Knee? What knee?

Knee-plus-12 weeks, 22-Dec-04, Wednesday:
I am now to where I do not think about my knee. Somedays, not at all. There is no pain. I am not even taking ibuprofen unless I’ve been on my feet for a long time and my legs feel tired. Range of motion is good: I can routinely walk up and down three flights of stairs. Right-leg ROM is almost as good as the left. Right-leg extension IS as good, maybe better, than the left. Certainly, my hamstrings are more flexible with my right than my left.

We visited relatives last weekend --- a 3+ hour drive. My wife and I shared driving duties going out, but because of the weather, I drove the entire trip home. No problems at all, although my thigh muscles felt a little tired.

It’s the holiday season. Two weekends ago, I stood and schmoozed at our Christmas party for more than three hours without pain. I’ve been up and down ladders hanging ornaments on the tree. I sat cross-legged on the floor for an hour putting together a stereo system.

My brother and I took a long walk yesterday. I realized that he was half a step behind me and was watching my stride. I said “What are you doing?” His response was “You really are walking normally”. Duh. We were only out for half an hour, but I walked hard, uphill and down. Yes, I was showing off, but I could do it comfortably.

12 weeks post-surgery, I am thrilled with the results of my TKR. I have much better ROM than I’ve had in 20 years. I can do things that I’ve been unable to do for more than a decade. I can ride a bike again --- we are actually planning bike trips for next summer. I felt so good this AM that I actually skipped across the parking lot at work!

There is still a long way to go in terms of rebuilding strength. I recognize that, too.

But there is NO pain. Yes, the quads and hams get tired, and can ache when they do. But there is no joint pain at all. I could not have asked for a more positive experience re my TKR.

Would I do it again? In a heartbeat! I feel 20 years younger.

Did I wait too long? I actually don’t think so. I took three months to prepare mentally and physically for my TKR. These were important. I am convinced that the physical prep made rehab go faster and easier. Equally important, the mental preparation --- both in terms of what to expect as well as what my limitations had been pre-surgery --- makes me all the more appreciative of how successful my TKR has been.

Contemplating a TKR? Here's my advice ...

Do I have any advice for someone contemplating a TKR? Of course I do.
One, take the pain medications that are available. Don’t be a tough guy. Recovery and rehab are going to be painful. Use the tools that are available to you to control the pain.

Two, prepare yourself mentally and physically for surgery and rehab. If you can delay surgery for a month or two, put the time into strengthening your arms, torso, and legs. You will need this strength during recovery and rehab. Your recovery is likely to go faster if you do.

Three, work hard at rehab. Physical therapy needs to be done at least once a day, whether facilitated by a therapist or at home, on your own. Every day that you work at rehab, there will be incremental progress. Conversely, every day that you don’t work at rehab, there will be incremental decline.

Four, don’t quit. There will be performance plateaus during rehab. Look for them, and work with your therapist to break through those plateaus. Full rehabilitation may take up to 18 months or longer. Be patient. Be persistent.

Five, ask questions. Your doctors and nurses have knowledge and experience you lack. If you don’t ask, they won’t know to tell you. Think about how many patients they see in a week. Asking questions of your healthcare team is YOUR responsibility.

Six, look for problems. Unexpected pain? Unexpected swelling? Unexpected brusing? Call the surgeon immediately. There is no reason to wait, or to worry. Make the call. Your surgeon’s staff is trained to answer your questions, and to know when to put you through to the surgeon.

Finally, you should realize that the first 2 weeks are going to be the most painful, and that the first 6 weeks will require the hardest work in rehab/PT. However, by 12 weeks, you should expect to be walking comfortably, sleeping comfortably, and asking yourself “Why didn’t I do this sooner?”

"Workin' in a coal mine, goin' downtown ..."

Knee-plus-10 weeks, 8-Dec-04, Wednesday:
The hardest part of working full time is making sure that the AHPT continues. “The plan” was to go home at 1130A, exercise, eat a quick lunch, and return to work by 1P. This week, this occurred exactly ONCE. Client lunches, interviews, holiday errands.

Swelling continues to come and go. I spent Wednesday pretty much at my desk (and then at a after-work meeting). Leg down, knee-high socks --- significantly swelling above the sock line. My wife worries about potential infections, blood clots, etc. I am watching very closely for any symptoms --- there are none. No hot spots, no localized pain, no joint pain at all.

However, I am very restless at night after falling asleep. It’s easy to think that it’s related to the knee, and it may be. But I feel no significant pain, maybe a little muscle soreness. Maybe. And I continue to take ibuprofen before bed, just in case.

Extension and flexion both continue to be good. Stairs up and down are getting increasingly easier.