PKR PoorlyKnees’ road to recovery

[PoorlyKnees]

March 9th: Busy Doing Nothing
I feel like I’m spending all day laying around. In reality, I’ve been very busy.

Pain Management
I’ve reduced the amount of Codeine in my pain management regimen. I haven’t noticed any change in the levels of discomfort. I think I’m less drowsy and my bowel breathed a sigh of relief (so to speak). The numbness around my knee is reducing, but I’m still having a few problems engaging my quads during the physio exercises. I hope this is temporary.

Physio Programme
I know that it is easy to get lazy with physio. It’s usually a bit uncomfortable (physically and/or mentally) and excuses to not do it are many and varied. With that in mind, I’ve put together a programme whereby I attempt each exercise and score it from 0 (impossible) to 4 (easy) and add comments. I repeat this 4 times a day. As time passes the scores will increase and this will help keep me motivated. If for some reason the scores do not go up, I will have information to share with the medical team.

Rest/Ice/Compression/Elevation
My ice machine is brilliant. I fill it with ice in the morning and it lasts all day. I ice my knee for 30 minutes directly after each physio session. I then rest for about an hour. After that, it’s either time to eat or time to do physio again. I keep my knee elevated at all times.

I’m hoping it actually stops raining long enough tomorrow to get out and take a walk. Fingers crossed.

 

[sistersinhim]

For the first 6 weeks or so I used the ice machine the whole time I was sitting or laying down. Of course, I'd get up and walk about once every hour, but then put it right back on. This really helped to keep the swelling and pain level down. When I finally made it back to church, I even took a pillow and ice pack and iced and elevated on the back pew! Church was about an hour, round trip, so it really helped. You can not over ice as long as you have a cloth between your leg and the ice pack.

 

[PoorlyKnees]

March 11th: The Weather is on my Side
Since I came home we’ve been plunged into a period of cold wet weather. The perfect weather for staying indoors.

Knee Feels Good!
The feeling is coming back to the area around the knee which has made me feel a lot happier. I don’t mind the occasional jab of pain because at least I know the nerves are working. I’ve made some progress on some of the physio exercises and have been able to do a few straight leg raises.

I’ve done quite a bit of walking about over the past couple of days. I felt like I needed it as all the sitting down was giving me back ache.

The best news is that there is no sign of any kind of infection and amazingly only the faintest bruising. I’m looking forward to getting the wound dressing removed next week.

Range of Motion
No more significant improvement in terms of flex range of motion, but I’m being patient.

 

[PoorlyKnees]

March 13th. I’ve Resorted to Crosswords
The weather has been atrocious, so I’ve spent the past 2 days rotating through a cycle of medication, physiotherapy, ice/elevation, rest, circuits of the house….. repeat.

How Does My New Knee Feel?
The numbness around the knee is restricted to a small area on the outside of the knee and the inside of the joint itself. It makes the joint feel unresponsive, but the only thing that seems to be restricting my movement is the enormous amount of wound dressings.

Is There Any Pain?
I get twinges of pain on the inside of the knee, usually when I’m straightening the joint after flexing it during physio. I’m assuming that this pain is around the area where the surgeon trimmed off arthritic bone growth. That’s the only area where there is any bruising.

What’s Happening Next?
I have an appointment with the physio in 2 days. I was hoping to be able to bend my knee to 90 degrees, but I’m not there yet.
The day after that I have my wound inspection (and dressing finally removed, I hope) and my follow up with the surgeon. I’m looking forward to hearing his feedback on progress.

 

[Layla]

Brighter days are on the way! The sun will shine again and you will have a wonderful Spring and Summer.
Glad you're taking advantage of the rotten weather and getting lots of rest. I hope you'll share the good news of your visit with the surgeon with us. We'd love to hear all about it. A great week to you!
@PoorlyKnees

 

[PoorlyKnees]

March 15th. Progress Check
Two weeks down. Today I had my first appointment with the physiotherapist.

Healing and Swelling
The physio was happy with how my knee looked. There’s still a bit of swelling, but he said that was normal. Apparently the numbness on the outside of the joint is most likely permanent.

Strength and Range of Motion
Curiously, my physio appointment was scheduled before I have had the wound dressings removed. They are impacting the amount I can bend the joint.

The physio seemed OK with my range of motion, but was a bit concerned about the quad muscle wastage and subsequent weakness in my leg. Not a surprise, I shattered my femur when I was 20 and the leg has always been weaker as a result.

What Next?
As a result I have new exercises to perform. Straight leg lifts to the front and to the side. Sound pretty easy eh? Not with my left leg, it’s tough! Nothing that I cannot overcome, bring it on.

Tomorrow, the wound dressing is removed. Woohoo!

 

[HaylingIslander]

Good thread.
Thanks for sharing helps us feel normal.
Whatever our current normal is!

 

[benne68]

Apparently the numbness on the outside of the joint is most likely permanent.

Did your physiotherapist tell you this? It's really not true.

In fact, most of us find that the numbness gradually recedes with time. I'm 18 months out and have regained sensation in almost the entire area that was numb a year ago.

Here's an article about it in which our Nurse Director Emeritus tracked her progress:

Numb area after TKR: how long will it last?

I'm cataloging the progress of my numb area so you can see how it progresses. To start with, the reason for this numb area is simple. A nerve called the saphenous that comes down the inside of the thigh and on into the calf. It has a small branch called the infrapatellar branch that goes across...

bonesmart.org

 

[beachy]

My left knee is 4 yrs old and the numbness has been gone for years.

 

[EalingGran]

At 20 weeks my numb patch is definitely a bit smaller and no longer fully numb.
If I tap over it I can feel it- although it is different to the normal area. I get sharp little prickly pains in it sometimes as well.

 

[PoorlyKnees]

March 17th. It’s All About the Physio
It had felt like an eternity but it’s finally time to get the wound dressing removed.

How was the wound?
Very neat and very clean. I had 3 incisions 1 over the knee and 2 smaller incisions, 1 above the knee and 1 below. My surgeon performed the procedure with robotics assistance. The 2 smaller incisions were required to support the alignment procedure.
31 glorious staples all removed without any problems.

What did the surgeon say?
The surgeon was very happy with the progress of the healing of the wound and the level of swelling around the joint. Apparently I have a Titanium plate attached to my tibia and an Oxinium cuff attached to my femur.
His advice to me now was to work hard to improve the range of motion.

What about the numbness?
The surgeon confirmed that the numbness was unavoidable as the infra-patella nerve has to be severed. He said that the feeling would slowly return as other nerves filled the gap, but there would may be a small area where the feeling would not return.

What advice did the surgeon give?
He was very straight about this. I have to get the range of motion back. I also need to wiggle the patella to ensure no scar tissue forms around it. So my days are mapped out with range of motion exercises and straight leg lifts to strengthen my quads, adductor and abductor muscles. The best bit…. I’m down to 1 crutch.

 

[PoorlyKnees]

March 19th. How Many Leg Lifts Does it Take?
Sounds like the first line of a joke, but it’s not.

Building up the Muscles.
When I started the leg lifts my leg felt like it weighed 10 times as much as my other leg. It just goes to show how “protecting” my left leg had resulted in a loss of muscle tone and strength.
The first few sets of 5 were so hard, but I was knocking out sets of 10 before the end of the first day.

Increasing the range of motion.
This continues to be a challenge. No matter what I try to do it doesn’t feel like it’s improving. I know that it is, I can lift my foot on to a step now. It feels like it’s a balance between pushing it through exercises and reducing the swelling through icing and compression; effort versus patience. Whilst I am feeling frustrated I know that I will overcome this and I’m looking forward getting my mobility back.

 

[PoorlyKnees]

March 21st. Digging Deep
If at first you don’t succeed…

Getting Back to a Routine
I love my food. I love to cook. So going to the supermarket to buy groceries for the week is a key part of my routine. My lovely wife treated me with a trip to the supermarket yesterday and it genuinely lifted my spirits. I know it sounds daft but doing something “normal” makes a big difference.

Range of Motion
I focused on increasing the range of motion yesterday evening. I flexed my knee to the point where I felt resistance and held it there for a count of 10, then flexed it a bit more and repeated the process. This has really helped; I can definitely flex my knee further.

One Small Step….
The greater range of motion has made walking (with one crutch) easier and more fluid. I decide to walk to a local town today and discovered that I can comfortably walk 3 miles. Unfortunately the round trip was 3.5 miles, that last half a mile was tough.

I thought the walk would result in my knee puffing up a bit but overall the swelling is decreasing each day. I’m starting to put more power through my left knee now and there is no pain.

All in all it’s been a good couple of days.

 

[EalingGran]

I decide to walk to a local town today and discovered that I can comfortably walk 3 miles. Unfortunately the round trip was 3.5 miles, that last half a mile was tough.

That's amazing- but you do need to pace yourself and not walk further out than you can easily get back.
I walk to a coffee shop ( various distances up to 2 miles) and then rest until I can walk back. The other good tip is, if possible, walk along a bus route. That way, if it gets too much - you can always get home!

 

[PoorlyKnees]

March 23rd. Finding What Works
I think of recovering from surgery as being like a long haul flight. Both can be insanely boring and frustrating unless you have a plan on how to fill the time.

More and More Normal
I’ve settled into a bit of a routine now. I go for a walk, during which I try to make sure I’m putting a reasonable amount of weight and effort through my new knee and using enough flex in the joint. I then ice and elevate the knee for an hour before doing sets of stretches to work on range of motion. I then repeat this process in the afternoon. My knee seems to be responding well to this and the strength/flexibility is improving.

How is the Wound?
My wound has healed really well, I had virtually no bruising and no bleeding or weeping from the staples. The area of numbness continues to reduce in size.

 

[EalingGran]

Sounds like you are doing really well!

 

[PoorlyKnees]

March 25th. What Goes Up…..
One of the most frustrating things after surgery is navigating the house, particularly the stairs.

Right… Right… Right, Right, Right.
I seem to spend half my time wishing that I had something that I have left downstairs. The remaining half of the time I spend wondering why I left something upstairs. I can scale the stairs, but it’s time consuming and frustrating; literally one step at a time.

Today I completed my first complete ascent of the stairs using a normal “left, right” stepping technique. This really helps me develop my confidence, strength and range of motion.

Et tu Patella?
Is this a kneecap I see before me? Yes! The swelling around my knee has reduced enough for me to see the shape of my kneecap. This is very pleasing as my range of motion improves as the swelling reduces.

And finally…
I mowed my lawn. This is not so much a recovery-related achievement but more a triumph of human spirit overcoming Mother Nature. It finally stopped raining for long enough!

 

[Jaycey]

I remember mowing the lawn about 4 weeks post surgery. Such a feeling of accomplishment! Well done!

 

[PoorlyKnees]

March 27th. First Dry Day in Living Memory.
At least, that’s what it felt like. The sun emerged and it was warm. Happy days

Walking the Walk.
Completed my morning walk today. It works out to be about 3000 steps (200kCal). I don’t find it hard, but I’m always happy to sit down and put my feet up at the end.

Stretching the Stretch.
I’m still doing my Range of Motion exercises. They are getting easier, but my leg muscles (quads) around my new knee are so weak from years of protection that it makes me very tired.

Impending Interrogation.
I have a follow up appointment with my Physio in a couple of days. I’m confident I will be able to demonstrate the 99 degree flex, but that’s about it.

Feel like a Prisoner.
The latest thing is that I can’t really get comfortable in a car. The position of my knee seems to aggravate something and I get a fair bit of pain shooting through my knee. I’m hoping this will pass.

 

[sistersinhim]

The position of my knee seems to aggravate something and I get a fair bit of pain shooting through my knee. I’m hoping this will pass.

It is not only the position of your knee in a car, it's the vibration or the ride and the bumps. It will get better!