Don't Kneed No Stinking Cane!

August 13 - Today I will get to the hairdresser! A cut for sure, maybe color as well depending on boss knee. I'm focusing on stretches and biking today to work out the stiffness.

I have a TENS machine which was prescribed to me for my back. Now that I know how to use it on the knee, I may start doing that as well. It has worked really well for my back.

It's interesting that the icing,TENS and laser were not at the end of my out patient therapy, but at the beginning. Maybe that's why I didn't feel much pain during the therapy. Nothing at the end, he just told me to go home and ice which I gratefully did the rest of the day. The only other times I had therapy which was after the arthroscopic surgeries, they iced at beginning and end. They also hurt a lot more.

August 14 - I went to the Dr  today for an un-knee related appt., walked all over the hospital and parking garage, and then went grocery shopping at the commissary! I haven't been in a grocery store in a very long time - lots of things managed to jump in my cart. I did pretty well, although by the time I was ready to check out - I WAS READY! Luckily husband had ice packs and pillows all ready for me, and I packed myself into the back seat for the long journey home.

August 15 - OK, hamstring spasms in back of thigh. What did I do to start them, and what can I do to end them? Could they be from the large amount of walking I did yesterday? Is more gentle stretching in order, or should I just rest?
Jeff mentioned my TENS unit for the hamstring spasm.  I tried using it on the hamstring spasm and it worked! Yeah! Now maybe I can do some stretches to keep it from happening in the future. I did my hamstring stretches afterward, and a spasm started, but went away. I've left the electrodes on in case it starts up again. I did have this kind of pain occasionally before my surgery, so I know that my hamstring wasn't being used correctly. I need to just keep on working them, and I guess eventually they'll settle down.

August  16 -  Had some bad news yesterday. I had told the home health agency that I didn't need to have a nurse come around once a week anymore. (It really was a waste of time and money.) Well, turns out they had the contract with my therapy people, and my therapy people don't have a contract with my weird insurance, so no therapy with them anymore. Now I have to find another therapist who takes my insurance and get my Dr. to authorize it, and all this happened at 5 p.m. yesterday, so I couldn't do much about it yesterday. Therefore I had a rotten night last night.

I've been trying to cut back on the Norco. I've been taking 2 extra-strength Tylenol morning and noon, but felt bad mid-afternoon and took 1/2 of a 10/325. Took a whole one at night around 10 p.m. Woke up at 1 a.m. burning up, kicked off sheets, cooled off, then got too cool, etc. Couldn't find a comfortable way to sleep and my mind was racing about the therapy problem. Finally went to the sofa with a book, read for a little while, then tried to sleep but without much success - hot, cold etc.. At least I wasn't disturbing my husband (although he says I never disturb him.) I think some of these temperature swings may be Norco withdrawal based on what I've read. It's not addiction, but dependency.  Maybe I'm trying to cut back too soon. I've decided that I will continue with the Tylenol and take 1/2 Norco as needed for a few days. I want to be through with the Norco, but I think I'm going to need more than Tylenol since I still have arthritis in my left knee, hands and back. My P.A. has been alerted, and we'll see what he comes up with next Weds. when I go back for 6 weeks post-op.

Good news!  I found a therapy place in my town (closer than the original place) that I am pretty sure takes my insurance, have had my PA fax them an authorization and have an appointment for Monday at 1 p.m. So unless we hit a snag, everything is now go for that. Other good news is that I'm going to quit carrying my cane around the house since I keep forgetting it and walking out without it, then forgetting where I left it. I will only use it when I go outside. My gait is pretty good. Husband says no discernible limp, and other than a little tightness, I can't tell a whole lot of difference between the two knees when I'm walking. Time to go and stretch the hamstrings though!

August 19 - I don't elevate and ice as much as I used to - only after stretches or if I have some twinges. Hoping to get cleared for driving this Weds. We'll see. I start my new therapy today (I hope - still have to call this a.m. and see if all the paperwork got through.) Hope they're good; I'd hate to have to change again!
Just finished with new therapy. WOW! What a difference! I really like my therapist - Tiffany is the Goddess of PT. I also feel such a difference between what she did and my previous therapist. He was a nice guy, but Tiffany is so professional. Never pushed me to pain, but I walked out feeling so energized and improved. My ROM is 125 and extension -22, so we know what we need to work on. She did something called ASTYM which was probably the most discomfort I had, but from what I read it gets better and really does accomplish healing. I'm actually looking forward to therapy on Thursday!

August 20 - Entered the Over Doing It Club today. All I did was walk around Sam's Club for about 6 items. I didn't even walk all over the store, but by the time I got out, I was wasted, and I went straight to bed when I got home and took a nap. Even with that I felt bad the rest of the day. I think I walked a lot more when I went to the commissary last week, but it wasn't as hot, so maybe the weather had something to do with it.

August 21 – Dr. was really happy with my progress today. I showed him my flex and told him the PT had measured it at 125 on Monday. He said he thought it was more than that although he didn't measure. He also thought my extension was more like -5. I'm cleared to drive as long as I'm not taking the heavy duty pain meds (which I only take before therapy.) I saw the xray of my prosthesis, and it looked pretty good. I feel like I did a lot more walking today than yesterday, yet don't feel as bad. Go figure. Also, my OS told me to take some ibuprofen for the rest of my arthritis, so I think that will help with my achy feelings. I haven't taken any ibuprofen since the first of July, and I took a lot of it before that. He made me feel really good when I shook his hand and thanked him for doing such a great job on my knee. He said, "You've done a lot of it." I don't have to go back until six months!

Kneedful Things

August 7 - 4 week anniversary - sleeping in the bed every night now, although I wake up and have to readjust frequently, I can actually sleep on my side! Yay!
Moved the pain meds to 3 times a day, going to try that for a week and then 1/2 pills for the daytime (except on therapy days)
Have really increased my extension, although not quite there yet. My flexion is almost as good as non-surgical knee, although no one has measured.
Don't have the energy drain as much, although I can still get a nap in during the day and feel the better for it. This is from someone who NEVER napped unless really sick.
Still using a cane, although I sometimes forget it, and leave it in the bathroom or kitchen. PT wants me to continue using it for now, but I am concentrating on walking w/o a limp. PT noticed improvement on that yesterday
Still get occasional pain spasms, but nothing debilitating, and they go quickly.
Still doing in home PT, yesterday he really pushed my hamstring in a good way.
Sat outside this morning for about 30 minutes with my leg down. When I got up to go inside, I just got up! Before surgery, I would have to straighten my legs out slowly and painfully, and then get up very slowly. Hey, this TKR thing really does work!

August 11 - One month out as of Saturday and doing really well; however, I have a new pain. If my knee is bent at a certain angle, and I move just a little bit, I get a really sharp pain on the outside of my knee. I first noticed it when sitting on the toilet, have had it happen sometimes in bed, and yesterday when getting on my recumbent bike, it hit. It's the worst pain I've had since my surgery, but I can make it stop if I move my knee out of this narrow angle. I've gotten to where I'm scared to have it happen because it hurts so much.

August 12 - First outpatient therapy completed. Wow! It was much longer than I anticipated - 1 1/2 hours! Of course 30 minutes of that was icing, TENS and cold laser therapy. Most of it did not hurt, although the stretches with the hamstring are still pushing the edge of the envelope. Also my quads are definitely out of shape as I found out with leg movements and the weights attached. I had to stop a couple of things that were hurting my non-surgical knee. Nothing hurt a lot, and the PT stopped when I said something, so that was good. Still no measurement, but I know that my flex is almost as good as my non-surgical knee. My extension still needs work, but don't have a number.

August 13 - Five weeks tomorrow and worst seems to be behind me. The pain on the outside of my knee is still harsh but definitely positional - so I try to avoid that position. I've been cutting back on pain meds and substituting extra strength Tylenol. I still have arthritis in my other knee, hands and back, so I need to take something for that besides the pain in the surgery knee. Still very stiff all over in the morning. It seems that I get my other body parts in a kink trying to avoid hurting my knee during the night. Surgery knee is about 3/4" bigger than other knee, so still some swelling (this is measured first thing in morning after being up all night.) I can walk without a limp if I think about it. If I don't, I sometimes relax into a limp.

Looking forward to OS visit next week - hopefully will have the movement to be able to drive. Will certainly be off the heavy duty meds during the day.

This Cane is Made for Walking

Thurs, July 25  Today I am having pain behind my knee and on the outside of my calf below the knee. Nothing horrible, just new. Had PT today and everything seems to be going along well. I tried sleeping in my bed last night, but no go. I did finally get to sleep, only to wake up with strange new pains. Finally said the heck with it and went to my recliner sofa where I slept quite well the rest of the night.

Friday, July 26 - I had a visit from old friends who drove from the Pacific Northwest to visit, so I went out for the first time. We went out for breakfast, then came back home where I iced and elevated, then out again for dinner, and back for same. I did feel a lot tireder than I would have normally. I've enjoyed the visit, but am really tired. On the positive front, I slept all night in the bed last night!

Sunday, July 28 - Had a tough morning today. I think the visit from friends and not napping as much caught up with me. We were supposed to meet our friends for breakfast, but when I started to get dressed, I was feeling so bad, I decided to take a couple of Tylenol and lie down for half an hour. I completely conked out, and my husband took pity on me and cancelled the breakfast. I woke up an hour later, and found that I didn't have to get dressed after all. Well played, husband, well played.

I iced and elevated and watched mindless TV throughout the morning, and by the afternoon, felt so much better. I also had a complete turn-around in the lower GI which I think made me feel better as well. Although things had been moving, I don't think they had been moving as much as they needed to.

Monday, July 29 - I slept on the bed most of the night last night. It's still harder finding a comfortable sleeping spot for a long time. I'm a stomach/side sleeper, and the knee will only tolerate that for a short time, so then it's the turn over, re-adjust, etc. It always takes such a long time. Finally got up about 4 a.m. and was back on the recliner sofa. Got to get back with my structured therapy today, since I let it go during the over-doing phase of my weekend.

Six hours is about all I can go without pain meds during the night, but can go longer during the day depending on what I'm doing.

Tuesday, July 30 - Had a couple of interesting things happen. First, I ran out of pain pills. I take Norco, and I had put in the refill order the day I got my staples out - last Weds. The girl at the pharmacy told me they would mail them to me because the refill date was not till Friday, but the order would be processed right away (this is a military hospital and very picky about controlled substances.) My P.A. had told me to call him if they wouldn't give them to me today, but I thought it would be OK to have them mailed since I still had some, and surely the mail would not take that long. Silly me!

I thought surely I would get them on Friday, couldn't imagine not receiving them on Saturday, and by Saturday night, I was in full hoarding mode, counting out how many I had left, and how many hours I would have to go between each one. I contacted my P.A. on Monday morning and explained what was going on, and that I was coming to the hospital (which is 70 miles away) on Tuesday, and staying overnight while my dog was being spayed, so I wouldn't be at home to get the pills until Wednesday. I asked if he could he could get me an emergency stash if they didn't arrive on Monday. He found out they hadn't been processed until Friday (thank you unknown girl at the desk,) and if I hadn't received them by 3 p.m., he would get me some on Tuesday.

I haven't had that much pain, certainly not as much as some others or as much as I was afraid I would have, but it's amazing how not having the pills made me so anxious. I wound up yesterday with three pills. I took one at 11 a.m. and I tried to stretch out as long as I could but by 7:30 p.m., I had to take another pill which left only one. I took my last at 4 a.m., and felt completely naked. Thank goodness my P.A. came through with the emergency stash today, and hopefully, the refill will be at home when I return tomorrow. I was already stretching the time between pills longer, and doing fine, until I thought I was about to run out. I feel much calmer now.

The other thing was that my steri strips started falling off, and I could see a big opening in a couple of places along my incision. It looked bad to me, but I told me P.A. about it, and when I went to the hospital today, he looked at it and replaced all the steri strips, but he said it didn't look bad at all. Anytime I can see below the first layer of skin, it looks bad to me.

Wednesday – July 31 Three week anniversary: I can go at least six hours between pain pills, sometimes longer. I walk with cane most of time except when I forget it and walk with nothing! No one's measured my ROM, but I think it might be 110. Extension is better but not zero yet. Still have swelling from time to time, so icing and elevating is what I do most of the time.

Finally received my pain med refill by mail today. I checked the tracking number just to see where it went,and why it would take so long, and it came from South Carolina! This does not compute.

On the plus side, slept in the bed all night last night although numerous wake-ups. Am finding that it is not so painful to move my leg in bed as it was. Yeah progress!

August 1 - I think I've learned a new lesson -Just because you could, doesn't mean you should! I tried the recumbent bike yesterday, and it felt so easy that I did about 15 minutes - some rocking, some backward rotation, some forward. I had a much tougher night last night, and my knee is stiffer. I think the 15 minutes of recumbent biking was about 10 minutes too much. Gonna try some gentle stretches this a.m. to loosen my knee before PT this p.m.

August 2 - Gave up on sleeping in the bed last night. The sofa seems to offer more support to my back when I try to sleep on my side than the bed, and I love to sleep on my side. Maybe a few more weeks of healing will help me return to my bed. Trying to just take pain meds at six hour intervals, or longer if I forget or sleep through.

Last night had lots of deep aching on the outside of my leg - calf and up into my thigh. Is this the infamous IT band? I massaged it, and it felt some better, but only really subsided when I took my pain pill.

Going to get back on the recumbent bike again today, but limit it to 5 minutes a couple of times a day until I see how my knee reacts. I asked my PT yesterday during therapy about the bike, and he didn't seem to think that the bike had anything significant to offer. He said it doesn't help with ROM or strength; however, my PT at the hospital said the bike was key, and all I really needed to do. Who to believe? My home PT says that I'm improving, but doesn't measure which is OK. I'm beginning to think it may be time to start moving to outside therapy. How do you know when that's right?

I'm improving, but the therapy at home seems awfully easy. I guess I need to get my head in shape. What do I want? For it to hurt? I don't think so!

I still don't have horrible pain, just new ones, and generally quite short lived - a stab or spasm which sometimes make me go "OW!" I guess I'm just impatient, I have to keep telling myself it's only been 3 weeks!

August 4 - What was that I said about therapy at home seeming "easy?" Well, we added some stretches on Saturday that are not easy, but definitely are good. My hamstring tightness is the worst thing I deal with right now, and all these stretches are working on that. I'm still finding that every six hours on the pain meds works the best. I have the norco 10/325 and one works well for me, have never taken more than one.

Last night I slept through the 4 a.m. time, and would have taken a pill when I got up, but I have to take the empty stomach meds then. I was just sitting with my foot elevated on the recliner when it suddenly felt like someone had taken a bite out of my knee. OK, time for pain pill - that put it at about 8 1/2 hours since the last one. So can't stretch for too much longer than 6 hours right now.

August 5 -  I'm working on getting my pain pill to a schedule which covers the night and therapy.

Last night, I took one at 9:30 p.m., slept in the bed (on my sides!) til 6 a.m. (of course I had numerous wake-ups during the night as I had to adjust, but I would go right back to sleep.) When I did get up, I had some painful spasms, but took a pill at 6:15 a.m., and now all is well. My therapy is generally around 2:30 to 3:30 p.m., so I'm planning to take another pill around 1:30 p.m, and if I can, not take another until the bedtime dose. That will put me to taking 3 pills in a 24 hour time period (compared to 6 when I first started taking them,) which I'm willing to go with for a while. My next step-down will be to cut the daytime pills in half, we'll see how that works. My P.A. said that I would be taking pain meds for at least 8 weeks, so I'm just at 4 weeks now as of Weds. I'm not worried about getting addicted as long as I am taking the pills for pain.

I will say that I have not had the pain that I thought I would have, or that others seem to have had. I consider myself very lucky.