TKR My RTKR journey

[Dulcimer Diva]

Weeks 4-5 post-op:
End of second week home, I was finally off warfarin. By now I'd gone out to dinner several times, frustrated at being unable to have my usual wine or eat the dark green leafy veggies necessary to maintain my weight loss. When I checked out of rehab, I was back down to 225, my pre-op weight; 10 days later I was at 214. By the middle of week 4, I had cut back further on my Norco--to one 10/325 tab first every 5, then 5-1/2 hours. And by now the warfarin was out of my system: this time the three of us toasted with actual champagne and a tiny jar of caviar I'd stashed for a suitable occasion. And I was able to switch from expensive and less effective Celebrex to generic OTC Aleve. My husband did the driving whenever we went out, which as a control freak of course drove me nuts. Restaurant chairs were either too low or high bar stools, and most rest rooms lacked a handicap stall with high enough toilet--but I coped. And the night of our champagne toast, I went upstairs to sleep in my own bed....and headed back down again. The bed was just too low to safely get in, and my side was the wrong side, requiring me to get in and lift both legs high before settling in--which did my back no favors. But we were able to switch our stuff on the nightstands, and the bedding store came and put the bed up on risers. So I was finally sleeping in my own bed. That meant getting up early to wash and dress for the day before even going downstairs for PT and coffee. Somehow, I got back into the swing of things. Meanwhile, despite the heat I was able to take a walk to the ice-cream parlor and around the block. I realized that until further notice, my walks were limited to my side of the major arterial at the end of our block: no way could I make it across, even starting with the start of the green, before the light changed, and Chicago drivers are not known for deferring to pedestrians in crosswalks. Oh, well. Was able to visit my best friends for dinner, and they thoughtfully let me lie on their couch, feet up on their wedge pillow, with an ice bag. That's what friends are for!

Week 5 was one of milestones: it was my last week of at-home PT, where I ultimately reached 127 degrees of flexion and -2 of extension. I also had my son drag my old recumbent exercycle into an air-conditioned spare room, where I can now do 15 min. with some resistance. Alas, it's not as pleasant as that recumbent elliptical in rehab, which i hope the outpatient PT center will have. Another milestone was walking to the drugstore to pick up some scrips--3 bl. ea. way up and back!
But it's been a week of challenges: my housekeeper is off till Monday, and today we had an aging air conditioner leak in the den and soak the carpeting, threatening to mildew. My son and his ex-GF, who have done yeoman service in my housekeeper's absence despite neither one driving, actually walked three miles to Home Depot for a wet-vac and a fan. All this on top of having to ride herd on our three cats--the oldest one, 16, has early kidney failure and needs to be fed separately from the two younger ones, who are obese and facing dental extractions the same day I go for my first dental cleaning since before surgery (yup, I filled my clindamycin scrip). And this week I cut back to 1/2 a Norco 10/325 every 6hrs; today was the first day I cut back to every 8 hrs. I am really feeling it, but the Aleve takes up most of the slack. (I also cut back to one 650mg time-release acetaminophen BID). Monday, when I have outpatient PT again, I am slated to go to every 12 hrs. I might need to pop a rapid-release 500mg. acetaminophen before the session.

So where am I 5 weeks post-op? Checked into rehab at 3 days, barely able to shuffle with a walker; today I am alternating feet on stairs and am not leaning on my cane when I go out walking. Today I even carried a full shopping bag from the farmers' market around the block. Going into rehab, I was taking two Norco 10/325s every 4 hrs; today, I am taking half a Norco every 8--that's 1/4 the dose and twice the interval. And I am at 211 lbs. and counting!

 

[Dulcimer Diva]

I awoke with a start this morning--NINE hours (minus quick bathroom trips, TMI, I know!) after my last half-Norco tab. By the time I got my head together to take it, it was TEN hours between doses! I am tempted to go another ten hours, but perhaps that's too abrupt a weaning-off. And this morning, on my active supine knee-bend I was able to flex as far with my right knee as my left--and my assisted supine (using my hands) bend was even better. Gotta get a goniometer! Today's project is to go to the garage, get into the car, and practice switching pedals---with the engine OFF, of course. Need to be able to drive by next Sat. morning--I have a rehearsal 40 miles north of here and shudder to think of the cab fares! (Have a gig next Fri. night, but that's a cheap cab ride away and I can bum a lift home from a fellow performer).

Rethinking that recumbent exercycle--it's sort of rickety and I'm expending more energy keeping my feet in the pedal stirrups, keeping the thing from rocking, and wincing from the uncomfortable seat than I am in loosening up those knees. Gotta rethink it. I'm thinking, on days when I'm not going to outpatient PT, walking half a mile each way (on my side of B'way so no major streets to cross) to one of two local "drop-in" gyms to use their recumbent ellipticals. It'd be slow going, but with a water bottle I could probably handle it. (And for the one along B'way, I could take the bus there and a cab back if I can't cross B'way yet).

 

[Dulcimer Diva]

Hi. Am now 5 wks+2 days post-op. I have noticed that even at rest my R knee is much warmer to the touch than my L (the non-operated one), and I stop an icing session not because it's been 30 min but because the ice pack has thawed (I use a freezable gel pack, because my fridge doesn't crank out ice fast enough for my PolarCare machine). No redness, no real pain, less swelling than at any point since the surgery, but the fact that here in my air-conditioned living room my L knee feels cool and my R one is warm is really weirding me out--especially in light of all the sudden-infection-long-past-recovery posts I've been reading here. The rest of my leg, a mere inch or two away (even over the incision south of the kneecap) is as cool as my L knee. Both thighs are warm. I have been sitting a lot of the time--only way I can use my laptop (too awkward perching it on my lap while reclining on my daybed) or eat a meal. I do walk around the house & stand up to cook (or even slap something together quickly). Should I be lying down and elevating constantly? If I do a true "toes above nose" w/o support beneath my knee it not only stretches my hamstrings to the point of pain (worse than any stiffness) but also precludes my doing anything but staring up at the ceiling or watching TV out of the corner of my eye. No way to rearrange the furniture & TV in this little room to resemble the ideal pattern in my hospital & rehab rooms. I see my OS again Aug. 16. Last time my husband and one of the nurses in rehab were concerned about its warmth, I was only 10 days post-op, the knee was much bigger than it is now, and the OS (who saw it later that day) said it was normal and in fact pulled the staples and told me I was ready to go home from rehab. Am I being paranoid or do I have real reason to worry?

 

[Dulcimer Diva]

Interestingly, I had to change the verb above to "weirding me out" because the one I chose, which begins with "fr..." is apparently recognized by the board's software as a euphemism for a four-letter obscenity.

 

[speccybecky]

My tkr knee is often hotter than the other. I was told to expect this as it is the tissues healing.
Also if I do a lot it heats up even now 6 months later

 

[Campervan]

Yep, mine still feels warm at 7.5 months. The worry re infection could have been written by me at 6 weeks. I don't think you should have anything under your knee when resting that has the knee bent. Its only going to shorten the hamstrings and make your recovery longer. You can stack pillows under it so in a wedge is formed keeping your toes higher and supporting your whole leg.

 

[Randi]

Yup. Mine was warm for a very long time. I had the same issues with hamstrings and thought it would never go away but I kept trying, elevating at a lower level most of the time then gradually stretching by putting my operated leg up on the arm of the couch, first for 30 seconds at a time, though even that hurt, then 45, a minute, etc -until one day I could keep it up there for a very long time. Hang in -you are still so very, very early along this road.

 

[Dulcimer Diva]

Thanks! I asked my PT about not having anything beneath my knee, and he replied that since I had full extension from the get-go (even lying in bed the first day) and now have a little hyperextension, and that I do walk without assistive devices, there's no reason to worry about inability to straighten my leg. I have one of those wavy contoured leg-elevator pillows on order from FootSmart, but it won't get here till at least Wed. Meanwhile, just how much are we supposed to be lying down at this point, anyway?

 

[Randi]

As much as you want to !? At your stage I was walking a bit each day, doing a very little bit of food prep, etc and then watching lots of dumb TV or reading, mostly sitting with my legs up on my recliner..where I still hang out whenever I have the chance!

 

[RestAssured]

The knee will be warmer than the other because you have a lot of stuff on the inside that you can't see that is trying to heal. Infections are not the norm, far from it! Most people have knee replacements, and their knee may heal fast, slow, or In between, or even do great and have setbacks, but none of those are due to infection in most cases.

Usually, it is overuse, or not icing and elevating, or just plain trying to heal.

Don't worry, just take care of yourself.

 

[RunA42K]

Dulcimer Diva! Hi and nice to meet you. I've been around here for a while now but things in my life won't let me be on Bonsmart as much as I would like. I can tell you that I am 16 months post op as of yesterday the 28th, and my surgery knee is still warm. My non surgical knee is cool, the TRK is definitely warm most all of the time. My therapist and my OS both told me that it is normal and not to worry...that there is a lot of healing going on inside there sending that blood flood right in there to help you heal. I am told that it can take 1.5 to two years to heal completely from a TRK. So at 16 months post op, my knee is still warm and still numb.

 

[bottomshollow]

I have left your thread about doctors, pain med, and the FDA as a separate thread since it does not relate directly to your recovery. We request one recovery thread in order to better assist when questions are asked by being able to find everything you've posted in one place. Thanks.

 

[Pumpkin]

My TKR knee is still warm at 10 months. I was told the same thing as Bonnie, it can take up to two years to completely heal. I find wearing shorts keeps my knee cooler.

 

[Dulcimer Diva]

Thanks, everyone. (Especially Bottomshollow--all that searching and merging had to entail a lot of work, and I am grateful that you were able to do that for the sake of continuity).

Went out to dinner again tonight and to my surprise I needed the cane only for walking on broken pavement and the slight incline in the grass getting back down into the car. I jury-rigged my laptop cable so I could use the computer without sitting up on the edge of the daybed and letting my legs dangle--and even before tonight's icing session my R knee felt a bit cooler. The only parts of my R leg that's numb are the side incisions where the old hardware had to be removed, and it's not an annoying kind of numb. But my L thigh--especially the outer portion--is both numb (especially the quad) and tender: there are a few trigger points along the side which if touched feel as if they'd been bruised by a ball-peen hammer; and if I am lying down any way other than either flat on my back with both ways flat or on my right side (pillow between knees) I get an intense burning in it. Could be because I had to readjust my gait, and I notice the part of me that now hurts the most when I walk is my L hip flexor.

Kicking back to watch all the Olympics I'd DVR'ed tonight. I think we who are disabled but not wheelchair-bound ought to have our own Games: the O-LIMP-ics.

 

[Dulcimer Diva]

Had my first outpatient PT visit today, mostly evaluation. Had a few surprises: my right leg is now stronger than my left, my flexion in both is identical and my extension is almost as good as the left leg. PT told me it was okay to walk unaided when I feel like it, but to carry the cane outside my home just in case (as with that broken sidewalk and mini-hill down to the curb last night). She also reassured me that it was normal for my new knee to be warmer than my left knee. But it turns out I have a leg length discrepancy. I knew pre-op, from my naprapath, that my right hip was higher but I assumed it had been due to scoliosis. But my left leg is actually shorter than my right--which explains the numbness & burning in the iliotibial band (which is what hurts when I walk, not my hip flexor). I will have to get new orthotics for my shoes--I like the podiatrist who did my current ones (for bunion & flat feet), but she is part of the orthopedic group in which my previous OS (who did the R lat. meniscectomy and told me I only needed the L knee replaced) practices, and going back to her could get a tad awkward if I run into my old OS. Will call my current OS Wed. (Tues. is one of his surgery days) and ask for a pedorthist recommendation--perhaps there's one in his group; if not, he can write me a 'scrip for one of the licensed ones at a number of walking-shoe stores in the area.

I will be getting 6 weeks of 3x/week PT. Only bummer is that the facility lacks a recumbent elliptical--it has a standing elliptical and a recumbent bike. She told me to use my recumbent bike at "2" tension--the rest of my family likes it, so maybe all I need to do is readjust the seat and maybe pad it a bit better. Also, on days when weather will not permit a safe walk around the block, I have permission to use my (ancient, wheezing) treadmill at 0 elevation, starting at 1.5 mph and working up. And eventually, to haul my old Tunturi upright exercycle and Nordic Track out of the attic to prepare me for learning to ride a real bike and resuming X-C skiing. My PT says her goal is to help me get my life back: to climb stairs normally, take long walks (especially the walking tours on my upcoming river cruise), be able to perform standing up an hour at a time without pain and stiffness, and to be able to mount a stage of any height. (I knew the time for a TKR was nigh when at a music conference in NC in May, I saw the 15" stage--sans stepstool or railing--and panicked. I had to be hauled up on to it, and got down safely only by first sitting on a chair and then sliding down off it. Only other person who had trouble was a 75-yr-old guy who was rehabbing a broken hip).

And I got my comeuppance today: felt so good after PT (got some good scar massage, did the exercises like a champ) that I didn't ask to be iced, and didn't use my cane to get back to the car. My housekeeper was jonesing for some good chopped liver, so we stopped on the way home at the only kosher deli on the city's north side. I stood for so long while my order was filled that I did need to start leaning on my cane--and oh, boy, did I need ice when I got home! (Unfortunately, my icemaker is on strike, despite a visit from the repairman last week. Have to use the gelpacks and make ice for the PolarCare machine the old-fashioned way: tray by tray by tray...or send my son out to buy a couple of bags of party ice from the grocery). And as my home PT had warned me, at rest I have gotten some twinges along the scar as the nerves wake up after massage. Today was my first day of stretching my 5-mg Norco doses out to a 12-hr. interval. Taking it with 2 Aleve and one arthritis-strength generic Tylenol has worked so far. By my next session I should be down to one 5 mg. Norco a day, and only on PT days.

 

[kneeper]

sounds like you're doing pretty well, and learning the lessons we all do by experience of how much the knee is really up for. ;) I'm glad they're going to get you set up with a new orthotic.

 

[Dulcimer Diva]

2 HUGE milestones today: Had to take a taxi downtown, and found I could get into the back seat of one of those defrocked police-interceptors just fine! (As recently as last week, I couldn't bend that knee back far enough and had to sit up front or in the back of a Prius V). And when I was done with my family shrink appointment and wanted to kill time in the Loop to beat out rush hour, we walked 5 blocks to the Gage across from Millennium Park! Dinner was awesome.(Yesterday, I had to climb 2 flights of stairs to reach my dentist's office--and my knee lived to tell.

Funny thing, though--when I was on Warfarin, both alcohol & green leafies were verboten. Tonight I had a Tavel rosé, a charcuterie plate and an arugula salad. And the arugula felt more decadent--like I was gleefully scarfing down contraband! (The wine and the pates weren't exactly chopped liver, either....well, technically the country pate WAS chopped liver....) :D

 

[Jacky48]

It looks like you're making great progress, good for you!!! Keep on, keep'n on Diva!

 

[skigirl]

If am a little jealous of your stories of walking three blocks to the grocery. I live in a small town in Montana and so live a completely different life.

When I am in Chicago, I walk a lot---my kids live there in Lincoln Park and Evanston---and I enjoy the city, but after 7 days, I start to long for the Mountains and a more peaceful outside life. It is not as convenient, yet I do love it here!! Kelly

 

[Dulcimer Diva]

6 weeks post-op today:

Tonight, I DROVE!!! First time since I drove myself to the hospital for my surgery on June 22. And it felt no different than before, except perhaps that it hurt a bit less! Granted, it was only 8 mi. each way, for a concert I was in; but had I taken a taxi there I'd have been unlikely to catch one home (and would have had to stay past 2am to cadge a ride from those who were left, jamming). Still and all, think I will take a pass on the farmers' market gig I'd booked for next Tues. down in Blue Island (>25 mi, outdoors in the heat for 3-4 hrs., hauling my own amp, chair and sun protection). My singing partner's wife had to go out of town to exhibit and sell her textile art & sculpture (their primary income source); and their regular caregiver for her 93-yr-old severely disabled mother suddenly had a preemie baby. So no way will I ask him to come down from Madison, WI and scoop me up for a speculative gig, even if it's only a day-trip.

Had my first three outpatient PT visits (out-of-network, alas--but the in-network centers lack both free transportation and adequate parking) this past week. I'd thought my PTs in rehab and at home were taskmasters, but oy vey! Actually, the toughest part is the massage: my muscles tightened up, and massaging them to stretch them makes my leg feel like a hunka-hunka burnin' trigger points. (No, I don't have fibromyalgia). After that, the exercises themselves are a relative relief (except those unaided step-ups with my TKR knee and the eccentric contractions--stepping down with my "good" foot--can be brutal. The latter is really aggravating my remaining tibial repair hardware, so they're ditching those for now). And the center's recumbent bike is no better than my own--I expend more energy trying to keep my left foot in the pedal. Using the upright instead (making sure the seat is high enough--it was so low at first I think I got an unintended >130-deg. bend). Oh, how I miss that NuStep recumbent elliptical at the rehab facility! Even if I could afford it, it'd take up an entire bedroom.

Now taking Norco (half a 10-mg) only before PT. On other days, and at bedtime, just the OTC stuff. Surprisingly, another one of my OS' patients, who's only a week behind me with a less complex surgery, is still on Dilaudid. Go figure. A perfect illustration of how everyone's recovery is unique.

Skigirl, I've been in Chicago since 1978--grew up in Brooklyn (NYC is hillier than some may think) with summers in the Catskills; and lived in Seattle 1971-8. If you go to the North Satellite at Terminal C at Sea-Tac, those fingernail marks in the tarmac are mine. I did not give up my mountains, evergreens and saltwater without a fight. Even now, every time we break through the clouds on approach to O'Hare or Midway, my first reaction is "OMG, who stuck a pin into the landscape and let all the air out?"

I used to do a lot of X-C skiing, but never did get the hang of downhill---made it to the intermediate slope once using the GLM method and chickened out when the instructor said, "OK, next week on regular skis, meet you at the chairlift."