Two Weeks Until Right TKR

 So it's been a minute.

14 weeks today since I had left knee joint replacement. It's going well. As noted in previous posts the persistent swelling inhibits full range of motion and hamstring muscle that connects to the knob on the outside of the knee is a persistent pain point, but super mild. 

Broken knee .. With the ability to really push and exercise at higher intensity levels after the left knee replacement (which doctor said was the worst of the two)  .. I pushed. A little over a week ago my right knee decided it had enough and has decided to be really painful. No idea what's wrong other than to say I'm really ready for this to happen. 

PT this time around will start from the very beginning. I expect better results.

TKR at 2 Months.

 So here we are. Exactly two months after my surgery.

I'm pretty mobile but I still have more inflammation than I'd like. I can do 90% of all the things I did before.

At PT yesterday I learned that most of my issues are around the hamstring tendon connections and them not being as strong as they should be. I did a weighted heal raise and the PT said that if it hurts more as I go then we remove loading and let it heal.. if the pain goes down then it means we need to strengthen it with more exercise. Clear and concise directions. Knee doesn't quite do 0 degrees on its own.. but can be coaxed with manual pressure. Range is limited, it seems, by the amount of pain I can handle due to the compression of the inflamed tissue. I have a deep tissue massage scheduled for Tuesday (exactly 9 weeks after surgery). It's supposed to help. I might schedule it sooner after the right knee is done.

Right knee, which I'm planning to do in June (it's looking like second week), is going to benefit from all the PT I'm doing now. I'm expecting better results and faster recovery. There will be 0% Oxy on this recovery, but I will add in topical Diclofenac in an attempt to accelerate the recovery.

I have at least one 25 mile bike ride that I've signed for, with a possible second one a week after the first. First one is May 17th. I'm hitting the stationary bike at home right now but will need to be able to ride for about 2 hrs (should be less, but we'll see). As long as I can do an hour at home without pain then I should be fine. I'm up to 35 minutes of interval riding on the stationary.

Things I've learned. 

Natural joints are still better than artificial, at least to me, because I feel like I still have better balance and control with the natural knee joint - however the remaining knee joint hurts more and sounds horrible. The physical feedback you get with an artificial joint is measured in vibrations and pain at spots you do not expect (or at least I don't expect). Phantom pain is real. Nerves are damaged during surgery...not just bone and muscle. Every day means every day .. especially early on and that means pushing through a lot of pain. This is not something anyone wants to really talk about, at least not the people I've talked to. Icing isn't just good for you, it feels GREAT. If I could buy one of those refrigeration machines I would...they are amazing. Icing with cold packs is a lot of work and has to be planned or you need to buy a lot of ice packs - it takes time to cool them back down. You'd think that the artificial joint would be ready to go quicker than the natural knee joint ... honestly it also needs to be warmed up before the range of motion and ease of motion improves - did not expect that.

Weight - Last measure I was down to 208 in clothes at the doctor's office. This should be 178 or even 168. That's a longs ways off though as I like to eat and exercise can only do so much. Better than the 220 I was at one point though. I have a legitimate goal of sub 200 for the right knee... or maybe I should do it in terms of percent body fat. If my scale at home measures remotely correctly dropping 5-10% should not be hard and will easily put me where I'd like to be either in terms of overall weight or overall strength. I'll trade not losing weight with adding strength and muscle.

Total Knee Replacement

 Happy Valentines day!!

For me I'm celebrating T+3. On Tuesday February 11th, 2025 I had my left knee replaced.

There is a lot to unpack and I wish I had started this on Tuesday.

Surgery - Seeing as I was passed out I'll take my wife's word that the surgery went well. The spinal block was fast and effective. I remember being wheeled into the operating room and sliding onto the table and then nothing. Waking up went fine. I've done this enough I don't get sick any longer. Took me a little longer to recover than I would have liked. First time I tried to sit up my blood pressure dropped quite a bit and they made me lay back down. I didn't feel light headed or anything but I'm only a passenger at that point and I do what I'm told. I used the walker to get to the car and getting home went fine.

Home - I'm staying downstairs in the guest room to avoid climbing stairs just yet. Also, the cold water machine isn't all that quiet and Carolee needs her sleep too. The cocktail of drugs is interesting and not as intense as when Owen has his knee repaired. The big common drug is Oxycodone - 5mg every four hours. I'm not a fan of medicine .. at all. If I can avoid it I will. Day T+1 I went 12 hours with no meds and it turns out that is not a great idea. Take your meds. First couple of weeks you need to dull the pain so you can do your PT (or so I'm told - since I'm only at day 3). PT came day after surgery and couldn't understand why I had home care. So, I only got one of those. She gave me exercises to so that hurt like hell when I'm doing them. But, three times a day and 5 minutes on the stationary bike. Recovery is up to me to a certain extent.

Diet - haven't been too hungry honestly. Also, start with Smooth Move tea as soon as you get home. The Oxy binds you up.. don't ask me how I know. I am taking my multivitamins again which is good.

Pain - There are moments I'm sure just cutting off everything would feel better and other moments when I think to myself this is ok. They prescribed Tylenol as well as Oxy but I haven't taken any yet. The nerve block they administered before surgery for pain is supposed to wear off after 72 hours so I'm expecting today to be interesting. At my 8am medicine I think I'll add Tylenol, but I'll only do it twice a day. 4000mg is the absolute maximum you're supposed to take and frankly I'd like to not kill my liver and kidneys just yet - so 2000mg should be fine for daytime as I keep up with PT home schedule.

Exercise - Doctors should emphasize exercise more pre-surgery. I had been going to the gym but I started emphasizing legs and core more when the surgery got scheduled. Originally it was going to be mid March, but Feb 11th opened up. Leg and core strength are vital to balance and recovery.

Showering - I made my way upstairs and got everything I needed and successfully showered on my own T+2. Felt good to clean up. The knee is still so swollen that bending feels like it is as much a function of the level of pain as it is the swelling limiting range of motion. The PT sheet says "small knee bends", though so I'm trying not to be too concerned.

Doctor Weiss called me and asked how I was doing. I asked if he had the bone pieces still. Was curious what they looked like. He said they don't have any sterile cameras so there would be no pictures. Bummer. Also, they do not save the bone pieces for the patient.

Carolee, Liam, and Gabe have been great. I'm still trying to do as much as I can just because the movement makes me feel better. Laying in bed all day isn't fun.. although I do feel like sleeping quite a bit. I've taken Benji out and fed the cats so movement is possible outside. Fresh air smells great.

Quarter Year Evolution

I'm fascinated by change and the inertia that prevents it.  Quarter year evolution is about 90 day cycles for change.  Define it, Track it, Achieve it.

What are the debilitating events in our lives?  What are the environmental and emotional triggers that pull us back into those ruts in our lives that we want to get out of?

The goal here is to create a framework for change that asks enough questions to allow the defined change to be tracked in a tangible way, that allows you to see the results and embrace the new you at the end of the cycle.

DTA90 - Define Track Achieve in 90 Days