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Revision TKR Third and final surgery all done

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I will be so happy when that day comes when my knees don't rule my life. I believe it is coming but the timeframe is definitely uncertain. In the meantime, I need to enjoy life in other ways.
 
Today I saw my OS for a three month follow-up. He wasn't terribly disappointed in my lack of bend post my latest knee surgery, because he knew my other knee wasn't much better.
He did mention that if I wanted, he could always do a manipulation, but he said that it would be a big setback for me and didn't really recommend it now. I told him I didn't want it anyway, and I sure didn't want more propafal to assist my short term memory loss. He agreed.
I told him I am being as active as my knees well let me be with activity and exercise. He was happy about that and seemed supportive even though I told him I can't do near what I would like to because the knees get very mad. He said it's better to do some activity stuff every day for a shorter period then to go days without, mostly referring to walking. I suppose this could apply to some strengthening exercises also.
I also told him that I think I have some lymphatic issues in both of my legs that cause me to have extra swelling at times, and it seems that it concentrates or feels worse in the knees. My swelling ebbs and flows all day from mild to moderate. Sometimes it feels like both knees feel really fat and swollen and unable to bend much. It can be after I've been standing too long, laying down with my legs elevated, sitting for a while. No rhyme or reason in my opinion. It is weird and unexplainable. Always some swelling though, and so stiff if not moving for more than 15 minutes.
He wants me to see a lymphatic specialist, and I set up that appointment for early September. I also explained to him that I am still having trouble with my foot, back, hip/pelvis area, ever since my September crooked knee surgery. It is better though since my last surgery, at least 50% better, but still troublesome. He thinks my biggest problem there is just weakness and still recovering from surgery. I tend to agree with the weakness part for sure because it does seem that the muscles just don't have what it takes yet. Despite that I have been using them, they have been very pokey to listen and respond as I expect them to. I have never had this problem before where the muscles don't get stronger from exercising and doing normal functions, within four to six weeks.
He realizes that some people just hang onto swelling and all the reasons may not be known. He also said that some of his patients that say that they felt pretty good at one year out, reported that one or two years even more than that, in the second and third year, is where they said they really felt much much better. I sure hope that is me.
What choice do I have anyway? Like the doc said, as long as I am progressing even though it is so slowly, it is in the right direction and we just need to let things go and hopefully they'll turn out well.
The visit was better than I thought it would be. I thought he would be a little pushy and disappointed in my lack of progress, but he seemed joyful and encouraging, and said I don't need to see him for another whole year unless I have new problems. I guess I felt good about that, at least at this point.
Just need more time time to heal :tiredwheel::whistle::sigh:
 
So glad to hear you have a great relationship with your surgeon and are doing well! I’m sure you will keep up the good work and continue to heal. I will keep you in my prayers. [emoji175]


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I am one of those that felt better 3 years out and now feel GREAT! I wish I had started a slow walking regimen earlier because that was the turning point for me. I did strength exercises at PT but nothing made a difference like slowly building my walking. It’s all I’ll do when I get my left knee done.

When my swelling got so bad that I had to peel my trousers off like a banana I laid flat on the sofa with my legs on the sofa arm with pillows under and ice on top. It was the only thing that helped my swelling and I elevated normally 95% of the time.
 
@KarriB, when you say you elevated normally 95% of the time, are you referring to your torso laying flat, with ankles, feet, legs, way above heart? Wasn't sure what you meant.
Where are you icing up to six months postop?
My plan is to try to walk mostly every day, but not for a long period of time time until I can slowly build up the time and tolerance. This was my OS recommendation. I was walking 25 minutes, 2 or 3 times a week, due to my legs and knees getting too sore and swollen from that amount.
When you say slow walking, do you mean on flat surface, and keeping it slow until a few months out or did you just gradually increase your speed as you felt able?
But I feel weak in my thigh and hip muscles, so I feel they could possibly benefit from specific strengthening, if they respond to it. Walking helps these muscles, but not as aggressively unless doing hills. Am I thinking wrong about this?
I am glad to hear that you continually improved for several years after surgery. That is my hope and plan. I have to have something to look forward to :-)
 
I only elevated toes above nose when my knee felt like a sausage, the rest of the time it was up and level with my hips, but rarely with feet touching the ground.

I started walking super slow, just 10 minutes 2x a day. I’d set my phone for half the time I was wanted to walk and turn around, not worrying about speed at all. Every week I’d had 5 minutes to each walk, then when I was walking 20-25 minutes twice a day I consolidated to one longer walk, still not worrying about speed. By the time I consolidated I had no pain in my TKR leg and my natural knee felt better when I walked, but I was still working on stamina. Now, 16 months later I intentionally walk 2.5 miles most days in about 45-50 minutes. I’m not speedy Gonzales, but the point was to not have pain in my TKR after 3 years and I’ve been successful. Actually the
Activity progression for TKRs has a similar walking schedule for the beginning,of recovery. Walking was also a way to help me lose weight and start a healthier lifestyle even though I’m not an huge exercise person at all.
 
@KarriB, how many months after surgery did you start your walking regimen?
I see your surgery was almost 5 years ago.
 
That’s the thing, I walked with pain for the first 3 years until I began the regimen. I had pain the first few weeks of walking, but that stopped as I built up time. There was a bilateral BS member who inspired me by beginning a slow walking regimen during the first 3 months of her recovery. I thought, “if she can do this early in recovery there’s no reason I can’t”. At the time I believed my pain when walking or standing was due to my infection complication and/or my weight. But 6 months after starting to walk I could stand for 45 minutes and walk for an hour or longer without needing to sit.

I had PT during my recovery and at 4-5 months strength exercises, but only walking has helped me to walk. @SusieShoes also began walking during her recovery and had great success. When I eventually have my left knee done walking is how I’ll rehab, following the Activity progression for TKRs to build slowly.
 
@KarriB, when you say you had pain with walking, do you mean aching and pain during walking, afterwards too, and for how long?
At 3 months postop for my left, and 1 year out for my first right knee, (they both feel and act the same), I start out at a fairly good pace with no problem, then about 15 minutes in, my legs get very tired, somewhat achy, swollen and heavy feeling. When I get home, I have to lay down with legs elevated and sometimes ice, and rest for at least 30 minutes for them to recover. Then a couple hours later, my legs/knees feel like I have overdone it, and they stay more swollen, sore, bend less, for a couple days. My total walking time would be 20 to 30 minutes.
Last week when I saw my OS, he said to walk for less time but try to walk daily. What do you think? What helped you? I would really like to have a walking regimen, with hopes that my symptoms would subside instead of increase. I could push through if I felt there was a chance that my tolerance would build.
 
I began walking as a form of rehabbing my knee early in recovery. It was my plan going into the surgery. I'd read @Roy Gardiner's recovery thread and he did walking, you see, and I like walking... so I thought that might work for me. Then my OS also said his preferred rehab method for knees was walking. It was a double bubble of TKR recovery rehab!

So even in the hospital that first day on my feet I said, "Can I walk? Let me see." It was horrible. I could barely move. But it was a start. And then in the rehab hospital for a week, I said, "Stop with the all the knee bending stuff. I want to walk. Let's do that." So I did and they worked with that.

And once at home I started my own program. Every time I got up to go to the bathroom I would do a few circuits of my tiny upstairs or downstairs (wherever I was currently nesting) before returning to the nest. And a week later I went outside and did my driveway and back. I walked outside every day. A few days later I walked to the next driveway and back. And two days later I did two driveways and back. And... well, I kept adding driveways. And to the end of the block and back. Then around the block. And by three months I was doing a few blocks, about a mile.

Along this walking journey my knees hurt. They never didn't hurt. They'd been traumatized, so I expected the hurt but kept my eyes out for pain that was new or different. At first my legs would get that tired feeling you talk about, kind of rubbery. I paid attention to any swelling afterward (iced after every walk). Lots of other body parts hurt, too. My lower back at first was a beast. Some days I walked less because of it, not my knees. My left hip acted up at one point. My right calf. Both feet. My back right beside my right shoulder. Not sure why that acted up but it sure hurt when walking! But I just kept with it, the walking.

After a while all the pains went away. My belly got tighter too. The body got more into alignment, I guess. Walking is easy and painless now. That was what I hoped for going into this surgery! For me, at least, the walking rehab plan worked.
 
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@SusieShoes, and @KarriB,
Thanks for your responses to my questions. But I'm still not sure how much I should push when my walking produces increased swelling for a couple days afterwards. I suppose I could try just walking 10 or 15 minutes to see if that also causes this response. I have been walking more like 25 minutes or So.
I would love to try what you guys did and have the possibility of similar positive results, but I felt that the main thought on Bonesmart was, that if an activity causes you to swell more for greater than a day, it was too much and to back up or back off.
it is so hard to know what to do for me. Everything I have done seems to be in excess according to my knees. And feeling more swollen and sore for a couple three days afterwards , is continually my problem it seems. It sure doesn't take much to get them mad.
It is also a complicated problem because one he is one year old, and should be doing a lot more, while the other knee has had two surgeries and the most recent only three months ago. So I guess I have to listen to that one way more of course.
I will try the walking once or twice a day for maybe 10 minutes, and see how that goes first. Then progress my time as I see how I respond. Maybe once a day is going to be a Knouff for me but I hope not. I do stand and walk a lot in my house, and sit down when my legs get tired, so it's not like I am not being fairly active. But walking is different when I'm out on the road.
Does this sound like a good strategy to you two, or do you have any other ideas for me?
 
The pain I felt in the first years was different than, pre-op but it stopped when I sat down. So when I was teaching or shopping I had to find a seat similar to pre TKR, then I could get up and walk a bit again. Standing was worse than walking though. My legs also got tired and I had to be careful to lift them and not shuffle.

If I was you I’d start out really slow, once a day for 10 minutes maybe and see how it feels. After a week if you’re fine add 5 minutes to your total walk or try a second walk but keep it at the 10 minutes. I did have pain when walking at first, but it eventually stopped.

The treadmill is awful for me and just sits in my basement. It’s difficult for me to find a rhythm and it hurts in a way that walking outside doesn’t. I’d rather walk outside in 10 degree weather than on the treadmill.
 
Try walking only a very little at first. Whatever time or distance doesn’t cause your knees to swell. It may be only a few minutes or half a block. Once you have figured out your knee’s limit for activity, you can exercise up to that limit (and not past it) for a period of time to build a little strength. And then push the limit by just a little to see what happens. If your knees don’t protest, make that the new limit and so on and so forth. That might work out for you.

But yes, if your knees are swelling badly with any exercise, including walking, then you should ease back from that activity. Continuing to anger the tissues doesn’t help them to heal. At the same time, you don’t want to stop moving altogether. You’re understandably frustrated by these knees!

It’s good you’re keeping active. You’d go stir-crazy otherwise. I totally identify with your desire to walk farther and more often. Walking gives us some of the better things in life, like shopping and museums and strolls around the neighborhood. Street fairs and parades. Airports and travel. You want all the good things. If only your knees weren’t resisting your efforts to get them to that point. :friends:

Give your plan a try. Find out what your knees are willing to do.
 
And let us know how it works for you and your knees!
 
@SusieShoes, and KarriB,
Thanks for your specific and detailed suggestions for my walking program. I will try the very limited walking and assess later and the next day. I would surely love to be able to walk every day, once or twice, even limited time, and build up from that point to more time. Sure hope this is A ticket to better health for me and my legs in the future. I will let you know how it all goes.
It's just really hard for me to pull back the reins because of how long this has been going on and how much I want to get better. But this is my next adventure :)
 
It had been the very best thing for me, that’s for sure. But it does take patience for some to not ramp it up too fast. On the other hand, I’m not an exercise junkie, so I had to make myself do it.
 
Lately I have been trying to improve my nutritional health, even though I eat really well.
So I have been making bone broth and drinking homemade kefir. This may all sound weird, but I have had digestive issues most of my life and thought that's just how I am made. I have had plenty of distress from this body system on and off for years. But I do feel the kefir is helping with my gut health.
I also started going to the gym a few days ago and I plan to go two times a week. I have some bone loss in my hips and want to strengthen the hip and glute muscles for more stability with my walking and balance in general that has been compromised.
I also worked out on some upper body machines and that went fairly well too. I did try a knee extension machine with the lightest weight which was 10 pounds, and my 13 month old knee did 10 reps but it felt like it was straining in my knee joint. 10 pounds is the lightest the machine can do. Then I tried the three-month-old knee, and it couldn't even do one rep.
I guess I'm not real surprised about this because of how my legs feel with ascending stairs. So I have decided to eliminate that machine for a month or two until I feel I get stronger. I do think it could benefit my leg strength and thigh muscles, but right now it feels too vulnerable to injury.
But I am happy I was able to do something at the gym and I will continue with my walking and try to increase that, as my knees allow me to.
Again, I am looking at weeks and months of healing in my body in several different areas. But I am hopeful that at least some things are, and will continue to be, improving even though so slowly.
 
Yesterday I went back to the gym again, I am trying for two times a week. I mistakenly tried the knee extension machine again with my 13 month old knee, and it always seems to rebel when I do too much of any activity or any knee focused exercise such as, too much standing or walking,or stairs,or bending,or quad strengthening.

I have always had a temperamental spot on the bottom half of the incision mostly to the medial side of it. But today, I noticed the temperamental spot is a lot more swollen and it moves over to the other side of the incision too. So it is a fairly large spot, squishy and swollen and sore and achy there.

This is 13 months now, I did not think that I would still be having this kind of problem with exercise or increased activity. Needless to say, I am for sure NOT going to use that machine again for at least a month or two, maybe never. I will stay with climbing stairs, and maybe some mini squats, or sit to stand from a chair for quad specific strengthening. They just need so much work and don't seem to be responding very well to my efforts. They're not listening, even the old one. I just might have to stay with the walking and hope that does enough, even if it takes longer.

My surgeons PA, who I talked to yesterday about this, said that it could be a pes bursitis or a neuroma. He also said that they do not typically heal on their own, especially the neuroma, but said that a Cortisone shot in that spot might help. Have any of you heard of such a thing or did anyone out there experience either of these?

I told him I want to give it a little more time but may end up seeing my surgeon again and considering that. The last time I had a cortisone shot, it gave me tinnitus which never left. So I am reluctant because I sure don't need MORE ringing in the ears. And I sure don't want another surgical procedure to remove things unless there was no other choice and I was suffering too much. :bolt:

I just wonder if this knee saga will ever end. I just tend to get more angry than tearful over these continued problems. I guess that's good though because it makes me want to fight it and conquer it and win. :xmark:
 
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@kayow11
I accessed amazon by clicking on the blue banner at the top of the forum. It took me to amazon smile and a log in to amazon option. When I logged in, I was logged into amazon and the page said something like thank you for supporting FARM (but the words of Farm were spelled out) I didn’t have to look for Farm, I was automatically connected to supporting FARM.

I clicked on shop and looked at things I wanted to and those products said something like they qualified for Smile.

I wasn’t ready to buy yet but I think when we do make a purchase it will automatically donate to FARM.
 
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