Mako Robotic Arm TKR Week Three

@saeternes : mostly: patience. I still remember having to do 3 30-minute exercise sessions each day, with an additional 3 20-minute excruciatingly painful static leg extension stretches, with lots of icing in between. At about the 4 week mark I was tired of the pretty constant pain (remember, I voluntarily stopped all prescription pain meds. at about 9 days), and at that point decided to join an indoor pool (saline, in a fitness center associated with senior living) to do my knee rehab. The trained person in charge of the pool developed a specific water exercise program for me and my knee, and I found it much less painful to do the lifts and squats etc. in the warm water, and was able to do a lot more repetitions. One example: instead of step-ups I was told put my foot on a pool noodle under water and push down on it, let it raise up, and repeat. I still did the step-up at home in addition, but I believe the pool version did a lot to strengthen my respective muscles. At about 6 weeks I started swimming some laps as well. Just a thought, in case you get frustrated, and want to change up your daily routine.
Also, since this is an old folk’s home, quite often I had the whole - small, 10 x 10 meters - pool all to myself, so I could grunt if I wanted to!
Regarding day-to-day functioning, at that point I was back to my normal routine re. household, cooking, cleaning (except no kneeling to scrub bathtub, and no walking for exercise because of inadequate leg extension). Also had the fun of hosting houseguests with an active 5 yr., old 5 weeks after TKR.
As to when the knee feels “normal” - no clue. An acquaintance said around 6 months. I’m still waiting. (14 months.... it works “normal”, just doesn’t feel “normal”).

@ellerbracke thank you, I will try to be patient and actually grunting sounds great right now. I do plenty of it at home. The pool is something I want to look into in the new year. Alex says I can also start light weight lifting again in January so I am hoping that will help. My knee generally feels like a lump of concrete. I think one thing I never figured out is that looking at the milestones that people reached I never thought to ask how they feel. Alex feels my fatigue is mostly due to the meds, but unlike you, I feel I have to have them to get through the exercises. I really admire you quitting so early and forging onward.

I have a friend who threw up with the narcotics so never could take them. She barely avoided a MUA and dosed herself with Ibuprofen and Tylenol, that was all she could do. She is over a year out and said her knee still aches after sitting for a few hours. In France, where she is from, TKR patients spend a week in the hospital and then another three weeks in a rehabilitation center. She said they are "good to go" after that but I doubt the tissue would be completely healed no matter what they did.

The itching has largely gone away, still a lot of stiffness and I assume that will go on for a while. I could get by with no meds as long as I didn't have to exercise, but the window is small so it is a trade-off I guess. Thanks again!

Also on the bike more now, edging toward 30 minutes at mild resistance. Hurray!

@saeternes : congratulations on your biking! I never liked any kind of stationary bike, even though I used it a little in the beginning. The fitness person made me aim for keeping my heart rate at 120 bpm or above (roughly 5 to 6 weeks after TKR), and that was pretty intense. And boring. And my butt hurt after 20 minutes.
Re. pool: no idea what facilities near you look like. Since “my” pool is specifically designed for seniors, it is moderately warm water, hand rails all around the inside pool wall, 2 entrances with wide, low concrete steps with hand rails on either side, depth ranging from 4 1/2 ft. (for lunge walks) to 6 ft. That is about as ideal as it can get. And to top it off, it’s less than a mile from my house.... walking distance if I should chose (I don’t! either I walk, or I swim, not both.)
Regarding pain medication: I had been prescribed Percocet or Oxycontin roughly 6 times over the past decade for various legitimate reasons, and I simply dislike the way they make me feel. I have no fear of addiction - if I am “addicted” to anything, it’s doing Sudoku or other brain games, reading of any kind, a good pinot noir - specifically from the Willamette valley in Oregon, more specifically from Stoller, Sokol Blosser, or Lemelson. Hard to impossible to get in SC., so I indulge when out West.

I don't understand the oxycontin addiction problem - the dose must be much higher than what I am taking. As far as I can tell, it just takes the edge off the pain, doesn't give a high or anything like it associated with addictive drugs.

Today for the first time the numbness on the outside of the knee seems to be shrinking in area. The top part has some feeling now. I am practicing going up and down stairs the normal way with the surgery leg taking most of the weight. Managed 30 min on bike yesterday although it did make me tired. Another thing I am doing is using a bench to put the top of my foot on, and then bending down while holding the walker. This stretches the quad very well. In the lower leg there is still pain right under the skin if I push on it - Alex says it is edema. So the lymphatic massage is helping. I didn't even know there was such a thing.

@ellerbracke yes those are great wines. Try some of the Columbia River Gorge wines too if you get a chance, both from Oregon and Washington.

Today 3.5 weeks, 120 degrees bend and 2 degrees extension. Extension is much more difficult although not as painful. Looks like I have a few weeks to go. Just for fun we measured my other leg - 150 deg. bend, of course 0 extension.

@saeternes : nice to find a fellow slow-straightener. Alas, I think you are coming up on close to a month, and you are definitely coming up on holidays. I wish you the best, and continued great progress.

I am indeed finding the straightening much harder and hope I can make progress over the next week. How did you manage to do it? I have cut down the drugs again as pain is receding. What I didn't expect is the exhaustion and feeling of just wanting to hide under a rock until it is over. I slept 12 hours last night, amazing.

@saeternes : my PT guy made me elevate the leg - as straight as possible - for 20 minutes sessions 3 (or more) times a day. I put my heel on the armrest of the couch while on my back. For me, discomfort set in after 5 minutes of that, by 10 minutes I was in pain, and by 20 minutes I was in tears. Hard to believe that just laying there, doing nothing but keeping knee totally straight can be so bad. In addition, I would sit on the floor with my legs straight out, and push down hard on the TKR knee for several 30 second sets, also a few times a day. It still took me months to get those last 1 or 2 degrees. At least you are lucky that you can sleep. I think I averaged 4 hours or less for the first month. Mostly because of pain. And of course I did not do my usual activities or exercising to the level that I’m accustomed to, and that make me tired enough for a solid, uninterrupted sleep pattern.

@ellerbracke that's close to herioic. I can't imagine doing all of this without the meds. I've found a new exercise on the web that involves lying on one's stomach, from knee down leg hanging over bed, and a rolled up towel right above the knee. It's pretty good. I also do the one you mentioned. I also haven't been able to do my regular exercises and that takes a toll. I have found that I am pretty happy when left on my own, just because it takes so much energy to interact. Hopefully that will diminish over time.