Bilateral TKR I Can't Believe It...I Did It!!!

[Pamx2]

Hello! Well, my knees are 9 weeks old today. I'm pretty amazed how this journey is playing out just like predicted on Bonesmart! I really like my new PT...he understands the Bonesmart philosophy and isn't pushing me too hard. And God bless my surgeon. Try as I might I can't help but compare myself to other knee patients at PT...and I have been worrying that my ROM isn't improving like it should. My PT hasn't even measured my ROM since I first started with him two weeks ago. I know I'm at a comfortable 90 degrees when my knees are warmed up. My husband saw my OS at the hospital yesterday and my husband mentioned my ROM concerns. Well, my OS sounded like he was reading advice right off Bonesmart...he said I am doing just fine...I need to take things slow and steady. He said that most patients gain ROM even 6 months to a year out. Sound familiar?? My biggest complaints at this stage of recovery...I hate how my knees stiffen up as soon as I sit and I have to work them out a bit to walk again. And I hate sleeping on my back...but it's still uncomfortable sleeping on my side or stomach....and I hate that I have trouble sleeping still. And I hate how I seem to overdo it and then I end up with sore knees (I'm elevating, icing, and even had to take a Percocet tonight because I helped a friend move a heavy piece of furniture today....very bad idea!) On the other hand...my "hates" are small compared to being able to walk again! I still am in awe even when I go to the grocery store because its so nice to be able to shop and not deal with that horrible bone on bone pain. I just need to remember the advice of Bonesmart and even my OS...DON'T OVERDO IT!

 

[MissJ]

Congratulations on your progress! My knees are 4 weeks old today.

I am surprised (and a bit jealous) that everyone is taking such a relaxed approach to your PT. I do exercises 2x/day at home, go to PT 3x/week - which is all good, except for the horrid "angle measure." One of my PT's really likes to go for it (pushing); another told me he wished they didn't have to measure the angle every time and could let it loosen more gradually.

At what point were you able to walk and go to the store? I tried Walgreens briefly last night - I could walk around slowly w/my cane; standing in line was a little tougher. And my walking is not totally pain free - yet!

j

 

[MissJ]

Congratulations Pam! I am 4 weeks out from BTKR and agree with Jim and Roy. People in the hospital kept saying it was "brave" to do both--I thought it was the chicken's way out myself. It's nice to know I won't be heading back to the OR.

It's amazing how quickly the little things will come back - walking down a hall, sitting in a chair with legs bent at 90, etc. Ray is right that the larger issue is strength, not pain. In my case, I also need to practice my gait and relearn how to bend my knees with each step (my gait was terrible pre-op).

Ok - it's time for me to do my home exercises - tedious but necessary, and my only real "job" for the time being! The housework's languishing, but that's OK.

Take care and keep us posted.
Jeanine

 

[skigirl]

Reember Miss J that you are in charge. Exercising on a swollen and inflamed knee is counter productive. I never had even a minute of pain in Pt and I have really good rom. So, it is not necessary to be aggressive in this early stage to get good rom.

 

[Pamx2]

Hello Miss J! I TOTALLY agree with Skigirl. It is NOT necessary to be aggressive at 4 weeks out. I learned the hard way...my home PT would do the "horrid angle measure"...love how you describe that!! And you know...it really wasn't necessary!!! My PT now never measures my ROM. He measured it when I first started PT (this is the second PT...not the original one I was going to who was too rough), and that's been it. Not sure why some PT's insist on doing such an aggressive stretch...and they insist on measuring your ROM each time. It's like having to go to Weight Watchers every day and get on that scale. Of course, you're not going to see results each time. PT's DON'T need to measure your ROM each time and stretch you into pain. Maybe that is there protocol...but you can say NO!!
But it's not easy. After 9 weeks I'm finally learning to say NO. If something hurts too much I say...that's too painful!! I'm stretching now through the stiffness to just where it starts to feel uncomfortable...and that's it!! I don't see results everyday...but you can bet I've been seeing results every week. I measure my results in church! At 4 weeks I could only sit with my knees bent a bit for maybe 30 seconds...then would have to straighten them for 30 seconds...then would have to bend them a bit. I'm sure people around me were thinking...stop being so antsy!!! Every week I"ve noticed that I can sit with my legs bent for longer periods of time...and I can bend them farther. Last Sunday I sat with my knees at 90 degrees...just in the "stiff zone"...no pain...and was able to sit for 5 minutes at a time. Then I had to straighten them a bit...then would go for another 5 minutes. I'm always glancing at my watch...I'm sure my pastor thinks I must be timing his sermons! Need to tell him I'm killing two birds with one stone...listening to his sermon AND doing PT!

 

[Pamx2]

At what point were you able to walk and go to the store? I tried Walgreens briefly last night - I could walk around slowly w/my cane; standing in line was a little tougher. And my walking is not totally pain free - yet!

I was just like you at 4 weeks...could walk with a cane for a few minutes around the store...or maybe a little longer if holding on to a cart. At 4 weeks I would have my son or husband go with me to the store...and they would stand in line while I sat on a bench near the checkout...because you're right...standing in line is tough. I found that walking felt good...but if I walked too much...then my knees would get sore. I can now spend an hour or so at the grocery store or Target or Costco shopping and checking out and getting to the car. By then my knees are letting me know that they are getting tired. So it sounds like at 4 weeks, Jeanine, you are doing great! You'll find that your stamina slowly increases. I had an occupational therapist tell me that when I am doing something...I have to think to myself how difficult is this chore on a scale of 1 to 10. The chore (like going to the grocery store) might start out as a 1....but she told me when I start to get to a 5 or 6 level of difficulty, then I need to start think of wrapping up that chore and getting it finished pronto so I don't get to a 10 level of difficulty. That advice has really helped me! And there is NO WAY we are chickens for having both knees done at the same time!! I still don't feel especially brave about doing it...I was freaking out terrified...but it was certainly the practical thing to do...because both knees were so bad. It is VERY NICE to now be able to dance around (gently!) and sing..."ONE AND DONE!!"

 

[60mom]

PT is very interesting isn't it! My first although he never brought me too tears was a bit too aggressive as well and we had to do the dreaded ROM check every visit. My new PT who I got after my MUA sounds like yours mostly does manipulation with massage and I don't feel any pain in fact it feels good. I do exercises there as well and she checks my ROM only when I ask. But now I don't even worry about it as I was 120 last she checked and knew I was improving so why bother anymore. I have had a set back and lots of stiffness that has taken me back to 110 per OS. I also finally stopped PT. But today I actually used moist heat and worked it a bit in the spa and if I guessed I would say it moved to about 115. So I think any given day it can vary depending on if we have done something to make it swell internally. So I am going to start a diary to determine what really sets it off because it is very hard for me to judge over doing and not doing enough. Your OT has a good point so I might incorporate that into the chart as well. I am almost 5 months and still learning about this new knee.

 

[skigirl]

I agree that the rom changes from one day to the next. Especially if you have been doing a lot and your knee swells, which drcreases the rom. It is frustrating to feel a little better at four weeks, but not quite enough to do too much. I used the electric carts at stores like target and costco which helped with the standing in line problem.

It was hard to do anything for very long at four weeks. I felt great when i was at home, but tired quickly when I went out. Some friends came by once a week and took me out to lunch, which was a treat and an hour and a half was about right.

 

[Pamx2]

My new PT who I got after my MUA

Hello 60mom! So I'm curious...how far along were you after your surgery when you had MUA? And what was your ROM at the time? Was it worth having MUA done? Just curious. I agree with you...it's so very difficult to judge over doing it and not doing enough. I like your diary idea!

 

[60mom]

I was only 5 wks which really is too early. He also easily got ROM to my butt I assume that is around 150. Says he heard pops but I have my doubts I really needed it. My PT was aggressive and I also don't seem to get enough pressure to tell me when it is too much. I have found the bike works better for me then trying to do heal pushes. My knee just doesn't like that, always makes it swell. After my MUA I had a lot of pain I think due to too much ROM during the procedure and stretching my muscles, ligaments, and tendon more then they have ever been stretched as I have never been flexible. My PT was able to get me to 120 right after and I was about 85 prior to MUA. The reason he did it was I had gotten to 110 but went backwards to 85, most likely due to swelling. 2 days later after getting me to 120 I was back to 90 due to swelling. I switched PT's and she was much less aggressive. Rarely even checked for flexion but I could tell I was improving. Took about 6 wks and I was back to 120. Went to a soccer game today 3 hours a way and no problems at all. So I am finally thinking ok, just maybe I am figuring out what this knee likes. Only taken me 5 months, lol. I just bent it and it looks like it is back to around 120. Thank God, I was starting to get a bit worried. My moist heat is working!

 

[Pamx2]

Only taken me 5 months, lol.

Don't you wish some little alarm would go off when we just start to overdo our knees...and we would know to stop and rest?!? Seems to me that my knees do fine during the day...then at night swelling and pain starts and I realize...oops...I overdid it!

 

[60mom]

So true, I took a bath last night and decided to do some heel slides in the water. I am paying for it today. I know my knee does not like that but I continue to do it from time to time. Such a learning curve that I am slow to get!

 

[Pamx2]

Hello Everyone! My knees are 10 weeks old today. Something funny happened at PT yesterday. My PT had told me on Monday that we were going to do some "good stretching" on Wednesday. I started to get panicky while thinking about it...remembering how rough my original PT had been in the early days. So I went on Bonesmart and re-read as many encouraging comments about no pain during PT as I could. I wanted to be sure that I would be able to say STOP if my PT got too rough. Well, my PT had me lay on the table...he massaged the back of my thigh near my knee...then SLOWLY would raise my foot to bend my knee. Eventually I could feel the stretch in my quad (front of my thigh), and my PT stopped bending my knee when I said I felt the stretch and said, "Let's just hold at this position for a few seconds to get a gentle stretch." Here I was ready for battle, and my PT wants to do a gentle stretch! He's a good guy!! Time for my morning stretches...have a good day!

 

[Janet2012]

Hi Pam, what a relief that must have been! It's a wonderful ing to have the right PT!

 

[jenn8759]

Yes, Jim is right. I had both done on March 11th and am going back to work next week. I did aggressive PT twice a week since March 25th and was able to drive at 5 weeks out. I still have problems getting out of a chair and lowering on the loo, without a rail (I know TMI, but hey, this is a medical forum with health issues discussed). I know that will come in time. I can go up the steps fine, but coming down is still kind of tight. Everyone's recovery is different. I had a great surgeon, great hospital, rehab and good PT people who have worked with me and I have worked on my own at home as well. My quads are back to where they were before I went into the hospital. I can walk without a limp and walk without pain and stand at the check out line without pain. Take one day at a time and remember to rest, ice, medicate and elevate. Good luck!

 

[MissJ]

What a wonderful thread this is for someone like me-- today I'm 5 weeks out from BTKR. As usual the Bonesmarties reassure me that my recovery is right on track.

I'm especially interested in the comments about tightness. I woke up this morning feeling strong and, instead of doing my home stretches/bends, started out by taking a 7-block walk. It felt fine - then I practiced stairs a bit (I'm having to retrain my right knee to bend rather than kick my hip when I walk/use stairs - and I'm doing stairs normally, not two-footed). Then I rested & iced...and now my knees feel so tight, as though I couldn't get 90 degrees - when at PT I get 110 & 120.

Jenn, congratulations on being able to go back to work - and for noting that movement still isn't quite all there!

Is the tightness actual swelling? The knees don't *look* swollen. I look forward to the day when I can work the knees a bit, rest, and not have them be completely stiff the next time I get up!

 

[Roy Gardiner]

MissJ, IMO at five weeks you are overdoing it. If training for a marathon you wouldn't run one mile one day, feel good, then run ten miles the next. You'd add little bits. Same with the knee. Do your home exercises + 10%, if your knee is fine next day, don't add another 10% but keep at the new level for a few days -- then add 10%. They add up dead quick.

I found the stiffness after effort went on some months. But now there are no limits imposed by my knees -- it comes, eventually.

 

[60mom]

I always get some stiffness after doing exercise if I over do and I am 5 months out. That internal swelling is telling you that what you did today was a bit too much. I doesn't have to look swollen to be swollen, stiffness is also a sign of swelling. Try to increase activity slowly so just walk a bit more then previously if it gets tight back off and wait a few days then try again. It takes time and some knees like to go more slowly then others.

 

[jenn8759]

Yep, stiffness is internal swelling and I heard that will be with us for a while. Today was my last day of PT, I graduated. My ROM decreased though, to 125, but my PT said not to worry, I am fine, keep riding my bike with the seat low and keep moving..... and by moving, not running or overdoing it, but moving enough not to lock up. I hate that stiffness too, it is uncomfortable. But as I read, our knees are nerve-rich. I still have numbness in some parts and it is 8 weeks out for me. I am not complaining though, I can stand without pain, walk without pain and not have that limp. Everything will come in time. I am done with PT and I go back to work on Wednesday next week, so I am going to celebrate and enjoy my last four days of freedom.

 

[jenn8759]

My stamina has come back too, I went to PT today, worked out for close to two hours doing bike, treadmill, leg muscle machines, then went to Kmart, Shop & Save and home. Laid upstairs in my bed for about a half hour with legs elevated and still have energy. I take vitamins and every morning I start out with almond milk, protein green powder, banana, frozen blueberries and a handful of spinach (AYE POPEYE!!) and put it all in the blender. I saw it on Dr. Oz too, it cleanses your gut and after what we all went through with the drugs, anesthesia, etc... our gut and our system needs cleansed. Milk thistle cleanses your liver as well. Looking forward to going back to work and getting full paychecks too. Each transition was a little scary, being wheeled to the OR, being in recovery and praying that I would be allowed to go to the rehab there at the hospital, which I did, then being told I was being sent home, I was scared to death. Got home and everything was good, I had two good friends who drove me to rehab twice a week. My church has a food ministry, so I had food delivered to my house every day by someone who cooked for me and my family, the meals were delicious. I am friends with a retired nurse who checked in with me every day by text and it was reassuring. Then I had to do the injections into my stomach every day for three weeks, then I was done with that, which was a good thing. Then I was told I was allowed to drive after 5 weeks out from surgery. Then today my last day with my PTs.... next step... back to work.... Wow... Been a wild ride and a good one.