TKR Grace's (CAdesgirl) recovery

[NavyGunns]

@CAdesgirl, I had no PT scheduled until after my first follow up with my OS at 2 weeks. He asked me if I was ready to start PT, which surprised me. I had already found BoneSmart by that time, so we had a good discussion about my concerns for overly aggressive exercises and therapists. I was expecting him to push back and be resistant, but he surprised me again. His preference is that PT focus and gentle flexibility, pain reduction through message, and helping to reduce swelling, everything that BS pretty much advocates. Since the hospital was almost 40 miles away, I picked a PT center closer to home. Had a similar discussion with the therapist and all was great. I find when we get past the notion that doctors are “all powerful beings” and realize we are the customer and set the requirements, discussions with doctors can be no different than our discussions here. Of course there are those who are “prima donnas” who need to be avoided.

 

[maryo52]

So glad your incision has healed up. There's one worry rid of! Yeah, I have these moments when I'm doing something normal again, and all of the sudden little alarms go off reminding me I've gone too far (sit, leg up, ice, rest!). I think I'm actually enjoying winter more because I'm semi laid up, reading, taking life slow. We all complain, where does the time go? Now at least it feels as if time has slowed down.

 

[CAdesgirl]

Today is my one month kneeversary and I am starting to feel like my old self again. I'm still walking like a 90 year-old and I'm stiff as heck every time I sit in the same position for too long but the recovery is moving right along. 2 weeks ago I was taking 8 Norco a day. Yesterday, I took one to sleep. I'm still really dependent on the cold therapy machine. I spend about 12-16 hours a day icing/elevating including while I sleep.

I'm doing my home exercises 2x a day and I have taken a few walks just for 5-10 minutes at a time. As much as I want to push myself to do more, I haven't because just those 5-10 minutes is enough to make the leg sore. Once it's not making it sore, I'll increase the distance. I've kept my ROM consistent without losing ground. I might have gained a few degrees since my last PT session a week ago but I'm not stressing about it.

I have gained a new pain on the outside of my knee going down into the shin. I'm thinking, based on what I've seen on this forum, that it might be my IT band. Does anyone have a suggestion for that? It feels "tight" but it's also painful to the touch.

 

[CAdesgirl]

@maryo52 - Life has definitely slowed down. That's probably the hardest part for me because I'm used to being so busy. I've ordered a tilting tray so I can ice/elevate and do some adult coloring or work on my diamond painting. I need something to "take me away" so the days aren't so long and boring.

 

[maryo52]

That is a wonderful report. I too have been making only tiny increases each day in what I do. That way there are no setbacks which always seem to come with dips in mood. Yesterday I lifted my leg into its elevated position as I have 100s of times since the surgery, but this time I experienced a painful twinge in my quad. It radiates down to the outside of my knee. I was thinking IT band as well. So now I have to be careful to heal that and certainly not to aggravate it. This is Murphy's Law raining on my parade, I suppose.

 

[NavyGunns]

@CAdesgirl, what you describe is exactly the same as what I experienced and was confirmed to be a tight IT band. Over time it has greatly improved. I only notice it every now and then, mainly when I move a certain way. Doesn’t prohibit me from doing what I want.

 

[CAdesgirl]

@NavyGunns - Thanks for the reassurance. Did you find anything that made it better? I've tried massaging it which almost brought me to tears. My instinct is to put on a heating pad (I'm not sure why) but I don't want to increase swelling in my knee.

 

[NavyGunns]

@CAdesgirl, I tried all kinds of things but never found the “magic” treatment other than good ole time. Massage felt good except when I hit “the spot” where the ITB connects to the tibia just below and to the outside of my knee cap. Initially, I thought it was a problem with my implant on that side since my PKR is on the lateral side. But quickly put that out of my mind since it didn’t bother me in any other way. Very warm, almost hot baths helped to loosen it some which I followed up with gentle stretches. I also took Ibuprofen to address inflammation whenever it would flare up, but I haven’t taken anything for it in a very long time. Like I said, mainly time to let to heal. I’m guessing there was a lot of stretching and other “man-handling” by my OS during surgery that made that area tender.

 

[CAdesgirl]

Oh, I know "the spot". I try to stay away from that when I massage. Was your skin really sensitive to the touch in that area, too? Mine is and has been since the surgery. Like you, I have been blaming it on the OS and man-handling.

On the positive side, I went out with my step-daughter to get our hair done today and was out for about 4 hours. It was a long time to be away from the ice/elevation but a much needed almost "normal" day. My hairdresser also works at the same place I do so I was able to catch up on the real story of how things are going.

 

[NavyGunns]

@CAdesgirl, I never really had much problem with the area around my knee being sensitive to touch, not like some experience. However, due to the numb patch across the front of my knee (which so far has not changed), my knee really does NOT like it when I kneel in the floor. It’s tolerable for a while when I kneel on a cushion, like our padded kneelers at Mass, but not for very long on the carpet or hard floor.

Glad you were able to enjoy a more normal day today. That’s what we all strive for!

 

[CAdesgirl]

It's been a roller-coaster week. On the plus side, I was able to get in my SUV and take a spin around the neighborhood. I only did it once but I don't feel so isolated now. I have the power to go do things. On the down side, I still am not walking as well as I'd like. I did walk about 1/2 mile yesterday but my gait is awful. I think it's a combination of a tight IT band and pain around the muscle flap (so both the inside and outside of the knee). I did get my exercise bike (my Valentines Day gift to myself) but I'm only using it for about 5 minutes 2x a day to loosen everything up because I feel like it's making the IT band worse. Everything I've found online to loosen the IT band involves exercises that I can't do yet.

Do anyone have any brilliant suggestions on how to loosen it up?

 

[maryo52]

The IT band is fibrous and not innately stretchy. Here's a link to a forum article, and also something I grabbed off a professional website.

https://bonesmart.org/forum/threads/itb-ilio-tibial-band-issues-and-treatments.18936/

 

[CAdesgirl]

Thanks @maryo52. I dug out the Voltaren gel yesterday and slathered it on 3x. I think it helped.

I'm thinking that I'm doing something to aggravate it because it seems to be getting worse in that now I have pain in my... uh, glute muscle and the side of my thigh. I used a heating pad on the thigh last night and that seemed to help. I've got a PT appointment tomorrow so I'll see if I can do any of the exercises from the site with a professional watching me to make sure I'm doing them correctly. What a pain in the butt.

Today is my 6 week kneeversary and I can say that I am glad I had the surgery done. There is still pain and stiffness but the pain isn't much worse than it was before the surgery and I know it's going to keep getting better. Now, if only I could start sleeping well.

 

[CAdesgirl]

So, it's been awhile since I posted on my own thread. I'm gimping right along at almost 8 weeks. I had PT last Friday (was supposed to be my last visit but we'll see) and didn't hit their goals for me. They measured me at 100/+5 and their goal was 115/0. They are going to recommend another 6 visits.

I go back to the OS on Wednesday and I'm going to plead with him to let me go back to work part-time. He didn't want to release me 2 weeks ago because he thought I wouldn't complete PT if he did. He's probably right. I'm not sure how he's going to feel about my ROM. He hasn't seemed that hung up on it.

Other than the ROM, I'm doing good. I'm driving wherever I want to go without even thinking about it. I can drive better than I can walk. Last weekend, I went to breakfast with one friend and a baby shower at another friend's house on the same day. Last night, I went to dinner with 2 friends and we ended up staying at the restaurant chatting for 3 hours (I left a great tip). I came home tired and needing to be iced but it was amazing to be able to sit for that long like a real person. Life is slowly returning to normal.

 

[maryo52]

You are doing GREAT! Considering all that led up to your TKR, 100 is fine. Some of us aren't turtles, we're snails (I was a snail the last time). With or without PT, your 100 will become 105 and 110 and likely more. It's just a matter of time (not exercise!). So nice to hear you had a long, enjoyable evening out . . . knowing the ice machine would be there when you got home. Yes, it's so good for the days to be more about living and less about recuperating.

 

[Jockette]

I had PT last Friday (was supposed to be my last visit but we'll see) and didn't hit their goals for me.

Their goal doesn’t matter, as they are not in charge of your healing, your body is, and you are coming along great, as you proved in your last paragraph.

It’s not exercising that gets our range of motion back, it’s Time:

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Exercise as in strength training is counter-productive and in the early weeks does more harm than good. Normal activity is the key to success.

 

[NavyGunns]

@CAdesgirl, great update. As others have said, numbers aren’t that important, not as much as how you feel you are doing. Numbers are just one indicator, but not the only or final indicator. How happy you are with your functionality, with pain, with endurance, those are what matter most. Stay positive, stay focused on small achievements, don’t get down about the occasional backward step, in the end, you’ll reach your final goal and won’t even realize you’ve been there quite a while already!

 

[sistersinhim]

I had PT last Friday (was supposed to be my last visit but we'll see) and didn't hit their goals for me. They measured me at 100/+5 and their goal was 115/0. They are going to recommend another 6 visits.

Why worry about their goals? It isn't their knee, it's yours. What was your goal? Are you starting to do the things you wanted to do? That is what counts, not numbers. For less than 3 months out 100/5 is doing great! Your ROM will improve with or without PT. If you want to return to work and you think your knee is ready, then go back. It's your knee, not your OS's.

Many of us have wished we were doing as well as you are doing. Pat yourself on the back for a good recovery well done!

 

[CAdesgirl]

@maryo52 @Jockette @NavyGunns @sistersinhim - Thank you all for your support. I'm not thrilled with my flexion but I know I'm doing all I can to get there. I'll admit that I was really quite down Friday afternoon. In fact, I was home in bed curled up with my ice machine when Mike came home from work. He said pretty much everything that you all have said reminding me how many surgeries we've been through. He's coming with me to the doctor on Wednesday.

I have to get the OS to sign off before I can return to work. If he wants me to agree to continue PT in order to sign the paperwork, that's exactly what I'll do. That doesn't mean I'll actually go because I know that work is going to be tough enough without trying to do PT.

 

[Jockette]

Please don’t let other people’s unrealistic expectations ruin the accomplishments you are happy with. Especially people who have not had this surgery and recovery, like most young PTs. And you do have accomplishments to be excited about.

You are coming along well. That will continue. My ROM continued to increase after my one year check up and well through my second year. ROM does not have to be regained in the first 8 weeks.