Urban TKR and PT

[TeeDee]

Hi, everyone! I've been reading the threads for months now, have memorized the BoneSmart mantra, and finally got the nerve to ask for some perspective.

I'm bone-on-bone in both knees, obese (5'6", 340), and the only medication I take is naproxen, which does help keep the inflammation at bay. I don't suffer pain except when I stand or walk for more than a few minutes, I do have a very noticeable limp so I have to walk with a cane when outdoors, and I have my first appointment with an OS next month.

What I want to ask you all is...is anyone out there familiar with the somewhat uncommon aspects of TKR recovery involved in living in an urban environment? What I mean is, I live in a typical tiny NYC apartment. I've gotten the advantage of rent stabilization so I've been here for several decades. That means I've got, quite frankly, a very cluttered apartment with little room to maneuver in.

I don't have an actual bedroom the way most people in this forum would think of one. Every wall is covered in bookcases stuffed to overflowing with books acquired over the years. There are packing boxes full of things (small childhood sculptures, letters from friends, more books and magazines, computer parts, etc.) I'm working on clearing out, but it'll take another couple of years before that project is finished. I sleep on a foldout twin-size sofa bed in the living room. The way my sofa bed, the recumbent bicycle next to it, the laundry sorter that also serves as my hanging clothes rack, the computer desk I'm typing at, and the large four-drawer lateral file cabinet, stick out from the walls into the middle of the room, makes for not much room to move around in. Oh, my bathroom is of course also a typical NYC bathroom, so there's practically no space around the toilet to put frame arms in.

Oddly enough, this arrangement makes me really happy under ordinary circumstances. Everything is very near to hand so I don't have to walk much and stress my knees. But the major obvious downside is that, in contemplating home PT, I can't imagine how a home health worker is going to have enough room to work with me. By any chance is it realistic for me to think that it'll be possible for me to have TKR, come home from the hospital, and then assiduously do my own PT at a point when most people would be having a home PT worker come visit them? I do have a compatible life partner, we get along fabulously and have lived together for almost 40 years, and he'll be able to help me in recovery.

So, are there tiny-apartment dwellers among us who have anything to say about what it's like to recover from TKR in the Big City? (I'm not yet broaching the subjects of things like "How do you get around on the subway or buses with limited ROM.")

 

[Jamie]

Hi, TeeDee.....welcome to the forum. I'm so glad to hear you've benefited from reading threads prior to joining in. But it's even nicer to now have you officially as a member of the BoneSmart family.

We have had some members in the past who lived in the tiny digs of New York City. As you say, it has its good things and its challenges. You will need to make sure you don't have any tripping hazards in your apartment prior to surgery. You don't want to fall!!! That means having clear paths that are wide enough for a walker and putting any small rugs or other items on the floor that could be tripping hazards out of the way for a while.

Your first exercises with a therapist will be very, very simple ones that can be done lying down on the couch or bed or sitting in a chair. With some time, you can graduate to some turns on your recumbent bicycle. So, actually, I think there should be no problem at all with therapy in your crowded apartment.

I applaud your effort to de-clutter. My hubby and I are in the process of that as well. We've lived in our house over 30 years and it is FULL of "stuff" that we really don't need at this point in our lives. It's a job, though. I'm betting you'll feel much more like doing it once your knee is replaced and recovery is completed. It makes a HUGE difference.

 

[possum_here]

I have a 4 bedroom home single level and I find de-cluttering just takes time. I do not think it really matters the size of your area for the PT to be completed. I am a Physiotherapy Assistant and Complex Pain Management nurse. I work on patients in their single bedrooms in and Aged Care facility. I am sure if I can manage the PT will be able to do what is required in such a small area.

Bed exercises, chair exercises you will be fine.

 

[TeeDee]

Thanks so much for your assurances! Possum_here, another thing that I've picked up on but don't know whether is relevant is about those chair exercises. When I see illustrations of them, they always seem to assume that the chair is a regular one with arms and legs, but the only chair I have room for is an armless desk chair on wheels that I use to sit at the computer. Might that be a problem, or not so much?

 

[Jamie]

The fact that the chair could move when you're trying to get up from it might be an issue for you. How about going to a second hand store and picking up an inexpensive chair with arms and no rollers to use for a while? You'll be using a walker at first, so it would let you raise and lower yourself to your computer chair. But with the rollers and no arms to steady it, you'd just need to be very, very careful each time you sit down.

If that is your only chair, where do you plan to spend your "rest" time? You need a place or two in your apartment that is set up for you to spend fairly extensive amounts of time.

 

[Josephine]

That's the problem I see also, Jamie, the thing about a chair to rest and elevate in. But a walker may not be necessary as she can use her furnishings to hold onto when getting around!

But I was reading and then read .... there are two of you in this micro apartment? Where does he sleep?

 

[catherinem]

hi
i would not worry too much i will just repeat you what i was told by the phisio at joint school before my first op. you already had to do a lot of adjustment with your body abilities and your space before your op more than you think. so you tend to cope the same than before.
i was like you worry as my house on small size, extremely cluttered, stairs to deal with,tiny bathroom and could only get in bed by climbing from bottom end because of space!!!but was on no shape to do anything about it, and neither my hubby.
and guess what my phisio was right i surprised myself how easy i got on with it!!and only used a few of the help product given by hosp
my most usefull, my high chair kitchen, gold!!managed to get on with cooking on 1st day back!!!!end soon organised my cup of tea station!!!!!

hope it is a little helpful
sory i ramble

most important than walls end chairs keep your spirit up and keep positive!!!

take care!!!!

catherine

 

[TeeDee]

That's the problem I see also, Jamie, the thing about a chair to rest and elevate in. But a walker may not be necessary as she can use her furnishings to hold onto when getting around!

But I was reading and then read .... there are two of you in this micro apartment? Where does he sleep?

Hah! Yeah, my beloved sleeps on one of those big bean bag sofas. They are soooooooo comfy, I have to say, I used to sleep on one myself before my knees gave out. We have it shoved into a corner along a wall and since it's a bean bag it can be molded to fit the area it's in. You'd think with all these unconventional sleeping devices that we'd have back pains for days, but it turns out not at all. In fact his back used to kill him and he had terrible sleep apnea until he started sleeping on the bag. As for my elevation needs, I figure to get one of the good leg elevator pillows and use it on the sofa bed when I'm laying down. Hmmmm. Actually, you put an interesting thought in my head just now. I can get a bean bag ottoman, put some pillows on it, and use that to elevate during the day while I sit up. I have to think about that and experiment ahead of time.

 

[pdx]

Is it certain that you'll have home PT? We don't out here (Pacific NW). All PT is at a clinic/office.
But do what you can to clear out things, particularly things that are trip hazards. As much as I love books, it's fun to pare down on those, too -- take a few boxes to The Strand and spend the cash you get on a treat for yourselves.