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TKR RTKR February 12th Recovery thread

So, to recap, three weeks post RTKR, I (67f) decided that my PT's approach did not work for me at all. He was introducing weights and resistance bands far too early for me, was not listening to me when I said I was more concerned about function than the number, and that I wanted to concentrate on healing and stretching, not strengthening for the first couple of months at least. Okay, he has expertise in physical therapy, but I have expertise in me. My son, who is a football (soccer) player and coach and has a LOT of experience with knee issues and PT, asked a simple question: do you trust him? When I realised that I didn't, I knew it was time for a change. So I did some research, found a new PT who is very experienced with post-surgery rehab rather than sporting injuries, and went for the first time today. What a difference! He asked a lot of questions about my lifestyle, pointed out ways that I can incorporate PT into everyday activities, measured my flexion/extension once and said we won't be doing it again, because he would rather observe how I'm moving. He got me doing some quite challenging stretching exercises - I like to be challenged - and basically left it up to me to do them as often and as much as I feel like. As he said, every day is different, and only I know what my knee can take at a given time. It is empowering; I feel like I am taking charge of my own recovery.
 
Boy, you are IN CHARGE…..I’m so glad you made this move and it sounds like your new therapist is a “keeper!” I can’t wait to hear how well you’re doing in a couple of weeks.
 
Hi Alice,
It's nice to know that you took matters into your own hands. You sound happy with your new PT and thankfully he seems okay with you setting your limitations. This should allow you to make steady progress with out overdoing it and stalling your recovery. Exciting news...thanks for sharing. Please keep us posted.
Enjoy the weekend!
@Alice Nutter
 
Alice Nutter said:
he has expertise in physical therapy, but I have expertise in me.
Click to expand...
Exactly! No one knows our bodies as well as we do. If we learn what hurts and doesn't, and recover accordingly, we normally have a much better time of it!
 
Happy One Month Anniversary, Alice!
I hope the week is off to a good start and finishes well also.
Keep us posted on your progress, good things to come! :thumb:
@Alice Nutter
 
I am still happy with where I'm at, today, 4 weeks post-op. Taking charge of the recovery process has been good mentally as well as physically, and finally the weather is starting to smile on us and I can walk all the way down my driveway without hitting ice.

I sat on my motorcycle the other day - just sat on it, hefted it upright to see how it felt holding it on my new strong knee, which was much better than my old rickety knee, and tentatively put my foot on the footpeg to see if a) I could do it and b) if I would be able to use that foot to brake. The answer to that was a) stiff but okay and b) yes, no doubt. I'm not going to be riding any time very soon, because I know I'm not ready for that and I know it wouldn't be comfortable for long, but just knowing that it's going to be physically possible in the future is cheering.

My concerns, which are not overwhelming, are the following.

1) Swelling. My knee is still +/- 4cm bigger than the other knee, and in spite of increasing the amount of time I spend icing & elevating, the swelling doesn't seem to be going down. It has stopped increasing, but it would be reassuring if it diminished. My knee was quite swollen going into surgery, and I suspect that has something to do with it, but this amount of swelling kicked in about a week post-op and has stayed pretty much the same ever since. My new PT said not to worry, but I do.

2) how much activity is too much activity? I don't do the same exercises every day, I switch between the original ones (quad sets, heel slides etc) and the new ones (stretching, standing from a sitting position). I also do at least two x 10 minutes on the upright bike, which feels really good, and walk between 2500 & 3000 steps a day. Walking also feels good; I use my cane if I feel my opposite hip nagging me, which it does if I limp at all.

3) lack of stamina/fatigue. It's hard to get a good night's sleep - I have been a restless sleeper with several waking periods during the night for the past ten years or so, but between my natural tendency to wake up anyway, and the discomfort, I don't feel like I'm getting much rest. I nap for more or less an hour every day, but even so feel exhausted after doing any activity, like PT or going shopping. I suspect all this is quite normal, but it's frustrating.

Oh and I still have a few tiny scabs on my incision. I wish they'd go away.
 
Alice Nutter said:
but just knowing that it's going to be physically possible in the future is cheering.
Click to expand...
Definitely a bright spot in your recovery!

Swelling can and will take a while to settle down, and it will fluctuate, depending on your activity.

Alice Nutter said:
I nap for more or less an hour every day, but even so feel exhausted after doing any activity, like PT or going shopping. I suspect all this is quite normal, but it's frustrating.
Click to expand...
Definitely normal. The energy drain of healing is huge.

It sounds like you’re doing very well!
 
Jockette said:
Alice Nutter said:
but just knowing that it's going to be physically possible in the future is cheering.
Click to expand...
Definitely a bright spot in your recovery!

Swelling can and will take a while to settle down, and it will fluctuate, depending on your activity.

Alice Nutter said:
I nap for more or less an hour every day, but even so feel exhausted after doing any activity, like PT or going shopping. I suspect all this is quite normal, but it's frustrating.
Click to expand...
Definitely normal. The energy drain of healing is huge.

It sounds like you’re doing very well!
Click to expand...
The swelling doesn’t fluctuate downwards. It fluctuates up a bit, then back down to +4 cm. I think I will ask at PT tomorrow what they think, and maybe contact the surgical team. They are very responsive.
 
At “only” a month post op, swelling is to be expected. The surgery caused major trauma inside your leg. Healing takes time.
 
Most people have swelling for months. At one month out, it is to be expected. There is nothing for you to worry about.
 
My suggestion on swelling.... Seriously... Is to stop measuring it.
I find the happiest recoveries have little to do with tracking numbers and everything to do with noting small functional milestones.
 
What you’re experiencing is very normal. You’re doing well.

It will help if you don’t try to hurry your recovery. It’s possible that your knee may remain somewhat swollen for a long time. Go back and read your post from last Friday (Post #42) where you were talking about working on function and strength for a couple of months at least. Please try to keep that mindset because you are a long way from “a couple of months” right now. I don’t know when you will be able to ride your motorcycle, but perhaps you should set a date of evaluating that at about 6 months out from your surgery. One thing is for sure, you don’t want to push this too fast. Motorcycles are not the same as driving an automobile and you don’t want to risk an accident that would put you back at square one or worse. Talk to your surgeon or your therapist about a realistic date to resume motorcycle riding. Then you won't be tempted to test things too soon.
 
Thank you for sending me back to that post; it was very helpful. As was Mendogal's advice to stop measuring the swelling. I wrestle with anxiety as well as the knee, and that's an exhausting and constant battle. I will not ride my motorcycle before I know that I am as safe as can be doing so; I learnt to ride late in life and am prudent, and well aware of the inherent dangers. I never ride when I'm tired, or out of sorts, or when the weather impacts safety, and I'm quite lucid about this. Yes, when you get on a bike it's a calculated risk, but also yes, it's calculated. I will talk to both the PT people and the surgeon about it though. Right now I doubt if I could pull my riding pants up over my poor knee anyhow!
 
It's not just the risk of having an accident, a motorcycle has lots of vibrations and that will be very painful on a healing knee. Most people find that it takes at least a year to be fully recover, some even more. You don't want to add to your pain and swelling by riding your bike before your knee is healed enough that the positions and vibrations don't cause you to have a setback. It just won't be worth it!
 
Alice Nutter said:
I will not ride my motorcycle before I know that I am as safe as can be doing so; I learnt to ride late in life and am prudent, and well aware of the inherent dangers.
Click to expand...
I am sure you're not a wild child bike rider at 67 yrs of age. :wink: :hog: Lol.
An awareness of the dangers is necessary for obvious reasons. You need strength in that new knee for quick stops, and balancing also. If you need to put a foot down suddenly, your knee must be able to handle the force without buckling. Swinging your leg over the seat can / will be challenging if you have stiffness or limited flexion. Riding does put stress on the joints with the vibrations, bumps and road conditions. Good to know you'll be talking with your PT about this and it wouldn't hurt to get your OS's nod of approval also.
Enjoy those rides, Alice Nutter, when the time is right. :)
Alice Nutter said:
stop measuring the swelling. I wrestle with anxiety as well as the knee, and that's an exhausting and constant battle.
Click to expand...
I was informed very early on by both my OS and PA that swelling can last a full year for some, normally decreasing over time. So try to give yourself a mental break in worrying about this since you're only one month post op.
Be like Scarlett O'Hara from Gone with the Wind in your thinking about the swelling..."I can't think about that right now. If I do, I'll go crazy. I'll think about that tomorrow"
Protect your peace, Alice Nutter :yes: Happy Thursday...hope its a good one!
 
Now for sleep...
Alice Nutter said:
3) lack of stamina/fatigue. It's hard to get a good night's sleep - I have been a restless sleeper with several waking periods during the night for the past ten years or so,
Click to expand...
I am sorry you're finding it difficult to get the restorative rest we all want post op.

Pillows certainly help me get comfortable in bed, making it easier to fall asleep. You can experiment with different arrangements to find what works for you. I surrounded myself with them so I could rest a leg, or arm easily enough, whatever felt comfortable. Doing whatever you can to basically "set the scene" for sleep may be worthwhile. I suggest making up the bed with your most comfortable bedding / blankets along with a few extra bed pillows of different degrees of firmness. Try to block out the light if it's daytime. Minimize noise unless you feel listening to calming relaxation music, a fan, or white noise may help lull you to sleep. Make sure the room temperature is not too hot or too cold. Try to disconnect from the devices at least an hour before the targeted nap or bed time, so it's easier to wind down. Limit caffeine throughout the day and consider natural sleep aids such as Valerian, Chamomile or, Magnesium, my personal favorite, which can assist in muscle relaxation and nerves and promote healthy sleep (falling asleep and staying asleep)

Apply ice for a time before bed to reduce swelling and numb the discomfort. Try some relaxation techniques if you feel they may work for you such as deep breathing, prayer or meditation or even some gentle stretching may help relax your body and mind.

An article on Magnesium from our Library -
https://bonesmart.org/forum/threads/magnesium-is-a-star.20301/

Most large grocers carry a variety of teas such as Celestial Seasonings - Sleepytime Herb Tea,
Yogi Teas, Bedtime, Bigelow Cozy Chamomile, all of which may help you relax...at least worth a try.

Time will also help, but that takes patience, especially when you're restless and tossing and turning all night.
Wishing you many nights of peaceful sleep soon!
 
Now I've got a stomach bug - day 2 which is definitely better than day 1 - and I have been really catching up on my sleeping! Had to skip a session with the new PT, which was a shame. It's most unusual for me not to want to eat, so I knew there was something wrong. It does mean I've been icing & elevating more than usual; every cloud has a silver lining?
 
Oh no! I am so sorry. Thankfully you're feeling better today than yesterday and you're remaining positive in recognizing the benefits of icing and elevating more, as well as getting more sleep! I hope tomorrow feels brighter, Alice Nutter and you're back to feeling like your old self soon.
Healing hugs! :console2:
@Alice Nutter
 
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