Mako Robotic Arm TKR Week Six

Posted by saeternes @saeternes, Jan 10 8:55pm

Visit to doctor yesterday who is very happy with my progress, called it fabulous. PT today who put me on a pressure-sensitive treadmill and showed me the results. For 6 weeks it's fine, but I roll through my foot from heel to toe much better on my good leg than the surgery leg. He now wants me to find a good place to walk (mall?) where it isn't wet and the ground is flat, and concentrate on hitting with my heel and rolling all the way through on the surgery leg. I am at 126 for flexion (with pulling on leg, but only trying once) and 0 for extension (all those painful exercises are paying off) but only when on the table; when I walk the knee does not get perfectly straight. He also assigned me a kind of isometric clamshell where you put the bad leg on top, a few inches in front of the good leg, and hold the leg in clamshell position with a band on it for 30 second. Not easy!

In terms of feeling normal, far from it yet. Big numb patch that seems to be shrinking slowly. In bed hard to move without the knee waking me up, various twisting movements don't work at all. Small sharp pains now and then. Certainly nothing like the good knee. I started weight lifting again and hope that will have some effect as the muscles strengthen.

A few additional comments:

Sleep: I sleep 10 hours a day but wake up several times, and sometimes need a nap. Did any of you experience this? It is hard to get much done with all the exercises and icing and elevating and then having to sleep so much. I feel sleepy through much of the day even without the meds. Is this the body repairing itself?

Bowl movements: I had to switch to the "gentle laxative" (Bisacodyl) as the prescribed one made me throw up. It works fine, but it would still be tough without my bidet toilet seat. On the strongest setting it is like an enema, and very helpful.

Glad to be here where people talk frankly about their problems and avoid the Instagram curse of performative posts. I've learned a lot. More soon.

@saeternes sounds as if you’re doing great, I wish I had that flex. The rest will come soon.
I do think that when you’re healing your body is using energy and you do feel more tired. I have definitely noticed that.
Mall walking sounds like a good idea. I forget where you live but if you’re not in a cold state and there’s a HS around you may be able to walk the track there. My son-in-law always walks the track at the local HS when they are visiting. It’s nice to be outside when the weather is good.
JK

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@contentandwell Sadly it is cold and rainy here and I have no desire to brave the weather. Snow may fall next week. I think the mall will be okay. PT said in one month he expects me to look from the outside as if I did not have a TKR, in other words no difference between my gait and the gait of others. That doesn't mean the knee will feel normal, of course. I am now scheduled for PT once a week for the next six weeks, then we'll see where I am and go from there.

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@saeternes : glad to hear that your extension has improved, and your progress overall is quite impressive. Sleep: I was the opposite, never got adequate sleep hours. Enjoy while you can. Yes, the knee will wake you up when moving in bed for some time to come, but it gets better. Bowel movement: within 2 days after stopping Oxycodone I was close to normal, and once I got back to regular exercising (swimming, mostly) everything was fine.
I wish our PT group had had a pressure sensitive treadmill; that might have caught my off-kilter gait due to the TKR leg being slightly longer than the other one in time to prevent the hip problems that developed several months after TKR. Custom orthotics took care of that, but I can tell that I still put too much pressure on the outside of the TKR foot when walking. However, as long as it does not cause any pain or problems, I can live with that.
Regarding any kind of twisting motion – I posted separately that even after 16 months those kinds of movements are still moderately painful.
Keep up the good work!
Little side note: at the 6 week mark I had the dubious pleasure of hosting my son, wife, and super active 5 yr. old for 4 days. Slightly stressful!

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@saeternes

@contentandwell Sadly it is cold and rainy here and I have no desire to brave the weather. Snow may fall next week. I think the mall will be okay. PT said in one month he expects me to look from the outside as if I did not have a TKR, in other words no difference between my gait and the gait of others. That doesn't mean the knee will feel normal, of course. I am now scheduled for PT once a week for the next six weeks, then we'll see where I am and go from there.

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@saeternes It definitely does not sound like good walking-outside weather. I am not a big outside walker myself but had been trying to get into it just before my fracture occurred. I hope by the time the better weather returns I will be back to being able to walk outside without limping up the street in pain. That is not appealing at all.
@ellerbracke A pressure-sensitive treadmill? I have never heard of that but it sure sounds like it would be a good thing for physical therapy.
I am sure the fun of having your son and grandchildren visiting outweighed the inconvenience, overall. That was probably one of those "happy to see them come, happy to see them leave" situations.
JK

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@contentandwell The pressure sensitive treadmill is used to test the pressure as your feet go down. At the same time a video of your walking gait is being recorded and can be analyzed by various metrics in the program. My PT used it yesterday and was fairly happy with the way I was walking, except that he wants me to focus more on getting the heal down as my surgery leg goes forward, and rolling through all the motions. You can see sometimes that people with TKR or other knee issues will shuffle, or put their foot down flat without going through the usual rocking motion. He wants me to avoid that and I also am anxious to do so, as some people I know with TKR do have that shuffle.

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@saeternes

@contentandwell The pressure sensitive treadmill is used to test the pressure as your feet go down. At the same time a video of your walking gait is being recorded and can be analyzed by various metrics in the program. My PT used it yesterday and was fairly happy with the way I was walking, except that he wants me to focus more on getting the heal down as my surgery leg goes forward, and rolling through all the motions. You can see sometimes that people with TKR or other knee issues will shuffle, or put their foot down flat without going through the usual rocking motion. He wants me to avoid that and I also am anxious to do so, as some people I know with TKR do have that shuffle.

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@saeternes this sounds like a wonderful machine. With the feedback it provides, a person can more easily correct what they may be doing wrong.
JK

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@contentandwell @ellerbracke This pressure-sensitive treadmill is the only one in town. My PT works at a Therapy and Performance center, and they work with not only people with joint replacements but also athletes that want to improve their performance. Our local orthopedic center, where my PT used to work, does not have a machine like this. He again told me that if I could go there and see what people were doing at 6 weeks I would be very happy with my progress. Maybe I'll sneak in and ask around?

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You should, for sure! I joined a senior health spa and center roughly 5 weeks after TKR surgery to find a less painful way to exercise in water. Had to take an intake evaluation as well as physician’s approval of health fitness. 2 days ago I chatted with the woman in charge and reminded her that I was really ticked off by her checking off the # of getting off a chair, arms crossed, within 30 seconds, as “average” at that stage. She remembered well, and told me that “average” was way beyond what she expected me to be able to do. Was based on “average” people. Of course, I also clocked in as a BMI of 21.3, also “average”. Not in this town’s Wal-mart, certainly. You sound like a determined, competitive, overachiever person like me?

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@ellerbracke I'm certainly very ambitious, while often being lazy as well. I wish I had your BMI! Walked 30 minutes today in a mall with attention to full roll of surgery leg/foot. Then weights for 45 minutes. Too hard to get to the mall so I will probably use the treadmill although PT says forward movement from your own muscles is better. Weather is miserable.

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I had my surgery last June and I remember sleeping a LOT for at least six weeks. I had an ice machine and used it when resting. I actually slept fairly well, but excessively. I assume it was my body healing and the sleep was restorative. Also, my gait is not completely straight and am trying to work on that. Good luck with your recovery.

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@lblazina Thanks for that note. Slowly my excessive sleep has started to wane. I noticed things changed about at the 5 week point, although I was still sleeping a lot. How long can one improve the gait and ROM after surgery – anyone have any data on that? My doctor said I would gain another 15% but I want a lot more than that. I want this leg to be as similar to the other one as possible.

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@saeternes: I’ve been following posts re. ROM for over a year, and even though I really can’t pin-point who said what, people still had improvements up to 2 years. Granted, small ones, but still. I remembered something I did to increase/speed up my ROM proficiency: instead of using a yoga mat on the floor with slippery socks to do the heel slides – yes, I did them on the floor the very day I came home, had bed right next to mat to help pull up after – at the level of your extension I went the other way. I did a few heel slides to loosen the knee up, then scooted over to carpet with sticky socks and hovered the bent TKR leg at the most flex just barely above the floor, put the foot down toes first, and very gently lowered the heel as well, and held that position for a bit. Repeat. Repeat. It really does increase your ROM without being forced, or supremely painful. Just go slow, and maybe take a day’s break in between. Not sure if anyone has tried that, but for me it really worked. Let me know if you try it, and how it goes. As far as gait goes, no advice. Still fine-tuning mine, for reasons different than yours.

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@ellerbracke thanks, that's a great suggestion, I'll try it. Logically I can see how it would help.

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@ellerbracke I tried the exercise and it works well, thanks! Onward.

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Now at 7.5 weeks. This morning was the first time I woke up without a stiff knee. At therapy today reached 135 degrees flexion, 0 bend; the first with lots of pulling, so not "naturally." I want to push at this upper end so as to make the lower numbers more comfortable.

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