TKR Sher101 TKR Recovery 4/16/2

[benne68]

Two things to consider, @101:

1. What would happen if you had to slam on the brakes in an emergency? Would your knee be strong enough to do it, or would it give out -- putting you and others in danger? That's the thing that kept me from driving on the highway for almost two months after my Right TKR.

2. How far can you walk or how long can you stand before you are fatigued or have pain in the knee?
Remember that, going to Target requires a lot of physical stamina in between those two 15-minute highway drives. You need to walk across the parking lot to the store, walk around the store, stand in line at checkout, and walk back to your car. At one month post-op, that would have completely exhausted me and would not have had the stamina to drive home!

 

[101]

Thanks for the suggestion, but don't have anyone to do that now. But a good idea.

 

[101]

@benne68 Thanks for the response. I was going to get something at curbside pick up, so walking/standing wouldn't be an issue. I didn't think of having to slam on the brakes though. Excellent point. When I concocted the idea, I'd just woken up from a nap and an hour on ice, so was feeling full of energy and strength. Oh, well.

 

[t2paythepiper]

@101

You are a week behind me (tomorrow is week 5) and I think you are doing great!

I'm confused about the narcotic prescription. I was admonished by my OS's PA for wanting a refill when I have been taking them as prescribed.

I too was schooled when I asked for narcotic refills and quite taken aback as my first follow up was week four and the rx as written was barely good for 2 weeks at the lowest prescribed dose and fx. I don't like taking narcotics but I try to be very compliant with surgeries as I know how important it is to stay ahead of the pain. I was actually somewhat offended and I am going to write it off to poor communication within the office.

It was such a different experience than my THR 8 years ago. They prescribed hydromorphone and large supplies (still have a bottle I should have disposed with at the pharmacy). Very confusing.

Of course, after multiple calls and finally getting the requested refills, I could tell I didn't need them as much and began weaning off them. Happy to have them for days like today!

Impressed with your ability to drive. I had a little reminder to be careful shortly before being cleared to drive. My Robot vacuum started to drive across the bare foot of my surgical leg and I reacted from instinct/ lizard brain and did some post-TKR version of a martial arts kick. I then screamed at the top of my lungs because I had bent my knee far further than was comfortable. It made me realize that had my surgery been my right leg I might not have the ability to make a quick reaction if I needed to. I know it took longer for me to get driving privileges with my hip because it was the right hip.

Again, you sound like you are doing great! Look forward to following your progress as someone so close to my timeline!

 

[101]

Impressed with your ability to drive. I had a little reminder to be careful shortly before being cleared to drive. My Robot vacuum started to drive across the bare foot of my surgical leg and I reacted from instinct/ lizard brain and did some post-TKR version of a martial arts kick. I then screamed at the top of my lungs because I had bent my knee far further than was comfortable. It made me realize that had my surgery been my right leg I might not have the ability to make a quick reaction if I needed to. I know it took longer for me to get driving privileges with my hip because it was the right hip.

Moderator note, this is an example post with explanation below in post 27.

 

[101]

Wanted to comment about the quote above from @t2paythepiper, but can't quite figure out how this works. Anyhoo, thank you and everyone for the cautionary tales re: driving. I am, you might have guessed, stir crazy. I was like this in the recovery room saying, "When can leave?" repeatedly to no one's amusement.

 

[Jockette]

Wanted to comment about the quote above from @t2paythepiper,

By the way, when you want to reply, rather than quoting the whole message, just go down to the reply box and type your reply. No need to quote if you are replying to the post directly above your reply. You can also mention the member you want to address by using the @ sign in front of their username (no space) and type your reply. Not quoting whole messages saves a lot of space on the page, and also saves duplicate reading.

If you want to quote just a line in a post, highlight that line.

At the bottom of the post you will see:

Like/ +Quote/ Quote this message.

Click the +Quote

When you get to the reply box, you will see where it says “insert quotes” Click that and it will put your highlighted area into your reply.

When the quote appears, just type right below it, in the same box.

Happy Posting!

 

[101]

I just returned from PT. I told the therapist my right foot had been attacked by my cat first thing in the morning (she is psychotic, I think--the cat not the therapist) and that I'd had a twenty minute crying jag about my sore back and butt before coming in. As a result I could not stand anything that would push me into pain. He was compliant and gentle. Really helped my hip and back. Gave me a little chair sitting and stair climbing to do. He warns though, "Next time..." which sets me up for high anxiety. What horrors does he have in store for me? He says if my ROM (119 & -2) or mobility backslides he'll have to have me do more. So again, he stirs up my dread of PT. He's hilarious however, which keeps me coming back. I'm sort of confused about PT, since reading the BoneSmart method. I don't think I would have asserted myself this morning and just let him put me on the rack. Overall, I am doing really well, no walker, no crutches, gait a tiny bit wobbly. Sorry for the ramble. I'm glad I did the surgery. Already going down the slight hill to my mail box is not the pain excursion it was pre-surgery. More ramble, ramble. Out for a walk in a bit.

 

[benne68]

@101 At less than one month post-op, your ROM is excellent, so please don't let your therapist -- or anyone else -- tell you that you are behind.

He warns though, "Next time..."

I hope he is joking with you when he says this. If not, please continue to advocate for yourself.

 

[Layla]

Hey there 101
You need to feel safe expressing your needs and expectations in PT. You have the right to say NO to aggressive therapy that causes stress and strain. I believe you'll feel better about your sessions if you're more assertive, taking control of what you will and won't do. There's no reason for high anxiety before your visits if you feel comfortable STOPing when movement causes pain. Have a heart to heart with the PT explaining you appreciate him and want to continue working with him, but will not engage in movement that causes discomfort for the remainder of the day and evening. Please be brave, be strong, stand up for yourself and let us know how it goes.
@101

 

[Layla]

Happy One Month Anniversary!
I hope you have a great day.
@101

 

[101]

@Layla thanks for the reminder that it's only been a month! That helps to quell some of my anxiety when I feel I am healing too slowly and get frustrated with my hugely swollen ankle and lower leg.

 

[101]

I had PT today:

• Cleared to walk up and down stairs like a normal person.
• Given squats in lower and lower seats.
• Discussion about the dreaded lunge.
• Flexion came in at 115 which resulted in frowny face from PT.
• Cleared for total rotation on bike for 5 minutes. Enough?
• I am only walking in my condo as it's too hilly for around the block. I hope I'm doing enough with 10 minute walks every couple of hours - plus meal prep, cat care, garbage dump, a little cleaning. So I am managing about 5000 steps a day.
• Felt energetic before PT, now completely enervated, like I went for a five mile walk without sleep.

 

[selketine]

Flexion came in at 115 which resulted in frowny face from PT.

I'd frown face that PT right out the door -- good grief. You're barely a month out - I sure wasn't getting that at one month. With all the swelling it's a great number. I'm 4 months out (still have one very bad left knee waiting for TKR) and I can't do 5000 steps a day yet and struggle on hills. My knee bend on the operated knee is better than it was pre-surgery and enough I can do whatever I try to do with it - probably about 120 or so but that sure took awhile for me to achieve!

 

[Jockette]

Given squats in lower and lower seats.

You don’t need any squats at 4 weeks post op. You get a natural squatting motion when you sit down on a chair/couch, and get up again, after a while.

Discussion about the dreaded lunge.

If you dread the lunge, don’t do it. It’s not essential.

Flexion came in at 115 which resulted in frowny face from PT.

He/she has no reason to frown. 115 at 4 weeks is fabulous!

Cleared for total rotation on bike for 5 minutes. Enough?

Yes, it’s enough. Maybe start out with less and build up to 5 minutes, if you haven’t done any rotations yet.

I am only walking in my condo as it's too hilly for around the block. I hope I'm doing enough with 10 minute walks every couple of hours - plus meal prep, cat care, garbage dump, a little cleaning. So I am managing about 5000 steps a day.

This is fine and is enough without PT exercises, it’s what I call natural PT. Are you also doing a list of exercises?

Felt energetic before PT, now completely enervated, like I went for a five mile walk without sleep.

This is because you are still in the early stages of recovery. Doing X amount of exercises within an hour or so is too much all at once, and does wear you out.

You are doing very well! Don’t feel pressured to do too much. Resting is also a part of giving your knee the best opportunity in which to heal.

 

[101]

@selketine I'd like to dump him. But I get talked out of it by my partner, who, being a very athletic guy, is of the no-pain, no-gain variety. Thanks for the encouragement and the numbers for comparison. I do find women PT's generally have a more gentle approach.

 

[101]

@Jockette I am doing the exercises he gave me, though not as often as he outlined: range of motion flexion (heel slides) and extension (foot resting on coffee table and pressing down) 10xday, 5 reps, biking every hour, chair sits 10xday, balance on TKR 30 seconds severalxday.

I am so grateful for the time and energy everyone puts into their responses on this site. You really are so supportive and Smart.

 

[Jockette]

Those are a lot of exercises, in addition to your 5000 steps a day. It’s fine if you’re handling it well, but if you still have a lot of pain and swelling, you might want to cut some, or even all, of them out. The things you mentioned above are enough to give your new, healing knee all the healing movement it needs. In my opinion “natural PT” is the best PT.

 

[benne68]

I agree with Jockette, @101. That's an awful lot of stress to be putting on your knee just a month post-op. Your bones, ligaments and tendons haven't even had time to heal. Take a look at this chart -- it will help you see how long it takes our bodies to heal after surgery:

I never did that amount of exercise after either of my TKRs. I'm now 5 months post-op on the second and doing extremely well. You might be interested in reading through my latest recovery thread here.

 

[101]

@benne68 Good feedback. I read your recovery thread. Inspiring! I shall follow your and @Jockette advice to back off. I'm going to fire my PT. I think he wants to prove that the Pre-op work we did results in much faster recovery.