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Mark Moeller: Early Summer Update on TKR Surgery Rehab

Hello everyone, It has been a quite a while since my last update. I was just discouraged with the lack of progress on my knees and therefore didn’t feel there was much positive info to share.

Checking in With Mark Moeller > Total Knee Replacement

Well, it has been nearly three months since my knee replacement surgeries and I wish I could report that everything is going smoothly.

I am still struggling in choppy waters!  My knees are very stiff and tight with limited range of motion. This is still causing me difficulty with walking, negotiating stairs, and even sitting in a chair.  It has been very frustrating to be working my knees very consistently, yet not make any progress in the range of motion department.  After consulting with my surgeon, I underwent a bilateral manipulation under light general anesthesia nearly 4 weeks ago.  My surgeon was able to achieve 130 degrees of knee flexion bilaterally in the Operating Room with  manipulation.   immediately after, I went right to Alpine Sports Medicine to begin my Physical Therapy regimen. I utilized a CPM machine set at 0-120 degrees at home as much in the daytime as I could and at night while trying to sleep. The best I was able to get was 130 degrees on my better knee and 120 degrees on my worse knee.  Both my knees have since stiffened up  and I am currently in the 100 degree ball park with my better knee cold and 115 degrees warmed up and stretched out.  My worse knee is about 90 degrees cold and 100 degrees warmed up and stretched out.

I am still having a significant amount of pain and discomfort associated with my knees as well. I am still utilizing pain meds 2 x daily, otherwise I can hardly move my knees are so stiff and hurt so much.  My daily routine consists of waking up at 5:45 am and stationary cycling 1 hour daily, knee Range of Motion and  stretching exercises. I also jump back on the bike in the afternoon and evening for 10-15 minutes as well. I am performing resistance exercises 3 x weekly, but I feel that I can’t proceed full speed ahead with strength exercises while I am still having so much difficulty with my knee-joint ROM.

I am still not back at work yet treating patients. My original plan was to return to work after 6 weeks. I am now almost 12 weeks out and still feel as if I am not capable of returning to work in my usual capacity. If I only had a desk job, it would be no problem at all. But with all the up and down, running around, standing, kneeling and walking required with my job as a physical therapist, I still feel that I am not ready. I am very concerned that my knees will stiffen up even more!  I am returning for a consult with my surgeon in two weeks. There just might be another manipulation in my near future.

This has definitely been the most challenging recovery I have gone through in my career of 12 knee surgeries. I know it will all work out in the long-term and I am willing to make any short-term sacrifices necessary to achieve a good long-term result. My experiences throughout my own rehabilitation are serving as a good reminder of what many of my patients have to deal with on a daily basis. It really is a good example of how everyone’s body reacts differently.  I will try my best to keep chugging forward and hope I can return back to work soon! I will update you all again following my consult with my physician!

 

Mark Moeller: Another Check in on Mark’s TKR Rehab

Mark Continues to work hard on the rehabilitation processes associated with Total Knee Replacement surgery.  Here is another BLOG entry from Mark….

Just a quick update on my progress > I was able to get rid of the forearm crutches exactly 2 weeks after my surgery. I was  also able to begin stretching out the doses of pain medicine at 2 weeks as well, from every 4 hours to every 8 hours. At Post op week 3, I was able to cut down the pain meds to 2 x daily. It is still difficult to get comfortable while sleeping. I usually wake up every couple of hours and try to get comfortable again. I have not been too concerned about the restless sleep because I still have not had to go back to work yet. If I need a nap during the afternoon before the kids get home from school……I can!  My staples were removed 3 weeks following surgery and the incisions are  now fully closed and I am able to soak my knees in the tub. The heavy feeling in my thighs is gradually reducing and I am achieving better quadricep control. I am now 4 weeks out of surgery and walking fairly well. The biggest problem that I am faced with is limited Range of Motion and stiffness in my knee that was replaced. I would still describe my left knee as feeling like “cement.”  I am having a very difficult time getting my knee to bend…. even just to 90 degrees! I have been working my ROM daily and have been have been stuck around 95 degrees. My world record is now 101 degrees but that is completely MAXED OUT. My quadriceps muscle feels as if it is going to rip off my quad tendon. With all my prior knee surgeries, I  have usually been on the tighter side and have always had to work hard to get my ROM (“Range of Motion” for those of us not in the business) back. However, this time is definitely the tightest and stiffest my knee has ever been! I have had to rely on assistance from Janna and Andrea to lean on me a little bit just to make any progress! I have been able to ride the stationary bicycle daily , but I still haven’t been able to get rid of a hip-hike on my left side when I get to the top of the pedal stroke. It still hurts to do it, but I suppose it is a hurt so good type of pain, I know that I need to do it. I still do not have great standing endurance yet. The longer I am on my feet, the more my knees swell, get stiff and hurt. Overall, I feel I am doing well….. just having a ROM problem at this point. I will keep you posted on my progress.

 

Until next time…

 

Mark Moeller: The Quest Continues, Total Knee Replacement Rehabilitation

Mark Moeller continues on his road to recovery from Total Knee Replacement (TKR) surgery. This installment Marks shows some serious progress, remarkable to see the improvement in mobility…and don’t leave before you see the staples coming out!

Mark Moeller…Two Weeks in on Total Knee Replacement Surgery

It has been two weeks since my surgery! The longest two weeks of my life but…..I am continuing to make steady improvements. The worst part of everything for me is having to take all the medicines. It just makes me feel like……well,  like crap! I have extended my time between doses of pain medicine from every 4 hours to every 8 hours +. I am moving around better  each and every day. I am still using forearm crutches to assist in walking, but I can now go up a set of stairs step over step! Coming down stairs is still nothing to write home about, but I am slowly improving. I actually took the stairs up into PT today at Alpine Sports Medicine for the first time. My knees  still feel very, very  stiff but I am continuing to work on it at home with  the CPM machine daily. It feels as if there is no way they will ever get bending easily again! It feels as if they have been set in cement!   I have just been able to sit on a stationary bicycle and get the pedals to go around the whole pedal stroke…granted the seat is up a lot higher than normal and I have my toes pointed down all the way….but it still counts! The staples holding my incisions together are scheduled to be removed in 1 more week. I can’t wait, as they make me feel kind of like Frankenstein.  Still the toughest part is just an overall lack of energy. Even the simplest things take a lot of energy to perform. I am basically just wiped out most of the time. I still have not shaved my face yet because I just can’t tolerate standing up for a full 5 minutes in one place to do so. Anyway, despite my moaning and groaning, I am continuing to make slow, steady progress. I will try and update everyone on my progress periodically. Check back soon for more.

Mark Moeller: 2 – 3 Days Post TKR Surgery

Hi everyone!  This is my first chance to write a little bit as to how surgery went. Most people probably know that I am barely a computer guy let alone a laptop guy. Anyway, surgery went as well as could be expected. My doctor told me that my knee was a lot worse looking inside than expected. I think that is pretty typical as X-rays and MRI’s can never really tell the whole story. I was pretty nervous going in to surgery which surprised me a bit. I was wide awake at 2:00 am the night before and I did not have to be there until 9:30. I  managed to shoot  some video clips with my trusty Flipvideo camera throughout my hospital experience (Check it below) > and NO …my physician did not take his hands off the tools to shoot some video in the operating room!

I decided to try a spinal block this surgery so I could compare versus the standard General anesthesia route I have always taken with previous surgeries. I had always been concerned about hearing or feeling  anything or coming to during my surgery in the past….therefore I always opted for  general anesthesia. Well, I must be getting wiser the older I get because the spinal block was awesome. Absolutely nothing to be afraid of pain wise getting the block in ( bonus) and had much less anesthesia drugs im my body. I had no recollection of anything at all until I was in the recovery room at 3:30 pm . But the best part was that I had absolutely no pain at all when I woke up. My lower body was numb which meant ZERO pain!  For about three hours I felt great….really tired but great. When everything finally wore off, I just transitioned to the pain pump which I could self control whenever I needed to use it.

I stayed in the hospital for three nights following my surgery and ended up having a hard time managing my pain levels to the point where my functional level was acceptable to my physical therapist. Too high a pain level when you try to exercise or get up and walk just translates into minimal performance. Thanks to my PT for relaying her observations of my declining functional performance to the medical staff which resulted in some medicine changes which ended up resulting in a night and day improvement in my pain and functional performance!

Let me also tell you that having both knees operated on at the same time is a lot tougher! There is no better side to help out on. Also,  both of my knees feel about the same from a pain  standpoint . I had a Total Knee Replacement surgery on my left side and was just having a plastic liner exchange on my right (basically an oil change). But post-op, they both hurt about the same which kind of took me by surprise.

I am back at home now and just trying to take it easy and recover. I am having a hard time trying to keep ahead of intolerable pain levels which become instantly apparent when I try to get out of bed and walk to the bathroom. It is not very pretty! (Meza, Jason and Kenny can get a pretty good visual as they had to drive me a few hours to the hospital after a dirt bike crash a few summers ago. I still feel bad for those guys who had to deal with that one!) My bedroom currently looks more like a medical supply warehouse. I have CPM machines, GameReady machines, Polar Care machines and a nightstand full of medication bottles. Anyway I am doing well overall and just wanted to write a little about my experience thus far undergoing Total Knee Replacement Surgery.

It is definitely a big one!!!

I will keep you updated. My plan is to begin physical therapy treatment at Alpine Sports Medicine this coming week!

Mark Moeller: D-Day…Total Knee Replacement Surgery

The day has finally arrived! October 18th.  Time to get my knee repIacement surgery. I  am scheduled to arrive at the hospital at 9:30am  which probably means surgery around 11:00. I do have admit that I have been wide awake since 2:00 AM. I guess even a seasoned knee surgery veteran like myself is not immune from getting nervous!  I even managed to get everything accomplished on my to do list prior to surgery! And let me tell you …there sure are a lot of things to get done ahead of time in preparation for surgery.  I am already exhausted! Talk to everyone soon!

Mark Moeller: Insights on Total Knee Replacement Preparation

A Total Knee Replacement Journey…

Our very own Mark Moeller will undergo a total knee replacement surgery mid-October, over the next six months we will follow Mark along his journey to full recovery.  We know Mark is going to push through this procedure and be back at 100% – living the dream Park City lifestyle we all cheerish.  Good Luck Mark!

My Total Knee Replacement Journal
by: Mark Moeller PT

In some sort of weird sense, I kind of feel like a death row inmate….. waiting for the scheduled date. In my case, the date is set for October 18, 2010. However, my date will bring about a new lease on life for myself and my family. I am talking Total Knee Replacement ( TKR) . Yes,  at only 44 years of age, I am scheduled for my second TKR. My first happened 5 years ago when I was only 39 years old.  I know…quite a bit on the young side to get a knee replaced, but  it was totally necessary. All the competitive mogul skiing  I did when I was in my teens and early twenties  on the Freestyle World Cup Circuit definitely caught up with me.  Anyway….now I have hit the crossroads with my other knee.  Two arthroscopic knee surgeries within the past nine months and I am still having trouble. If I had to, I could probably gut it out another couple of years and not have the surgery. But I definitely would not be able to do all the activities that I enjoy with my family. The simple things seem labored such as playing football and lacrosse in the yard with my children, or even doing a little roller hockey in the driveway with the kids. Add to that youth lacrosse and hockey coaching duties.  Let alone skiing with my family or participating in adult ice hockey which has become my favorite recreational sport.  I felt like my knee really began impacting my quality of life more and more which prompted a return to my knee doctor.  After careful evaluation, we decided to proceed  with Total Knee Replacement surgery. At the same time I will also have my original knee operated on to replace  the “plastic insert” . You have probably heard me say it before,   but even a Ferrari needs a 40,000 mile tune up!

So, I am just waiting for my surgery date set for mid October. I keep having thoughts of self-doubt in my head, wondering if I am making the right decision…although I know I am. Even though I will be making many short-term sacrifices over the next 6 months with regards to my post operative recovery and rehabilitation, I know that I will be building  the foundation for remaining active personally and with my family  ( and belive me… my kids demand it!) I will try to keep you filled in along the way.  Check back periodically for my updates. and a first hand account of what it is like to undergo Total Knee Replacement surgery.