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TKR Take Two

Today I had a different PT come to the house from the VNA. I like this person so much better and will have them Wed/Fri and then onto outpatient rehab.

Tomorrow is my 2 week post-op so I'm anxious to see how that goes.
 
Staples came out today, a couple not as easy as the others. Steri-strips were put down and I go back in 3 weeks. No more compression stockings either-yay! My outpatient rehab starts on next Monday. The health system where I had my surgery done and will have PT done has a transportation service for people like me who can't drive yet They utilize Lyft/Uber. So thankful for that.
 
oh my gosh you guys...the VNA home health PT coming out is so good at what he does. I walked today from my front porch down to the corner and back. A short half block, but I did it! Of course I was gait belted, but what a confidence booster and just being outside makes me feel human! I particularly like this PT, because he doesn't push me beyond any severe pain. It seems I will have a good start with OP Rehab starting Monday.
My measurements today were 116 flexion and 7 extension. I don't worry too much with the numbers because they do and will improve especially with good PT and my initiative to complete home work. Documenting the numbers is helpful to me because I tend to be forgetful at times.
 
Sounds like you are on your way to a great recovery! Don’t forget to elevate and ice frequently.
 
Awesome report @Jewlz1 I had a good PT like that who walked with me outside, gave me good tips and really helped build my confidence in those early days.

I think your attitude is great. The numbers are milestones that help you see that you are making improvements but you're not obsessing. (And most of us :whistle:have obsessed at one time or another about our bend, the scar etc. )
 
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kneeper said:
Awesome report @Jewlz1 I had a good PT like that who walked with me outside, gave me good tips and really helped build my confidence in those early days.

I think you're attitude is great. The numbers are milestones that help you see that you are making improvements but you're not obsessing. (And most of us :whistle:have obsessed at one time or another about our bend, the scar etc. )
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Thanks kneeper. Confidence after this surgery makes a big difference. I can be the queen of obsessing and can take the smallest thing and it will become a big deal quickly. I have to stop myself and back out of that way of thinking.
 
Today was a nice day. Sleeping is an issue and I noticed it today big time. Hoping to see improvement soon, but realize I'm in the way early stages. I had a neighbor come over and bring in a heavy box for me and we had a nice visit and had a couple of phone calls and did some exercises.
 
Finished up my home health PT yesterday. I'm going to miss my therapist. We were talking about my upcoming outpatient PT coming up on Monday. I asked him what should I do if they push me too hard? His reply was, well I push you hard. I agreed but reminded him of his mindfulness in making me stop if I'm wincing or seem uncomfortable and asking me what's goin on, talk to me. He told me that I'm the boss over my body. I wasn't trying to check him, but he gets an A+ from me with his answer.

I ditched my walker this past Monday evening and am now completing my exercises wearing brand new New Balance trail shoes this weekend so they will be somewhat broken for Monday. Pain level is 0 at its lowest and 2 at its highest. Nerve pain kicked in last night. Thank goodness I had some non-expired Gabapentin that brought quick relief within 45 minutes. Big bonus is I had quality sleep for the first time in 4 days. Really thankful for that.
I do need to figure out the nerve pain that is presenting in the web space between my big toe and 2nd toe. I can't remember the name of the nerve, but it was injured when I had a bunionectomy in 2004. There's something that is making it flare again and from studying anatomy in a classroom setting and using Google images, it may be coming from the common peroneal nerve, which branches off the sciatic nerve. Interesting to note that my lower back on the right side has also been painful, flaring during exercise. The back pain has on occasion been more severe than the knee. Heat works well for that. I'm not too concerned about the nerve pain, but will discuss with the surgeon's office this upcoming week.

If anyone has experienced sciatic nerve pain or peroneal nerve pain post knee replacement, chime in and share your experience. I did not have this type of nerve pain after my first knee replacement.

Enjoy the rest of the weekend!
 
Jewlz1 said:
Finished up my home health PT yesterday. I'm going to miss my therapist. We were talking about my upcoming outpatient PT coming up on Monday. I asked him what should I do if they push me too hard? His reply was, well I push you hard. I agreed but reminded him of his mindfulness in making me stop if I'm wincing or seem uncomfortable and asking me what's goin on, talk to me. He told me that I'm the boss over my body. I wasn't trying to check him, but he gets an A+ from me with his answer.
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He gets an A+ in my book too! IMHO a good PT will encourage and even challenge you a bit, but pay attention to the individual's situation.
 
I had another great night of sleep last night (thank God)! I do, however, find myself getting so fidgety as the day moves on. I do rest thru the day, but I'm also busy with adl's-today I took out the trash/brought it back in, did dishes, prepared a simple lunch/dinner and did a couple loads of laundry. It doesn't seem like restless leg, just bored and fidgety. Anyone else?
 
I'm officially past the one month mark. I'm reminded that even though the incision is healed, underneath the skin has a ways to go. I was all in my feels a few days ago as PT has been going well, good communication with the therapist who listens to me! But I am at the point in my recovery now where I suffered a major setback in my first TKR in December 2019. I don't want that to happen again. Last week while I was at therapy I was told I could start working on strengthening which I know is way too soon. My ROM is where it needs to be, so I'm guessing that's a marker for PT to start teaching strengthening exercises to their patients?

I've done something to my lower back that I think is from sleeping in a wonky position + doing some home exercises that exacerbated the tenderness. And my mind went right back to January 2020. The lower back is feeling better today, but still twinges on the right side when I raise my right foot off the floor. I did do some easy seated exercises today and some stretches for my back that helped. I need to check the Bonesmart library for when strengthening should start after TKR. I want to say 3-4 months post op? I go to PT on Tuesday and am going to tell them I'm not ready for strengthening exercises yet and want to continue the take it slow and easy with stretching exercises. Heck, they may be able to release me which would be okay with me. I have been experiencing a weird sensation like when a person hits their funny bone from my calf where I get zingers to my foot. Totally new, never had it with the first TKR. Sleeping seems to be improving and I hope I haven't just jinxed myself. Spending
time with my 7 & 9 year old grandkids tomorrow for a bit and feeling excited!!
 
Now Jewlz, don’t overdo it today with your grandkids! Sounds like you are coming along great. The zingers are quite common and can persist for some time.
Here on BoneSmart, we recommend strengthening exercises at 4 months out.
 
Hi Sr. Pat-thanks for that advise on the grandkids and the info on when strengthening exercises should start. They are great kiddos-we hung out talking while doing some Lego building, watched a Sponge Bob Square Pants and my granddaughter prepared our marinara sauce for spaghetti and meatballs. It was so good and she was very proud. So I didn't overdo with the kids. But the standing over the stove supervising and plating the meals and then sitting at the table were a lot for me. It's difficult for me to sit at the meal table because I have bar height seating and my legs dangle which creates a lot of pressure for the surgical leg. So, I put it up on another chair. Even though, I was pretty tired when they left to go home and then couldn't sleep Sunday night-argh! It was just so nice to have them over!

On to this hip pain I'm experiencing...it has really slowed me down. And my bend has suffered I'm sure. I'm also experiencing that tight feeling across my knee where it feels like the incision site is going to split right open, although it is fully closed and healed. Such a weird sensation. I'm not new to the TKR experience but there are new things and some old things that I had forgotten about. Going to PT today and am going to discuss putting off strengthening until later in this game and to continue with gentle stretching. I also think I'm going to start walking and see how that goes. I will admit I'm a big baby and afraid of falling. I have been ever since a bilateral bunionectomy where my deep peroneal nerve was damaged causing loss of feeling. And I'm by myself, and think what would I do if I fell? I need to get over that as walking would help me with my sleep problem too.
 
Falling is always of concern. I would start slow and take a cane and a cell phone to call for help if needed.
 
Had my official 6 week post op visit that was really at the 5 week weak mark. ROM is good, I've been walking unassisted in the house, and for dr's and PT appointments since week 2. I'm pleased, dr is pleased with my progress. He wants me to continue PT at home 1x daily. The next time I see him will be January 2022! He and the PT department at the hospital system I'm utilizing are all about no pain, and being gentle. I have to be careful because I have a tendency to push myself more than I should.

Sooo my health insurance benefits run out the end of this month. I do have another plan, a retiree's plan but it does not pay @ 100%. It's such a blessing that all of my care has been paid @ 100%. However, on August 1, I will be subject to a high deductible. So my PT is teaching me some strengthening exercises that I can utilize when the time comes. The PT is very aware of when I become uncomfortable with the strengthening and we will stop altogether or take things back a notch. I have not done any walking outside yet, but have been using the stationary bike, at the lowest level of difficulty and the seat is low as well. I'm close to completing an 8 minute mile on the bike which I'm pleased with. Hopefully, the weather (rainy) will behave soon and I'll see how things go walking outside.

That's all for now. I hope the other June TKR's are doing well!

Side note: with my complaint of hip pain the doctor had x-rays taken of the hip and pelvis. Both hips have mild osteoarthritis and there is degeneration of the lumbar spine as well. Really, no surprise there. I am stretching each day, sometimes before I get out of bed in the morning which has helped a lot with the hip pain. Speaking of the bed, I've had two nights in a row where once I fall asleep, I stay asleep-thank you Jesus! And I've allowed myself some extra sleep-in time to boot! I know things are always subject to change after TKR but I'll take sleep hygiene improvement as a win!
 
@Jewlz1 you might want to consider trying OneStep, a gait-based therapy program that we have found to be helpful in many cases. Your gait can impact all your joints and create back problems if not in proper alignment. We should be starting another promotion here soon for the program with special discounts for BoneSmarties, if you'd like to register. Just click on the sidebar ad to the right of your screen if you're on a desktop or laptop computer or at the bottom of the page on a smartphone. Here is a link for more details of the program:
bonesmart.org

OneStep App Request

Since December, BoneSmart has offered a number of pilot tests and special promotions with our partner, OneStep. Members were allowed to use this unique app at no charge to help us evaluate the program’s effectiveness for prehab and recovery for joint replacement patients. Feedback has been...
bonesmart.org bonesmart.org

It's also possible that you are experiencing some sciatic pain that could be helped by therapy for your back. This would be a separate diagnosis from your knee, so it's possible the clock on your insurance coverage might help cover therapy costs. It depends on how your supplemental policy is worded.
 
@Jamie Hi! Thanks for the info on the One Step program. I do think I would benefit from this. How will I know when a new promotion is put in place? Thanks for your feedback on my pain as well. Part of my problem may be a shoddy mattress. I have ordered a nectar mattress that was rated the top choice in Tom's Guide. It won't be delivered until September due to logistics in back of Covid and now with the Delta variant I hope it's not pushed out even further.
 
Update: I graduated from outpatient PT a couple of days ago-yay! My hip and back pain continues, mostly on the right side. Stretching continues to help. I was hoping to be able to get out and walk at a nearby park, but it's very hot in my part of the U.S. and I tend to sleep in past the cooler start to the day. So I've been riding the stationary bike and continuing with gentle exercises. I would like to start building endurance/strength for an upcoming trip to Washington, DC in about 30 days. But don't want to overdue that and create a setback for myself. Remember, I'm the gun-ho, self competitive type. So any suggestions for building strength and endurance so I don't poop out during our DC vacation are welcomed. p.s.-my knee has been so stiff in the mornings and I have the darn tightness feeling. Non TKR folks think this recovery is a one and done! Ha-sometimes I feel the same way! I know it's a slow and steady race to the finish line. I hope everyone is doing well!
 
@Jewlz1 A trip to DC in 30 days may indeed be a challenge. I would recommend focusing on getting comfortable with being on your feet for many hours. Start with short walks and build up. You do not need strength building. You need to be able to walk for a good length of time. DC is a great place to visit but here is tons of walking needed.

Be sure and take a walking pole or cane with you. Also take ice packs so that you can ice and elevate after a long day.
 
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