TKR Winner winner, chicken dinner! Bionic Liz's new RTKA

[L.I.T]

@little red canoe, yes, St George (or sunny St George, as the lucky retirees call it). It takes about an hour for me to drive from Springdale to my PT in St George. People here gripe about the drive all the time, but it's really not so bad - there's no traffic and it's a beautiful drive. I used to drive an hour and a half to get 25 miles in Dallas/Ft Worth! I admit, though, it's a wee bit long at the moment, though, to be comfortable having my knee bent like that, doing an hour of therapy, and then bending again on the hour drive home. But it's worth it to have this particular therapist.

Did you guys come to St George to hike? The entire area is beautiful. I'm so SO sorry about your dog (you've had a rough year). I'm happy she got to hike almost till the end though. Our cat also has 'cactus issues'... All the time coming in with needles sticking out of his rump. I'm sure he sees it as HIS badge of honor

 

[L.I.T]

@Mireille, Angel's Landing was the last hike that did me in (the third in a series over two weekends). I did do one more small hike later that year, after my steroid shot experiment.... But then I was kaput!

 

[mbrown]

One of my favorite places on earth

 

[Mireille]

@L.I.T Wow, that looks beautiful! Totally up my alley, Zion is on my bucket list and I will get there someday soon.

BTW, love the "steroid shot experiment" ha, ha ha. Been a part of that and the "chicken shot" one.

We'll be back to hiking and traveling in no time!

 

[L.I.T]

Well, I still love my physical therapist... Yesterday, we did ultrasound, tens, 10 min on the Nustep at resistance 6 (which actually turned into 14 min b/c the aide didn't come get me, and I felt like a tool just sitting on the machine doing nothing...),a heating pad under my knee and quad flexes. Bad news was that I've lost a wee bit on the extension, but with flexion, I could bend even further than last time (we didn't measure - just eyeballed to make sure there were no major setbacks). I asked if there was anything I should be doing to help with the extension, and he said just what we had been doing - he did say to make sure I warmed under my knee before I did my quad exercises since it really seemed to help. He said there is a 'magical place' between doing the exercises and pushing too hard.... And that the line differs for everybody. He said I will figure it out on my own - but warned me that to overdo it would irritate my knee and it would fight back by contacting the area even harder.

I iced the entire hour and a half home (an additional stop at the pharmacy on the way), and when I got home a LOT the swelling was gone. By last night (with no more icing, my swelling was almost down to pre-op levels. I was floored! The only thing I can think of is that my knee REALLY loves the tens and ultrasound... Because nothing else is different than what I have been doing at home - and the swelling decreased a similar percentage after my PT last week.

Oddly, though, even though the swelling was down, it did ache more last night and through this morning. Only just about 10 minutes ago did I start to swell again. Oh well, at least the icing helps a little with the pain!

And I'm going to ask a question here, but not because I am in hypochondriac mode... But just because I want to make sure there is *some* solution out there. When my knee had lost a couple of pant sizes last night, I still couldn't extend my leg to neutral, much less near the - 10 of my other leg (which I think would be a bit optimistic anyhow). I *know* I am early, and I do know that there could be focal swelling internally back there, as I do have area on the posterior medial section that hurts when I stretch. BUT, in an absolutely worst case scenario (which I don't anticipate I will have), do people have MUA for extension? Or can they go in to remove whatever the blockage is? I just would feel a little more secure knowing there would be an option *if* I don't get there. I'm not actively worrying about it, though.

On the interesting home side of things, someone was challenging my husband and I do a 'who smells worse' contest, as our fancy schmancy hybrid hot water heater went out last night. It, of course, is a you-can't-fix-it-yourself model, so when we looked up the company, it turns out they went out of business 2 years ago (only 2 years after we bought the darn thing)! So while we looked up new hot water heaters, we decided as a last ditch effort to try every IT person's favorite solution.... We turned it off and on again, and voila! Of course, it went off again 3 minutes into my husband's shower, so I think we will still be looking for a new unit.... But I did manage to get an entire shower WITH shaving in before it went out again. That made my day, as those little prickly hairs and the hypersensitive skin were giving me chicken legs!

 

[KarriB]

The resistance on the Nustep could be the cause of your achy night and swelling this morning. I think it's wise to keep it at 0 reisistence until a few months out. Usually when you've done too much the knee complains through the night and into the next day. Resistance is equal to weight which my PTs wouldn't use weight until 4 months post op. A month old knee doesn't need resistance to gain ROM and that's all you're looking for right now, not building muscle.
Tens is wonderful and my knee loved it too! I don't know about an MUA for extention, but I do know it can take some longer to gain than ROM. Even though I wasn't on BS I let my knee bridge between my chair and ottoman just because it felt good. My extention is in the negative and we never used heat. It just took time.

 

[L.I.T]

Aaahhhh, you are probably right - I know the aide who put me on it has only been there for two weeks, so it's possible the machine was set up for someone previously and she didn't notice. I didn't really think to ask, as I just went a lot slower than if there were less resistance.

Thanks for the suggestion - I'll know better next time!

Also, any idea with the Nustep - when they ask me what is comfortable for me seat-wise, how far away should I be? For example, should I be getting a full extension of my leg or just under, like you would on a bike. So far, my PT is not worried about my flexion ROM at all.

Gracias, @KarriB!

 

[KarriB]

I've never been on a Nustep (that I've know of) just recumbents at PT and one at home. But the closer the pedals are to the seat the more flex you'll need to go around. In the beginning I could only rock back/forth, but by my 2nd week of therapy I was able to get a full rotation.

I'm not sure if you've seen this link on extention. If you have just ignore this!

https://bonesmart.org/forum/threads/extension-how-to-estimate-it-and-ways-to-improve-it.9529/

 

[L.I.T]

Thanks, @KarriB, I did read it a couple of weeks ago - my mom (who had her TKR done a month before me) has also been having extension issues.

I'm really just more curious than anything else - neither my surgeon nor my PT are concerned. I'm not even very concerned. I just can see the logic behind an MUA for flexion, but I would imagine it would be operationally difficult to do MUA for extension unless it was quite severe.

Thank you, again!

 

[KarriB]

They're not concerned because you're so very early in recovery. There's plenty of time to gain ROM (both flex and extention). Just use those stetchess a few times a day and although it may take month it'll come. Also as you begin to work on a more natural gait your extention will improve as your stride lengthens. My PTs didn't worry about my gait until I was walking with no pain.

 

[Celle]

Hi Liz,
To answer your question a few posts ago - no, an MUA usually doesn't do much to help with extension.

It's not at all unusual for extension to take longer to achieve than flexion, so don't feel concerned if yours isn't improving fast. It will come.
I'm sure your PT (who seems good) will give you some exercises to help with extension (don't use any weights or pressure) but here is an article with some suggestions:
Extension: how to estimate it and ways to improve it

 

[kneeper]

NuStep resistance at 6! I wasn't at six at 12 weeks! Strengthening will come gradually, but letting those tissues heal is more important early on in my experience.
I had to laugh at your "Angry Liz" description. I thought I was really fairly even tempered with just a few cranky episodes, but just recently my sister (who came to help me out early on post tkr) recalled events differently!

 

[L.I.T]

NuStep resistance at 6! I wasn't at six at 12 weeks! Strengthening will come gradually, but letting those tissues heal is more important early on in my experience.
I had to laugh at your "Angry Liz" description. I thought I was really fairly even tempered with just a few cranky episodes, but just recently my sister (who came to help me out early on post tkr) recalled events differently!

@kneeper, Yup, I don't think I'll be making that Nustep mistake again - Nustep will be nostep in notime! I blame myself - the aide probably didn't know and my therapist was doing an evaluation at the request of a doc. I remember it saying something about adjusting the resistance with the knob below the seat.... I may have to do some seat bottom exploring on Thursday!

That's funny what you said about your sister. My mom is the most submissive person on the planet, and she about bit my dad's head off two or three times. This pain be crazy stuff! But at least we have a good excuse.... "oh shoot, I'm so sorry - was I on pain meds?" (cue innocent look)

 

[KarriB]

We all have our moments. Mine happened coming home from the drs in 0 degree weather. My best friend was trying to put gas in my car and the little door for the gas broke and wouldn't open. It was the straw and I lost it! I'm still apologizing three years and a new car later.

 

[Mireille]

Hi @L.I.T just doing by to see how you're doing. Hope it's good knee day for you!

 

[L.I.T]

@Mireille, hey there! Just cruisin' right along over here. Decided to ride my 'deskcycle' yesterday for a whole 5 minutes. Can we say recovery FAIL  not a lot more swelling, but the pain (that meddling ache) got a bit worse. I'm trying to determine that 'line' b/w what I can do vs pushing too hard. I swear, I need a map for this stuff LOL

So today is rest and relaxation day, as tomorrow is PT again. Feeling much better after the antibiotics - no more fever chills or malaise. All that being said, this standard 'exhaustion/hangover' stuff is challenging. I no longer get crazy exhausted standing up or sitting upright. I don't even take a nap during the day anymore. But waking up in the morning.... It's like having a 2 ton weight on top of me! In real Liz-land, I never am able to go back to sleep when I wake up. But with this Leg-Liz-land thing - I could seriously win a contest for who can knock themselves out the most times in one morning. Today took me 1.5 hrs from "time to wake up" to me actually keeping my peepers peeled for good.

I feel fortunate that I have the time and the means (not having to be back at work).... So it's not necessarily a bad thing - it helps me get my sleep in. But it's definitely an interesting feeling/experience!

Oh fun news, though - we ARE going to get the Alto teardrop trailer. Bad news is they are back ordered for about 18 months.... So a long wait. But I think it will be worth it - will be nice not having to crawl with my new knee in a tent when we camp. Somehow I think Mr I. M. Plant will enjoy memory foam cushions a bit more! Woohoo!

How are you hangin' in?

 

[Mireille]

I'm glad you're feeling better. You didn't get a map??? I got one but it has so many detours, I'm currently lost.


At least you can nap, so it's good you're taking advantage of it. I can't nap no matter how tired I am.

I discovered that sleeping 6-8 hours straight doesn't work for me. I'm so stiff when I wake up, it takes me hours to get going. Peg leg comes back. Now, I set my alarm and I'm up at least every 4 hrs. and do a little stretching and go right back to sleep. Last week I was desperate for a good night's sleep, go figure.

I have an ache in my knee too and i get this stabbing pain out if nowhere every once in a while. Made some headway with ROM and extension at therapy n today. Tomorrow is my rest day. I'm working from home now but I'm slow. Take a lot of breaks.

Teardrop trailer sounds fantastic! Right now the thought of crawling inside a tent, or anywhere else, gives me the creepy crawlies.

BTW, love your knee's name

 

[NightQuilter]

Finally catching up Liz - looks like things are coming along really well for you! Love your trailer - I have worried that because I never lost the pain in my knees (even though I can almost sit on my heels again), camping would be a thing of the past for me since getting in and out of a tent would be quite problematic. I see there is hope. And ... Zion, etc. are on my bucket list as well. Love how you face recovery with your tongue firmly inplanted in your cheek. Humor is the only way to appropriately deal with this!

 

[Red's Mom]

Liz I [emoji179] reading your thread. Makes me smile and giggle! Your doing great. Keep up the good attitude. Love the camper concept! Keep us smiling!!


Sent from my iPad using broken link removed: https://r.tapatalk.com/byo?rid=75543

 

[Cratchit]

Hey there ESP, how did PT go today?