TKR Twelve days post op for my second TKR: left side this time

[susanlondon]

You pegged me to a T, as my mom would say. I am extremely "hard" on myself, but I am also a very active woman who has a lot of energy. The recovering knee has certainly slowed me down, but hopefully, all will be well as time goes by.

I can empathize with your man. I, like you, wanted to know all there was to know before committing to this very acute surgery. Not on,h did I read, but I also watched YouTube videos of the surgery. Yikes! If anything will make one cringe, that will. On one hand, thank God for the technology and knowledge to help those of us with worn knees to have a new lease on life, bit on the other hand, the surgery is very complex and affects so much soft tissue. My crying was often connected to the feeling of being aghast at what I'd subjected my poor knee to by giving permission for the surgery. It's amazing to consider the healing properties and power of the human body.

I hope you hubby is doing well and that you are finding some time to rest. Not many consider the caregiver's role in convalescence. My youngest son, a carpenter who also does EVERY thing around his house, was helping me several times a week for the first four weeks of recovery. Although he would do anything for me whenever I needed it, I could see the exhaustion and expending of energy on his face after a day of work and a bout of helping me before heading home to deal with several more hours of household chores at his own home.

Enjoy the weekend. My daughter in law is from Missouri. Where do you live? I'm in upstate NY, a beautiful rural area surrounded by farms and rolling hills and dales. Hooray for summer!

 

[tiredwife]

@susanlondon I live in a little town about 60 miles east of Kansas City. I hate our summers here, very hot and muggy and lots of bugs. I was raise in Wyoming, this is a lot different.
Really I only had to do things for my husband the first few weeks, he hates people waiting on him. He has had a fairly easy recovery compared to a lot of people on this forum. The main thing that exhausts me is I watch our 3 year old grandson while his mom and dad are at work. I'm to old to be getting up and down off the floor to play with him all the time.
Hubby is 6 weeks 3 days today, and other than the scar you would never know he had his knee replaced. He is doing a lot better than before surgery and will get his other knee done the 6th of August.
Don't overdo it, and have a great day.

 

[kneeper]

it's great that you're getting out and riding your bike.

 

[susanlondon]

Feeling impatient today due to still having unaccounted for stiffness popping up several times through the day. At 9 weeks post op today, I am riding a paltry 3.5 miles on my road bike, spending time several times a day in my pool, gently kicking as I paddle round and round, doing PT exercises every other day as per my therapist's recommended and trying to have a normie life again. I still take stairs one at a time out of habit and have an almost constant pulling at the tippy top of my knee where the quads seem to connect to the knee. I am massaging and gently touching to stimulate blood flow. At times, my gait looks normal; at other times, not. I'm hoping that, as the chart for recovery notes, that twelve weeks will be the turning point for the after effects of surgery to magically disappear.

My big concern still seems to be my now 114 degree rom, which is 13 degrees less than my right knee now has. I keep thinking (Negative Nancy) that I won't get to 127+ on my left knee! which would be a disappointment for me. I have been bending in the pool, which is much easier than out of the pool, but then feel a stinging below my knee which reminds me of the dastardly discomfort of the osteoarthritis that made me want to have the replacement in the first place. I spent last night wondering if my OS actually cut out all the arthritic bone or not, thinking the osteoarthritis was kicking up again.

Someone on the site was supposed to send me his ideas about ROM, but I have not received anything yet. Thank you for any suggestions you may have to offer.

 

[kneeper]

You might be actually doing a bit too much at 9 weeks. remember that each knee is individual in its recovery.

 

[ATPlus]

You're an active person and eager to return to your active lifestyle. I feel some of the things you've done might've been a bit much earlier in the game but it is over 2.5 months since your surgery. The words @tiredwife gave about no 2 knees being alike couldn't be more accurate. ROM will increase with time.
I had a PKR 8.5 years ago. No PT other than my own. I was NOT willing to sweep floors etc. but after 3 weeks I did drive because I ran out of groceries. You're activities me wince thinking about the pain but I'll give you loads of credit for going for it.

I'll be having a BKR in August (postposed for 2 weeks) and I'm going to take things from my knee's perspective-
What is she doing to me? Give me a break! I'm really sore! There will be no sweeping, weed pulling or berry picking for me no matter how driven I feel. Getting to the toilet will be the big work-out of the day for me!
You're enthusiasm is going to make me feel like a total loser!

 

[bottomshollow]

ROM, Extension and Quad exercises.

@susanlondon, This may be what you were expecting to get. Take a look and see if this will be of help to you.

 

[tiredwife]

@susanlondon From my husband to you "If my bike (motorcycle) was going I could ride much further than that"You are much to hard on yourself, you are doing great!

 

[susanlondon]

I have posted under another thread but am unable to open it for well over 12 hours, so I am posting on another thread. I hope to hear from some Smarties about this issue.

I am 12 weeks post op from a LTKR. My arthritic stinging waves of pain are gone -Hallelujah!- and so is most of the soft tissue discomfort. I know I've overworked my knee and have been told by PT, doc's office, etc, to lay off the bumpy yard walking, exercising everyday, trying to increase bike mileage more quickly than one week at a time, but I am a foolish girl and continue to try to live my life without heeding to my knee's needs. Now, I fear, I've wrecked myself.

On a bike ride last week, before I'd actually gotten off the block, I felt, on the first upstroke, a screaming pain along the outside of my knee. I'd just finished using a foam roller to stretch the quads and IT band before heading out on the bike, a thought that came to me while laying in bed the night before and reading about tight quads. (I'd used the roller successfully for my RTKR after a few months and didn't hurt myself the way I seem to have now.)

Upon, as I said, the first upstroke on the bike, I felt the pain, but I continued to ride (for almost four miles-not as far as I hoped I'd be with my left knee at this point), thinking the pain would work itself out. It did, for the ride, anyway. Several hours later, however, I was one hurting cowgirl. I've been using knuckle massage, laying off the roller, no bike rides, except on the recumbent bikes in my house. The side of knee pain has subsided somewhat but not enough to say it's gone.

I see my OS this week and will ask about this. I have read the BS site and articles about IT band syndrome and realize it's not uncommon. Grimace here.

Another, more worrisome concern, is the still swollen area above my knee. It's located above the kneecap toward the medial side of the knee. I have returned to work at the farm stand in my town, but only for 2-3 hours at a stretch a few days a week. The floor there is concrete. I've been out in my bumpy yard from time to time as well, trying to do some minimal yard work (applying milky spore for moles, berry picking, etc.). Do you think the concrete floor is creating stress to my recovering soft tissue?

I also realized, last night (do my best thinking then, apparently), that I find myself limping (at 12 weeks!!!!) when at work on the farm or at other times. However, when I get home and walk barefoot or in my sandals, my gait is normal. I had the sneakers checked before surgery and found them still wearable, but now wonder if, now that my leg is straighter and my foot falls differently on the ground, could the old sneaks be worn at the angle of my former gait, and might this be the cause of my limp in my sneakers. I will be seeing my pedorthist to be fitted for new orthotics next month. Needing new inserts may also be a factor.

I appreciate any advice or suggestions anyone may have to offer about these issues. Thank you.

 

[Pumpkin]

Sounds like you are a member of the ODIC, and need to rest.
Concrete is very hard and could be contributing to your discomfort. Your shoes are probably worn in your old walking pattern and should be replaced. Since you are fine with barefeet and limp with the shoes, that is an indication that they are causing the limp.
I will tag @Josephine to assist with the swollen areas you have mentioned.
Follow your OS's orders and stay out of your yard for now and let your knee settle down.
Once you have your new shoes and inserts, and you knee has healed you will be able to resume your active life.

 

[Josephine]

I have posted under another thread but am unable to open it for well over 12 hours, so I am posting on another thread. I hope to hear from some Smarties about this issue.

I've merged your threads.

but I am a foolish girl and continue to try to live my life without heeding to my knee's needs. Now, I fear, I've wrecked myself. Another, more worrisome concern, is the still swollen area above my knee.

Easily done but very difficult to undo. As a cautionary tale, I am going to tell you about a gentleman I had occasion to review in the course of my occupational health work who was 5 years post bilateral TKR. He had appalling ROM, only about 90 and 100 flexion and both legs were grossly swollen. He also said he was in bad pain in both knees and was convinced his surgeon had botched the surgery.

In my time honoured way, I picked at him until I had a good report on his activity in the first three weeks when I found he was doing 60 reps of various exercises three times a day from day one, (total of 180 per day) he went shopping every other day in the first week, walked 1½ hours twice daily and returned to full time work at 6 weeks. He's a shelf stacker at a supermarket so it's heavy work. In addition from the start he would take any pain meds as he felt that, being a man, he should be able to handle the pain! So I asked him if it didn't hurt them he did all that exercises and walking. His reply was"oh gosh yes, it was agony"! Seems he has kept up this insane exercise regime ever since then and so I had the sad job of telling him that he had an extreme case of self-inflicted chronic inflammatory condition and would most likely be stuck with this for the rest of his life!

So you are only 12 weeks out yet and still early enough to take this warning and cut back significantly on your activity so you don't suffer the same fate as this unfortunate man.

Do you think the concrete floor is creating stress to my recovering soft tissue?

Maybe but the activity is the bigger cuplrit.

could the old sneakers be worn at the angle of my former gait, and might this be the cause of my limp in my sneakers.

Could be.

 

[susanlondon]

Thank you, both, Pumpkin and Josephine. The story of the gentleman who has the chronic condition has put the fear of God in me. I am going to back off on farm work for a few weeks and hope that my swollen knee will subside. I also began icing again, which I had slacked off on doing as much as I had been. I think icing through yesterday and last night has helped the swelling subside a bit. New sneakers tomorrow and a good, solid boot in the rear to help me maintain a less strenuous lifestyle will have to do for now. Sigh...

How do I post on this thread again several days from now? I clicked on my content, which brought up my former thread to make this morning's post, but couldn't figure out how to add yet another "litany of complaints." Thank you for your patience and your help.

 

[susanlondon]

I'm wondering about the prevalence of pulled muscles around the knee and generally along the leg at 13 - 14 weeks post op. I've been struggling with what seems to be pulled or strained IT band (I've read the articles posted about this on BS) several weeks ago. I let that heal, staying off my bike for a week and then took a gentle but longer ride on mostly flat roads. I did the same milage two days later. In between, I was on my feet for most of the day with visiting grandchildren.

After the second bike ride, my leg was tired and the symptoms of pulled muscles were evident. I was limping again for the next few days though I had just stopped limping (yay!) a week or two before. Now, the hamstring and calf are very sore.

Although my knee feels wonderful, I think I have wrecked the muscles around my knee and am back to square one today. Throughout the week, I seem to feel the tightness moving from one place to another in both those muscles. I initially felt the pulling pain behind my knee before any of the generalized hamstring and calf pain started. Now, I'm icing, elevating and even canceling plans to go to the Cape for a few days in order to let this all heal.

I thought keeping up with motion exercises was important, so I tried riding a for a few minutes on my exercise bike only to find it painful. I tried doing knee bends on the bed, using the exercise ball under my feet and it, too, became painful along the side of my knee. I am learning to stop when there is pain, but I am impatient with my recovery.

In two weeks, I begin teaching 3 days a week on a hilly campus and don't want to have a hard time getting around. I guess my knee IS the boss and I am merely its humble servant. I am Its unwilling but accepting serf.

On another note, and one that makes me think this may be the cause of some of the other pulled and strained muscle issues, I can feel a contraction of muscles in my gluteus area. Even when resting with feet up in the couch, I can feel that there is a tightness in the glutes on my recent TKR side. I have focused on relaxing my "butt cheek" and plan to do some concentrated breath work and relaxation today, but when I notice this area on my leg, the butt is clenched tight! Someone suggested it's my body's way of protecting the knee, but it has caused, perhaps, some difficulties in other places.

Any suggestions or links to reading would be helpful. Thank you.

 

[susanlondon]

I feel like I've pulled/strained/torn every muscle in my leg. The pain travels from one place to another depending on the day and time of day: behind the knee, middle of hamstring; upper calf; lower calf; side of knee, etc.

I've gone back to using a crutch for support, so I'm not wincing so badly as I walk from kitchen to couch or bed. I have done nothing all day except sit with leg up or down. Leg up for too long makes the muscles on the side of knee hurt when I get up to walk.

I put in a call to my surgeon's office, though it's not my knee that hurts. It's all the muscles around it. I'm determined to do nothing until these muscles heal. I am worried about losing range of motion while I'm doing nothing. What do you think? Should I be doing some heel slides or knee bends with exercise ball against wall or on bed? Meanwhile, Tylenol's not helping this at all!

 

[Jamie]

Gentle bends and stretches are always fine. Just so long as you don't go past the point of mild discomfort. Do you have anything stronger than Tylenol to try for the pain? Tramadol? Hydrocodone?

 

[susanlondon]

I have completely resigned myself to the idea that I've done too much too soon. At thirteen weeks, I'm back to sitting with my leg elevated and crying about the pain of pulled, strained, sprained muscles and tendons in my left leg. I haven't been on my bike in over a week, haven't done any exercises at home and have barely left the house due to my stubbornness in thinking that at age 65 I could recover from the trauma to my knee as quickly as I did from my other tkr at age 62. I am paying the price now and can only hope that rest and staying put will help the healing.

This torturous experience began about a week and a half ago when I thought a six mile bike ride was in order. I'd ridden six miles two days prior after a week of resting and I felt great after that ride. However, resting only one day in between that and the next six mile rides was certainly not enough. The pulling feeling behind my knee, which I noticed several hours after the second ride, was enough to make me wonder what the next symptom would be.

But, with family (and grandchildren in town, and a one year old whom I couldn't get enough of), I ignored the need for feet up and continued to plunder my way through the next four days with no daytime rest. By the time the family left, I was hobbling horribly and crying for days.

I then exacerbated the whole mess by sitting in a one hour training for work. In order to see the screen in the classroom, I had to twist my body to the left (same side as tkr). By the time I stood up, I was literally struggling for stability. That night, I used my crutches for the first time in twelve weeks. What a bummer! Talk about going backwards!

I've now using Norco again every six hours as the intense pain to all the muscles and tendons in my leg has been on a pain scale of 6-8. I'm back to long stretches on the couch or bed, icing like mad and waiting to go see my OS this week. As I spend each day doing nothing, I feel a little stronger.

Now, I'm realizing how very foolish I've been and the need to sit still has encouraged me to examine why I felt the need to abuse my body as I did. Was I trying to prove something to myself or others? If so, it was a pretty ridiculous price to pay for ego. I've been asking God's forgiveness for my lack of respect for my own body and will be glad to share with others how taking it easy is soooo important when recovering from knee surgery.

Josephine, you were so right all along. I hope to be as wise this time and not allow my impatience to get ahead of my need to recover gracefully. I'm hoping to hear from anyone who's had a similar experience. Just when I was cleared by my doc, I got myself into a pickle and a jam. Being 65 doesn't necessarily make me smarter obviously. I have a lot to learn.

 

[Jamie]

Hon, you have a whole lotta company in the ODIC (Over Did It Club). Please don't beat yourself up over it. You did what you thought was okay at the time. Now you've learned from the experience. That is a good thing and you can go forward as a much wiser woman. Life is all about making a mistake here and there. It's how we humans really learn things. I'm betting from here on out you'll listen to your body and take things a little more slowly.

Oh....and in case you might be believing the comments you made about recovery at 65 versus recovery at 62.....that has very little to do with it!!! Recovery at 35 can be a real bear. It is the fact that each surgery is unique and so is the following recovery. This one is tougher than your previous knee replacement because......it just is!

So rejoice in all you've accomplished so far....and in the great days that are to come. And also be happy that you don't have any more knees to replace.... (a little humor to make you smile, hopefully).

 

[kneeper]

As I spend each day doing nothing, I feel a little stronger.

Sounds like a plan. As you've learned the hard way, recovery goes on for months== even when you are starting to feel pretty good the knee can use a little tlc.

 

[susanlondon]

I'm surprised to find that I've posted only 3 weeks ago...it feels like forever. I'm still battling the overworked knee and worrying that I've compromised by recovery. I've cut back on activity...haven't been on my road bike since my last post, have cut back on exercising, trying to give my knee a break. It seems, however, that any overuse (standing too long, for example) sets me back to a place of pain and discomfort.

I visited my OS (after my 12 week "final" visit, at which time he cleared me, wished me good luck, etc....me leaving, hoping I wouldn't see him again for a very long time, if ever) again two weeks ago. He said, that I hadn't damaged my knee or torn any ligaments. He wrote "enthesopathy" the PT script and sent me down the road.

I began a second round of PT last week, after resting and feeling much better (after another round of being on my feet which brought me to my knees...). The first session went well, and, I think, so did the second. Visit 3, my PT had me using 25 lb weight to strengthen hip (flexors, maybe?) where a strap was placed around my knee and I was pulling straight leg back, then sideways, then bent knee to straight knee. I limped away from that session, mad at myself for not letting the PT know the weights were too much. Needless to say, I called him the next day (had to cancel my college classes again!) to report my pain. He was surprised and agreed that canceling PT for the rest of this week was a good idea. He suggested I continue quad sets, straight leg raises (no weight) and bent at knee to straight leg exercises as well as walk instead of using the stretch bands, which is what he had me doing at PT's last session.

All med people are suggesting NSAIDS to relieve the inflammation (my knee is swollen but not hot, though I am still icing and keeping my leg up more than I wish I had to), but I had a bleeding ulcer two years ago after taking Aleve (one twice a day) for several months. My meds now include a half tab of Norco (a full tab is 7.5 mg Hydro and 325 acetaminophen), and a Tylenol. Some days this works okay; other days, when my knee is more sensitive, not at all. I'm taking them anywhere from 6-12 hours apart depending on pain level and on the worst days, like after the grueling PT session, a whole tab of Norco.

I've had to cancel classes twice so far, and it's only the beginning of the semester! I've missed family and friend functions due to an inflamed knee. I am afraid, as Josephine discussed in an earlier post, that I have developed a hot knee (if she described it that way), a chronically inflamed knee. I pray that's not the case. My OS and PT don't think I have, but my worried mind cries about that at least once a day.

One difference between this surgery and last (I know we're not supposed to compare) is a medicine difference. After my last surgery, I got off pain meds and started taking Aleve. It reduced inflammation and had me on my way to "normie" activities much faster than this time. Due to the bleeding ulcer (the summer after my last TKR), I haven't taken any NSAIDS. I was told that I could do so if I coupled it with Protonix, a med that will protect stomach lining from the acid eating Aleve. I have been reluctant to do so b/c the Protonix has indications for hip fractures in people with osteoporosis for long time users. I have been diagnosed with osteoporosis of the spine and osteopenia of the hip for the past couple of years, though I'm still (or was) very active-cycling, snowshoeing, hiking, farm work, gardening, etc.

I'm considering a short term use of Aleve coupled with Protonix for a few weeks (or a month or so) to take down this inflammation that is causing the tendons and ligaments around my knee to scream in anguish. I know I caused this from stupidly doing things I had no business doing right after surgery, so the fault is mine. I can't keep missing classes and the other obligations I have now, though my family thinks I should just say no to everything except my knee's recovery.

Does anyone have any opinions about the Protonix and Aleve for short term use? Do you think it's a good or bad idea? I'm thinking that a 3 week regimen might give the tendons and ligaments that are inflamed a chance to calm down while I continue to curb my activities and then slowly go off those meds to see if I can begin some moderate exercise again.

I've contacted my doctor, whose return call I missed yesterday, but am about to make the 25 mile round trip to the "local" pharmacy to pick up the script and the Aleve and try to get back to some sort of life..

I hope to hear from some of you Bone Smarties this morning (I know the time difference around the country and across the pond is different, but you've offered sound advice before. Thank you for considering my most recent dilemma...I remain, "kneedy as ever..." Susan

 

[Jamie]

Considering you are just three months and a couple of weeks out, I'd say it's perfectly within normal range to experience some pain and swelling. I think you're better off continuing to keep on the low side with activity rather than try the NSAIDs. But if you absolutely feel you must try an anti-inflammant, talk to your doctor about Celebrex. It is supposed to be easier on the stomach than Aleve or ibuprofen products.

This really is a time where you need to be patient. I know it's inconvenient to not be able to do all the activity you want to. But it is only temporary. And you DO want to give your knee all the opportunity you can for healing.....