TKR Looking for reassurance - or company for my misery...

[soSuesew]

Thanks, everyone, for the advice and support.

Been elevating and icing a lot more today - no sign of any change, yet, of course (that's always been my problem, wanting instant results!). And, of course, wouldn't you know it, the other knee has been playing up. Arghhhh....

 

[Titianlady]

Hang in sweetie!! It will get better

 

[soSuesew]

So, I've been elevating and icing my knee much more over the past few days, and been much more regular with the paracetemol/ibruprufen. Very early days but probably a bit less tight and stiff. I'm also trying to listen to my knee rather than pushing on, and using the cane a little more. I'm trying very hard to regard this as moving forwards, not backwards...

I have physio this afternoon and I'm at a bit of a loss to know how to approach it. Isabelle the PT is good and I get on well with her but she's a traditional physio focused on pushing me forward. I don't have a problem in asking her to back off but, culturally, it's unusual to challenge and question in this way here and I'd like to keep on good terms with her.

A new pool opens up today in our local town. I don't swim but I hear that there's a shallow exercise pool and a hot tub. What type of exercises would be good if I go?

Sue in chilly and damp Aix en Issart

 

[Josephine]

Yes, it is a big step when you've never done it before and perhaps you need to start off by having a chat with her and telling her that you've decided on a different approach, a less aggressive one, to see how it goes. A suggestion though, don't whatever you do, tell her "oh I read this stuff on an internet forum and decided to give it a go" because her immediate reaction will be totally negative. It's not her fault, she's been 'brought up to it' but you have rights to choose how you want to proceed and she should respect those. You don't need to argue or be antsy, just stand firm, be assertive and don't be swayed.

Let us know how you get on.

 

[tkrme]

A new pool opens up today in our local town. I don't swim but I hear that there's a shallow exercise pool and a hot tub. What type of exercises would be good if I go?

Sue in chilly and damp Aix en Issart[/quote]

Hello. My surgery date is the same as yours. Welcome to the long hard journey. About anything you do on land you can do in water. I do the same exercises in the pool as I do on land. I go to the pool three times a week. Mini squats, mini lunges, stretching the calf, leg lifts with knee bent(kinda like a march), leg lift to the back and to the front and to the side, bicycle movements. And I walk frontwards, backwards,and sideways. When walking force your feet to walk just as you would on land. It is easy to be bouyant and bouncy instead of forcing your foot to the bottom and walking normally. On the off pool days, I rest from most of the exercises. I just do a gentle calf stretch, my gravity assist exercise(described below), and the stationery bike for about twenty minutes with no or little resistance.

With all the suggestions here, I am sure you can find something that works for you because we are all different in the way we heal.

As far as what I do to increase my bend (I do not know ROM number) I lay on my back, lift my leg with it bent at the knee, put my hands behind my thigh and let gravity pull my leg down until I feel the discomfort, then back up. I do this only three times. As it got where it didn't go down any further, I added one pound weight to my ankle. I am up to about eight to ten pounds of weight now, but have been doing this for eight weeks. It was about five weeks of just gravity before I put a one pound weight on.
Good luck finding what works for you.

 

[ElanorG]

Sue,

My surgery date is also the same as yours. My regimen is not a lot different than tkrme. I walk in the pool three times a week, front, back, and sideways. I concentrate on walking correctly although I also lift my knees up high to help strengthen my hip flexors. My left knee is not very good so I use the pool walking to improve my land gait and also give me some relief from the pain in the other knee. I do some marches at the beginning and then I get in the hot tub and do a lot of stretching for about 15 minutes afterwards. I still do PT twice a week and I workout with my trainer at my health club twice a week on my upper body weights. Two other days I ride both the recumbent bike and upright bike for 20 minutes. I add two minutes a week to my pool walking and biking. I stretch every day, particularly for extension as my flexion comes easy for me. I do most of the PT exercises at home one other day. Hope this helps you.

 

[Poppet]

Hi Sue, I am from the 'hippie' side of the forum, so don't know a great deal about TKR's, but thought I would drop by and send you happy thoughts and hugs

 

[skigirl]

When I work out in the pool, I often put on a buoyancy belt(which I bought at a sporting goods store). Then, I go into the deep end of the pool and "run" or race walk for an hour. It is a great workout--I am sweating when I am done! Kelly

 

[soSuesew]

Thanks for all the advice and encouragement re. the pool and hot tub. Off to check it out at the weekend (and to check out my swimsuit - so long since I wore it, it could have moth holes!).

My knee is definitely more comfortable after five days of more elevation, rest and ice, and better drug timing. Less discomfort either side of the knee and less tightness across the kneecap. Slightly more uncomfortable after a walk today but that's to be expected.

Still have a dilemma re. physio. I need to go, I think, to ensure that I do actually exercise and not sink into daytime tv, but I need to manage it so that it meets my new objectives - non-aggressive, not worrying about ROM measurements (although that's me more than Isabelle, Madame la Torture...) and less achievement-driven.

I am beginning to believe (although it depends on which day you ask me...) that the ROM will come when the knee is ready and that the world won't come to an end if I take longer than some others to get to a particular milestone. Glass half full reading - before the surgery I needed two crutches to walk, couldn't unbend my knee (there's irony) and normal life was grinding to a halt. Nine weeks later, I'm so much better off, plus I've lost 26 pounds over the length of the whole sorry saga! (The only explanation is that was so much harder to get to the food...)

Sue in windy and chilly Aix en Issart

 

[tkrme]

So very glad to hear you are doing better. Congrats on the weight loss.

 

[ElanorG]

Sue, great job on the weight loss. The pain meds helped me lose about 13 pounds. Maybe we can advertise this as a new weight loss solution. Just get a Total Knee Replacement and drop 20 pounds like that!

 

[kneeper]

Glad to hear your knee is feeling better, soSuesew. Rather than focusing on numbers it can be helpful to just think week by week--what can I this week that I couldn't last week? It's not always fast, but you will see progress bit by bit.

 

[Dulcimer Diva]

Sue, don't look back. Keep looking forward and don't beat yourself up with guilt over your pre-op physical condition. I too am "overweight and underfit." 3 yrs. ago, when I developed a cuboid bone stress fx in my L foot, I asked my orthopod whether obesity caused it (at the time I didn't recall any specific incident but in retrospect it was probably from my foot sticking to the floor occasionally while walking in Crocs). He smiled and said "I never discuss that on the first date." He never brought it up again (and neither did the podiatrist, a rail-slim marathoner). When I went to my current OS for my first consult prior to the RTKR, I asked how big a part my weight and relatively sedentary habits contributed to my OA. He said "Don't go there. We need to focus on where you are NOW, how we can fix your knees, and how best to get you able to move more easily and comfortably. The fitness and weight loss will follow. According to your chart, your first arthritic episode was in your neck at 27--and I can assure you you don't have a fat head." He went on to explain that since both my parents had OA and were of normal weight, and my tibial plateau (bottom of knee joint) had been shattered by a car bumper and my left ACL torn in a fall, both heredity and trauma predisposed me to OA. Any serious injury to a weightbearing joint can start the process of traumatic OA in motion, no matter how young/thin/fit you are.

Measure your progress in terms of how you are improving, relative to how you were when you decided enough was enough and that old knee needed replacing. You are occasionally reaching for a cane. Pre-op, you were in agony and on crutches. Do the math--it's a lot more encouraging than a raw number on a PT's goniometer, especially when you and the PT natively speak different languages (and she hasn't known you very long).

 

[soSuesew]

I was introduced to the elliptical trainer at physio today and could do it. Not well, not for long and not elegantly...but a minor achievement!

I continue to be bewildered. Nine weeks out and I have healed well. I don't have pain - more like discomfort. I sleep ok (I wake up a couple of times in the night but I did that anyway). I can walk pretty well without support. I'm doing fine - just can't bend my knee much...

Can you believe that it snowed this morning. In October. Unheard of! Doesn't bode well for winter...

Sue in cold and snowy Aix en Issart.

 

[soSuesew]

Woohoo...five degrees improvement! It ain't much but I'll take it! (Trying not to be hung up on numbers but it is proof that the improvement I thought I felt wasn't imaginary.)

Sue in extremely wet Aix en Issart (but who has nothing to complain about as the rain isn't called Sandy)

 

[Pumpkin]

Five degrees, progress in the right direction! Yes, glad to be out of the storm path.

 

[vicki c]

Sue: In regards to the pool, I have been doing physio, with an instructor, for 3 weeks. I started at week 4 post-op. The exercises that you have already read about are a bit advanced for a beginner. You will work up to them. At three weeks, I am walking at a normal pace, with proper posture. The second exercise is bending my knees and letting them float to the surface as I walk (one at a time, of course). This bent, floating, knee will help increase flexion with no added pain. I would stick with the two exercises for a while. Good luck!

 

[reetpteet]

Bonjour et bienvenue Bonesmart, you are doing tres tres bon. Ce n'est pas facile ........... malheureusement! We are your nouveau amis, comprenez? Ce n'est pas Le Tour de France mais un longue journee (terrible french!) x

 

[soSuesew]

Bonjour et bienvenue Bonesmart, you are doing tres tres bon. Ce n'est pas facile ........... malheureusement! We are your nouveau amis, comprenez? Ce n'est pas Le Tour de France mais un longue journee (terrible french!) x

Mais non, Reetpteet, c'est tres bon francais. Whichever language, no, it's not easy. Good job they don't tell you in advance how tough it is!

Sue

 

[soSuesew]

Although it was my right knee that failed with (unsuspected) serious degenerative osteoarthritis, an x ray has shown some OA in my other knee. It had been grumbling a bit with taking the strain and my left foot slipped slightly on an exercise mat a week or so ago, since when it's been grumbling a bit more.

Can I do anything to slow down the grumbling? I am slowly losing weight. But are there exercises that would particularly help? And what about glucosamine and chronditin, or other supplements?

Sue