First time out and about:
Up until today I have been pretty much house bound since coming home from the hospital. I have been out of the apartment to walk up and down the hall and have ventured outside for short walks down the block but that it is. But with a physio appointment to go to I was finally out and about for real.
The idea of driving to the appointment came with a decent amount of anxiety. The pain of getting into the truck to go home from the hospital was still VERY fresh in my mind and I was scared to try it again. Luckily forwarned is forearmed so I was more careful getting in and while it was uncomfortable, it wasn’t too bad.
When I got to the appointment I walked to the building with my walker – it did feel weird to be out “in-public’ walking with my walker. I felt a bit self-conscious and was quite sure everyone was looking at me. But it was also nice to be somewhere new – even if it was just a physio office! It’s funny to think about the things I didn’t realize I would miss! Simple things like walking down a sidewalk or going into a coffee shop. Definitely looking forward to more outings as I continue to heal.
Starting Knee Replacement Physio Appointments:
Today was my first in-person physio appointment. As part of the recovery process medical services gives you 12 physio appointments (twice a week for 6 weeks) to assist in your recovery. I would be lying if I said I wasn’t dreading it. My knee has been SO stiff and sore and I knew it wasn’t anywhere near where it should be in terms of range of motion – I felt like I had barely progressed at all since leaving the hospital. So I was terrified that a) the physio would tell me that I was failing in my exercises and that I wouldn’t be able to get my range of motion back and b) that it was going to hurt. A lot.
I fretted about the appointment all day. To prep I took painkillers (extra-strength tylenol as I was out of T3’s) about 45 minutes before the start time so I would be in the sweet spot. To my surprise the appointment went much better than expected. The physio took down all of my details and did some assessments of my current state and work we needed to do.
The good news: my leg straightening was exactly where it should be and where they would expect it to be at this stage in recovery. My angle had good movement/flexion. The less good news – I am at about 10% of where I will be by the end of the 6 week program when it comes to bending the knee. So there is a LOT of work to do.
We went through the exercises I need to be doing (heel slides to get the knee bending). I have been struggling SO much with this exercise. The pain hits very quickly and the stiffness and swelling in the knee makes it feel impossible to move. Sarah showed me how to use my muscles and move my leg so that it is easier and less painful to do the bend. She also gave me tips on relaxing my leg when I hit the stopping point. Waiting a few seconds for the pain to subside and then pushing it just a bit farther. It hurt, but not nearly as much as I expected it to.
I discussed the swelling in my leg and foot (my leg is GIANT and I have never seen my foot/ankle look so puffy!) Sarah recommended elevating my leg every hour for 5 minutes. I had been hesitant on elevating for very long because I find it quite painful, but 5 minutes sounds doable. She also recommended compression socks – so I will be doing some retail therapy on amazon tonight!
We also discussed pain management and Sarah as in agreement that using pain meds pre-appointment/exercise is a good idea so that we can push the knee bend. Right now getting the knee to bend properly is the priority so I can’t have pain getting in the way of it progressing.
The rest of the appointment was focused on massaging my calf and quad muscles. I hadn’t realized how tight my quad was until Sarah massaged it! Wow! Part of the knee replacement involves moving the muscles over the knee out of the way which leaves them angry and tight post-surgery. Releasing them is an important part of the rehab. I will do some work massaging and rolling the quad on my own as well.
I left the appointment with homework to elevate my leg every hour (for 5 minutes), put on compression socks, move/walk every hour and try and do 10 heal slides each hour. While this doesn’t sound like a lot it definitely feels daunting to me right now. But I am going to do my best to stick to it.
Overall I felt pretty positive after the appointment. While I have a lot of work to do, my progress isn’t as terrible as I was fearing it was. Sarah is quite certain we will get there over the next 6 weeks, but not without a lot of work. Clearly exercises and recovery will be my full time job for the next little while.
Pain Management:
I have been a bit worried about having run out of T3’s already. While I still have hydromorphone I don’t find it effective and rarely use it. I have been managing with regular tylenol and advil for the past several days but nights are tough and it is tough to push through exercise.
I had a phone appointment with my GP and we discussed my post-op progress, my upcoming physio and pain management. She advised me that I should be off T3’s as a regular schedule (which I am – only taking as needed) but agreed that having them for as-needed pain at night or for physio is a good idea so she put through a small (30 pill) prescription for me. I am relieved to have that option. I have made it a priority to wean myself of the pain meds as much as possible, but I don’t want pain to slow my progress so it is comforting to know that they are available if needed.
State of mind:
The last few days have been rough. It’s hard being stuck with limited movement and not being able to do whatever I want to do when I want to do it. Even going to the bathroom is a chore and there is never a time when I don’t feel some level of pain. The challenges have taken their toll on both Matt and I and we have been bickering a bit. The good news is that we are both aware of what is causing us to be out of sorts so we get over the squabbles quickly.
I have a lot of time on my hands so I did some facebook surfing and found a couple of groups dedicated to people who have had (or are going to have) a TKR. I signed up for one on TKR recover (a support group) and another dedicated to runners who have just had a TKR. I did some reading and was surprised at how much I REALLY did not know going in to this surgery. See my post on “things I wish I knew…” for some of what I have learned!
High Points:
High point for today was 100% my physio appointment. I have been panicking and googling like crazy (yes I know – I should NOT be using Dr. Google – I can’t help myself!) thinking that my progress has been too slow and that I will never get my movement back. It has been the source of more than one rabbit hole of thought as I try to sleep at night. Meeting with the physio and learning that I am doing ok, and that I am not hopeless – my movement WILL come back with work was a huge relief. As irrational as my fears may have been, I had them and putting them to rest for now took a lot of pressure off.
It was also a relief to really learn how to do my exercises effectively. They showed me in the hospital but between lack of sleep and pretty intense painkillers (not to mention all the information I was taking in about home care) I don’t think I retained it all. I now feel like I have a lot more purpose and achievable goals when it comes to the exercises.
I know that future appointments will be painful as we move to more manual manipulation of the joint, but I am hopeful that it will get better and better every time.
It’s now after 1:00 am as I am typing this and I’m not even close to being tired. But I’m closing out today feeling more optimistic than I have for the last several days so I’m counting this one as a win!
