kmak81230
post-grad
I have a glass of Metamucil twice daily, 4 prunes once a day and if I am taking any pain pills then add a stool softener once a day and that works for me - along lots of water and eating more high fiber foods.
TKR Put the right knee in...and then the left.
- Thread starter gertie
- Start date
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gertie
post-grad
Today I'm beginning week 2 recovery for knee 2 (Left knee--the toddler) and week 8 recovery for knee 1 (Right knee--the teen-ager).
I haven't reported on the teen-ager in a while. She seems to be bearing up under stress of being the "good" knee although she's really annoyed that just when she had some independence she's been grounded. Swelling has diminished although there's still a lingering puffy spot, incision looks good, zero to minimal pain at this point but that's probably because of the pain meds I'm taking for the toddler. Before the 2nd surgery, when I was off everything but acetaminophen, I had some soreness when I'd been out and about--nothing excessive but a reminder that this was a new knee. Knee feels smooth when I walk--I sometimes forget that I have an artificial knee. ROM was 0/120 before the 2nd surgery. In-home PT measured today and it was 0/117 Quel horreur! You're losing ROM! I wanted to tell her to take a chill pill. I think it's just fine since the knee is functioning nicely.
The toddler? Well, she's still cranky and needs lots of naps but that's what I'd expect at this point. Swelling is mostly behind the knee, as is any bruising. Pain is mostly in the quads a few inches above the knee. Tourniquet pain? I didn't experience that with the teen-ager. As with the other knee, quad strength has been good from day 1 and ROM is good--was 0/110 when I left the hospital. Today was down to 0/100 (more expressions of horror and concern from the PT that I'd lost ROM but I'm fine with this #). I'm still using a walker but doing that thing where I push with one hand so I can carry something in the other hand so I suspect I'll be onto a cane indoors fairly soon. When the PT was here we went for a stroll outside--just down the drive to the mailbox--felt fine, steady, stable. Toddler is stiff when I walk but that's not surprising given the swelling behind the knee.
Overall, I'm tired and stamina is low, especially first thing in the morning. Today, I bathed (sink bath), got dressed, got the coffee going then needed to sit down while it dripped, feeling like I'd run a marathon. (Meanwhile, I neglected to feed the cat, who yelled at me.) Stamina improves as the day goes on but I'm glad I've got meals on wheels deliveries since I wouldn't have the oomph to do any meal prep or clean up.
My mood is variable and tending toward easily irritated and crabby. I'm just so done with being in a state of recovery! But I also recognize I'm doing well and will be getting back to living life before long (or so I tell myself).
And that's the news from my back porch on this sunny day.
I haven't reported on the teen-ager in a while. She seems to be bearing up under stress of being the "good" knee although she's really annoyed that just when she had some independence she's been grounded. Swelling has diminished although there's still a lingering puffy spot, incision looks good, zero to minimal pain at this point but that's probably because of the pain meds I'm taking for the toddler. Before the 2nd surgery, when I was off everything but acetaminophen, I had some soreness when I'd been out and about--nothing excessive but a reminder that this was a new knee. Knee feels smooth when I walk--I sometimes forget that I have an artificial knee. ROM was 0/120 before the 2nd surgery. In-home PT measured today and it was 0/117 Quel horreur! You're losing ROM! I wanted to tell her to take a chill pill. I think it's just fine since the knee is functioning nicely.
The toddler? Well, she's still cranky and needs lots of naps but that's what I'd expect at this point. Swelling is mostly behind the knee, as is any bruising. Pain is mostly in the quads a few inches above the knee. Tourniquet pain? I didn't experience that with the teen-ager. As with the other knee, quad strength has been good from day 1 and ROM is good--was 0/110 when I left the hospital. Today was down to 0/100 (more expressions of horror and concern from the PT that I'd lost ROM but I'm fine with this #). I'm still using a walker but doing that thing where I push with one hand so I can carry something in the other hand so I suspect I'll be onto a cane indoors fairly soon. When the PT was here we went for a stroll outside--just down the drive to the mailbox--felt fine, steady, stable. Toddler is stiff when I walk but that's not surprising given the swelling behind the knee.
Overall, I'm tired and stamina is low, especially first thing in the morning. Today, I bathed (sink bath), got dressed, got the coffee going then needed to sit down while it dripped, feeling like I'd run a marathon. (Meanwhile, I neglected to feed the cat, who yelled at me.) Stamina improves as the day goes on but I'm glad I've got meals on wheels deliveries since I wouldn't have the oomph to do any meal prep or clean up.
My mood is variable and tending toward easily irritated and crabby. I'm just so done with being in a state of recovery! But I also recognize I'm doing well and will be getting back to living life before long (or so I tell myself).
And that's the news from my back porch on this sunny day.
kmak81230
post-grad
Great report Gertie! 3 degrees - what is that - a 1/32nd of an inch? That PT does need a chill pill! Good grief - and 100 is excellent for the toddler knee - I didn't reach 100 until 9 weeks! You are doing so well! Walker today, cane next, and then it's on to Belgian chocolates! Enjoy this sunny day on the deck - great for the mood and tempering any crankiness.
Re: constipation. My favourite is/was melons and cantaloupes. But also berries and cherries.
I eat plums instead of prunes ( now in season) and both fresh and dried apricots.
I can't imagine what it would be like to be fructose alkergic. would be my downfall. A distant cousin ( children's hospital dietician ) would repeat herself : the real fruit is better than the juice version. FWIW.
I eat plums instead of prunes ( now in season) and both fresh and dried apricots.
I can't imagine what it would be like to be fructose alkergic. would be my downfall. A distant cousin ( children's hospital dietician ) would repeat herself : the real fruit is better than the juice version. FWIW.
SusieShoes
Former BoneSmart staff member
Wow, you're doing fantastic! That ROM thing could be illusion anyway, depending on how measured. Your PT is making much ado about nothing at all. All of us are in awe of the 100 on the baby. Nothing to look at here! You are functioning at a high level for so soon after surgery. No matter what the cat says!
Pheebs52
big-cheese
Gertie, what an absolutely splendid report for BOTH knees! Huzzah, you are now in the official "RockStar Hall of Fame,"...well...here, at any rate! That PT needs a head adjustment, lol. My goodness, what would she make of someone like me who just achieved 102 at 11 weeks? I really am in awe of your ROM and especially pleased that we finally have a nice weather day for you to enjoy your success on the porch! Hat's off to you Gertie!
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gertie
post-grad
I'm curious about who is setting these benchmarks that she's trying to get me to adhere to. When I went for my 2 follow up visits for knee #1, the surgeon's assistant eyeballed ROM and just seemed satisfied that at the 4 week visit I could go slightly beyond 90 degrees--he did not get out the goniometer or push for more bend. And another assistant, who did the first part of my preop exam for #2, simply noted that ROM was slightly inhibited by some swelling but again didn't measure or seem concerned. And the assistant I saw just before leaving the hospital said they didn't really care about individual #s, just that there was some progress over time.
So the # obsession might be coming from the larger, very conservative, stodgy practice (my OS is the new guy w more progressive ideas) or from insurance. In any case, I try to ignore her on that topic because I find her helpful in other ways.
So the # obsession might be coming from the larger, very conservative, stodgy practice (my OS is the new guy w more progressive ideas) or from insurance. In any case, I try to ignore her on that topic because I find her helpful in other ways.
OP
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gertie
post-grad
Pheebs52
big-cheese
Gertie, I strongly suspect those benchmark numbers are set by insurance companies. Once a particular benchmark is met, then they are "off the hook," financially. Make sense? In comparison, the post-op surgeon visits are covered regardless of ROM. For instance, my surgeon has really shown very little interest in my numbers, but great interest in my function. I'm sure there are also benchmarks for number of visits allowed, but I'm also sure there are many exceptions due to complex recoveries.
OP
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gertie
post-grad
OP
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gertie
post-grad
She is a very vocal, 16 yo feline with lots to say about a number of topics, mostly I suspect having to do with my "neglect." "Open that door!" "Clean that litter box!" "Supply better food!" "Why is your computer in your lap? That's MY lap!"
SusieShoes
Former BoneSmart staff member
It could be insurance. They like to quantify things, and numbers are a means of doing that. Demonstrating "improvement" and all that. Interestingly (to me, anyway) no one ever felt a need to assign numerical value to the ROM in my pre-op knee. Did I need surgery at an extension of 5? At 10? If my flexion went below 80? It was all about bone on bone. Surgery resolved that issue!
PT needs to track numbers because they need some way to demonstrate improvement to insurance and OS. Numbers, like grades, are easy. A better number equals a better grade; it's a measure. One could argue improvement is best measured by improved function, whatever the numbers involved. Like your OS, mine (who is an older, very well-established surgeon in a very big practice) merely eyeballed my ROM, assigned what he thought the numbers might be, and was most interested in what I could do. How was my walking? How far? Pain? Swelling? What about stair climbing? Driving? What activities was I doing? It was all about activities of daily living. Where was I functionally compared to where I wanted to be. The goal of the surgery was not to achieve certain numbers but to restore function. My mom doesn't know what her flexion is, but she can sit on her heels. She's had both knees replaced. I want what she has. Numbers? Whatever hers are.
PT needs to track numbers because they need some way to demonstrate improvement to insurance and OS. Numbers, like grades, are easy. A better number equals a better grade; it's a measure. One could argue improvement is best measured by improved function, whatever the numbers involved. Like your OS, mine (who is an older, very well-established surgeon in a very big practice) merely eyeballed my ROM, assigned what he thought the numbers might be, and was most interested in what I could do. How was my walking? How far? Pain? Swelling? What about stair climbing? Driving? What activities was I doing? It was all about activities of daily living. Where was I functionally compared to where I wanted to be. The goal of the surgery was not to achieve certain numbers but to restore function. My mom doesn't know what her flexion is, but she can sit on her heels. She's had both knees replaced. I want what she has. Numbers? Whatever hers are.
OP
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gertie
post-grad
@SusieShoes The preop measure was for my first knee, which would be taking the load after 2nd op. Although in earlier assessments I think they did look at ROM, maybe as part of making the case for insurance that I needed the op.
Sit on her heels? Wow! Haven't been able to do that since I was much younger and more gumby like.
Sit on her heels? Wow! Haven't been able to do that since I was much younger and more gumby like.
SusieShoes
Former BoneSmart staff member
My mom is a freak of nature, and a very stubborn woman. Still, I can hope...
I have no idea what my pre-op ROM might have been. My OS did bend and note it, though, so maybe he wrote something down. More "proof" of the need for surgery, given that god-awful pain isn't quantifiable.
I have no idea what my pre-op ROM might have been. My OS did bend and note it, though, so maybe he wrote something down. More "proof" of the need for surgery, given that god-awful pain isn't quantifiable.
Correct. Some PTs get obsessed with numbers, because it's the one way they can demonstrate to the insurance companies that their ministrations are effective - so they get paid.
Just because the PTs are obsessed, it doesn't mean you have to share their obsession. Function is far more important than the numbers.
My surgeon never asks about the numbers. He just says "Show me what you can do."
I didn't go to PT at all with my last TKR, so my ROM was never measured. I "guesstimate" my knee bends to somewhere between 125 and 130 degrees and it straightens fully.
Function, to me, is the most important thing. If you can use your knee normally, then all is well!
Thesoutherncook
post-grad
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Lets think about what sent us to the OS to begin with - the inability to function without pain. THAT is my goal...to function normally without pain. Period.
OP
OP
gertie
post-grad
On the positive side, I had a lovely nap this afternoon on the back porch, sun streaming in, nice and warm. I do love those naps.
But today, overall, I've been feeling the weight of doing 2 Tkrs close together. Intellectually I know that I will eventually recover and will have 2 knees that are pain free, etc. but emotionally, I'm just tired of being back in early recovery. Tired of being dependent on others, of limited mobility. All is exacerbated by most of my support group being out of town--it's that time of year--and the one person who is not away just had minor surgery of her own and can't drive. With the other surgery, this was the point when a friend whisked me away from the house for a drive, which greatly lifted my spirits, but that will have to wait.
Ah well, this will pass.
But today, overall, I've been feeling the weight of doing 2 Tkrs close together. Intellectually I know that I will eventually recover and will have 2 knees that are pain free, etc. but emotionally, I'm just tired of being back in early recovery. Tired of being dependent on others, of limited mobility. All is exacerbated by most of my support group being out of town--it's that time of year--and the one person who is not away just had minor surgery of her own and can't drive. With the other surgery, this was the point when a friend whisked me away from the house for a drive, which greatly lifted my spirits, but that will have to wait.
Ah well, this will pass.
Thesoutherncook
post-grad
- Joined
- Aug 4, 2015
- Messages
- 1,285
- Age
- 75
- Location
- Western North Carolina
- Gender
- Female
- Country
- United States
Ahhh...Lynn, this has been the week for BLAHS! I was right there with you yesterday. Today was a brand new day! Who knows where this emotional roller coaster comes from ( probably connected to energy drain?) but we do know IT WILL PASS! Hang in there! You are not alone!
