Bilateral TKR Bubbles BTKR 9 November 2015

[Timetolive]

@hawk2go, not to highjack Bubbles' thread, but I see the walking stick as not as secure as a cane - more of a "pay attention to where you are walking" kind of tool. You can still use it for aid though. AND, as a very dignified elderly lady at church, who uses one says, they just look cooler than a cane. Hahahaha!

 

[Celle]

I am not using a cane anymore, although I am afraid of falling. In the house, I am fine. Outside, I walk like an old lady. The OS told me to start walking for rehab three times a day, and it frightens me to think about it. I have a nice walking pole I think I will take as a "just in case". I was attacked by a dog while walking several years ago and still have some of that fear left, so it will be a good protector also.

I didn't need the cane but for a long time I would carry it anyway, when I went outside in bad weather or when I was going to be amongst crowds. It served both as a confidence-booster and as a way of warding off rushing people and dogs.
I still carry it in my car, even 15 months after my TKR.

 

[GratefulNana]

Great progress! Before my surgery, I walked 3.5 miles daily in our hilly neighborhood, until my knees finally had other ideas. As my knees became worse, I tried various things to keep me walking. We live in an older neighborhood with tree-lined streets. The sidewalks have become cracked and raised everywhere mostly from the trees. I, too, was always fearful of falling. I finally settled on a pair of Nordic walking poles that I purchased based on my height, not the adjustable ones. I found that they gave me balance as well as helped me concentrate on my gait. Best of luck to you.


BTKR Scheduled for 12/28/2015

 

[kneeper]

@Bubbles do you walk around the house with your cane or only outside? If you're still using it inside you might practice walking near a counter or couch or something for security without the cane. Sounds like your PT is on the right track working on your balance.
There's no set time to get rid of the cane, but I bet you're getting there soon.

 

[Bubbles]

Thanks for all the advice!

Still using the cane everywhere. I force myself to carry it rather than use it in the house but it's tough. I still tire so easily because of the blood clots that I need to be careful. I get lightheaded so fast when I tire but it's improving. I just need to keep forcing myself to walk normally around the house even though I'm uncomfortable.

I have baker cysts behind both knees, they've been painful lately. Different little pains and discomforts cropping up as I progress. Very interesting recovery with new things every day.

Walking sticks are a good idea. Can't put weight on one like you can with a cane. The knees work well so I don't need to put weight on a cane but I need to get that through my head. I've been using walking sticks while hiking for years and I always 'look down' when walking. It's important IMHO to know what your stepping on each and every step.

 

[KarriB]

Looking down is a habit I got into and now can't seem to break. I try to look up when I see someone coming toward me. I still keep a cane in my car and basement, but often need it due to my left knee and back. My TKR doesn't hurt when I walk.

 

[kneeper]

I don't know that you have to force yourself to not use the cane. If you're tired or feel unstable, definitely use it during the day all the time. Maybe just practice without it once a day if you want. The important thing is to be safe.

 

[Celle]

I agree with kneeper. The cane is just a tool, to help you walk and keep you safe. Eventually, you will feel you can walk without it. Until then, there's nothing wrong with using it. As kneeper said, practice walking inside for short periods without it and gradually you'll gain more strength and confidence.

 

[Bubbles]

Safety first for sure--thanks for reminding me @kneeper and @Celle.

When I said I try to walk without my cane I'm still carrying it just not using it. I'm really am a chicken. But because I tire so easily and have been told to be particularly cautious because of the blood thinners I don't push too hard. No falls allowed. My PT is also very cautious. I've been doing more standing exercises which tire me quickly. We keep a chair close and I stop to rest between sets. Amazing how quickly I tire standing on one leg for 30 seconds. I can't do three sets on each leg without sitting down to rest. Hoping this too shall pass.

I was noticing that I'm looking down too much while walking because of the discussion @KarriB. I can see where it could be a problem hunching over, it's harder to look from side to side. To see well I need to stand up straight and tall (PT is good for point it out). I had to adjust how I walked across the parking lot into PT today to be able to look around well. Looking down with just my eyes, not my head or shoulders. It's like learning how to walk all over again.

My bad knee hit 113 ROM today.

 

[Anchovy]

Bubbles,
How are you doing? I can see from the thread that you had some complications.

I seems we have some history in common. I also have a long history of bilateral knee dislocations and multiple surgeries to attempt repair of same and many, many ongoing treatments for pain and rehab.
I also have Attune Dupuy knees, surgery done at Lehigh Valley Hospital in Allentown, Pa.

I do have many concerns about my recovery potential given this somewhat complicated history. The knees are clunking and clicking and of course I imagine they don't "track" properly.

Do you have any of these concerns?

 

[Anchovy]

BTW, Congrats on your ROM!!!!

 

[referee54]

I had a BTKR on November 8th of 2007, so I can see easily where you are on your timeline, and I had some of the same issues.

I had gait issues and some balance issues about the same time you are having them, and I also used a cane for that, too. I also used a cane when I went to the mall or the grocery store, as it not only helped me, but warned other people that I was unsteady and that they should be wary of me and be careful around me.

I have baker cysts behind both knees, they've been painful lately.

This is interesting. I had a Baker's Cyst in one knee, and after my BTKR and the knees stabilized, the Baker's Cyst has been dormant. I hope that once you gain the strength and the stability, the Baker's Cysts should go away.

Amazing how quickly I tire standing on one leg for 30 seconds.

Please remember that stamina is one of the very last aspects of recovery to come back---the recovery from a BTKR is tiring to begin with, and I, like you, also had some DVT's, as well.

It's like learning how to walk all over again.

"Mechanics is muscle memory"----and some habits are tough to break. I had some gait issues and I had to retrain my body to things the truly correct way. I did not realize how dysfunctional certain activities were---this is a slow, frustrating process, but just focus on what you need to do and it will become habit, as well.

 

[Bubbles]

@Anchovy,

We sure do have lots in common. Maybe the Attune knees are a PA thing! The only surgery I've had on my knees is BTKR, I was told at a young age to not let anyone operate. Back then they would have probably removed my knee caps. I don't think they did patella realignments, which may have helped, plus I lived in a small town in Wyoming. Don't think I would have been able to find a good doc. My hyper mobility is a big part of the problem. What do they have you doing in rehab? Are your quads weak too?

At this point in my recovery I'm thinking quad weakness is a problem. I've mentioned 'jumping' when my knees are in a particular position. It's a reaction I've developed after years of dislocations--an attempt to get weight off an about-to-dislocate knee. I think it's going to dislocate and the quad weakness is a big factor. It's hard to explain. I've been working on building quad strength, carefully. My PT is good and understands my issues. I've been able to see that the jumps don't really cause any problem other than scaring me. They don't make me fall.

I spent time in PT yesterday just walking around discussing a good gait, exaggerating the movements to get them engrained in my head. Muscle memory, @referee54, is what it's about. You're right, thanks for the encouragement. Walking bent over is a good example. Bent over a little I could throw my leg into a step with my gluteus and hamstrings rather than using my quads properly (which caused pain). I've been doing this for years so relearning isn't easy-old dog, new tricks. It will happen but it's slow. I was stepping on and off a step and had a difficult time doing it standing straight. Standing streight forces the quads to do the lifting. They are working fine--I just need to let them. It used to be so painful. I need to think about every step and do it right for a while.

Good to know I'm not lagging behind on my recovery, it sure feels slow. I've been itching to go somewhere warm for a week or so. I don't have a clue how I'll be doing in a month or two. I told my PT I have an opportunity to play golf first week in April. She said I could chip and putt a few holes by then! Are you kidding me? Will I still be that bad then--five months out? I won't be back playing golf then? (I've been using my putter as a cane on hills for years.)

Stamina! Oh don't I know--add anemia and blood clots and it's even worse! Moving right along with my cane.

 

[Dragonkeep]

I know when I was working with the PT, he was adamant about my gait issues. In the decade prior to my knee replacements for OA, I would come down on the outside of my foot, rolling it in, just to cut down on the pain on the knees, ease my weight down on them. Mark, my PT, insisted that I stand tall, head up and come down on my heels, rolling through to the toes as I walk. It's amazing how difficult it is to install new muscle memory, so keep after it and it will happen.

 

[Bubbles]

I'm with you @Dragonkeep -- new muscle memory is tough to get engrained. How much walking are you doing? I've been making it a point to walk as much as I can paying attention to walking properly. Head up, shoulders back, heel to toe, just like you say. We get a nice day here and there so I get outside to walk. Decades of walking to relearn. When I get tired I tend to go back to bad walking habits.

It's a long process, this recovering, but I see improvement regularly. I've played a few holes of golf and I can swing the club fine, it's the walking around on the grassy hills that's difficult for me. I'm too slow but the more I walk the faster I get. I still tire easily from the blood clots but it's much better. I'm back to work as usual.

My biggest problem is still quad strength. I'm doing PT once a week paying lots of attention to my quads.

 

[suemegane]

@Dragonkeep & @Bubbles I am having the same issues, finding walking the correct gait so difficult. I can sometimes get it, but today I have been all over the place & the limp is back!!

 

[Bubbles]

Good to know I'm not alone. It's difficult, isn't it! I feel like a two year old sometimes.

 

[Timetolive]

Hi Bubbles! I was thinking about you yesterday and was wondering how you are doing. I see that you are progressing with the same issues I have - stamina and gait. My foot turns out and I have to consciously think about walking with it straight. I know with the blood clots ( sure was praying hard for you!) and having a bilateral, you have been through so much more than I have, although I have stamina issues too. Naps seem to be the order of the day most days!

 

[Celle]

I told my PT I have an opportunity to play golf first week in April. She said I could chip and putt a few holes by then! Are you kidding me? Will I still be that bad then--five months out? I won't be back playing golf then?

It all depends on the progress your knees make.

The problem with golf, as I see it, is that it imposes twisting movements on your knees, especially when you swing to tee off. New knees don't like twisting motion.

You might also have to consider the amount of walking you would be doing, especially if the course has hills - although you might be able to use one of those little carts to get from A to B.

 

[Bubbles]

@Timetolive stamina and gait, still the issue. I'm working on both. Try to walk as much as I can tolerate each day. I've played a little golf, just a few holes, and find the swing isn't too much of a problem. It's the walking on the eneven grass, up and down hills that's difficult. How are you doing?

I understand what you're saying @Celle. The twisting can be a problem, I didn't notice it yet but I'm not really taking a full swing. I can't walk fast enough to keep up like I need to.

A couple days ago my bad (or worse of the two) knee started hurting and got very stiff. It hasn't been this bad in months. It continued to hurt really bad even after I elevated and iced. I don't recall doing anything unusual that might cause this--it really hurt. The one thing I can think of is that I was wearing jean capris that were rolled up to just below my knee. Maybe it was too tight. Much of the pain was from around my bakers cyst, maybe it squeezed and irritated it. I've worn these capris before without issue. It's feeling better now but still a little more stiff than usual. Any ideas or suggestions. I don't need this happening.

There's some doc appointments and tests for me in the next week. I'm hoping to be able to go off the Coumadin. If the lung tests show any clots, I'll need to stay on it. I'm also looking at taking some fairly long flights in May, not sure how to handle that. One doc suggested lovenox shots just before and after the flights. I'll see what the doc's this week think.

Thanks for all the help and advice. This site is great!