PKR Right knee 9/24...so far so good...

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Well, cutting back on the Tylenol seems to have been a bit ambitious. I turned off my 5:30 alarm just to be awoken at 6am by the knee telling me it needed some attention and drugs. Tylenol and ice later...I'm awake anyway. Oh well. gave my liver the day off so now back to the grindstone for it.
 
I have also had a good recovery both times with no major issues (thought not as speedy as yours) - still taking some Vicodin and of course the Tylenol and Motrin. I read some of the issues others have had and am very thankful mine has been pretty routine. I think it it is important for all of us to post -- the difficult and the more normal so others trying to decide what to do can see that there are many outcomes. Lee
 
There used to be a commercial on TV with a guy dragging himself out of bed in the wee hours muttering "time to make the doughnuts" (Dunkin Doughnuts perhaps?). I find myself in a similar situation with my knee and ice. It is getting better, formerly I was getting up at 2am and staying up for an hour or 2 icing it down and waiting for my next Tylenol (considering a Tramadol or Ibuprophen). Now It is waking me up at about 5am and requiring ice. If I am lucky, I will be back to bed by 6 and get another hour in. If not, this is morning. It isn't horribly painful or anything, just uncomfortable enough to preclude going back to sleep.

I have gotten very used to a bowl of cream of wheat at 5:30. It's not chocolate at midnight, but it isn't bad with some maple syrup on it...

Tomorrow is 5 weeks to the day from the surgery. My recovery has been amazing, on the front edge of what is the normal recovery curve, but I certainly miss a full night's sleep.

On the non-PT PT (I fired the "pros"), I am getting about 20 minutes a day now on the recumbent bike (still at 0 resistance), and trying to do a full set of the exercises I was given. Workout 3 times a week with my personal trainer, who has taken those exercises to heart. ROM is within a few degrees of the other leg (which my trainer has decided we need to increase as well). Drawing the knee up into a tight bend can cause some pops that can be painful, but I am assuming this is the "gravel" people talk about (got one getting out of bed to ice this morning which evaporated whatever sleepiness I had left). My trainer is also concerned with keeping the other limbs in good shape, and wants to keep at least 50% of the weight loss after recovery. I am now doing crunches and reverse crunches in bed. Walking is at probably 70-80%, still on the cane.
 
Well, up again for the pre-dawn icing. While it is irritating, if this is the worst problem I am having at 5 weeks out, then that is a pretty good thing. It's not even really pain, it's just uncomfortable, too much so to get back to sleep without doing something.

My personal trainer was yesterday, a full suite of exercises for the leg, plus as much of a workout as we can get in otherwise. A lot of upper body work and work for the left leg. Also managed to get on the exercise ball for my crunches, although blocked it on the sides for stability and she spotted me pretty heavily. The leg continues to get better every day, I am at 5 weeks to the day today. On the initial injury I was at this point at about 5 MONTHS, so I find my recovery pace just short of biblical. Still sleeping with it elevated mostly, although I will roll to my side with a pillow between my knees at some point. Makes for a crowded bed with a large wedge pillow+a knee pillow+extra knee pillow...and my wife in among all that too somewhere.

Still walking slow, but in the house I find myself walking away from my cane more. Not intentionally, just "I am going across the room, don't need it for that" and then 5 minutes later I am in the back of the house going "where did I leave my stick?". Out in the wild, however, the cane sticks with me like glue. Sidewalks, stairs and curbs (not to mention badly misnamed "safety mats") are all waiting to make me loose face. I used a cane for 6 months after the accident, and got so used to it that it's like second nature to me. The cane isn't a trial at all. Did get some better vitamins (without the ginseng and other garbage) so I am hoping that may help with sleep as well.

Back to bed for round two of sleep (hopefully).
 
Well, yesterday was a good, nay, great day, but I am paying for it this early morning. Had the trainer over again (doing Mon/Tues/Fri), with a good set of exercises (but lighter on the knee this time). Got out of the house a bit, got the CPM machine shipped. When the UPS guy showed up, I was missing some packing tape, but he had some and so we went around to the FX to get it. I was keeping up with him without the cane for a short distance (40 yards) and hardly a limp at all. Of course, was moving fairly fast and had my mind on other things, but sidewalk and 2 steps up and movement like the old days.

I thought I had tonight nailed. I rearranged my meds so at 3:30am I would get the alarm for both Tylenol and Advil, getting the double convergence right when I needed it the most. Then, 20 min for it to take affect and Bob's your uncle. Instead at 3:15 the knee wakes me up and says it is quite upset with me, after an hour for both meds to take affect (and the obligatory cream of wheat at 3:30), I went back to bed with nothing but the knee throbbing to show for the pills. At 5am I gave up and grabbed a tramadol. The best laid plans and all that.

3am is always a bad time. Even in non-surgical conditions, 3am is when the doubts and the dark thoughts come out to play. Probably bad that most of my postings happen at 3am, but, that's when I am up. On the other hand, recapping the day is a good defense for 3am, because the truth about 3am is that it is a lie. I am having a fantastic recovery, I will not have this durn knee pain waking me up forever, and will be back to 110% soon. I am having little or no swelling now (sleeping with the leg elevated helps) and my ROM is very nearly normal.

The thing to remember about 3am is that it's a lie.
 
Well, last night's sleep in a hotel actually went pretty well. I substituted one tylenol/Hydrocodone for one of my usual Tylenols at 9:30 and again at 3:30. Went right back to sleep until the guy in the room next to me was using his door excessively at 6:30. Oh well.

Yesterday went pretty well, although 4 hours worth of sleep took it's toll. Went to bed early tonight and up for my 3:30 drug run (1 tylenol, 1 tylenol/hydrocodone and 2 Aleve today as I ran out of Ibuprofen). Knee is not in as bad of shape as it was Tuesday night, which I am wondering if a frontal passage had some affect on. The personal trainer is today, and I want to keep today more on the stretch/light work side. I am not entirely happy about diving back into the narcotic side of the drug cabinet, but think that the sleep is worth it. Will try slacking off this weekend and see how sleep works without the extras. Beyond that, the knee seems to be doing well. It was raining during the trip and I was being quite careful about cane placement and such, don't need a fall. The swelling is down quite a bit, this morning it looks almost normal.

Tuesday will be 6 weeks. The recovery is still on the front edge of the curve, the nighttime sleeplessness seems to be a normal occurrence. I have started to occasionally bump into limits on stamina, which I think is a good thing, as it means I am doing more. Next week I will have a longer trip on the boards, so we will see how that works. Driving has not seemed to be much of a problem so far, but this will be 4-6 hours.
 
I am also trying to stay of the narcotics but I am finding that with the return to work- evenings and nights need some extra help. Good luck next week on your longer trip.
 
Today has been marginal, personal trainer this morning (we did light work on the knee only) and work all this afternoon. The knee has been complaining somewhat, just got out of a warm bath and now icing. While the discomfort has been irritating, it is part of the healing process, and worth no more comment.

What I did want to comment on was work that should be done to prepare for your convalescence. For the most part it is not expensive and it can be done by anyone handy. I am fortunate in that I have just completed some renovations, and the people who did those were quite happy to come in for a day or 3 to install bars and new toilets.

In at least one bathroom (I would recommend all of them) I would recommend an ADA toilet. They make some seat extensions for regular toilets, but if you are having knee replacement done, a higher toilet will be the gift that keeps on giving. You will also want grab bars for the toilet, grab bars for the shower (outside and inside) and grab bars for the bath. My guys probably installed 25 ft of grab bars in 3 bathrooms. With all that I called them back with a bonus for same day work after my first shower. After getting into the shower using the newly installed bars, I closed the door and suddenly noticed that I was standing in a cube, with a wet floor, using soap (making the floor even slicker) and NOTHING TO HOLD ONTO. 10 ft more of grab bars were installed before my next shower.

I am, like my father and grandfather before him, bull strong in the upper body. I can get in and out of the tub almost completely using the bars and just holding my feet in place. I have bars everywhere now. If whosoever buys this house when we move doesn't like them, they can take them down themselves, they are up for the duration. My wife and I have lived here 20 years, and it is only by the grace of GOD that we haven't fallen getting out of the tub (26 inches deep) without bars previously. I am old enough that such chances don't now bear thinking of.

The renovations included a new front deck, with better rails, and I have put electronic locks on all of the doors. Steps are bad enough, fumbling for keys in the rain while using crutches or a walker? Not worth the 80 bucks for the lock. All of our floors are wood or tile, all the area rugs have been put into storage for the duration. I had several good canes from the time of the accident, I prefer "palm canes". A good set of crutches and/or a good cane will make you feel better about using it, and preclude you trying to get off of it too soon. I have 3 different primary canes, all with different finishes and handles. I have one favorite, but I choose among them each day. I also have, since the accident, kept folding canes in each of the cars for any sort of emergency. I plan on continuing that.

Our furniture had already had the low couch elevated (wooden blocks, with capture points for the legs, quite steady), and any other low furniture culled. I did switch to a chair at the dinner table with arms, something I usually don't like. The aid that the arms give getting to your feet though is worth it.

There are undoubtedly other things, but these (the bars and the toilets) are the most important. I fell once after my surgery, when my walker was caught by a badly misnamed "safety mat". I was very lucky that I wasn't hurt. I don't feel like using my luck up on such a fall a second time. I have other needs for it...<G>
 
Well, made it through the night with just 45 minutes up for pills (and cream of wheat). I suspect I have been messing myself up with the change to a hydrocodone at night, as in the past I have sometimes had trouble sleeping while on them. Last night I decided that I would hit an oxycontin if I didn't sleep, instead of trying to get in front of it with the hydrocodone. Instead, I woke at 3:30 (4:30 CDT), and took the pills and went right back to sleep, waking at 7:30 this morning. I believe whatever transient condition that was causing my leg to wake me has passed, and once I stopped fiddling with the meds, I was able to sleep again.

I ordered a TENs machine today, off of Amazon. Highly rated, relatively inexpensive. I suspect that if it works at all I will be ordering a better one later, but thought I would try it as the pain level continues to drop and I wouldn't mind getting off of the Tylenol and Ibuprofen soon...

I would swear at least a third of the discomfort I am having is off the scar, and I have less scarring that almost anyone's pic I have seen so far. I suppose it might be from under the incision site, but still. Not sure what to do about that (hence the TENs).

Yesterday was a good day.
 
I would swear at least a third of the discomfort I am having is off the scar, and I have less scarring that almost anyone's pic I have seen so far. I suppose it might be from under the incision site, but still. Not sure what to do about that (hence the TENs).

Frankly, I think the answer to this discomfort is TIME and PATIENCE. I know that recovery from a partial is supposed to be very short term according to the hype, but actual experience seems to indicate that it much more in line with recovery from a total. There's a lot of healing going on in that knee which was sliced open with a scalpel and then invaded with saw, hammer, and drill. It's suffered a lot of trauma which is going to take TIME to heal and that requires a lot of PATIENCE from you to let that knee move at its own pace.

The TENS may help you feel better and is perfectly alright to use, but TIME is the real answer.

Take care and keep us posted. We care.
 
Frankly, I think the answer to this discomfort is TIME and PATIENCE. I know that recovery from a partial is supposed to be very short term according to the hype, but actual experience seems to indicate that it much more in line with recovery from a total. There's a lot of healing going on in that knee which was sliced open with a scalpel and then invaded with saw, hammer, and drill. It's suffered a lot of trauma which is going to take TIME to heal and that requires a lot of PATIENCE from you to let that knee move at its own pace.

Oh, I agree totally, and I will say that NOBODY at Mayo Clinic tried snowing me with the "partial will be faster" garbage. My Dr's rational was that a) the outside of my knee was in textbook perfect condition, the injury only affected the inside compartment and b) that her opinion was that I would feel more "natural" with a partial. Her other thought was (I believe, from some other comments that she made) that in the event I needed a revision to a full in the future, that the partial would give a better base to work from.

I swear I am (not more than normal) trying to rush this. As a matter of fact I turn (figurative) back-flips with every day of progress. With the initial injury, i spent from November to May on a cane, and at least 3 of those months were no progress at all. In comparison, the recovery from the surgery has seemed to come at an almost supersonic pace, with that pace even accelerating over the past couple of weeks. I find myself walking away from the cane on an almost daily basis, and I am NOT ready to give it up yet, for my own piece of mind.

The TENS may help you feel better and is perfectly alright to use, but TIME is the real answer.

Take care and keep us posted. We care.

Thank you. I have found this forum not only to be a wealth of information, but a place that I can post my own progress and successes (along with failures) both without worry of censure and in the hope that the stories can help others.

Today is a good day.
 
Hi! I just read through your thread. Glad you found Bonesmart. Seems that you are doing quite well. Congratulations. Time is what is difficult. We all want things to get better quickly. If you want to read an overachiever's thread go ahead and take a look at mine. Sleep was a big issue for me. It took quite some time before I slept through the night. Like 3 1/2 months. Hopefully you will be more successful that me at sleep.

Take care.


Sent from my iPhone using BoneSmart®
 
Well 2 good nights of sleep in a row with just Ibuprofen and Tylenol. Workout this morning, and recumbent bike for 30 minutes, followed by icing. Little or no swelling, but a fair amount of stiffness in the joint. ROM getting better still, although getting some "pops" at the limit of bending, with a bit of ouch involved...

TENs unit supposed to be here today. Quite happy with the sleep, which I am prepared not to have continue...

Workout went well. Starting to bump up into my limits of stamina, which I think is good. Although I have lost quite a bit, time to start getting it back in the upper body and left leg, the right (surgical one) can proceed at it's own pace.

6 weeks post surgery tomorrow....
 
[Bonesmart.org] Right knee 9/24...so far so good...
report, cheetahdriver! You're doing extremely well for 6 weeks. That stiffness thing will be with you for quite awhile. I am almost always a bit stiff if I sit for a long period of time even almost 2 years post op. But upon standing and taking the first few stops, it disappears. Of course, I am a bit older than you---and stiffness is an old age thing :heehee:.

Great that you can be off opiates so soon--I needed them for 12 weeks. And I do hope the ability to get a good night's sleep is not a transitory one 'cause there's nothing better for a body.

Take care and keep up the good work and keep us posted. We care.
 
The six week anniversary!

I would probably be happier if I had slept through the night, although I don't think this time it was the knee. I got up for my 3am pills and instead of my usual cream of wheat snack to get something in my stomach for the ibuprofen to work against, got some lemon pound cake instead. So, indigestion the rest of the morning.. finally back to sleep at 5 and up at 7:30 when the calls for my business started coming in (durn East Coast people, would be a lot better if the world was flat and all on the same time zone..).

Knee continues to improve. Socks are no problem now and I have used the foot a couple of times to move the wedge pillow, a thing I tried last week to much complaint from the knee. It is almost scary how quick this thing is improving over the past week or so...
 
Long trip starting today, 1 full week (all driving). with a weekend at my father's (first visit since the surgery). I have it chopped up into small bites, nothing more than 4 hours until the return at the end, and am perfectly willing and able to trim it as required (but I will be seeing my dad).

One of the things I am going to do is be rigorous about stopping every hour and walking around a bit. I am normally one of those people who will do a 13 hour drive stopping twice for gas and chicken fingers to eat while driving. I am convinced that that will be a mistake for the next year at least (and probably was before..).

Reasonably good night's sleep last night, I substituted the TENs unit for the 4am ice pack. Timing was about the same but seemed to get back to sleep quicker. Did a fair amount of sleeping on my side last night (pillow between the knees) and that seemed to work pretty well. Personal trainer yesterday, she has come on board with enthusiasm, we did the whole suite of exercises for the knee yesterday (with no real downside results). My wife noticed that I am taking stairs with both legs now instead of just one. Still on the cane, and not in a big hurry to get off of it, although I still walk away from it in the house. My recovery is still taking large strides, things that were last week marginal are this week old hat. I am thinking when I get back from the trip, I may start a mile or so (walking at a slow pace) on the treadmill. I feel I don't get enough walking during the day..
 
[Bonesmart.org] Right knee 9/24...so far so good...
Enjoy seeing your Dad----but watch out for the over doing---you want to feel good for your entire visit.

Take care and keep us posted. We care.
 
Thanks for the encouragement.

One thing for those who have gone before, at what point did you start using an elliptical machine. I have a very good precor sitting in the exercise room, but am a bit worried about it....
 
Cheetahdriver . . .a few questions for you. . . . . do you know what type of partial you had? I am going in for my ninth knee surgery at Brigham and Womens on January 6th and this is to receive a conformis unicompartmental which is being made specifically for my leg as I am only 44 years old. Your post has been much help, not that I'm not seasoned with surgeries.
 
I had a uni compartmental replacement of the medial (inside) right knee. I am unique here as I don't know what appliance they used and it isn't in the normal notes I can access with the Mayo Clinic App.

I can tell you a few things. One, the partial will take nearly every bit as long as the recovery from the full, so all of the posts with "full" on them will apply to you too. My Dr at Mayo (who appears to be one of the few who gives you the truth instead of soothing syrup) told me to expect walker for 2-4 weeks, crutches until 6 and a cane thereafter for a bit. I pushed that some, I was crutches at 3 and cane at 4, but my recovery has been quite fast. She said to expect to be back at the point you were at when the surgery occurred at about 3 months (which for me was about 75% of original mobility) and full recovery could take a year or so.

Two, I think younger helps with the recovery a bit and may make pain management a bit more challenging. Be in as good of shape as you can before the surgery, I was doing personal training hard for about 6 months before. I hadn't lost any weight to speak of, but my muscles, especially in the legs, were in as good of shape as they had been in the last 20 years. That has helped in the recovery.

Three, get the best surgeon and hospital you can. Mayo Clinic was where I go for Flight Physical exams (part of it), so I already knew them, and my surgeon was one of the best in the country. My scar can very nearly be used as a straight edge, and the closure looked like a zipper with a 1mm pitch. I could complain about 50 staples, but I am going to have such a small scar that I will not. My tissues were not mishandled and the care afterwards was exemplary.

This was my first major surgery, so you are a long way ahead of me there. Read the articles here about icing, pain management and elevation, don't push it and you will be fine. Feel free to PM me or post either one about questions.
 
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