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TKR New Left Knee . . . Check!!

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Great news!! It sounds like you are definitely seeing some big improvements.

Shopping on your own is probably comparable to my return to work. It gets better each day, however, and I am amazed how much I feel like I have returned to real life, except now one of my knees is no longer a problem.
 
Niki,

What a wonderful report. AFter shopping and all and you still got another 10 degrees that is really super. Hope you realize this is a big step forward.

Wishing you and yours:mrych: and a Happy Healthy New Year.
 
That's really great news Niki! Well done. An early Christmas present!
Come the new year and I am sure there will be no stopping you.
Have a wonderful Christmas.
Diane
 
Well congrats on the improvement but .... he hurt you for the sake of a tiny 5 degrees? The flexion is there anyway - why do they have to hurt people to demonstrate it? Man, that would have ticked me off big time!
 
Great to hear you are doing so much better, getting around, shopping, and your ROM!
 
Well congrats on the improvement but .... he hurt you for the sake of a tiny 5 degrees? The flexion is there anyway - why do they have to hurt people to demonstrate it? Man, that would have ticked me off big time!

I know 5 degrees doesn't sound like much, but mentally it is HUGE! Jo, I know that being an orthopedic surgical nurse, you know more physiologically about this recovery than I can ever hope to know. Everything that you tell us about not pushing hard in PT because of swelling and pain being a setback is logical and true. I know it. But I also know what the mental/emotional side of this recovery is like for me.

My PT pushed my knee to 105 degrees today, and yes, I would say it hurt a little bit. But I would also say that it gave me a mental and emotional boost that I really needed. If he hadn't done that and I had only gotten to 100 degrees on my own, I know I would have been down today, since that is only 5 degrees more than I got 10 days ago. But 10 degrees seems like a big deal to me--especially because my OS threw 105 degrees out there as kind of a magic number. He said that once I was able to get to 105 degrees, things would move along much more quickly for me as far as flexion goes. Maybe so, maybe not. We'll see.

And yes, I have some swelling tonight. I doubt I am bending much past 90 degrees tonight. But that's okay. I know it's because of the swelling, and that will subside. And I also know that this knee will bend to 105 degrees--at least! The encouragement that I felt today by that little bit of push from my PT was worth it in my view. It did hurt a bit, but I was not crying and not screaming out, and he took it very slowly as far as I would let him. So physiologically, I agree, maybe settling for that 100 degrees might have been better. But if we had, I know I would have been feeling discouraged today. And instead I am feeling GOOD! :yes 4:Mind games, maybe--but my mind plays a big role in this recovery as well. :biggrin: Niki
 
Great news Niki and you still have another 3 weeks to go; you will be fine :thumb:. Wishing you a Merry Christmas and a fab New Year xxx
 
Oh okay - you are right of course. I tend to be a little over-protective of you all where this is concerned!
 
Ah, Josephine, I know you are! And we are grateful! Have no idea how I would get through all of this without your wise counsel. You are much appreciated! Niki
 
Thirteen weeks and exactly three months to the day today! Seems like forever, but I know it is "still early" in my recovery. I keep reminding myself of that--seems like every day.

Here is what I know three months later:

--I have what I would call a significant swelling issue. My knee still looks like a cannonball. The only time that I don't really feel swelling is within about the first 30 minutes of getting out of bed in the morning. Once I'm on my feet for as little as 30 minutes or so the swelling kicks in. One of my PT assistants thinks that I just have one of those stubborn knees when it comes to swelling.

--My knee feels tight and stiff just about all of the time. See above.

--I continue to ice and elevate A LOT. I am still icing for probably three or four hours on average during the day, and anywhere from two to about six or seven hours at night.

--Since I work from home, I continue to work from my bed where my legs are elevated whenever I am working. I tried to go back to my desk about 2 weeks ago, but sitting with my legs under my desk on a footstool was not at all comfortable. (My hat's off to those of you who have to go back to an office and work from a desk! Don't know how you manage it.)

--I am starting my 11th week of PT this week. I am usually doing three times a week, but last week and this week just twice because of the holidays and PTs being on vacation. I have another two weeks to go. See my OS again on January 12th--so we'll see what he says at that time.

--I am taking 1,000 mg of Tylenol about every 6 hours during the day. On PT days, I take 7.5 mg of hydrocodone about 30 minutes before PT and usually take another when I go to bed that night. I've had to take some intermittent hydrocodone at night even on non-PT days for some reason recently. I seem to be having more discomfort at night lately--probably because of being on my feet more than usual with the holidays. So sleeping has been a little tougher recently.

--I am walking completely unaided (put away my walker, my crutches, and my cane and returned my wheelchair--hopefully never to be seen again). For the most part, I don't think I'm limping--but my husband catches me doing the "stiff-legged" walk occasionally. And I do start limping when I've been up walking for a while. I am trying to really think about walking heel to toe and bending my knee.

--I can go up the stairs pretty well foot over foot. I can also come down that way, but I do not look like a normal person! :snork: Definitely need more flexion to master coming down the stairs.

--I am doing 15 minutes on the elliptical at the gym and then 15 minutes on the bike. Have been able to lower the seat a notch or two--but I'm still cheating, mainly in how I place my foot on the pedal. And no matter how hard I try, I can't seem to make it over the top without grimacing. (Hate doing that cause the gym is usually pretty crowded.) I try to get to the gym on the days that I don't have PT. I am not doing any other exercises at home--except gently stretching my flexion. My muscles have come back really well. My ROM is another story. :sigh:

--Speaking of ROM, I don't really know how it's doing cause I haven't been measured in more than a week I think. Eyeballing it, it doesn't look to have improved at all (and a lot of times looks worse than 105 degrees). I have a sub PT this week, so may not be measured again till next week when my regular PT gets back.

All in all, definitely still slow going, nowhere near normal, and not yet happy that I went ahead with the surgery. I have a very long way to go before I even come close to recovering the function (painful though it was) that I had prior to surgery. Hopefully I'll get there.....
Niki
 
Niki,

I know that you've heard this before from many of us, but I'm impressed by the progress as your "clock" really didn't start right after surgery given the other unique challenges of your particular situation. I'll let the experts provide their feedback regarding your current swelling status.

In terms of walking around and specifically stairs, that does sometimes take a while especially as we have all focused on increasing our range of motion.

Best of luck as you continue to make progress - you've demonstrated a tremendous amount of patience ...
 
Niki, you are making great progress - slow and steady. You are doing more every day! And doing some things I am not up to yet even though I was walking long before you! Keep it up - you will get there!! :thumb:
 
Are you doing heel slides at home? I really think that is the most important activity to do, even more important than going to PT. You can do it at your own speed and degree, gently but firmly but also frequently, like half a dozen times every couple of hours or so while you are watching TV and such. And you can press it to the limit as much as you care to cope with but not extreme pain, of course. I really think that small and regular doses like that are going to reduce your swelling and improve your flexion a lot more than doing an hour or more of exercise 2-3 times a week.
 
Niki, You are really doing well. Three months and having the break at surgery, you are doing a great job.:yay: Steps, no cane ,I did not walk without a cane till 4 1/2 months and it is only in the 7th month that steps were easy for me.

All the good stuff came to be for me when the swelling went down. That was between 5 and 6 months for me. You are ahead of the game, just don't push too hard. That vicious cycle of swelling comes back each time you push too hard. I know you want that ROM now, but it will come faster if you do not force it. :yes 4: My swelling left when my PT was done. Actually about a week later it went down so much that it shocked me to see this prune knee. That was at 5 months and since then I have not needed much icing. Listen to your knee cause it screams its needs to you:loll:
 
Niki, I am with Jo on the activity. If you're experiencing significant swelling still, I'd scale back on the gym visits and PT. You are moving about each day as you go about your normal home activity. Adding some gentle stretches and bends are enough to keep you flexible. I did the heel slides like Jo suggests and also some bends by putting my leg up on a stair and leaning forward. Some days I would do 5-10 minutes on the bike. But if you're doing "formal" exercises every single day, you don't give your body any chance to recover before you are at it again.

You might also want to add some Aleve or Advil to your Tylenol. As an anti-inflammant (NSAID), it may also help with the swelling.
 
Thanks, all, for the comments and encouragement. I think what is so hard for me about this is that I was so active and fit before my surgery--and I see that slipping away more and more every day. I have worked out hard my whole adult life (probably what got me into this situation in the first place). Up until my surgery I worked out at the gym 5 to 6 days a week--and hard--cardio and weight training. I also briskly walked my dog anywhere from 2 to 4 miles every single day. So now, sitting here for months on end doing heel slides and gentle stretches is truly hard for me. To keep reading that I'm doing too much when I feel like I'm doing nothing at all is tough!

My substitute PT did measure me yesterday--105 same as last week. I was disappointed; he said not bad since it was over the holidays and I didn't lose anything. He did show me a couple of new stretches for flexion that I hadn't done before. And if I'm being honest, I have not been stretching as often as I should at home. What Jo says about doing some stretching frequently makes sense to me. It is hard to remember to stop and specifically do some stretches, so starting yesterday I've set my cell phone alarm for every 2 hours so that it reminds me to stretch. I have four flexion stretches so I am alternating them throughout the day, doing 10 of one stretch and then every 2 hours switching to the next one. Not going to the gym today to do the bike since I had PT yesterday and have it again tomorrow. I don't do any strength exercises at home at all since I do a lot of that at PT and I feel like my muscles have bounced back pretty well. So I really don't feel like I'm overdoing it. I don't know how I could be doing any less and still be doing anything at all!

Jamie, I did take some Advil last night with the Tylenol when I went to bed because I had already taken two hydorocodone during the day and didn't want to take more. But I am also taking 7.5 mg of Mobic every day--so not sure I should be taking Advil on top of that. I don't really know that the Mobic does anything for me and maybe I would be better off taking Advil throughout the day with the Tylenol. I did sleep fairly well with the Advil and Tylenol combo last night.

Looking for the lesson in all of this--maybe God is trying to teach me what a virtue patience is!
Niki
 
That's a fact! :snork: But I would recommend you only do 5 stretches each time, for a while anyway.
I really think 10 would be overdoing it as you will be doing them throughout the day, don't forget.
 
Hi Niki,

Perspective is hard to come by as we are going through this journey. Just remember that you are a young woman with many years of an active lifestyle that is simply waiting for you on the other side of the recovery mountain. It's been said before but it bears repeating again, this is a marathon, not a sprint. The active Niki will be back soon! Now is time for the recovering Niki to take it slow and listen to your body.

Of course, its easier to give this advice than take it myself!! Hang in there!

Dawn
 
Hi Niki
Reading through your post I can see why it is so frustrating for you. I think the more active the type of person you normally are the more this recovery seems to be so slow.

I love walking holidays - I used to think nothing of doing 10 miles a day tramping across the hills. And I loved my guiding work, taking people on long walks around London.

Like you I am impatient to get back out there and resume my active life style. That's why I had my disastrous day in London when I had to stand on the train - far too soon and from which I am finally thankfully recovering but very slowly.
What I am learning is that yes I think we are being taught to be patient and that slow and steady is the only way.

I get anxious that I'm never going to get back to normal and I have setback days but I always come back to the reassurance that the Lord is with me through the journey however rocky it is.

If you trust what Josephine says and keep to the simple stretches and slides for a little while longer I am sure your knee will start to swell less and your mobility will increase dramatically. Hang in there!
 
One thing my pt told me, that I still do, is when I'm sitting in a chair, do a couple of slides back with the foot, rather than just leaving it in a "comfortable" position. Nothing too intense, but just doing the bend.
What others have said makes sense, you may need to ease off a bit and let the knee swelling come down more before you do some of your more vigorous activity. I'd bet when the swelling comes down a bit you'll "magically" gain some ROM.
 
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