TKR Sharing my experience . . . so far

[kgang1957]

Ordered mine, but haven't arrived yet. Sure could use them now, calling for sleet and snow here today in the Northeast.

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[GimpyGal]

NetballKnees (Ellen) I have a deal for you! We'll house swap one Christmas! I'll get the warm and the pool and the cold salads, and you can have our snow, cold, ice skating (on your two good knees!) skiing and sledding!

We are home now, with less snow here than what we had down south where we ran to escape it! We didn't take enough stretching breaks on the 5 hour drive back because we didn't want to wake our (finally!) sleeping puppy so I'm a little rough around the edges today, but I'll bounce back.

My plans today are to prioritize like I advise others to do. With a wedding celebration Christmas week, at our house, I'm trying to do just a little every day. ALL Christmas shopping is taking place online only, for starters.

I'm six weeks post op today. You know, that magical point where you are told recovery takes six weeks. Yeah, right . . . unless that kicks in by midnight, it just ain't so! LOL

One question came to mind as I've read some of the thread updates today and that's about stairs. I'm still taking them one at a time, both up and down. Will I just discover one day that I can do them foot over foot? Or should I consciously be making the effort to do so, as part of my recovery? I can force myself to do it, but my posture leaves quite a bit to be desired as I'm not achieving it in a normal manner.

We do have a short set of four steps and walking up them properly is not a problem - it's the full floor sets of 12 I can't do. And down is, of course, harder than up.

 

[kgang1957]

GimpyGal, I'm just 8 weeks post RTKR and just started working on the step over step today at PT. They had me stepping on and off a small rise like they use in aerobic classes, but stepping up with the new knee and down with the old knee, opposite of what we've been taught to do going one step at a time. I can do shallow steps on my own step over step but still haven't attempted others yet!

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[GimpyGal]

kgang1957 - Your post helped me a lot. Made me feel I'm not 'behind' and also gave me some ideas how to proceed with your PT tip. Interesting to start using the opposite of what we were told earlier.

I have a shallow step into our garage so I'll test the waters there.

 

[NetballKnees]

Hi GG ... You're on!!! I would love to spend a Christmas in snow. Mind you, it is nice to sit in the air conditioning and go out to the pool and drink with ice rattling in the glasses. But I do so long for a cold, white Christmas.

I am not much help with stairs as I have only gone up and down 3 outdoor stairs (set in landscaping in the garden) once since the operation - until tonight. I went over to a friend's place as it was the anniversary of their brother and brother-in-law's passing from brain tumour. I was taken over by another friend and had to go up a set of 5 stairs in the front - relatively steep. When I got upstairs discovered they were downstairs, so had to go down a set of stairs at the back - there are about 13 stairs there. Managed not too badly, except stumbled down the last 2 steps and badly wrenched the non-surgical knee, which already has a medial collateral ligament strain. Then to have dinner, had to go back up the 13 stairs. I managed really well when I went both feet on each stair, but for a couple of stairs I started foot over foot like I used to and that was too difficult. But it went well enough for me to realise that in another few weeks I may be able to do foot over foot. After a very frustrating and depressing weekend just gone and lots of tears, that was a big positive for me.

I think purely for recovery purposes, it is better to go both legs on one step for a while until stronger. However, you may find that practising kgang's method for a while will allow you to go foot over foot.

I am right with you with the "6 week recovery". I think somewhere we have imprinted on our brains that recovery takes 6 weeks - for anything. I know when I hit 6 weeks I was so frustrated that recovery just didn't happen. I certainly don't think you are "behind" at 6 weeks though - and you sound so positive.

You have a very busy time coming up with a wedding celebration leading up to Christmas and then Christmas itself. I only have to go to a wedding on 22 December and it is hard planning for everything. Please remember to take it easy and be kind to yourself and delegate - a lot.

Sorry to rave on for so long.

Take Care GG and remember to be kind to yourself ..

Ellen ...

 

[Josephine]

You know, that magical point where you are told recovery takes six weeks.

You never heard that on here!

I'm six weeks post op today. One question came to mind and that's about stairs. I'm still taking them one at a time, both up and down. Will I just discover one day that I can do them foot over foot? Or should I consciously be making the effort to do so?

My advice is to just let it happen. You should never force your knee to do anything - that way lies swelling and pain, etc., etc. And six weeks is far too soon to be worrying about that anyway. In my case it was around 4 months before I could go upstairs normally and another 2 months after that before I could go downstairs normally. Remember how we're always saying "listen to your knee" and "knee is in charge"? This is a classic case. You don't decide when knee is ready to do this. When it's ready, it will let you know. Much the best way.

 

[GimpyGal]

NetballKnees, those stairs sound like a lot to tackle all at once! But, if it gave you the lift you needed I guess it was probably worth it. Getting together with friends is healing, too.

Josephine, I expected you'd say that! LOL And, after testing the knee yesterday, let's just say I now agree with you. I earned a sleepless night for my efforts. Maybe by the time my other knee needs replacing, I'll have learned. I hate to think how much more I would be pushing myself without this message board to guide me. You make it okay to not expect too much too soon.

Had my six week post OP today and 'called out my surgeon' about him neglecting to tell me that at six weeks I'd be allowed to resume normal activities but wouldn't WANT to! He said that was meant to be just the first stage of my recovery. That at 3 months he hopes I'll not have much pain and at 6 months I'd be starting to forget about the knee. Ah, the truth come out!

He said I'm just at the point in recovery where I probably no longer hate him for what he's put me through! LOL That in 5 weeks when I return, I'll not only have forgiven him, but may mean it when I thank him.

I was about 110 flex and 10 (-10???) extension, so I still have a ways to go.

I do love my surgeon. He's sending me to out patient PT because he feels they're the right people to guide me from here on out with how much PT, stairs, etc. but made a point of saying I'm the boss. He said he'd be fine with them evaluating where I am and just checking in with them weekly and doing the PT on my own at home. Or if I'd rather do it with them 3-4 times a week, that was okay, too. With Christmas and our daughter's wedding and house guests, I'm relieved PT appointments won't dictate my days.

I was worried about asking for more Tramadol, knowing some OS make the decision on when to withdraw pain medications. No problem - he expects I'll need it, gave me a script with a refill, and told me he's comfortable with me being on that for quite some time. (I did notice the dosage decreased, though!)

I asked him if he'd heard about Bonesmart and yes, indeed, he had. Told him because of this site he didn't have to field a dozen or so calls from me.

 

[GimpyGal]

So . . . I thought I'd share my first out patient PT session -2 hours with lots of talking in there. I'm almsot 7 weeks post op.

I was just very surprised by the whole thing since it seems to be so different than the norm. Yet, parts are not.

First, he gave me a generic 'knee talk' about visible and invisible swelling and how it contributes to recovery. Then mentioned that WINDOW OF OPPORTUNITY and how a MUA is ordered if the ROM isn't good during that time. (I was respectful and just listened.) It bothered me that talk of that came up before he even took a look at me, but I guess that's how he rolls.

Anyway, my ROM was 120 and about -10. No back peddling on the MUA which would have been nice.

We're working on my gait.

Now, for the actual PT. My biggest issue now is sciatica. He thinks I've been overdoing the hamstring stretch and the nerve needs gentle stretching, not the muscle. I'm very limber and can fold up easily - while standing can keep feet together and knee straight and put my hands flat on the floor, but he thinks the nerve is firing and needs way more gentle.

So, I've a very easy stretch with heel on a chair and fingers sneaking up on the knee just a bit while I press the knee down. 15 minutes of this (one minute knee on chair, one minute recovering with foot on floor.)

Also, 15 minutes of heel slides.

EVERYTHING else stops. No strengthing, lifts, bends, other than this for a week until the nerve settles down. No more than 40 mintues on feet at one time. Stairs only one foot at a time, up and down.

Icing three times a day - but no more than that and for only 15 minutes.

At first he told me to do the PT every three hours - 6am 9am noon 3pm 6pm 9pm. Then backed off to three times a day after I said that seemed excessive - 1 hour of PT and 2 hours off all day long?

He did tell me I'm in charge and he'll never hurt or force me. That if I start PT at, say a 3 on the pain scale, to never let it rise more than two steps higher, to a 5.

I only had his PT session yesterday and the sciatica was improved last night already. Does this sound like we are on the right track?

 

[kneeper]

It will take how long it takes with stairs. I can tell you what I did on those longer flights. I'd do a few "normal" steps but the rest of the flight one at a time. So I got some practice in, but I didn't over do it. Gradually you will be able to do stairs more easily. I think it was at least 3 months for me before I could do *down* really approaching normally. And that doesn't mean *easily.*

The PT seems to be giving you mixed messages... but I like that he seems to at least somewhat listen to you.

 

[Josephine]

the nerve needs gentle stretching, not the muscle

Nerves never need stretching, only muscles.

Also, 15 minutes of heel slides.

Far too much. Much better to do 5-10 slides every 20-30 minutes.

Icing three times a day - but no more than that and for only 15 minutes.

Much better to ice lots and all the time you are resting and elevating. Limiting it to that extent doesn't allow it to be effective.

At first he told me to do the PT every three hours - 6am 9am noon 3pm 6pm 9pm. Then backed off to three times a day after I said that seemed excessive

Good for you! Remember, less is more in this situation. You don't need to go at it like gangbusters are you are already 'there' in terms of ROM. You are wise no to risk it by doing too much and that's too much!

 

[GimpyGal]

Thanks, @kne That's a great way to tackle stairs. I have one flight of just 4 steps and I keep catching myself doing them the right way, but once I hit the full flight I have to back off. Because of my sciatica, though I'm trying to do them all the easy way for awhile.

You are right about me getting mixed messages from the PT. It's 'back off' but do these every 3 hours!' It's 'you're in charge, but if you don't you might need a MUA!' I asked him if I was behind and he said at 120 degrees I got an A+ but my minus 10 extension got me only a C-.

Josephine, thanks (again) for your attention. When I got out my sheet of exercises, I realized I didn't remember the heel slides were for 15 minutes, but that's alternating one minute of slide with one minute of rest. I still like your approach better.

I'm going to have to ask about "stretching the nerve." I have a feeling I don't have a clue what he was trying to tell me. Something I was doing was aggravating the sciatic nerve . . . stretching too much or something.

And I'm still icing whenever I sit down and elevate, darn it! LOL

 

[Josephine]

alternating one minute of slide with one minute of rest

That's not a good way to do it. One slide back as far as you can go without pain, lean into a a tiny bit and hold it for about 5 seconds, then slide out again. Rest for a few seconds and repeat. Do no more than 5-10 slides every 20-30 minutes every 1, 2 or 3 hours according to how you feel pain-wise, etc. (I got that wrong! )

'm going to have to ask about "stretching the nerve." I have a feeling I don't have a clue what he was trying to tell me. Something I was doing was aggravating the sciatic nerve . . . stretching too much or something.

Aggravating the sciatic nerve says it all! You don't stretch nerves or that's what you get!

 

[NetballKnees]

Hi GG - Fantastic ROM. I am sure the extension will come eventually. I think there is an exercise on here about elevating your foot only on something a little distance away from your chair and allowing your leg to just hang and let gravity help with the straightening. You may wish to run this past one of the moderators though as I often get things wrong way around. I have done this stretch and you need to be very careful lowering your leg back down to the ground as it gets a bit stiff being extended.

Sorry to hear about your sciatic nerve I have never had any problem with sciatica, but have heard from friends who have that it is very painful and very irritating.

The PT over there is so different and they have you doing so many different things. Maybe that is why your ROM is so good and mine keeps going backwards even though I am 11 days ahead of you.

I hope things continue to go well with ROM and that your extension improves. I also hope your sciatica can be resolved soon so you don't have to worry about that too.

Take Care ...
Ellen :giftsb:

 

[GimpyGal]

Thought I should check in again, after a very busy holiday season. You would all be SO proud of me! 16 guests for a wedding dinner at my house and all I did to prepare was sit at the kitchen table and chop vegetables for those who were cooking. I did no clean up, either, thanks to my daughter and new son in law.

I'm 9 weeks (I think?) post op and doing well. Only minor sciatica, 130 flex (135 if I force it) and -2 extension. I can now go up a few stairs w/o pain if using the railing. I switch to the toddler technique when I feel pain and can't go down the proper way yet at all.

Now, I have another issue. My OS says I can do whatever I want as long as I don't increase the pain. And, if the pain does increase, then pull back. My PT doesn't want me doing anything except my PT! Not even walking my 30 lb puppy! Or using my exercise bike. It's such conflicting information. Today I decided I simply have to start resuming some of my normal activities and I *gasp!* took the pup for a 15 minute walk. If I survive that (read that with sarcasm) I may even ride my bike for 5 minutes at no tension tomorrow.

I'm actually wondering WHY I'm even going to PT if my ROM is so good, yet I'm afraid to stop and lose what I've already achieved. I have 8 more visits that insurance will pay for and I think they just want to use them all up and only then cut me loose.

 

[tek'smom]

I quit PT early but I have a regular exercise program where we work at extension and ROM in a variety of ways. Maybe they would let you put it on pause.

 

[Josephine]

Your PT doesn't keep your ROM up, YOU do! This is how they earn their keep by ensuring you feel dependent upon them for your progress. Your ROM is good, you don't have any issues and and yet this person is trying to limit your quality of life to such a degree you feel intimidated about taking out your dog? Gimme a break! With advice like that, I suggest you can do without him completely. Time to strike out on your own and claim your life back, my friend!

I had no such PT, I did my exercises all on my own from day one with just three assessments to check my ROM. That was it. I reached 120/0 around 10 weeks and then forgot all about the exercises and just got on with life. So can you!

 

[jeano]

PT "fired" me when I showed them a picture of me on my horse, taken the day before. They said, congratulations, we cant come up with anything THAT challenging here, so you are done. I'd say ditch the PT and walk your dog. Take a cane or something with you, in case you run into your therapist and get the urge to give him a pain in his knee.

Even when my PTs were doing their darnedest to hold me back they NEVER gave me prohibitions like dont walk the dog. It was more along the lines of, please use your walker when you go outside, remember you only had surgery three days ago....

 

[kneeper]

You may have all the exercises etc now that you can do at home. If you don't want to do all 8 visits maybe you can arrange to do one in a couple of weeks as a sort of "check up"

 

[GimpyGal]

Thanks for your replies. I think time and increasing my regular activities will take care of getting me 100%. It helps that posters here agree.

I canceled my next two PT sessions and told them I'll reschedule when I get back into town. We're at our (warm) vacation home now and extended our stay since I don't have to go back BECAUSE of the PT appointment.

I've taken our puppy for two short walks the past three days! And guess what? I'm no worse the wear for it.

Meanwhile, my knee is starting to feel different. Although I measured -2 on extension before we came down here, suddenly I actually FEEL like it's straight. Does that make any sense?

But, in bad news, my good knee is starting to give me a lot of grief. I'm pretty upset about that - I need a break - a break from living with pain - before I do this again!

 

[Josephine]

It makes perfect sense. Quite often our bodies are a better indicator of how things are than any PT's goniometer!