TKR The right knee this time

[NimbleKnee]

I've actually got to the point where I want to clean the toilets.

Haha! Too funny! But yes I know what you mean. I’ve been knitting up a storm, even got a couple of items finished from my stash of Works in Progress, so some good is coming out of being bored!

Today I did my first outpatient PT. Not too bad. She is focused on my stretching and although there was some discomfort, there was nothing I would call painful. She at various points told me to let her know if the discomfort was too much and I only had to cry uncle once. My hamstrings are super tight because of the multi year pain I was in due to arthritis. Prior to surgery my extension was 12. Today it was 8, so some improvement there. My flexion today was 85, but the PT said not to worry, with consistent stretching and time, it will get better. She was very kind and optimistic, which really soothed the anxiety I was having about starting outpatient PT. I have my list of stretching to do at home, as well as her suggestion that I heat the back of my knee to loosen up the hamstring while icing the front. I am scheduled for weekly appointments with her and now I’m looking forward to them!

 

[mendogal]

Yes it's a fine line between discomfort (ok) and pain (not ok!) with manipulation by PT. If you can deep breathe and relax into the slow stretch it helps a lot, and makes it easier to say when it's time to stop.

 

[NimbleKnee]

Week 5

Sleep is slowly coming back to normal. I’ll have 2-3 days of 6 or more hours sleep, then a night of just 3-4. It’s ok, not perfect but getting better.

My OS cleared me to drive, as long as it feels safe, so I drove around the block in the middle of a weekday to test it out. Not bad, I felt I could brake and control the vehicle. I’ve been dependent on my husband to drive me around, so knowing I can now get behind the wheel if needed is reassuring. I will probably not drive much in the next week or two. I did ride in a car for about an hour each way to a nearby city and that was fine.

I also attended a performance by my ukulele group that lasted about an hour. It was fun being in the audience, and my knee was fine with the sitting. I hope to return soon to playing with the group.

Outside I use my cane, but mostly forget to use it indoors unless my leg is tired and complaining. I keep icing, elevating and resting as needed. I’m able to comfortably, if very slowly, walk my dog for 6-8 blocks a couple of times a day. He enjoys the slower pace since it allows him to sniff more.

I met with a friend who had seen me a few weeks ago, and she said I looked and seemed much better. She may have said that out of kindness, but I’m trying to believe it, especially on my down days when I feel progress is slow.

I’m grateful that I am retired and am not under pressure to return to work. I can really focus on activities that support my recovery.

Enough good news, haha. I’m doing my stretching 3 times per day, and am frustrated that my leg is not as bendable as I would like. I’m just impatient. I know it will get better in time, I just wish that time were right now! The stretching exercises start out being uncomfortable then feel quite nice by the end. They are a combination of straightening and bending in various positions. I sometimes also pedal on an under desk pedal machine I used when I was working from home before I retired. It’s less of a rotation than a regular bike. I mostly use this when zooming into a class or group event. One silver lining of the pandemic is definitely the wide availability of online meetings and classes. It makes life more bearable for people with health issues. My zoom sessions have been high points during this recovery period, and have helped me stay connected to people.

Allergies are in full swing, sigh…I know that has nothing to do with TKR, it’s just an addition to the misery level.

Even though I’m off the opiate pain meds, I seem to have the worst brain fog. I’m forgetful and having difficulty concentrating. It could be recovery from the sleep deprivation. I was probably worse before, but didn’t notice it. Now I’m a bit more with it, I notice how not with it I am.

Boredom comes and goes. It’s much improved since I can get out more. I am focusing on being mindful when I’m feeling bored and trying to recognize what is going on leading to the bored feeling. I think mostly it’s impatience and wanting things to be other than they are, which is basically a recipe for unhappiness. On the other hand, I’ve been reevaluating some activities I was doing to see if they were really adding to my enjoyment of life. I may drop a few things I was doing previously.

Wow! This is much longer than I intended. It’s so nice to have a place to express all this. Hope all of you here are having a good week!

 

[benne68]

Great update, @NimbleKnee! Lots of good information that will be helpful to others.

It's wonderful to read that you finding sleep comes more easily. That's a big milestone and definitely helps us feel that things are improving!

I’m able to comfortably, if very slowly, walk my dog for 6-8 blocks a couple of times a day. He enjoys the slower pace since it allows him to sniff more.

Being outdoors really helps with our recovery, so glad you can walk him and not worry he will do this!

Even though I’m off the opiate pain meds, I seem to have the worst brain fog. I’m forgetful and having difficulty concentrating

I had the same problem with my first recovery. I couldn't even concentrate enough to read a book until I was 6-7 weeks post-op. As you say, some of it sleep; but it also just takes our bodies time to recover from surgery. You'll get there -- just give it time.

 

[Layla]

Even though I’m off the opiate pain meds, I seem to have the worst brain fog. I’m forgetful and having difficulty concentrating.

Like both you and benne68, I experienced the same! I hated it. Couldn't concentrate on reading and I'd forget if I asked my husband a question and knew that IF I had, I forgot what he said! Honestly, it kind of frightened me, but it did pass, thankfully! Great update overall. May it only get better!

 

[NimbleKnee]

Week 6

Sleep is pretty much back to normal. Most nights I get at least 7 hrs. This is wonderful. I am so thankful.

Continuing stretching and bending exercises. This week at my PT appointment I had 4 extension and 103 flexion. This was after some massage and warm up exercises led by the therapist. Uncomfortable, not pleasant, but she listens when I say it’s too much. For example, she had me do some straight leg lifts, and asked can you do 3 more? I said maybe, and she said take a 30 second break then try. And I could!

Went to the pool twice this week, for just 15 minutes each time to stretch, bend and walk. After the first time, my quadriceps was sore the next day. Not painful really, but workout sore, though I didn’t think I did much. The next time, no soreness.

I made a mistake and sat for 2 hours playing mahjong, so my knee stiffened up. I got caught up in the game. I went home and iced and all was well. It was fun playing and talking with friends. Next time I will get up and stretch between games.

I’m still like Goldilocks trying to figure out what “just right” means for me in terms of activity, sitting, etc. Still icing and elevating. I often forget to use my cane and to take acetaminophen/paracetamol. I am fortunate in that I am rarely in pain and my stamina is increasing, although I have to watch it so I don’t overdo. I’m still in the early stages of healing, so have to take the time to rest even when I want to push through. Otherwise I get exhausted.

Hope all are healing well. And for those who celebrate, Happy Mother’s Day!

 

[NimbleKnee]

Week 7

Not for the first time, but this past week I practiced poor judgement and as a result ended up in the Over Did It Club (ODIC).

My desire to get back into the swing of things overwhelmed my common sense and my willingness to listen to my body. Now I'm paying the price. Ouch!

What did I do? A few things: longer and more frequent walks with my dog, more activities with friends that involved lots of extended sitting, and the worst one: instead of gentle walking and stretching in the pool for 15 minutes, I decided to resume a water aerobics class. After 20 minutes, pain started and I had to limp out of the pool and lick my wounds. As a result of all that, I had pain and swelling most of the week, some of which interfered with sleep. Back to icing, resting, elevating and mild pain relievers. Lesson learned!

My PT session was 80% the therapist massaging my leg. She recommended I do heat on the back side of my leg and ice on the top, as well as massaging the scar. I did some light exercise on a machine that looked like a horizontal elliptical which felt really good. My therapist said function is more important than numbers, but numbers are one way to track progress, and my numbers were showing progress: 2 extension and 110 flexion, which is only slightly behind the measurements for my other leg. I can definitely do more, but I need to go slow. She said very kindly, just because you can do something doesn’t mean you should do it, everything in good time. I’m very fortunate to have such a wise and knowledgeable physical therapist.

Hoping to get out of the ODIC jail soon, and slowly resume more activities. I guess I need to exercise my patience muscle more!

Hope all are having a good week!

 

[mendogal]

Don't beat yourself up! We have all done our time(s) in the ODIC.

Doing well puts us into a danger zone where we overestimate ourselves AND start slacking off on icing and elevating.

My takeaway from repeated, though brief, ODIC memberships was this:

If I can do something X number of repetitions, or X amount of distance, or for X length of time, don't increase anything by more than "X + 20%" - and try that at least a couple of times before the next increase!

 

[DizzyBlond]

@NimbleKnee Just hopping on here to tell you how much I appreciate your week-by-week progress report! My first TKR is scheduled in just over a month, so I'm now busy readying the house, purchasing the equipment, and attempting to mentally prepare for the "adventure" ahead! Seeing how your recovery is playing out (as well as the stories of so many others here on BoneSmart) helps to give me a general sense of how it might go for me, as well!
Just wanted to say thanks!

 

[NimbleKnee]

@DizzyBlond . Thank you for the kind words. Some of my experience might just be specific to my situation, but here are a few things we did that worked well, especially since this wasn’t my first rodeo (knee #2):
For the ice machine, which was provided to me from the hospital, we bought small water bottles (8 oz/250 mL) and rotated in and out of the freezer. Much easier and less messy than ice.
Equipment wise, the raised toilet seat topper was essential. Optional but nice to haves: gloves or padding for the first week on the walker when you are putting your full weight on it. A flexible but sturdy loop of some sort such as a belt or tubing to lift your operated leg in and out of bed until you can do it on your own. A compact bed rail (Google it) that fits under the mattress that has a handle to help steady you when getting in and out of bed. Lots of pillows, and a desk bed to eat on or put your book, cards or crafts. A pitcher of water and glass next to the bed. Easy to reach light since unfortunately you will be awake at all hours the first couple of weeks. If you have a separate bed or ideally a separate room to sleep in apart from your partner ( if you have one) , it will keep you both sane and comfortable. My husband doesn’t really cook, so we before surgery we bought a stock of healthier frozen meals (lots of veg and protein) as well as premade salads for the first couple of weeks. I had cottage cheese or yogurt and fruit for breakfast. Herbal tea with valerian root to help you sleep. Think about any supplements you may want to take such as calcium or magnesium. I’m not sure where you are located, but I also drank bottles Fairlife 30g protein shakes for the first couple of weeks to support muscle healing.
Just a few ideas, might be too much, but hope it helps you think about what will make your life a bit easier and more comfortable while you are recovering. It will be painful and uncomfortable enough as is, so anything you can do to make it easier will benefit you. Best of luck!

 

[Jockette]

In addition to all the suggestions above, I did a major stock up shopping trip, the week before my surgery, for imperishables, mostly non food items. I figured the less my husband had to shop for, the better for both of us!

 

[DizzyBlond]

@NimbleKnee Thank you SO much for the fantastic detailed list of ideas! I’ve got my raised toilet set and frame, lap desk, ice machine and small water bottles ready, but hadn’t given much thought to the challenge of getting out of bed. I’ll be referring to your post as I wrap up the last minute details come the first week of June - so appreciate you taking the time to type it all out for me!

@Jockette Yes! Buying all the things I can the week before will be on the schedule! I’ll be making my shopping list and doing a Costco visit, just so I make sure I have everything I may need or want - and thank goodness for Amazon in case there’s something I’ve forgotten along the way!