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TKR BoneSmart Works!

I have learned several new words on this forum. And I thought my vocabulary was pretty extensive because I read a lot! Especially when I first got on the forum and I’m like “I know that’s a bone but which bone is it?”.

How far can you walk now @mendogal? Curious what distance you are trying for.
 
My progress has stalled at 3 miles non stop, due to rain on so many of the days I had time for an hour + walk (doesn't help I'm cold sensitive and barring a real need would never try a long walk even with mid40 temps we often have early morning). I was doing the 3 miles once a week, but it's been over two weeks now.
My usual near daily walk is about a mile and a half to two miles.
My prior baseline, due to severe R knee arthritis, had been 1.5 miles non stop *on a good day* so I'm ahead of the game!
My goal is 5 miles non stop by end of the year!
 
sistersinhim said:
Thanks for the clear explanation. I bet I'm not the only one who didn't know what that meant. It sounds like something that is caused by nerves. Occasionally I get tingling in my shoulder and arm caused by a compromised nerve in my neck. Zingers in our knees are definitely nerve-related.
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Yes all three are intermittent nerve disorders each arising from a different cause!

To you and @MSuki : knowing prefixes and suffixes is so helpful!
Dys - disordered, wrong, bad... as in
dysesthesia - bad feeling (sensation, not emotion)
dyskinesia - bad movement (various motion disorders)
dysphagia - bad swallowing etc
 
mendogal said:
Dys - disordered, wrong, bad... as in
dysesthesia - bad feeling (sensation, not emotion)
dyskinesia - bad movement (various motion disorders)
dysphagia - bad swallowing etc
Click to expand...
Now, will I remember this? I hope so. Thank you for your help!
 
Today my first TKA (on the left) turned one year old. I didn't come to BoneSmart until a little after my second TKA so I thought today to give a little back story!

My left knee gave me no trouble until autumn 2021 when, literally shifting weight while standing alone in my dining room, there was excruciating pain and it wouldn't bear weight. Having been through a right knee blown ACL and torn medial meniscus, I knew immediately this was the medial meniscus.

I worked for over a year with a sports medicine osteopath and intermittently with PT on conservative treatment. But periodically and randomly, there would be sudden excruciating pain and inability to bear weight. Arthroscopic surgery on badly torn medial AND lateral menisci didn't fix it. When an episode didn't resolve after a cortisone shot, I knew it was time for a knee replacement.

I had an interesting prep protocol to follow: instead of just washing with antimicrobials, I was to do three separate applications of chlorhexidine over two days, via three sets of prepackaged wipes - whole body except for the sensitive bits and head. It seemed a lot, and being 5'1" I decided to only use 2/3 of the wipes in each package.

Surgery was easy. Spinal, fentanyl, propofol. Woke up in recovery and started doing ankle pumps as I thought I was supposed to right away, much to the amusement of staff. Had a beverage and snack, walked independently with my walker to the bathroom, and we were on the road for the hour drive home at 3:45.

First four days were fine - pain controlled between the prescribed meds and the three days of anesthetic into my thigh via a slim catheter. My ROM was fast to come back (I have joint laxity) and my quads seemed to wake up quickly.

On day 5 the nightmare began.... continues....
 
Post Number Two of the story of my now 1 year old TKA...

POD 5 I noticed that an itchy spot on the back of my neck had turned bumpy. By evening I had an angry red rash on my chest and tummy. By the morning of POD 6 it was spreading further, to arms and beyond, and it itched. I called the oncall OS and we couldn't figure out what med might be causing it. Fortunately Monday morning I got right in to my primary care doc.

Very long story short.... despite a course of oral steroids plus every oral and topical antihistamine known to humankind, my whole skin itched and hurt and burned for over three weeks. That plus the steroids gave me the worse case of insomnia; I was nearly delirious at times.

What kept me sane? My knee rest and rehab regimen. I never overdid things - the exhaustion kept me out of the ODIC! - but except for a weird bout of severe overnight knee weakness and stiffness from week 8 to week 12, the actual knee recovery was ahead of anticipated targets.

The obvious culprit was the chlorhexidine wipes. Under the direction of an allergist months later I did a series of small self administered patch tests. They were negative, and the consensus between me, the allergist, my PCP, and my OS is that it was the massive preop dose that elicited the reaction.

Needless to say, I didn't do any prep besides soap and water for my second knee. And I did allow the OS to apply, then wipe off, a small amount of chlorhexadine in OR before the incision. It was fine.

My one year old knee has been a great support for my baby knee. Long may they walj together!
 
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mendogal said:
Dysesthesia is literally "bad feeling" and can be anything that sensory nerves normally convey that's happening in the absence of any external stimulus - feelings of hot, cold, itch, pain, friction, etc.
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Agree with this definition. My numb patch is a lot better but doesn't like any little knocks- like accidentally banging it slightly on a table or being hit by a child's plastic toy. It gets really nasty nerve pain like hitting your 'funny bone'.
 
Interesting story about the allergy. I have sensitive skin too ( was a redhead many years ago!) and I am sure that rather excessive pre-op regime would have triggered me as well.
 
Janet, what a horrible start to your first knee replacement. At least you learned the cause of your skin's awful reaction and you didn't have to go through it again with #2's replacement.
 
I have a history of odd allergies as well. And usually the only way to find out is the hard way. Belated sympathy to you, that’s ALL you need right after knee surgery…

I really hate the whole wash with scary soap at home anyway. I never know if I’m doing it right. And it makes me crave lotion afterward.
 
Today's progress: rode the upright stationery bike at the gym, maintaining 50-55 rpm at resistance level 3 (still very low) but increased time from 20 minutes to 25 minutes.

The R lateral quad complained during but quieted down.

On Monday I will get cast for custom orthotics. The podiatrist made a very good case for my overpronation (it's present when I stand as well as during all phases of walking) being the cause of my seemingly out of nowhere L medial meniscus wreck that cascaded into my TKA. He showed how when I stand relaxed the flat feet make my tibias turn inward and my patellas with them.

If the podiatrists had actually specified this structural effect to me circa 1982 I might have stayed in custom orthotics forever and been spared some grief. Well, so it goes. Better late than never.

Until I get the new orthotics I will reduce walking and increase biking (when sitting or reclining I do have quite lovely arches!).

He also showed how this has chronically shortened my gastrocnemius and demonstrated with passive ROM where I have constricted movement and where I have hypermobility.
 
@mendogal I had no idea you still had issues like this. You seem like you are so active and have been able to do so much, so now I’m even more impressed that you’ve been doing it with unresolved foot problems.

Hope this gets you on the right track toward no more injuries!
 
MSuki said:
You seem like you are so active and have been able to do so much, so now I’m even more impressed that you’ve been doing it with unresolved foot problems.
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Oh well the feet never BOTHER me (despite bunions and flat feet) even after a three mile walk, and overall I have had (the illusion of) good strycture, so I didn't realize how badly they affect my legs!
 
Oh well look what I did! The increase from 20 minutes on the bike to 25 minutes this morning put me in the ODIC :banghead: Newer knee isn't squalling but it's definitely sulking.
Okie dokie, 20 minutes it will be...
 
Oh no! This is what reminds us that the knee really does take at least a year to heal. When I first heard that I found it difficult to believe. Actually my surgeon told me that although you are mostly healed in a year, it can take 2 years for complete recovery. Not sure if that is true or not but it gave me some respect for the magnitude of the surgery. Sending you a hug, hope you feel better after a day or so of ice and taking it easy.
 
MSuki said:
really hate the whole wash with scary soap at home anyway. I never know if I’m doing it right. And it makes me crave lotion afterward.
Click to expand...
My surgeon/ hospital didn't ask for anything special beforehand with washing. I just had a nose swab at the pre-op check a week before for MRSA ( methicillin resistant Staph).
 
MSuki said:
Oh no! This is what reminds us that the knee really does take at least a year to heal. When I first heard that I found it difficult to believe. Actually my surgeon told me that although you are mostly healed in a year, it can take 2 years for complete recovery. Not sure if that is true or not but it gave me some respect for the magnitude of the surgery. Sending you a hug, hope you feel better after a day or so of ice and taking it easy.
Click to expand...
I took a couple of acetaminophen yesterday and alternated rest and short walking. ROM and stability were fine, no pain getting in and out of the car or walking up three steep steps to a local shop before dinner.The knee hasn't wanted ice but once in the past three months and today is back to normal.
But yes, it's definitely still got its limits and demands respect:heehee:
 
So are you getting multiple sets of the orthotics or will you have to move them shoe to shoe? Just curious how that works.
 
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