FOUR FULL MONTHS TKR POST OP

I wasn't sure a couple of weeks ago that I was still making progress, but as has been the trend, as soon as I doubt, I turn a corner.

I am still leaving work a bit early to get in some extra PT time every day.  To be honest, though, I frequently use the time to do errands and just escape that last boring hour of work that feels like it lasts 2 hours!  I still experience enough stiffness by the end of the day that I am taking  my PT seriously most days.  Honest.

I realized about a week ago that when I get out of bed in the morning, I hardly notice my knees - I am back to my lower back being more of a bother than my knees. Hurrah?  By the time I am up and around for awhile I tend to get a bit stiff, so I do a few stretches before I leave for work.

 I started parking up the hill in my usual spot and have given up the luxury of the handicap spot right in front of the building.  I am fine on the hill and the extra walking is good before and after a day of sitting. I am also getting in and out of my car with much more ease.

The biggest issue I have had is a bad tooth infection in a molar I had a root canal in a year ago - I experienced several days of significant pain, stiffness and general feelings of being unwell until the antibiotic kicked in.  Those admonitions about oral health are not to be taken lightly. The infection did not travel to my knees, but they were definitely impacted.

FIFTEEN WEEKS POST TKR - GETTING SOME SLEEP

I am happy to report that I am finally getting some sleep - the medication has been helping a lot.  Not every night, but most nights I am getting at least 6 hours of sleep. I would prefer 7 1/2  so I am taking the meds a bit earlier each night.  The medication I am taking is called Gabapentin.  I still have tender and sensitive incisions, but the sharper nerve spikes have diminished and I am not waking after I am asleep - at least not due to the healing incisions.

I am still leaving work a bit early to do my PT every day.  It really helps to do this - I feel so much stronger and more flexible each week.  I am able to get up and walk around enough at work that I experience much less stiffness, also my walking has improved a lot, hardly any "hitch" in my gait.

I spent several hours on my feet at an event this weekend and rode 10 miles on my bike the next day. I was tired and sore each day, but I think I need to push myself in order to build my strength back.  Besides - before the new knees I could not have stood and walked as much as I did!  I could, however, put many more miles in on the bike - so I have more work to do. I am 10 days away from 4 months post-op.  I think I am still doing really well. Yay.

PEOPLE TOLD ME THIS WOULD HAPPEN - WEEK 6

At least 3 people with experience of surgeries or serious medical issues told me that I would get to a dark place, hit a wall, wish I had never had the surgery - and then I would turn a corner.  Guess my last post came from that dark place and then - I turned the corner into the light.

I got over the stiffness that had been plaguing me for days and managed to hit the 120 degree mark on my flexibility.  Apparently that was my goal - so I need to keep at it, keep working on improving my mobility and get to the place where I can walk without a hitch, get in and out of the car and on and off chairs, up and down stairs and stand and walk for more than 20 or 30 minutes at a time.

I am still working on the pain medication weaning.  I am now able to go all day just using Tylenol. The nights are a different thing.  I am not managing to make it through the night without being awoken in pain - then can't go back to sleep with Tylenol .  If I take another Percocet I am still awake an hour or so before I can sleep again. So need to work on that.  I am down to 2-3 in a 24 hour period but hope to be off entirely next week and see about driving the car....Freedom!!!

FRUSTRATED AT FIVE WEEKS

Prior to surgery for TKR there is a required class, a pile of paperwork, binders full of information all about the pre-op process, the surgery and preparations and equipment needed  for the  home. We are told there will be a call to set up PT appointments and a couple of follow up visits with the surgeon's staff. 

At the time time it seemed like a lot of information.  I was anxious about the realities of  recovery, but I  assumed there would be more guidance offered along the way.  Bad assumption. The last tab in the binder is "Follow-up".  There is one sheet of paper with a phone number. The number is for a general appointment call center.

At two weeks I saw the PA. he took off the dressings and advised on care (basically, do nothing to it - no creams, etc.) renewed the Percocet prescription while suggesting I should start reducing my use, asked about PT and that was it. 

I moved from home based PT to a class twice a week.  We rotate from exercise equipment and stretches and are measured to determine our level of flexibility. I am aware there are goals, but they are not discussed... We are told to do the stretching 3-4 times a day at home, not to spend too much time walking around and over using the joints.  The PTs are very nice and very reluctant to discuss any issues other than the class related exercises - we are told questions should be referred back to orthopedic staff.

So I have been waiting longer to take the pain medication, using ice and elevation more to help the pain, doing my stretches many times during the day, taking breaks between tasks so I don't cause additional swelling, only using the bike once a day as I was told - in other words, doing my best to be a good rehab patient.  I have seen the small increases in flexibility and mobility but wonder if I ould be doing better.

So why am I frustrated at five weeks?  I am still very stiff and experiencing a lot more pain than I was in the first post-op weeks.  I am very pain tolerant - not one to whine.  I find myself whimpering and screeching in pain quite a bit.  I am not afraid of getting hooked on opioids, I have been fine with taking the meds as I feel I need them, but there have been many days and nights the pain has gotten ahead of the medication and there lies much misery. One day I go 7 hours before feeling the pain building and another night I'll wake after 4 hours in throbbing pain and can't sleep. So how do I do this?  I need guidance. 

I emailed the surgeon's office and requested a consult.  They referred me to my GP who offered me a phone consult a week away.  Sigh.  If it is like the last phone consult I had with him, he didn't even know why he was on the phone with me and was not prepared.  It was a complete waste of time.  So I called my future daughter in law, a nurse, to discuss whether I should add an OTC between doses  and how much.  She was a great help.

There doesn't appear to be anyone in the orthopedic office available to discuss the rest of my questions, goals and concerns.  I have a follow up appointment on the 28th, so I hope there will be some answers then.

The other issue weighing on my mind is going back to work.  I can't even imagine it right now.  I can't sit for 8 hours at a computer being kind and helpful when I am in pain after about 20 minutes of sitting and need a break to move around and stretch out.  Can't exactly strap on my ice machines while at my desk!  So how do I get there from here?  I am expected back at work in less than 3 weeks - will everything suddenly turn around?

It doesn't seem reasonable to cut me apart, add new parts and sew me back together and then leave me to figure this out on my own.  Right?

KEEPING SPIRITS UP - ONE MONTH POST-OP

I know that I have had an amazingly positive experience with my bilateral total knee replacement.  I planned well, got onto pretty good shape ahead of the rigors of the recovery and have a good support circle.  I seem to be hitting all the markers per the PT staff, I have been reducing my pain meds but feel free to take more if it creeps up. We have even had a couple of weeks of temps in the 70's so I have gone outside to sit in the warm sun with a book a few afternoons.  Still, one month in,  I am tired of the whole thing and having to make a real daily effort to keep my spirits up.

One of the ladies in my class summed it up - we just want normal again.

That is gonna take a while!  It may be 2 months before I go back to work, but it may be 6 months before I can bend my knees without some pain.  Each little moment when this experience is not uppermost in my mind is great - then there is a reminder laying in wait!  Yesterday I went to stand up without thinking and without using my arms to leverage myself up and I thought I was going to pass out it hurt so much.

There is some distance to go.

On the other hand - I am up on this bike!!!!