Yet another knee surgery thread

[W2R]

Congratulations on taking out the trash!

Yeah, it seemed like a big victory to me! OK, it was just a handful of trash but I don't have to ask F to take it to the kitchen for me; I did it myself. Maybe I'm not Sir Edmund Hillary quite yet, but that was a pretty big baby step for me.

One of the things that has fascinated me are the stories from people who have had two TKRs several years apart. A large amount of these people, perhaps a majority?, report that one was easy as pie, and the other was a long painful process. Often with the same surgeon, same hospital, etc.

Obviously, there are many variables that affect the outcome.

+1000000 I really think that is SO true. We just don't know what we are facing until we are in the middle of coping with it.

 

[MRG]

Now that I don't need the oxycodone, I am taking a combo of acetaminophen/ibuprofen when I need the meds. Alas, needing the pain meds is occurring somewhat more often that I thought. Yesterday was a lousy day in terms of knee swelling, and soreness throughout the joint. I believe that is my fault for overdoing the new PT exercises and adding my own stationary biking on top of them. Very foolish of me.

Ice and meds today, all day. To heck with bragging rights about a near miraculous recovery.

I've learned PT is great in moderation. When I've pushed too hard I feel bad things. Last week I managed to get my right shoulder involved, it hasn't been before. They said I was cleared for any activity, ten minutes jogging on a treadmill was a huge mistake. I'll stick with walking for a few more weeks or months.

 

[Chuckanut]

I've learned PT is great in moderation. When I've pushed too hard I feel bad things. Last week I managed to get my right shoulder involved, it hasn't been before. They said I was cleared for any activity, ten minutes jogging on a treadmill was a huge mistake. I'll stick with walking for a few more weeks or months.

I think you are right. The trick is to find that balance that keeps one moving forward while avoiding needless setbacks to recover from too much stress on the joint. It's a delicate balance, one that I have not mastered yet.

 

[Chuckanut]

I've learned PT is great in moderation. When I've pushed too hard I feel bad things. Last week I managed to get my right shoulder involved, it hasn't been before. They said I was cleared for any activity, ten minutes jogging on a treadmill was a huge mistake. I'll stick with walking for a few more weeks or months.

I think you are right. I really don't care if it takes me 12 weeks or 12 months to get back to being able to hike on the local trails. Just as long as I get there.

The trick is to find that balance that keeps one moving forward while avoiding needless setbacks to recover from too much stress on the joint. It's a delicate balance, one that I have not mastered yet.

I wonder how others are doing their PT?

 

[SumDay]

I wonder how others are doing their PT?

I'm 5 weeks post-op today, and have decided to take a PT break. I had surgery on 7/11 and started outpatient PT on 7/15, 3x per week. I found I was coming home REALLY sore, usually nauseated and thoroughly exhausted. Last time PT measured me I was at 115. I'm a high-functioning introvert, so going somewhere three times a week and making chit-chat for an hour each time was mentally exhausting.

I'm now doing all the exercises they printed off for me, daily, at my own pace. I'm riding my indoor and street recumbent bikes, and using my under the desk elliptical peddler. I'm walking the dog, and have returned to chair yoga classes. Monday I plan to return to a regular yoga class and will do what I can. I consider getting down to and up off the floor a major accomplishment.

Honestly right now I'm more concerned about stamina. It's better than it was the first 2 weeks, but I'm still easily overheated and fatigued. My son's out-of-town wedding is September 14, and I'm worried about keeping up. I plan to try.

Keep up the good work knee warriors! We're all on our own path.

 

[W2R]

First Home Health visit

The Home Health lady (the first one) just came by and she basically wanted me to sign a bunch of forms, and to check my medications since she didn't know what dosages I had been given, and to briefly glance at my incision (without touching the coverings). Then we chatted for maybe 45 minutes to an hour, long enough that she could tell I am doing fine. She was very nice and not at all mad that I had insisted on an afternoon visit instead of this morning. So, I am glad I stood up for myself and said "NO!" to the morning visit.

Next, the PT guy! He is supposed to be here in about a half hour to hour from now. I'll be having PT at home three times a week for a couple of weeks, and then it will move from my home to where ever the PT facility is. Not crazy about the idea of PT at all, but my surgeon is really good and he wants me to have it. So, I'll at least give it a chance, and then play it by ear.

 

[MissMolly]

You need to just accept that PT is necessary for you to get your mobility back. Will it be fun? Nope. Will it hurt? Yep. But little by little you will see improvement. The therapists know just how far to push your joints to provide benefit without causing harm. PT, especially after any kind of joint surgery, is critical to regaining your mobility and the quality of life you would expect/want/need after going through surgery to fix a problem. Just grit your teeth and know it will only help over the long term.

 

[W2R]

You need to just accept that PT is necessary for you to get your mobility back. Will it be fun? Nope. Will it hurt? Yep. But little by little you will see improvement. The therapists know just how far to push your joints to provide benefit without causing harm. PT, especially after any kind of joint surgery, is critical to regaining your mobility and the quality of life you would expect/want/need after going through surgery to fix a problem. Just grit your teeth and know it will only help over the long term.

OK, I'll try! So far I have found my fears surrounding various aspects of this surgery were unwarranted. For example, I didn't think I could come straight home without going to a rehab hospital, but so far that has been really easy for me and I am much happier at home than in a rehab facility.

So probably I am just overly afraid of PT as well. Call me "Chicken Little"!

 

[MRG]

OK, I'll try! So far I have found my fears surrounding various aspects of this surgery were unwarranted. For example, I didn't think I could come straight home without going to a rehab hospital, but so far that has been really easy for me and I am much happier at home than in a rehab facility.

So probably I am just overly afraid of PT as well. Call me "Chicken Little"! [emoji23]

We are all different but the folks at PT have been able to keep doctors from whacking my neck apart for 20+ years. Yes it's a pain but it's better than the alternatives.

 

[W2R]

First Physical Therapy session

The PT guy was pretty good. He didn't try to push me too far for today, and rather than saying "you must do 50 reps of this exercise every day", he said "your goal is 50 reps every day but do what you feel you can reasonably do". He liked what I did to stand up (putting my lift chair upwards, and then pushing myself up the rest of the way using the armrests), and he liked my walker technique. He had me walk around inside the house and we covered all but one room before my stamina gave out. He said I did more than he thought I'd be able to do, given how little I could do for the last few months before surgery.

The only thing he said that was upsetting, was that I shouldn't ice for more than 20 minutes at a time and only a few times a day if that. I told him how helpful icing is to me. F was listening to all this and said that pretty much the guy was saying, "our company policy is to not encourage icing" but that also, subtly "I don't actually agree and you gotta do what you gotta do". I hope that F's interpretation was correct because I am going to continue icing. I draw the line at quitting icing. Given how helpful it has been for me, and how much it helps my range of motion, I'd be nuts to cut back on it like that.

Anyway, he gave me exercises to work on, and tomorrow I have PT again since they want to get at least two PT sessions done for the week. He is sending a subordinate in to do the sessions with me tomorrow. He says I should get up and move around every hour, even if it is just to walk 6 feet and back, and I see the reasoning and suppose I could do that.

 

[Chuckanut]

The only thing he said that was upsetting, was that I shouldn't ice for more than 20 minutes at a time and only a few times a day if that. I told him how helpful icing is to me. F was listening to all this and said that pretty much the guy was saying, "our company policy is to not encourage icing" but that also, subtly "I don't actually agree and you gotta do what you gotta do". .

What reason did he give for the 20 minute icing recommendation?

I ask because I hear that recommendation from various medical professionals (PTs, nurses, PAs) over and over again. So far nobody has bothered to point me to a good study showing that more than 20 minutes a few times a day is bad. Or for that matter what the optimal icing time and frequency is for a TKR patient.

This reminds me of the 10,000 steps recommendation - It was made up by a company that was selling pedometers. A recent study showed that 7500 steps max was all that was needed to get the best life extending benefits of walking.

As I write this I am icing my knee for the 3rd time today for well over an hour. It's swollen and stiff, which is a big problem for me when I try to do PT. If I can't get past this swelling doing all those PT exercises is going to a big problem.

Note: Icing is a poor description. Ice-water cooling would be more appropriate.

 

[MissMolly]

I think the thing about icing is because it constricts the blood flow to the joint which can hamper healing. I would think as long as you have periods of at least an hour between icing sessions that it would probably be fine. It would give the blood time to circulate around the area well.

I remember when I had my shoulder surgery the ice was the only thing that helped with the horrible pain (I'm pretty tolerant of pain meds - they don't do a lot for me). I kept the ice machine on a lot, but did give my shoulder breaks between sessions until the pain got too bad.

 

[W2R]

Yes, the reason he gave was that it cuts back on circulation, like Miss Molly said.

Come to think of it, compression stockings cut back on circulation too, but so far I have not heard similar objections to compression stockings. Oh well.

And yes, Chuckanut, he meant ice water cooling using the ice machine because we were talking about ice machines at the time.

I probably iced for 6-8 or more hours yesterday, in three sessions with at least a couple of hours in between. For me this helps considerably with the pain and swelling, not to mention the range of motion and ability to bear weight.

 

[omni550]

W2R,

Your progress sounds wonderful. Keep it up!

omni

 

[W2R]

Fourth Day, Second PT session

Thanks, Omni550.

This afternoon I had my second PT session in two days. So far, so good. I can't do most of the PT exercises yet, but I can do some of them and the therapist helped with the rest and was encouraging. On a scale of 1-10, my pain is probably a 2, so not bad thus far today. I might take another hydrocodone with acetaminophen pill soon, just to stay ahead of the pain. I have only had to take 5 total so that would be 6, and I have another 75 left.

Earlier I was able to take off the compression stockings, leave them off for the required hour, and get them back on. Not an easy task by any means! Well, the skills required are ones I don't have anyway. I am so glad Moemg suggested using the sock assist for that.

Tonight, my plan is to rest, relax, heal, and recover. My daughter and DSIL (both out west in Oregon these days) sent me a beautiful bouquet of flowers.

Like chuckanut, I tend to think I am not improving at all because recovery is so slow. But when I think about it, there are several things I can do now that I couldn't do a couple of days ago, and am feeling more energetic as well. Besides, my surgery was just on Tuesday.

Some things I have been doing on my own: refilling my ice machine and hooking it up to my knee, getting my own coffee in the mornings, dressing and taking yesterday's clothing to the dirty laundry bin.

Some things that F has been doing for me: my laundry (including putting it away), bringing me things like a jug of water that I could get myself (but was putting off due to pain), bringing me take-out for lunch every day, refilling my ice machine when he is over here, giving me company and support even though I have been awfully crabby lately.

 

[Calico]

Thanks, Omni550.

This afternoon I had my second PT session in two days. So far, so good. I can't do most of the PT exercises yet, but I can do some of them and the therapist helped with the rest and was encouraging. On a scale of 1-10, my pain is probably a 2, so not bad thus far today. I might take another hydrocodone with acetaminophen pill soon, just to stay ahead of the pain. I have only had to take 5 total so that would be 6, and I have another 75 left.

Earlier I was able to take off the compression stockings, leave them off for the required hour, and get them back on. Not an easy task by any means! Well, the skills required are ones I don't have anyway. I am so glad Moemg suggested using the sock assist for that.

Tonight, my plan is to rest, relax, heal, and recover. My daughter and DSIL (both out west in Oregon these days) sent me a beautiful bouquet of flowers.

Like chuckanut, I tend to think I am not improving at all because recovery is so slow. But when I think about it, there are several things I can do now that I couldn't do a couple of days ago, and am feeling more energetic as well. Besides, my surgery was just on Tuesday.

Some things I have been doing on my own: refilling my ice machine and hooking it up to my knee, getting my own coffee in the mornings, dressing and taking yesterday's clothing to the dirty laundry bin.

Some things that F has been doing for me: my laundry (including putting it away), bringing me things like a jug of water that I could get myself (but was putting off due to pain), bringing me take-out for lunch every day, refilling my ice machine when he is over here, giving me company and support even though I have been awfully crabby lately.

I continue to be impressed by your progress. I am so glad to hear that you are keeping ahead of any pain. That is good news! Here's to a weekend of resting, relaxing, healing, and recovering at your own pace.

 

[ivinsfan]

You don't sound crabby to me, did your therapist give you instructions of things to do during the weekend? It always cracks me up when they say therapy is essential a must do once or twice a day and then on the weekend they disappear.

 

[W2R]

I continue to be impressed by your progress. I am so glad to hear that you are keeping ahead of any pain. That is good news! Here's to a weekend of resting, relaxing, healing, and recovering at your own pace.

Thank you! That's exactly what I need.

You don't sound crabby to me, did your therapist give you instructions of things to do during the weekend? It always cracks me up when they say therapy is essential a must do once or twice a day and then on the weekend they disappear.

Thanks, but you should see how crabby I get when therapists and so on demand my time these days, when I am exhausted and would rather be napping, or when F selflessly works hard here to help me with those necessary tasks that presently I can't do, and I don't think he is doing whatever-it-is right. I try not to be crabby but it spills over.

Oh yes, I have been assigned daily exercises and tasks to do by physical therapy. I must admit that I have been doing the easier ones (like ankle pumps and getting up to walk a few feet every hour or so) but blowing off the hard ones that I can't possibly do yet. Some people don't even have to start PT until a week after surgery so I don't feel bad about slacking off a little bit and just doing what I can.

I do think physical therapy might be helping with stamina. I discovered that apparently my lack of stamina after surgery is actually something that many people experience. I didn't know that. But anyway, yesterday afternoon (after two PT sessions in two days, even so soon after Tuesday's surgery), I felt some stamina coming back and felt more "like my old self" for a while. So maybe there are some advantages to PT even if I don't knock myself out with it.

I slept well last night in my recliner and did not want to get up but did anyway. I need to maintain a more or less normal sleep schedule since PT and Home Health come over during normal hours. It's almost as bad as working for a living. Stamina is back to about zero for the moment but may come back in a little while since I only awakened a few minutes ago. I did, though, bring my coffee from the kitchen over to my recliner, clean off the kitchen counter a bit, take care of business in the bathroom, and now I want to read and post for a while with my coffee. I'll probably nap later.

My knee is beginning to be a little painful, probably from all that PT yesterday. So, I am going to take a hydrocodone+acetaminophen right now, before it gets any worse. I have been so lucky when it comes to pain but I still need to be very, very careful not to let it get ahead of me.

 

[pacergal]

The concern for icing more than 15-20 minutes at a time is for risk of "ice burn" or frostbite. You can damage your skin cells, reduce blood flow which also reduces oxygen needed for healing, and blood clots can form.
Always have some protective barrier between your skin and the ice bag/pack.

 

[W2R]

The concern for icing more than 15-20 minutes at a time is for risk of "ice burn" or frostbite. You can damage your skin cells, reduce blood flow which also reduces oxygen needed for healing, and blood clots can form.
Always have some protective barrier between your skin and the ice bag/pack.

I always place a cloth between my skin and anything cold when icing. The instructions for the ice machine say to do that, and I do. So that takes care of that, for me, in that it makes it not quite so cold on my skin.

 

[MRG]

Like chuckanut, I tend to think I am not improving at all because recovery is so slow. But when I think about it, there are several things I can do now that I couldn't do a couple of days ago, and am feeling more energetic as well. Besides, my surgery was just on Tuesday.

The great question, how am I? Its tough on long term recovery to not.lose track. I'm on my 5th cspine recovery, its 3 months since my injury and sometimes I wonder if I'm getting better. Well I am but it seems slow on a daily basis. Sometimes that had me a little down in past recoveries.

When my DW started biofeedback the therapist gave her a daily headache chart, four entries for each day, a month on a sheet of paper. Silly little thing, pain rates 0-4. Very light weight logging and wow! It's amazing how much it told you. I was amazed at some of the things it told us then the therapist made some suggestions about morning headaches. I was going to do one for myself but I'm almost well now.

Maybe just review this thread to keep track of how much progress you have made.

 

[W2R]

The great question, how am I? Its tough on long term recovery to not.lose track. I'm on my 5th cspine recovery, its 3 months since my injury and sometimes I wonder if I'm getting better. Well I am but it seems slow on a daily basis. Sometimes that had me a little down in past recoveries.

When my DW started biofeedback the therapist gave her a daily headache chart, four entries for each day, a month on a sheet of paper. Silly little thing, pain rates 0-4. Very light weight logging and wow! It's amazing how much it told you. I was amazed at some of the things it told us then the therapist made some suggestions about morning headaches. I was going to do one for myself but I'm almost well now.

Maybe just review this thread to keep track of how much progress you have made.

Thanks, that's a good idea. To be honest, that is part of what motivated me to post on this thread. I had heard that recovery can be a long, difficult journey. Still, I was determined to do this and do not regret it one bit.

Five cervical spine surgeries? Holy cow, you have really been through a lot.

 

[Squirrel]

Last time I got cortisone shots, the doc told me that 9 out of 10 of their knee replacement patients opt for a rehab facility afterward.

Is there a reason you rejected that idea? Do you regret it now?

BTW, your recovery and reporting are helping me plan for my future replacements.

 

[Teacher Terry]

The people that I know that went to a Rehab facility for a week before coming home regretted it. They said never again. Glad you are doing well!

 

[W2R]

Last time I got cortisone shots, the doc told me that 9 out of 10 of their knee replacement patients opt for a rehab facility afterward.

Is there a reason you rejected that idea? Do you regret it now?

BTW, your recovery and reporting are helping me plan for my future replacements.

Thank you!

Originally I told my surgeon that I wanted to stay in a rehab facility afterwards, and he said, "Let's see how you do after the surgery, and then we can decide". After the surgery, I was surprised at how little pain I was feeling (I was lucky). I just wanted to go home, sleep, and recover. Since I was doing well, he thought that would be best for me as well.

I do not regret it at all! The hospital was exhausting, with people in and out of my room every thirty seconds sometimes and I am not even exaggerating. It's funny at first, but after a while it becomes extremely annoying. For example: "Just checking your sharps container" (I hadn't had a shot yet, never did). Then twenty seconds later "Just checking your sharps....Oh!!! I was already IN this room."

In the hospital even an hour's nap was almost impossible to get, much less a good night's sleep. I have heard that rehab facilities are more like that than my home has been. I needed to get home where I could rest at least some of the time and sleep, and recover. Also I think I might be more likely to get an infection or illness in a rehab facility than here at home.

I did a lot of planning (and buying of home equipment, as described earlier in the thread) in the weeks leading up to surgery, and my sweetie Frank has been helping me too now that I am home. So it's not like a rehab facility would be doing work that I would otherwise have to do. PT is tiring but I would have had that in a rehab facility too.

The people that I know that went to a Rehab facility for a week before coming home regretted it. They said never again. Glad you are doing well!

Thank you!