I have moved from crutches to a cane this week. I can now stand with my full weight on the surgical leg, but moving still requires the aid of a single crutch or cane for balance. I have to step deliberately insuring that my leg is locked forward, not backward. The quadracep muscle has not fully recovered, so there remains instability when walking. Without a cane for balance, I am afraid that I may accidently hyper-extend the knee. Knee bend is at 60 degrees, and I am finding that I can sit at a desk with both feet on the ground for short periods of time. Bending the knee to 90 degrees or greater will require continued Physical Therapy. My right knee is still very swollen. Using a tape measure, I am 18 and 3/4 inches in circumferance around the knee. By comparison, my left knee is 16 and 1/4 inches.
I started Physical Therapy (PT) on December 22. So far I have been to 3 PT sessions, and I have been working out on my own at the home gym. My focus has been on exercises to improve flexibility (bending) of the knee. At PT, with significant effort, I have been able to get the knee to bend to 81 degrees, but the knee swells up after the PT. On the continuous motion machine, I have been able to get full extension and a knee bend of 70 degrees. I am finding that the wall slides (sitting on my back with my feet against a wall) really helps with the aid of gravity to force the knee to bend.
I had a bit of a scare on Xmas eve. As the Physical Therapist had encouraged me to use the stationary bike in my basement, I decided to give it a try. While I was not able to rotate the pedals in a full revolution, the Physical Therapist asked that I push and pull the pedals back and forth to exercise the knee joint. I began pushing/pulling the pedals back and forth. While doing this, I decided to adjust the seat in order to give my legs greater extension. As the seat was moving back, my good left leg moved the pedal to the top pedal position thus forcing my surgical leg into a larger bend of the knee. Since my feet were in stirrups on the pedals, I ended up doing a full revolution of the pedals. My surgical leg bent more than I intended, thus causing a a sharp shooting pain and a sense of something ripping in the knee joint. My knee swelled immediately, and the muscles in the back of the upper thigh area of my leg bruised and hurt.
I called the on-call physician later on that day to confirm that I did not cause damage to the knee. The on-call physician said that I probably tore some scar tissue and bent the knee more than it was ready to in the recovery process. But, he did not think I had done any real serious damage--just some additional swelling that will abate in a few days. He seems to be right as the swelling has gone down, and the tenderness and bruising of my thigh muscle has improved considerably in just a few days. Lesson learned: never adjust the seat of a stationary bike while your feet are in motion and in the pedals with stirrups.
I continue to take medications. I am still taking "norco" as a pain medication--one tablet every 6 to 8 hours, and I am also taking one 325mg aspirin per day as a blood thinnner and anti-inflammatory medication. I am finding that I need the pain medication to sleep soundly at night, and that icing of the knee during the daytime can sometimes take the place of the pain medication. I am trying to lengthen the time period between pain meds to see how long I can go without the medication. This also helps if I want to test my driving abilities. I cannot be on a narcotic if I am to begin driving a vehicle once again.
I did drive a car for the first time since surgery yesterday. Having been off the norco medication for most of the day, I drove my car two miles to the Produce Station to pick up some groceries. I was able to successfully sit (although with some discomfort) in the drivers seat. My leg bend and control of the leg was sufficient to manage the brake and accelerator. I was also able to walk to the mailbox for the first time since surgery and retrieve the mail. The cane is aiding in my increased mobility as I am able to get in/out of the car easier and carry some things in my free hand.
Overall, I am generally satisfied with my recovery to date. Other than crutches, cane, and the urinal, I have not needed any other special equipment or arrangements for the total knee replacement. Some people undergoing this type of surgery require a stay at an extended care facility for several weeks after the surgery. If not at an extended care facility, arrangements have to be made at their home to have a bed on the main floor of the house, a raised toilet, and nursing care for bathing and personal care, etc. I am fortunate to have reasonably good health and assistance of my wife Margaret and sons to avert the need for additional special care items.
My next appointment with my doctor is scheduled for January 10. I hope to have a 90 degree knee bend by then. Increasing the flexibility of my knee will remain the focus for the next several weeks.
One note of humor. This past Monday, after PT, Margaret and I did a bit of shopping. We went to Target on Carpenter to pick up a few things. I walked with the cane into the store, but then sat in a wheel chair cart provided for Target customers. Margaret then pushed me around the store. I had a little fun with this as I asked Margaret to push faster and pull wheelies. We both had a few laughs from this.
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