Bilateral TKR Yaelchai Recovery

[Yaelchai]

I hope I am posting this in the right place!

I am 11 weeks PO bilateral TKR. I live in Israel. Though I've been reading this site since before my surgery, I just joined today.

I put off my surgery for over a decade. I had severe OA (and possibly RA according to the rheumatologist). I finally had the surgery on June 4, 2017 at age 66. I've had a pretty good recovery, and I must say that reading this site helped a lot. My ROM is 0-110. I worried a lot about it not being enough of a bend until I re-read articles and posts here. My surgeon says he does not expect more than 120 and thinks I am doing great.

I have metal allergies: nickel, gold, and palladium, so the surgeon ordered special knees from Switzerland. They are MyKnees made by Medacta. I had CT scans that they used to make the knees.

At this point I am walking very well--I've walked more in the last few weeks than in the last decade. It is such an amazing feeling. I still have pain, but I know that this may continue for awhile. If it is very bothersome, I take 5 mg Percocet. During the first month I was pretty heavily medicated, but weaned myself off of everything. Then a couple weeks later, my doctor told me not to suffer if I am feeling pain.

Current issues: I still do not go down stairs gracefully. Sitting in the car for long rides is also still hard. I am sleeping pretty well, but have been getting up to urinate 3-4 times during the night. I am watching my blood sugar which has been a little high (I am not diabetic). On the plus side, I've stopped my blood pressure medication since the surgery because my blood pressure has been normal to low.

Anyway, I am glad to be here and glad for the information and support.

Yaelchai

 

[SusieShoes]

Welcome to BoneSmart, Yaelchai! Always glad to see another bilateral join us. Your current issues sound pretty much par for the course. I'm a little ahead of you (I think) and find that the stairs are getting easier every day now. I'm still not what anyone would call graceful on them, but I'm competent. It's natural for blood sugar to be a little higher during healing post-surgery. Your doctor will let you know if it gets to a point you need treatment. Good news on the blood pressure meds!

If you would give us the date of your surgery, one of the moderators will add it to your signature. It helps responders know where you are in your recovery.

Here's some good reading for you, if you haven't already found this trove.

Knee Recovery: The Guidelines

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these
the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy
5. At week 4 and after you should follow this
Activity progression for TKRs

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?

Energy drain for TKRs
Elevation is the key

Ice to control pain and swelling
Heel slides and how to do them properly

Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds


We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[Yaelchai]

My surgery was June 4, 2017.

Thank you for the encouragement!

 

[Roy Gardiner]

Current issues: I still do not go down stairs gracefully. Sitting in the car for long rides is also still hard.

June 4 - Aug 23 (today) I make 2 months and 3 weeks, about. At this stage what you cite is normal or indeed pretty good recovery, not really issues needing addressing. These things will Just Go Away.

My ROM is 0-110.... My surgeon says he does not expect more than 120 and thinks I am doing great.

You are doing great. Continue stretching exercises (no pain, no strain) and you will get as much as you want, it's only soft tissue stopping you getting more and that can be changed!

 

[Ruby9297]

@Yarlchai, welcome to bonesmart . You've come to the right place for support. You are about a month ahead of me, and it sounds like your doing very well. Keep it up!

 

[Yaelchai]

Thanks for the support! I don't know how I would have done this without the online support groups. I am in a couple on Facebook. However, I like the basic philosophy here--a kinder, gentler approach. I feel so much better with the knowledge that the bend will come in time. Cheers!

 

[SusieShoes]

It does make great sense, doesn't it? Kinder, gentler healing leads to less pain and equal or better results. You're already doing great!

 

[Neveragain]

That is so encouraging reading how you are doing, I am a lil over a month behind you...your doing amazing!
I also find vehicles are very tough, just not enough area to be able to rest your leg as you should, I find after 20 minutes of being in our jeep or truck, when I get out, very very stiff and sore, initially I just stretch carefully til I feel safe using my cane and my steps become easier and easier, Thank God!
Like yourself I hung around this site pre op, not joining, and until just yesterday, was here invisible lol, Welcome!!

 

[Yaelchai]

Neveragain: my PT gave me some exercises to do in the car. Basically it is pushing your heel up against the floor of the car. She also said to get out and walk around every 30 min- hour. The exercises (basically just moving) have helped. I haven't yet traveled over an hour. Working up to doing that next week!

Has anyone dealt with a numb heel? Ever since surgery my left heel has been uncomfortable and now it is numb. I asked the surgeon about it but he kind of shrugged his shoulders and did not give me any answer. I assume it is some nerve that got compressed in surgery?

 

[SusieShoes]

Interesting about the car exercises. I've noticed that if my knees are starting to feel stiff it helps to move them, so I do very similar little exercises at the dinner table as well as in the car. I have no insight about your numb heel, though. I'll tag @Josephine, the site's very experienced nurse, to see if she can help you.

 

[Polkadot]

Welcome! I am about 2 weeks ahead of you, and your issues/milestones seem very similar to mine. Nice flexion, BTW. I'm still at 105 when I really huff and puff, so functionally it's more like 95-100 in daily activities. According to others on the site, this can and will improve for many months, perhaps past the 120 degrees your PT hopes for!

Car rides have been difficult for me. This is great advice. I can travel about an hour and a half, and can attest to needing to stop and stretch periodically. Every 30 minutes is ideal, but in a 1 1/2-hour drive, I stop once, in the middle, and that's okay for me. One funny-odd thing: driving is more comfortable than riding. Perhaps the driving activity distracts from the discomfort? Or the seat is more comfortable on the driver's side?

I haven't dealt with a numb heel, and maybe you should get it checked out by another doctor. I have been dealing with numb fingers on the hand in which they placed the IVs--and no, haven't taken my own advice to get it checked out! A couple of IVs in the hospital had to be replaced because fluid backed up in the hand and arm, and there has been an obvious "knot" of swelled veins on the wrist that has been going down over time. So, like you, I have been hoping that it's a pinched nerve, and that as the swelling decreases, the numbness will, too. And it has been decreasing, but is still there, a bit. So I now have an appointment and will be visiting the doctor who did my carpal/ulnar tunnel surgery.

When we're dealing with all the other issues of recovery and it's difficult to ride in the car, handling details like making and keeping appointments is really hard, isn't it? The good news is that around 11 weeks, these details started to seem manageable, and I called for a consult.

 

[Josephine]

Ever since surgery my left heel has been uncomfortable and now it is numb. I asked the surgeon about it but he kind of shrugged his shoulders and did not give me any answer. I assume it is some nerve that got compressed in surgery?

Which leg is it? Do you have any pain in your calf? Front or back?

 

[Yaelchai]

I don't have leg or calf pain--just the numbness in the heel.

 

[Yaelchai]

Someone told me that you only have a short time to prevent scar tissue from forming. Is this true?

 

[Jockette]

No, it is not true.

Usually what people are referring to when they say that is adhesions, which they incorrectly call scar tissue, and adhesions don’t form quickly.

But, true scar tissue does form, it is the way that your wound knits itself back together and is necessary and good, you would not heal without it.

Two very different things and should not be called the same, though many people do, and they scare us with their misinformation!

 

[SusieShoes]

Not true. As Jockette said, you don't want to prevent scar tissue from forming (it's what holds your incision closed, and knits cut tissue together). The people warning you are talking about adhesions and exercise doesn't prevent adhesions. Adhesions are rare and occur as an aberration of the healing process whether the patient exercises or not.

Exercise is important for other reasons, but "preventing" scar tissue isn't one of them.

 

[Celle]

These two articles explain about normal scar tissue and adhesions:
Scar tissue and adhesions - what's the difference?
MUA (Manipulation under Anaesthetic) and Adhesions

 

[Celle]

@Yaelchai
You'll notice that I have merged your newest thread with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

So please post any updates, questions or concerns about your recovery here.
Don't worry that we won't see your new questions - between us, the staff read all new posts every day.

If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on. It's a good idea to do that.

 

[Yaelchai]

Update: I am now 17 months PO. Generally, I've been doing well. However, over the past month I have felt a lot more stiffness throughout my whole body, including my knees. I believe my arthritis is acting up in other places. Maybe I am not exercising enough? I stretch every day but do not do a lot of physical activity (except some light walking).

I am scheduled for carpal tunnel release this week. I'm worried about infection from that surgery.

 

[Yaelchai]

Can you change the title of my thread to Yaelchai Recovery