TKR Adventures with a new right knee

[PrincessTia]

Today is 10 days post-surgery. I'm at home, living in my recliner, with several hours of hired help each day. I'm using a chair-side commode, since the distance to my bathroom is still too far for me to manage as often as I'd need to.

I had the surgery Thursday, Oct 23, and was due to go on to rehab last Sunday. But no beds were available; after several days, we decided I should just go directly home and give up on the idea of a rehab facility. I did keep up with PT in the hospital, so I was probably at about the same state of recovery as I would have been in a facility. I was very glad to be going home (and that I wouldn't have to learn another whole schedule and menu and staff!), but worried about being alone there.

The first night home (Wednesday) was nightmarish. The commode that was to be delivered to my house had never showed up, and I had to walk all the way to the bathroom with NO spots where I could rest on the way. The toilet riser seat-with-arms was obviously inadequate, but it was SOMETHING. Somehow I pushed myself to make the return journey—carefully—and I thought I'd never felt anything so wonderful in my life as that solid and sturdy recliner seat!

Though my knee was pretty swollen after that, things got sorted out better overall—the commode was delivered, my helpers settled into a sort of schedule, and I made bits of progress each day.

I have been really lucky with pain—I am not taking much in the way of pain meds, yet haven't felt much pain. I hope it means I'm successfully staying "ahead of the pain."

Today something changed, though. I got up to walk as I usually do, but my knee seemed to...spasm...in front, like a sharp pain stabbing into the knee. It's as if the muscles around my kneecap suddenly clenched, as if my leg were trying to do a goose step! I had felt precursors to this a few days before, but I had taught myself to relax the knee and let it bend slightly, preventing the spasm. But that didn't work today; it spasmed twice more and felt like it would just plain buckle under me, so I maneuvered myself back to the chair.

My physical therapist will be here tomorrow morning; I hope she will be able to help me move past whatever my leg is doing.

 

[Djbrund]

Being by yourself means you are probably doing to much. I did NOTHING except get to the bathroom for the first 3 or 4 weeks. Someone fetched my ice and pain meds , cooked and served me, etc. in home PT was very gentle and I was still taking lots of pain meds. I can't imagine doing this without my husband.

My knee still spasms. Never know when or why. Just does. Good luck with your recovery. -- Joni

 

[PrincessTia]

PT just left, and I'm feeling much better about my "spasming" knee. I walked farther than I have before (except for that first miserable night), and had a chair to sit in to rest. My flexion was 70° at that point! I felt good about that, 11 days out.

Since I'm due at the hospital for my 2-week post-op appointment on Thursday morning, I have a pretty clear short-term goal: practice walking so that I will be able to get all the way out of the house, down the porch steps, and down the driveway to get into my helper's van. Also to keep trying for more flexion.

 

[PrincessTia]

Being by yourself means you are probably doing to much.

LOL, no, I am by nature very sedentary and try to get by doing the minimum possible in everyday life. At this point, I'm not even making it to the bathroom—I use only the commode that sits next to my chair. Everything else is being done by my helpers: food, cleanup, ice, water, etc.

I think my fairly sluggish nature makes it more likely that I will UNDERdo my exercises, instead of overdo them.

Thanks for your kind words and commiseration!

 

[Josephine]

since the distance to my bathroom is still too far for me to manage as often as I'd need to.

Like how far? I was walking down a loooong hospital corridor twice a day before I left hospital which was on day 7 but when I got home, I was going up and down stairs at will - carefully but at will!

I had the surgery Thursday, Oct 23, and was due to go on to rehab last Sunday. But no beds were available;

Probably the best thing that has happened to you!

 

[PrincessTia]

Like how far?!

I'm terrible at estimating distances, but I'd say about 30 feet? With a couple of tricky corners for my walker to maneuver around. I was not walking nearly as far as you in the hospital; probably about 15 feet, out to the hall and then back again. I've always been slow at anything physical, so I'm not expecting fast results with this recovery.

Probably the best thing that has happened to you!

I think that may be true!

 

[Jane B.]

Princess, my knee spasms all the time. It comes on suddenly and is painful. And then it is over.

I planned the first time out driving, I was supposed to take our son to the airport. Instead I was rolling around on our bed moaning and groaning with a spasm. My husband walked in and said, "I guess you aren't going to the airport..."

THIS DARN KNEE!!!!

 

[PrincessTia]

THIS DARN KNEE!!!!

LOL! I'm just learning — The Knee is In Charge !

 

[kneeper]

Just keep practicing the walking a little at a time and getting to the bathroom. Try for it before you have an emergency situation so you won't have to hurry. As you do it more you will gain confidence.

 

[PrincessTia]

It's amazing to me how much confidence plays a role in this process. Right after I felt that first bad spasm, I didn't want to even try to walk. Both times I did, the spasm attacked and confirmed that I "shouldn't be walking."

But yesterday my physical therapist came, and I ended up walking all the way out to the kitchen, where there is a chair set up for me to rest in. The possibility of that spasm sort of hovered in the back of my mind, but I didn't allow it to take the focus off of what I was doing.

Today, I walked again out to the kitchen to my resting chair, then back again to my recliner. A few hours later, I walked that far again, then continued to my bathroom! I actually used my own toilet! Suddenly, all kinds of possibilities feel open to me, and now I understand the temptation to do too much!

However, I will try to apply the lessons I've learned here, and be judicious in my activity. But I love this change of perspective!

 

[PrincessTia]

on another note, I was kind of pleased to see that your surgeon is a woman. Not too many of them out there it seems.

That pleased me no end, too @kneeper. Especially because she specializes in more difficult and complex cases. On her web page, she says she always loved constructing things and putting things together; she's also been a professional dancer and has a Master's in kinesiology! Definitely competent and an interesting person.

 

[Jane B.]

An orthopedic surgeon has to be very strong, and women are not well represented in the field. Good for her, and good for you for choosing her.

 

[Minnie's knees]

@PrincessTia Congrats on being on the recovery side. I am 1 day ahead of you and can relate. Yeah for walking to the kitchen and bathroom. Small accomplishments are good for us. Best wishes on your continued recovery.

 

[PrincessTia]

An orthopedic surgeon has to be very strong, and women are not well represented in the field. Good for her, and good for you for choosing her.

It's funny; I didn't really choose her, she was chosen for me. When I decided it was time to do my knees, I first went to my primary care doctor. He referred me to a surgeon in the orthopedics department. When I went to see him, he took a look at my knees, and told me he was referring me to a different surgeon. When I asked him why, he said that my case looked especially complicated, and that he was referring me to someone who had better skill levels. Who turned out to be Dr. Holly Haight, my OS!

Mind you, if I had been doing the choosing, I would have chosen her! I feel quite fortunate.

This is a snapshot I took when she visited me in the hospital.

 

[PrincessTia]

@Minnie's knees , we're knee-sisters! We even got the same knee done. Thank you for your kind words!

 

[Minnie's knees]

@PrincessTia hi knee sister! I didn't realize it was same knee. I couldn't do leg lifts first 10 days as my quad muscle wouldn't engage. I had to wear an immobilizer and use walker with any weight bearing. By day 5 I was asking "what have I done?" I am finally walking without it as of yesterday but still using my walker. My ROM is 60 which is not where I wanted to be at 2 weeks out. But slow and steady wins the race.

 

[PrincessTia]

@Minnie's knees I can't imagine having "log leg" as long as you have been dealing with it! I'm glad you're not needing the immobilizer as much, and that your quad is beginning to take its responsibilities seriously.

 

[PrincessTia]

Well, three steps forward, then two steps back. Yesterday I made it to the bathroom three times; today I've made it once, and had to use the commode twice.

I don't think my problem is related to the TKR; I've had stress incontinence for years. But this seems worse. As soon as I wake up in the morning and get vertical I have to go! Right then! Right there (almost)! There is simply no time to get to the bathroom. I'm beginning to think that I really need some sort of adult diaper! It's either that or keep the commode indefinitely. Pooey. NOT the kind of issue I was expecting to have to deal with.

 

[Jane B.]

That is no fun, PT. Have you been worked up for the stress incontinence? My good friend had minor surgery for it and it helped a lot. Nothing like a knee replacement. Hers was from difficult deliveries, did you have children? Kids cause all kinds of problems! I didn't have stress incontinence, but I did have really awful frequency issues that curtailed a lot of activities. I had a hysterectomy for other reasons and it cured the urinary frequency. It is a world of difference in my daily life.

I have difficulty understanding how your house/apartment is set up. The bathroom seems too far from that wonderful recliner. Do you have one level or two? Does your space normally work well for you, or would a move help the quality of your life?

 

[PrincessTia]

@Jane B. The stress incontinence has never really bothered me much, except when it first started, before I learned to always wear a pad. So I haven't ever talked about it with my doctor. If this pattern continues, though, I definitely will!

My single-level house is a fairly small two-bedroom, one-bath, 1951, ticky-tacky little box, not on a hillside. My recliner is in a large family room that was added off the kitchen by the first owner. It's at the other end of the house from the bedrooms, and the bathroom is along the hallway that goes between the kitchen and the bedrooms. I've lived here for 24 years, and it still meets my needs, as long as I put aside a few aesthetic considerations.