TKR Recovery Progress Stalled

[DEL2022Jan-23]

It’s been a while since I have posted an update on how I am progressing with my TKR, setback and of course the twice broken toe….
The TKR is ok-ish, I am being slow to say I am getting on with it- one day I am able to move with only a little pain and the next it is like I spent the night running a marathon. I know, I know - it’s a marathon not a race but there are times when the pace slows down so much you feel like you are never going to progress. I also know the setback I had in week 5 pushed me so far back it was almost like being right back at the starting line again.
My exercise is really just steady walking for 20 minutes and then my pedal exerciser for 9 minutes( increasing by 1 minute every few days) all done indoors as it would be unsafe to walk outside due to having a driveway with quite large pebbles- very uneven surface. I do treat myself to music tv as I exercise, I find it distracts me regarding how long I am walking/exercising and being of the early MTV generation it makes it fun for me! I have found repeating the ‘heel, toe’ mantra keeps me aware of my foot placement and posture- it works for me but may not work for everyone. I also use my EMS setting on my Tens machine for my quads, at this stage I use it on quite a high setting but I do feel the benefit from it.
I am doing the activities of daily living, cooking, making the bed, laundry, helping with the pets - all at a sensible safe level, using a chair when possible , taking breaks in between or even during the activity. Stretching, icing when needed, and elevating the knee.
The nerve pain treatment by my GP worked slowly for about a week before I saw any true improvement then it started to really help with the knee buckling and the extra high pain levels which of course helped with the sleeplessness. Treatment was Gabapentin 300mg one tablet twice daily and two tablets at night with Oxycodone 10mg slow release one tablet twice daily and OxyContin 5mg at night if needed for breakthrough pain. There was a re-occurrence of the nerve pain and buckling approx 6 weeks after I started the treatment, I was back using crutches again. After contacting my GP my Gabapentin was increased by 2 tablets per day - because of this I re-adjusted my medication schedule and now take 2 Gabapentin 300mg at 8 hour intervals, 12pm, 8pm and 4am. My symptoms are already settling down again and I have noticed longer sleep intervals, whether it is being caused by the Gabapentin or just that it is finally time for it to happen naturally I don’t know - but I do know I am glad it is happening!
I have reduced my Oxycodone 10mg slow release down to a 5mg slow release and I haven’t had to take the OxyContin 5mg for the last few days- I am a little sore but not enough that I would need to go back on it. I intend to eliminate the Oxycodone 5mg slow release hopefully over the next week or so, fingers crossed.
Regarding the twice broken toe, it still needs to be kept strapped to the toe next to it and is still well bruised and marked, it will be about another 2 weeks before I think it could be left without the strapping. The foot was so swollen that it is only the last couple of days that I could wear shoes, it throbs a bit at night when I take the shoes off and it still doesn’t like the weight of the duvet on it. Could have been worse, at least the skin wasn’t broken and it didn’t go in an unnatural direction! It does make for interesting times using the pedal exerciser, I can’t wear shoes doing it so am extra careful sliding my foot onto the pedal and back off it again. I tried to use the exerciser with shoes but found it hurt the toe too much so shoeless it is!
I found since the surgery my appetite isn’t the same as it used to be, there was some weight loss at the beginning after surgery but I don’t think it is continuing- my temptation would be to increase my exercise as who doesn’t want to lose weight BUT given the combination of TKR and toe I don’t think it would be a smart move on my part
Slow and Steady is the pace!

 

[Rubyroo]

Hang in there my friend! Sending hugs & encouragement!

 

[Sara61]

Good to read your update, you have a very sensible approach, I feels like a couch potato in comparison, as I'm hopeless at doing exercises at home, hence it's a blessing I go to PT twice a week, although he doesn't push me much either. With my left knee it was I the same, and I had a good outcome so not overly worried.
Dieting whilst dealing with a recovery is not a good idea, our bodies need strength, and the odd treat makes us feel happier, yesterday I bought my first hot crossed buns ( Roll on Easter) I has one for tea, covered in Irish butter and Jam ( oink oink) but so good xxx

 

[DEL2022Jan-23]

Oooh hot cross buns!!!
When able I would make the River Cottage recipe for them- I would also eat most of them
Unfortunately my PT was into visualisation for healing my knee- if I thought that would work I would be visualising myself as a millionaire first! Can’t afford to go to private PT and I would not take the risk with Covid and Omicron anyway. So instead I do it all at home with my furry followers

 

[Jaycey]

 

[Sara61]

You are funny fortunately PT is provided by my local hospital complimentary as part of the knee recovery programme ' its held in the hospital and due to the pandemic at any one session there are only 2- 3 people in the room as opposed to in 2019 where there was about 20 so all very well controlled.
We are fortunate to have a very good health care system similar to that of the NHS.

 

[DEL2022Jan-23]

You are very lucky, here it is down to where exactly where you live and the standard can be a little hit and miss. It is free but the one I am allocated to is also a day care unit so there are a lot of people coming and going, they are doing their best but it is just too busy to feel safe going there and that is before you actually get called into the physio unit.
The last time I went there was an older man as a patient who was there with his wife and he was hard of hearing- his physio was shouting so loudly at him that my physio and myself had to wait till he took a breath before we could talk to each other- that was when she suggested visualisation……
So exercising at home is my plan, that and visualising all my millions

 

[Susie-Q]

I'm sorry about your nerve pain and your broken toe . yeah, the last place anyone wants to be right now is at an urgent care or dr's office. So many omicron patients!

 

[CamGram]

Oh no, nerve pain and a broken toe … in addition to your TKR? So very sorry. (I took Gabapentin for nerve pain when I had shingles years ago and it was a Godsend. I hope it works that way for you.)

You made me laugh at your visualization - may I join you?

I’m only about a week behind you in recovery. In addition to improving my extension and flexion, my latest goal is to walk normally - and without pain - down the stairs. I may have to wait until my second TKR to accomplish that, though.

Hope you keep improving!

 

[DEL2022Jan-23]

@CamGram You are welcome anytime!
Yes, I am finding the Gabapentin very good, started at a moderate rate but had to increase the level - it is back working again so I am very happy with it! I am afraid stairs are still beyond me for the moment.

@Susie-Q Thank you!

Please everyone stay safe and stay healthy!

 

[DEL2022Jan-23]

Just an update regarding the”toe” -finally stopped strapping it, it looks mildly odd and a bit lumpy but may have been that way prior to the double breaking- the foot still swells and throbs slightly, when it gets a little more than slightly sore the shoe comes off and I elevate. It bends a little now which is a great improvement on sitting there trying to get it to bend and it stubbornly refusing to. So I regard it a success- now if the knee could just participate nicely I would be happy!
I am down to one lonely OxyContin 5mg at night and I intend to give him the push as soon as I can. I am sticking with the 8 hourly schedule for the two Gabapentin 300mg, it seems to be keeping things under control for the moment, there are still issues with the occasional zingers and trying to get comfortable at night- legs get tingly and then you move and 10 minutes later they tingle again- not quite pain but uncomfortable, both legs involved…. Righty is not quite as bad as lefty was but it certainly doesn’t appreciate being the support leg.
Rather than my walking and pedalling this past week I have been doing more of the ADL or activities of daily living- I finally got the Christmas decorations down, packed into their boxes and all the clean up and re-arranging done- something that would have taken me about 2 hours to do has taken me nearly a week but at least it is done.
I have got a strange one for you, yesterday I decided I would make rice pudding in my crockpot/slow cooker, same recipe I have used for years, same ingredients, no change to anything- I ended up with sweet soup- no other word to describe it! I am stumped and frustrated, I wanted to do something that was normal, that I would do pre knee with my eyes closed- and I ended up with sweet soup….
Before the crockpot incident for the first time since my surgery I was left on my own for most of a day as my husband was in hospital with his consultant - I assured him I had everything under control, after all how hard could it be to look after 4 dogs, 3 cats, have dinner on the table when he arrived home, get a little tidying done before he got back-…. have you ever walked sideways down a slippery stairs with no bannister trying to persuade a dog he really should come in and take his tablets or try to catch 2 cats outside to feed them while they think it is the most wonderful thing to try to trip you, while of course you have forgotten to turn on the oven during this escapade…..I am lucky that nothing other than aches, pains and swelling were the result of my day, lots of icing and elevating took care of it, dinner was late but other than that I survived , as did the dogs and cats.
Sometimes no matter how hard you try to do something, no matter how much you want to do it, even if you have done it a 1,000 times before, sometimes you just end up with sweet soup…..

 

[djklaugh]

Sweet soup indeed! Since I have never made rice pudding I have no clue what could have gone wrong .... maybe one of the standard ingredients was passed it's "use by" date? Or the slow cooker settings were not quite right?

Your purr-a-medic and dog-tor posse is cute and challenging

I am glad the toe is feeling a bit better! When I broke my toe years ago doctor said to buddy tape it and wear flat shoes ... the pain did go away eventually but it (broken toe) still is crooked and does not bend like other toes. For me that's not a big problem so I ignore it now.

 

[Sara61]

You're an absolute hoot, I just love your posts, one can visualise everything you just described , although probably not funny to you at the time but certainly gives us a giggle.
Glad to hear your toe, is getting better, hopefully soon your knees will too.

Yesterday I made the Mary Berry Lemon drizzel tray bake, must admit, it was superb, I'm usually a clot in the kitchen but you can't go wrong with her recipes.

The recipe I have for Rice Pudding was given by a very elderly Portuguese neighbour, it was from her Grandmother, this serves 4 good sized bowls
Basically its 125g long grain white rice, 150g sugar, 1lt semi skimmed milk, 1 egg yolk, 1 tsp butter, a rind of lemon skin, 1 cinnamon stick.
Pre-boil rice in boiling water with a sprinkle of salt for 2 minutes, drain off water. Meanwhile slowly heat milk, sugar, blob of butter, rind, cinnamon stick, add cooked rice and bring to the boil, take a little of the warm liquid and mix with egg yolk, and then stir in the egg yolk, simmer whilst stirring frequently once rice is cooked, remove lemon rind & cinnamon stick- serve either hot or cold ( if served Portuguese style "cold" sprinkle cinnamon on top ,)

 

[DEL2022Jan-23]

@Sara61 oooh that sounds good, must give it a try soon.
I am slightly obsessing on the idea of making cinnamon buns , doing the dough in the bread maker to save on the old arthritis fingers, cinnamon, brown sugar and butter inside and a gooey icing like a cream cheese style icing- next item on my planning board.( we do not discuss diet or calories during our food fantasies)
I feel like everything in my life at the moment is currently like a military campaign- lots and lots of planning before the action starts!

 

[Sara61]

Thank goodness we are all in recovery, as we are encouraged to eat things we enjoy

 

[DEL2022Jan-23]

 

[Susie-Q]

How true is this! I've never made rice pudding but I've eaten it. Hubby even bought some recently in those little plastic cups from the store.

My mother used to make cinnamon rolls on Sunday morning (she'd do the dough the night before and let them rise overnight). I've never had the patience to make them from scratch. We have a family tradition for Christmas morning we buy cinnamon rolls from Cinnabon, an American chain that sells the best, gooiest cinnamon rolls. Ok, now I'm hungry......

I love your posts too, @Eire1 ! So descriptive and visual. Your animal menagerie sure keeps you hopping!

 

[EalingGran]

feel like everything in my life at the moment is currently like a military campaign- lots and lots of planning before the action starts!

Know exactly what you mean- laying out everything needed for shower/ dressing beforehand whereas once I would have casually pottered about the bathroom/ bedroom.