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TKR Strange New World

@Denny39, very well said! Great to hear the optimistic outlook. I’ve said many, many times, one’s attitude and outlook during this recovery greatly impacts how successful it is! Mind over matter as they say. I’m convinced that members who have difficulty with anxiety and depression have the most difficultly during recovery, one feeds the other and vice-versa. We all face challenges, we all have our share of setbacks, but I find those that seem to be able to face them head-on with a positive, “I can overcome this” perspective, seem to do the best coming out the other side. I wish I had actual data to back up such a claim, but it’s really just based on my own observations.

Keep up the good work, keep that same attitude when you get ready for round two. I can’t wait to see you post about that hike you talk about, coupled with some amazing pics!
 
Denny39 said:
But it is easier and less painful than before surgery.
Click to expand...
To be able to say that at less than 3 months out is outstanding! You are doing so well. What an inspiration to those coming up behind you.
 
So, yesterday I began my official, new, conservative, “strengthening exercise” regimen. My coach at the Y is currently also working with 3 other TKR survivors, and he is very good. We set up an appointment next Monday afternoon to do a full evaluation and set up a program. But in the meantime, he gave me a couple of low-key, moderate exercises to kind of get things going.

1. Leg presses on a machine where you push yourself backward against a vertical surface. He showed me exactly how to line everything up so as not to put pressure in the wrong place or direction, and told me very firmly, “If it doesn’t feel right, or it causes pain, don’t do it. If it feels OK, do 2 sets of 10 repetitions”.
2. Leg raises. Specific settings for the machine; knees lined up with the axis of rotation; 45 degrees maximum raise. Same caution; if it doesn’t feel right or causes pain, don’t do it.

So, let’s get started. Leg presses with 10 Lbs. resistance. One cautious lift; felt a little bit too much. Reduce the weight to 5 lbs (You’re also pushing your own weight slightly uphill on this machine); one more cautious lift; felt OK, so go for a set of 10. Relax for 30 seconds; still feels good; go for another set of 10.

On to the leg raises, same cautious approach; same result, 2 sets of 10. It felt great! For about 4 hours. During which time, those muscles, which have been pretty much on vacation for almost 3 months now, thought it over and decided, “Nope! We’re not puttin’ up with that stuff!” So late afternoon found me with some sore and stiff Calves and Quads. I had no choice but to break out the Ice Pack and freeze those rebellious little people into submission! I hate it when that happens, but I guess I’l have to compromise just a bit. For the rest of the week, we’ll do one 1 set each instead of 2. But next week, those muscles ARE going back to work.

I can hardly wait until June to start this whole process over again. That will become the second time that which I once adamantly stated “Ain’t never gonna happen”, did happen. Makes me really glad I only have 2 knees, but on the other side of the coin, I’m now convinced it’s worth it. So hang in there Y’all. Your good day will come.
 
@Denny39, I remember those same exercises. In fact, I now do them as part of my regular workout. However, I have significant weight added (120 lbs for leg press and 75 lbs for leg lift). The leg press is a slightly different machine setup so the added weight is not the same as yours.

The instructions you were given are spot on! Did you notice, the pain you felt 4 hours later is not your knee, but the muscles that suddenly have to do more work. Start light, start easy to give them a chance to become reacquainted with exercise, then slowly and cautiously increase as you are able to tolerate. I found I was not able to handle much weight until 6 months post op, but not because of my knee. My issue was the IT band. That’s why it’s good to give those muscles and ligaments time to readjust.

Keep up the good work. You are making progress.
 
@NavyGunns
Yes, that’s exactly what I had; muscle pain. No surprise after they have been dormant so long. Actually, I now have very few sensations in my new knee that I would really call pain. Occasionally, where the implant is pressed into the Tibia causes a little bit of agitation, but nothing of concern. Prior to surgery, I used weight levels similar to what you do. My main focus now is to be in shape for the next round. I want my new knee to be strong enough to support recovery for the other one, and I want the next one to be in good enough shape to facilitate a quicker recovery. Once I can start a strengthening routine for the second one, then I can start focusing on those great pictures of South Carolina waterfalls that are beyond my range for the present. But I will take them, and I will post them. Thanks for your encouragement and support.
 
That's brilliant Denny, sounds like you have a great coach. I can't wait to start proper strength exercising again and get back to my Pilates and Keep Fit classes. I'm still not ready for that other knee yet, but it is still behaving at present. It will be interesting to see what happens when the painkillers stop and it gets more exercise.

Looking forward to seeing those pictures.
 
@Denny39 and @NavyGunns , gentlemen I applaud you, albeit the description of the exercises you’re doing with weights and machines is making my teeth water and baby knee is shrinking visibly in front of me!!! Hopefully I’ll get to that stage too but oh boy is it a while away yet:good-bad:
 
It’s trash day today. At some point this morning I suddenly remembered that I should have taken the trash out to the curb an hour ago. Our trash can be picked up anywhere from 7 AM to 2 PM. It usually comes around 10:30 AM. Unless of course, I haven’t taken it out on time, then it usually comes around 7:30 AM. Without Murphy’s Law, we would have no way to explain such phenomenon.

As I was scurrying around rounding up trash and bagging it to go out, it suddenly dawned on me that I was working furiously with absolutely no awareness of my knees; either one of them. That’s rare for my right one, because it has been a cantankerous pain in the South end lately. It’s also rare for my left one, because that is the first time I can remember that happening since my surgery, 12 1/2 weeks ago today. As recently as a week ago, I was still nursing a lingering doubt in my mind that could even happen again.

This knee is still very tender, and has a long way to go. There is still stiffness, numbness, and sensitivity to touch. It still won’t let me pull it up far enough to easily put on socks or tie a shoe, and will not put up with very much radial movement. It will still jab me with a sharp pain if I get careless, and it is still tired at the end of the day. But even that is so much better than anything I could clearly hope for, not all that long ago.

For those still in the early stages of recovery, I know what you’re going through, I’ve been there, and I’m headed there again, June 17. In a recent post, I said I could hardly wait to start this process all over again. I was being facetious. I absolutely do not want to do this again, and I am not looking forward to it. What I am looking forward to though, is being able to walk on 2 pain-free knees that are not pulling a bad back out of line. I got a little taste of that this morning. When my wife was diagnosed with Cancer, her Oncologist said, “The good news is that this is cureable; the bad news is how it’s cured”. He was right on both counts. She is going on 6 years full remission now.

That pretty much applies to TKR as well. The good news is its 98% success rate. The bad news is that first 8 - 12 weeks of recovery. It feels really, really, good to be looking back on that. There are of course, very real risks in any surgery, and this is a major surgery. When you are released from the hospital, you were given, or will be given, a list of things to watch for that could signal some kind of problem. Be aware of those, and if you experience any of them call your surgeon immediately. But don’t be pulled down, worried and anxious needlessly. If you are not experiencing any clearly defined danger sysmptom, but you are just plain old miserable, you are probably doing fine. That’s just the (bad news) nature of the first few weeks.

But there will be a time (a NOW if you will) to be looking back on the experience, and fully harvesting the results.
 
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Having no awareness of your knees must be wonderful Denny, even if it's only for a short while. I am looking forward to that day. Great news about your wife. I know what that's like. I'm 10 years in remission, long may it continue for us both!
 
@Denny39 I am less than 48 hours post-op and love your outlook and positive attitude. Thank you for the continued inspiration as I forge ahead on my own journey. I would love to be back on my road bike by fall for at least an easy 10 mile ride. Hope to be discharged from hospital this afternoon to start working on that goal.
 
@JDinCT
Good Morning, welcome to the club. While this particular club is not one we may look forward to joining just because it is “so much fun” (experiencing TKR was very, very, VERY low on my bucket list). Under the circumstances I can’t think of a better one to be in. I joined a little more than 2 weeks post-op, and immediately began to feel like I had found a Gold Mine of information and new family of traveling companions.

I hope you reach your goal. One of mine is to be able to hike into some of South Carolina’s many beautiful waterfalls that are currently beyond my range. But I will have to wait until I recover from having my other one done June 17, which is just as bad as the first one.

You have 6 months until Fall. That is probably a realistic goal. But DON’T PUSH IT if it doesn’t seem right. I know one guy who did that and set himself back a month or so. Remember pain and stiffness is usually caused by swelling, which is usually caused by overdoing it. I cannot deny that patience (unfortunately, one of the main ingredients in this formula) is NOT among my strong points. But under the watchful eye of my wife, I executed the prescribed ration of appropriate exercises and temporarily set aside my various conquests, and patiently plodded along the trail. Short-term recovery, 8-12 weeks, long-term recovery, 3-6 months, full recovery 1-2 years. We are all different. Find the pace and regimen that is comfortable and right for you, and you will be fine.
Hope you make that 10 mile ride, right on schedule.
 
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@Denny39, excellent feedback based on your own personal experience. Both of us know the value of our fellow members and the benefits of the feedback and encouragement we both get from and provide to each other!
 
Passed 3 months 2 days ago without even realizing it. New knee definitely strong enough to walk on normally with what I would refer to more as a minor discomfort level rather than a pain level. But notice that I said WALK on it. It still isn’t giving me a lot of latitude to do anything crazy, but it tolerates very well a good range of introductory strengthening exercises. @Lindylee, I think I almost caught up with you this morning being able to put on socks. I was talking to my wife at the time, and didn’t even realize I was doing it.

So here I am, experiencing things that I was assured were soon to be, but really had a hard time believing it. So for all who are still in those sometimes scary early stages, take heart. Those days and weeks will pass, and it will all have been worth it.
 
That's great Denny. Who would ever have thought something as simple as putting on a pair of socks comfortably could mean so much? The fact that you missed your 3 monthversary is also telling. We move from days post-op to weeks and then months and the day we forget to count says a lot.
 
@Denny39
I read one of your posts where you were getting a sharp pain under your patella. I am experiencing the same thing but at 4 mos po. Did the pain ever resolve? My doc thinks I have a fat pad impingement but thinks it will go away as it strengthens. It is very uncomfortable. My PT said there is a tendon there as well. I dont know what to do, it's still stiff, which means there is still swelling. I hope you are healing well. Let me know how you made out with that pain.
Thanks,
Dale
 
@Elad1002
Sorry you are still having that pain. It very probably is just a part of the very complex healing process that has to occur over time. When I discussed that with my surgeon, he explained that there are multiple layers of stitching under the staples that you do not see. Those can take up to six months to completely dissolve, and they will most likely cause some occasional discomfort or pain. The tendons and ligaments in that area could possibly be affected by that as well.

I told my surgeon it feels like the pain originates where the implant is pressed into the Tibia, and he agreed. That’s a major trauma for that bone, and it will take time to completely heal. Mine has diminished to the point where I no longer am really affected by it, but it still presents itself almost every day. I have found that I can walk pretty good now throughout most of the morning and into the early afternoon. But it still wears down and gets weaker and stiffens a bit by the end of the day.

You are right about the swelling. I realized that at this stage, most of the swelling was behind the knee and mostly in the bend. When Icing, I had been putting the ice over the top of my knee, and wrapping it down the side. I found that by laying the ice pack down flat on the pillow, and resting my leg on top of it, it got more directly to the swelling, and was more effective.

You are two weeks ahead of me, but that really doesn’t mean a whole lot as applied to any specific situation when you consider how different we all are in recovery, and my comments certainly aren’t meant to be a comparison. I think your doctor is probably right that it will get better as it strengthens. Remember, those muscles have been on vacation for quite awhile, and if they’re like mine, they are not real eager to go back to work. But they will. Ice and elevate, give it some rest. Hope you see more improvement soon.
 
@Denny39
Thank you for your response.
I, like you spent the first 6 weeks icing only the top and sides of my knee. I now use 2 ice packs, one for the bottom, and the other for the top and sides.
Things that have helped:
I go to PT for gait training, which has been very effective. My PT also does massage which also helps to loosen up the tightness.
Going back to work and being on my feet for many hours is challenging to say the least but takes my mind off of my knee. My husband takes over the cooking and evening chores as I am pretty well done by 5:00.
Good luck to you on your recovery and may you heal well.
Dale
 
@Elad1002
What exactly do they deal with in gait training? I think that might be helpful to me as well. I had a massage at about 4 weeks and I was afraid to let her touch those muscles because they were so sore. But I was amazed at what she was able to do with them.
 
@Denny39
In my case, gait training consists of my PT offering corrections to helps me retrain my muscles to walk properly and without a limp. I was limping for awhile before surgery and I was beginning to walk as if I was still struggling with an arthritic knee. It has made a great difference, and my posture has improved.
If you feel this may help you, go for it! Massage does hurt for a day or two after, but it helps increase the blood flow to the area. My PT uses a cupping method- also very helpful for swelling.
 
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