TKR Martha's Journey One Day At A Time, Phase Two

I made it to church last night and it went pretty well. I did have some discomfort, but it was so good to be in God's house, to worship and hear our pastor's awesome teaching. It was also great to see so many good friends. It was very refreshing, but I have to admit that I was ready for my recliner and my ice by the time church was over. Today I decided to try a short trip to the Goodwill. We love to go to all the thrift shops, and I just wanted to get out and do something "normal". So we took my granddaughter to work, stopped to get a Coke and drove out to the Goodwill nearest to us. Not such a good idea! I was there maybe 15 or 20 minutes and I was ready to go. I rested most of the afternoon icing and elevating, just doing a couple little chores, a load of laundry, and emptied the dishwasher, then rested all evening icing and elevating. Now, tonight I can't sleep because both my legs are hurting. Not just my knees, my whole legs are aching. I guess I joined the ODIC. I thought that at a little over 4 weeks I wasn't doing too much. I guess I was wrong.
 
Going to church is fine, just keep the leg propped up. Sit in a space where there's an extra chair you can use for your knee as it's too early for your leg to be down for that length of time. As far as shopping, it's also too early for that. I think you did join the ODIC. But I totally understand wanting to do something normal, so head to your favorite restaurant and again, be sure you can prop your leg up on the booth seat beside you or a chair across from you. I had been pretty much house bound between my TKR and then the infection surgery a month later. I really needed to get out of the house! Stopping for breakfast or lunch after my drs appointment was just what I needed, then I could head home to rest, ice and elevate.
 
I am so glad you got to go to church. I really miss that.

Good news that you realized when enough was enough and got back home. I bet it helped a lot to do something normal. Now you can rest up and recuperate. :)


Shelia
RTKR - 8/23/16
LTKR - 10/11/16
 
Well, you tested your limits and found them! :heehee:
 
Therapy yesterday morning went well. I can tell my sore quad gets a little better every day. I am still being very careful to not hurt it again. My ROM measured at 105 which I think is great since I only had 90 degrees before surgery. My therapist said I am walking great. She said if she saw me walking down the street she would never know I had just had a TKR. I am still using the cane when I go out, but not around the house except for on the stairs.

KarriB I did go out to eat last night. Our grandson has been wanting to take us out to eat ever since I came home, so last night we went to our favorite Chinese Buffet. My husband helped me with my plate and we had an extra big booth where I could put my leg up. I enjoyed it very much, but again, I was ready for my recliner and my ice by the time I got home. A couple weeks ago, or even a week ago I don't think I would have been able to go to church or out to eat, so I am making progress. I just need to keep reminding myself of that.
 
Nice on the flexion at 105. That's great. I am a week behind you and at 100. I'm going to try going to church tomorrow. I'll be happy to get back, worship and visit with all my friends. They have been so great and supportive as has our pastor. I ran a few errands (farmer's market, bakery, grocery store) with my husband this morning. Even though we were only out for an hour, I was icing and elevating within five minutes of being home. I guess this truly is a "journey" and not a sprint.
 
It's good that you are getting out and about. At this stage, it should still be just an occasional treat.
I always looked for somewhere that had room for me to put my leg up, and I also planned for venues where I could leave early, if I was getting too tired or sore.
 
Very cool on the gait assessment! Yay!! You sound so good. Ice on, ice on :)


Shelia
RTKR - 8/23/16
LTKR - 10/11/16
 
Isn't it funny how much your perspective changes with this surgery, how little things you took for granted before seem like such great victories now. Yesterday I was able to cut my toenails and felt like I had made a big accomplishment, and on top of that, I was able to get both shoes on by myself all tied and everything. Another big accomplishment, or so it felt. lol Every day is such a mix of challenges and accomplishments. I am finding that retail therapy is still very challenging. The energy drain is very much alive and well. It takes so little to completely wear me out. That in itself is so very frustrating! I am not sleeping well either. I slept better early on than I do now. Thus lots of middle of the night BoneSmart reading and posting. My appetite is better, and I am not sure if that is a good thing or not. lol but my stomach still hurts from all the pills. I am transitioning from hydrocodone to tramadol and tylenol, and don't really need the cane any more except for going up and down stairs and stepping up and down curbs. I have one more PT session and then I am finished for this knee. I know I am rambling. I am mostly just thinking out loud so to speak, and sorting things out in my own mind. Weighing the good and the not so good, and over all I am making progress. So I just need to count my blessings and move on even if it is very, very slowly. lol
 
Yes! I was thinking last night how much more I appreciate little blessings. Going down the stairs without sweaty palms and a trembling lip is such a blessing.

You passed the foot challenge. Huge! I am smiling for you.

Yes, the energy drain is REAL and powerful. But it won't last forever. Our arthritis pain would have gotten worse and never ended.

You sound great. But I'm learning it's ok not to feel great and admit it. That's been hard for most of us, I think.

I continue to pray for you daily . God is good.


Shelia
RTKR - 8/23/16
LTKR - 10/11/16
 
You are right on all counts, @sheliac Thank you so much for your prayers. I also pray for you daily. God is definitely good and it is His strength and our prayers for each other that will get us through all this.
 
I had my last PT for this knee yesterday. I can straighten my knee completely, and my bend is still at 103. My therapist said she would like to see me get it to 110 which I guess is realistic since it was only at 90 before surgery, and I know it would be functional, because that is what my other knee is right now. I am still hoping for more, though. We will see, I guess.

I think I overdid it a little yesterday. I made a trip to Aldi for a few groceries. I chose the smaller Aldi closer to our house, but pretty much walked the whole store. Although it is a pretty small store, I guess it was too much. I was pretty wiped out when I got back to the car and had to let my husband sack all the groceries. My knee hurt more through the night, too, and both knees are sore today. The left knee has been hurting more the last few days. This makes me want to hurry up and get it replaced. I just have to get this right one healed enough first.

I promised my granddaughter we would go out for coffee later this morning, and my grandson wants to go out for supper this evening. Hopefully if I rest, ice, and elevate a lot in between I can do it. It is definitely a learning experience, and a balancing act. What is enough? What is too much? How long will it take? The problem is that the answers vary from day to day. You just never know!
 
My experience has been really similar to yours. I tend to feel good, overdo it, then rest..ice..elevate. We are almost the same age, had RTKRs a week apart, both use CPAP and my flexion is 107/extension 0. It feels good to do normal things like shop, go to church, go out to eat, but sometimes we really pay. I have been a member of the ODIC a number of times. You are making great progress and I'm sure you'll continue. Congratulations on graduating from PT! Have a pain free Sunday. :SUNsmile:
 
@birdinger We do seem to have a lot in common, and you summed it up pretty well. I hope you have a pain free Sunday, as well.

I took my granddaughter out to eat as I promised. My husband took us and dropped us off. When we were finished he picked us up and we dropped her off at the Mall, I knew I wasn't up to that yet. While she was in the Mall we drove to a small thrift store where I sometimes buy books and I replenished my supply of books, then we drove back to get her. I went home and iced and elevated the rest of the day and evening except for washing my hair and drying it a little. I propped my leg up on the booth while we ate, and I was only in the thrift store less than 30 minutes, but I guess it was still too much. My op leg as well as the left one have both hurt all night, and here I am awake when I need to be sleeping so I can go to church in the morning. Oh well, I will keep trying and maybe eventually I will get it right. One day at a time...
 
@Ronsgirl , you'll get to 110 and I'd bet beyond especially now that PT is over. A year or more after TKR I realized I could squat while exercising in the pool.
I'm glad you enjoyed eating out and propped that leg up while there. Six weeks is still early to be walking for 30 minutes. If you're at all worried take a look at the activity progression chart. At 6 weeks no longer than a 15-20 minute walk, so you may have joined the ODIC for a few minutes. Enjoy church today and prop that leg up during service.

For TKRs.

Activities of Daily Living are assessed in hospital as a means of assessing your fitness to be discharged home. Your domestic circumstances will be taken into account as in if you are living alone, etc.

ADLs include:
~ Personal hygiene and grooming
~ Dressing and undressing
~ Functional transfers, e.g. Getting out of bed
~ Voluntarily controlling bladder and bowel elimination
~ Ambulation (Walking or using a wheelchair)
~ Housework
~ Meal Preparation
~ Care of pets
~ Meal preparation and cleanup

Walking and other activity
Walking is about the best exercise you can do but again, you need to moderate your time and distance.
Always use your walker, crutches or canes as appropriate, only moving from one to the other as you gain confidence.
Don't be despondent if you have to go back once in a while in the early days.

Week 1
Minimal PT, just gentle heel slides and a 2-3 leg lifts before you get out of bed in the morning Heel slides and how to do them
Walking around the house - trips to the bathroom and kitchen are included!
Be up on your feet several times a day as you need to but don't get obsessive about it
A 5-6 minute walk every 3-4 hours is plenty

Week 2 -
add to previous
Start on a plan of walks around the house 3-4 times a day for about 5 minutes but don't
a) get obsessive about it
b) get into too much pain and
c) get too tired. Stop before you get to that point.


Week 3 -
add to previous
Lengthen the walks to about 5-10 minutes as before
Activity: prepare yourself a small meal or a snack


Weeks 4 and 5 - add to previous
Increase walks to out in the garden or street; to 20mins or longer if you feel up to it.

Additionally activity:
Gather a little bit of laundry, or put it in the machine OR take it out but not all of it
Now you can do a little dusting and tidying; do a little meal prep (for yourself not the entire family!)

Weeks 6 and onward
- add to previous
Start taking car trips to the shops but keep them short and sweet at the start, no longer than 15-20 minutes
Take at least one 5 minute rest while you are out.

Activity: a very little ironing, washing, meal prep but get someone else to clear up after. Wash up but someone else clears the table, brings you the dirty dishes, dries and puts them away after, NOT you!!

Week 10 add to previous
Bed making and changing sheets, cleaning bedrooms etc., can wait now by which time, all things being well, you should pretty much start getting back to normal but don't rush it. If you do and you start getting pain and stiffness in your knee, that's a sign your knee doesn't appreciate what you're doing, that you're rushing ahead too fast. Slow down, right down, and start again. This stage might last until week 14 or even 16 but if it takes a even longer, don''t worry about it.
 
Thanks for the encouragement and for the reminders, @KarriB I have been checking the activity progression chart every once in a while just to see if I am fairly on track. On weeks 4-5 it said to walk for 20 minutes or more and I wasn't doing that, so I tried to step it up some. I guess I pushed a little too hard. I need to find a balance that both my knee and I are happy with, and that sure is hard to do.
 
@Ronsgirl I believe I made a mistake! The chart said 15-20 for car trips at 6 weeks, not walking. But now you know 30 minutes is too much for your knee at this point and you can make adjustments. Every knee is different, but you're right, it's all about balance and listening to your body. But I totally get how important it is to replenish your book supply! I'd be lost without my kindle!

I hope you aren't feeling any after effects from your activity yesterday. Have a Blessed Sunday! My grandnephew is being dedicated this morning, so it'll be a good one for my family.
 
@Ronsgirl I am having my surgery at noon tomorrow. I just read your entire thread and I want to thank you. I had a distal femoral osteotomy in 2013 and was back at work in 6 weeks. I had thought I would be able to return this time in 8 weeks, now I am not so sure. May I inquire as to what caused you to accept rehab and not go home right away? I can see it was a good decision for you but am just wondering why it happened. I know that each journey is different as is each person is different. But this is a huge surgery and not to be rushed. I think you are a brave person as is anyone that puts themselves in these positions. But I know I will be living in this recliner for a long time to come. I AM A HUGE SIDE SLEEPER!!! And I roll from side to side all night long. So napping and recliner sleeping it will be for a long time I see. Best of luck to you Martha and all the kneesies that are encouraging you on your journey. I will pray for you as I make my way on this journey. ~~Tiptonits
 
Hi @tiptonits I will be praying for you as you have your surgery today. I pray that all goes well. I am also a huge side/stomach sleeper and I still can't get comfortable on my side in the bed. I tried it last night and could get comfortable on my left side for about 10 minutes and then my leg would start aching too much. I can't even get on my right side which is the side I sleep on most of the night, so it is still the recliner for me now at 6 weeks today. I spent 5 days in the hospital instead of the anticipated 3. They had a really hard time getting my pain controlled. The nurses were great and always gave me the meds on time, but they had a hard time finding the right combo for me. This caused my blood pressure to be high. I also had a problem with my electrolytes being out of whack. Even though I spent a couple extra days in the hospital, I was just not ready to go home safely. We have 6 steps going into our house and 13 going down to the lower level where our bedroom and bathroom with a walk in shower are located, as well as the small sitting room where our recliners and TV are. There is no place on the upper level for me to be comfortable since we have two grandchildren living with us who occupy the bedrooms on the main level. There was just no way I could have managed all those stairs. Because of my horrible pain levels I was never able to even try the stairs in the hospital, so the nurses, PTs, my husband, and I all agreed that it would be best for me to go to rehab. It did turn out to be a good thing. It gave me time to get my pain under control and get strong enough to negotiate the stairs. I also had some trouble with bleeding even though my incision was healing nicely. It just seemed to seep out the little holes where the staples went in. The nurses in the rehab place were able to keep a check on that and keep my bandages changed. Fortunately the bleeding stopped as soon as the lovenox shots were stopped. I have an appointment on the 17th of this month with my OS and I will probably schedule my left knee surgery then. More than likely I will go to rehab again when I have my second surgery unless things go very differently this time.
 

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