TKR 5 months Walking and Stairs? Help!

Bones, joints and muscles
1

Folks

I haven't been on here for a while. My last posts were all "Mrs. Job" posts as Chico and I joked.

On top of my quad palsy I developed a peptic ulcer, tooth abscess and severe shoulder rotator cuff tendonitis from over use of the arm to compensate for the weak leg (changing positions; pressing on the elbow to get up and grip on walker).

Lost my job. You get the picture.

So, back to business. Finally starting walking on my own 2 weeks ago. Which is about 5 months - I am actually about 5 months and two weeks now. Couple of times per day, now most of the day. Outside I still use the walker.

Don't know how much is fear of leaving the walker (security blanket) behind because I had to use it so long because of the quad palsy). I feel very unsafe, limp and the walking doesn't feel natural (I seem to inadvertently overcompensate with raising my hip when I walk. How long did it take you to walk strongly and feeling secure?

My pt told me to use a sleeve over the knee to help the brain recognize the knee because of the disruption in nerves.

A week ago I finally mastered going UP the stairs. Painful. How long were you doing up before you could do going down? I feel like it is going to be exponentially harder going down normally.

The pt (which I had to stop ($$$) told me not to overdo it. Yet I feel walking the first few weeks on my own and climbing the stairs up will automatically come with pain that will eventually decrease???

Any helpful advice and your experience would be great!!!

Milla

2

Hi Milla

Well, i'm 7 mos out and on the walker.  I have "episodes" of swelling in my right knee.  Just on a whim thru out the day.  Had it drained twice - .  Dr sent fluid out for tests and sent me for a myriad of tests which all came back normal.  Except for the fluid in the knee that was drained, it's blood so I'm bleeding into the joint and he doesn't know why.  Took a second sample to do further tests.  How did you know you had Quad Palsy?  what were your symptoms?

As far as the walker, I get it.  I'm still using it - seems everytime i feel better (this last week was 5 days with no episodes - longest ever) until this morning it blew up  .  Like i'll leave it in the middle of the kitchen while i walk around it -but not too much.  So i can't shake the walker either.  DR wants me to not do PT till he figures out why i'm bleeding into my joint. 

Don't worry about the walker - security is everything too.  We have to feel safe.   And take it easy - i get it - u feel a little better - you want to do do do.  Like yesterday i cleaned the counters - felt great to do something!  And now today, I MAY be paying the price - Like i said it swells up for no reason even if i'm lying down or sitting down, so who knows.

Hang in there go ez -

Walk if you can without the walker - I can't even do stairs foot over foot yet - still one at a time - and like i said 7 mos out!

Hang in there

3

Milla, it's so lovely to hear from you.  I remember you saying about the abscess!  Is that all healed now.  It sounds as though you are progressing much better now.  I did have a period a couple of weeks ago or so when walking felt odd - I didn't feel balanced, but that has passed and it does feel better despite the other knee needing doing, so I hope you'll find the same.  It went from one day, walking very slowly down a path by a river, feeling I was going to fall in (!!!) to still walking slower than I'd like but feeling more solid.  I don't know how much of it is leg strength or just getting used to the new knee, or if it's all in the mind!  But not got stairs, so can't tell you about those.  Great that there is another physio saying not to overdo it - we're hearing of a few more of those now, rather than the physios not caring if people are in agony with pain!  Wish you a good continued recovery!

4

Jeanie,

Sorry to hear about your problems with the TKR.

Quad palsy is diagnosed with a test called EMG and I had a nerve conduction test as well. Both tests measure the response of either muscle or nerve. Based on response (or rather lack thereof) forms the diagnosis.

Can't say that I have heard of bleeding. But hopefully you have had or will have a scan (MRI) done. Keep us posted and hang in there!

5

Chris! Hello😀

Abscess resolved by extraction. Ulcer doing well with meds. Just the shoulder driving me nuts.

But yes, I have made great progress!!

Initially when I started on the cane the leg "buckled" often. The quads are still weak so that is normal. But, doesn't help with trusting the leg. You can tell me a 100 times how strong the new joint is... I feel solid standing, but the quads support the leg and more so the knee.

Probably a mixture of a still weak leg and fear.

How are you doing? I remember you doing really well. Have you heard anything about the other knee?

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Hi Milla!

First I want to acknowledge your STRENGTH, BRAVERY, and TENACITY!⭐⭐⭐⭐⭐ You have endured quite a lot of challenges lately and STILL are able to literally pick yourself up and KEEP TRYING! Kudos to you! You WILL be successful!👍

I totally agree with Jeanie about the safety! We MUST be SAFE as we are moving around, or we risk falls that can sideline progress for months!

At the beginning I practiced STANDING while my walker was right there. I focused on putting my shoulders back, breathing in and out, straightening myself and breathing in and out long breaths. This gave me a good feeling of strength and control. The good breathing clears your mind and provides much-needed oxygen to your whole body!

Next, I would focus on heading toward a point across the room. I would focus on putting my heel down first and then rolling my foot to my toes as I took each step. I walked in bare feet so that I could feel each subtle movement. That helped me VERY much!

My kitchen was my first SOLO RUNWAY when I took my first steps without my walker because I could go from counter to counter in just a few steps. There was countertop to grasp if needed, and I knew this was a SOLID choice that would be a reliable holding place. I moved slowly but continued to focus on shoulders back, straight back, breathing evenly in and out, and heel to toe shoes foot movements. This small area built confidence, and being close to SNACKS wasn't bad either!🍓🍇☕️🍪😁

Later on I moved to a cane and followed my same plan.

My big breakthrough when I realised I had become really confident as well as competent was when I found myself in the living room LOOKING FOR MY WALKER or LOOKING FOR MY CANE!😄 It was actually quite funny!

At physical therapy I mentioned to my therapist that I was VERY EXCITED to go outside and tend to our garden. My husband had been watering and weeding during those first post-surgery weeks, but I really wanted to get out there myself. My therapist added additional BALANCE exercises, increasing difficulty because I ALSO mentioned that our backyard was pretty uneven due to our sweet little MOLES! 😏

I used my walker. I got the hose going. It felt GREAT! I did some weeding by leaning over. I felt proud like Jeanie did with cleaning her counters!

I went slowly, followed my INDOOR plan OUTSIDE, and felt very good about my efforts. In a few days I found myself LOOKING FOR MY WALKER and LOOKING FOR MY CANE when I was in another flower bed or watering my vegetables in another part of the backyard!🤔😁

You will be ready WHEN YOU ARE READY. Be patient. Be SAFE. Let know how things go for you.

We are all there right WITH you in solidarity!😊

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I understand what you're saying with the quads Milla - but I'm sure you'll get there!:-))))  You are doing so well, despite so many difficulties!

I'm doing brilliantly thanks and go for the pre-op for the other knee on Monday!  It's likely to be 8 - 12 weeks to the op for the second one then:-))))  Looking forward to a date:-))))

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Cheryl, I loved what you said there - it was just the same for me - wondering where I'd left the stick and going off looking for it, to see what room it was in:-))))  It made me laugh too:-)))  It's a glorious moment though:-))))

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Cheryl, thank you for your kind words. I am a Pisces but I act more like a Taurus. I am stubborn and just won't give up! 😬 I feel much better now but for a time there it was rough physically and emotionally.

You gave me GREAT pointers:

- breathing. I think I am literally holding my breath. I now remember the pt guy saying frequently "breathe!" I only remembered that when you mentioned it!

- Get a focus point! I just mosey with no plan.

- Going barefoot. Not only for this purpose but my Ayurveda mentor suggested this months ago. I was in so much pain and drugged up I also forgot about that.

Thank you! This sounds like an excellent plan. I do concentrate on walking "tall" and maintaining good balance with my shoulders, especially now that my left shoulder is giving problems.

We did start some balancing exercises before I quit pt. I think it will be money well spent to get the "half moon" ball.

I live in San Diego, California. Outside the terrain is sometimes uneven but my biggest challenge is steep inclines. I am not even certain I am suppose to do those right now. But it sure is a great strengthening workout.

How about pain or feeling achy? I definitely feel an increase with walking on my own but assume that is natural?

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Noooo! My reply is being "moderated"

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Glorious is surely the best word for the feeling!😁👍😊⭐

I'm guessing it must be a lot like we are when we first learn to walk as a child. We see something interesting and, after LOTS of trials, we JUST GO!

WOO-HOO!!!🎉🎉

👍👍🎉😊⭐⭐🎉🎉

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Don't worry!

Sometimes things get WONKY!😵

Try again!

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Yes!  One of my first ventures without the stick was when I walked to the front door with it, when someone was there, and then had to go and get my husband, and in my rush realised I'd left it by the front door LOL!  It did surprise me though, just how strong the knee was to stand on from the start.  I hadn't expected that.  I'd read that if you sit down or get up you should stick the operated leg out in front, and I thought that meant put no weight on it.  Tried that and thought 'no way!' and was REALLY worried until I saw that some were getting both knees done at the same time, so it was obviously you could put SOME weight on it - relief!

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That's funny!😁

I can see myself doing that!

I was surprised, too, when I first put weight on my surgical leg that evening of my surgery. From the beginning on surgery evening my leg hurt MUCH LESS than it had PRIOR to surgery. (That REALLY put in perspective just how BAD my leg was BEFORE!) 😵

15

Yes, that's EXACTLY what I found.  I never had anywhere near the pain that I'd got with the arthritis in the knee! 

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Hi Milla, long time no hear! I'm sorry to hear of all your problems.

I remember you saying about the abscess last time you wrote. All ok now the extraction's been done?

You also said about your quads & you were having the tests done & quad palsy, do they treat it or is it time? I even remember you saying about your shoulder but that hadn't been diagnosed then! Phew, you don't believe in having one thing at a time do you! Be very careful with the rotator cuff problem, conservative treatment is best!

I'm sorry to hear you lost your job! Talk about kick you when you're down!! Once your are 'up & running' again I hope you'll find yourself a better job, with employers who appreciate you & your achievements!!

It really has been a run of bad luck for you, but you're on the up now!!

I don't think you can judge yourself against any other person here! We all recoup at different times & levels, & for you who has suffered the quad palsy etc,it's a totally different ball game!! Also don't think the tooth abscess is just one of those things,it goes to show how rundown your system is.

So you use the aids you need in order for you to keep your balance & go further with your rehab! Let's face it who would use a walker for fun!! They are hardly the most elegant of items!! But so useful for this, so use it whilst you have to! As the saying goes don't try to run before you can walk, please forgive the pun!! You will get to leave it behind soon enough & only you will know when that is.

Live in the moment, try to find comfort & joy in the here & now! This will pass, you have to BELIEVE it!

Good to hear from you again.

Marilyn

XX

17

Gosh - i can't wait till i can say the same with this dang right knee - i really need to figure out what the heck is going on -

the Left knee was done in Dec/2015 - now that I can say feels so much better - who was i to think the 2nd one would be easier - a ding dong!  that's what!  I just hope it all gets figured out and soon!  7 Mos since the surgery and maybe a good 2 weeks of feeling ok

18

Weird, isn't it?

Prior to surgery I would sometimes have about a minute or two without pain. I would sit, hardly even breathing, taking it the pure JOY of no pain. Then, the THROB-THROB-THROB-THROB would start again.😵

Sooooo glad THAT is O-V-E-R!!!

Glad yours is over, too!❤️

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YES!  Up until that point I thought I'd only get arthritic pain when I walked or moved the leg.  The shock came when I realised it was when it was still too, as it throbbed!

20

Stairs...this take time and a lot of strengthening...

https://patient.info/forums/discuss/mastering-post-tkr-stairs-552728

NOTE: This is probably the most controversial of my posts because it seems that what some other people were taught is the EXACT OPPOSITE of what I was instructed in PT.  Just know that this method worked very well for me.

You've had a tough time of it, Milla...tougher than most.  I hope you get well soon.