Revised PKR to TKR Tosh's PKR to TKR Recovery.

[Legseleven]

Oh no, the sciatica sounds awful. Otherwise you sound like you’re doing great. I wasn’t allowed to take celebrex or any NSAID until the blood thinners finished, but started them on Monday night. I find naproxen also good, as an alternative however the celecoxib is easier on our stomachs.
I still have inhibited quads, they’re improving, but this will improve more as the internal swelling subsides. I started with the leg lifter to do the lifts over the rolled towel, and can now raise a little unaided although not yet get onto the bed without lifting, however I can get off the bed now without it.
I’m happy with little victories as I know it’ll all come right. I too have zingers and niggles which are easy to cope with, it’s the deep seated bone pain through the night which remains challenging. This too will pass.
The numbness will lessen, it takes many months for nerves to regrow, and you may always have a tiny numb patch which you really won’t notice.
Thank you for updating us.

 

[Layla]

Taking steps away from the walker already, great news!

I am sorry you're dealing with the sciatica. It sounds miserable, Tosh. Regarding the numbness -
small sensory nerve fibers are cut with the incision. It is a temporary sensation that normally resolves over a period of six months to one year post op. While healing you may experience sensations of tingling, pins and needles, itching, burning and even the feeling of a minor electrical shock. These zingers, as you described them, are usually good signs that the nerves are spontaneously firing through the regeneration process.

First PT on Monday was disappointing b/c my quad was so weak. By Wed's appointment, I made sure to do the home exercises and it showed.

It is amazing how quickly our body responds!

Sounds like you'll be set up nicely for the 4th. Handicap access and fireworks at the beach! All you need to add is some bbq

A word of caution if you plan to walk on the sand. Your gait changes while walking on sand.
It's more of a workout. Beach sand provides an unpredictable and uneven walking surface. This can place increased stress / strain and loading on your joints. Walking in the softer sand requires increased energy expenditure, forcing you to work harder, compared to walking on an even, firm surface. The foot will sink slightly into the sand. This will provide the least amount of stability, which forces you to use muscles throughout your legs more.

Have a safe and happy 4th!

 

[benne68]

I empathize, @Tosh30. I've struggled with sciatica as well and it flared up during each of my recoveries. It did improve as I was able to become more mobile. For me, walking helped a lot.

Enjoy the fireworks!

 

[Tosh30]

Hope everyone in the States had a wonderful 4th. No beach time for me, as I didn't want to chance anything, but I reached the edge and caught some great fireworks set off just north of us. I've cut my Oxy pills in half and took a page from @Legseleven and moved my med schedule. I think the Celebrex has been helping a lot, but I was taking it in the morning. Just yesterday, I pushed thru the day and took it and other pain meds in the evening. I think it worked better, as I was able to log 6hrs of strong sleep. I'm getting zingers, happily, and was getting "bone" calls, which I'm calling these sharp intense pains in the inside of my knee, but go away pretty quickly. They have been diminishing over the past two days thankfully. Thursday morning I go to the surgeon to get the staples removed.

 

[Layla]

Sorry you missed the beach time, Tosh, but it was wise not to take any chances, especially so early on. Glad you caught some great fireworks in spite of your limitations. You have to be pretty remote to miss a display from some direction on the evening of the 4th in the states. The fireworks are still fun to ooh and aah over as an adult.

I hope the tweak in meds continues to work for you. Six hours of great sleep is a good thing! Funny how accepting we are of pain and discomfort (zingers) when we know it's a sign of healing, lol.
Roll on Zingers and bone calls! Happy Monday, and good luck on Thursday!
@Tosh30

 

[Legseleven]

@Tosh30 what a great description for that deep gnawing bone pain.

bone" calls, which I'm calling these sharp intense pains in the inside of my knee

You’re doing great. I was prescribed the Celebrex twice day, still on paracetamol (acetaminophen) and down to two single Nefopam per day. Looks like we are both progressing normally. I’ve also had 3 better sleeps in a row. Yay. We can do this.

 

[Tosh30]

Got my staples out this morning and it feels good. Showers now allowed without plastic wrap. Sleep is hit or miss, as some nights I get a solid 6hr, or like last night where I was up every hour. Dr says the swelling is down more than he anticipated, which sounds encouraging. Sciatica still beating me from behind, so Dr is going to prescribe a steroid and muscle relaxer. I'll try it to see how it goes. If it doesn't work, in another couple of weeks, I'll go to my back Dr and get an epidural, but I'll need to go off any NSAIDs 1 week prior - shouldn't be an issue. Dr says I'm cleared for driving, but I'm going to hold off one more week before getting behind the wheel. Starting today, I'm trying a whole leg sleeve to help reduce swelling a little more. Prior to today, the combination of staples and sciatica made that sleeve so uncomfortable. Icing multiple times per day in 10min spurts. Also touching my toes about 3x a day to help with the hammies. Yesterday I started walking slowly around the house and not using the walker going out. Focusing on making sure I'm pulling my right foot out of the step in line and not pushing out. Fingers and toes crossed.

 

[Legseleven]

Oh I’m so sorry about the sciatica, that’s a complication you could do without. Sounds like you have a good plan.
My sleep is good overall, however I wake to move, walk, or pop to the bathroom and then sleep again. We’re back in a heatwave and that is not helping. Wound looking good 7” long.
I can walk with no aids in the house but the swelling still limits the movement, and too much with no support leds to increased pain. Extension improving and flexion good (90+) for where I’m at. Mostly one crutch in house and definitely two outside for safety.
Keep on keeping on @Tosh30, we can do this. I had glue not staples.

 

[benne68]

Dr says I'm cleared for driving, but I'm going to hold off one more week before getting behind the wheel.

That's a wise decision -- especially since it's your right knee. Here are some tips for getting back behind the wheel:

Be sure you have been off all sedating painkillers for at least two days.

Before that first outing, make test your ability to safely control your car -- especially making an emergency stop. Simply sit in the driver's seat and practice pressing on the pedals. (Do this in a safe place without putting the key in the ignition.) Build up gradually until you can put enough pressure on the brake for an emergency stop.

If you feel pain, stop immediately. If you feel sore afterwards, wait a day or two and try again. You want to be about to hit the brakes hard enough to do an emergency stop - without feeling any reluctance or inhibition - before you consider driving again.

Best wishes. Let us know how it goes.

 

[sistersinhim]

Dr says I'm cleared for driving, but I'm going to hold off one more week before getting behind the wheel.

Before I did alone driving, I got a girl friend to drive me to an empty parking lot. I got behind the wheel and drove around for about 5 minutes. I did some fast stops to make sure I could and would. It was at my 6 week out that I tried this. I decided to wait another week, and felt real secure at that point. How freeing it was to finally be able to drive again! I'm sure you'll feel the same way!

 

[Layla]

Slowly but surely you'll get there. At not even three weeks post revision, I'd say you've earned a gold star so far.

Keep up the good work and have a nice weekend,Tosh.
@Tosh30

 

[Tosh30]

Good morning, but it wasn't a great night of sleep. Last night there were a lot of bone calls and zingers, which occurred in two spurts (130am and 330am), so I was in wide awakesville for a little bit. Last night, I took my normal Celebrex, Tramadol, and Magnesium Citrate, but no Zquil - to see what my pain was like. I think I may go back on it just so I fall back asleep a little quicker.

I've noticed some differences and similarities between my double partials last year and my RK TKR this year (more on that later). Good news is that I'm able to walk, albeit gingerly, for about a week. I was using a cane for some stability, but that was ditched about three days after ditching the walker. I'm concentrating on strengthening the quad. Early on, I'd feel my knee "go out", which my PT says was my quad not being up to the task yet. So I took it upon myself to use all opportunities to work on my quad, but not to excess. I'm taking 15 min each day to stretch. I'll lay on the ground, touch my toes, do some light trunk turns, and use a foam roller for my IT bands.

At PT, we're doing some e-stim, mini-squats (bar aided and butt out , and other quad exercises. Behind my knee tends to be painful, but I'm working through it, and wondering if it's also a little sciatica related. I haven't taken anything more than 2 Tylenol before those visits, but today I'm going to down an Oxy b/c it's inflexion Friday - yeah me! It needs to happen. I have intense pressure/dulling pain on the inside bottom left side of my right knee. The good news is that there's little pain anywhere else. I'm hoping that's just the last of the bone healing.

Sciatica has abated a bit, but isn't gone, so I'm stretching as much as possible. The incision sensitivity is different than last year. The top was the problem last year, but this time it's the bottom of the incision, but it's a smaller spot than last year (that's good news). K - sorry for the long update, but it's been a few hot days since. Hope everyone is doing well and staying healthy.

 

[benne68]

I was using a cane for some stability, but that was ditched about three days after ditching the walker.

While it can be satisfying emotionally to do this, please make sure you are ready for this step. You are still pretty early in this recovery and want to be sure you don't end up creating a different problem.

It's really best to continue to use some type of walking aid (walker, crutches, cane) until you are able to walk with a normal gait. Give up that support too soon -- while your body is still in the process of adjusting to its new structural alignment -- and you may end "locking in" a limp that is later hard to get rid of.
You might want to try heel-toe walking when you notice that you are limping.

If you are seeing a physical therapist, ask him/her to asses your gait. Or you can try something called heel-toe walking. This involves striking the ground with your heel first, then rolling through your heel to your toe, and pushing out of the step with your toe. It's important to slow way down and concentrate through the entire step. Here is a visual

If you can't do this securely, go back to the cane for a couple of weeks and practice this using the support. It can feel awkward at first, but with repetition, become more natural and after a week or two, you'll notice a difference in your walking.

 

[Layla]

No worries about the length of your update, we appreciate you sharing here and others will benefit through your words / experiences.

Sorry those odd sensations interrupted your sleep, thankfully they are reminders that our body is healing as it should. It's good to read that the sciatica is easing, may it only continue to improve.

Hope you have a relaxing weekend, Tosh!
@Tosh30

 

[eaglemom]

Checking on how your doing. I have some concerns about you not using a cane or walker. You don't want to get in the habit of walking incorrectly, as has been pointed out. I'm just surprised that you feel steady enough to go without. Good for you if you do, but don't rush things. None of this has a timeline.

 

[Legseleven]

Checking on how you’re doing. I have some concerns about you not using a cane or walker. You don't want to get in the habit of walking incorrectly,

I agree, plus I find too much unsupported walking can increase my pain. Currently I’m on two crutches outside, especially as the streets/pavements are not level; one crutch on rising (as always stiff) and room to room. No crutch within a room eg the kitchen and bathroom as there’s plenty of surfaces to lean on if needed. It’s absolutely vital to walk correctly as @benne68 illustrated and explained.
After the 18m I have had I do not want to be left with a limp or wonky gait. I’ll report in my thread after my physio sees me on Wednesday. I have over 90’ flexion but it’s still not enough for normal strides. Small steps are ok, and this is just temporary.
My motivation is simply the end goal, and I’m not fussed about using aids, and when out and about it also creates a useful warning as the many dogs, children and others give me a wider berth for which I’m grateful. It’s school holidays here now and there are many people all milling and dashing about in this small place.
My physio also warned last year that it potentially takes up to a year for the quads to be fully reliable and not ‘misfire’ when walking and especially on the stairs, so I am to always hold the rail even when I can do stairs normally again. Hope this helps, you’re doing good.

 

[Layla]

Hi Tosh,
Happy One Month Anniversary! I hope you're having a good week so far.
Wishing you continued healing...the best is still ahead.
@Tosh30

 

[Tosh30]

Good morning. I took the advice of everyone and went back to using the cane for 4 more days to focus on the heel ball toe process. On this Wednesday, the PT and I felt that I was walking pretty well. By Friday, we were practicing step ups of up to 6in. That came easier than I thought it would. For walking, I am making sure I work on my first step, it's straight ahead, dropping the heal, etc. Trying identify if I use the hip to move the leg forward, and stopping that habit. The PT shifted our focus to strengthening the right quad. I'm able to master the mini squat, I'm able to sit and get up from a 30in box (26in is the next goal). Even though I'm able to walk, I'm only walking around the house. We walked from a Dr office to the car and I felt so stiff in the knee, so I'm only practicing in the safe confines of home. My last knee inflexion only pushed to 105. I don't have a skateboard, but I do have tile floors and socks. I sit in a chair and go back and forth to try to get better at that number. I'm not pushing past slight discomfort - that's not my job . Last night was first w/o taking Tramadol - just Celebrex and 2 Tylenol. Slept in two blocks - 1030p-230a, then 3a-730a - good 'nuff. Incision area still uncomfortable.. Incision itself looks great. Yet I can't put a blanket on it, and the wind from the fan slightly aggravates it. Nervive may or may not be helping - jury still out on that. It's the small things that I notice that leads me to believe I'm making progress. It's a little easier to put on shorts in the morning. I can put all of my weight on my RK to get my left leg into the shorts. Getting into the car is easier now. It's the little things, right?

 

[Legseleven]

It's the little things, right?

It is and you’re doing well. Keep up the great work.

 

[Layla]

Yes...It is the little things, and they all add up. I think you're doing excellent given you are only one month post op from revision surgery. Hopefully the sensitivity you've described improves gradually over the next several months. You're still in the very early days of the healing process in the entire scheme of things.
Keep up the good work, Tosh!
@Tosh30