TKR Done. And now the *real* work begins!

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beachcomber

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Everything went fine, until the nerve block wore off early (during my first PT session) and things got rocky from there. Stayed an extra day trying to get adequate oral pain control.

I don't seem to be able to fire my quadricep muscles properly. No straight leg raises, no short arc quads, no supine heel slides, no hip abduction/adduction. Lots of work to do, but I will make it happen.

Beach

RTKR 4/29/13
LPKR 12/21/07
 
I couldn't lift my leg or even lift my forefoot. We had a new forum member today or yesterday who's experiencing the same thing.

I had a big pain episode the first day too. That's quite trying, isn't it? Hope you get settled into a decent recovery. Keep us posted.
 
With my first TKR, I couldn't lift that leg/foot at all for a couple of weeks. In the hospital PT everyone else was able to kick their foot out, but not me. Then I referred to the TKR instructions - this site! - and found a post about that same thing. Give yourself a few days, then make your other leg kick/lift 5 - 10 times like you want your operated leg to do, then right away attempt the TKR leg. It worked for me the first time. Guess it was a matter of reminding my brain what to do!
 
The one thing that has surprised me the most about the surgery..my inability move my lower leg! Before surgery I couldn't comprehend that, in the hospital the first time the therapist told me to try to lift my leg...my brain was saying move and my leg just sat there! I am ten days post-op today, and two days ago noticed I could lift my leg about two inches while sitting in my "exercise" chair.
One of the therapists in the hospital had me move my left leg a few times and then the right...it actually made a little jerk! Amazing what your brain can do. And another therapist had me tap on my thigh while I tried to lift my leg with her help. That also produced a little movement.
The things I was successful at: the foot/ankle flexes, tightening my quad muscle and moving my whole leg side to side like the snow angel motion I practiced a lot simple because I could!!
 
leg lift.jpg Inability to life leg after surgery is the result of quad lag---the quad muscle just needs time to wake up. My left leg I could lift the day of surgery, the right I could not lift on it's own for a week. It resolves itself in its own time.
 
Lots of work to do, but I will make it happen.
I am glad that you have arrived on "the other side" and do not worry---as has been said, the quad will wake up and begin to take care of itself---and you, too.

Recovery is not work---it is more patience than anything Remember, the harder you work, the slower the the progress. Do not work hard---just work "smart." Take it easy and keep that surgical knee happy.

Josephine said it best that recovery "just happens"---too much work will cause pain, stiffness, and frustration.
 
Glad to see you Beach on the other side I was wondering where my other 29ers had gone too! I think patience is a word we are going to hear a lot of over the next few months! I have found keeping track of when the pain meds are due has helped me through I even set an alarm when they are due to keep me on track! all the best :flwrysmile: :flwrysmile:
 
Well, I am still doing "assisted" leg lifts on my right so don't worry! :heehee: Actually mine is because of extensive damage and the VMO. Yours will start firing soon. It takes patience.
 
I didn't mean to break any BoneSmart rules by the title of my post-op thread, but I still maintain that recovery from TKR *is* work. Just hobbling my way down the hall to the bathroom umpteen times a day is work these days. Taking 3 trips from the kitchen to my recliner to carry my dinner while juggling my walker and compression device is work.
I go to PT twice a week and am making good progress toward the ROM goals and just not making a big deal out of not doing the prescribed exercises from the joint replacement institute as listed. If it hurts too much--- I don't do it.
Tomorrow is my freedom day from the "leg huggers" compression devices. It seemed like a great alternative to coumadin/clinics and lovenox self-injections--- but hauling this unit around has been more inconvenient that I thought it would be. It worked, but it has been hard to deal with, especially at night. I will gladly drop it off at my OS office at my post-op appointment on Thursday. Good riddance!:happydance:
 
I'm trying to practice the concept of baby steps, very foreign to me, but it sure looks like you are taking steps toward the ultimate freedom! Good job! One less contraption to deal with too!
 
It is hard to take it slow, but the reward of a full pain free life ahead of you makes the waiting worthwhile! You will be surprised how quickly time flies! :happydance:
 
Yay! I am now 30 staples lighter and like the way my new knee looks with steri-strips instead of "bling".

Swelling remains minimal--- perhaps a result of a new drug combination my OS tried with me and one other gal for the first time? Sounded like it would be inconsequential after such a big surgery (Celebrex and Tylenol after a TKR?) but he had just read a journal article about it and asked if I was interested in trying it out. I figured it couldn't hurt, although I was more interested in the oxycodone TBH...

The other gal (who had a revision surgery) is about the same age as me (I am 57) and also just had her first post-op visit yesterday. Both of us have little swelling, good ROM, and are walking easily with our walkers. Our doc was like a little kid who got the coolest present for his birthday and had the biggest grin on his face. I expected him to start clapping his hands any minute when he watched me walk down the little hallway. Glad I helped make his day!

The past 2 days were busy ones for me with PT, my first trip to the grocery store, and my doctor appointment via our city bus (they *need* better shocks on those buses!) so I am planning an easy day with lots of ice, elevation, and naps today. Starting now...
 
That is really interesting about the celebrex/tylenol protocol. I'd do just about anything to avoid that kind of swelling and inflammation the next time.

BTW Who is your doc?
 
My doc is Michael Vessely. I live in McMinnville, Oregon (pop. 33,000). Our small hospital recruited him when they started a 6 bed Joint Replacement Institute here 3 years ago. He has an impressive resume and often does "problem" knees, with patients traveling to work with him. I found him to be a very thoughtful and caring doc. I interviewed several surgeons, looking for someone with experience and a sound plan for dealing with my previously re-constructed knee and its 30 year old hardware and couldn't be more pleased with my choice. The fact that he practices here in our little wine-country town was icing on the cake; it is literally a 10 minute bus ride to his office on the hospital campus from my house in these early days when I am without wheels.

My insurance won't pay for Celebrex, but I chose to accept my doc's recommendation and pay the out-of-pocket $400 cost. There is no way of actually knowing if the Celebrex/Tylenol protocol is the reason my knee has so little swelling, but is worth every penny when I consider the alternative.
 
My quad seems to have finally decided to join the party. I can do quad sets, move my leg laterally, and do some painful short arcs (although I don't plan to pursue those much for a while).
Once I was able to get rid of the leg cuffs for the compression device I wore for 2 weeks, I was very dismayed to see how much muscle atrophy I have. I know some of it is from before the surgery, but it is very marked after 2+ weeks of quad lag.
It seems that most of the exercises the hospital PT emphasized were ROM-focused. I am wondering about activities that will help strengthen the muscles in my calf (and thigh, although it doesn't seem to have atrophied as much). Sounds like my first question for my PT on Monday!
 
Good to hear that the quad has come to life and you can now start serious rehab for both ROM and strength.

I have found an avatar that I thought you might like to use. It is already sized to fit perfectly as I have tested it. Just right click on the attached picture and "save image as" in your picture files. Then hover your mouse of your user name at the top of the page and from the drop down menu select "Avatar". The click the browse button and find the picture in your files and double click it. Then click "Okay"and you are done.
beachcomber 1.jpg
If you are not interested, my feelings will not be hurt. I just enjoy doing this when the opportunity presents itself.


Take care, keep PT pain free, and keep us posted. We care. hugs 25.jpg
 
Me, too. Thanks for finding it for me. I am afraid I was so stretched for time when I joined back up here pre-op that having an avatar was pretty low on my priority list. Since my surgery my brain has been too mushy to consider working it out, but I love this one.

Thanks!
Beach
 
If it hurts too much--- I don't do it.
Great attitude!

My quad seems to have finally decided to join the party.
Great news!!

I was very dismayed to see how much muscle atrophy I have.

I am wondering about activities that will help strengthen the muscles in my calf (and thigh, although it doesn't seem to have atrophied as much).
Do not worry about these---you will slowly regain muscle strength as you go through your PT---Atrophy is to be expected---and you can deal with it, albeit it slowly---as you slowly regain your ROM and muscle strength. Stamina is usuall y the last to arrive on the scene.
 
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