TKR Post Op all is well<

[Schenk]

Hi all, I am going to throw this out, knowing in advance that some of you won't buy it.

From the time I got home from the hospital, my wife has been putting essential oils on my surgical leg. She has been immersed in learning about essential oils, and found a blend of oils specific to knee replacement. She has also used oils to manage pain. I was skeptical, but was open to anything that would reduce my discomfort.

My principal problem was edema in my calf which caused pain and discomfort. It prevented sleeping at night. I have been home for 3+ weeks and am happy to say that I no longer have edema caused suffering or pain in my knee.

Is this the result of a great surgeon, naturally good healing, or was the process accelerated by the oils? Perhaps all these elements are at play, but I do know the oils work.

By the way, used an exercise bike for the first time since the surgery. It hurt a bit so I backed off, but I was able to go for a minute.

 

[Josephine]

Schenk, Shalom, my friend. I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?

 

[Schenk]

Thanks,
I was worried about the window for achieving ROM.
Bonesmart really helped me calm down and just take each day, one at a time.
This has helped so much.
Today is 5 weeks since my surgery.
I am virtually pain free.
My ROM is more than 90 degrees but I don't know how much more.
I'm going in the right direction so I'm not concerned with the precise measurements.
My dog has been in a kennel for training and boarding until I could take care of him.
I want to bring him home on Sunday. My wife (she doesn't walk the dog) thinks I should wait a little longer.
I have a big yard he can go out in and I can take him for progressively longer walks.
He is trained and will not pull while on a lead.
What do you think?

 

[LuckyKY]

Thanks for your posts, I learned a lot from reading them! Best of luck with your continued recovery...

 

[SusieShoes]

The main danger with walking a dog, even a small one, is that the dog can pull you off balance and you might fall. Falls are never good things. If your dog hasn't been walked in a while, he might get... excited. And if excited, he might pull, or just act out. Even well-trained dogs can slip on occasion. You're only five weeks out from your surgery, so I'm going to agree with your wife on this one and say you should wait a little longer.

How stable are you when walking? How is your balance?

I too have a dog, a lovely and old standard poodle. She's sweet. I waited until I was walking well without a cane and was sure I had excellent balance. Just to be safe.

 

[Josephine]

Do you want me to post my questions? I couldn't quite tell

 

[Schenk]

As promised, here is the state of my recovery beginning week 6.

My ROM is greater than 90 degrees. I don't know how much further but more, so I'm pleased with that. There is no pain except for some residual edema caused pain in my thigh slightly above the knee. I developed some exercises using a big exercise ball. The PT was impressed.

I've begun to go up and down the stairs using both legs equally; downstairs is harder than upstairs. Going downstairs, I don't feel like I have full control. This could be partly psychological as I don't trust my leg yet.

Last week I started doing PT in the pool. I do deep water walking, running, flies and abdominal crunches. I also do walking in forward, backward, shuffles and kicking on my back and stomach. This session takes me almost 45 minutes or until my knee says stop. I do this 5 times a week and think it really helps me.

I'll bring my dog home next Sunday, as this week I'll be extending my walks each day. All told, my PT says that she is pleased with my progress. As I said before, I'm not concerned with comparing how quickly I'm recovering with anyone else. Each person's recovery is very individual and the only guide should be that you progress from week to week.

Don't cause yourself pain. Don't let the PT cause you pain. Pain is counter-productive and will retard your recovery.

My greatest challenge is still sleeping at night but found that some natural supplements like melatonin are helpful. I don't stress over not sleeping but look to make myself comfortable and sleep when I can.

In summary, I feel really grateful that my post op hasn't been more painful and that my recovery is progressing positively.

I'll be back next week.

 

[Schenk]

I've listened to my wife and will wait another week to bring him home.My balance is fairly good when walking. Hopefully, I'll make more progress this week.I did 3 minutes on a stationary bike today. Also walked, unaided, around the block. Started using both legs to go upstairs. Going down is going to take longer.

I'm encouraged but really miss my dog.
Thanks for the advice.

 

[kneeper]

Yes, going down is usually later to come than going up. When I first started to do stairs foot over foot, I'd do a few that way and a few one at a time until I felt more confident and as it became less uncomfortable.

 

[NightQuilter]

So glad to hear your recovery seems to be progressing smoothly. Don't stress at all over the ROM ... many of us had improvement into the second year. Keep us the good work.

 

[Schenk]

Josephine, I would be happy if you post your questions.

 

[Dearjr]

Hope your recovery continues going well
And just to let you know I walked the Miami 1/2 marathon yesterday with one tkr done 2 1/2 years ago
My bad knee even made it

 

[Schenk]

That is awesome

Congrats on a great accomplishment.

 

[Josephine]

downstairs is harder than upstairs. Going downstairs, I don't feel like I have full control. This could be partly psychological as I don't trust my leg yet.

It certainly would be at 6 weeks. Generally it takes around 2-4 months to accomplish that! But I can promise you it's not psychological!!

 

[Josephine]

Here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?

4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[Schenk]

Hi Josephine,
Here are the answers to your questions in the same order as you list them and numbered accordingly:

1 Pain level is 1

2 FI am not taking any pain medication right now. I was prescribed Tagrin 20 mg, Zaldiar and Arcoxia 90 mg.

3 My swelling is slight.

4 My ROM is greater than 90 degrees and can straighten my leg completely.

5 I don't ice often. Only when I overdo my PT, but certainly not on a consistent basis.

6 I elevate whenever I lay down. It's just more comfortable right now.

7 I don't really do much housework. A little sweeping and washing dishes. Nothing extensive.


exercises in the pool and at home, as follows:
Home:
heel slides 20 reps
Quad sets 20 reps
Hamstring sets 20 reps
Straight leg raises 20 reps
Hip abduction 20 reps
Hip extension 20 reps
Quad extension 20 reps

Quad stretch and Gastroc stretch 3 x 30 seconds
Hamstring curls, toe raises & single leg stance - 10 reps each
Wall Slides, step ups, mini squats - 10 reps each
Stationary bike - I'm up to 5 minutes

I also do a whole series of pool exercises both deep and shallow water, as follows
Deep water:
basic walk, flies, run - 2 times two minutes for each
speed walk - 1 min
run - 2 min
power walk - 2 min
speed walk - 1 min


Sit kicks, heel lifts (straight leg), abdominals (bring knees to chest) 30 reps each
flutter kick, front and back - 45 seconds each
Gait training - walk forward, sideward and backward across the pool - 1 min each
Curl and stretch and hamstring stretch - 3 x 30 sec.
squats, bounces 10 reps each.

I've had PT at home but am arranging PT 3 times a week at the PT clinic

That's about it.

Forgot to say, that I do each, once a day except for Saturday.

 

[Josephine]

1 Pain level is 1

Hmm okay

2 I am not taking any pain medication right now. I was prescribed Tagrin 20 mg, Zaldiar and Arcoxia 90 mg.

Tagron is oxycodone with naloxone (which is a non-opioidal pain med)
Zaldiar is a combination of Tramadol hydrochloride and paracetamol
Arcoxia is an NSAID
But you're not taking anything at all so okay!

3 My swelling is slight.

Good

4 My ROM is greater than 90 degrees and can straighten my leg completely.

Excellent

5 I don't ice often. Only when I overdo my PT, but certainly not on a consistent basis.

Okay

6 I elevate whenever I lay down. It's just more comfortable right now.

Okay

7 I don't really do much housework. A little sweeping and washing dishes. Nothing extensive.

Okay

Stationary bike - I'm up to 5 minutes
heel slides 20 reps
Quad sets 20 reps
Hamstring sets 20 reps
Straight leg raises 20 reps
Hip abduction 20 reps
Hip extension 20 reps
Quad extension 20 reps
Wall Slides 10 reps each
step ups 10 reps each
mini squats 10 reps each
Sit kicks 30 reps each
heel lifts 30 reps each
abdominals 30 reps each
Hamstring curls 10 reps
toe raises 10 reps
single leg stance 10 reps
squats 10 reps
bounces 10 reps
Quad stretch and gastroc stretch 3 x 30 seconds
flutter kick, front and back - 45 seconds each 90 secs
Curl and stretch and hamstring stretch - 3 x 30 sec.

I also do a whole series of pool exercises both deep and shallow water, as follows
Gait training: walk forward, sidewards and backward across the pool - 1 min each
Deep water:
basic walk, flies, run 2 times two minutes for each
speed walk 1 min
run 2 min
power walk 2 min
speed walk 1 min
12 minutes in all

So you're doing in excess of 318 reps of exercises per day ?! At 6 weeks? This is quite, quite ridiculous and really is unnecessary. Your ROM is good for 6 weeks out so please stop doing all this stuff so you keep it. My concern is that stories like this have inevitably ended up with complaints of pain and I seriously wouldn't want that to happen to you. You are doing so very well. But you are over doing it so at the very least, just go with the pool work and cut out everything else.

 

[Schenk]

Hi Josephine,
I have come to the conclusion that I am overdoing my PT. Today by doing nothing but resting my knee actually feels the best it has since my surgery. I am going to take your advice and scale my PT back. I'm not anxious to cause myself pain.

I can't express how much I appreciate your advise and support.

Have a great week.

 

[sistersinhim]

I hope you continue to feel better!

 

[Josephine]

You too my friend!! And thanks for the thanks!!

Shalom