TKR out of the question when you've got PN?

Posted by Ray Kemble @ray666, Nov 16 11:40am

Hello, fellow PN'ers!

I'm suffering a double whammy. A triple whammy? Whammy No. 1: I'm 80. Whammies Nos. 2 & 3: I have large-fiber PN – no pain, but poor balance – and a left knee that aches with arthritis. My right knee is already a TKR, so I'm familiar with the procedure. I'm doing PT for my poor balance, but much emphasis is on building leg strength. My therapist and I both recognize that the most effective exercises for rebuilding leg strength are the same exercises that aggravate my arthritic knee (e.g., squats, thrusts, sit-to-stands), so I'm relegated to "gentle" exercises. I feel my bum knee is hampering my chances of rebuilding leg strength. But at 80, with PN-related balance issues, I'm pretty sure I'm no longer an ideal candidate for a second TKR. Has anyone else found themselves at a similar crossroads? Has anyone 80 or thereabouts, with poor balance and bad knee arthritis, ever found a workable alternative to a TKR? I'm obviously on the hunt.

Ray (@ray666)

Interested in more discussions like this? Go to the Neuropathy Support Group.

I had a knee replacement 20years ago. It’s been great but now can be painful
I do have neurothapy
The walker with the seat works very well out of doors
Good luck

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Profile picture for debbieod @debbieod

@projfan I still work on gait and balance after therapy for both 25 years ago. I had to learn to walk again and developed balance issues. Car accident
You are correct not every PT is as trained in depth as others.
@ray666 the specialist might be good also for more in depth balance - brain- training.
My trainer from the gym that runs Parkinsons classes is high on core strength to prevent falls. You have to be strong in those muscles to self correct when an uoset occurs.
You can strengthen your leg muscle by simply standing on one leg. I always brush my teeth like a flamingo.😂
Blessings to both of you
debbieo

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@debbieod After flunking out of PT after a hip replacement, one year later and now with a new neurologist who recommended I go to a PT group that works neuro individuals. My new PT is addressing core strength to keep me upright and also to reduce the pain I have on waking in the morning. This PT, trained to work with neuro clients, started me where I was. This week I start in the pool; I'm looking forward to that. Gentle movement. I still do sit-to- stands, and also stand-to-sits (sitting down very slowly with great control, not plopping down). I used to be able to pop off 45 (3 x 15); now I'm glad when I can do 10! I'm hoping to increase this with time. The new PT is at a location that works with neuro (PN, Parkinson, stroke, brain conditions of known or unknown origin). It is heartwarming to see us all working on whatever it is we need to be able to do including walking, sitting and standing up, very important, basic skills.

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Profile picture for Ray Kemble @ray666

Hi, @debbieod One of the practices my PT and I do is petturbation drilll, where he'll attempt to knock me off balance by giving me a shove without my knowing from what direction the shove will be coming. –Ray (@ray666)

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@ray666 😳😂😇

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Profile picture for bjk3 @bjk3

@ray666 Hi, Ray ~
How on earth do you keep your balance? I could be on the floor faster than in a New York second with the slightest brush of a passerby if I'm not, as you say, paying attention to every step or even to just standing. Consequently, I avoid walking in crowded places, or at least I wait for people to clear out.

This discussion is VERY interesting. I had to look up perturbation - never heard of it. And the conversations about gait training are wonderful. Lots of things to bring up with docs and PTs. I sure hope some of the options that others have experienced success with, will help you find a tailor-made solution to your knee and balance problems. Please let us know how things are progressing. All the very best to you with your upcoming appointments this week! ~ Barb

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"How on earth do you keep your balance?"

Hi, Barb! (@bjk3)

How on earth do I keep my balance? It ain't easy! 🙂 Do you remember those inflatable thingies of a half-century ago, those life-sized baloons that had something like sand in their bottoms, so that, when they got knocked over, they'd pop right back up? I think my PT believes I'm one of those inflatables. I may be an inflatable, but I'm more like my neighbor's inflatable Santa Claus: my neighbor will inflate it every morning, but by lunchtime Santa will be air-less, lying face down in the snow like a rubber flapjack.

Cheers!
Ray (@ray666)

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Profile picture for Ray Kemble @ray666

"How on earth do you keep your balance?"

Hi, Barb! (@bjk3)

How on earth do I keep my balance? It ain't easy! 🙂 Do you remember those inflatable thingies of a half-century ago, those life-sized baloons that had something like sand in their bottoms, so that, when they got knocked over, they'd pop right back up? I think my PT believes I'm one of those inflatables. I may be an inflatable, but I'm more like my neighbor's inflatable Santa Claus: my neighbor will inflate it every morning, but by lunchtime Santa will be air-less, lying face down in the snow like a rubber flapjack.

Cheers!
Ray (@ray666)

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@ray666 Ray, that is quite the visual!!! 🤣

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Profile picture for bjk3 @bjk3

@ray666 Ray, that is quite the visual!!! 🤣

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I can't help it, Barb (@bjk3). I see everything in Super Panavision 70. It's these dime-store progressive lenses I've got. 🙂 –Ray (@ray666)

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Profile picture for debbieod @debbieod

@projfan I still work on gait and balance after therapy for both 25 years ago. I had to learn to walk again and developed balance issues. Car accident
You are correct not every PT is as trained in depth as others.
@ray666 the specialist might be good also for more in depth balance - brain- training.
My trainer from the gym that runs Parkinsons classes is high on core strength to prevent falls. You have to be strong in those muscles to self correct when an uoset occurs.
You can strengthen your leg muscle by simply standing on one leg. I always brush my teeth like a flamingo.😂
Blessings to both of you
debbieo

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Hi, Debbie (@debbieod)

I had a PT session today and once again my PT "upped the ante" on the balance routines. What I often find puzzling in the aftermath of one of these "up the ante" workout sessions is of course my balance: Is it getting worse (because the routines were more difficult and Inaturally had more difficulty), or Is my balance imroving (because I was able––albeit with some wobbliness––to do all that I was asked to do). I guess that part of the charm of PT. 🙂

Cheers!
Ray (@ray666)

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Profile picture for joanland @joanland

@ray666
I found a wonderful assistant who came in to help after my latest hip replacement. She came every day for a few hours and kept me going; she was not here full time. (My daughter stayed stayed for a week after my hip replacement. ) The assistant came daily for a few hours after that. How did I find her? She worked full days, in turn for two families I know where member of the family was staying in the home while in hospice care. Perhaps a call to a local hospice to see if they know of people they can recommend who can do in home care for someone needing care for a few weeks. Another location that might be able to suggest someone is an Adult Foster Care home. I found I could manage during the night. She came came in during the day, fixed meals, did errands, got groceries, saw that I got my meds, picked up Rxs, did laundry, changed the sheets, etc. She did not do full house cleaning. She was worth every penny, and now as PN is increasing, she comes for 3 hours one day a week. That is enough to keep me going; I still cook, make my own meals, get my own groceries (I still drive.), but she does whatever needs doing, and now we have a regular check list that she goes through so I don't have to be telling her or reminding her what needs doing. She's probably in her early 30s, has a 1 1/2 yr old daughter who spends the time w/ grandma while her mom, my helper is here. She is becoming a very good friend. With my permission, her mother and her 1 1/2 yo daughter stopped by to say hello last week. It was a delightful visit. Good luck. Wonderful, capable people are out there.

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Hi, Joan (@joanland)

Thank you for your wonderful message! I'll be meeting on Wenesday with both my orthopedist and his nurse and I plan to ask if they know what support systems may be out there for someone in my situation: (1) 80, (2) PN balance issues, (3) living alone, (4) problematic knee (interferring with PT). Having had one before, I'm fully aware of what's involved in a TKR, particularly post-op. I'll go into Wednesday's meeting with an open mind. My overarching question: What would you advise a fellow like me do?

My best wishes to you!
Ray (@ray666)

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Profile picture for Ray Kemble @ray666

Hi, Joan (@joanland)

Thank you for your wonderful message! I'll be meeting on Wenesday with both my orthopedist and his nurse and I plan to ask if they know what support systems may be out there for someone in my situation: (1) 80, (2) PN balance issues, (3) living alone, (4) problematic knee (interferring with PT). Having had one before, I'm fully aware of what's involved in a TKR, particularly post-op. I'll go into Wednesday's meeting with an open mind. My overarching question: What would you advise a fellow like me do?

My best wishes to you!
Ray (@ray666)

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@ray666 As I mentioned, before I have a wonderful young woman who comes in once a week for only 3 hours, and she does wonders. My daughter is quite the gardener and she is here for Thanksgiving week. They are both out in the front yard chatting away while pruning the shrubs to get them ready for winter. She is a delight. She knows my daughter has food allergies and can't eat chicken eggs. She brought us 18 duck eggs! Duck eggs, since the bird flu epidemic are like gold! We'll have Swedish pancakes, maybe a very late birthday cake (daughter's bd is in May) maybe it's an early bd cake! Possibly a smoked salmon, asparagus frittata. My next step is to see if my helper can come in another half day or portion of a day. I do hope you can find someone who works well with you, is flexible, and willing to do whatever needs doing. My very best wishes to you.

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Profile picture for joanland @joanland

@ray666 As I mentioned, before I have a wonderful young woman who comes in once a week for only 3 hours, and she does wonders. My daughter is quite the gardener and she is here for Thanksgiving week. They are both out in the front yard chatting away while pruning the shrubs to get them ready for winter. She is a delight. She knows my daughter has food allergies and can't eat chicken eggs. She brought us 18 duck eggs! Duck eggs, since the bird flu epidemic are like gold! We'll have Swedish pancakes, maybe a very late birthday cake (daughter's bd is in May) maybe it's an early bd cake! Possibly a smoked salmon, asparagus frittata. My next step is to see if my helper can come in another half day or portion of a day. I do hope you can find someone who works well with you, is flexible, and willing to do whatever needs doing. My very best wishes to you.

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Hi, Joan (@joanland)

I'm fortunate in the number of friends my partner and I had (and have). They've been powerfully supportive throughout, and continue to be, if, perhaps, a little less "on site" recently. That's completely understandable. We're entering the holiday season and my friends have many to-dos related to this time of year: family visits, office parties, shopping, local events to take the children to––the list goes on and on. I'm taking that in stride. So far, so good. Tomorrow I'll be talking to my ortho doc. I'm curious what sort of suggestions he might have to "fix" my arthritic knee. If he suggests continuing with injections, that will be fine with me. My knee will continue to "complain," on and off, but I'll bear up; I have up until now, and I can go on "as is." I'll rebuild my leg strength one way or t'other.

Merry day, Joan!
Ray (@ray666)

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