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TKR Bikeknit's Recovery Thread

Bikeknit

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Left TKR June 23, 2020. Bikeknit
I was originally scheduled in January. Blood work showed anemia and followup showed very low iron. Testing and iron pills got that resolved. Rescheduled for March and my hospital shutdown elective surgeries the day before. Finally had my surgery in June! Hope this is the right way to post.
 

Pumpkln

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@Bikeknit
You'll notice that I have moved your newest post and started your recovery thread. For several reasons, we prefer that you have your own recovery thread:
  • That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
  • With your own recovery thread, you will see the posts and advice others have left for you.
  • Having only one thread will act as a diary of your progress that you can look back on.
So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

Here are the instructions on finding your thread, How can I find my threads and posts? Many members bookmark their thread, so they can find it when they log on.
 

Pumpkln

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Bikeknit,
Welcome to the Otherside! Finally!
Glad you got your blood work up and were able to have your TKR.

Here is your copy of the Knee Recovery Guidelines, the articles are short and will not take long to read.

Knee Recovery: The Guidelines
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
ice
take your pain meds by prescription schedule (not when pain starts!)​

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

5. At week 4 and after you should follow this

6. Access these pages on the website


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 a 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 history before providing advice.
 

Celle

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Hello, @Bikeknit
This is your recovery thread.

Please come here and tell us how you're getting on.
 
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Bikeknit

Bikeknit

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Hey all. I'm approaching 5 weeks and doing relatively well. I was excited to find my new knee so much more stable even when I first stood up in the hospital. I could walk, do stairs, and get out of bed so they sent me home after one night.

I slept a lot of that first 2 weeks but managed to move to the cane from the walker and felt pretty darn proud of myself at the first doctor visit when I got my staples out. Now things are slower. My knee is still swollen, sometimes more than others, and I'm making modest improvements. Was so excited this past week when I finally could pedal the exercise bike for 10 minutes.

My main frustration is that my knee is still swollen and therefore uncomfortable. It gets worse if I do more so I seem to be always looking for that goldilocks place - enough activity and exercises to move me forward but not so much that the swelling increases. My right knee is also damaged (scheduled to start al over with it the end of September) and so my left leg with the new knee is longer. I put a drugstore shoe insole in the right shoe and that straightened me out. My PT doesn't measure all the time but I'm at least close to straight on extension and I'd guess a little more than 100 on flexion. I've been doing stairs the normal way for a few days. Decent progress I'd guess. Aiming for slow and steady.
 

sistersinhim

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For just a month out you are doing fantastic. Swelling is normal for many months. Just be sure to ice and elevate frequently to help get that swelling down.
 
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Bikeknit

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Too slow! I want to be like my friend who, with his physical therapist's blessing started taking gentle bike rides outdoors just 3 weeks after his surgery. I am not like him! I can do careful slow exercise bike rides for 12 to 15 minutes but anything more and I've got a day wrapped in ice! I want to go on long walks with my sturdy new knee but am still taking short quarter milers with my husband. I want those two nights of gentle slumber with no discomfort to go on and on. Unfortunately, they were the exception, not the rule. I know that I am doing as well or even better than most but still I want there to be something that will hurry things along. I mostly want the swelling to be gone!

My apologies to those with serious postop struggles. I know I'm on schedule and I see my surgeon on Wednesday to confirm that. This is a long haul and I suspect we all hit a point where we want it to go faster.
 

Pumpkln

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This is a long haul and I suspect we all hit a point where we want it to go faster.
You may want to go faster, but your knee may have other ideas if you go too fast to soon.
It is a challenge to figure out what is just right for your knee, through trial and error you will find your way through this marathon of a recovery.
 

Jaycey

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@Bikeknit I'm tagging my colleague @Roy Gardiner who is an avid cyclist who had BTKR. He will have tips on getting back in the saddle. But remember you are not in training - you are healing from major, traumatic surgery.
 

Roy Gardiner

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I can do careful slow exercise bike rides for 12 to 15 minutes but anything more and I've got a day wrapped in ice!
good call, if it causes swelling, don't do it!

If you can get a static trainer (to put your road bike on indoors), or if you already have an indoor bike, you can use it to help regain mobility
  • 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
 
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kneeper

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You're absolutely right that we all hit a point where we get frustrated with how long it's taking. I was well prepared by my surgeon but after about 4-5 weeks I still had my little :tantrum: moments.
 
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Bikeknit

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I can do careful slow exercise bike rides for 12 to 15 minutes but anything more and I've got a day wrapped in ice!
good call, if it causes swelling, don't do it!

If you can get a static trainer (to put your road bike on indoors), or if you already have an indoor bike, you can use it to help regain mobility
  • Set the bike to zero resistanc
Here is a bit more chat and some pix and how 'healing' and 'training' are different
Thanks Roy. I got a trainer for my bike when the gyms shut down in March to use for bad weather days. I'll experiment with the seat adjustment.

Hoping to get a 125° flexion but would be delighted to get to 135°. Apreciate everyone's encouragement.
 
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Bikeknit

Bikeknit

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Tomorrow marks 8 weeks and the past week has been a roller coaster. I had a follow up appointment at my surgeon's on Wednesday. I went bouncing in thinking I was doing great and he came in talking about maybe postponing my second knee cause they didn't think I had made much progress on my extension and flexion and spoke to me about scar tissue and the "window of opportunity".

I have a question about these range of motion measures. My PT had only measured once, a week and a half before the doctor's appointment, on a day that my knee was particularly swollen. In any scientific study you want to repeat measures to rule out an anomaly. I'm sure I can bend and straighten my knee more or less depending on how angry and swollen it is at the time. I imagine you can definately focus too much on numbers and measure too much but an individual number seems potentially to be an anomaly.

Anyway, I convinced my doc I was working and can be ready. I know bonesmart disagrees with the window of opportunity on Rom but the vast majority of docs in my city don't seem to have caught up. My 1st surgery was postponed twice (anemia (mine), then covid cancelled elective surgeries) and I really just want to be on the other side with both knees.

All that aside, I'm doing pretty good. Sunday morning, my husband and I took the bike to a nice flat museum drive that looks out over the city and I did my first outdoor ride. It was a beautiful morning - no humidity, which is unusual in August here) and I did loops around until I hit 3 miles. Today we again took the bikes to an area that is flat and rode around the neighborhoods for 5 mikes. Perfect. I'm convinced that bicycling loosens up my knee without putting too much stress on it. This morning I woke up and didn't feel my knee! No pain, very little stiffness. I know I'll have more bad days again but also can see more good days like today.
 

newlybionic

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Sounds like you are doing very well. Don’t forget to ice and elevate even if the swelling is not apparent to you. That will help keep the stiffness to a minimum.
 

Jockette

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You are doing very well for 2 months post op, bike riding that far outside with no ill affects is awesome! Function definitely wins out over numbers, and those numbers will improve with time and more healing.
 
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Bikeknit

Bikeknit

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I've got a question about graciously changing my physical therapy provider. I'm not willing to skip the PT but have been frustrated by the lack of communication with my provider. I've tried various ways to talk with him about my goals, the purposes of my exercises, when it might make sense to adjust with little success. He also was disparaging of my doctor when I said that the doctor was concerned about my progress. Don't get me wrong, I would have been fine with something like, "I disagree with him because ..." but what he said was, "Was he having a bad day?"

Anyway, I've found a new provider and will be leaving. My preference is to just disappear but I've been to 15 sessions with him, it feels a little rude. I've been trying to find a plausible reason why the other place is more convenient but haven't come up with anything. I don't think he's the kind of person looking for constructive criticism. He's not a bad person, just a bad fit for me. Should I just disappear?
 

leejaa

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You have tried talking to him in the past according to your post so I do not think any more conversation will have any effect on him. You can always send a note saying that you are stopping PT with this office and you are continuing at a location that will suit you better.
 

newlybionic

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I hope your new therapist works out well for you. Just remember you are in charge as you are paying them.
 

allin1

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I wouldn't worry about saying a goodbye. People stop and start therapy all the time, I'm sure he is used to people not coming back for many reasons.
I also ride bike and have been using it as my main therapy for my TKR recovery. Sometimes it will get a little sore at the end of the ride, but the soreness doesn't seem to carry over for me. Even an hour post ride my knee will be back to "normal".
 

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