate ligamentS? Mine were removed, I still don’t quite know why.

 

[Pumpkin]

Most likely they were removed due to instability when they checked your ligament stability.
You will have to ask your surgeon for the reason yours were removed.

 

[Fran55]

Wow ! @Ghostpipe is sounds like you are doing very well. I was on elbow crutches for a few weeks after my surgery. I am still not game to get down into a bath after 12 months !

 

[Ghostpipe]

The getting down is easy, getting out is quite another matter! I tried at 6 weeks out, managed, but the effort and the safety aspect was not worth the reward back then. Not sure that it is now, chickened out and had showers since.

 

[Ghostpipe]

I am a scuba diver. Please, if there is anybody else reading this who has experience of getting back in the water post tkr, or of breast stroke leg kick, can you start a conversation? Although I am doing very well 9 weeks past bilaterals, I despair of ever getting my strong kick back, or with dealing with current etc. After over a year of no dive trips, I need something to look forward to.

 

[Jaycey]

@FCBayern has had TKR and dives. Not BTKR - but he does have experience. Time is your best friend.

 

[Coker]

Ghostpipe thanks for your thread. I over do too. Slowly but surely I'll get it through my thick head to be mindful and patient with my knee.
I'm sure you're missing diving, it's the type of activity that is great for fitness...and fitness for your head too.

 

[Ghostpipe]

Nearly 10 weeks out now, found myself walking without having to think about straightening up. Checked my extension and found that it is much better, zero in one leg and close in the other. The only PT I have done on this is a few days of pushing my knees down into the bed with straight legs. I believe that is the reason for the improvement. Happy days, especially for my back.

 

[Sisterpat]

Fantastic news, Ghostpipe . Seems like once we get past 6 or 7 weeks, the road gets less bumpy! Soldier on!

 

[Ghostpipe]

Thank you Sisterpat. Less bumpy, still not smooth!

 

[FCBayern]

I am a scuba diver. Please, if there is anybody else reading this who has experience of getting back in the water post tkr, or of breast stroke leg kick, can you start a conversation? Although I am doing very well 9 weeks past bilaterals, I despair of ever getting my strong kick back, or with dealing with current etc. After over a year of no dive trips, I need something to look forward to.

I think you will be surprised by how well you will be able to do by November. I had my TKR at the end of January and dove in mid May. I took the BCD off in the water, but after that I could get up the ladder with no problem. I did need to switch to a smaller set of fins that early to be comfortable. I don't use a frog kick when I dive, so I can't really answer that. There should be no physical reason you can't do a frog kick by that point, but I would take it slow and easy until you know what your knee will tolerate and what it wont. Long term though (12-18 months) I think you will find that your diving is as good as ever, or maybe even better if the knee ever acted up afterward. Hopefully that helps set your mind at ease, I'm sure you will find diving just a good or better than before TKR. A liveaboard in Indonesia is on my bucket list! Although I'm completely spoiled by where I live.

 

[Ghostpipe]

Thank you, FC. I do feel more optimistic now, was even motivated enough to step up the leg lifts today! Also to get back to the gym soon, upper body only to start with. The two flights of stairs to get down into it will be quite enough for the legs.

 

[Ghostpipe]

Just had a massive revelatory thought. Up until about five years ago, I used to keep fit by walking hard in the hills and mountains behind our house. Then my knees got too painful to walk down slopes, a short while later followed by up hills too, then uncomfortable with fast walking. Couldn’t find the motivation to exercise at home, so started at the gym, where it was possible to find ways of exercising without impact or stressing the knees. I actually hated it, all those fit young people and vain muscle men.
I can, in a short while and all being well, go back to the hill walking!!! Hooray for new knees. First time I have considered being pleased to have them.