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Bilateral TKR Getting in & out of a kayak - suggestions?

I bet half of those who come on this forum are like you: simply didn't realize how big this recovery is, and how slow. Now you know!

I only read your opening post because I saw the "kayak" part. I am a kayaker, and the first year of my TKR was challenging. My kayak outings in Maine begin and end at the shore. We're in Florida now and I'm using a Manta kayak which is very stable and which I can enter and exit at the dock without incident. I use the ladder and place one foot on the ladder and one in the middle of the kayak and then kind of plop into the seat. Not pretty but it works. Getting out, I swing my legs over the side, get my feet on ladder rungs, and pull myself up. One thing I'll add: it has taken me almost three years to achieve my prior agility getting in and out of my kayak in Maine. It look two years at least to get enough of my quad back to do it decently.

A not-so-subtle hint: You cannot speed your recovery, improve your recovery, or gain an edge by your choice in trainer or PT. Yeah, this works when you're dealing with non-injured tissues. But you have had major surgery (scalpels, saws, hammers!). There is no way to accelerate recovery, and in fact efforts to do so often backfire and cause regression. I've also found no way to improve patience either :sad:

You simply have to experiment and find what works. Make sure no one's filming you and posting it on youtube!! As far as recovery, it has its own pace, but I bet like the rest of us, you'll push it and need to find out the hard way. That being said, I know a guy who biked 100+ miles three months after BTKR, and someone who climbed Maine's highest mountain at seven weeks. But it wasn't PT that helped them achieve these goals but rather they had excellent surgeons and their bodies handled recovery quite well (little or no pain).
 
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@Spiritbee51 Hi there! You're a night owl!!! posting at nearly 1am. Or is it the way the forum works: 11pm for you shows up as 1am on my computer as I am 2 hrs ahead of you? who knows. I hope you got a good night's sleep!!

You asked about pain. My experience is that pain is pretty variable. Some days I just feel great (overall) and my knees don't hurt at all when resting and I can walk (stiffly and with a cane) for lots of 10 minute intervals (walk, sit, walk sit, etc) or sit upright (at a table, in a wheelchair, at a movie, etc) with little difficulty and using only acetaminophen 1000mg three times a day with in between doses of ibuprofen 400mg. Most of the time the pain I feel is sort of an achy, deep discomfort. Occasionally I'll get sort of shooting sharp pain in just one area but it is related to activity and if I stop, the pain stops.

Ironically, the knee that was worse pre-surgery is now the better, more flexible, less painful knee. Go figure.

I was able to function at this level by about week 4 or 5 post op. I tracked my use of "as needed" pain meds (for me, dilaudid 2mg tabs) and went from using 2 or 3 tabs per day during week 3 post op to needing 0-1.5 tabs per day during week 5. I've now switched to Norco 5/325 and use maybe 1 tab per day.

For me, I have usually been able to relieve pain by lying on a couch/bed, legs up, with or without ice.

It also seems the weather influences my pain levels. I "know" it shouldn't but I sure do feel more energetic on sunny days. May be I just find it easier to ignore mild/moderate discomfort because I am motivated to do other stuff.

As for swelling: I cannot (still, during post op week 7) see the outlines of the patella when I look at my extended knees so I know there is swelling in the joint capsule. I can feel "heat" in the joint capsule area, much more noticeably after activity or exercise (that's when it's a good idea to ice!). I feel the stiffness most all the time but, sometimes, for just a few minutes, I can get a better sense of flexibility after I do the hip-to-shin stretch my PT taught me. It sort of gives me a vision of what I'm after, reminding me that progress is possible.:yes:

I agree completely that no two persons, or knees, are going to have identical recovery pathways. All I can say with confidence is that what has worked best for me is to:

a) listen to my body. If it is hurting, take meds, lie down, rest, ice. If something looks like fun and I feel like trying it, then I go for it.

b)be diligent about exercising at least 5 of 7 days per week. Keep doing the gentle stretches, they do help slowly and incrementally. Even when I feel crummy, if I do half a work out, I feel better than if I did none at all. And my self-respect & mental health is better too.

c)use meds as tools to help achieve reasonable goals. Keep pain under control so good quality sleep/rest and exercise are possible. When I was a crying basket case in the beginning, I used xanax to keep me sane. When I cannot sleep well, I use a different med to help with that so I sleep soundly. I don't worry about addiction because I use meds as directed and for specific goals.

I'm not taking any anti-depressant but I wouldn't hesitate to accept a course of meds if I felt like my mindset was getting in the way of my physical recovery. We KNOW mind and body are connected and we should always approach healing holistically (IMHO).

I do recall making a mental shift somewhere around reaching week 4 where I stopped thinking of myself as sick/post-surgical and started to see/think of myself as normal with "a few" limitations (!). I'm not sure how that shift occurred - spontaneously or thru some self-talk. I do know it makes me feel better in an overall way. (funny side effect: my husband has been a stellar caregiver but he started to get a little whiffed when I started to do more for myself, especially when it was clear it required effort or discomfort on my part. I wasn't ready for that kind of push back!)

I don't know if this is quite what you're looking for...but it is what I've encountered.

I hope you have some restful and restorative plans for this lovely Sunday. Take care!!
 
Thanks RimRoc, sunny here in the Southwest, which always helps. Saw your post and similar surgery dates, so wanted to see how you were doing. You sound very energetic compared to me and I only have one leg tied up in this, great to hear. Fun to have this forum for passing time and checking in with others in same situation.

Every day is better now, the pain level is dropping, I'm becoming more active and hoping that continues. Working on walking farther now without pain. I had rotator cuff surgery in June and I'm always doing my simple strengthening exercises along with knee PT, so now if I can get to walking more I should be burning a few calories too. My surgeons, my PTs all say the strength will come back and don't overdue it, sure enough the shoulder is strong again. It just takes time, so I guess I need to believe this knee will just take time. I just didn't know how much!
SBee
 
hey hey @Spiritbee51 -- glad to hear things are looking up a bit. This is definitely a slow & steady kind of deal. I know I fretted about losing strength and conditioning while lying about all day. I don't think there is any way to avoid it. I do find that my stationary bike gives me a good work out without stressing my knees at all. It just took me about 3 weeks of trying it for 60 seconds at a time before I could actually execute a full pedal cycle!

I guess the real message is -- take care of the basics, be patient and persist. healing will come.
 
hey all you kayakers out there -- many thanks for all your comments and suggestions. I really like the description about getting in and out from a ladder & dock (I think I might be able to do that). I do have an outing planned for Jan 24, with a group (lots of potential helpers), and a beach launch with pretty open cockpit type craft. I'll post some pics, assuming we don't rained out or frozen out :SUNsmile:
 
I guess I get to join the ODIC (over-did-it-club). Have had a couple of visitors and spent half of Monday in an art museum, spent Tuesday driving for a couple of hours, and Wednesday walking the beach and a marine museum, plus dinners out. It felt great to resume a 'normal' life of on-the-go activity but, oh!, my aching knees. And I kind of skipped my exercise sessions...so I guess I'll be admonished in PT on Thursday.

Time to get back to basics I guess.
 
What do you mean...admonished for skipping your exercises??? What do you think all that activity was???? Anything with movement IS exercise when you're in recovery. So don't feel at all bad about that. However....as you recognize, you did overdo the "outings" a bit. But no worries...just go back to the mantra of rest, ice, elevate and take something on a schedule for a few days for the pain. You'll get back on track. And....if you'r hurting on the day that you have therapy scheduled, it's okay to cancel it. Or at least if you go, insist they only do very mild movements, massages, heat/ice treatements or something that doesn't work those irritated tissues. They need REST!!!
 
GOOD that you skipped your exercises. Your legs had had it after those visits. If you get admonished, tell them to stick a sock in it!
 
In one of your post you asked about oils for the scar . My family physician had me get wheat germ oil . She said to rub in in the circular motion on my scar taking one finger and going down scar for about 15 minutes total . My scar is long . It seems less messy than vitamin e I had. And has vitamin e in it.
 
Ironically, the knee that was worse pre-surgery is now the better, more flexible, less painful knee. Go figure.
Click to expand...

Yup, happened to me, too. Both knees are pretty tattered, with the right knee giving me more pain and swelling more. Left knee got operated on because it was bone-on-bone, and now the right knee is a happy camper compared to how it was before the left got the PKR--presumably the right knee was killing itself taking up the slack for the left knee.
 
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OK, so I had zero progress in one knee and negative 8 degrees in the worse knee (from 108 to 100)

The PT guy is great. He took a look at my reverse progress in flexion and shrugged...seems he does not expect steady progression, just an attitude of keeping trying. He just says "you'll get there"

I feel much worse about it than I probably should. I can tell my knee that actually lost flexion is really swollen. So today my activity plan was rest, elevation, ice and gentle stretching.

I did try climbing the stairs to our 3rd floor condo and it was easy. Nice surprise.
 
You're taking just the right approach when you have one of those little setbacks. Take things easy for a bit and let things settle....:thumb:
 
Ha Ha, success!

Went on a kayaking trip today (I am 7 1/2 weeks post op BTKR) and things went great. Now, it was about as easy as it can get -- we used 'sit upon' type kayaks so there was no cockpit to climb into or out of; we launched from the beach, so there was no need to stay stable next to a dock; and there was a big group of people, so I didn't have to single-handedly pull the craft up onto the sand. I paddled a tandem with my 85 y.o. mother in the bow for two hours, in and around some sheltered mangroves off of Sarasota bay.

The sun shown, the tropical shore birds were nesting, and it was a gorgeous day. There was a bit of a head wind on the way back but nothing too difficult.

I'm a little pooped but I'm really glad I went.

Thank you to all who made suggestions on how to tackle this fun challenge. I appreciate your help :-))
 
How wonderful!!!! Congratulations!!!!
 
That is more than fantastic, I can't imagine btkr and kayaking in that time frame, but I'm not a kayaker either!!! Great progress.
 
Ha Ha. I think I wrote a bit to soon. It wasn't just the two hours in the kayak; it was the 2x45 min of car rides and the (interminable) 2 hour lunch with the kayaker crowd thereafter that also did me in. So in truth, there was definitely a toll in the way of really tough stiff knees, sore shoulders, sore legs, etc. Of course, I should have expected that -- sitting mostly on my fanny for two months and then trying to do a full day of activity. What else should one expect?? But now it is 2-3 days later, and the worst of the soreness has worn off.

I went to PT today. According to the PT guy, I'm doing just fine for 8 wks post BTKR. My left knee is at 116 degrees, but my right knee is only at 105 degrees. The criteria for discharge is 120 and the ultimate goal is about 130. Anyway, the main advice is to put more time into firmly forcing flexion in both knees (but at tolerable levels of discomfort only), with a goal of 8xday @ 3 minutes of max tolerable flexion. It's really an issue of time on task.

He also said, if I really want to go for it, to put in 3x10 minutes on the exercise bike with the seat as low as I can tolerate, plus walking and climbing steps to the degree I feel like for the sake of quadricep strengthening. Plus all the other exercises I'm already doing once a day. I know it sounds like a lot but it is "the goal" not the minimum, it's just what to aim for. If I accomplish all that, I will be able to relax and tell myself I've done my part. Plus I'm really bored!!! I may as well amuse myself by exercising.
 
I still think you have been far more active than I can even fathom right now, you must have strong legs or really good pain meds. Way to go, your ROM is coming, are you swollen? If so that will make it difficult to bend to the 120. Do as the Bone Smarties say, Ice, Elevate!!! How about a little rest too?
 
OK, I have been consciously increasing my activity levels these past couple of days. I have a spread sheet so I can record all the stuff I do, which makes me feel better. I can't measure flexion directly or precisely but I can say I wake up feeling like it is easier to bend and walk. I get a lot of tightness in my R hamstring area -- I think from walking with a slight limp & un-natural gait. So I'm trying to do more stretching to keep it loose. I really long for the feel of a full body workout from a 90 minute hot yoga class but I don't feel quite ready for that. I am SO SICK of not feeling strong and able...ugh. For me, it feels best to push to the point of semi-exhaustion and then rest up for a day or two. Maybe not quite the measured pace recommended on this site but, heck, I know I won't hurt myself and it really does help my mental health.

My pain med regime is pretty simple: acetaminophen 1000mg in the morning and at night. ibuprofen 600mg mid-day. Glass of chardonnay at 5:30. I have a bunch of opioid pain meds on hand and will take one maybe twice a week if my usual meds don't relieve the deep aching I get sometimes. And, yes, I do occasionally lie down, elevate and ice. But not all that often.

Prior to surgery I was pretty energetic and able in an everyday sort of way. I had given up most athletics due to stupid arthritis and knee pain but could be on the go for 18 hours even if it hurt. I've been blessed with good overall health and energy. That's the feeling I want to get back. Plus, I'm still in Florida while my work colleagues are stuck slogging through another polar vortex up in Chicago. I feel it almost criminal not to take advantage of the pleasant weather here, while I can. I'm all too mindful that the Feb 24 return to work date is not that far off. Too bad I can't afford to retire!

@Spiritbee51, we can only do what we can do -- I've been lucky. I hope you are able to move back to an activity level that brings you happiness and contentment very soon!!!
 
Ya know, the number thing for ROM is pretty arbitrary, as is any time frame. I opted for another 4 weeks of twice a week PT after the daily PT (5xweek) for the first 2 weeks postop--I wanted to do this so as to get ready for horseback riding. As it turned out, I was not even to the 4th week of 2Xweek when PT "fired" me because I was already at my goal and riding. Their goal for me was 130--I have no idea if that was because they felt I'd need that much to ride, or just because it sounded good. The day they fired me I was at 120-something and that was declared good enough.

This whole discussion is making me want to try to kayak but although its 60 degrees right this minute there's no one at home to haul me out of the boat if I cant manage on my own. And I dont have the sit on type kayak, more's the pity.

In addition to riding and trimming the horses I have been toting and splitting firewood--NONE of which is as tiring as riding in the car for very long and grocery shopping.
 
It sounds like you're doing well. You're (mostly :wink: ) listening to your body and finding what works for you.
 
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