TKR Second TKR complete! Hoping I can ride my Mt bike again soon!

bertschb

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I had my LTKR done in October 2016 and it took a VERY long time for ROM to return. Because of that experience, I’m prepared for another slow recovery for my right knee. I’m an avid mountain bike rider and it took six months before I could ride my bike after my LTKR.

Here’s my experience so far with my RTKR-
Surgery was yesterday morning and completed as outpatient. It took a long time to get the pain under control after surgery so check-out was later in the day.

So far I’m seeing two big differences from my last experience. When I had my left knee done, it felt like it was going to explode when I stood up. Thankfully I haven’t experienced that with my right knee. The other big difference is I’m feeling slightly nauseous all day long. I’ve never experienced that after any of my surgeries. When I get up to walk around, it gets worse. I can only walk around for a couple minutes and I need to lay back down. I’m going to see if cutting back on my meds helps. I usually have Hydrocodone after surgeries but this time I was prescribed Oxycodone. I’ve been taking two 5mg tabs every 5-6 hours.

I purchased the Lounge Doctor pillow recommended here and it seems to work really well. It makes it easy to get my knee elevated without messing with multiple pillows.

I got very little sleep last night so I’m hoping tonight gets better! I’ll start logging my ROM like I did last time just for kicks. My goal is to be back riding my mountain bike at six months. Anything sooner than that will be gravy.

Here’s a drone video I shot last month of my winter mountain bike trail. It was the first time I tried using the active track mode on the drone and I had to ride really slow so it followed me properly. Even then it “lost” me a couple times and stopped right before hitting the ground.
 

Jockette

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Wow, that’s a great video! And you did that with one knee needing a replacement! Wow!

Best wishes for your second recovery. I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​


4. PT or exercise can be useful BUT take note of these

5. At week 4 and after you should follow this

6. Access to these pages on the website

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 

SkiBikeHikeDude

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Nice video bertschb! I'm an avid mountain biker, too, and I'm hoping to be riding before too long. I'm six weeks post surgery today, and I think I might get to start riding the gravel bike outside in a week or so, and then hopefully a mountain bike again at 12 weeks. Hopefully.

I live in WY and started fat biking this winter - I now love snowy single track! It turns really rocky trails into flow trails, and it is challenging but so much fun.

I suffered nausea and dizziness when I'd try to walk the day after my surgery. The hospital thought I was dehydrated so pumped me full of fluids. Personally I think I was reacting to anesthesia and my meds. It cleared up by the afternoon of the day after surgery after I stopped taking all meds. I was able to go back to them by bedtime and felt fine after that. I hope you feel better soon.
 
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bertschb

bertschb

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I suffered nausea and dizziness when I'd try to walk the day after my surgery. The hospital thought I was dehydrated so pumped me full of fluids. Personally I think I was reacting to anesthesia and my meds. It cleared up by the afternoon of the day after surgery after I stopped taking all meds. I was able to go back to them by bedtime and felt fine after that. I hope you feel better soon.

Thanks for sharing this. I'm going to drink some additional fluids and delay the pain meds for a few hours and see what happens.
 

Roy Gardiner

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You could get a static home trainer onto which you could set your own bike. Then you can use it to gain ROM:
  • Set the bike to zero resistance
  • Set the saddle low enough so that a single rotation is a challenge; difficult but not painful. When a rotation becomes easy right from the start, lower the saddle a max of 1cm.
  • Gently turn the pedals, through discomfort but without pain.
  • Continue until the knee is 'warmed up' and the rotation is now easy, or for 2 minutes, whichever is the shorter time.
  • Repeat several/many times a day, but don't go mad. Diminishing returns will apply; my guess is that half a dozen reps would be enough
  • Do not pedal fast or for more than 2 minutes, this is a stretching exercise, not training.
  • And if you get any pain or swelling in the 24 hours after doing this, cut it down until you don't
Here is a bit more chat and some pix and how 'healing' and 'training' are different
 
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bertschb

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So yesterday my pain level was really good and I decided to stretch out the time for taking meds to help with my nausea. I waited 8 hours then took two Tylenol. Nausea was gone but of course pain returned. That was a good trade off for me. Got back on schedule for my pain meds overnight and I'm feeling great this morning (relatively speaking of course). The swelling is less than it was on my left knee and it doesn't feel like my knee is going to explode when I stand up!

So far this second TKR is going much better than the last one. WhooHoo!!!
 

liam2015

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Wowza, that video is amazing and you were fantastic going up and down those hills. I don't know what made me more anxious watching: the downhill or uphill lol. :yikes: It also took me 7 months before I could ride my bike again. After my TKR surgery, I had terrible nausea, no appetite, constipation even though I was taking the prescribed stool softener ~ then when I took a laxative, I got terrible diarrhea. At the 3 week mark, I stopped all meds, put up with the pain and it took 2 more weeks before I felt better.

I recently (Dec. 20) had surgery for broken femur (in hospital a week) and once I got home, I didn't take anything until I was able to weight bear; then I took extra strength Tylenol. (I believe they gave me hydromorphone in hospital). I didn't have any nausea whatsoever this time; even ate the hospital food.
It was lucky that the surgeon prescribed hydromorphone to me, not that I used it, but hubby had a relapse of an old high school knee injury, had to have blood drained from knee; he had 2 more relapses and my hydromorphone helped with the excruciating pain he had. (his e.r. surgeon also prescribed him hydromorphone at his follow-up, so we have extra now). He's a lot better now from going to physio and doing the appropriate exercises. MRI was cancelled due to pandemic and re-scheduled for June 16, to figure out what's going on.

Great that things are improving for you. Keep up whatever you did last time for a successful outcome. You'll be back on your bike again soon. I cannot fathom that you and one other member here had outpatient surgery and home the day after ~ very brave.
 

Pumpkin

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Fun video, enjoyed watching.
Hoping for a smoother recovery for you, and am looking forward to a follow up video when you are able to ride safely.
 
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bertschb

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Wowza, that video is amazing and you were fantastic going up and down those hills. I don't know what made me more anxious watching: the downhill or uphill lol.

I recently (Dec. 20) had surgery for broken femur (in hospital a week)

I cannot fathom that you and one other member here had outpatient surgery and home the day after ~ very brave.

I actually picked the flattest part of the trail I could find because the drone won't adjust the height as it follows you. It was a little unnerving starting it up then riding away - hoping it wouldn't crash. I need to learn more about that auto-track mode. For those who aren't familiar with this technology, I was riding by myself and the drone was following and filming me automatically with no input from anybody.

Really sorry to hear about your broken femur. That sounds horrible.

As for outpatient surgery-
I was actually fine going home the day of surgery. I think I spent two nights in the hospital when I had my left knee replaced 5 years ago. Really all they do is wake you up every couple of hours checking your vitals. I can rest better at home without the constant interruptions.
 

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Wow, I enjoyed your video. You seem to be pretty darn motivated to get on that bike again. Me too. I like to hike and bike... I too had out patient. But I think I got a bit ahead of myself and backing off a bit on PT.
 

BBCG

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Wow, great video BertschB! I've got friends in Central Oregon too who ride over there on their bikes, so maybe you've passed them, or been passed by them, as they, especially Randy, are super-competitive. My first TKR was also in 2016 and here they had me in the hospital for 4 days as a blood clot snuck out from the dressing on the 3rd day. I also react unfavorably to Oxycodone so told them not to give it to me this time, so was only on Tramadol and Tylenol and off all but Tylenol now, at 2 weeks. Last time I was horribly sick, loopy, depressed, unable to progress and with terrible muscle spasms and twitching from nerves. This time, none of that, although I have tools I didn't have before, too. I use a magnesium gel for the nervy twitchy stuff and a herbal tincture (that has some CBD in it) for breakthrough pain or if join the OCID club! (Over Done It Club). My goal is to be able to ride a bike by my birthday at the end of June and get back to riding my Elliptigo by the end of July...so we'll see!
 

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You'll get back on the bike for sure! First season post TKR is all about expanding rom and waking up the quad. I'm into my second season now (TKR April 6th 2020) and have my power back, am becoming able to pedal with the seat dropped, on the downhills.

@SkiBikeHikeDude , are you my friend in Lander?
 

SkiBikeHikeDude

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You'll get back on the bike for sure! First season post TKR is all about expanding rom and waking up the quad. I'm into my second season now (TKR April 6th 2020) and have my power back, am becoming able to pedal with the seat dropped, on the downhills.

@SkiBikeHikeDude , are you my friend in Lander?
Yes, It's me! I am happy to hear you are able to drop your seat now. Seems you've been riding a lot. Awesome!!

I got to 113º flexion with some help yesterday at PT so am hoping I'll be biking soon. I finally was able to pedal on a stationary bike starting just over a week ago, and I'm dying to get outside. Your story gives me hope. . .
 
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bertschb

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Swelling is MUCH better than last time!

TKR comparison.jpg
 
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sistersinhim

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That is a huge difference in the swelling this year.
 

BBCG

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Indeed, that’s a big difference! Mine is much less swollen than last time too, so I wonder what sorts of techniques have changed... I know anesthesia has changed!
 
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bertschb

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Day 5 update-

I took the max dosage of pain pills for the first 2 1/2 days. Didn't have much pain (which was expected) but they plugged me up (which was also expected). Sooooo, I switched to Tylenol for days 3 and 4. They didn't seem to help much so I stopped taking them last night. Pain is fine although when I stand up there is definitely a feeling of pressure on the surgical area. It's pretty uncomfortable but once I start walking around it gets better.

I've been sitting with my knee elevated 23+ hours a day. I use the ice machine most of the time. I get up about once an hour and walk around for a couple minutes with my crutches. After I finish walking around, I lay back down on the couch but let my leg lay "flat" for a couple minutes rather than elevating it.

I'm already going stir crazy but this is my 2nd TKR and I knew what I was getting into. I really don't feel much different today than I did five days ago but I did take my first shower today since surgery and that was awesome!

I've decided not to do PT for this knee. I expect ROM to return VERY slowly and I'm just going to keep doing what I'm doing until it returns - many months from now.

One thing I'm really pleased with for this second TKR is the reduction in swelling. My knee looks much better this time and I'm grateful for that! OK, back to watching Star Trek reruns....
 

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Sounds good, Bertschb! I skipped the evil drugs, too, but Tylenol has helped me quite a bit. Yay for ice machines! I’m now on day 18 and just using ice packs now, maybe 2-4 x a day. I’ve got good buddies in Bend, so if ya need something, let me know and I’ll call them! Good for you to skip the PT, as we know what to do... in many places, it’s not part of the protocol.

Sending healing energy over the Cascades to you!
 

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@bertschb ~ sounds like good progress, sorry about the pain. good for you having the confidence to rehab at home. my current injury is different than yours so I felt I should go to physio. the only thing I like about physio is the massage, TENS, Laser, hot pack and lights turned down low for 20 or 25 minutes. you definitely have the skill and motivation to do this on your own. take care.
 

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