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[BILATERAL TKR] Second Year Progress

Discussion in 'Knee Replacement Recovery Area' started by mlwreader, Oct 24, 2017.

  1. mlwreader

    mlwreader senior
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    Hello everyone: I have been lurking on this site since about four weeks prior to my 9/11/17 bilateral tkr's, and have found so much wonderful information and comfort from all the posts. I had a bit of a technical challenge at first in trying to register, etc., and decided to let it sit for a while and just read everyone's posts anonymously. Then, this morning, I woke up and said to myself, let's try again, and I was able to register successfully.

    I had both my knees done last month, and prior to that I was virtually housebound for at least six months. Originally I was scheduled to have my right knee done only. Then one fine day in April my left knee totally "blew up" and I landed in the ER in excruciating pain. I was told there was a baker's cyst in the left knee, and an MRI revealed a lot of stress damage to the bone in the left knee in several places. Bottom line I had been favoring the right knee so much, and the left knee wasn't all that great to begin with because there was definitely some reduced cartilage, causing it to really become a problem. I was on a walker from then on.

    My first OS was not tremendously responsive to my plight with the second knee, and it took him six pain filled weeks to pay enough attention to me to send me for an MRI. Then he began to acknowledge that I was having real difficulties, but would not consider doing both knees at once. That, plus some screw ups with appointments and his medical assistant with an attitude problem made me decide to look around for an alternative. A friend had bilateral tkr a few years back and she swore by her doctor, so I scheduled a second opinion appointment with him. He is in San Diego, about 45 minutes from where I live. Still my son went with me to the appointment and we both got on board with this guy pretty quickly. He said a person like myself, healthy (thank God), whose only prescription med at the age of 72 is a thyroid supplement, is a good candidate for bilateral surgery. To wait and do one at a time is to waste time, because one of the knees would still be in horrible shape after the first surgery, making rehab more difficult.

    I got on board with the second doctor and fired the first, thanking him, of course for all his help. I was right away so impressed with the immediate response to my inquiries and questions on the website portal that they had created for me when I had my second opinion appointment. Since that June, 2017 appointment, any time I have had a question or concern, I have always gotten a quick response.

    My surgery went well, and I spent a week in a rehab facility in San Diego. The good news about the facility was that the PT and OT staff were outstanding. As were the CNA's and most of the nurses. And the food was soooo good, when my stomach finally settled down enough for me to eat. One of the nurses was a definite problem, and she tried to give me the wrong meds on two different occasions. She became very hostile to me when I called her on it. Other than that, it was a fine experience, and since I live alone, necessary with two knees done at once. Plus the fact that my son and his family live five minutes from the facility and my son stopped in for a coffee and chat every day at lunchtime, and they brought the kids over for visits as well. I felt very supported and safe, especially when my son assured me I could call him any time day or night and he'd be right there. What a lovely person he is!

    When I got home there was some concern that some dark areas on my left knee might be an infection. That was dark news indeed. After a visit to the doctor's office, I was prescribed two forms of extreme antibiotics for a week, which made me so sick. However, whatever was going on with the knee seems to have resolved, because the dark areas went away quickly. The visit to the doctor resulted in the staples being removed that day as well, and that was two weeks out from surgery and no fun at all. Ouchie is all I can say.

    My knees are still hurting somewhat, especially at night. And the left one is definitely still a problem child, in that one of the stitches popped open and caused a fright, not to mention that the left knee is more swollen and hurts more at night. What is it about nighttime that causes these suckers to start singing and dancing. I have read so many threads where everyone talks about how the pain keeps people up, and folks are up with their iPads and books and audiobooks, etc. through the night. Same for me. I got to bed with an audible book, and usually fall asleep for about an hour, and then wake up and lie there until I finally take 1/2 ambien at about 11:00 and sleep for a few hours, and then take the other half ambien and sleep for a few more hours, and am up around six. Most of the time the pain is more like nerve pain, where it is almost too painful to have the sheet and blanket touching the stitch area. And I am not a back sleeper, but that has changed by necessity, because it hurts too much to sleep on my side.

    I can tell you I am forever grateful to be rid of the horrible bone on bone pain I experienced pre-surgery. What a miracle. And at six weeks out I am at 120 degrees in my knees, which I actually was able to achieve by week 4. I had a wonderful home health PT up until last week, and she guided me and inspired me. I put off outpatient PT until tomorrow, based on some things I read on this site. I was pushing myself quite hard and was having unnecessary pain when I should have been healing. Right now I am doing stretches and leg lifts first thing in the morning in bed, then knee bends and more leg lifts from a standing position later in the morning, five minutes on the recumbent bike at 0 resistance, and a ten minute easy walk around the apartment complex where I live, although today it is expected to be close to 100 degrees, so I will probably skip the walk, and maybe walk the inside corridors - lol.

    Please know that I am so grateful for this site. You have provided me with so much comfort and good solid experience, strength and hope. My son has visited the site as well, reading some of the articles so he could become more informed.

    All best, looking forward to comments, if any, and looking forward to reading more stories from others and their knee adventures.

    Mary Lou
     
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  2. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Hi, Mary Lou, welcome to Bonesmart! I was a long time lurker, too, before I joined.

    And yea for bilateral and it’s one recovery!

    That’s great that your son has also read things here on Bonesmart, hopefully he agrees with Bonesmart and you following it, it does seem radical from what everyone I know thinks about recovery from knee replacement. I am so glad I found this forum!

    Best wishes with your recovery!
     
  3. SusieShoes

    SusieShoes FORUM ADVISOR Forum Advisor

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    Why, Mary Lou, I say you're doing just fine! Your recovery sounds right on course for five weeks out. Gentle exercise, walking and biking, and keeping up that wonderful cheerful outlook. Thanks to being well-informed, you've got this. :yes!:

    I'm so happy you changed surgeons and are with one you trust and know you can communicate with should problems arise. A good surgeon is so important... maybe THE most important thing. Knowing you can count on your medical team takes away a lot of the stress that can derail a recovery.

    Sounds like we both have cranky left knees. My Lefty was the scourge of my recovery, but has since come around and is well-behaved. Just took a couple months longer than my right knee to get there. :bored: But I too still had pain in my knees --and stiffness, and tightness, and swelling-- at five weeks. All of that went away quite gradually. I was still happy as can be, even with painful post-op knees, to have gotten rid of that terrible arthritis pain! The surgical pain wasn't that much worse. And now, of course... no pain at all! :happydance:

    Now that you've joined and are a member, you get your own set of Recovery Guidelines! :welome:

    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
    elevate
    ice
    take your pain meds by prescription schedule (not when pain starts!)
    don't overwork.
    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

    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 a 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 history before providing advice.
     
  4. Pumpkln

    Pumpkln FORUM ADVISOR Forum Advisor

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    Welcome to BoneSmart, glad you joined us!
    Sounds like you are doing well.
    Thanks for sharing your story!
     
  5. skigirl

    skigirl FORUM ADVISOR Forum Advisor

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    Just remember, that taking it easy right now is the way to improve. Doing too much during the day will result in pain at night. During the day, we are interested in other things--movies, talking with friends and we suppress the pain. At night, we notice it so much more. At five weeks, I am pretty sure I was still taking Tramadol at night as well, which did help me sleep too. taking the two halves of the ambien, makes sense too.
     
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  6. Roy Gardiner

    Roy Gardiner FORUM ADVISOR Forum Advisor

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    EX ACT LY!!

    As has been said, take it easy. Doing too little won't hurt, doing too much might.
     
  7. mlwreader

    mlwreader senior
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    Hello friends:

    I am not having a good day/night. My left knee is giving me fits tonight.. I have two little blisters on the knee, they look like blood blisters, and my doctor said that sometimes the subcutaneous (sp?) stitches cause a reaction that can result in these little pop up blisters. I was told to keep clean, use antiseptic cream and cover with a bandaid. The problem is they are sooooo sensitive, or something is sensitive in the left knee. Sometimes at night trying to go to sleep, just having the sheet rest on the knee drives me crazy. And then it will subside and I will fall asleep. Tonight it is just driving me nuts. And I am out of all prescription pain meds, and am relying on advil, which I am beginning to think is a mistake. In fact, I feel like a big mistake period. Know what i mean? I've been in my head all day, which is never good.

    I went to outpatient PT for the first time yesterday. I took 10 days off between my home health care PT and outpatient. I told the new PT that I did not want him moving my knees or adjusting them without asking my permission. He seemed ok, and did an assessment on my knees for most of the time I was with him. I am scheduled to go back twice next week. The thing is, he explained how elevating and icing the knee helps drain the fluids from the knee, especially elevating higher than the heart, which I had not been doing, so that was very helpful. But my left knee hurts today, and I think it is from the assessment yesterday. He is having me do a hamstring stretch 6 times a day, and I agree my hamstrings are tight, but dang, I get all kinds of goosey nerve type pain after I do those stretches, which just adds to my general discomfort. When I walk, I am a bit herky jerky, and I understand my muscles need to get stronger so I can eventually walk without the cane. But this pain and discomfort is just so present, at least a 4 or 5. I am so bummed, I had no idea I would be this uncomfortable at six weeks.

    The right knee is doing quite well, however, and I am most grateful for that. But the difference between the two knees is so obvious. I think if those two stitches were not driving me crazy on the left knee I'd be in much better shape psychologically. It just seems endless. I have always had the kind of skin that scars horribly when having skin lesions removed, although over time they always calm down and blend in. My knee scars look to me like red angry lumps. And oh my gosh, I want to shave my legs so badly, my legs feel so weird and I swear my hairy legs are so obviously gross. But I'm scared I'll cut them (I always do a little bit) and then risk an infection. And it has been so blipping hot in SoCal this week - triple digits, that it is impossible to wear long pants. And my feet - oh my gosh I want a pedicure so badly, but I am afraid to go anywhere because I don't want to pick up some germ.

    Basically I feel like a hot mess. Basically I am a hot mess. I left a message for my doctor's office tonight asking for a refill on my Tramadol meds so I can take it at night and get some sleep. Sitting here on the couch writing this post, my pain in my knees is really great, probably about a 2. But the minute I lay down in the bed, it's up to a 4 or 5. Why is that? I have an appointment with my doctor in two weeks.

    Thanks everyone for reading this post. And thanks Jockette, SusieShoes, Pumpkin, Skigirl and Roy for taking the time to respond to my earlier post, which, upon re-reading it tonight,, I sound like little Mary Sunshine. What a difference between 5 and 6 weeks. Bah humbug. Only good thing is that awful bone on bone pain pre-surgery is gone.

    Mary Lou
     
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  8. Roy Gardiner

    Roy Gardiner FORUM ADVISOR Forum Advisor

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    All the woes you quote are, I'm afraid, quite typical for your stage of recovery. All I'd suggest right now is to go to your normal doctor for proper pain relief, it makes such a difference.
    That's right, it's the only good thing.

    And it will never come back, and your current discomfort/pain will go away.

    100% worth it.
     
  9. DebM

    DebM senior

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    It’s normal for your knees to be different. Mine swapped a couple of times as to who was going to be the petulant child!
    Nights are the worst! Being a side sleeper I was probably about 6 months out before I had consistent good nights sleep and even now often use a pillow between my knees.
     
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  10. SusieShoes

    SusieShoes FORUM ADVISOR Forum Advisor

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    It's true. The things you're describing are typical of your stage of recovery. Pain can continue for a while yet, along with stiffness and no energy. And hairy legs... I swear after having my knees replaced my leg hair became coarser and there was more of it!

    Each of my knees took a totally different road to recovery. My right knee was the perfect knee replacement. Pain-free early on, 120 flexion at four weeks, 0 extension. Wonderful knee. My left knee, however... what a laggard! Pain until four months. Always behind in flexion. Didn't get 0 extension until five months. My left knee wouldn't let me sleep on my side for months. So having bilateral replacements can meaning having two very different recoveries.

    But yes! That awful bone on bone pain is gone, gone, gone!
     
  11. Dianna_WA

    Dianna_WA junior member

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    Isn't it wonderful not to have bone on bone pain anymore. I had BTKR 8 weeks ago and I rejoice every day that I will never have that pain again. I look forward to the day when I never need any pain meds again. Prior to my op, I was taking so many different meds to soothe the agony. My surgeon told me that in most bilateral patients, both knees recover in different ways. My lefty is my tricky knee too. I suppose you could look at it as though they are two separate operations really.

    I have just started back working a few hours each day, not doing too much. I am sure you will be back to your normal self very soon too.
     
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  12. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    I know, the early weeks are so painful! It does get better. :console2:
     
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  13. mlwreader

    mlwreader senior
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    OMG these are the early weeks? I guess you are right. And with the two knees at once, it is really early. I have read the helpful timeline and see I am in the 6 - 10 week stage doing light housework, etc. Thanks for the feedback Jockette.
     
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  14. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Unfortunately this is a very long recovery, as long as a full year, but you’ll feel better before that!

    I did not know it was a year long recovery until I found Bonesmart at 4 weeks post op. I was expecting 2-3 months. What a shock!

    Oh well, there was no where to go but forward.

    For me, I didn’t really start to feel MUCH better until 6 months, but others on here have been better long before that. My knee is just taking its time, or the scenic route, as others on here have said.
     
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  15. mlwreader

    mlwreader senior
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    I love this Jockette and may I add, probably singing and carrying on as it travels said scenic route- lol. My right knee is my easy child, and my left my problem child. I love them both however, same as I love both my sons, whose personalities are completely different.

    I have to say I feel better this morning, more hopeful. I got some decent sleep - about 7 hours altogether, and am planning a few activities for today, such as a hair wash, bill pay and put away laundry. I sent out my laundry this week, after my children treating me to that service the first three weeks I was home. I thought I could handle doing it myself after that, but since I don't have machines in my unit, but must pack everything up and haul it downstairs to the laundry room in the apartment building where I live, I realized I just wasn't up to that yet. So I treated myself to another couple of weeks of the service. And also I am having my weekly groceries delivered, which is an awesome service. I can handle a short run (well walk) around the grocery store, but not a major shop.

    I would so love to go back to my water exercise class, but with these two little bumps and/or cysts on my left knee, I want to see my doctor before venturing into the water. I understand completely that the incisions must be completely healed before venturing into the pool, due to the risk of infection. My class is called Twinges in the Hinges, and it is an arthritis association approved class of gentle movement geared for folks post surgery and/or with arthritis. I miss my ladies, although I do keep in touch with them on Facebook and texting.

    I work at home as a tutor for students studying for a professional licensing exam. My company is based in another state and they assign me the students. The exam is given in February and July. I told my boss not to assign me any students to begin any earlier than December 4, and I will take a very light student load for that month, with the goal of ramping up in Jan and Feb. I miss the interactions with the students, but I know I need to concentrate on recovery for now. I tutored last exam period this past summer prior to my surgery in extreme pain, and it was very challenging. I took a lighter student load because the pain, although not in evidence when sitting and tutoring, was so present in my life at all other times that it left me drained and quite frankly very grumpy. I don't want to repeat that experience AT ALL. However I do need the money, so I am grateful for the work. My boss just assigned me my first student to commence Dec. 4, twice a week, so that is a great start. The tutoring sessions are conducted via Skype, and I so enjoy meeting these, mostly younger, very bright people in various parts of the country and sometimes even overseas.

    Not sure why I am blabbering on about my work, I guess I just miss it. So anyway today, exercises, hair wash, bills. This week-end I want to compare my medicare plan to what's available to make sure I've got the best one for me. I have all the information ready to go, just need to pull it up and do a comparison. I think I love my plan, especially when I viewed the actual cost of the knee surgery - I about had a heart attack. I know medicare will negotiate it down, but how do people survive without good health insurance? I know when I was in my early 60's, I paid huge amounts every month for health insurance, - at the end around $1000 a month. In fact the last year before I was eligible for medicare, I didn't have any coverage at all. I just couldn't afford it. I was very lucky that I didn't need any medical care that year. This was before Obamacare. So now with medicare, I feel rich, because the cost to me is so reasonable and it is such a blessing.

    Thank you to any of you who have read to the end of this thing. I am impressed if you did, lol, as it is pretty much free association from my mind to yours.

    Happy Friday all!

    Best,

    Mary Lou
     
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  16. jaschembra

    jaschembra post-grad

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    Sounds like you are doing really well. What a smart idea (and a great gift) - a laundry service.
     
  17. PoetryChef

    PoetryChef senior

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    Awww, Mary Lou, you seem like such a lovely person. I am scheduled for bilateral replacements on the 8th and 10th of November. As I am reading this my knees are screaming with bone on bone pain. I guess it's the getting through all of this that is the tough part. Blessings and sound sleep to you.
     
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  18. rickj

    rickj junior member

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    Hi Mary Lou
    So cool, and heartening to see so many responses to your posts! Yeah were in an exclusive club! I’m 8 1/2 months past my bilateral TKR. My left knee is lagging behind my right knee, and has been from the start. My surgeon did tell me that my right knee surgery was very smooth, and he had to do a lot of work on my left knee. I didn’t ask him for the details, but I don’t think I need to.
    The reason I’m posting this to you, as a person who is 8 1/2 months out, is that you have some good things to look forward to!
    As you are probably learning, recovery from TKR , And especially bilateral, is a long process, figure a year. Give or take for each individual I’m sure.
    I am so grateful to not have that horrible bone on bone pain with every step I took.
    When I wake up in the morning now, my knees feel wonderful, and then within an hour so I feel some swelling come back and I need to walk through it etc. but it get better and better JUST VERY GRADUALLY!!!!!
    After 8 1/2 months I feel 3/4 healed. That is a lot!
    In the early stages of my recovery, through the first few months, my knees felt like wooden two by fours.
    Oh so Stiff!!
    It gets better, it does get better! Just realize it takes time, remember to elevate, and do not under estimate elevating and icing and, it is so so important!
    Keep on your rehab, listen to your body, and the wonderful folks on this forum, you’re going to be fine.
     
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  19. mlwreader

    mlwreader senior
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    Hi folks:

    I am feeling so much better tonight. I asked my doctor for a refill of the Tramadol, on the basis that I would take it only at night to ease the evening discomfort and they did give me a refill, although they cautioned no more after that. Hopefully after another month, some of the post-op pain will have eased. I am just loving not having that awful discomfort from last night, and today was such a much better day overall. Also, I stopped taking Advil and switched back to Tylenol, based on some things I have read on this site. I think that really made a difference.

    I was so looking forward to a visit from my son and grands tomorrow, but it looks like that may have to be postponed. My daughter in law's father is quite ill, and they need to figure out how to deal with that. So a visit to Nana's house may not be in the cards. And how about that Dodgers loss tonight? I feel so bad for those boys in blue. They are such a great team. I just think that the Astros have the spirit of winning for the folks who have suffered from the hurricane. That is what is doing it for them, because otherwise the two teams seem like such an even match. I am not a huge baseball fan, but I love to watch the World Series and text with my friends throughout the game.

    We had a lovely break from the heatwave today, temps in the low 70's and even some beach fog.

    I hope everyone has a great week-end. I wish I could figure out how to reply individually to people, but I am just not there yet.

    Best,

    Mary Lou
     
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  20. mlwreader

    mlwreader senior
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    I am just past my two month surgery date. My knees and I are still here, mostly lurking, but just wanted to check in. I have a couple of concerns/comments:

    1. I am still taking one 50 mg Tramadol per day, late afternoon/early evening, but I expect to cut back on that pretty soon. Mainly because my doctor has indicated there may not be any more refills coming my way. I still experience quite a bit of discomfort at night which is why I asked for the last refill. Anyone else have any thoughts of taking pain meds at 9 weeks post op?

    2. I found a PT that I really like, but I wonder if 3 times a week is too much? My last session was Thursday, and today, Sunday, my knees feel very comfortable with occasional discomfort. I took a 500 mg Tylenol about five hours ago. My extension and flexion are fine, 120 and 0 (or vice versa - I'm a novice with these terms), I am mostly having trouble being wobbly when I walk. My PT broke it down like this for me: 60% of the time while walking we are standing on one leg. The other 40% of the time we are on two legs, but they are not side by side, one is placed forward of the other. All this requires a lot of muscle coordination to stay upright. Then throw in looking from side to side, and we are really getting into sophisticated navigation. So, for me, I was on a walker for about five months prior to surgery, and now have had both knees operated on. My PT said its going to take some time for my body to get used to coordinating all that walking navigation, not to mention that the muscle strength needs building up. So my thought is I need PT to help me build up my strength and coordination. What do you guys think? Part of me thinks I can do that just by walking without any PT, but I feel so unbalanced while walking. I'll start in a straight line and before you know it I'm veering off on the diagonal. So funny. I especially notice it if the ground is even a little uneven.

    I have read some posts that say they recovered fine without PT. I do know that I fired my first PT because of what I read on this forum, because he really seemed clueless about TKR, and the place seemed geared to sports injuries. They were totally guilting me when I declined to do suggested things because of pain. One session of that (well half a session) and I was a gone girl!

    3. Is driving in my car an hour each way next week too much for me at this point? I have a call back visit at my doctor's next week, and the office is about 50 minutes from my house. I hate to ask my son to leave his business to drive all the way to my house (also 50 minutes for him), take me to the appointment, return me to my home and then drive back to his area. I suggest to him that we meet at a park and ride about 30 minutes from my house, and he can pick me up there? That will cut about 2 hours of his driving around time, and I can see if I can drive the 30 minutes up and back comfortably. It will not be stop and go because its all freeway, and my right knee, my driving knee, is my good guy, healing beautifully. The left knee is the bad boy, causing me all the grief, so that is good. I have been driving around town on short trips, 15 - 20 mins, for the past month. I think I'm up for it, my stamina is a lot better than it was, but I'll take any opinions out there.

    I think that's it for today. I hope everyone is well, that we all had a fun Halloween. Thanks for reading, guys.

    Best,

    Mary Lou
     
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