TKR The adventure begins

[sistersinhim]

Going down and back up those steps is not a baby step. It's a giant step! Especially on a 12 day old knee! Give yourself a huge pat on the back!

 

[Jajakio]

Day 13.
Had the best night I've had so far. Took a percoset about 10 and waited the requisite 35-40 minutes for it to kick in, icing and elevating while my son and I watched old reruns. Went to bed at 11 and fell asleep fairly quickly with ice on my leg. Slept until nearly 2, quickly popped another percoset, iced again and fell asleep fairly quickly. Woke up a few minutes before 6. New record for me. The pain is definitely more manageable. Tylenol and sometimes 1/2 percoset in daytime. One percoset every 4 hours at night. But nearly two weeks in, it still HURTS. I know I'm luckier than some, no infections, no setbacks, decent progress. But like a lot of others have said, this is a longer and more painful adventure than I imagined.

 

[SusieShoes]

Those stairs really are a giant leap. Just knowing you can do them if needed is a huge plus. I navigated a flight of stairs twice a day since week one, because that was where my bed and husband were. I told Mr. Shoes there would be no escape. It was a slow and painful process at first, but a real confidence builder.

TKR is unfortunately a painful and tremendously inconvenient surgery. NO ONE in the world would have it for a lark. The pain does get better, but slowly at first. Around the 5 to 6 week point most people notice they've taken a turn toward less pain. That's a long slog, but we all eventually get there. Stay with whatever meds give you relief until Mother Nature gives you the green light.

 

[Jajakio]

Thank you Susieshoes. It does help to be here and know others understand. I suspect my kids and husband are a little tired of my self absorption although they have all been very good to me. My 16 year old son is off for the summer and has been an unfailing source of comfort. He nags me to do my PT, doesn't complain abount driving me to appointments, and is always checking to see if I need something. My dear husband is doing both of our work in our appraiser business and cheerfully getting up at night if I need something. He is getting tired so it is good I'm sleeping better at night. He keeps telling me take as long as I need before going back to work. I have the option of doing a little at a time, a couple hours a day or desk work only when I start back. I originally planned for 8 weeks off but I can adjust as I come up on that date.

 

[Jajakio]

Well rough PT day. I could tell from the time I got up this morning I was stiffer than usual. No especially swollen just stiff. All PT exercises felt harder than usual, not really painful but high end of discomfort. Range of motion was down by 5 from the other day. PT says not to worry, it may be one step forward, one step back some days. They are good and don't push me excessively. On positive side, I am overall moving better. He says I can transition to cane as I want to and gave me a short lesson in using it. Still feels awkward and I need practice. Maybe not ready to give up walker entirely. Although I seldom use anything inside the house anymore.

 

[nensi]

Sounds to me like you are doing quite well jajakio! I am 8 days ahead of you, am a Slow Bender and have not done more than 3 steps at a time. I know, we are all individuals but still - your progress is good !
Not as fast as your would like, but our knees do the choosing. The only choices we have are to learn to make good ones, not overdo it, ice and elevate, etc, etc.

 

[skigirl]

I read your post on another thread and I wanted to say a few things, so came here to do so!! First, I do not think it is a good idea to take extra pain meds for PT. For one thing, you could injure yourself without even knowing it. For another, PT should not hurt you!! I never had a minute of pain in PT.

If you are stiff and in pain, then you are doing too much in PT. I really hope the PT is not pushing on your leg to get more rom!! That is a fast track to extra swelling and longer recovery. So, take it slow right now---you employ the PT, so you can decide how much is too much. Here is my idea of a guide---ride a bike for five min---swelling?? too much, ride for 4 min. No swelling? great, ride for 7 min the next time.

Each activity has to be added and increased slowly enough that you will not be in pain or swelling the next day.
Right now, your quads and hamstrings are not strong, so if you have to do a lot of weightbearing exercises, your joint has to help hold up the leg. It complains with pain and swelling. Listen to your joint, not your PT>

 

[Jajakio]

I appreciate your concern but as I stated i am stiff today but not swollen. I was very swollen is the beginning of week from going on an outing and sitting up way too long. I have learned from that and am being more careful not to sit with knee down for long and spend more time elevating and icing. I have a long time PT that I have a good relationship with and thus far he has not touched the leg or forced a thing . I am not one to blindly follow anyone's advice and if I were in pain or felt too overwhelmed I would stop or refuse an individual exercise. In fact today I was stiffer when I woke up and a little less stiff after PT. I do see the sense of the the advice not to push to the point of swelling or pain.

 

[kneeper]

Being stiff in the morning is very normal. It sounds like you're listening to the knee. Though do remember that stiff feeling throughout the day can be a manifestation of pain. I remember you are off the pain meds, but it's ok to take Tylenol to help with that feeling. While activity can help in the short run, activity can have a cumulative effect and make you more stiff and achy. Finding that balance is the adventure of tkr recovery.

 

[Jajakio]

Kneeper, it may be about the meds and that is worth considering. I did cut down somewhat on meds early in the week but I'm still on one percoset every 4 hours at night and cut to one half percoset every 4 hours in daytime plus a couple of tylenol. My plan is to slowly replace all daytime percoset with tylenol but probably keep on percoset at night for a while longer until I'm sleeping more consistently.

I did get another prescription for percoset so there is no urgency about completely swapping. I am considering whether go back to all percoset for a couple of days and see if that has any effect on stiffness. It honestly seems to have little effect on short term daytime pain whether I take one or one half. Nighttime pain has been worse from the beginning even when I was on full doses of everything. Going back on full doses all day may or may not have an effect on stiffness but I guess I won't know unless I try.

 

[Jajakio]

I had no idea using a cane was so complicated. I've been lucky enough to not need one before now. My PT, Paul, practiced with me today but I felt clumsy and haven't picked the rhythm yet. I may practice a while in the house tomorrow. I seem to get mixed up about which foot to lead off with and get out of synch before I know it. I think I'll stick with the walker outdoors for a while yet until this seems a bit more natural.

 

[SusieShoes]

It took me a few tries before the cane became "natural." Once I got the hang of it, I preferred it immediately. From there it didn't take long to using no cane. Mostly it was a matter of achieving a smooth gait. If your muscles aren't quite strong enough yet, the cane won't feel natural, so you're wise to stay with the walker until you get to that point.

 

[jeffm1955]

I'm have the LTKR with a conformis implant on August 31,I hope it goes as smooth as yours.Good Luck and keep up the good work.Keep me posted.

 

[Jajakio]

Good luck, Jeff. I did a fair amount of research and I have to say it was confusing. I met with 3 different surgeons with three different approaches. My original surgeon who had I been seeing for the past couple of years used an off the shelf knee with computer guided implant system. I had insurance issues and could not coordinate surgeon and a hospital which had his computer guidance system so had to switch surgeons. I decided on 2 other possibilities (one referred by my original surgeon). Surgeon#2 uses a minimally invasive side incision and a "sports knee". Surgeon#3 who I eventually chose uses the conformis custom knee. I was impressed with the notion of fitting the implant to the knee not cutting the knee to fit the implant. He told me I would lose 20-25% less bone than with an off the shelf knee and less blood loss. Surgery time was about an hour-roughly half the time the other surgeons quoted.

Overall I think I'm glad the first surgeon did not work out. I didn't know there were as many different choices as I eventually found out there was. There are a lot of varying opinions on whether the brand of knee makes a difference and I'm sure the skill of the surgeon and the condition of the knee prior to surgery and overall health of patient matter a lot also. All I can say is that I seem to be recovering well and the knee feels natural (like my natural knee with a bad sprain) and so far no clunking, popping or weird stuff. No tightness below knee, just overall soreness and pain where quad was cut, a little soreness in back of calf muscle and a little back pain/bursitis probably from laying around more and not being able to evenly balance on both legs yet.

 

[newlybionic]

Getting a rhythm using a cane was difficult for me too. It will come as you practice. Just remember your Right leg needs the help so the cane moves with it.

 

[Jajakio]

Thank you, newly bionic. I keep telling myself that but somehow it unravels in the middle and I am putting the wrong foot forward after a few steps. I am encouraged to see others struggled with it at first and I'm sure with enough practice I'll figure it out.

 

[Jajakio]

Day 15

My first full night's sleep! Or close. I went to bed about 10:30 right after pain pills, slept until 4:45, took another pill, walked around for 5 minutes, went back to bed, fell right to sleep and slept until 8:30 this morning and woke up feeling pretty decent. First time I woke up because I was ready to get up, not because pain wouldn't let me sleep anymore. I am so exciTed!

 

[sistersinhim]

I'd say that was a wonderful night's sleep! What a good morning!

 

[Jajakio]

It is a good morning. This is day 15 and I've had my two weeks of not being to concerned about what I eat. My dear friends planned a meal brigade and we've had dinner dropped off every night since I got home. It ends today and that is fine. I was enormously grateful and did not want to make a don't make this , don't make that list for them. We have no real allergies or other food issues so I just rolled with whatever was brought.

Now I'm able to get up briefly to cook. Long enough to fry an egg anyway. Plus I've got meals in the freezer and a 16 year old gourmet chef. He makes homemade bread and everything. So back to diet. I lost 40 pounds between this January 1 and my surgery in early July. I really had no choice. Not only did every surgeon I talked to want a lower BMI but so did my insurance and the two major hospitals in the area that I felt were the best to use. I had tried to lose weight before of course but I guess I just wasn't sufficiently motivated. This was do or die time. I was miserable, could barely make it through work, and too exhausted to do anything but lay on the couch and fall asleep in the evenings. So no more excuses about not being active enough to lose weight. A physical therapist did help me design 20 minutes worth of exercises to do twice a day in my hot tub and that helped a little with short term pain and made it easier to sleep at night after a workout but didn't do anything for weight loss.

I did some research thinking I had too much weight to lose to try some crazy diet for 2 weeks or a month only to go off and gain it all back. I had to figure out something I could do from here on out. I'm not going to preach a diet philosophy, I think everyone has to ask themselves what they can live with long haul and there is no one right answer for everyone. But I am living proof it is possible to lose weight in spite of limited mobility. For me, I virtually eliminated sugar, both natural and artificial, and cut down on bread, rice and high carb stuff. Those changes brought my appetite under control. I ate a lot of vegetables and meats along with a little cheese and fruit. The boys helped me clean out the pantry and fridge and we have had a rule if they are craving sweets or candy or ice cream they can go out and get some as long as they eat it all and don't bring any home. My husband has ls 15 pounds and my son between 5-10 probably due to not having sweets or junk in the house. When I was craving something I would tell myself later after surgery.

It was tough but on the day of the surgery I was 40 pounds lighter than 7 months ago. It didn't make much difference to my knee pain though and surgery was still a necessity. Still I was at a weight that made surgeon, hospital and insurance willing to do the surgery.

I am 5 pounds heavier than the day I went in for surgery but knee is still pretty swollen so some of that might still be swelling/water weight. . 5 pounds lighter than last week which I'm sure was due to some swelling going down. Somehow the diet turned into a way of life and although I had planned to take a month after surgery not to care, I'm ready to go back at it today. It feels like the normal way to eat now. I do indulge now and then. Like a dessert or candy bar once or twice a month but mostly I still tell myself later. I would like to lose another 50 pounds and for the first time in my life I think it might be possible. Mobility will be the icing on the cake when it happens but now I know diet alone can work for me.

 

[liam2015]

congratulations on your weight loss and just as important your lifestyle change with healthy food choices. your whole family will benefit. how kind and sweet of your friends bringing you meals for the first 2 weeks you were home. they must think you're pretty special.