PN's little "extras": tired knees & swollen feet.

@bettyg81pain That is exactly correct. One of the surgeons is at Rothman Institute and he is a knee and hip specialist. The concern is that if I were to fall with a replacement knee and damage the knee, it could be a very serious situation. It is obvious from my gait that I have a problem walking. My poor balance and a history of periodic falls is the reason for the refusal.

That's a question I plan to ask my neurologist, podiatrist and cardiologist. Thanks for bringing up the two may connected.

I have also had a minor heart attack, is there a connection between PN and a heart attack?

I also have swollen feet with my PN. I find taking pycnogenol plus Butcher's Broom works very well to get the swelling down. There are many research papers in support of this, and commercial airline pilot's and others who have to sit for long periods of time (resulting in edema, muscle cramps, deep vein thromboses, etc.) frequently use pycnogenol to prevent these events. I personally use 100 mg of pycnogenol with breakfast, a 500 mg Butcher's Broom at lunch and another at dinner when the swelling is bad. When it levels off, I drop the BB at lunch. Just a suggestion. Hope it helps.

Yes, same here. And that's a very good way of describing it. I feel like my knees are saying, "C'mon, really? Just sit down, already." That adds to the instability I have. Can't count on those knees to hang in there very long.

Ask for pool physical therapy to start, if it is available to you. I was barely able to walk last July. I go to pool exercise class 3 days a week and am now able to swim 40 laps. I could do only 5 strokes to start. The swelling goes down after the class and other days a light work out with the exercise tools. I take my tape measure along to see just how much swelling goes. I was pleasantly surprised. Just light kicking floating with the noodle is helpful. Sometimes I use the steam room, sauna, or hot tub after the pool. I drink a bottle of water during the exercise and in the hot areas. This seems to help flush the junk out of my system. There are a lot of exercises on You Tube to do while sitting or with a chair at home to help swelling. Moving your ankles, feet, toes with legs up helps some. The gym I go to also has a light yoga class and chair exercise. They are helpful also. There are electric massage tables I use to help circulation. Different intensity settings. This helps some to just to relax. Ask for a guest pass to see how you like it. Go for at least 10 times. You will feel the difference. If you go, please share how it helped. I just know you will be happy you tried this.

I want to add that disabled people are lowered in to the pool for the classes. People in their 90's come. One lady is 97. You go at your own pace. Lots of nice people too. I pay $18. Some insurance may cover this. You have nothing to lose and may gain a lot of relief.

Very good advice. Thank you.

My doctor just ordered physical therapy, with pool therapy. I'm looking forward to how it will help.

@proteusx Thanks, that sounds promising so I looked up pycnogenol on Wikipedia. It is an extract of Europeon coastal pine bark. They only had this to say about it's medicinal use:

"A 2012 Cochrane Review, updated in 2020, Robertson et al. reviewed the evidence on the efficacy of pine bark extract for treating a wide range of complaints (including asthma, children with ADHD, blood pressure, pain in CVI, reducing fasting blood glucose, osteoarthritis of the knee, cognitive failure in those with traumatic brain injury) and in all cases failed to find evidence to support the efficacy of the extract.[2]"
But they did not mention foot swelling so maybe it works for that!

Which goes to show how unreliable a medical source Wikipedia is. There are at least 15 clinical trials of pycnogenol for venous insufficiency, all showing efficacy. It is superior in this regard to troxerutins, oxerutins, horse chestnut and butcher's broom, though all of those can be very helpful as well.
Here's an abstract from one such study:

Summary: The aim of this study was to investigate the clinical efficacy of oral Pycnogenol® (Horphag Research Ltd., UK) in patients with severe chronic venous insufficiency (CVI) in comparison to the combination of diosmin and hesperidin (Daflon®, Servier, France). A group of 86 patients with severe chronic venous insufficiency (CVI), venous hypertension, ankle swelling) and previous history of venous ulcerations received either oral Pycnogenol (capsules) 150 mg or 300 mg daily for 8 weeks or Daflon, 1000 mg/day. All patients completed the study without dropouts. At the end of the study, microcirculatory results indicated: a progressive decrease of skin flux at rest (RF); a significant decrease in capillary filtration (RAS); an improvement in the symptomatic venous score (ASLS); a reduction in edema; a significant improvement (increase) in pO2 and a decrease in pCO2 in the Pycnogenol group. A significant level of improvement was reached after 4 weeks of treatment in most patients (p < .05) of the Pycnogenol group while clinical improvement was significant only in 6 subjects in the Daflon group. The positive effects of treatment with Pycnogenol after 8 weeks were significantly larger in comparison with the Daflon group. In conclusion, this study confirms the fast clinical efficacy of Pycnogenol in patients with chron ic venous insufficiency and venous microangiopathy and its superiority—considering the evaluated parameters—to the combination of diosmin and hesperidin.
Key Words: Venous microangiopathy—Edema—Pycnogenol®— Diosmin and hesperidin—Daflon—Venous disease—Chronic venous insufficiency—Varicose veins.