Mako Robotic Arm TKR Week Six

Posted by saeternes @saeternes, Jan 10, 2020

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.

@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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@saeternes

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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@saeternes: great progress! I get that you want to push to the limit, so an average day is still excellent. That’s where “my” exercise helped a lot. I got the knee and all the workings inside used to fairly extreme bend (the higher you start when pointing and putting down toes, the closer to butt the heel will end up), so that eventually flex in general became easier and better. But realistically, a FINAL 135 degrees is outstanding, and what most people would be envious about. I myself, nor my PT, ever did any pulling or pushing on the TKR knee, so whatever bend they measured was all on my own power, without assist. No matter, end result is what counts, and yours adds up well.

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@saeternes

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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@saeternes You are doing amazingly well. That's great, I am really happy for you.
JK

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@ellerbracke your exercise works really well. I'm trying to get used to just icing the knee with a pad when I do these exercises and no meds. That seems to be going okay. @contentandwell thank you. But I still want to note that the knee is far from "normal" in terms of sensations. Also I noticed the kneecap is a different shape than the other one, slightly more pointed. Is that true with your knees?

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@saeternes

@ellerbracke your exercise works really well. I'm trying to get used to just icing the knee with a pad when I do these exercises and no meds. That seems to be going okay. @contentandwell thank you. But I still want to note that the knee is far from "normal" in terms of sensations. Also I noticed the kneecap is a different shape than the other one, slightly more pointed. Is that true with your knees?

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@saeternes I pulled up my pants to compare my knees and then realized that they are both fake knees so I can't compare! They are two different brands of knee though. Neither looks pointed.
JK

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@saeternes

@ellerbracke your exercise works really well. I'm trying to get used to just icing the knee with a pad when I do these exercises and no meds. That seems to be going okay. @contentandwell thank you. But I still want to note that the knee is far from "normal" in terms of sensations. Also I noticed the kneecap is a different shape than the other one, slightly more pointed. Is that true with your knees?

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@saeternes : nope. TKR knee/kneecap is flatter and slightly wider. Other knee/kneecap more pointy.

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@ellerbracke @contentandwell Now when I look again I'm not sure. I can see the shape is different, slightly, but pointed-ness depends on the angle.

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One more comment: I can tell that now, as I near 8 weeks, my knee is recovering to the point where the flexion and extension are starting to "solidify," if that makes any sense. I don't experience much pain pushing on the bending (or doing @ellerbracke exercise) or in flexion even with weights on my ankle. I think that means my knee is healing and perhaps in another month will feel more normal, if not completely so? I'll report.

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@saeternes : Next time you see Alex, could you ask him something? Once I reached 132 degrees (more now, that was about 6 to 7 weeks post surgery) one of the PT’s mentioned that 135 to 138 is about the upper limit of what an artificial knee is designed for. When I asked my surgeon, he did not seem to set any limits (probably figuring that knee function after TKR is self-limiting). I’ve always been curious what the consensus is. Your therapist sounds like a dedicated specialist, so his answer might be interesting. Thanks!!
I personally know 1 lady, about 65 or so, that can actually touch her heel to her butt – but only once she has done a 45 minute water aerobics class. And supporting/pulling ankle with hand to get the leg bent all the way.

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@ellerbracke I have heard that too but I suspect it applies to earlier generation knees. I'll see Alex on Friday and try to remember to ask him. Your flexion is excellent! I would also love to match what that lady can do, we'll see.

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