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TKR CaliGirl's post op journey.

Ugh, I am paying an involuntary visit to the ODIC (over did it club). Yesterday I got a visit from the PT supervisor for my discharge exam. He said "I'll be pusing your leg to bend today." I told him that he was not to touch my knee. I would bend my knee myself to the point of discomfort, but we would not be doing anything that would cause me pain. He agreed and backed off.

He brought with him a pedaling thing. I don't know what they're called. Pedals like an exercise bike, but you sit in a chair. He wanted me to do "5 to 10 minutes" on the pedal thing. I told him I'd do 5 minutes, since I've been mostly sitting on my butt for a month and I'm really out of shape. I was able to do 5 minutes without any pain in my knee, and he praised me, since I was using the appropriate muscles to pedal and not compensating with my hip. He had me do all the usual exercises my other PT'S have me do, plus had me straighten my lower leg from a bent position with some resistance from him (10 reps x 2), and had me bend my lower leg from straight, again with resistance (10 reps x 1).

My knee was killing me last night, and I woke up in the middle of the night and needed more pain meds. My meds say take every 6 hours, but I know they're frequently written as every 4 to 6 hours, so I took the middle of the night dose at 5 hours, rather than waiting for the pain to totally build up again.

None of the exercises I was doing hurt at the time. I think the biggest culprit in my pain was the 5 minutes of pedaling. Did I mention this was my first attempt to pedal at all since my surgery?

Is there any way other than trial and error to know what your limits are? Physical therapy feels good. High pain levels for a day or two after, not so much. I guess these are issues to raise with my new outpatient PT.

:groan::chillpill: :ice:
 
I haven't figured out an answer to the question yet to your question. Some days I have no problems at all but on a different I'm suffering the entire next day. There should be some formula to get the answer.
 
If you don't try then you will never know your limits, this I find easier second time around I seem to understand my body's limits, I understand if I go out to lunch or do something different then I need to rest the next day, not follow another big thing the next day sort of ease yourself into it, if that makes sense, it's not a race to see how much you can do in one day or one attempt it's what you can do that is important.


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Hi, @CaliGirl I'm glad to see you're doing well. When I first used my pedal bike at home after the TKR, at first I could only go backwards. Then when I could go forwards I only did a few rotations the first time. Each time I tried it I added a little bit more, until I could just go without any discomfort at the time or later. It's not a race so take it slow and steady.
I love Tiramisu and make it for my daughter's birthday when she requests it. I use coffee, but no liquor in it, but I use a recipe I got from America's Test Kitchen I absolutely love. Plus, I make the ladyfingers myself, although that's kind of a pain, but it's hard to find the firm ones in stores anymore so I just make my own. They're not perfectly shaped but by the time they're in the Tiramisu and cut, no one can ever tell anyway.
Keep up the great work and I'm really glad you're over a month and well.
 
Hi Gayna~ First I want to comment on your walking off without your cane in one of your earlier posts. I've done that- and it's so funny because once I figure out I've left my cane behind I freeze. Stand there for a few moments as if I'm on a bike or pair of skates wondering if I'm going down- lol! Like you I go back for it just to stay safe!

And I'm so sorry you're having that horrible ODI pain. I think figuring out what the limits are is as simple as we'll overdo it and then realize we just aren't ready for that much activity at only 5wks out.

I'm doing such limited PT right now I feel guilty every single day. But I continue to remind myself every single day that Josephine recovered just fine without any PT.

I've noticed the past few days more discomfort from stiffness and am sizing it up to be the 6wks angry tissue spoken of here on bonesmart.

We just have to hang onto those basic mantra's that will enable us to see more strength and ability in our new baby knees!

Hope you're feeling better soon.

:console2:
 
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I keep walking around without my cane also. I'm supposed to actually be using my walker still, but it's so hard to use on carpet so I keep using my cane instead. I prop it when I'm where I want to be, then forget to get it before walking off and have to go back for it. My OS says to use the walker another week, then transition to cane for a week, then I can walk unaided.......hopefully I'll be okay considering I'm only half following his instructions.....
 
Each day I feel like I'm able to do a little bit more. I can now go up and down my front steps with my cane, by myself (there's no handrails) - a long way from having to go up the stairs backwards with my walker when I first came home from hospital.

I can get into the passenger seat of hubby's compact car like a normal person, although getting back out again is still a bit less than dainty. Took my first post op trip to the grocery store. I was very thankful for those motorized cart things. Hubby has been doing all the shopping. He did come with me, and of course carried everything in, but it was lovely to do something normal again.

I start outpatient physical therapy tomorrow. I am confident in my ability to set limits with them regarding what I will and won't do.

I was taking 15 mg oxycodone at bedtime. I recently dropped that down to 10-325 Percocet. Last night at bedtime I wasn't in much pain at all, so I took a couple of Tylenol and an Ambien at 10 pm. Woke up at 1 am, on my side, needing the Percocet. There have been a couple of times where I've taken naps without any pain meds, and that natural (non-drugged) sleep is so nice.

I have plans to fly from Los Angeles to Boston to attend my great aunt's 100th birthday party. This will be just before my 5 month kneeversary. I will be traveling with my mom, who needs wheelchair assistance, so I will be looking after her. By 5 months is it a realistic expectation that I can stand in line at airport security, walk through a large airport, and then sit on a non-stop 6 hour flight - all without my cane, since I'll need my hands free? I'm short, so leg room has never been a problem, and I can certainly get up and walk and stretch a bit during the flight. I just want reassurance about how I'll be at 5 months, rather than my current 5 weeks.
 
I am sure you will be fine, you might need some medication, have a word with your GP. When do you hope to return to work x

LTKR 11 May 2016
 
@Dawni Yes, having meds on hand sounds like a brilliant idea, especially since I won't be doing any driving.

As far as work, I'm not sure yet. I start outpatient PT tomorrow, and I'm seeing my OS next week. I think I'll have a better idea then. I think I need to spend time sitting at a computer desk, to build up my tolerance for sitting with my knee bent for increasing periods of time. Still can't ride in hubby's car for very long without being very uncomfortable, although it could just be it's a low seat compared to a desk chair.
 
I went in to work today for 3 hours to do my weekly paperwork only, sitting at my desc getting up every so often to move around, my knee let me know that it had been in to work. I intend to go in once a week to do the paperwork just for a few hours, I work as a catering manager in a school so will only need to do this untill the end of July then the school shuts untill September when I will return back to work full time, with my other TKR I had about the same time off work so am hopeing it will be ok this time. I will have had 16 weeks off work by then x

LTKR 11 May 2016
 
Hi Gayna, I did a <2 hour flight about six months after my first TKR. The flight itself wasn't as much of a problem as walking through the terminals, which was tiring. Take advantage of every moving sidewalk and shuttle. Take sit breaks. Wear comfy shoes that are easy to kick off and put back on. I was headed to AZ, therefore low-heeled cowgirl boots were an easy choice.

Depending on the airline you can sign up for "TSA pre-check". The TSA pre-check lines are generally much shorter.

Reserve an aisle seat, if possible, so that you can move and stretch out your leg (when safe to do so). Do ankle pumps. Stand periodically.

Despite meloxicam and Tylenol I was pretty stiff when my flight(s) landed. This decision's up to you, but I let almost everyone else disembark ahead of me so that I wouldn't feel rushed. Last tip: Don't be me. I left my purse on the parking shuttle late at night and had to trot after it while frantically waving and yelling. Doh!
 
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P.s. Flights out of Burbank cost a bit more, but for the mobility-challenged *almost everything about Bob Hope airport is far better than LAX. *Burbank doesn't use jet bridges (gangways), but I had no problem walking the short distance across the tarmac and climbing the stairs. I was nervous about it, but I did fine.
 
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@Clipless I'm traveling with my mother, who is far more mobility challenged than I was even right before surgery. I've arranged wheelchair assistance for her. I will definitely use the people movers, and will take your suggestion of sitting breaks while walking through the airport. Also, I reserved the aisle seat for my mom - again she needs it more than me, and I'm sitting next to her. I'm short enough (5'3") that legroom has never been a problem. I should be able to stretch my leg out if I need to, and I'm sure mom will let me up to walk in the aisles. Standing for a bit will do her good, too, I'm sure.

We already have our tickets, and they are non-stop LAX to BOS. First, it was more expensive to fly from Burbank, and second, there weren't any non-stop flights, and my mom had a lot of anxiety about having to change planes somewhere.

We're flying Delta, so I will check into the TSA pre-check. That's a great idea. Thanks.
 
Went to my first outpatient PT appointment yesterday. I chose to go to the outpatient rehab facility at the hospital where I had my surgery for a few reasons. First, they are pretty close to my house. Second, they have a pool. Third, one of the therapists I worked with inpatient told me she mostly does outpatient. I really liked her, as well as the other therapists I saw in the hospital. Finally, they're in network with my insurance, so it doesn't cost me anything.

I was nervous going in, having read horror stories about PT'S. Thankfully my fears were unfounded. The first thing the therapist asked me was about my pain levels - present pain level, general day-to-day pain level, and highest pain levels. She asked what had caused the high pain levels, and listened when I said overdoing it in PT. She asked what I can tolerate, and what causes pain.

Going in she measured me at 0 and 100. She said we should set a goal of 110, which I thought was reasonable. She had me do an exercise, which basically amounted to heel slides with my feet up on a yoga ball. She also massaged my quads and the skin around my scar, as it is all very tight. It felt wonderful (although there were a couple of tender spots).

She had me walk back and forth with my cane, so she can see how I'm doing. Then she had me walk back and forth without it. I did better than I thought. She said I need to work on bending my surgical leg a bit more when I'm walking. It's stiff, and she said I'm swinging it out to the side a bit to compensate. She said not to exaggerate the bend, just to try to be aware of it when I'm walking, so I develop a more normal gait.

While I was walking back and forth, the therapist I worked with as an inpatient walked in, and she remembered me. She even remembered our conversation about pool therapy. Turns out she's going to be my therapist for pool therapy, once I'm cleared for swimming next week.

The land PT took my measurements again before I left, and I was at 105. She encouraged me to ice more frequently, as there's still swelling.

Best of all, I did PT, increased ROM, and was not in pain afterwards.

Choosing this PT facility was the right choice. I'm very happy.
 
Had a couple of milestones.

In the evening, around 7 or 7:30, I just get uncomfortable and fidgety, where I just can't find a comfortable position. I had been trying to tough it out. During the day, I don't take any pain meds, except for the occasional Tylenol (haven't needed to for a while). I do need a pain pill (Percocet) at bedtime, which is around 10 pm. I haven't wanted to take a pain pill at 7, because then at bed time it's too early to take another.

I decided yesterday to take half a pill at 7, and the other half at bedtime. I figured worst case scenario, if I woke up in pain in the middle of the night, I can always take another half (or even a whole one if the pain was that bad). I actually got the best nights sleep I've had since the surgery. It was very restful sleep, too, since it wasn't drugged sleep. I slept for a solid 7 hours. :sleep:

My other milestone was that I drove for the first time today. I've felt ready for about a week, but I finally did it today. Drove to the gas station and filled my car up. It was lovely being able to do such a normal task independently.

I think tomorrow morning I'll be able to drive my daughter to the bus station, so she can catch the bus (she has summer school). That has always been something I do, but hubby has had to do drive her in the morning and afternoon since my surgery. I think I'll also be able to drive myself to PT tomorrow.

I am starting to feel like a capable, independent being again!:happydance:
 
I know your milestones have you grinning from ear to ear! And rightly so. To gain little bits of our independence feels so good! You have had a very good recovery overall and I up I can do as well! Right now I'm facing the everything burning. Weight bearing isn't that bad.
 
That is so awesome Gayna~!! I just today had the strong feeling that it's time, that I'm ready to drive now-!! I really wanted to go out today but was busy doing other things. I just know in my heart it's time! I'm proud of us- we are truly getting there Partner-!!

[Bonesmart.org] CaliGirl's post op journey.
 
That's is so great..it must feel amazing when we can get back to our routines!
 
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