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1 day ago · Mako Robotic Arm TKR ONE WEEK in Joint Replacements

@ellerbracke thanks for the apology, I appreciate it. MAKO for full knee replacement was not available until 2017 so it may have not even been around when you had yours done. It is still a relatively new technology so the long-term results are not in. The two reliable studies that have been done show a better, faster, and less painful recovery period, but from the individual's perspective, I think it is impossible to tell unless we undergo double knees for comparison, as did @debbraw .

Although I have been trying to get off the narcotics, I find it hard to do the exercises without at least some. Tuesday the stitches come out so I'll post a two-week update in a separate thread.

2 days ago · Mako Robotic Arm TKR ONE WEEK in Joint Replacements

@ellerbracke I'm not posting on Mako and nerve ablation (which itself was very painful) to gain bragging rights on doing something faster or better or with less pain, so I am surprised that you proclaim yourself reassured that I had to suffer like everyone else. Knee replacement surgery is evolving and hopefully that evolution will mean less pain for all of us, as well as better and longer-lasting results. It seems that individual differences in pain perception and also uncontrollable things such as surgeon skill are as important as anything. My goal is to keep a record that is public and can be viewed by anyone who will be undergoing this process, so they can evaluate and make good decisions on their own. Instead of going to my local orthopedic center, which swears by Zimmer knees (no robotic arm), I decided to try Mako to see if it would help the ardous recovery process. I will have no way of knowing how different it would have been to go the traditional route, but as @debbraw has posted, she did one knee the traditional way and one with Mako, finding clear better results with Mako.

@dixiedog I have seen those canes, thanks for reminding me! If I need a cane for a long time I'll check them out.

@contentandwell I have some gastro issues and cannot take Ibuprofen or Aleve (naproxen, which like Ibuprofen is also a NSAID). But thanks for the advice.

2 days ago · Mako Robotic Arm TKR ONE WEEK in Joint Replacements

@ellerbracke @contentandwell @dixiedog @babette thanks so much for the comments, they do help flesh out the context and make me see that there are many differences in body type, muscularity, etc that will alter one's own experience of recovery. I had therapy yesterday and Alex added and changed a few of my exercises. He has now started the leg raise, which I am able to do, about 4" is all I can manage. I am doing toe raises holding onto the wall, and squats by the bed where I try to touch my butt to the top of the bed without sitting down. Then of course the bends and extensions; extensions are relatively easy for me but bends of course take effort and teeth-gritting. And finally lymphatic massage with leg elevated, starting with ankle pumps and then gentle massage at back of knee, then at the groin area where the leg connects to the torso. Needless to say, this is my favorite (no pain involved).

Alex also transitioned me to a cane which was not difficult. It is good for stairs and I went up and down a few times. However it doesn't stand up on its own so when doing things in the kitchen is less convenient, it dangles from my wrist or I have to put it down. I will go back and forth as needed.

Today I started weaning from the narcotics onto pure Tylenol. I made it through the first set of exercises. I suspect I will have to take a med at night and then can slowly get off the things.

@babette I had bursitis before the surgery so I sure hope it has gone away.

@dixiedog you are so right, form is everything and slight changes in form can produce very different numbers. So I think the best thing is to only use numbers in a relative way. I can also see that in the weight room, where people change the position of their bodies and suddenly can lift more, or use their backs when they are supposed to use only their arms, and so on. Being a PT yourself (what is a PTA?) must give you a different perspective.

Thanks all and I'll post about my progress (or backsliding) with meds!

5 days ago · Mako Robotic Arm TKR ONE WEEK in Joint Replacements

Also I wanted to correct something I had said before: it IS painful to work on bending. I just completed the 10 min bend (two 5 min segments, pulling back with strap while on chair) and it hurt like heck. So the ablation is not wiping out that pain!

5 days ago · Mako Robotic Arm TKR ONE WEEK in Joint Replacements

@contentandwell I don't expect to get my new knee to 145! That's basically pushing up against your leg and buttocks completely. Alex told me the goal was 120-125 and anything extra was good but not necessary. @ellerbracke I almost made the mistake of getting the four-wheeled walker, especially when that urge was confirmed by reading on this man's very comprehensive site, which was so helpful in other ways. Fortunately I continued to look around and learned exactly why one needs the two-wheeled model, for the problem you describe. My surgeon had the correct kind of walker listed in the recovery materials he gave me, but there was no explanation as to why, so naturally I was thinking, how can I improve that? This tendency of over-thinking sometimes can come back to bite you! Watching me walk from the back with the walker, Alex corrected a slight turning in of the foot on the surgery knee, so now I am conscious of it and thinking of it as I move, walking slowly and trying to make sure my form is correct. Like you, I also am competitive, but that is offset by my strong aversion to pain and preference for gradual change (especially when pain is involved!). My experience in trying to hurry various physical processes along is that when it comes to the body, slow change is better than fast change, and sustaining proper form is always good. But next Tuesday I should have my numbers and can post them. I totally understand the urge to beat the numbers, which I have to fight against at the eye doctor's so that my prescription will be accurate. You are right that a good therapist will work with whatever personality quirks we have.

I have a very itchy rash on my upper thigh where the My-Q pain drip was inserted. It came out last Friday. I suspect the rash is from the tape that held it in place. I was surprised when I pulled it out – a long, thin, very stretchy piece of elastic with black nodes along the way. It stretched a lot when pulling and I was worried it could break and half of it stay in there, but that did not happen. Anyone else with this rash problem?

I can see some mild bruising on the back of my leg and it is still swollen. I hope that the swelling will start to go down soon. Maybe it has, I can't tell. If it does not seem to change soon I will start measuring and watch it.

For a laxative, I have switched from ducosate sodium to bisacodyl USP, and that solved the vomiting problem. I am able to have some bowel "movements" with the help of my toilet bidet seat. It is the kind with "endless water" (i.e. heats on the spot instead of having a tank) and very powerful. Outside of the knee surgery, this addition to our household has been most welcome. I tell everyone once you have one you will never want to go back. Anyone with any gastro issues should invest in one of these if at all possible.

I am posting a lot so that any future Mako patients will be able to read in detail about the process, the recovery, and so on. I was happy to have come across @debbraw and her story because it was the first detailed comparison (via experience) between traditional and Mako knee surgery that I had read. I really appreciate the feedback from all of you, it helps tremendously. Thanks for spending the time to read my posts and comment.

6 days ago · Mako Robotic Arm TKR ONE WEEK in Joint Replacements

@contentandwell Alex is my PT. The bandages prevent him from getting a real measurement although he said close to 0 on extension and way beyond 90 on bend, about three weeks ahead of where he thought I would be based on his experience. There is a thick pad in the way and it prevents me from bending as far as I physically can. Next Tuesday I get the bandages off and the stitches taken out, that will be 2 weeks, so then we may have a measurement. Alex also recommended quad tensing and buttock tensing, which I will do several times a day, as well as shallow squats, which he also did not expect me to be able to do but I could. I honestly think none of this is because of my efforts, although I try several times a day. I credit the ablation and the Mako process. I will be interested in seeing the wound which should be smaller than that of the traditional TKR because it is not necessary to pull muscles and ligaments aside to see the entire bone surface, and the program guides the saw (still in the hands of the surgeon) based on the 3D scan. Alex also mentioned that he had seen weird gaits develop out of abandoning walkers, crutches, and canes too often so suggested slow-going. It looks like I have found the perfect therapist!

6 days ago · Mako Robotic Arm TKR ONE WEEK in Joint Replacements

Therapy started this morning and I was looking forward to getting an opinion about my progress from "Alex." Since the rough 3-hour ride home from the hospital, I had doubted myself in terms of whether or not the Mako robotic arm was worth going to such lengths. But now I am happy I did it, since Alex pronounced me at the top in terms of one-week progress, with only one other person having done this. I could tell he was genuinely impressed, and he also had worked at our local large orthopedic group, so he has seen plenty of knee replacements. Like me, Alex veers away from competition and from creating too much inflammation and swelling through painful exercises, instead saying push it slowly several times during the day and make steady if not linear progress. He did not want to take off the thick bandage and pad at the knee so could not get accurate measurements, but he eyeballed it from several angles. As many of you have mentioned, he also said strength training can wait a while longer.

Next week I will be able to see the scar, how long it is, and in general how things look once the stitches are removed. Although I have nothing to compare it with, the Mako right now seems to have been a good decision. I should also mention that I don't have any real pain when pushing the ROM, so maybe that is the nerve ablation kicking in?

Mon, Dec 2 9:36pm · Mako Robotic Arm TKR Day Five SETBACK in Joint Replacements

@dixiedog, I don't know my ROM numbers as they were not measured in the hospital. They will be for the first time tomorrow at PT so I can post then. I am pretty sure my numbers were better in the hospital than now as I was much more pumped full of drugs and didn't feel much. I do plan on taking a slow road to getting rid of the devices and slowly get off the meds. The biggest problem of course is constipation from the meds although I am managing some movement (not really movement at all). The laxatives have made me throw up twice in a row now so I will try something different. @ellerbracke the PT may also take my ace bandage off and check the wound so we'll see how that goes. I also am wondering if I'll be able to tell whether or not the painful nerve ablation helped me at all. Maybe next week I'll be able to tell!