BACK TO WORK - 10 WEEKS POST SURGERY

I survived my first two weeks back at work - weeks 8 and 9 I worked between 3.5 and 5 hours per day.  My job keeps me on a chair, wearing a headset in front of a computer.  I managed very well with taking breaks to stretch my legs and use ice during a break. Put a box under my desk to change my leg position now and then.

I was stiff when I got home - about a 20 minute drive which is hard on the right leg - and usually did an immediate PT session followed by ice, then another one before dinner.  I found I was very tired and in bed early each night.  I am still using Tylenol and Advil  and, though I keep trying to skip it, still using the Percocet at bedtime - hopefully I'll be off that in the next week or so.

The only other complaint I have is continued incision pain/discomfort.  The incision is healing really well and looks good but by the end of the day is so tender and sensitive I frequently go to bed early so I can leave my knees exposed - no clothing,  sheet or nightgown touching them! Have not read about anyone else having this issue...

This week, week 10, I am up to 5.5 hours per day (at work 6 hours due to required lunch break) and plan to increase to 7 hours next week and back to full time on my 12th week following surgery.

 My surgeon thought this was ambitious but I am feeling good, I still have time for at least 2 sessions of stretching and strengthening.  I was concerned during week 9 because my right leg was not showing the same improvement and strength as my left, but it suddenly kicked in, they are getting more equal and my gait is much improved.  I still get more stiffness in the right knee and work it harder during my PT sessions.

 I am only up to about 20-25 minutes a session on the exercise bike - I do feel more pain following the longer sessions so I am trying not to cause a backwards slide - tho I really feel good when I am on the bike!!

STARTING BACK TO WORK

I graduated from physical therapy last week about the time I got a paycheck for $54.00.  Time to go back to work so I don't owe them money for my benefits!

Over a week ago, I achieved a flexibility level of 126 on both knees - had no issues from the start with getting to 0 on my straight legs. I have some wobbliness and weakness on my right knee that I am working on strengthening for, but I was the first of my PT group to "graduate".

 I spent my last few sessions working on things like balance, climbing stairs and the hardest for me - getting on and off a regular chair without pushing off with my arms.  Ouch.  (I admit my biggest fear is getting stuck on a low public toilet and not being able to get up!) I had to put my fear of the pain behind me and after a few practice tries at standing up from the low chair in the gym - I could do it pretty well and it got less painful as I went. 

I also started driving during week 7. Freedom!!!  Though I wouldn't want to try to drive very long or far at this point! That driving leg is my weaker one and it gets stiff when I am in stop and go traffic.

At my appointment with the surgeon I asked for a letter to return to work on a limited basis and was given permission so long as I keep in mind this is still "early days" as he put it. So I started last Friday for just 3.5 hours with 1  break to ice and a few stretching out walks around the office.  I went again today for the same amount of time and might try for 4 hours tomorrow. 

Not sure if there was a betting pool on the likelihood of my returning at 8 weeks - but there were some very surprised people...also very welcoming people.  Nice to be out of the house for a few hours a day, then home to do my PT and rest.

Normal here we come.

HOPEFULLY HELPFUL TIPS FOR TKR PREPARATION

I did a lot in preparation for surgery and for the post op period at home.  I have a few hints that I thought I would share,  Having had both knees replaced, I am in a slightly different position in terms of functionality and recovery, but these things may turn out to be helpful for any TKR patient,

Having some help keeping track of paperwork, post op instructions and pharmaceuticals is a big

help.  My future DIL is a nurse and she actually created a daily chart for me to track all the things we needed to deal with daily.  I could check off the timing of my meds, supplements, water intake, activity, use of ice machines, etc.  Plus keep notes of any issues for follow up.  I am still using it to keep track of my pain and inflammation doses during the day - it can be a challenge to keep track and remember the timing as it can change day to day.

FYI - For those who might be bariatric patients or who take a lot of nutritional supplements - take care with adding vitamin K when taking blood thinners in the first couple of weeks following surgery - check with your physician on this.

Mine is labeled TheraBand

Initially I spent a lot of time in bed - it was more comfortable and close to the bathroom. I recommend having as large a bedside table as possible!  There were a lot of things on it - water bottle, usually a tea cup, meds, phone, TV remote, clock,log book and pen, etc.  I also liked having a chapstick, some gum, a book and hand lotion.  Think about he little things that give you pleasure and make you feel pampered when you are in pain and can't shower with the frequency you would like! This is really just for the first week or so - but FYI.

Having a strap around has been invaluable.  Mine is a stretchy one, but a static one like those used in yoga works, too. I used it to leverage my legs on and off my bed and sofa and now use it several times a day for my PT exercises.

I love my ice machines!  A great tip is to freeze water bottles and use them instead of ice cubes - not as messy, easy to carry to and from whatever room you are using the ice machine in.

I was unable to sit at a table to use a computer for about a month or so - and I could not tolerate a laptop on my lap as my legs were too tender - so a TV tray, breakfast tray or other sort of lap desk would have been great for meals and for computer use.

We put our  family room leather sofa up on bed risers to make it easier for me to get up and down.  Very helpful when you want to use furniture without arms to leverage up and down. With two knees out of commission - I had to have someone lift me up before we got the risers - afterwards I could do it by myself.   Eight weeks later and the risers are still there!  Might as well have some things easier.

Hope these ideas are helpful - going into this surgery there is not a lot of info on recovery - I was lucky I had help and some of these items on hand!

CURIOUS ABOUT THE INCISIONS?

I am posting these photos - don't look if you don't want to know!!

The incisions were closed with surgical glue - which I didn't know until the big reveal two weeks in when the dressings were removed.  The glue is sort of purple and the incision was very puckery which made me nervous.  also the knees are very swollen.

Post surgery dressings

At 2 weeks when dressings removed

This is taken at almost 1 month.

And this is at 6 weeks.

The swelling has decreased - I still get discoloration like bruising when I have over done it - like standing or working out a bit too much. That is an indication of swelling, which I relieve with ice and elevation. Adding Advil has helped in the last 24 hours, too.

 I mentioned the SalonPas cream for tenderness in a previous post - it has helped. I have used lotion right up to the incision to relieve the itchiness and peeling skin - but followed doctor's orders and did not put anything on the incision until now.

The incisions are still puckery but so much improved I am not too concerned for the scar being too bad.  As you can see the right one is curved and the left one straight - didn't ask the surgeon about that!