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TKR Cyclist - Managing My Recovery

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Wow, that is incredible, a 2km bike ride - I can't wait to be able to do that. Well, my meds have been changed to a slow release tramadol, one a day and am also treating severe gastritis so am on liquids for a few days. So far, so good. I feel my knee a lot more know though but I am hoping it will subside once my body absorbs my knee meds. Knee is also stiffer and more difficult to move. Will be seeing PT tomorrow. Looking forward to getting her input on all this. I am really, really hungry though but have to take my time.
Blue bunny ice cream? I would not refuse a very good chocolate chip cookie and chocolate cake.
Again, good for you.
 
let me know how the tramadol works. I didn't have luck with the one pill I took but someone said you have to take it for a few days to get an effect. I eventually want to stop the hydrocodone at night and would like to do tramadol.
I like Blue Bunny because it is lower calorie and they served it in the nursing home I was in.
I anm heading to the mountains in a few weeks and hope to be able to do some hiking while there. I will have internet access so I can keep in touch. I will also probably take my bike. Lots of nice lakes for swimming.
Good luck with Pt.
 
You are doing well. I've got better extension than you but my flexion isn't there yet. I can't quite peddle.
Oh for :bicycle1:
 
Hopper
With your extension can you lock your knee? I am always standing on my good knee because my old knee and now my replaced won't extend enough. I assume it will come. I have had this problem of not being able to lock for several years and as a result my left quad is less developed than my right. I hope to get the left one more developed as it will help with the bike.
 
Patbike, you need extension stretches. See the exercises thread linked from my sig for one. The quad isn't the problem, it's the shortening of the tendons behind the knee that is.
 
I can stand on one leg on either side. I dont think I'm quite locking out yet.
Just so much tightness on the lateral side stopping my bend. It's frustrating but I realise its still early days - or should I be panicking?
I'm definitely walking better gait wise than I have for a couple of years all be it slowly. How are you walking?
 
Hopper
Roy Gardiner
My walking seems straight and correct. I do feel a little soreness after extended walking but not to much.
Big difference is that my leg is no longer bowed and I don't limp and ache like I used to. I think once my extension gets to the locking point my regular walk will be like new. Lack of flexion in the first week or two made walking a little difficult because I couldn't bend my knee enough but that is fine now.

Roy I will check out your stretch, I think i am getting close. Hope I dont have to wait a year to get the last couple of degrees (only my knee knows for sure) Also I think once I can lock and stand on my new knee that the quad will improve too and start to be like the other quad. Perhaps not. Perhaps the new knee quad will improve once I start walking on it correctly. Or both.
 
And just taking long strides will give a stretch to the tendons on the back of the knee.
 
Almost 5 weeks out. Feel pretty much the same with some degree of tired and nausea in the afternoons and uncomfortableness at night for which I take a night time pain med at around 9pm and 2 Am.
Today I went out on my second bike ride and felt much better than the first. I went about 7 miles at a decent pace and rom was just good enough to let me pedal freely. I might lower the seat next time to cause a little more stretching as long as there is no pain. I came home and iced and elevated and I am now lying down in bed and I notice that my new knee leg is stretched out straight in front of me and I can just feel a little stretch if i raise my foot up. This is a first for me and I think a sign that my extension is improving. Roy said take long strides when walking to stretch the back of the leg and I think it is helping me. If I could fix anything it would be the funky feeling I get with a little nausea although it was a little better today. I might try the ginger someone suggested.
More Late
Pat
 
5 weeks today, not much change, will go to Pt thurs. i still feel tired in the afternoon and have discomfort at night which requires I take a pain med to sleep. went for a 10 mile bike ride today on fairly level path. still need alittle more rom to feel comfortable.
 
I am 5 weeks and 2 days out.
At Pt today the extension was around 2% without assistance. My good leg is negative 3%. The 2% is probably better than preop because of the arthritic swelling that had developed. having a full extension will let me stand on my left leg by itself and will help to condition it. The quad muscle in the left leg had gradually become smaller than the right partially because I could only stand on the right , I think. I also went for a 10 mile bike ride on my old course with some hills and felt that my aerobic fitness had not suffered too much. The first section of the course which i timed took me 6 minutes longer than my best time pre-op. So I am about 20% slower. I wasnt pushing it too hard and there was a head wind. The whole thing gave me a mental boost. I iced it when I came home and it feels pretty good given that the ride was just 4 hours ago. My flexion has me more concerned because other than exercise there is nothing i do very often in day to day living that will help it get into the 130's so I will have to rely on stretching to get there. The therapist also has me massaging my scar which may be impeding my flex ROM.
I think my unassisted rom is around 120. There is still the area above the knee that is a little swollen. It was swollen for several years prior to the op as well and I am hoping it will lessen.
I still take pain meds at night to help me sleep
 
Hi Pat,
Glad to hear you on the road to recovery. Keep you eye on the road to riding, but you be the judge of the pace. I found the knees recovery is a little like the cycling...ride at your own pace. Good luck, and I know you will be back in the saddle soon.
 
Hi - just noticed your thread - wow - you are really doing well for your stage in recovery! I had my tkr end of Sept. and I was able to get a full rotation on stationary bike at 3 weeks - then I did that bike everyday until I was at about 3 months - I had so much pain I was really afraid to go outside and ride! I got on my hybrid and after a few really stiff rotations I loosened up enough to go a couple of miles. Increased that everyday until I could get on my road bike - at about 5 months I was doing some pretty hefty riding with hills and miles. Now I'm also on my mountain bike but not strong enough for all the hills. I walk 'em until I can ride em! :) At 9 months I can really say I am doing as well if not a whole lot better than before surgery...I wish you loads of luck and good rides!!!
 
6 weeks out now. Thanks, for the luck wish. As an update I have been going out on my bike about every third day due to minor discomfort on the day after my rides centered a few inches above and below the new knee. Monday my therapist encouraged my riding so yesterday Tuesday I went for a 17 mile and I walked some of the hills. Knee was a little tired when I got home and I think perhaps some swelling but gone this AM.
I probably should have kept the miles to 12 or 13. I did not take pain med for the last four days and was suffering a little at night with discomfort that kept me awake. Last night I took my Hydrocodone around 9:00 and went to bed about 10:00. Well I had the best nights sleep in probably 6 weeks. Plus after four hours I thought I might need to take another pill but it wasn't necessary as I realized there was no aching in my knee of any significance so I just slept on my back most of the time with the leg straight and I was fine. I was really surprised that it went so well given the trouble I have been having at night. In previous nights I would move it and it would feel fine for a few minutes and then start to ache again. Having had a reasonable nights sleep I feel great this AM and am anxious to see how I will feel later this afternoon when I normally have had a tired and sort of yucky feeling.

Next week I am going to the sierra mountains for a week or so and plan to ride about a 12 mile route from one town to the next with a 1200 ft elevation gain up to 5000 ft. I will probably go every other day or as the knee dictates. It is a beautiful ride along a river and if my knee gets tired I can pretty much coast all the way back. Also there are lots of swimable lakes in that area with short walks or one or two mile hikes that I hope to try out. I haven't been able to comfortably hike for about 6 years. I have done it but it was painful so this will be be a first with no arthritic pain although I expect some knee tiredness so I will have to be careful not to overdue it.

My appetite is still strange and I noticed that I am still loosing weight. It is OK because I had gained some over the winter that I didn't but I'm down around 15 or so pounds to about 170 at 5'11. This will be easier on the knee and also better for the bike.

My extension was at 1 degree on Monday and my good knee is -3 so I have a little way to go. I read that extension is very important with respect to locking the quad and creating knee stability. I did not know this and was focusing my concern more on bending/flexion. I think my unassisted flexion is now around 120 but I think I will need more to be comfortable on the bike. (If you havent gathered I'm passionate about bikiing, my wife and daughter feel the same way about horses and it all works out-(wife also bikes a little)).

I have two types of exercises, those for range of motion and those for strength and joint stability.
They are all fairly easy as exercises with the exception of the range of motion exercises for knee flexion/bending.
For this I have been prescribed heel slides and now as of Monday they added one where I lie on my stomach and bend my leg up toward me and assist it with the other leg or a belt. I find these the most uncomfortable exercises and I wish I could get more positive about them. They don't cause swelling but they do hurt and progress is sooo slow.

The therapist has me massaging my scar in a couple of spots to spread it out so it doesnt interfere with flexing.
This is easy to do when ever you are sitting around and it see,ms to actually work.

Final comment, I also read that TKR is 40% the surgeon and 60% physical therapy. I agree and think that surgeons should emphasize this when you meet them. (Bone smart would probably say that the body's natural ability to heal should get a significant percentage as well) Perhaps 30% surgeon 30% PT and 40% body. If I had know this I would have perhaps spent more time researching the PT side rather than just the surgeon side.

I'll give an update next week from the mountains.
 
Hi Patbike
I just got through reading your thread - I myself had bilateral TKR 10 weeks ago and lately have been neglecting the single knee replacement folks - sorry!

A comment on ibuprofen, etc.: Don't fear the hydrocodone. Your story is much like mine in that I experience more pain and discomfort during the night than during the day, generally, unless I'm doing a lot. I am unable to take ibuprofen or any NSAIDs due to a stomach bleed last year - I had pounded aspirin, ibuprofen, and finally naproxen for decades, though the dr. said the ulcer they caused was probably fairly recent. So be careful with that stuff; note the insert stating that stomach bleeding can happen "without warning and can cause death." It's no joke. Hydrocodone is better for your stomach; I am lucky in that I have no "icky feeling" from taking it. In fact, I often have the experience you describe re: finally taking the pill after I've already been having pain, then feeling very "up" and wondering why I hesitated! Occasionally I will also take a hydrocodone in the a.m. if I really can't get going (though now it's been a few weeks since I've done that). Typically I need one mid- to late-afternoon after PT, doing errands, etc., then one when I go to bed. I've gone from always taking one in the middle of the night (as you do) to only needing one occasionally.

Sleep: I still battle sleep. Last night was great - I think because I was in alone my own queen-sized memory foam-enhanced bed after two nights spent in a dreadful lumpy old double w/my husband (he is at a backwoods fishing cabin for a few weeks) - NO sleep there! - followed by a 5-hour drive, followed by PT. But tonight might be back to the whole sleep 15 minutes, wake up for 15 mins routine. I try not to stress over it and assume it will improve over time. Often I lie down around 9 because it just feels better, then watch TV for a couple of hours on my Kindle.

Food: I ate more ice cream and cookies in two months that I usually eat in two years. I was particularly hooked on chocolate shakes; then a local drive in began (evilly) to offer "mini-shakes" for $1. Once I started driving, imagine what became my favorite destination

I just joined a new workout facility sponsored by a regional rehab center. In my evaluations, no one was too worried about my doing cardio in the near term. That will come. The trainer suggested I do the "arm bike," but it was lame. I do the stationary bike to work on ROM but so far have not used it for a true workout. I hope to start swimming soon; that will probably be my cardio once I get up to it. Right now when I kick my legs slowly sink...not strong enough.

You are determined enough that all of your biking, walking, cardio, etc. goals will return. Give yourself this time not to push. Part of the emotional/spiritual process of the TKR is about letting something other than flat-out willpower take some of the load of life. Stop and enjoy the Blue Bunny!
Sorry I got so long-winded. It's what happens at Bonesmart.
j
 
I'm so happy for you that you're riding after only 6 weeks. That's a really good recovery. Doesn't it feel great to get back on your bike?

I also did those exercises where you lie on your stomach. It was incredibly painful and I hated having my face smushed into the table. I hope it's helping you!

I just had a MUA, so I'm off my bike again. Hoping to be able to still go on the 2 week bike trip I had planned in Aug, but we'll see.
 
I just want to add one thing to my previous post. I just made a bowl of oatmeal and I have to ask a question.
My wife and I have been eating oatmeal for breakfast for three years, every day and we love it. I put frozen black, blue and raspberries as well as cinnamon and Splenda (sweetener) and milk in my oatmeal. It tastes like a fruit cobbler when I get through preparing it and I really look forward to it and a cup of coffee in the morning.

Right this second I am staring at a bowl of oatmeal that I prepared earlier and from which I had a few bites. Problem is that since my TKR few things make me really want to eat or excite my appetite. I won't even finish this wonderful oatmeal that I am staring at it tastes funny and I have no desire to eat it. I have seen posts where people have had problems with appetite for a week or two but has anyone had the problem for 6 weeks and when did it finally return to normal. Just curious.
 
I mostly had my appetite back by six weeks, but not completely. For me it was related to the pain meds. A few days after I stopped taking them completely, my appetite was almost what it was before. What I have noticed is things that I ate regularly during early recovery now mostly taste really bad to me. At 5 months out, I'm slowing adding back some of that food. It's like when I was pregnant - things I ate then tasted bad to me for several years afterwards. Don't worry - you're probably not pregnant.
 
Sad to say my appetite recovered itself after two weeks. Blast!
 
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