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TKR The adventure begins

I've got two knees to work with, and while I've experienced some clunking, I don't get a lot of it. Sometimes a little clunking in one knee, sometimes the other, and then might not have any in either knee for a week. Darned if I know why. My mom claims neither of her knees ever clunked. My sister says both of hers clunk all the time. The type of implant, individual anatomy, surgical techniques, swelling, muscle tone, gait... any and all of these might be reasons an implant will, or will not, clunk.

Given my druthers, I would rather have an implant that doesn't clunk!
 
I am sure we all would, Susie. I was in so much pain for so long presurgery, I will take what I can get now. My 23 year old daughter looked at my knees and felt so sorry for me. She's young and sees it as a great tragedy to have scarred knees. I told her I'm happy with the tradeoff. If I can walk comfortably I honestly don't mind the scar. I know it will fade some and look better but it still seems a small price to pay. I think I might feel that way about clunking. I don't have any yet and hope I don't but if the knee is comfortable and works well, I'll learn to live with it.

It seems I've reached another point in the aging process where I learn to accept that not everything is 100% problem free. Don't get me wrong, I'm only on my late 50s and plan to be active for a long time yet. My grandmother and all six of her sisters lived into their 90s and were pretty vigorous up to the end. My grandmother lived alone, did her own cooking, got a little help on cleaning and was pretty independent up until 2 weeks before she died at age 97. I'm hoping for much of the same. It's time I made the most of things, hence the weight loss and the surgery and hopefully continued weight loss. I was originally peeved when I couldn't find anyone to do surgery until I lost weight, but it was probably the best thing that could have happened to me. It forced me to figure it out and get going. I won't say it was easy but I lost 40 pounds before the surgery and just started back working on it again. I'm determined to lose another 50 pounds by next April. Husband says let's plan a nice Belize or Carribean vacation. That is our 38 anniversary. It is my goal to be 50 pounds lighter by then and walking well.
 
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Congratulations on driving so soon with a right TKR Jajakio! Whoohoo, there's just nothing like the sense of independence we gain when we get back behind the wheel!:yes!:

I used to clunk when I rolled around in bed, but not when walking. Now I don't clunk when rolling around in bed, but since PT yesterday, I have been clunking while walking, lol. I actually went back into the office immediately after my session was over to ask if this was ok 'cuz it was so...active! He laughed and said "Yes, it's the result we just worked for." They had me do several different types of "Silly-Walking" yesterday, so the clunk seems to be the result of that.

It's my understanding that as swelling decreases clunking may become more evident and as strength increases, it will become less evident. Makes sense to me.:SUNsmile:
 
Good for you to be driving so soon. I was forbidden to drive until 6 weeks post op and wouldn't because insurance would not cover any mishap prior to that ( being signed off by OS) but good for you if you can! As for clunking, I have had none but a friend who had his TKR last November is peeved that his clunks loudly!
I have heard it is nothing to worry about but most who have it are disturbed by it! I think perhaps they think others will hear it!
 
Yes, I'm pleased I can drive a little. 10 or 20 minute one way trip seems like about it yet. I think it will be a while before I'm ready for anything longer. I'm going to drive 10 minutes to PT tomorrow but still making my husband drive me for the hour trip to Nashville for my 4 week check up on Friday. But it is a nice sense of independence to drive for little errands. Or it would be if wasn't still too tired to bother! Still napping twice a day, elevating and icing then plus a few other times depending on the day. Just had a tired day and sent hubby out for pizza. We haven't done that too much but today I'm too tired for much else. I haven't done a whole lot today. Chickens and garden, wiped up the kitchen down for maybe 10 minutes, rode my bike 10 minutes, did some basic stretches. I did not leave home once. Pain is definitely improving from the first two weeks, swelling is slight to almost none depending on time of day. Mostly an issue of mild pain, stiffness and not full range of motion yet.

Prior to the surgery, I had asked the surgeon how long it would be until I got back to the point I was before the surgery; hurting but functional. I'm sure we were all at different points of functionality and pain presurgery. He said 4 to 6 weeks and I have to say I think he's going to be right. It is very different though and harder than I imagined to make a direct comparison on functionality. Already I'm sturdier on the leg with less pain just standing, pretty close but not quite to presurgery for ease of walking, much easier to swell, much more pain bending. Stairs are beginning to get pretty close to presurgery point of painful but possible for a least a flight or two. Im not going up foot over foot yet but i couldnt do that presurgery either. Much much more tired. A little more pain at rest than I used to have presurgery but that is catching up and it looks like that might be pretty close to equal by 6 weeks. I was in a lot of pain whether i was walking or not before the surgery. I used to wake up at night hurting. The pain is slowly ramping down but it may be longer than i would like before I'm energetic again. I still have a ways to go on ROM, about 100, but flexion is 0. I'm not quite able to walk without a limp yet but getting there. PT has me working on gait in front of mirror, trying not to swing my leg out or let it be stiff, at least a couple of years of bad habits to overcome. I can do it when in concentrating and then go back to bad form when I'm not thinking about it.
 
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Hi @Jajakio, I see you are a fellow Tennessean. I haven't been able to read your complete thread yet but saw a post from you on Jennszoo thread. I also had my knees 10 weeks apart. A lot of my reasons were the same as hers. I originally wanted bilaterals but my surgeon doesn't do them ever.

In PT for the lefty my right old knee bothered me more than the left which reaffirmed I needed to have it done. The plus side: only one event from work. I'm fortunate that I have 26 weeks of 100% pay. But I never dreamed I would be close to using it all! One deductible and I reached my out of pocket on my first surgery so the second surgery didn't cost anything.

If you are well prepared physically and emotionally it's okay. I had a total misconception of recovery. That's 100% my fault. I am a RN and knew how brutal the surgery is as I have been in the OR numerous times for knees. What I totally ignored was the recovery phase. I truly believed it would be bad for a couple of weeks but by the 3rd week I would be back to doing things I enjoyed around the house. I knew I wouldn't be working but thought I would have all this time to clean out closets, organize etc. I was told correctly but thought it didn't apply to me because I was strong, healthy, no weight issues and really wanted my active life back. None of that mattered. It didn't matter how strong, healthy or determined I was, pain is pain. Yes I believe my pre PT helped, being the correct weight and no other medical conditions helped but all it helped was I had no complications from those things.

The recovery is hard. It's just plain hard! I've been doing this since March and I'm sick of it. My left knee was fairly uneventful except for some back issue that aggregated a lot of things and pain meds make me a crazy woman!! I had two pretty good weeks between surgeries. My right knee was different from the beginning. Much more pain and a huge amount of swelling. I had swelling with the left but no where near. You have to remember you can't compare knees, even your own. There's no reason that I know of. He said he had to do more work on the right. I am 9 weeks today and have 0 ext and 90 flexion. I took to week 7 before I could get 90 on my own and no progress since. I am scheduled for a MUA on Wed. If this had been my first knee I would wait it out but since it is the second one I am running out of time workwise to get the flexion I need. My left is 0 and 130.

So... I would maybe consider bilaterals because I would be back to work now because I am 19 weeks on the left. If I couldn't do that a year later would give you time to recover and have some good months between. If the other knee is really bad like mine then be really prepared you are in for the long haul. Even when you know, it's still a long time. I'm sick of knees consuming my life! Would I do it again,,,probably:hairpulling:. This group is really an amazing support, they have helped me through some really dark days. Sorry this was so Long!
 
Thanks @becticu. Valuable information. I know we are all different but it is so helpful to hear from others like you who have gone through the process as I make up my mind.

I had my 4 week check up today. They took 18 xrays (literally) up, down and sideways. The tech frowns at xrays and says don't get dressed yet Dr might want more. So I'm terrified something is wrong. But Dr comes in with xrays in hand and says it looks great. We sit and go over xrays and he shows me everything in place where it should be. He prods, and pokes and bends my knee . He thinks my progress is good. I'm officially released to drive. We discussed the other knee. Im not sure what I want yet because it hasn't been hurting too bad yet but this has been a more sedentary than usual month and obviously I've been on a lot of main meds. He says probably wait and see. It is strictly up to me. He says he is ready when I am and he's sure insurance will be okay with it. We agree to discuss it again in 2 months. All in all an good day.

Now I have a tough decision to make. Case manager in the hospital told me I have maximum 20 possible physical therapy visits this year. I have already used 10. I'm doing well and actually enjoy my physical therapy. But it's not rocket science. I can do 90% of it at home and based on the hot tub therapy I did before surgery I'm pretty sure I can make myself do what I need to do. I bought a recumbent bike the other week and have ridden it every day since. That would save 10 visits for my other knee if I get it done this year. Dr would prefer me to stay with PT but he gets my point. No guarantee I will do the knee this year . Maybe I'll get lucky and not need it. I'll know better in a month or two as I get more active. But I need to decide on continuing PT now.
 
Day 29.

I though I'd post what I could actually do at 4 weeks to remind myself how it was when I'm looking back or doing the other knee. I can walk with mild discomfort probably under 1/2 mile, knee isn't all that painful but a little and still some stiffness, I don't have full range of motion yet. PT measured 100 a couple of days ago and flexion has been 0 from the beginning. I can climb 12 stairs to basement foot over foot if I concentrate but some discomfort/ pain. I have to go down 1 step at a time not foot over. I can ride exercise bike- tight for the first minute or so then loosens up and isn't painful. None of the PT exercises hurt at all except mild discomfort on the particle squat, undoubtedly because I was doing nothing like that preop. The knee was so bad I was exercising sitting down in hot tub, bicycling, leg raises, stretches and all those came pretty easy afterward. I generally feel pretty good after PT, less tight anyway. I'm off everything but tylenol and an oxy every now and then on a tough night. Sleeping is better but I still generally wake up once a night and get up for tylenol and fresh ice. I'm still napping with elevation and ice once or twice a day. Doctor says I can ease back into work as it suits me. I scheduled one job for next week which means maybe 2 hours in the field and 5 or 6 hours on the home office computer broken up any way I like. I'm going to see how that goes before I schedule any more.
 
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Wow! you are doing great @Jajakio. I'm glad you are easing into work and can break up the computer sitting. I did the same at about 4 weeks and found even half days to be quite tiring. It is nice to be able to do some work at home.
 
I'm sure it will be tiring. I figure to put about 10 hours in next week spaced out as I need to over the whole week. And 3/4 of that at the home office on the computer. Sitting for a long time is still an issue. If that goes well, I ll up it the next week. We have had our business for over 20 years and have plenty of clients. I told everyone this next month is going to be catch as catch can and I expect I'll turn down more work than I take. It's just too hard to guess how fast I'll bounce back.
 
Sounds like you have a good plan for easing back in. It's hard when our brains are ready for a little more challenge when our knees aren't. Hopefully your clients will be patient with your recovery timeline.
 
What a fantastic post-op visit you had! Just because you have 10 PTs available to you, why do them if you don't need them. Every way we can help to save insurance companies just might help to save our monthly premiums! Especially since you can do almost everything at home. That saves you gas money, too.

After going back to work, don't plan on doing anything but resting when you get home. You will probably be pooped. Don't forget to take some ice packs with you. They really help!
 
While i can ice at my desk at home or just quit for hour or two, taking ice to work really isn't much of a possibility. I'm a real estate appraiser and my out of office time involves driving to a property and walking it over while photographing and measuring. The last few months before surgery I was in such bad shape I usually took husband, who is also an appraiser, or 16 year old son to help with any rough parts or climbing. This is a partial week for school so my son will probably go with me for the first job.
 
Re: insurance and physical therapy. I'm all for not unnecessarily using medical resources but honestly if I wasn't contemplating another surgery, I would probably keep going to PT. I like the structure and the professional opinions on where I am. I am not in bad shape but I still can't bend past 100 yet. It has been slower going with that the last couple of weeks and while I'm not worried yet, I like the idea of someone keeping an eye on it. I need to make up my mind and so far am opting for no PT at least for this coming week. I plan to do my own routine that fairly closely mirrors what they were going. If I don't progress in the next few weeks, I may go back.
 
Sounds reasonable. See how it goes on your own for a couple of weeks.
 
@Jajakio, I don't know if anyone has told you this as yet, but you are doing remarkably well for just 4 weeks post-op! Truly, you are, and your ROM is fabulous for this point in time. :wowspring:

I can see how your work would be tricky since it requires two of the more difficult aspects of recovery; driving and lots of sitting with the leg down. With any luck, both will improve quite a bit over the next 2-3 weeks.

Like you, I also have another knee that needs replacement, but....I'm holding out for at least a year unless something dire occurs to force my hand. I decided on this path because I want some lengthy, quality time that isn't knee-centric. In other words, I need a break, and my husband does as well.

At 11 weeks post-op, I am still in PT, but I actually enjoy it and find it very beneficial. I've had a slow recovery with very hard-won flexion, and feel I need all the help I can get. My PT is of the "Less Pain=More Gain," philosophy, so it's not a hardship to attend. So far, insurance has not been problematic.....*knocking on wood*. My OS wants me to continue for the next 4 weeks in the hope my flexion will improve to at least 105-110 degrees. It's at 94 degrees right now, so that's certainly within the realm of possibility.

At 4 weeks, I still needed daily naps, often more than one, and was able to slowly taper of the Rx pain meds. I found a big increase in energy between weeks 6-8, and that was a most welcome surprise. :SUNsmile: Like you, I was not able to go up or down stairs, foot-over-foot at 4 weeks, (not sure if anyone can?) but going up became possible around Week7. Not gracefully, but possible; hah! Going down was just achieved this past week! It's a really exciting moment and one you will enjoy enormously.

So, be patient, and good things will come your way very soon. Hang in there!:flwrysmile:
 
Thanks @Pheebs52 , it is nice to hear you think I'm doing well. Sometimes I think so, some times I don't know what to think. My husband says I'm too competitive and I suppose that true. He is my true compliment, very laid back. He keeps telling me we are fine financially and I can have as much time off as I want or need. I just want to get back to normal I guess. This last week was the first week i was feeling well enough to be getting bored too. So I'm taking one relatively easy job just to see what happens. . A normal week is 5 jobs or occasionally a bit more. I think 8 or 10 hours spread out over the whole week will do it, allowing for a little spaciness and taking breaks when I need them.
 
Hah, my husband and I are also good examples of "Yin and Yang." Apparently, it works, since we've recently celebrated 43 years of wedded bliss.:heehee:

I think your back to work plan is a good one, although quite early. But, since most of it is done at home and you can just dip your toe in with only 10 hours spread over the whole week, it might work. I know I couldn't have done that at 4 weeks, but, we're all different. I wasn't even driving until Week 5 and that was limited to very short drives of just 10-20 minutes.

I think we all question our recoveries too much, but I also think that's a natural response. When we just let go of how we think we *should* feel, things seem to improve dramatically on an emotional level. I much prefer the days when I don't pay any attention to how I feel and I just "go with the flow." Thankfully, this has become a more frequent state of being, which doesn't mean I'm 100%, but I accept where I am on this very long road.

At any rate, I'll be interested to see how you do with your work experiment and wish you the best of luck!
 
I can see why you can't ice while out on the job. Could you take a cooler with ice and put your ice packs in there? Any icing would be a help. It is so early for your going back and it sounds like it's not an easy on the knee job. You can ice while driving. I think most of us have done just that in the early days.
 
Yes, I suppose I can ice while driving. It is about half hour one way trip and I plan to take son. He can drive if I poop out. It is a repo property which means no one else there. Just lockbox and a code to get in. So I can take my time or sit down for a few minutes if neefed. I've deliberately taken small easy properties. So far one for this week, one for next week. Depending on how this week goes I could add another,job next week or stay where I am. Client would be happy if I would take 5 or more but I can kind of be selective at this point.
 
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