TKR Trailspud Recovery thread

[trailspud]

5 Weeks: Still at 115 flexion. Did a good elliptical workout last night so maybe some impact there as my knee had a little soreness afterwards (very little). I'm taking the next two days to focus on ROM and hoping to get closer to 120. Extension still around 6, but feeling like I can get a bit closer to straight in due time.

 

[trailspud]

1.5 Months: Stuck around 115 flexion, but I have been on my feet more at work and PT days have been following this and some longer workouts both which may have added a little swelling. I think I have hit closer to 120 at times in the evening, but outside of my morning PT sessions where I do not have a measuring tool. All in all I'm pleased with strength, motion, and general progress. PT exercises have progressed and I'm up to 40 mts. on elliptical at about 85% of old effort level. (do this roughly every 3 days). So far, the knee is sooth as can be on the bike, elliptical, and every other exercise.

I will admit the darn leg and knee still hurts a lot much of the day. I am down to 1.5-1.75*Percocet (the higher dose 10/325s) per day...one (1) in the morning and then 0.5 to 0.75 at night. I also take 2*500 mg Naproxen (old school anti-inflammatory). I would love to get off of the Percocet and just do ibuprofen (which also means stopping the Naproxen) and acetaminophen for pain management...may try to switch next 3-day weekend.

 

[maryo52]

Well heck you're doing better than you probably think. Probably if you lightened up your routine your leg would hurt less. It's a fine balance, fitness vs. healing. Do you give your knee Sundays off or anything? Do taper your percocet. I'm glad to see someone cutting pills according to need. Go to half a pill twice a day and then a quarter before dropping it. But don't rush because, hey, you're still less than two months.

 

[trailspud]

Well heck you're doing better than you probably think. Probably if you lightened up your routine your leg would hurt less. It's a fine balance, fitness vs. healing. Do you give your knee Sundays off or anything? Do taper your percocet. I'm glad to see someone cutting pills according to need. Go to half a pill twice a day and then a quarter before dropping it. But don't rush because, hey, you're still less than two months.

...taking every other day off and sometimes two in a row except some very light cycling to get my knee bending...so, I'm not overtaxing myself too much. I decided to quit the Percocet today...it's bed time so hopefully I can sleep. It's been over 24 hours since I've had anything except ibuprofen. If it's not time yet, I'll try one-half or 2/3rds of a tablet sometime in the night.

 

[maryo52]

Just so you know, if you have any withdrawal symptoms they might not surface for 2-3 days. Very likely you won't. Each person is different in this respect. But I have to ask, are you cutting out percocet because you think you should, or because you're not having much pain?

 

[trailspud]

Just so you know, if you have any withdrawal symptoms they might not surface for 2-3 days. Very likely you won't. Each person is different in this respect. But I have to ask, are you cutting out percocet because you think you should, or because you're not having much pain?

Maryo52: Thanks for your insights they are very helpful.

I tried last night, but couldn't sleep after 3 hours so I went back to to the Rx which helped give me a night's sleep. I have enough pain that an Rx is appropriate, but I can sense that a good deal of the tiredness I feel throughout the day is related to the pain med. During the day, pain is easier to deal with, but I couldn't sleep last night on just ibuprofen. I've already started a bit of a taper w/the Percocet so I'll try to do that on a bit more of a schedule. I'm also due to call my doc this week so I'll see what he thinks.

 

[maryo52]

That's a great compromise: med at night so you can sleep. You can also try less med during the day. I found 1/2 percocet 5/325 worked well. That would be quarter of yours.

You know that ROM thing, when I gave up focusing on ROM it continued to improve. I think it will do that regardless of what we do except when there are adhesions involved.

 

[trailspud]

2 Months: Flexion 120 & Extension 3.5 degrees respectively.
Too much activity...I told you sos welcome...beginning a couple of weeks ago brought on more swelling for a week or so (too many cardio workouts at the gym and outside work in the garden). I only hit 113 flex on 10/24...so I took 5 days off of any workouts and just rested my knee with only some light bending each day on the bike. My PT worked me over pretty good this morning, but I'm happy to have hit 120 after being stuck around 115 for a few weeks. Improving extension was good, too. I'm walking with a near normal gait and now just wish I could start working out normally again. But, I'm getting less impulsive (I wish slightly smarter) with experience, and I will take another couple of weeks off and start back slowly.

 

[1ELISEA]

2 Months: Flexion 120 & Extension 3.5 degrees respectively.
Too much activity...I told you sos welcome...beginning a couple of weeks ago brought on more swelling for a week or so (too many cardio workouts at the gym and outside work in the garden). I only hit 113 flex on 10/24...so I took 5 days off of any workouts and just rested my knee with only some light bending each day on the bike. My PT worked me over pretty good this morning, but I'm happy to have hit 120 after being stuck around 115 for a few weeks. Improving extension was good, too. I'm walking with a near normal gait and now just wish I could start working out normally again. But, I'm getting less impulsive (I wish slightly smarter) with experience, and I will take another couple of weeks off and start back slowly.

Hey there trailspud, sounds like you are doing well. Man, I know what it's like to be stuck at a specific ROM for awhile. And then klutzy me didn't help when I sprained the ankle on my other leg which didn't have the TKR.

Walking with a normal gait, now, pretty impressive, I remember your first posts about it. Say, have you noticed the surrounding muscles bothering you now that you are more evenly? I've been having the worst problems with my hamstring; it was so short for so long from limping, now I'm paying the price.

Great report, thanks for following up with it.

 

[trailspud]

1ELISEA,

I'm close to a normal walking gait. Of course, I have to loosen up a bit after being at rest. I still need to work more on my walking form, but I'm happy it's as close as it is. I'm only walking short distances now...would love to go longer, but I am being conservative. My quads are still weak which is more of what I have noticed (compared to hamstrings). Stairs are still a challenge, but I'm getting better. I definitely feel the weakness on stairs.

I will take time to read your recovery thread again. I do wish you the best and appreciate your kind words. My right leg was around 20 degrees extension at surgery and had not been straight for a decade or more...definitely a hard task to remedy post-TKR. My PT is certainly helping me get the extension back which is very important for walking form.

 

[1ELISEA]

Excellent trailspud!
Isn't it great, too, that PT is so helpful!
Sounds like we are similar on the stairs. I was progressing until my sprained ankle. PT an I decided to wait until the ankle recovered before tackling them again. Up is fine, but those same stairs going doooowwwwnn , well, let's just say it will take more practice.

 

[trailspud]

Happy Thanksgiving to all (well, a few hours early). I read this board a few times each week and follow a number of stories, but I'm posting less frequently. I enjoy reading of successes, struggles, and the comradeship in the exchanges.

12 weeks update: Flexion 124 degrees, Extension under 2 degrees. I have been able to make steady progress, and in the past week or so, I feel like I can finally be more active w/o causing a lot more swelling and/or regression in ROM. I have gone as long as 60 mts. on the elliptical and walked a mile yesterday in 16 mts. without pushing. Lots to be thankful for and just enough time to get to the gym before it closes for the holiday.

 

[TheHistorian]

Bravo!

 

[Nanners]

Wow you are doing wonderful! I am at 12 weeks now, but becuz of a set back getting sick at 2 weeks and being sick for the next four, really set me back. If I had your bend and straightening numbers, I would have already been dismissed from PT. But becuz of my setback I am still in PT, which is okay, I need the work. Keep up the good work! Hugs!

 

[trailspud]

Thanks, Historian and Nanners for the shout outs. I read the last page or so of Historian's recovery thread and will do so for Nanners. I'm thankful to have made the progress that I have.. Going from around 20 degrees extension before surgery to under 2 has been a bit of a surprise. I thought I would make progress on extension once able to cycle, but still I was only at 90 at surgery so getting to 124 in 12 weeks was hardly assured.

I really have to thank my surgeon, Dr. Kirt Kimball (Orem/Provo, Utah) and my PT, Dave Anderson (Meridian, Idaho). I traveled 350 miles to Orem, Utah to have Dr. Kimball implant the custom shaped/sized Conformis iTotal, and I was initially disappointed that he had to switch to another device mid-surgery. However, a few weeks afterwards at my last appointment, he told me that he gave me a new knee that will straighten and bend...it was now my job to get that part done. Dave, my PT, has really helped me accomplish everything to date, and I'm hopeful for more progress soon. The implant feel so perfectly smooth when I cycle, walk, or work out on the elliptical, I can't imagine any better at this point. The knee is far from healed and I don't expect my knee at age 30 to return, but it's so much better than before. I'm thankful I had such a skilled surgeon for my first TKR. I have thought that another surgeon might not have handled the mid-surgery switch so well and who knows then? I plan to return to Dr. Kimball for the left knee next spring and the same for my local PT, Dave, post-LTKR.

 

[trailspud]

4 months ago I was checking into a motel the night before my RTKR. Tonight, just after dark, I went for a 60 minute, walk (roughly 4 miles) with my 12+ year old dog, Cocoa. I had not walked for an hour in well over a year and on Christmas Eve did my first 30 mts. walk since TKR. Some of the past two night's light snowfall was left for Cocoa to enjoy and a near full moon lit the cold, still air. It was so nice to get some outdoor exercise. I'm usually going nowhere on a stationary gym machine. My replaced right knee feels pretty good and I clocked one lap on an old lumpy cinder track at 13 mts./mile pace. If I continue to progress, and my left TKR goes as well, I think I will be able to get back to some long distance hiking in the semi-near future.

Best wishes for 2013 to all who participate in this forum.

 

[Dulcimer Diva]

Congrats, Trailspud--no doubt the hard work you and your PT put in paid off big time. We finally got our first snow of the season here in Chicago Christmas morning (okay, weather gods: not funny, you can stop now). If my left knee and foot weren't so dodgy I'd drag my X-C skis out of the basement to practice in the back yard; but instead (if my cold doesn't spread to my lungs) I will do my first shoveling since before my RTKR. Guess for us flatlanders that's sort of a milestone.

Even more impressive, since you're just 4 mos. post-op. You live in a truly gorgeous part of the world. Oh, to live where snow is a welcome way of life instead of something to clear off the sidewalk and hope to avoid skidding and falling on!

 

[TheHistorian]

Bravo!

 

[trailspud]

Diva, Enjoy the Chicago snowfall. Sometimes a good hour of shoveling in crisp air is as good as anything. I live in a lower elevation valley in Western Idaho where the weather is pretty mild for the latitude. Before climate change, or whatever it is, we used to have real winters with a few good snowfalls that stuck around awhile. There were weeks where the temperature stayed below freezing. However, it's a short drive to the high country and plenty of deep snow. I'm hoping to strap on the snowshoes soon and take Cocoa for some real snow fun.

Historian, Keep those bike trek pics coming.

Hope all make great progress in 2013.

 

[trailspud]

5 Months tomorrow:
Flexion 125 degrees about 3 weeks ago is my best. I have stopped going to PT on a continual basis, but I think I'm still at or above 125. I wish for more and hope to get 130+ eventually. Extension near 0 and my right leg is straighter than my left. Walking outside w/my dog 40-60 mts. about 3*week plus a little more on the treadmill. Working at a higher rate at the gym on the ellipticals than before surgery (even set a one hour personal record on one machine last week), and did 90 mts. for the 1st time since surgery last night at a high cardio rate. I still have a little swelling at times, but icing helps as does taking a day or a few off from working out. A little pain here and there, but the replaced right knee is much better and stronger than before (and much better than my left). I have a bit more numbness (lateral down to upper shin) than I would like, but even if that never resolves, I think I have a great result from the RTKR.

My left knee is now limiting my replaced right knee (even in the gym). I exchanged a few calls last week with my surgeon's PA. I am in the process of deciding when to have my LTKR. I have to take some classes in June through early July so it's either do it by mid-April or wait until late summer (can't miss the height of summer). Conformis has made a design change to their iTotal (G2). The poly tibial spacer is a unique two-piece design (medial/lateral) and now the tibial tray has a divider for (theoretically) better fitting and articulation. I made sure I am getting the upgraded, newer design. I am torn as when to schedule, but I guess if I don't pull the trigger soon on an April date, latter August will be the default.