TKR Seatides Right TKR Recovery

[Samsrf]

Hang in there @Seatides . We have all done it! At my 3 month OS appointment he said that’s the biggest complaint he hears from people is that they feel good due to much and then have to slow down for a while. It is so hard! It is also a lot of perspective. For me, leaning into the slower pace was The best way to cope with the roller coaster. Reading, sitting , praying and chatting (actually calling) people I love was the best way to get through it.

 

[Seatides]

Thanks, @Samsrf! That's what I've been working on, accepting a more gradual, comfortable recovery, knowing that my knee and I will both feel better that way. But now (after 5 weeks and 3 days), I almost feel cranky when I go to physical therapy, not because it's painful, but because I know that my knee is slowly improving every day and will eventually be great, whether I continue with formal PT or not.

Yesterday my therapist saw that my knee was still a little swollen and that, with my leg extended, the back of the knee wasn't quite hitting the table. She said that was fine and I'm doing great and that the swelling will be gone with time. She suggested that I really don't need to continue with the formal PT (I have appointments scheduled for a couple more weeks), so I don't think I will! I'll go tomorrow morning and I see the surgeon tomorrow afternoon. Then I'm planning to go back to work (right here, since I work from home) on Monday. But the PT warned me to set a timer and get up from my computer every 30 minutes, so I will definitely do that. I'll just keep icing and elevating and whatever my knee requires so that my job doesn't interfere with my recovery.

And I just want to add that I realize how fortunate I am not to have to be on my feet all day. I've read some of the posts here by teachers and my heart breaks for them! It must be incredibly difficult to take care of your recovering knee(s) when your job requires you to stand most of the day.

 

[sistersinhim]

It sounds like you're doing quite well for being only 5 weeks out from surgery! Your PT is sensible and sounds like she's honest about your recovery and has been helpful for you.

 

[Seatides]

Thanks, I've been very lucky; things have gone a lot more smoothly than I expected. And you're right, @sistersinhim, the PT's been great. I explained to her and her assistant at the beginning that I had a bad experience last time (i.e., with my first TKR) with a PT who forced my knee and hurt me. I essentially made them promise that they wouldn't hurt me! They didn't.

This time I went to the outpatient PT department right at the hospital where I had my TKR, instead of to a freestanding PT practice. Do you think that makes any difference? They didn't use any of those "modalities" (heat, cold, electrical stimulation) while they worked on someone else. They had fewer patients at one time, so they weren't bouncing from patient to patient to patient. It wasn't spa-like by any means, but I felt like I received more individualized attention, not like I was being moved through a PT assembly line! LOL.

 

[hawk2go]

Hi @Seatides. I'm glad you're doing well and getting ready to return to work. I wish you much success. I returned to work at 5 weeks post op and found that stamina was my biggest challenge. Even though I only worked 1/2 time for 3 weeks, it was tough to get through those 4 hours and I split them up over the course of the day. Here are few things I learned that may be helpful when you return (you may already by aware):
- take your meds
- ice while you work
- use a foot rest or some other device that allows you to shift position frequently
- have a second chair or stool to elevate your leg as one of the shifts in position
- set an alarm to get up and walk about every hour
- rest when you are done (don't be a hero)

 

[Seatides]

Thank you for all these tips, @hawk2go ! I have been following them and I agree that the biggest challenge is the lingering lack of energy. I decided to go back full time; Monday I was ready to call it a day by 2, yesterday I felt OK all day, but today was very busy and I am SO TIRED. But I'm being very good (for me!) about not overcommitting because I want to be helpful, and I'm giving myself little breaks throughout the day instead of pushing through fatigue. Overall these first 3 working days have been good, I think because right now, I'm finding it easier to set my limits and take care of myself and not overdo it than I normally do!

 

[hawk2go]

Good for you. Keep setting your boundaries based on how good you knee feels in the moment and a few days after. I'm rooting for you!

 

[Seatides]

Getting That Guilty Feeling Again (Is It My "Fault"/Am I Doing Something Wrong?)

Hi everyone! It's been 8 weeks and 3 days since my right TKR. I'm almost done with my third full week back at work. I work from home as a medical editor, so I sit at a computer all day. My knee feels great in terms of how good it feels to be able to walk without pain. I take a couple of Aleve in the morning just for my overall morning stiffness and one at bedtime.

What's bothering me is that it's still pretty uncomfortable for me to walk down stairs "normally" -- that is, I still find myself taking one step at a time going down stairs. (Up stairs is fine.) I have to consciously make myself put one foot on one step, then the other foot on the next step. My right knee still feels a little swollen and somewhat stiff and I notice that it hurts a little when going down stairs. I also get those occasional stabbing pains in the knee when I'm off my feet and resting or at bedtime.

I know I have to walk around more to break up the sitting. I should ice and elevate more often. I should be getting out of the house to take walks.

I also don't remember from my first TKR 3 years ago if I had this "issue" with the stairs. Then again, last time I had 12 weeks off from work vs. 6 this time. I don't know if this is "normal" at 59 days after surgery or not. (Probably.) I stopped formal PT just before I went back to work on September 12. I guilt myself by thinking, maybe I should have continued it for a little longer.

I do tend to imagine that I'm fully recovered and do most activities that I did before the TKR. Maybe that's why I feel surprised when my knee still isn't liking going down stairs. Then I start to think, I've done something wrong, and that's why my knee isn't 100% perfect yet.

I think I know the answers to my questions, but I need some reassurance from fellow BoneSmarties. The unfortunate thing is, I feel that I can't ask my surgeon or PT about it because no doubt, they'll say that I SHOULD go back to PT and make me feel that it IS my fault!

I know my "problem" is so minor compared to what so many others are going through. So I appreciate in advance any advice or encouragement! Thank you.

 

[Jockette]

Everything you are feeling, including the guilt and what if’s, is normal. Many of us struggle with stairs at 3 months. We forget that this recovery takes a year, or more, for complete healing. You’re coming along fine.

 

[kneeper]

Jockette makes a great point that *down* stairs usually takes quite a bit longer to be able to do normally. What I did was to do just a few steps normally at first but go one at a time for most. Gradually I'd try doing a couple more.
At three months I was not doing a full flight down normally, but I was making progress.

I so get that it is hard to remember to get up and walk around for a minute or two after you've been working at your desk. You tend to remember when it starts feeling really stiff.

I'm not surprised you are tired with being back at work and don't feel like going for walks. I pretty much came home and crashed (and elevated) my first couple of weeks back at work. Remember that you must be doing some walking and activity just getting ready for work, walking from your car or bus etc. and so on and that counts.

In those early days back at work I did some heel slides or a few minutes on my exercise bike (to warm up) and then maybe a few heel slides at the end of the day (after a session of elevating).

 

[2hips1knee]

Hello Seatides, I'm a little past 6 months since tkr, and had a MUA, I still struggle with going down stairs. I can go up them with ease, but going down, not so much. What I have been doing is going down somewhat sideways, instead of straight down.

 

[hawk2go]

Hi @Seatides - I returned to work from home at 5 weeks with my RTKR and believe that was too early. I was part time for 3 weeks then went to full time. I learned to ice while I worked. I change position frequently so I have a footstool that shifts and would elevate my leg occasionally during the day. I set an alarm on my phone to remind to get up and walk a bit every hour. I had a low end cycler in my home office and a slider for heel slides throughout the day. I did 2 minute stints on the recumbent bike when my knee felt stiff. All of that helped but it took several months before I could sit for 8 or so hours without getting super tired and ending most days in some pain. Luckily as I healed, it took fewer and fewer steps to work out that stiffness that occurred from sitting too long.

As for going down stairs, that is one of the last skills to regain and it far lags behind the ability to go upstairs normally. Kneeper's approach is an excellent way to both assess how you're doing and to improve your ability. Take it easy on yourself. It sounds like you're improving and that is the whole point.

 

[LZeno24601]

Finally figuring out how to actually use the forum. @Seatides I am your surgery buddy for Aug 1. I hope you are doing well! I will be released from PT Wed. Oct 5, and am a little nervous to be "on my own". Dr. Says I am doing fine and should be able to do anything I "need" to do, but I want more. How does your experience feel this time?

 

[Seatides]

Hello @LZeno24601 ! Very nice to meet you! It's funny how being on our own -- I mean, to be done with PT -- is what most of us want; but once we are, then we feel like it's all on us. Then we start to worry that our knees aren't progressing, are progressing too slowly, or are even regressing! So I think I know what you mean about "wanting more." At this point, less than 10 weeks since our TKRs, sure we're getting around fine, and don't have the constant pain we had anymore. I love that both my legs are straight again, not bowed.

But my knee still feels stiff and it doesn't feel comfortable/natural at all when I'm going down stairs. Fortunately, I do know that I had these same concerns last time (almost three years ago), but I still worry and have to keep reminding myself that complete recovery from this procedure can take up to a year or more. It can't be rushed. But I shouldn't be assuming that I know what you mean when you say that you want more! How are you feeling now?

 

[Seatides]

Thank you, Jockette , kneeper , 2hips1knee , hawk2go , and @LZeno24601 ! I feel relieved to hear that it's very "normal" to have discomfort going downstairs for quite a while. It's been less than 10 weeks and I have to remind myself that I didn't return to work until after 12 weeks with my other knee versus 6 weeks with this one. This is my fourth week of sitting full-time at a computer all day. No wonder my poor knee feels stiff! It's true, we seem to think that magically, at 5 or 6 weeks, we can act as though we didn't just have artificial joints installed! No big deal, LOL!

I'm getting better about getting up more often and walking around the house or in my yard a little. The icing and elevating still help and I need to do them more. I have a recumbent bike right near my work area (I work at home) but haven't been using it enough; even just a few minutes here and there would be helpful, I'm sure.

This group is so great! It's so helpful to be able to discuss these things with people who understand.

 

[benne68]

Happy 3 month an-Knee-versary, @Seatides!

Please give us an update when you next stop by. We'd love to hear how you are doing.

 

[Seatides]

Hi @benne68! Yes, yesterday was 3 months (13 weeks on Monday). I think I'm doing well. I unexpectedly had a short bout with what I think was the flu about three weeks ago (low fever, headache/body aches, no appetite); COVID tests were negative. That did wipe me out for a few days, and then it took a few more days to feel like myself again.

About a week ago I was worrying a little about my new knee's progress, so I messaged my orthopedic surgeon's office through the patient portal. My knee still feels a little stiff and puffy at times. I feel the stiffness mostly when going down stairs (which I mentioned the last time I was here) or when I've been sitting for awhile. The puffiness is mostly on the outside (lateral side) of the knee; it sometimes feels tender in that area and on the inside (medial side) of the knee too.

Something different I'm noticing now with this knee that I didn't experience with my left TKR three years ago is clicking! This knee makes a little noise when I bend or extend it. Sometimes I remind myself of the Tin Man in "The Wizard of Oz." I hear it and feel it when I've been sitting at my desk awhile and get up. It creaks! I want to grab a can of oil and lubricate it like the Tin Man did, to loosen it up and help it move smoothly so it doesn't make those rubbing noises or whatever they are. Does the clicking go away eventually?

I work full time sitting at a desk, but have been getting up and walking around more, just around the house in circles or up and down my block. I also try to do 30 minutes about every other day on my Teeter FreeStep (it's kind of a recumbent crosstrainer/stepper, very low impact). I elevate my leg throughout the day but only ice the knee once or twice a day. The only thing I take now for general osteoarthritis is Aleve (naproxen) a couple of times a day.

So to (finally!) make a long story short, I messaged the ortho's office to describe this and asked if maybe there were specific exercises they'd recommend I do. This is what the Nurse Practitioner said: "Some stiffness or occasional tenderness can happen as you are still healing. You should continue with the exercises you learned in physical therapy. You can also use your stationary bike, start off slowly and you can increase the resistance as you can tolerate. Listen to your body and don't push too hard too fast."

I liked what she said! I think I'm still trying to find that happy medium between relative inactivity and then trying to make up for that by maybe doing a little too much. I feel better every day and I love the absence of agonizing pain, so I think I'm back to doing my usual household chores plus more, just because it doesn't hurt.

I'm sorry I haven't been here more! I do stop in and read people's stories and want to comment, because it's all the sharing of our common experiences that's so helpful at BoneSmart. I haven't done enough of that lately because it's usually late and I'm tired when I come here to read! LOL. I need to stop by earlier from now on. Thank you for checking in on me, @benne68!

 

[hawk2go]

I want to grab a can of oil and lubricate it like the Tin Man did, to loosen it up and help it move smoothly

@Seatides, in this case motion is your lotion. I also have a work from home desk job and it was just this month that I realized that I am not stiff after sitting for long periods of time. Previously I had to take 20-30 steps to loosen that knee then as time passed it decreased to 2-3 steps, now BAM! I get up and it acts like a normal, non-arthritic knee. During the 1st 6 months, I kept my stationary bike in the dining room so that I could get a 2 minute stretch in (seat high, no resistance) when I was stiff and that really helped.

The knee clicking is common and will likely fade over time. I still notice some clicking with very specific movements, but they're few and far between. In my OS exam today, the PA noted low level, barely audible clicking when she manipulated the lower leg from side to side on both knees (1 year and 7 years) and mentioned it's quite normal.

 

[Seatides]

@hawk2go , I apologize for my lateness in replying to your very helpful response! I love that "motion is your lotion." It really is true that moving the knee regularly is much more helpful than immobility. Another lotion is simply the passage of time. I wrote the post to which you responded three weeks ago; my knee now is less stiff and less "clicky" (but now it's more like a grinding sound with certain movements). I've even had a couple of instances where I've momentarily forgotten that it's a "fake" knee! That makes you realize how far you've come since those miserable pre-TKR days, doesn't it?

It feels miraculous sometimes. I think of my poor mother who had two terrible knees 40-50 years ago. In the early days of knee replacements, she heard only stories of people who were worse off after the surgery, so she never considered them. I wish she'd had the good fortune to have today's surgical and technological advances available to her! I feel blessed.

And thankful! Happy Thanksgiving, @hawk2go and everyone else who's part of this wonderful BoneSmart community!

 

[benne68]

I've even had a couple of instances where I've momentarily forgotten that it's a "fake" knee!

Isn't that the most amazing feeling? Sounds like you are progressing well.

Happy Thanksgiving.