Bilateral TKR Puppylove's New Knees

[PuppyLove]

My 4 week update:

I still have in-home PT coming three times a week. My insurance approval for outpatient came today, so I start there next Monday. I had flexion of 115 in both knees yesterday. I had to stretch "extra hard" to get there, so I don't think that is realistically accurate- I would not do it on my own. He didn't measure my extension, but said it looked great.

I walk several times a day on my street (about a block). That's about my limit. I spread my exercises out during the day and night- it helps to keep me more flexible. I probably group them once a day.

I'm still sleeping in my recliner. I slept six hours Saturday night, and regretted it Sunday morning- I could barely move! I now set my alarm to wake up at 4 hour intervals so I can stretch and medicate. I start out at night with ice, then take off the cuffs when I wake up. That allows me to get more comfortable for the next sleeping session, with a pillow between my knees.

I'm back to doing laundry and some ironing. I have a roller chair in my laundry room, so I can roll between my washer and dryer (they're raised on a platform), and the kids hang up clothes for me so I don't have to get up and down so much. I also sit while I'm ironing and do leg exercises at the same time. I do this in very short spurts. And no, I do not trust anyone else to iron yet- I need to schedule them for ironing lessons!

I've ventured out on a few shopping trips (necessary for daughter's choir uniform) and even using a power cart at Wal-mart wore me out. I guess I need to build up my stamina. I have to remind myself that I had hip surgery 5 months ago and my stamina wasn't back fully from that yet. Patience is a virtue I'm still working on!

I'm still trying to work out my meds. I'm at the " how much pain should I tolerate" stage. I would like to be off narcotics so I can drive, so I'm trying Tramadol and Ibuprofen during the day( I know some of you love Acetaminophen but it does nothing for me). I still take Norco and Benadryl at night and can sleep 4 hours at a time on that combo. I know the Bonesmart mantra is to not premedicate for PT, but I've always scheduled my pain meds to be an hour before my session. Now I am seeing the error in my ways. I think I've been letting my PT push me too far and for the next day I have increased pain and stiffness. I've become pain tolerant over the years in dealing with my hip and knee pain, and I don't know how much pain I should expect at this point.

I've been fortunate to not have any external swelling at all. I tried to include a picture but can't figure out how to get it from my photo section to here on the IPad. I'm still icing several times a day and rst a lot with my legs up in the recliner.

I feel like I'm having a good recovery. I'm really curious to see what differences outpatient PT will bring. I hope everyone is having a great day. Thanks to all for such great support and advice!

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[Threads]

Thanks for your great update @PuppyLove - on the whole, you seem to be having a great recovery. You seem to be pacing yourself well but ironing? Guess that's one advantage of being older - I only iron when I have no other choice! Keep up the good work and updates - they help me believe what's possible.

 

[PuppyLove]

@Threads I only iron when necessary these days. My 14 year old has a "business casual" dress code at school, as does hubby at work. Since hubby has to do all the carpooling, I have lots more time at home. Plus, I iron more efficiently than he does (or so he leads me to believe by his efforts)

 

[rosietosie]

You are really doing well with your recovery! Feels great to get out and about but yes, the stamina really takes a hit. I'm amazed at all you are able to do especially with the recent hip surgery.

My home PT was not agressive and did not really force me to bend much. In fact, I don't remember that she put her hands on me. Mostly focused on exercises and helping me regain mobility to manuver stairs, crutches, etc. My outpatient PT seem to be focused on rehabbing my total body, helping to regain flexibility, strengthening glutes, quads, etc. Lots of massage to breakdown scar tissue and help with extension.

Keep up the good work. And about that ironing......?

 

[PuppyLove]

@rosietosie I hope my outpatient PT is like yours. I really need to work on overall flexibility.

Ok, if I'm getting it over the ironing, I may as well 'fess up. Our master bath shower/tub spouted a major leak last weekend and we have to rip out all of the wall tile. So.... Every time I go into the bathroom I pull a few tiles off the wall. I did all the easy ones and will leave the hard ones for the muscle men. Then comes repair and tiling time....I'm really going to need that flexibility!

 

[PuppyLove]

I think I finally figured out how to attach a picture of my knees. What looks like swelling is actually flabbiness!

 

[Threads]

That's amazing healing @PuppyLove! I'm very impressed. Now, about the ripping the tiles off from the the bathroom .................... not so much. Watch your balance, please.

 

[ljrfrm]

@PuppyLove Great 4 week update - you are doing so well. Your ROM is around where I am, and I am 10 weeks out - you will be bending with the best of them in no time Remember......don't do so much too soon, or you will never get help!

I always take a Tramadol before PT. For me, it doesn't mask the pain allowing me to do too much - but without it (I've tried) I'm not able to do enough! I never do anything that hurts - and if I hurt too much after PT, I do cut out whatever exercise bothered me. As I've posted before, it's a fine line between not doing enough, and doing too much. I think it's great that you are out and about a bit......I think maybe I have spent too much time in my recliner. I do think it's important to take it easy, rest and listen to our body......but at the same time, I get just as stiff and sore sitting around and not doing enough.

Keep up the great work and the great recovery........you're doing great!!!

 

[PuppyLove]

@ljrfrm I'm going to follow your example with PT. Today ( my last in- home PT visit) I told him I would stretch to the point of discomfort but not pain. He didn't measure me today. I will definitely let my new PT know that next week.
I switched to Tramadol and ibuprofen two days ago and I drove today for the first time in a month. Woohoo!!! Just a short trip to the library during very low traffic- my son ran in while I stayed in the car. The hardest part was releasing the emergency brake (hubby presses it down tight). I had no problems with anything else. When I got home I went straight to the recliner and ice. It will only be very short trips for me for a while.
And by the way...I spend a lot of time in my recliner!

 

[ljrfrm]

@PuppyLove Great news on the driving - isn't it a great feeling to do something like that without relying on someone else for once?? I don't drive often, only when I need to. Today I will take my son to the orthodontist.

Good luck with your new PT. I talked to my PT at one point about pain vs. discomfort. It's sometimes such a fine line between the two. She told me that she used to push patients past the point of pain, because that was how she was trained and that was "thought" to be the way to do it. Now though, they have found there is NO evidence to show this is helpful, and more pointing to it not helping and causing damage (swelling) so she will never push me past the point of pain. She does however have to rely on me to let her know. SO, make sure to speak up, and be honest. Also, as you continue this journey and have new aches and pains (for example, tight hamstrings, certain particular pains in knee, etc.) make sure to let your PT know so they can work through those pains with massage, ultrasound, etc.

 

[Yorkimom]

@PuppyLove Hi Chris! Just stopping by to see how you are. driving.....what an accomplishment!!!!!!!! That is just awesome. Good luck on your outpatient PT. I'll be anxious to see how you like this one compared to your in home PT. Just don't let them hurt you. Take care. Anne

 

[PuppyLove]

Outpatient Therapy Update:

Today was my first visit with the new PT. He measured me and we discussed numbers. He said he is not as concerned with the number as with my function. We discussed discomfort vs. pain and he said his job is to push me to improve and it may be very uncomfortable at times but that I would never be in pain walking out of therapy. He said pushing too hard is counterproductive because it will cause bruising and a setback. I really hope he is true to his word. He showed me how to massage my incisions and said they look great for almost five weeks. They are completely healed, so I can start aqua therapy on Wednesday.

I'm going to have hubby drive me until I know how I respond to therapy. I'll have to drive myself to my OS appt. on Thursday, but I'll be sure to be well rested. I have not resumed any carpool duties yet (30 miles round trip). I still have that post surgical energy drain and nap during the day.

No new accomplishments except I can put my pants on while I'm standing up (I've had to sit until now). I still can't stand still for very long- I keep stools around the house so I can "perch" while I do things. My kids have become more self-sufficient ( and without complaining!), so I think I'll count that as an accomplishment.

 

[ljrfrm]

Good Morning @PuppyLove. Great update - sounds great that your PT doesn't believe in pushing to pain. Make sure to speak up if something hurts too much. Even if it doesn't hurt while you're doing it, if it causes pain later on, let them know.

What do you plan to do for your aqua therapy? Will you take an aqua fit class or work on your own? I just started working out in the pool last week - am doing things on my own. There is an aqua fit class in the evenings I'd like to do - but evening are hard with my son's activities. It's so nice to read how great you're doing!!!

 

[Yorkimom]

@PuppyLove Hi Chris! Your PT sounds great. You are doing awesome!!!! I'm reading what you are doing and you had both knees done. I can put my pants on standing up, but usually sit because it's just easier. I can't imagine doing it with both knees done. I haven't gotten brave enough to try driving yet. Just sitting in the front seat of the car for just 20 minutes has been painful let alone drive. Since this weekend, I have seen a big change in what I can do, so hopefully I'll try driving soon. Isn't it amazing what our kids can do for themselves when they have too!!!!!! Keep up the good work. Anne

 

[PuppyLove]

@ljrfrm I will be doing aqua therapy as part of my outpatient PT. They have a small SwimEX pool that I will be in at the start of each therapy. I checked out aqua therapy classes at my local rec center and there is one for arthritis and joints that looks promising for after PT is over. It all depends on the class schedule, as I need to be available for the kids and I need to find a new job.

@Yorkimom for me, driving is actually better that riding in the car because my legs are doing something (well, one anyway, and I just move the other one). I drove my daughter to the fabric store tonight (hubby came along just in case) and the 10 miles round trip would have been fine if I hadn't stood in line for 10 minutes at the store. I don't do well standing still, and they didn't have any motorized carts available. I was hurting when I got home, plus it was time for meds. Therapy is 13 miles away, so we'll see how that goes after hubby takes me tomorrow. You should try a short trip- you might be surprised!
And I usually sit when I get dressed- I was just surprised I could do it standing up! Things seem to be getting better every day. I still have a lot of heat and tightness, but I think I'm more mobile. I just don't let the family see me doing too much!

 

[Yorkimom]

@PuppyLove, good idea. If they see you doing too much, they'll expect more from you. Take advantage of this time. I know I am because something like this doesn't happen. We are always doing and giving and it's nice to be on the other end for a change. Have a good night. Anne

 

[Threads]

You continue to blow me away with your progress @PuppyLove - I can't stand for 10 minutes now and driving sometimes hurts. I'm not surprised that you were sore after your expedition!

 

[ljrfrm]

@PuppyLove That's great that the PT has the aqua therapy. My PT has said on several occasions that she wishes they had a pool. She's been able to give me some exercises to do in the pool, but it would be much nicer if I could do it there. I'd like to join a class too, but so far the class times haven't worked with my schedule.

Like you, I find that driving is sometimes easier that just sitting in the car as a passenger. Really, I could have driven much earlier. I'm glad I held off because of the pain meds usage, but it wasn't as daunting as I made it out to be in my head.

 

[PuppyLove]

@Threads I couldn't stand that long before surgery either. My knees would buckle or just whine way too much. I think you will be very happy with the decision to go bilateral. As far as I can tell, stiffness and soreness in just one leg wouldn't be any better for me than having it in both right now. The worst part for me currently is not being comfortable enough to sleep well (I took Norco and benadryl 1 1/2 hours ago and you can see how far that got me). If I stay in one position too long I get stiff and need to move around. When I finally fall asleep I wake up in pain from being in one position too long, then I try to stretch and I get spasms in my lower legs. I have an OS appt tomorrow and will ask him about that.

@ljrfrm i had my first PT appt with aqua therapy tonight. I started out in the SwimEX a and did walking, side to side ( shuffle), marching in place, bicycling while sitting on the side step, lunges, and modified squats. I was surprised that they didn't come up to the pool (it's on an elevated platform) to check if I was doing it correctly- PT and technician gave me directions from the floor. Afterwards I changed into regular clothes and did leg lifts, chair slides, and sitting kicks (I don't know th real name of those). THEN, PT "worked" on me for flexion. It was a bit painful, and he is adamant that I will thank him for it in a few weeks. I'm going to ask the OS about the pain part tomorrow, and I will try to get a session with the director of the PT clinic. I googled my PT and he got his doctorate about six months ago and has been at this place for three months. The LInkedIn website is very informative. I saw three different PT's for my hip rehab and I liked the variety of techniques.

Thank you all for being so patient in reading my posts. It is actually therapeutic for me to write these!

 

[Threads]

@PuppyLove - sorry you are having trouble sleeping. I can understand in my brain that this will be a problem but you will have to talk me through it when I get there myself! We found some Diphenhydramine in a stand alone capsule today at the drug store. Our son is having problems getting his system back on our time and I thought that this might help without the other things that are in Benedryl. He's headed to bed now and I hope he can sleep more than a few hours. I'm having trouble sleeping but it's mostly Restless Leg and I'm concerned about having that happen on top of my healing leg pain.

I loved the detailed description you gave @ljrfrm about your Aqua therapy today. Might have to copy your comments and put them in my notes. I'll probably go back to our community pool as soon as I can and it will be good to know what exercises are helpful.

Good luck with you OS appointment tomorrow and keep us posted.