TKR Carole’s recovery thread

[Celle]

The PT people called and for 45 minutes or longer they pumped me for information about what I might say concerning why I quit. The OS already knows I quit PT. They are freaking out, worried, and upset -

I would have hung up on them!

You did completely the right thing in leaving that PT place, Carole. Well done. You took a positive action in support of your knee.

 

[luvcats]

I'd just like to say, YUM!
I have a lot of food sensitivities. My food options are required to be somewhat limited. But I have a great imagination.

Now, if I could *rent* a live poodle puppy

In a way you can. Check out your local shelters and rescues once you're recovered. I bet you could take a sweet puppy for a walk for them, or spend some time cuddling and playing with a kitty while they wait for their forever-people to find them. All the loves, none of the expense.

 

[sistersinhim]

Now, if I could *rent* a live poodle puppy.

I've always wanted a beagle, but not the responsibility. We have many that get lost after hunting and are at our pound. I have thought about volunteering and giving them some much needed love. That would help the dog and me at the same time! luvcats has the right idea!

 

[kneeper]

Good for you for quitting that PT place.
I also noticed you mentioned having trouble sleeping on your side. I had to sleep with a pillow between my legs for a while and experiment a bit with angles. Slowly but surely I could stay on my side longer and longer.

 

[Carole4815]

Thanks @kneeper . I tried placing a pillow between my legs, but I didn't really experiment with angles. Maybe that would help, good idea!

 

[kneeper]

Yeah, I couldn't do direct leg on top of leg at first.

 

[sewhat]

Wow, I've had a bad PT experience. I quit PT last knee because of a problem with a therapist. She's no longer there. I didn't ask for the therapist that I had last time that was good to me. She had a little boy that stayed at his grandmother's daycare during the day. He picked up something off the ground while they were outside and choked to death on it. I feel so bad for her, I couldn't have her as a therapist. The guy that I have is my Parkinson's therapist and I have fun with him. He was late last time and I gave him a hard time about it. He said his last patient was still in the room putting his shoes on. I said I didn't believe that and that he was probably crying. Another patient nearby looked at me thinking I was serious. lol

A porch swing or rocking chair is good therapy. Just use your operated leg to push off.

 

[Carole4815]

Progress report:

I am starting to recover from my last PT ever, hopefully, which was on Monday. Yesterday I was determined to go out to eat with my sweetie, because to us this is returning to our normal life. It wasn't easy since I am still not quite back to where I was, but I managed to do it, yay me! So happy about that. We had a great time. I had a small caesar side salad and water for lunch, which is one of my favorite lunches. Then sweetie took me on a long pleasure drive here in our suburb, which was SO good for me. I loved seeing the neighborhood and chatting and having fun. Getting out of "TKR jail" for a while was a huge lift to my spirits.

Today we will probably do the same but this time I plan to be openly rebellious and take my rollator walker. Now that I don't have PT to veto the idea, I can actually use common sense to make that decision. I know that my knee will get more, better, and more varied exercise using my rollator than using my plain Jane walker and I think I have been ready for this for over a month already. Maybe we can go to Walgreen's or something, too. I know, that's starting small but I haven't been in a store in nearly forever.

Along with my recently usual series of 1-2 hour naps, I actually slept for maybe about 4-5 hours straight last night!! yay!!! Life is finally starting to look up again.

 

[Macknit]

So happy to hear you are on the mend and life is returning to normal!! Isn't it funny how we can use those small actions to just breathe back life into this journey!!

You have called it "TKR jail" and I call it cabin fever, because we live in the Eastern Oregon Cascade mountain foothills and every winter, when the snow arrives, we have to come up with little activities to break the sense of cabin fever!! Whatever we call the activities they are freeing and uplifting to our lives! And that is why we read and post on this forum.....to be uplifted!

Blessings Carole!

 

[Carole4815]

Thank you, @Macknit! And yes, TKR jail must be much like cabin fever feels like to those living up in the mountain foothills.

We went out to lunch, and for the first time since surgery I took my rollator walker instead of my Plain Jane metal walker!!! yay The rollator is so much easier to handle, faster, and more maneuverable, and I feel perfectly safe using it. I know, what a rebel I am. I figured that if I am my own PT, then I can declare myself cleared to use my rollator.

Then after lunch we went on a long pleasure drive, and went up to the boat launch, and I walked 100 yards on the levee (a nice, flat, paved walkway). I am so proud of myself. That is far enough that for me it was exercise, maybe even the farthest I have walked since surgery. It was hot but with beautiful blue skies and puffy white clouds over the green grassy levee and Lake Ponchartrain, where sailboats were sailing. Sure beats TKR jail.

After that I also wanted to try going to Walgreen's since I haven't been in a store for 3 years, but my sweetie knows me and knows I tend to overdo so he gently suggested that we could do Walgreen's another day. That's OK, Walgreen's isn't going anywhere and I'd rather work up to it gradually instead of overdoing.

What a perfect day!

 

[Carole4815]

P.S., I just decided that I am DITCHING my plain jane walker. I am so happy to be using my rollator again. For one thing, my stride was awful with Plain Jane and even my sweetie remarked on how much better it was with the rollator. Also my legs don't hit my rollator as I walk so I can take longer steps which is natural for a tall person like me. And for another thing, my rollator is a Driver Medical "Nitro Euro Style" rollator which encourages me to walk upright and not hunch over like I'm 150 years old, and like I do with the Plain Jane.

OK, Plain Jane can go in the closet for now.

 

[Celle]

It sounds as if sticking with your rollator is the right thing to do.

 

[luvcats]

Look at you! Taking charge and rollating all over the place! I think it's just wonderful!

You sound so happy and confident using your walker. I'm really surprised that your PT people were so against it, if it's something you've been using for years and are comfortable with. Of course, your PT people were pretty sketchy and not at all working in your best interest, so maybe it isn't a surprise.

I'm completely with you on TKR jail. It was bad enough before surgery with such limited mobility, but completely trapped in the house has been really tough. Last time I went to the store after only 13 days, and that kicked my bum. I regretted it. Yesterday was 23 days and for me it was a more appropriate time. It was just the store, but just being in the car on a clear day with blue skies felt wonderful.

I love hearing about your lunch dates. We haven't gone out for a meal yet. I'm still uncomfortable sitting up in a regular chair, but soon. I shall have to consider where I'd like to go for my 'victory' meal.
And right after that I'll have to go back to my normal sensible weightloss oriented food plan. sigh. lol

 

[Carole4815]

Celle, thanks for your perspective and I couldn't agree more. It seems like a terrific change to me and one that was way overdue.

Thank you, @luvcats ! Speaking of weight issues, I just set up my weight loss Excel sheet for the first time since TKR. The last time I recorded my weight was August 2nd (on maintenance). But since then I gained back 11.2 pounds of those I lost in 2018. Got to get that under control pronto. Hopefully some of it is bloat, and more is knee swelling, but still I need to start working on it. Ate sanely yesterday, recording my calories and carbs for the first time since TKR, so in that first day of being back on track I lost a pound of bloat and now that gain is 10.2 pounds.

You are right; I am SO lucky that my knee can handle sitting in a regular restaurant chair. Of course the other side of that coin, is that it isn't comfortable when I straighten it too much. You can't win. But perhaps walking a bit every day will help extension eventually. Now that I am my own PT, I can definitely say "My PT says I should walk every day and walking is top priority!" The restaurant chairs at our favorite restaurant are low, 16.5 inches from the seat to the floor, with nothing suitable to hang onto while rising so that makes standing up after lunch a terrific daily exercise for my quads and other leg muscles.

I think my PT people and I are just on a totally different wavelength that delayed rollator clearance. Honestly I don't really know why they were dragging their feet about it. All I know is that it is totally 150% safe for me at this stage and has been for over a month, it improves my gait substantially, I am getting a lot more movement and healthy exercise with it, and nobody can tell me no if I am my own PT.

Can you tell that I LIKE these new changes and especially being my own PT?

Last night I could NOT sleep because of some minor knee pain whenever straightening it more. I think it is the leftover pain from last Monday's PT injury, but after such a great day yesterday I needed some good, solid, uninterrupted sleep. So, I took a half dose of hydrocodone (5mg) which did the trick - - 8+ hours. That's only the second pain pill of any kind that I have taken in September and the other was also a half dose. I hope it won't delay my clearance to drive.

Plan for today: Just like yesterday! That was fun. We can go out to lunch, and then walk on the levee, then ice and rest.

 

[lovetocookandsew]

You're doing great, Carole! I am so glad you decided to ditch that horrible PT facility. I'm also glad you've seen how well you can do on your own, and that you are totally free to make decisions based on your own knee and body. You're moving around a lot, and yet not overdoing things, giving your knee the time it needs to heal, while still allowing yourself to get back to daily activities. You're not a couch potato, and are striving to get back your life. Great job!

I chose not to do any formal PT also after my revision, and, IMHO, it was a great decision. I never had to worry that a PT would do something harmful and/or overly painful to my knee without my permission, as they can move pretty quickly and before you know it they push your knee even though you've told them not to. I never had to put my recovery in the hands of someone who was trained in the "no pain, no gain" school of PT, and so on. I knew what my knee needed and allowed it to heal while gradually upping my daily activities, until I got back to my usual routine. Granted, I'm still having a few issues, but they are totally unrelated to rehab and might actually be worse if I had gone to PT and done a lot of the kind of exercises they advocate and push one to do.

My belief is most people would benefit from less formal PT of the kind most of them advocate and practice today. I see glimmers of change in that area, and hope one day this old-fashioned belief about pushing patients hard to achieve given ROM numbers by certain dates will change and they'll look at each knee as an individual with different recovery rates, and do more to support and help patients gradually recover in a way that does no harm, yet still benefits them. IMHO, too many have caused both mental and physical pain to their patients, and their methods need to be looked at and changed.

 

[Tykey]

My belief is most people would benefit from less formal PT of the kind most of them advocate and practice today. I see glimmers of change in that area, and hope one day this old-fashioned belief about pushing patients hard to achieve given ROM numbers by certain dates will change and they'll look at each knee as an individual with different recovery rates, and do more to support and help patients gradually recover in a way that does no harm, yet still benefits them. IMHO, too many have caused both mental and physical pain to their patients, and their methods need to be looked at and changed.

Indeed, I hope the day will come.

Out of interest,

Our NHS doesn't offer it. When I had my first TKR, ten years ago, the use of CPM machines were just being scrapped, and a very limited group PT was offered "if anyone wanted it". The PTs did not do much more than help them on and off a static bike.
This time around, nothing was offered apart from advice if we wanted any.
As you probably know, our NHS is strapped for cash, and a body called NICE has to approve all treatments as being cost effective. I think they decided that PT wasn't cost effective.

I can't disagree with them.

 

[luvcats]

Hopefully some of it is bloat, and more is knee swelling, but still I need to start working on it.

I bloated up about 13 lbs with July and only about 10 with Newbie and the current swelling seems to be receding a little more quickly.
This whole surgery while dieting thing has felt so stressful and confusing to me. There is just no research to guide us on how to find the right balance. The only data I could find on eating after surgery was the usual nonsense about eating according to the usual nutritionist guidelines, and a report from the Hospital for Special Surgery that says you need 15 extra calories per lb of body weight after surgery for healing. But I couldn't find any information on how long you need the extra. I hate it when there is no good data.

And since weightloss is a big goal, I am completely irrationally grumpy that I never lost my appetite from the surgery or drugs and I also didn't get a weightloss boost from the surgery. Lol. I find that unsatisfactory!

"My PT says I should walk every day and walking is top priority!"

I think your new PT has excellent sense and you should listen carefully!

I'm glad the half dose of pain meds works well enough for you. I don't think in small amounts well away from driving it should limit your ability too much. I was able to start driving pretty early with July, since she's the left and didn't impact the actual driving process. I was still on the occasional bed time pill and I didn't find it made much of a difference. I will say that just the general fatigue and basic brain fog did impact my ability. I stayed strictly slow back roads away from peak traffic. I think I was at 7 weeks before I tried a freeway, and I could tell my reaction times still weren't quite where they should be for that.

I think they decided that PT wasn't cost effective.

In general, I think they might be correct. I had home PT after both surgeries and frankly, I think I did better with Newbie where I did very little of the recommended PT on my own unless my leg really wanted to move.

I think the PT I'm getting now is amazing and helpful, but we aren't really even working on the knee much, it's all gait training and other stretching. I think no PT is much, much better for us all than bad PT.

 

[Tykey]

I didn't lose my appetite from surgery or drugs. Exactly the opposite! I was having regular meals, plus my puddings, plus grazing on cheese and biscuits (cookies) between meals. My result has been my 4lb gain.

I'm sure you'll find that as you feel better, get more energy, and looking forward to life (as you obviously are) you'll correct things.
Dieting needs a lot of mental energy.

Do it when you are ready - plenty of time

 

[Carole4815]

Weight gain issues: @luvcats , I don't have any info on dieting and surgery either. Like @Tykey, I had a big appetite after surgery from the moment the general anesthesia wore off. And then at home, I felt like I would need extra calories to heal, so I have been eating whatever I wanted for the first 45 days after surgery. I hardly weighed at all but my sense of it was that (for ME, not everybody!) I was actually losing weight the first couple of weeks, and then started gaining slightly and by a month I was not using so many calories for healing and was gaining more. For some reason, now seems like the right time for me to start cutting back on calories. It might be too early for Newbie to be doing that? I'd say follow what your body is telling you and be sure to give Newbie the calories and nutrients she needs to heal for at least the first month or two until she doesn't seem to need as many. Or maybe you can find more info about it than I did.

Today my weight is still up 10.2 pounds from before TKR, like it was yesterday. But at least I am working on it so I won't gain more.

I have not had the mental energy to diet until this week; brain fog I guess? plus all the sleep disturbances and exhaustion from PT. I have been a disorganized mess. I am just now getting back into my usual routine of checking weight, blood sugar, and BP when I awaken each morning, and recording everything I ate and the calorie and carb totals for each day. Even worse, I must admit that often I was even forgetting my daily pills. But now I feel capable of behaving like a grownup again and I am doing a check-off list to make sure that I do these things. Getting back to normal; I like normal! It beats brain fog by a mile.

As for driving, I am hoping SO much that my OS will give me clearance to drive again, on my appointment tomorrow. That will be the end of my 7th week. It's not that I have a burning desire to drive somewhere but I will feel less like an invalid when I can drive. I am thinking that if it has been a day or two since a half dose of hydrocodone, I should be absolutely fine, assuming my OS agrees. We are planning to practice in a big empty parking lot at first, and then the first few "real driving" experiences he is coming with me in case I get unexpectedly exhausted and need him to drive me home. I am only going to drive in residential streets within a mile or two of our house. But since everything is close by, with my rollator I'd be able to do my walking practice in a supermarket if I wanted to! Be still my heart. LOL Honestly this is my dream.

 

[judgar]

You were talking about diets. My daughter lost 32 lbs. she did it by intermittent eating. That’s what iam starting. Not eating after 7pm and not eating till 9 the next morning. I need to do something.