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TKR Cyclist - Managing My Recovery

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Still weds. just did the walk up the steep road about 1/4 mile out and 1/4 back. Got my heart rate up and
started to perspire. Great feeling. zero pain on the walk out and as soon as I felt the slightest sensation ( not pain)in my knee I turned and headed home. I am now icing and elevating. I took a hiking stick and my daughters service dog.
I will do some more walking out at the horse stable later today. Probably another 1/2 mile.
 
Took another ibuprofen this afternoon. did not walk much at the horse stable. Feeling better this afternoon then yesterday when i felt antsy. Been off the hydrocodone for 30 hours and I think that is why i feel better but still a little tired in the afternoon today. Only took the ibuprofen for swelling as there isnt any real pain. Barley a hint of discomfort.

I think I will try the rom and extension exercises shown above in the post.

Also for sleeping tonight I am gonna make a pillow ramp to elevate my leg and keep it somewhat extended.
I'm wondering if I will need any pain meds tonight around 2 am.. We shall see. I of course just read on the BBC news feed that long term use of high dose ibupropphen is increased risk of heart problems. Dont think it applies here but it always concerns me when I read these things.
 
patbike said:
I of course just read on the BBC news feed that long term use of high dose ibupropphen is increased risk of heart problems.
Click to expand...
Any type of NSAID's can lead to a risk of heart issues. Naproxin, ibuprofen, celebrex can all raise the risk of a heart issue.

For the record, I was on a med call "Vioxx" and had just taken two of them (my normal dosage) before I was about to officiate a game. I was on my way, listening to the radio, when they announced that they had removed Vioxx from the market due to significant heart risks. Needless to say, my concentration level during that game was focused elsewhere...
 
Hi pat bike, I have also been loosing weight since my surgery and I know it's because of the medication. I take tramadol. I'm surprised at how much walking you are doing, good for you. I can't believe they took your cane away, wow. I'm still using a walker.
 
Thanks for this reminder. I'm feeling good about the progress I've made so far. It's weird how the knee is the boss.
 
Day 23 , thursday AM. Last night I took a couple of Tylenol at 9:30 and then awoke around around 3:00 with discomfort/pain so I took 2 ibuprofen and went back to sleep at about 3:30. I feel so much better this am then I did the day before yesterday and I think a little better then yesterday. I think it is due to stopping the hydrocodone which I haven't had for about 48 hours. I'm gonna ask my OS about how much of these two pain meds I can use in combination. By the way Im saying I feel pretty good this AM even though I didn't have a perfect nights sleep.
My alarm also woke me up accidentaly at about 6:00 and wife has a mouth guard that makes her snore sometimes so I also had to roll her onto her side a few times (she is very cooperative) . I can only imagine how good I would feel if I had been able to sleep all night. I did make a pillow ramp in bed last night ( I have about 10 pillows on my side of the bed) but I couldn't get comfortable enough to sleep on it so I slept mainly on my side. I will try the ramp today when I ice and elevate. I'm thinking about an ambien or benedryl. Also I think if I need a different pain med I will try tramadol as well. My daughter takes it for a neck injury and says it is much better than hydrocodone from a side effects standpoint.
 
Hi patbike,
I am sleeping well ( except for the snorer next to me too) For the last few days I have stopped taking pain meds at night. I have noticed that I still wake in the middle of the night with some pain and when I get up in the morning, my leg is really stiff and sore, takes a while to get it going. I went for physio this morning and my PT suggested that I continue taking meds at night and if I feel I'm ready to reduce my meds to try and cut back during the day slowly, like take 1.5 tramadol (Instead of 2) every 4 hours. She feels that not taking them at night is not worth the outcome of being stiff and in pain in the morning. I like tramadol but it does upset my stomach so as a result I have lost 12 lbs in the last 3 weeks so I know that is not a good thing either. That's why I will try and cut back on how much I take over the next few days and see what happens. ROM up to 98 today, very happy.
 
I have not felt stiff in the AM so far and the pain pretty much disappears when I get up. Just having trouble getting my Rom to increase. Although I don't measure, it just doesn't look like it is improving, I guess around 90 - 95 but I know it will get better. I need it for a number of things. I was just reading Bonnie's story about problems after two years. It makes me sad and reminds me how vulnerable we are. I will pray for her. We had a tragedy 3 years ago when my then 24 year old daughter who lives with us became a quadriplegic due to fracture of her cervical (neck) vertebrae. She lives with constant neck neck pain and discomfort as well as being paralyzed from her chest down and only has bicep function in her arms. She is getting a masters and has become a competition horse carriage driver with her body strapped to the seat and the reins strapped to her wrists. She has such great feel for the horses that she regularly beats the able bodied drivers in the 3 day combined driving events. She gives me perspective and inspiration. Plus she says I can try her Tramadol!
 
Yes, it is incredible how vulnerable we are which is why we work so hard at making this surgery a success. The surgery itself is just a small piece of a big pie. The bulk of our chances at a good recovery rests on our shoulders. When I was leaving therapy this morning, an elderly gentleman was trying to get out of a truck while I walked by him with my walker. He only had a cane, a home made cane, and was having great difficulty walking. He yelled to me "hey, want to trade places". I replied no saying that I think we were already in the same boat. I asked him how long it had been since his surgery, he said 2 weeks. I was shocked because he was having so much trouble walking. I asked him why he didn't have a walker. He just said "we'll, one of us is more stubborn than the other". So, it was obvious he has not found bonesmart. I told him about it but it was obvious he had no computer skills. I felt really bad for him because it was obvious he was pushing it. He even commented that he just wants them to take the leg off! I'm glad I've found bonesmart and friends like yourself to help get through this. I am so I,pressed with your daughters natural talent with horses! Horses are very therapeutic animals and its obvious she has formed a tight bond with them. Thanks for sharing this story.
 
I went to the gym yesterday and did my exercises there and used the stationary bike for about 20 minutes on almost no resistance. Felt good but I have an intermittent tweak in the back of my left hamstring. I have PT this am and will check it out then. I feel pretty good this am. I did have big trouble staying asleep last night. I took a couple of tylenol and a couple of ibuprofen around 9 and woke up around 2:00 for an hour so I took 2 more ibuprofen and put on some ice and did go back to sleep until about 6:30. I might try the tramadol tonight. My dr said ok to use Tylenol and ibuprofen (and tramadol)within the normal limits. He also prescribed some kflex to take when I go to the dentist for a cleaning in 2 months.

Anyone have idea as to how long the discomfort at night will probably last with a single tkr.
 
You are zipping along its great to read your posts. :)
I've an extension of 2 and rom of 90-110 - the 110 is with a bit of help. I'm quite happy with this at the three week stage - but I can't peddle yet. Why can you and not me I'm wondering?
I'm not on pain meds and maybe it's because I'm not pushing my knee. So now I'm wondering if I should be pushing it a little more.
I'm an ex athlete so fairly tough physically. Shame I've not felt as tough mentally.
Your daughter is a true lady of courage - you must be so proud of her. :)
 
Did about 10 min on the stationary cycle at PT today for warm-up . I wasn't on the highest seat setting but one or two below i think. I also can now circle my pedals on my homemade stationary bike. Not sure if this exercise improves flexion/ROM (i think I read it doesnt)but it sure makes me feel better to be able to do it. I had a very good PT session today. Massage of the lower quad and then stretching. Plus I got some tips on my exercises. Also I was trying to learn to exhale to get the muscle to stretch a little more. It works but I have to concentrate on it. Trying to stay clear of pain although I still have an intermittent little tweak in the back of my quad about 5 inches above the knee.

While I don't have knee pain (perhaps just alittle) during the day I still don't feel consistently good. It is sort of a tired feeling (which would make sense as I am having trouble sleeping) or like a slight hangover without the headache, or even a little sick , but I'm not sick nor febrile. Just dont feel great consistently. It effects my appetite and I look forward to food. Very strange but is probably just part of my body sending its energy towards the task of healing.

I am not looking forward to sleep issues tonight and may try something new(tramadol)
 
Hopper and Patbike,
It weird how I am feeling many of the same things as the 2 of you right now. I keep wondering if I should push the knee more. Today, I waited 7 hours to take my tramadol (instead of 4 hours). I had read a post of someone who stopped taking her meds after 2 weeks and was doing great so I thought maybe that could be me. The pain level was low so I thought it would be ok. Well, now my knee is very stiff and I had trouble doing my exercises so I guess I will stick with full meds. Feeling tired and yucky too but I now it's because of lack of food. I can circle the pedals on the bike but not tonight. So I guess I will need to continue full meds in order to be able to increase my ROM. Just seems like a vicious cycle. I'm confused.
 
I agree sault. I took a tramadol last night but it didnt seem to do any thing. I still woke often and had trouble sleeping much. It is not significant pain at night but enough to keep me awake. my PT said the sleep was important even if I had to put something under my knee joint (not generally recommended) to get to sleep. Now I think it has been 4 days since coming off the hydrocodone so I assume I can no longer attribute any of my issues to it. Therefore my feeling of tiredness etc must be do to the body dealing with healing and some pain and lack of sleep. Also I did go on a 1 1/2 mile walk at the end of the day on a 12% to 18% hill around 7:00pm and while it didn't bother me at the time it probably contributed to the soreness last night. my daughter joined me on the walk with her power chair and we had kaz her golden/lab mix service dog as well as we wandered up the road on our hill. I'm walking on a hill to get my heartrate up and hopfully to not loose all my aerobic fitness which I need for biking eventually , however if it is gonna be a problem I will stop.​
As far as appetite (PS in my previous post I meant to say it effects my appetite and I DONT look forward to food) I new I should eat last night but nothing seemed appealing so I just had a little dinner. However in the back of my mind I felt like getting something sweet might appeal to me and break me out of my eating funk. so after the walk and a shower I went to town and bought chocolate syrup(sugar free) vanilla ice cream, strawberries and angel food cake. When I got home I had a dish and the sweet flavors combined with the cold were really good.​
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For pain tonight I might go with a 10 mil of hydrocodone if I wake up and can't get back to sleep. Ambien another possibility. Another possibility is Flexeril but I dont know if it works in these situations. I will have to research it.​
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I feel better just sharing my thoughts this Saturday AM. best to all of you.​
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By the way there is an article on this site that says to really take it easy on exercise bikes at first. And stop if any pain at all.
the article is in the Home physio (pt) and activity progress forum/thread near the end of the article.
https://bonesmart.org/forum/threads/home-physio-pt-and-activity-progress-suggestions.8954/

It is good to read if you are using a bike.

I think that the secret of BoneSmart is that while you are typing on the forums or reading articles you don't think about any pain or discomfort.
 
It's funny, I feel the same way about food right now. A side effect of tramadol is stomach upset. My family has to pretty well force me to eat. I manage with breakfast, no problem but lunch and dinner are hard to do so I drink 1 to 2 protein drinks a day. The chocolate one made by premiere, available at Costco, SAMs club and some walmarts. There are 30 grams of protein in them. It's like a juice box. It's delicious. Need to keep the protein up in order to not loose muscle. As far as the tramadol, I was told at the hospital that you need to take a new med for a couple of days for it to fully work. I'm no expert on this but thought I'd share. I hate to say it but I really think you're doing too much and that's what causing your problems. Again, just my opinion but a 1.5 mile walk? I never could have done that. I know you really want to get back to your regular life and can see that you are very active but slow down - lol. Oh god, I'm lecturing, sorry. My PT still tells me to only do short walks in the house.
 
Protein shake sounds like a good idea. And you are probably right on the walking. I'm gonna discuss with my PT on Monday.
 
Titianlady
I saw you mention that feeling tired after tkr was normal. I have felt tired and in a bit of a funk and had low appetite since my tkr as well and I thought it might be the pain meds, or lack of sleep. What causes the feeling of tiredness and lack of energy and do you have any write ups on it. I also lost some weight. Does the body burn significantly more calories after this type of surgery?

thanks
 
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