Revision TKR Never give up, keep trying, don't settle - that's me, Bonnie

[RunA42K]

I grew up with Fred Meyer stores Dorothy @turtle68 . I knew that Fred Meyer bought Kroger a few years back, but have not seen a Fred Meyer outside of Oregon and Washington. You have a good plan, only one BIG trip in one day. I know how that med makes you feel better fast...that is the only way I was able to run the marathon that year. Then I took 4 months off of running so my foot could get better, but it was this danged knee that broke my streak after 13 years :-(

 

[patbike]

regarding the Medtrol ---- my daughter has some chronic shoulder/neck pain that is particularly bothersome at night particularly after a day of significant shoulder movement. we have been experimenting with various things since her injury about 4 yrs ago. Can you take it for long periods of time? After you take a pill how long before it starts working. ie can you get relief within an hour or so or do you have to take a multi day course before it has an effect.

 

[Josephine]

Sorry I haven't been back before - your should have tagged me!

Pain meds: you're still only 5 weeks out - whether you like it or not or feel you need it or not, you need a regular regimen of pain meds.

Icing: more and more! Any time you are off your feet, ON with the ice!

PT:
Formal outpatient Physical Therapy 2X per week.
Quad sets,
heel slides,
wall slides,
straight leg raises
30 each leg in all 4 positions (strengthen quads). Do 10 not 30
Toe tapping standing and sitting 50 each (building shin muscle). Try 15 not 30
TKE's 2X 25 times (straightens leg) Leave this till week 8
Clam shells 2X 25 each leg (strengthens hips/gluteus). Leave these till week 8
Last but not least (hurts the most) is laying on stomach legs off Physical Therapy table below knees hang 3 pound ankle weight on TKR leg for 8 minutes (straightening leg). Totally unnecessary at any time!
The day after doing that twice a week, I pretty much do nothing but daily living in my house. Good!
Second day after that
heel slides at home Do 3 sets of 5 x 3 per day
quad sets, Do 5 once a day
TKE's 2X 25
Ye gods and little fishes! What are you doing, training for the Olympics? My dear girl, this is FAR too much for 5 weeks out, and I bet you've been doing them for at least two weeks, haven't you. Do you realise this is the reason your are having so much pain? The ONLY reason? I've put suggested amendments at each exercise. One thingyou must bear in mind is that your muscles aren't weak, they are INJURED and the last thing they need right now is all this boot camp stuff. I didn't know what TKEs were so looked it up on YT and my jaw nearly hit the desk! That is so counter-productive at this stage of your recovery, I am totally appalled that you are even attempting it. The best thing you can do for extension is to rest your heel on a stool and just let your leg hang. NO weights, nothing.

My doctor has just freaked me out about not refilling pain pills so I know I don't take them as often as I should.

I'm saying nothing!

One thing that worries me somewhat is that I have read here on BS as well as other places that your ROM you achieve many times is dependent on what ROM you had pre surgery.

That's 'might' not 'will'. And it is, as Jamie said, mostly concerning people with severe long term deformities.

I tried to sleep with the wedge but I just could not do it.

What kind of wedge? One like this?

This is bound to make your leg hurt for obvious reasons. A newly operated upon leg is swollen and doesn't like being held out straight for long periods. Now I know people throw up their hands in horror and say "NO BENDING OF ZE KNEES!"

but that extreme is also wrong.

It's okay to have a little bend like this

It does no harm at all.

What you must avoid is this - get the picture?

But actually I am seeing some improvement today in swelling and ROM.

That's another no-no. Don't obsess over numbers. It's fine to check where you are on the floor tiles in the bathroom, but nothing more. If you must measure, do it twice a week at the most!

 

[turtle68]

@patbike The medtrol is a pak where you take it for 6 days, with decreased dosage for each day. It works immediately for me. It does have its side effects. The alternative is prednisone, which is also a steroid, usually taken more consistently but not, except for certain illnessess. My O.S. put me on prednisone for 14 days 7 months post TKR, and it really helped with swelling and inflammation. He also did blood work at same time to rule out infection. I take it when I have to because I can't take anti-inflammatories because of asthma and being on aspirin for atrial fibrillation.

 

[turtle68]

Talking about Fred Meyer and Kroeger, Bonnie, it's in Rosenberg, and in order to drop in and pick up some milk, you have to go all the way to the far back of the store, through furniture, jewelry, etc. No wonder my back hurts, but it really is a nice grocery store - they have everything you could possibly want.

 

[turtle68]

@Josephine I have a reverse gravity recliner which puts me in the position in picture #2, and is really great for my back. Is is okay to use that at 10-1/2 months?

Dorothy

 

[RunA42K]

regarding the Medtrol ---- my daughter has some chronic shoulder/neck pain that is particularly bothersome at night particularly after a day of significant shoulder movement. we have been experimenting with various things since her injury about 4 yrs ago. Can you take it for long periods of time? After you take a pill how long before it starts working. ie can you get relief within an hour or so or do you have to take a multi day course before it has an effect.

@patbike is is a dose pack for 7 days. It is actually prednisone so should not be taken for long periods of time. The first day there are 7 pills and less each day. 7654321 then done. You do start getting relief the first day but after 7, 8, 9 days the pain if it is a significant condition will return.

 

[patbike]

Thanks for the explanation on medtrol.

By the way when I was at the 4 to 5 week point I found typing on bonesmart was a good relaxant and helped with pain although I am not sure it helped with ROM.

 

[Jamie]

You're right, patbike!!! When I had my first TKR, I came on BoneSmart to help pass the time. It took my mind off my knee and really helped when I had people I could chat with.

 

[RunA42K]

@Josephine, I've answered/responded to your comments in blue below. Thank you for taking your time with me, especially me being here nearly 3 years! It's easy for me to give advice but hard for me to take it. But I have been being good since your last post to me, I can see the difference. Thank you!

Pain meds: you're still only 5 weeks out - whether you like it or not or feel you need it or not, you need a regular regimen of pain meds.

I've done better with that Josephine and have taken one Norco every 4 to 6 hours while I am awake, although I don't wake up specifically to take them, if I happen to wake up I will.

Icing: more and more! Any time you are off your feet, ON with the ice!

I have done much better with this, icing on and off all day, morning till night. Elevating all day long while icing. Yes, I have that first wedge pillow that you showed. Just like you said, it was very uncomfortable after surgery to use it so that is why I was not elevating, because with the pillows I thought I could not have a slightly bent knee. I'll try the pillows for sleep tonight.

PT:
Formal outpatient Physical Therapy 2X per week.
Quad sets,
heel slides,
wall slides,
straight leg raises
30 each leg in all 4 positions (strengthen quads). Do 10 not 30
Toe tapping standing and sitting 50 each (building shin muscle). Try 15 not 30
TKE's 2X 25 times (straightens leg) Leave this till week 8
Clam shells 2X 25 each leg (strengthens hips/gluteus). Leave these till week 8
Last but not least (hurts the most) is laying on stomach legs off Physical Therapy table below knees hang 3 pound ankle weight on TKR leg for 8 minutes (straightening leg). Totally unnecessary at any time!
The day after doing that twice a week, I pretty much do nothing but daily living in my house. Good!
Second day after that
heel slides at home Do 3 sets of 5 x 3 per day
quad sets, Do 5 once a day
TKE's 2X 25

Advice well taken, I will adjust as you have suggested

What kind of wedge? One like this?

This is what I have, I will try the pillows below starting tonight.

It's okay to have a little bend like this

I'll do this, it looks much more comfortable!

What you must avoid is this - get the picture?

I've never done this one

Don't obsess over numbers. It's fine to check where you are on the floor tiles in the bathroom, but nothing more. If you must measure, do it twice a week at the most!

Yes ma'am, I know our Mother Hen knows best!

 

[Josephine]

Let me know how it goes, okay?

 

[RunA42K]

Let me know how it goes, okay?

Yes @Josephine, I will certainly let you know. Icing and elevating for a full day 3 now. Last night I slept with the stacked pillows like in the picture you posted, so my leg was elevated all night long. Today my husband vacuumed, swept, mopped the floors, dusted all the furniture. He will not let me do a thing. I even got served breakfast in bed. I've got a good support system for sure.

 

[Jamie]

I wanna come live with YOU, Bonnie!!!!

 

[RunA42K]

Well, after 3 full days of elevating, icing and taking pain meds my ROM is moving up again. I had Physical Therapy today and ended up with a measurement of 103. I am exactly 5 weeks post op today. Last week while there I started out at 97 degrees and had to fight to get to 100. Today right away it was 102, then 103 all without pain. Tomorrow I will rest, ice, and elevate all day! I'm a believer!! @Josephine

 

[Josephine]

 

[patbike]

Bonnie, in the words of Aesop: TKR rehab is a tortoise activity.
So glad to hear your progress.

Pat

 

[RunA42K]

Another happy day today! Went to Physical Therapy, was not expecting too much because I didn't rest enough yesterday (just rested 3/4 of the day). So when I've been doing heel slides for about 5 minutes, my therapist measured me. He said do you want to know what it is yet? What do you think it is? I in a pescemestic tone said...about 97 degrees. He said where did you end up on Monday? I said, 103. He said you are at 103 right now first measurement! He says continue with the heel slides, but don't push it, just take it nice and easy, so I continued nice and easy for about 10 minutes. He came to measure again and asked me if I wanted to know? I said not if it's less than 103...so he stepped over to his other patient without saying a word about it. I couldn't take it and said, "Tell me!" He said "105! You'll be peddling a bike before you know it."

When I left there I drove down to my running store (my job) I had not been in there since before Thanksgiving. I was so happy to be in there again I love the people I work with (well except for one who I just tolerate). I realized how much I miss being there. I told them I'd be back once I could ride a bike! Once I can ride a bike I can keep my ROM and then some!

Anyway, I'm happy tonight and just wanted to share.

 

[Jamie]

GREAT news, Bonnie!!!! I'm so glad you are doing better now that you've slowed yourself down a bit. See....Momma Hen does know best......

Keep up the good work and you'll be pedalling in no time!

 

[turtle68]

That's fantastic news Bonnie. You will be riding a bike in no tiime. Just remember the mantra, slow and steady. I know it's so easy to ovedo, because even at 10 months I often exceed my limitations. Going off to water exercise this morning, and really looking forward to it.

Again, I am thrilled for you that the rest is paying off, yours is a truly amazing and inspirational story.

Hugs, Dorothy

 

[Pumpkin]

Bonnie,
Slow and steady wins the prize, keep up the good resting, and great results!