TKR New Left Knee . . . Check!!

[editor98]

Mimi, You always make me feel so much better about how I'm doing. Thank you.

Just got back from the gym where I rode the bike for 24 minutes on level 7. I've been adding about 2 minutes a day and bumping the resistance up slightly if it feels okay. I actually had to change my shirt when I got home cause lo and behold I broke a sweat at some point! Progress (or maybe it was just really hot in there)! My heartrate also got up to 112 very briefly, but averaged 100 for the 24 minutes. Have a ways to go before I can think of it as a workout, but these are small steps in the right direction. Next week I am going to add some weight training--just upper body stuff since I do some weight stuff for my legs at PT. For the majority of the upper body weight machines at the gym, you are sitting, so I don't see why I shouldn't be able to get started back with weight training. I think I'm not going to feel any sense of "normalcy" in my life until I have working out back in my daily routine. I know it will have to be slow and easy at this point, but I feel like I'm ready to get back to it.

In my 16-week update, forgot to mention that I am no longer taking even OTC pain meds during the day. Gave them up completely a little more than a week ago, but I am still having some uncomfortable nights, so I went back to taking 1,000 mg of Tylenol when I go to bed. That seems to have helped a little bit the last two nights. I am also still using the ice machine of and on during the night if I'm really uncomfortable--that seems to help more than anything. (I'm surprised the motor is still running on my Polar Care 500 cause it sure has logged many, many hours over the last 4 months!) When I saw my OS on Thursday, he also put me back on Mobic twice a day. I was taking it once a day, but he bumped it back up to twice in the hopes that it will help knock out the remaining inflammation. And I do think taking it twice a day makes a difference, cause I didn't think it was really doing anything for me at once a day.

Anyway, I was excited about my progress at the gym today, so wanted to post something positive for a change. (Don't want y'all to think that all I do is whine! :th_heehee
Niki

 

[carousel66]

YIPEEE!!! I'm so glad to read your post, I'm hit and miss on the forum.
you were a tough girl on the bike today! I have not pushed resistance past 5.
NICE ride!

 

[Josephine]

Your PT was boasting, pay no attention. I can confidently tell you two things
1. in all my years of ortho surgery, I have never known nor even heard of a leg being broken whilst having a manipulation
2. it would be humanly impossible for a man to break a human leg bone with his bare hands

Let me tell you a story: many years ago (1979, I think it was) I went on a course to learn how to use the latest thing in bone screws and plates. We were provided with human cadaveric bones to practice on :eeew:
We each had either the upper end of a tibia or the lower end of a femur and before we could begin, we had to break the bone in order to fix it! We had heavy hammers and chisels and all sorts but I can tell you it took some effort to break them! Even the young chaps who were there found it difficult.

So I would suggest that any surgeon doing an MUA who applied enough force to break a bone shouldn't be doing it in the first place! Trust me, they know what they are doing, they know how much pressure they can apply and they also know other tricks to get what they want out of the procedure. It's a risk but almost a theoretical one.

 

[Jazyb]

Hi Niki, Great report from the gym - good for you!!! I can't wait to get back to a good fitness level - it's been so long and I miss it so much .... Exciting times for us

 

[Mimi]

Niki, look at all of the progress you have made in your recovery. :happy dance: What you are doing at the gym is fantastic, and coming off the meds in the daytime are all good things. Just remember not to push too hard and keep on moving forward.

Wish I could ride the bike for 24 min. My problem may be the bike seat. It is a gel seat that feels like cement I thought maybe it was me, but my husband has a problem with it too. So I have been doing a search for a softer seat. Anyone that knows about a good one, let me know.

 

[Dhare63]

HI Niki,

Glad to hear you are starting to add some additional exercise that you are accustomed to doing. I think the strength training, specifically the core muscle group, will actually help you a lot in feeling more steady on your feet. I haven't done any of that yet but can see it in my future. It's nice to get a little closer to the routines that were part of your life before TKR. That has really improved my attitude and outlook!

Also glad to hear about the bike. I am doing about 25-30 minutes a day with resistance at 7. I have been gradually increasing it with no issues. I honestly feel the best on the bike, that freedom to move my knee is truly a gift! I do break out into a sweat and that feels good too. I used to be an athlete but over time lost my conditioning by not being active and having a desk job. I can see now that adding back in the exercise not only helps the knee, but seems for me, like a gateway to additional activity and getting fit again. I'm so glad for you!

I think we all know that not everyday will be filled with positive updates, so keep putting your challenges up so we can support you. At 4 months, I was feeling pretty blue and like I hit a wall. Fast forward and here I am, things just turned around.

I love Jo's post about breaking bones during mua. My OS was doing his job with disclosing the risk, but I could tell he was very confident there was little actual risk.

Hope you have a good day out there!

Dawn

 

[Josephine]

Yes, they are legally obliged to tell you this is a risk however slight, same as they are legally obliged to warn you that a complication of surgery and anaesthetic is death!

 

[editor98]

Jo,
That was a very interesting story about the cadaver bones! Makes me wonder what on earth went on in the OR that I wound up with a broken leg!! So you think even with having had the fracture during surgery there is little risk if I do wind up having to have the MUA? I did have a bone density test done last week and the results were perfectly fine.
Niki

 

[KathyH]

Niki, it has taken me several nights in small doses to read your journey. My, you are truly an inspiration to us all. I feel I know you and I am in complete awe of you. You have done so very well after all you have been through. Thank you for sharing your highs and lows. It certainly gives those of us who are waiting for this procedure insight of what is to come, apart from the fracture of course

I look forward to the rest of your journey

With all good wishes

Kathy
x

 

[kneeper]

Great report, editor! I should be doing 24 minutes on the bike. You put me to shame. :redface: Sounds like you've figured out a a good system to deal with the nighttime pain.

 

[Josephine]

Jo,
That was a very interesting story about the cadaver bones! Makes me wonder what on earth went on in the OR that I wound up with a broken leg!! So you think even with having had the fracture during surgery there is little risk if I do wind up having to have the MUA? I did have a bone density test done last week and the results were perfectly fine.
Niki

Ah but that was different. He did that from within the bone with a rasp and a hammer. A fair bit of damage can be done like that. An MUA will be done with just his hands. You'll be fine but I am very doubtful you will need an MUA anyway.

 

[editor98]

Kathy, Wow! I think one of your gifts must be perseverence to read all the way through my thread! I'm glad that it's helpful. I know that it helped me too when I was on the pre-op side to read recovery stories, somewhat scary though too, but at least it gives you some perspective on what to expect. I should go back and read through my thread! It's kind of like childbirth--you forget what it was like in the beginning! Maybe reading back through it would really give me a better idea of how far I've come.

Two things to report today. First, I walked a FULL MILE with my dog this afternoon! Almost gave up about halfway in because my knee started feeling really tight, but I kept at it and it kind of loosened up as I kept walking. I am icing and elevating now so not really sure yet how it's reacting, but I think I see a hydrocodone in my future tonight :wink1: (I had PT today too).

Second, at PT today I ran into a TKR fella that I hadn't seen in about a month. He is about 6 or 7 weeks behind me I think. Anyway, we got to chatting and I told him about the issue I'm having with flexion. I asked him what his flexion was like, and get this--he said about 135! A short while later I saw him across the room doing his flexion stretches, and I'm not kidding, he had his heel pulled all the way up to his butt! I told him I was jealous! Jo, I know you're thinking that I'm not going to need the MUA, but I tell ya, if it would get me that kind of ROM, I'd do it tomorrow! The other thing was, his knee looked so different than mine. I know that no two knees are the same, but seeing his really made me realize that I have some issues going on with this knee--swelling or scar tissue--whatever they are, there is something in my knee that was not in his!

Anyway, I have been hoping all along to avoid the MUA, but maybe it wouldn't be such a bad thing. I think I'm so used to seeing how little my knee bends that it really kind of shocked me to see a TKR bend like that! I want one!
Niki

 

[Diney]

Hi

I know you do focus on the positive but I think you should be really happy with your achievement of walking a mile. It wasn't that long ago when you said you were only supposed to be on your feet for 10 minutes. That's a huge step forward.

Your journey has been really different with your fracture and the man with the great bend hasn't had any of your problems.

Whether or not you have the manipulation I can see you are improving all the time and your attitude is amazing.

PS aren't men's knees generally bonier than women's!

 

[KathyH]

I should go back and read through my thread! It's kind of like childbirth--you forget what it was like in the beginning! Maybe reading back through it would really give me a better idea of how far I've come.
Niki

That might be a good idea, Niki. But walking a mile is a great achievement. Give yourself a pat on the back.

The man you saw bending his heel right back to his butt must be a most unusual thing I would say. How amazing! I haven't been able to do that with my left knee for 30 years Saying that reminds me of went I went to see my GP on Monday to ask him a few questions. I said one of the things I want to do is dance at parties and weddings, etc. He said, "did you dance before?" Well of course I did, used to love bopping away, silly questions really

 

[Roy Gardiner]

Just got back from the gym where I rode the bike for 24 minutes on level 7. I've been adding about 2 minutes a day and bumping the resistance up slightly if it feels okay.

First, I walked a FULL MILE with my dog this afternoon! Almost gave up about halfway in because my knee started feeling really tight, but I kept at it and it kind of loosened up as I kept walking.

Second, at PT today I ran into a TKR fella that I hadn't seen in about a month. He is about 6 or 7 weeks behind me I think. Anyway, we got to chatting and I told him about the issue I'm having with flexion. I asked him what his flexion was like, and get this--he said about 135! A short while later I saw him across the room doing his flexion stretches, and I'm not kidding, he had his heel pulled all the way up to his butt! I told him I was jealous! Jo, I know you're thinking that I'm not going to need the MUA, but I tell ya, if it would get me that kind of ROM, I'd do it tomorrow! The other thing was, his knee looked so different than mine. I know that no two knees are the same, but seeing his really made me realize that I have some issues going on with this knee--swelling or scar tissue--whatever they are, there is something in my knee that was not in his!

Niki, at the risk of offending you may I suggest that you are overdoing it?

Riding the bike and walking are both putting force through damaged tissue, this can make matters worse not better.

Mr 135 and you have different knees; do you find that as you bend your knee, it gets tighter and tighter because it's a bit swollen? That's what happens to me, and so I don't push it past that point -- there's no indication at all that it's scar tissue, just the swelling.

Does Mr 135 have swelling? I'd guess not, or he wouldn't be able to bend so well. Perhaps asking what his recovery regime is might help?

Again, I'm sorry to question what you're doing, no insult is intended, just to suggest alternatives is all.

 

[Mimi]

Niki, you know I am with Roy on this one. Thought you understood the work smart not hard part of recovery. The mile is great if you felt well the whole time and afterwards. It you pay a price for all the "exercise" then it is not worth that for your recovery. We all have setbacks, but to bring them on by overdoing is not necessary. I know you want more and more and you want it now! That is not how it will work for you unfortunately. I know cause that is how my recovery went. You are doing wonderfully:biggrin: , don't slow it down by OVERDOING the exercise.. I've done that too.

As for the 135 knee to his butt man, forget about it!!:rolleyespink: We are all different and men are far different than women in all ways! I had a ROM of 145 before surgery in both legs (hyper extension). Yes, with all my problems, the OA and bone on bone, blown meniscus, I still could get my foot up to my butt, standing or sitting. NOT NOW and I ACCEPT that! It gets better all the time and maybe some day. I will not force it cause I am so happy to walk, move without pain and enjoy my life.:yes 4: No one is the person they were one or ten years ago.

All good things will come to you eventually, you can't force this recovery without paying for it. You have been through enough already, please take it easy!

 

[Pumpkin]

Niki,
Great you can walk a mile, but like others have said you maybe overdoing it. Our knees are still the boss, listen to them, tightness is pain, slow down.
Ditto what others said in previous posts.

 

[Josephine]

Well, I agree about Mr 135. Some people just streak away with this stuff while we poor mortals have to limp along behind.

However, Niki is 3½ months now and should be able to really get going like this.

Niki, I don't know if I said this before, but if you are at 105 now the likelihood is that you will get there eventually. People go on getting better ROM for a year and more. Anyway, it's my experience that surgeons really don't care to MUA a knee when it's over 100.

 

[editor98]

However, Niki is 3½ months now and should be able to really get going like this.

Josephine, THANK YOU for saying that! I don't know if you meant it the way I'm reading it, but I'm taking that sentence to mean you are NOT telling me that I'm doing too much! I appreciate all of your comments, and Roy, definitely never any offense taken. I know that y'all are giving me the best advice you know how to give with the intent of helping me to have the best possible recovery I can have. Truly, I understand that. And honestly, I don't know if my issue is swelling or if it is scar tissue, but don't you think that it could at least be a possibility that my flexion limits could be from something other than me trying too hard?

This is probably going to be very boring reading, but this is what my typical day looks like at 7 days away from 4 months post-op:
--Wake up, go to the kitchen for coffee, feed the dog and get the paper from the front yard, about 20 to 25 minutes on my feet.
--Take my coffee back to my bedroom where I sit in bed with my legs elevated on two gigundo pillows while I spend anywhere from 45 minutes to an hour with the Lord (devotional, Bible, prayer--best part of my day by the way). I may have the ice machine on during this time if I haven't had it on right before I woke up.
--If it's a PT day (twice a week), I go to PT where I do what you do at PT. If it's not a PT day I go to the gym to ride the bike for 20-some minutes.
--When I get home, I usually work for about 3 or 4 hours, which I do sitting in my bed with my leg up on my two gigundo pillows. I will ice off and on during these hours--maybe 45 minutes on, hour off, etc.
--During my work time and for the rest of the day, I will do 5 reps of some kind of flexion stretch every two hours (by the clock so I don't forget). I ice and elevate after every single time.
--After working, I take my dog to the park to run around. The park is about a 3 block walk. At the park I stand for about 10 minutes throwing the ball for the pooch, which is about how long it takes for her to get tired. Then we head the 3 blocks home, after which I ice and elevate. Yesterday was the first day that I really "walked" her for that mile instead of the 3 blocks to the park.
--While my daughter-in-law makes dinner for us, I usually have a glass of wine and watch the news--with my leg elevated and maybe icing if I haven't iced in a while. (This is soon to end because my kids are moving out in 10 days so I will have to start cooking for my husband and me.)
--About 75% of the time I volunteer to clean up the kitchen and load the dishwasher--probably about 20 minutes on my feet, after which I may ice if I feel like I need it.
--Last, I shower and either read or watch some TV, usually in bed with my legs elevated.
--Most nights I ice for a couple of hours at some point. Last night I started out with the ice machine at 11:00, woke up at 2:30 and took it off, and then slept without ice the rest of the night.
--The next day I wake up and do it all again. Obviously there are some variations if I have to go somewhere or do something, but this is generally how my days go. Very exciting life I lead!

So reading that, and with being almost 4 months out, do you really think I am doing too much? I really don't know if I need an MUA or not, or if time will take care of things. That's what we're trying to figure out and that's why my OS during both my December visit and my January visit decided to wait another 4 weeks and see what happens. Obviously I'd like to avoid the MUA, but I just don't know how long we should keep waiting to see what happens. Maybe my PT is right and we should just get it over with.

If you've stuck with me through this marathon post, I appreciate it! And I do appreciate all of the support that y'all continue to give me--even though I'm sure you must feel like shaking some sense into me at times!
Niki

 

[Roy Gardiner]

Wow! I don't do 1/10th of what you do. I do very gentle flexion exercises in the day, maybe. Or maybe not. I do extension exercises a bit more, because the effect is pretty immediate and beneficial, and doesn't involve damaged tissue.

I haven't used the ice packs for 10 days or so, I don't find them very helpful. I have never bothered much with elevation.

So we have a right contrast here :th_heehee: