TKR FitGal’s Recovery

[Carole4815]

@FitGal , I am so sorry you are having such a difficult time with swelling! Believe me, I can relate. Even the home health nurse remarked on how much swelling I was having, just a couple of days after surgery. While activity can aggravate swelling for all of us, I also think that some individuals just have a harder time with swelling than others. If there is such a thing as a "swelling gene" then I have a double dose of it. But then so what, life isn't fair. All we can do is deal with the hand we are dealt.

 

[Jockette]

I had another thought for you, try elevating at night while you sleep. Ask the hotel for extra pillows, and see if they have any that are firmer then the standard feather pillow.

I still sleep all night with my legs up on my elevating wedge, as my knee is extremely sensitive to different angles and it likes the angle of the wedge.

I was a die hard side sleeper until this recovery forced me to sleep with my leg up on my wedge, so the transition can be done!

 

[FitGal]

@Jockette - Thanks for the info. I know it sounds like a lot, but I really do have a sedentary job most of the day/year. We are sitting most of the day during this conference, so sometimes I feel that I am not moving enough which may be causing some issues as well. I like your idea about the extra pillows - but at the place I am staying, it is more like a "barracks", so I have been using my suitcase to elevate - LOL At least there is a large fridge with a freezer to store my ice packs! When you say I could develop a "chronic issue", would that be just pain and swelling or something else?

@marieltha - thanks for the voltaren gel info - may have to ask my doc about it; wish it was OTC!

@Carole4815

If there is such a thing as a "swelling gene" then I have a double dose of it.

- that is hilarious - I DO have this!

 

[Poctdb]

@FitGal
At the conference, can you pull out an extra chair and sit with the knee on it? Even if it is a bit bent?

 

[FitGal]

Hi @Poctdb - Yes, I was able to put my leg up a bit this afternoon, but was in a big theater for the morning briefings.... uhhh. Will be doing some of the same the next two days

 

[Jamie]

When you say I could develop a "chronic issue", would that be just pain and swelling or something else?

Yes, it is possible to develop chronic problems with pain and swelling if you allow your knee to stay inflamed for extended periods of time. And I wouldn't really think of it as "just' pain and swelling. Believe me, the people who end up with these chronic problems can be miserable and often wish they could go back and do things differently.

Since you are back at work so soon and traveling (conferences are especially bad for recovering knees), you'll need to take every possible opportunity to lie down to ice and elevate your knee. You're getting much more activity than you realize. It's not at all like being home or even just being in your workplace.

 

[Roy Gardiner]

Hi Fitgal, only just caught your thread, managed to miss it completely for some reason...

So, my tuppence worth. I absolutely agree with Jamie et al, you are risking developing chronic problems by doing too much, too soon and not backing off.

I will get there at 6:00am and leave NLT noon! My plan is to work half-days until I start feeling better

I know I set limits on working just half days, but that did not really work out after Monday

Dear Lord 06.00 - 12.00 is not a half day by any measure, and no doubt there's travel time too. And if you're not doing that 'half day' but working on, that's more than one would expect from someone at 100% fitness.

basically, it feels better on the bike than it does at any other time - once I stop - it gets stiff

No doubt because you're treating it as training, not stretching, I betcha.

Using a bike to gain ROM is pretty simple:

• Set the bike to zero resistance (I bet you're not!)
• Set the saddle low enough so that a single rotation is a challenge; difficult but not painful. When a rotation becomes easy right from the start, lower the saddle a max of 1cm.
• Gently turn the pedals, through discomfort but without pain.
• Continue until the knee is 'warmed up' and the rotation is now easy, or for 2 minutes, whichever is the shorter time.
• Repeat several/many times a day, but don't go mad. Diminishing returns will apply; my guess is that half a dozen reps would be enough
• Do not pedal fast or for more than 2 minutes, this is a stretching exercise, not training.
• And if you get any pain or swelling in the 24 hours after doing this, cut it down until you don't

Here is a bit more chat and some pix and how 'healing' and 'training' are different

 

[Macknit]

I agree with @Roy Gardiner on this knee warm up; I'm fairly early on in this recovery (3 weeks) and was advised by PT that her recumbent bike patients regained ROM rather quickly following very similar information to what he has laid out here. NO PAIN being key. (I've written on my wonderful PT clinic and their gentle approach in my Macknit recovery blog)

I also have had to learn the hard way that in the early weeks, when I think I can move up to 5 or 6 minutes of peddling, it is the law of diminishing returns. So I just head to the bike more frequently with short 2-3 minutes of peddling, which is helping in multiple ways. I walked a lot prior to the surgery and I have found the biking definitely helps the quads and knee while walking right now just inflates my knee !! Good Luck as we travel this arduous road!

 

[Roy Gardiner]

biking definitely helps the quads and knee while walking right now just inflates my knee

Cycling just rotates the legs, walking bangs the foot down every step; low impact vs. high impact.

 

[Macknit]

@Roy Gardiner - oh that makes so much sense. Since I haven't biked in many years, I'm amazed at how different muscles are responding. I am sold on the biking now. Not sure if I'll ever get to the point of being out on the open road though!? (One step at a time, right?) We live on the eastside of the Oregon Cascade mountain range and there are multiple trails as well as beautiful biking tours that meander through this part of God's country! I really hope to one day be able to travel these areas by bike. Time will tell; at least now I can pretend to be traveling the countryside on my little stationary recumbent bike!

 

[Poctdb]

@FitGal
Are you home?

 

[FitGal]

@Poctdb - Hey! Yes, finally made it home. Thank you for asking

I got home on Friday and have been a couch potato ever since with a few minutes here and there on the Spin Bike (and even followed @Roy Gardiner suggestion on lowering the seat, etc). My knee was so swollen while I was traveling, but since I've been home, the swelling has reduced (though I have had some itching inside the knee cap area - which I am hoping is some sort of sign of "healing"!)

I can't believe that I am almost 10 weeks post-op! I really thought that I would be much further along by now, since the OS says it takes about 12 weeks to be back to doing things I was doing pre-op and about a year to be 100%. I guess I gotta have patience! Hoping I will make some big strides in the coming weeks!

 

[marieltha]

Love the “big strides” pun!

 

[Tmgrl3]

@Poctdb - Hey! Yes, finally made it home. Thank you for asking

I got home on Friday and have been a couch potato ever since with a few minutes here and there on the Spin Bike (and even followed @Roy Gardiner suggestion on lowering the seat, etc). My knee was so swollen while I was traveling, but since I've been home, the swelling has reduced (though I have had some itching inside the knee cap area - which I am hoping is some sort of sign of "healing"!)

I can't believe that I am almost 10 weeks post-op! I really thought that I would be much further along by now, since the OS says it takes about 12 weeks to be back to doing things I was doing pre-op and about a year to be 100%. I guess I gotta have patience! Hoping I will make some big strides in the coming weeks!

I just got the link to your thread FitGal. I love it. Wish I had found it earlier. It’s late here on Long Island, NY, so will reply at length tomorrow. I am 76 years old and had a bilateral knee replacement on March 21, 2019 so six months out now. So much comfort and help in this thread. Thanks! I started a thread. BLKR,Where to Begin.

Not sure if this link will work: https://bonesmart.org/forum/threads/where-to-begin-did-too-much.54546/page-4#post-1353629

Pretty much takes me up to today, but want to comment and add. There is such hope in knowing one isn’t going through these things alone and to see how commonplace some of the issues we all share are. Back tomorrow . Have some eliptical questions.

 

[luvcats]

Welcome home! I'm glad it went well and your knee is quickly recovering from the excesses of travel.

 

[Tmgrl3]

It is so good to see long posts like this so people can see all the ups and downs that can happen and how we can meet all the challenges. So I won’t go into lengthy summary of my journey but being 6 months out on my bilateral knee at age 76, I can say the challenges have been difficult. Until I read this and especially since you gave me the info on training vs. strength (will check out more today), I realize that now I am in for the six months more of the long haul to get to a more normal state by that one year marker. All of the depression and weight loss and severe fatigue and pain are behind me. Yesterday, I went to the mall for the first time since both of us had our major surgeries. Mainly to have dinner out but also to walk. I did about 4 blocks of walking indoors. Wow. End of day and wobbly. No cane but I held onto Mark’s hand and stood up straight and tall and took nice measured steps. I had not repercussions last night despite my fatigue at end of the walk. I think tylenol will continue to do the job for me. Also, I have to sleep in at least two different positions at night. I have vertigo, central and peripheral which is currently in remission but it is always triggered during night on left side and can last for up to 3 months. All tests confirm it and confirm it isn’t the simpler BBPV type where one can have the crystals moved and it’s gone. So I rest on that side before going to sleep and sleep on right side most of night and have never been a back sleeper because of snoring, but now, I find that if I alternate between side and back during the night and use a thin pillow between my knees, I ease the pressure and can sleep without extra tylenol during night.

My recent visit to my tracking ortho revealed that I had lost 2 degrees extension, so doing the push down stretch daily on knees when I sit. (Mark does it gently) and that is working. I was one of the lucky ones . I reached 0/130 within less than 4 weeks and have stayed there.

So now, I think the eliptical and walking (mall mostly inside) will be my leg/knee workout. That and some daily mini-squats and various standing leg raises and the calf stretch on the stairs. I used to do 40 minutes on the eliptical but have to be happy now with slow and steady at level one for 10 to 15 minutes. This week, I pushed towards 20 at 30 RPM average and felt twinges of pain in right knee and paid for it two nights during sleep. So slow and steady here wins the race.

Will continue to check in on your progress, FitGal and wish you continued great recovery!!

 

[ApricotPie]

Yes, it is possible to develop chronic problems with pain and swelling if you allow your knee to stay inflamed for extended periods of time. And I wouldn't really think of it as "just' pain and swelling. Believe me, the people who end up with these chronic problems can be miserable and often wish they could go back and do things differently.

.

At the risk of repeating this story to often, I will tell it again.

A friend had a TKR. He was doing fine but his recovery at a few months was slower than he liked. So he went to his gym to ‘strengthen’ his legs and knee. He worked out four to five days a week. No Pain No Gain, right?

His knee became badly inflamed and he could barely do anything for many weeks. Alas, it developed lots of new scar tissue in that time and his flexion is stuck at about 90 degrees.

Slow and gentle gets you there.




RTKR July 15, 2019

 

[Jamie]

Those are the stories we really hate to hear. But thanks, @ApricotPie, for posting it as a reminder for all to listen to the pain signals your body sends you.

 

[Tmgrl3]

So true about listening to pain and inflammation. Two days after my first mall walk, I went back and strolled the mall, for about 3 hours...easy walking. Then got a stab of pain in right knee. We skipped eating out, got back to the car, hubby picked up some thing to eat and home to icing.
Took one motrin and two tylenol. No pain next day but some swelling and by last night back to normal. I still ice. Twice a day minimum.

 

[FitGal]

WARNING - "Venting ahead"....

Well, I am in my 10th Week. I returned to PT on Wednesday (after 2.5 weeks not being at PT due to travel). I requested to go to my original therapist as my last therapist put me in terrible pain the week before I travelled. My ROM got worse over the past couple weeks, but, so my original therapist wanted to really work the knee....well, she did. AND, I am never going back to PT. Knee is swollen like a basketball. I am so upset, as I was really doing very well - on steps, etc - with no pain. So, no more PT....just my own PT and gym.
Thought I would be so much further along by 10 weeks.