TKR Round 2, RTKR, a new journey and hope

[Creation]

Day 40 post-op
I feel I am doing good progress. I walk with my cane and sometimes loose it the house because I took a few steps on my own. When I do not walk with my cane, my gait is still showing a limp. I need to focus on doing steady, slow proper steps.
I can manage pain mostly with tylenol and Aleve. I am looking to cut completely the percocet this week. I would still take 1/4 pill once or twice, but I don't think I need this much strenght anymore, it just makes me sleepy!
I have manage to go around a full pedal cycle on my stationary bike, better in the morning, by mid afternoon there is too much inflammation and it wont go around anymore!
I have more energy, can sit with my leg down for 1-2 hours comfortably.

I will ask my OS to schedule me back to work for part time at 10.5 weeks until my 3 month appointment on May 19. We can than review how well I am doing and what my restrictions will be. I think he will restrict some of the travelling, as I regularly am required to drive up to 3 hours a day for my job. My knee being the right, this may be too much for awhile. I was testing this week moving my foot left and right like if I was driving, I could feel pain in my calf, some muscles and knee. i know this well get better in a few weeks but not enough for long travels (1-1.5 hours trips).

Still struggling with stairs, one leg after the other, can not go down, but can do 3 steps up with tkr leg! This is really frustrating, of course if I weight 50 lbs less it would be much easier!

 

[newlybionic]

You are doing well and have had great progress. I think part time work is a good idea to ease back into work. Stairs seem to be the hardest going down for most of us. In time you will be able to handle them.

 

[Creation]

Doing week 7...I have graduated to the lazy boy recliner! Yay! I have noticed that going up and out of it is a very good quad exercise. I am now on tylenol and aleve only for pain. I sleep pretty good, wake up just a few times per night.

I noticed that my lower back has suffered this recovery! By sitting so much, I have lost some strength and my back hurts when I stand for too long. This is frustrating. I now not only need to recover muscle mass for the leg but back too! Grrrr.

Once I can drive, I will go to the pool, this should help!

 

[newlybionic]

As you start to do more walking your back muscles will regain its strength. If you haven't looked into getting new shoes this might be the time. I know my gait was different after my surgery. I wear sneakers at work (and almost everywhere else) so I went to a running store where they examined my old ones and checked my gait and chose a couple of pairs for me to try. They did make a difference.

 

[Creation]

Thanks Newlybionic. I am waiting a few more week before going shoe shopping. I had a pair of sneakers that I wore only a few times and they are very comfortable right now. They keep me steady. I will wear those for a bit, until my walk pattern is set up and I don't need my cane anymore.

 

[Creation]

I had a so so night. My knee was bothering me and I had no positions. The only thing I did different yesterday was climb stairs, I did 4 steps in total with that knee leading. No pain when I did them???? I guess my knee was only pretending!

 

[Creation]

Guilty, guilty, yes I over did it! You start feeling better and then you get busy with your life and the evening comes! Then your knee comes back with a vengeance.
I walked around the house, sat at the computer and went grocery shopping. Iced once for 20 minutes...perfect recipe for an awful night and morning pain!
Well Monday will be a boring day, sitting with my leg up all day and the ice pack! I am upset at myself, 6.5 weeks is not 3 months!!!!
:(

 

[karol723]

We usually don't realize we're overdoing it until it's too late! Just rest today & ice and elevation should get you back on track. Yesterday I was in the car for about 3 hours. Took a ride out east and bought some vinyl records(yeah, they are coming back!). Now when hubby sets up my X-mas gift record player I will be so happy. Anyway, sitting in the car for that long left me stiff and a little achy. I shall be trying to take it easy today, although I do have stuff to do. So, this goes on for awhile, not being able to do as much as we'd like. I think you are doing great and it's just a matter of time before we are back to normal. Hope you have a good day.☺

 

[Creation]

Thanks @karol723,
It just seems that this whole process is a trial and error one....you know once you've done too much!

 

[Creation]

A Bad pain just showed up , as per Josephine's quadrants, the pain is located at RF1 E and at the junction of RF1 E and D. It is sharp and happens when I get up . Other than having done a bit too much standing over the weekend, I do not have anything else that could have done to justify this pain! What could be the cause?
. The pain appeared when getting up from a chair this morning. My OS did say after the surgery that he had a hard time with setting/balancing the RF1 C,D area. i had a valgus.

I have been resting and icing all day yesterday and I am taking it very easy today.
Thanks for your input

 

[referee54]

If you haven't looked into getting new shoes this might be the time. I know my gait was different after my surgery.

I would strongly suggest that when you are ready, you purchase several new pairs of shoes, as your wear pattern, due to the gait issues, will be entirely different, and you will be having a new, normal, and functional gait.

It is also a great way of celebrating the new normalcy and the reclamation of your life and lifestyle that arthritis stole from you!

 

[Creation]

I would strongly suggest that when you are ready, you purchase several new pairs of shoes, as your wear pattern, due to the gait issues, will be entirely different...!

I agree with you referee54. In house I either am barefoot or wearing my moccasins ( flat, no heal, no wear pattern showing). For outside , I have been wearing a new pair of runners. So , I do not believe footwear is at cause! But I do have an external tibial torsion on the right leg. So if I put my foot toes forward, my knee turns inside! I have been trying to be careful to walk with toes out so my knee is looking forward when I walk. I had talked about this to my OS at my 3 week post-op and he said not to worry!

But since walking is not always a thought process, I may be walking with my knee misaligned because of that tibial torsion. I would guesstimate the angle to be 15 ish degrees.

 

[referee54]

But since walking is not always a thought process, I may be walking with my knee misaligned because of that tibial torsion. I would guesstimate the angle to be 15 ish degrees.

I had gait issues after my BTKR, and my PT folks gave me some exercises to do to take care of it. You are right in the idea that walking is not a thought process, but, since "mechanics is muscle memory" I had to concentrate on walking correctly for a while--focusing on what was correct (and it felt weird) until it became a habit.

I would not concern yourself with it now---the pieces will eventually all be put into the puzzle, and you will be on your way!

 

[Timetolive]

@Creation, I don't fully understand what you mean by "tibial torsion". Do you mean your foot turns outward 15 degrees or your knee does? My foot turns out and I have to consciously turn it inward to have it pointing straight ahead. When I asked my OS aobut it, he said that as my quads got stronger, it would take care of it. I feel like I am walking pigeon toed when I turn it in.

 

[Creation]

@Creation, I don't fully understand what you mean by "tibial torsion". it in.

It is the tibia bone that is slightly twisted, see image here:

It does affect my gait because I instinctively put my foot pointing forward which makes my knee turn inward. This cause pressure points at various places. Now that the knee must track in one axis, I have to get used to have my toes point outward so the knee tracks ok!
Before the tkr, the damage in my knee had adapted my alignment in that axis...but was causing pain in other articulations.
It is called : external tibia torsion. It is not severe but enough to cause issues since the knee tkr.

 

[Creation]

My progress seems to have stalled. I have pain at night around 4 am, every night, and it lasts until I get up. Its like my knee does not want to be horizontal anymore! I want be horizontal, I am not done sleeping, but that stupid knee does not care.
This morning, the pain is not going away, like a 3.
I did work my quad, 5 raises sitting on a chair. I should be able at 7 weeks to do this. Maybe there is more muscle damage from the surgery than I thought. This leg quad was very strong pre-op, now it is **** and painfull.
I am going back to work on May 9, and I need to be more functional than I am now. Still can not do any stairs one leg after the other.
Should I take pain med ( already taking max dose of tylenol) to be able to do more)? I have some tylenol 3 at home?

Update: I ended up taking 1/4 percocet, just had enough of the pain!

 

[Celle]

It's still very early in terms of a full recovery, so you are still going to get aches and pains.
There's nothing wrong with taking something for pain relief during the night, but please don't exceed your daily total of Tylenol - you risk liver damage if you do. Many people still need pain medication for as long as 4 months.

Your quad is going to strengthen naturally with normal activity. I think it's too early to start specific strengthening exercises - 3 months is early enough - so give those leg raises a miss for now. Your quad is telling you it isn't ready for them yet.

Remember that it's time that will improve your function, not exercises. You can't hasten you recovery by working hard at it.

 

[Creation]

@Celle, you are so right. I guess I a m growing impatient. It is spring in this part of the world and I wish I could go outside more and be more active.
Dont worry for tylenol I make sure I do not go over the max daily dosage. I had taken 2 tylenol at 6:30 am and waited until 2 pm to take the 1/4 percocet with 1 tylenol.
I went with my son for a short grocery trip ( hubby is gone on business trip). Both legs muscles are aching now after dinner. Just sooooooooo frustrating, I am thinking of going on a vacation all inclusive resort to give myself a break from that knee! Only problem , it has to come with me!

 

[karol723]

Hi Creation, Sorry you have been dealing with pain. It's so annoying after awhile, especially at night when all you want is sleep. I still have a tough time getting comfortable overnight. Pillows all over the place, I keep trying to find the right combination!!! My knees have both been feeling very tight and stiff lately, not sure why. I will try more I've & elevation tomorrow and see if there's any improvement. Hope you have a better night tonight. I'm not on any pain meds, will try some camomile tea tonight. Things will improve soon, st least the weather is getting better.

 

[Creation]

This morning my old 15 1/2 years old schnoodle could not hold it and did her brown thing on the carpet near the door. She was outside 45 min prior to her accident. I can not be upset at her because she is old and has bad health. She as always been a great dog. She has been having the little accidents very rarely just since the past year but over the last month the frequency is picking up.
This morning having to clean this just made me really upset. Scrubbing a carpet knees 1/3 bent, and picking up the water out of the carpet made my back hurt pretty bad! My carpet machine is in the basement so not available! That was so hard to do. I moan and groaned. And now all I am thinking of is, when I go back to work, that old dog will be having more of these accidents because I will be no longer home to put her outside every 2 hours! Grrrrr.
I love the old fury thing but not her condition....