TKR Back problems, 14 weeks in

[cmgknee]

Hi Josephine,
Thank you so much for your detailed answer. I do, however, have a number of clarifications;
1. Pain score - YES, I DID factor in stiffness and swelling, which is why it’s so high. If I didn’t, I would call the pain 2-3.
6. I am elevating properly.
Ok, I jettisoned the Fitbit! Now how shall I measure the length of my walks?
When you say I am “back at work”, please note it is a fun volunteer activity that I do for 2 hours only 2 days per week. I do not have any other job.
By Sessions 1 and 2, I mean exercise sessions—one in the am and one in the pm.

I still cannot disengage my back/hips when I do a full rotation on the bike. So for the time being, the PT suggested rocking instead.

Given the above clarifications, do you still feel my activity level is too high?

 

[Celle]

Now how shall I measure the length of my walks?

I took a timer with me and set it for a certain amount of time, say 5 minutes at first. When the timer went off, it was time to turn around and head for home. You can increase the time in small increments.

 

[sistersinhim]

My first walk, I took my walker and a friend. We walked halfway around my house, then went back inside. I thought I could have done more, but afterwards, that night I was sure glad I didn't. My knee let me know I had done something different! Slow and easy is the way to go!

 

[Josephine]

1. Pain score - YES, I DID factor in stiffness and swelling, which is why it’s so high. If I didn’t, I would call the pain 2-3.

Excellent!

6. I am elevating properly.

Also excellent!

Ok, I jettisoned the Fitbit! Now how shall I measure the length of my walks?

How about being old fashioned and using a clock!

When you say I am “back at work”, please note it is a fun volunteer activity that I do for 2 hours only 2 days per week. I do not have any other job.

It's still activity and counts just the same.

By Sessions 1 and 2, I mean exercise sessions—one in the am and one in the pm.

I see - think I actually figured that out in the end. But you really only need to do one session and none at the weekends. Also none when you go to 'work' even if it's not a formal job!

I still cannot disengage my back/hips when I do a full rotation on the bike. So for the time being, the PT suggested rocking instead.

Ah - I see. Good idea then.

Given the above clarifications, do you still feel my activity level is too high?

No - I still stand by this

Your exercise regimen is far too intense.

 

[cmgknee]

Ok so it’s time to be a bit gentler with myself.
Would you say that is the reason I am so very tired?

 

[Jockette]

Our surgeries caused a lot of trauma and our body is working hard to heal, that alone will makes us tired. Add too much activities before our particular body is ready and it makes us even more tired.

This recovery is long, but even long, it’s still temporary. We’ll get back to doing what we want. If we do too much now we will cause a setback which will lengthen the recovery.

Been there, done that!

 

[Celle]

Would you say that is the reason I am so very tired?

No. That would be the Energy drain for TKRs . Everyone gets that.
It happens because most of your energy is being directed towards healing your knee and there isn't much energy left for anything else.
While the energy drain will decrease as you heal, it can linger for quite a long time. I think it was about 6 months before it left me.

 

[cmgknee]

Also, following up on timing my walks//How long do you think they should be?

 

[sistersinhim]

Left in your recovery articles was this that tells you what you should be doing at your stage:
https://bonesmart.org/forum/threads/activity-progression-for-tkrs.14334/

 

[SusieShoes]

Also, following up on timing my walks//How long do you think they should be?

The idea is to gradually build up your time (or distance) to where you are just pushing the knee a very little. Pushing too much causes pain, swelling, and setbacks, so you want to walk enough... but not too much.

For example, the way I did it (I had both knees replaced) was distance. My first trip outside I walked down my short driveway using my walker. My knees handled that well, so the next time I walked the driveway and then down the sidewalk along the street to my next-door neighbor's driveway and back (always remember there will be an "and back"). It felt like a long way. The next day I walked to the next driveway down the street... and back. Then the next two driveways (I was feeling bold).

As the knees told me they were good with the distance (I measured distance in driveways, then blocks, and only much later in steps and miles), I would extend my trips. If my knees got sore, I'd cut back a little for a few days, then test the longer distance again. It took several weeks to go from driveways to around the block, to a mile. But there was never a serious setback. The knees handled longer distances when they were ready to handle longer distances.

You could do this the same way with time. First, 5 minutes. If the knees are happy, make it 7. If 7 is great, go for 10. At some point your knees will tell you that you are pushing their limit. They'll be sorer, or might swell. That's your signal to cut back to where they weren't sore after. Give it some days of just doing the not-sore timing. Then test the longer timing again. The knees may be perfectly happy with the longer time walk by then.

You will get there! I know it can seem to take forever. But in the end you want a good result, and you will get that. I can walk for miles and hours now. I sure couldn't do that the first time!

 

[kneeper]

The energy drain lasts a long time. Even after I went back to work, I'd come home and crash. I would fall asleep on the couch while elevating. And I was lucky that at first, I had some days where I was only working 6-7 hours.

 

[cmgknee]

So I tried going to a play this week (10 weeks) and couldn’t stand sitting that long, my thigh muscles felt SORE and I couldn’t stretch out my knee. It just felt awful and we left at intermission!
How long before I can sit through an entire show or concert or plane trip for that matter?
Honestly, I can’t sit comfortably for more than 10-15 minutes!

 

[liam2015]

hopefully each week you will get a little more comfortable. for comparison: i went to a play downtown toronto, taking the subway at 11 weeks post op to see "the carole king story", and dinner at a restaurant before. i made out okay, not too much discomfort. one month later (16 weeks post op) we drove 2 hours to our friends in the peterborough area to "the 4th line theatre" to see a play outdoors on a farm in very uncomfortable wooden folding chairs, and then slept overnight there. i made out okay with a little more discomfort due to the long drive and the uncomfortable seating.

could it be that you're doing too many of the exercises that's causing swelling and then pain? you already have excellent flexion. how is the massage going and how is the numbness you described? i had massage for physio starting at 6 weeks post op and i loved it. it was a little painful at first (a feel good pain) but i got used to it, along with the laser therapy, tens machine with cold packs under and over for 20 minutes or more ~ very relaxing. (note that i did not start physio until 6 weeks post op). i did very minimal exercising, very minimal ~ mostly activities of daily living. having said that, it took 7 months before i could pedal a full rotation on my bike. i was a very slow bender; however, i didn't have too much pain. i stopped all percocet pain medications and other medications at 3 weeks post op, because of the nausea, constipation and lack of appetite and weight loss.

try to be patient with yourself and experiment to see if doing just the activities of daily living for a couple of weeks, forgoing the formal exercises, helps with the swelling and discomfort. i still have stiffness after driving and upon rising after sitting. this really is a longer recovery than i ever imagined. i was told the recovery time was 6 weeks ~ that is a cruel joke! i am just over a year post op and doing great but it took a long time to get the appropriate range of motion. i was lucky with not too much pain for very long. wishing you all the best in your continued recovery.

 

[cmgknee]

Thank you so much for sharing your experience!
I’m continuing with massage dnd dome mild exercise.
I also started a little bit on the stationary bike—I can get all the way around(!) but can only do about 10 minutes.
I agree this is a MUCH SLOWER recovery Thani ever imagined

 

[liam2015]

that's fantastic you can get all the way around on the bike!

 

[Josephine]

So I tried going to a play this week (10 weeks) and couldn’t stand sitting that long, my thigh muscles felt SORE and I couldn’t stretch out my knee. It just felt awful and we left at intermission!

Hardly surprising! You need to read this Movie sign in TKR

 

[cmgknee]

Oh my! It seems a
I want to rush EVERYTHING! Honestly, I’m trying very hard to slow down and not expect too much. What would be a reasonable expectation for going to the theater or a concert?

 

[Josephine]

A bit soon! Leave it another 2-3 weeks at least.

 

[Celle]

And make sure you book an aisle seat in the theatre, so you can stretch your leg out from time to time.

 

[manda124]

Oh my! It seems a
I want to rush EVERYTHING! Honestly, I’m trying very hard to slow down and not expect too much. What would be a reasonable expectation for going to the theater or a concert?

I'm a few weeks behind you, but I started going to the movie theater recently (I HAD to see Infinity War!) and once I made sure no one sat next to me, I stole the seat next to me and put my leg up! Also some movie theaters have recliners now!

Theaters can be really smushed so I understand how that would be uncomfortable!