TKR Second TKR Done, but still not very patient

[JackiFL]

I'm the original "fat girl with fat legs" and my ROM/flexion has been wonderful, oddly enough... even post op day 1.

I'm sorry that he was rude, in his phrasing, and perhaps also inaccurate?

Well aware that I'm fat and how my weight has affected my daily life, my knees and more. Doctors have discussed my weight with me with varying degrees of compassion, awareness, helpfulness and, at times, scorn. They're human, after all, with their own biases and such.

Hang in there, chicky!
Jacki

 

[Ellejay]

Hi Ellen, I just love the idea of you being 7 foot 6 inches it made me laugh. Well done for all your efforts in the pool, you'll be leaping around before you know it.
xxx

 

[jeano]

Your sitting on a pool noodle in the water and walking exercise sounds inspired to me, the equivalent of scootching around on an office chair with the added benefit of buoyancy and therefore less effort and I would think less force throught the knee joint, which would mean LESS swelling as a consequence of the activity and very likely a few extra precious degrees of ROM. I have been wondering for a while about the degree to which a post op knee can meet or exceed the ROM of the pre-op knee--one of the deciding factors for me to submit to a KR in the first place was when I became aware that I was losing ROM in the right leg. As it happened that wasnt the knee that got replaced--now the right has a bit more ROM than the left, but also has improved since before the surgery now that it isnt compensating for the other knee.

Ellen, are you having any issues with tendons and muscles that might be effecting your ROM? At this point in my recovery I feel like the ileo tibial band is preventing me from having even better ROM since that is what feels tight and protests, much more than the medial side where the implant is, although my kneecap still isnt as mobile as I'd like--probably I should work on wiggling it around more.

 

[leejaa]

The pool sounds wonderful. That might really help you stretch the leg without trying (best way). You really had limited flexion before the surgery also so have had an extra hard road. Another celebration Ellen --

I am 30miles away from closest YMCA to do any pool stuff and the hours are not conducive to anyone working unless they live nearby. I know I could make the effort but I really cannot stay awake that late if I go out at 7p or later. When I worked different hours and worked closer to the Y- I loved the water aerobics with no impact on my knee and not really sweating since you are already wet.

I am riding my recumbent exercise bike a 2-3/wk starting this week, before this only 1x/wk. Wed I did 5m in 23 minutes at level 3 and felt really proud of myself - I was stuck on doing 5m and wanted to get off the bike so forced myself periodically to pedal fast. Celebrating that and feeling good.

 

[NetballKnees]

Yaay Lee @leejaa for the improvement in the bike riding. How fantastic. I am so looking forward to the time I can ride the bike like I used to, but am so so scared I won't be able to. My surgeon did say that maybe I won't get more than 90 if I get to it and that is not enough to ride a bike. And don't worry, I wouldn't be making an effort to go 30miles to a pool either. The local pool is on my way home.

@jeano ... That is a good question. Can post-op knee exceed the ROM of the pre-op knee? My knee is bigger now, but that is swelling still and apparently I had a ROM of 100 pre-op and I still managed to ride the bike and participate in RPM and Cycle Express classes. Fingers crossed I can get back to there and do them again. I'm not sure about the tendons and muscles Jean. I am quite embarrassingly ignorant of the mechanics of the knee. I know my quads are strong, probably because of all the bike riding and my hamstrings are tight, which my PT and I are going to start working on. I do have a pain in the medial collateral ligament area of the surgical knee (I know it is this area because it is the same pain as the one in the non-surgical knee, which was diagnosed by my GP). I think I will have to start seriously addressing my weight issues and see if it becomes easier over time. To be honest, I have no idea where my kneecap is hidden under all the fat and swelling and fluid.

@Ellejay thanks for your visit. I am quite tall enough really and 7' 6" - (I so love that yikes face). I am 5' 10" (175cm).

@JackiFL ... I have seen a photo of your legs and I don't think they're fat at all. Mine are actually huge. I used to affectionately call them tree trunks and pretend I was wary of dogs getting to close to them, in case they cocked their leg. (well, by affectionately, I guess you could say I used to say something before anyone else could). Surprisingly, from the top of the hips up, I am a lot smaller. They tell me it's healthier to not carry the weight around the stomach.

Hi JoAnne @Jozilla .. It is really funny how the whole size thing works. I had 4 children - the 3 boys are all over 6' and my daughter is about 5' 6" and has never forgiven me for it I don't think. She was a great netball player (I taught her everything she knew ) and did play in rep teams, but was told a lot that if she was taller, she could go further. Still, good things come in small packages you know.

I won't make this post a War and Peace one, but will post another underneath with some questions and things that are occupying my mind at the moment and please feel free, anyone, to offer some advice or point out things etc.

Have a great weekend everyone and take care and be KIND to yourselves ...

Warm Hugs ... Ellen

 

[NetballKnees]

Okay fellow Bonesmarties ... here is my pickle at the moment. I knew right from the start that my right knee was in the same state as my left - bone on bone and the only alternative was a replacement. My OS and I chose to do the left one first because it was the one that kept locking up and causing the most problems. I was never offered a BTKR and even with the trouble I have had with my bend, if I had my time over, I would have had one.

My right knee now gives way and is very painful and also has that medial collateral ligament strain/?tear that was diagnosed 2 weeks after this TKR. It is not strong, is no help whatsoever in my recovery of the TKR and I am wondering if it will improve.

Next year, which is the year I turn 60, a group of friends and I are going on my dream holiday - Hawaii, Alaska and Canada and bits and pieces of US. At the moment, no matter how good the bend in my TKR may become beg, I would still be severely restricted in what I could do and where I could go.

Now, my quandary is this - do I have the right leg done sooner rather than later, finish recovering the left knee and recover the right at the same time or do I just work on getting the left leg stronger and just cope as best I could with the limitations. I know the left leg is really strong even though it doesn't bend too well and I actually use my crutch to support the non-surgical leg. If the non-surgical leg was stronger, I would not even need a crutch and/or cane unless in unfamiliar and uneven terrain.

So, what to do, what to do Does anyone have any advice, suggestions, personal experience they could possibly help me with?

Many thanks for listening ...
Ellen

 

[DogLoverx3]

Oh goodness Ellen (I'm 5'10" too btw), that's quite the quandry. If your non surgical leg is already giving you so many challenges, I can't see it getting any better before your dream trip next year and will only get worse. While I can think of nothing I would like to do LESS than go through this process again (I hear that day will come though), I might tend to lean towards doing it sooner than later? Just like every recovery is different, every leg's recovery is different. Your next could be better, worse, or the same. Who's to know?

I'm quite certain that I am absolutely no help in weighing in, but heaven forbid I keep my opinion to myself, ya' know. ;-) You want to give yourself every opportunity to be the best you can be for your wonderful trip next year.

Look at all the bilateralls on here and how great they are doing. While my OS doesn't even give that option, I think your next might *fingers crossed* be loads easier in that you're fully aware of what's to come.

As far as ROM goes, I have been told that ROM will not get better post TKR than it was before. But oddly enough, I've been wrong before. (let's just keep that between you and me)

xoxoxxoxo

 

[Jozilla]

Hi Ellen - I am in the same situation. My non operated knee is also ready to be done whenever I am mentally ready. I totally understand the hesitancy but I would also go ahead and schedule it now. I am scared as I keep thinking I had a very fortunate recovery with my right knee but what are the odds it would be so good again with the left? I am going to do it though and just have to figure out when but probably not for about six months. I also still need a cane outside because of this. If i find out if i am still unable to do things as the weather improves I will schedule it sooner. With such a big trip coming up, if it were me, I would do it the sooner the better. I am sure this trip which sounds spectacular will involve lots of walking and I would want to give myself the best shot of that! As you tell all of us be kind to yourself. We are here to support whatever decision you make.

JoAnne
Xoxoxo

 

[leejaa]

Ellen, as you can see from my postings, I had the right knee done as soon as I could (mainly work related decision as to when) when I could and my right knee was not as painful or difficult as yours. It did hurt like heck if I did any walking so I thought I might as well get this one fixed too now (yes, I was scared again if it did not go well or the usual stuff). It worked for me. In fact my aha moment was after the lt. knee surgery when I went to the store, I was shocked to have pain -- I was still on pain meds - and then I realized it was the unoperated knee that was hurting and not my new knee. I had forgotten about it since the unoperated knee only hurt with use. It was my aha moment and I just reminded myself that I still could not fully reclaim activities due to that knee.

My OS would have done a bilateral but due to work issues I felt it was better to split it up. For me also, I knew I would have to go to rehab after a bilateral and I wanted control over my recovery and to be at home so I did not have to argue with caretakers as to what I should do when or what to eat or sit or get up.

I can only state what I did and why. This is a hard choice but for you it sounds like the crutch is for the unoperated knee. You do not have it as a support and perhaps having it replaced sooner than later will make the recovery on both knees better. It is an unknown but at least it is some action and doing something for yourself before your tendons and muscles shorten and tighten on that knee also and recovery could take longer.

Hard choices for all of us at those times but keep reacching for your life as you want it and so you can enjoy it. Hugs to you. Lee

 

[kneeper]

Sorry your other knee is going downhill. And right now while your other knee is recovering it's probably taking more load.

 

[jeano]

I'd get the other knee done and make contingency plans for traveling insofar as double checking about handicapped accessible accommodations--PLENTY of people travel who are permanently and completely confined to wheelchairs and I dont think you'll be that badly off. My former sister in law who is morbidly obese, diabetic, and an amputee goes on cruises and such and as far as I know she cannot walk At All.

What are you defining as "severely limited in what I could do and where I could go????" You probably couldnt kayak or go ice-climbing in Alaska or firewalking in Hawaii but most of your friends if they are 60ish couldnt or wouldnt want to if they could! We cant take a vacation when we are 60 and do the stuff we could do when we were 20 and didnt have the money to take the vacation. When my Ancient Mother was well into her 70s she was the most able bodied of her friends and they went on marathon driving vacations and she pushed the wheelchairs! One had MS and couldnt walk at all, and the other one had chronic foot and other orthopedic issues and her ability to walk was extremely limited. The latter would fly here with her little rollvater walker. She could be pushed short distances sitting on it and could push it when she was up for walking. They did all kinds of touristy things, museums, sightseeing, shows, restaurants.

It will be all right for you to need a little help from your friends. They wont feel rained on--they are going on this trip with you because they love you and value your company, not because they want to admire your physical prowess. It'll be OK if you wave bye-bye to them when they go out for a 6 hour trail ride with Canadian cowboys or whatever it is you have planned--you'll be laughing at them when they cant walk the next day and are moaning that they should have known better!

Right before, I mean like 10 days before my knee surgery I went on a short but intense trip with my two best girlfriends--this involved driving hundreds of miles, negotiating the Mount Everest of stairways in one's home, hiking many city blocks and going on an all day train excursion, also a trip to a huge State Fair. I had bone on bone knee pain, braces that pinched, had to be enthroned in the front seat of the car and exempt from most driving duties, couldnt tote my fair share of any of the luggage, and was sucking down one friend's Vicodin because I didnt have any. We had a wonderful time anyway, and my only regret is that I didnt get the knee done 2 months earlier. If any pain is controlled I dont think your dream trip will need to be cancelled or postponed, provided you have healed sufficiently to tolerate the trans-Pacific flight. Your friends will love helping you with any little obstacles that arise.

 

[referee54]

Now, my quandary is this - do I have the right leg done sooner rather than later, finish recovering the left knee and recover the right at the same time or do I just work on getting the left leg stronger and just cope as best I could with the limitations.

I would get it done as soon as your surgical knee can handle the work load. Many of our members here have had one done and the next one done a few days, weeks, or months later.

If you want to not only enjoy the trip and the amazing vacation, as well as your life, the only way to truly do it is to get the other knee taken care of---otherwise, pain, limitations, and locking-ups will be a constant part of your lifestyle.

 

[GimpyGal]

Ellen, I've been thinking about what I'd do in your situation. And, as much as I'm not ready to have my other knee done yet (how can I face that so soon?) I think you might be ready. My mother said her recovery from her second one was so much easier. Not because she knew what to expect, but because she trusted the knee that was operated on first. You don't trust your un-operated on knee now - you can't. Your good knee is now your operated on knee.

Do you have other considerations like sick leave to consider? Are you relying on someone to help you after surgery? Or can you make this work. Your dream vacation will be easier with the most recovery behind you.

And then, there's the knowledge that I've never heard anyone say they wished they had waited. It's always, "I wish I'd done this sooner."

Hard decisions. Sometimes I wish we all lived in a little community where we could support each other in person!

 

[Ellejay]

Hi Ellen,
I find I'm in exactly your situation, nearly 4 weeks after my RTKR and I find my left knee is the one that is slowing me down, stopping me walking properly. I'm going to have a guided cortisone injection in it soon so hopefully that will help for a while, but when to get the left knee operated on????? That is the big question.

 

[NetballKnees]

Hello everyone and thanks so much for your advice - @DogLoverx3 @Joilla @leejaa @kneeper @jeano @referee54 @Ellejay @GimpyGal - I appreciate so much you all taking the time to help me with my "dilemma". I am going to see the orthopaedic surgeon again in April for a 6 month check-up and then I will broach the subject of when to do the right knee. I have decided I would like it done as soon as possible after June (my son's wedding is in June).

The new knee is so strong - the only problem being swelling (still), numbness and its inability to bend. I tried an experiment the other day and while in the kitchen stood entirely on the leg with the new knee, balanced only by a finger on the bench. I held this for 45seconds before moving slightly to one side. I then tried on the leg with the old knee and used the same, obviously very strong finger, and if I lasted 3 seconds I would probably be exaggerating. So it HAS to be done.

Jean - my group of friends who are all younger than me and in their late 50s still - are quite the little machines and still do everything they would do if they were in their 20s and 30s. The activities you mentioned - kayak (I adore kayaking, canoeing, rowing anything) and ice-walking are all things that they would want to do and probably could and will. Fire walking is probably something we will all leave to the experts. And I would probably be the first to want to go on a 6-hour trail ride with Canadian cowboys, but I wouldn't because horses frighten me - they are such lovely animals and so BIG. I have tried riding a couple of times, and was uneasy the whole time, which of course the horse senses. And I know plenty of people with much more severe impairments than mine travel and travel a lot and get so much enjoyment from it. I sort of just wanted to be the best me that I could be to ensure that I could get the best out of this, what will be for me, a once in a lifetime trip. I doubt that I could afford to travel again after this one.

I am still going to the gym a couple of times a week and riding the bike backwards and forwards. I am no closer to doing a full rotation than I was 6 weeks ago, but I still persist. If my doctor is correct and maybe I won't get much better than 90, my bike riding days are behind me - which to me is very sad. I have tried all 3 styles of bikes - the recumbent (which I found very hard, even though others find it the easiest); the spin bike (which is my favourite but now is the hardest for me to do) and the upright (which is just right, except I still can't do a full rotation). I have the seat so high up that I am almost straight legged, but even with lifting the hip and other such adjustments, it is no go. That is probably the hardest for me to come to terms with. Last night at the gym I was on the upright bike, doing my backwards and forwards bit with tears streaming down my face in sadness and frustration. Still, at least I can get on one, a lot of people can't even do that.

BUT I did discover that I can use the elliptical. I hate the elliptical, but if it is the only thing available to me, then I will learn to love it. My first instinct was to go for ages, but managed to rein myself in and do 5 minutes and then 7 minutes the next time. This is with no resistance and I will gradually increase the time before I increase the resistance to anything. I am enjoying personal training again - upper body workouts only, but I feel "normal" doing them.

The rowing machine is also another favourite of mine - but it is too low to the ground. I don't think I will ever be able to get closer to the ground than chair height again. Getting down might be one thing, but getting back up again

Have had a few problems this week with the entire surgical leg swelling - right down to the toes, which were like little fat sausages. It is probably from having the leg down so much during the day at work I suppose.

Today is a "don't look at me or I will burst into tears" kind of day. They still happen occasionally and for no reason that I can think of - just being a sook I suppose.

Anyway, I will try to visit some of you today and see how you are getting on.

Once again thanks for taking the time to visit and provide advice. Take care everyone ...

Hugs ... Ellen

 

[pakline]

Hello, hello Ellen, you sound in good spirits & that is good. Even little achievements are worthy of note. I am not going to commit an opinion on having your other knee done..........at the moment I would be in no rush, but that is me & you have future plans which will need you to be as strong as you can be & as well as you can be, so really you already know which direction you will go. I saw my OS today & surprisingly she was pleased with my progress. She did say that my knee was in such a mess that she's surprised I've done as well as I have. I took that as a kind of backhanded compliment! I told her about my quad muscle being so weak I can't life my leg to do a fast stop in the car if needed. She said it will take time but it will happen (reminded me of a haircare ad that was on TV years ago) and suggested I get a pedal gizmo to have on the floor when I'm watching TV or the like and pedal away to get the muscle awake & working again. It has been atrophied for so long it's going to take a while to kick into gear again, but, it will happen! I saw the podiatrist also today & she did my toenails so next Monday I start with the stockings - hopefully the weather will be a bit more user friendly by then! I didn't want to snag my new hosiery ($243 worth) with rough toenails!Hope everyone is well today. Love to all. Kerry

 

[Ellejay]

Oh Ellen, I do hope your bike riding days aren't over, that is the thing I'm really looking forward to getting back to, I'm sure you are. I bought myself an electric bike so I could keep going when my knees were bad, it has three levels of power assist, and when things get really hard, I can use it on throttle only. But I still need to be able to pedal, which at the moment is still impossible. My husband and I were hoping to use our bikes a lot now we are both retired, I will keep working towards that goal. I bought myself one of those pedal exercises which I use for a couple of minutes at a time throughout the day, hopefully it will help. I attended my second group physio session yesterday, it went well but I don't seem to have progressed since last week. The therapists were pleased with me, they said I'm doing well for nearly four weeks, but doesn't it go slowly? It is so hard to keep sitting here and not doing anything to push myself too hard. I haven't been back to the gym yet, I thought I'd wait until the six week check which is also when the PT sessions finish. My local gym has a special 'over 50s' room where all the equipment is motorised, so even if you are not strong enough to do the full movement the machine does it for you, and your joints still experience the full range of movement. Nothing is forced, you can push against the machine if you want greater resistance. I found it really good to prepare my muscles for the operation, so I will return there in a couple of weeks to begin to strengthen them again.
It's good to chat to you, I hope you have a good day. xx

 

[kneeper]

Just the right thing with the eliptical--tougher than it looks.
I'm afraid of the eliptical with my unstable knee just getting on and off the thing But maybe next year at this time.

 

[leejaa]

Ellen, I believe you will bike again. You have such determination and maybe once your other knee is stronger this one will compete and do better and bend more if the swelling goes down--you know just like kids wanting to outdo each other.

I am riding my recumbent bike about 2x/wk doing 8miles so far in about 30 min at level 3. Trying to get to 10m in 30min and then I will have to try some of the other programs that go up higher and vary the fake terrain. The one think I have to also start is upper body - I just realized I have become a whimp in my upper body and will need to build up. You are smart to have already started doing that.

We all have down days - and still get a little weepy even when doing well. I really think some of that is still the body adjusting to all the trauma and continued recovery.

Take care and have a good day. Lee

 

[NetballKnees]

Thanks again everyone for your lovely visits and support and encouragement. Unfortunately, I am not in a good place at the moment. I find I am turning into a bitter, frustrated person. Although I do not post much any more, I still read and while I am happy for those that achieve great results with ROM, I feel myself getting more and more envious. I watch the people who go scooting past me in the halls at work with sadness and glaring eyes. Everything is so much effort. Hard to get up and moving in the morning, hard to put underpants on (I am so sick of having to site just to get them on and long for the days when I could stand and just put in one leg after the other); hard to get in the car, harder to get out of the car at work; hard to walk from the carpark into work, hard to walk between offices as necessary and hard to sit for long periods and by lunchtime, hard to get back out of the office chair. The other day I was so frustrated at not being able to reach something across the desk, even after I stood up and reached across and then knocked over a couple of things and couldn't get the crutch off my arm, that I eventually picked up the crutch and slammed it down on the floor. The others in the office thought I had fallen off the chair and rushed over only to find me standing up glaring down at the poor crutch lying on the floor.

I find that similar to a couple of others on the forum, when I go to bend my knee I can only get so far and it is like it hits a wall or something and after the OS eyeballing my bend on my 12 week visit and saying he thought it was about 80, it has actually decreased again. So, with the experience of the others on the forum in mind, I went back to the OS and asked about it and whether in fact he thought MUA would be of some help. He said he did not think it would benefit me very much and that my ROM would be okay some days and not okay some others and that he doubted very much if I would achieve anything like a ROM of any more than 100, if that. Yet, I still go to the gym a few times a week and ride the bike backwards and forwards over and over hoping for a miracle and that one day I will just go all the way around. Actually the other day I was riding the bike and on the backward movement, accidentally went all the way around. I must say I have not had pain like that before or after the op. That may be why my ROM has gone backwards somewhat.

My poor personal trainer was giving me my pt session the other day, congratulated me on how well I was doing the rowing exercise and I just dissolved into tears. Tears are not far away these days (yes, I have considered depression, but am already on antidepressants). They are tears of frustration and dread that I will never be "me" again. I know others have it much worse than I do, I know others have it much worse and manage to be cheerful and get on with life and still do things - whatever they can. I know there are people who would love to be able to just get on a bike and never mind not being able to pedal, but this is me and I do not like it and appear to no longer have the strength to deal with it. Perhaps I do not have the fortitude and strength I always thought I had inside. Unfortunately this remains the worst thing I have ever voluntarily had done to myself. I took a knee that was working (albeit not at optimum strength or capability) and have turned it into a knee that won't even do the limited things it could do before TKR. Constant comments that I receive at work of "I thought all this was supposed to improve things" are getting to me. I laugh and just say "I thought so too" and cry buckets inside. I laugh and smile and make jokes like getting married to my ever reliable crutch

And yet, despite all that, I know I must have the right knee done because despite not being able to bend and despite me not being able to do the things I love, the TKR knee is the strongest and I need that same strength in the other knee. Then maybe I will be able to hobble around evenly without pain in back, hips, and thighs.

Gosh, I AM having a good old wallow in the self pity, aren't I? And I hate that about myself as well.

Still, despite all the above, I am about to embark on quite the adventure - for me that is. I was married at 21 and went from my parents' home to a marriage home and even when Geoff and I first separated, the two youngest boys who were still at school, lived with me. My daughter was already living away from home with friends and my eldest son went to live with Geoff because he didn't want him living alone. Then we got into this arrangement of sharing a house and a mortgage. Geoff is no longer working and the financial struggle is immense and I cannot afford to pay the mortgage myself, so the house is going on the market and I am moving out with my dogs, into a place all by myself. I will be renting until the house sells and then see if we can get anything extra out of it after the mortgage and personal loan is paid off. What a big girl I am becoming.

Anyway dear Bonesmart friends .. please forgive my wallow. I truly hope you are all having good recoveries and life is being kind to you.

Take Care and Be Kind to Yourselves ... Ellen