Do's and Don'ts after a TKR: A Typical List

The only problem is falling off the horse from that height.  Then again, you may just land on your head or shoulder to save the knee.  If I was a trained horseman/woman with good strength back on my TKR-side quad, calf, glutes and core, and a history of never falling off a horse, I'd be back in the saddle as soon I was back up to speed.  Never seen it addressed in reference to a TKR.

Four months after brain aneurysm surgery, my wife was back on a 16.1-hands thoroughbred ... and jumping him.  But then again, she's really, really crazy...then again, we got her a GREAT helmet!!!  She still fell off and landed on her head!  How much more damage could she do...right?  Sixty-two at the time, trained by a Mexican Federale in her teens, riding all her life.  A few months later she stopped; realized that her right side weakness from the surgery and two TIAs was keeping her from completely controlling the horse.  Judged for herself that it was too much of a risk.  Meanwhile, I just held my breath the whole time...

Not being anything closely related to being a horse person (although I have been referred to as a horses a** on a number of occassions) I can only reference two personal situations. My ex D-I-L was riding with 3 other ladies when the horse in front of her shied and kicked catching my D-I--L square on the knee cutting her badly. They couldn't do surgery for fear of infection so she was weeks in bed and months recovering. Luckily she was young and they were able to quickly stabilize and her leg was saved. The second was a young (30's) professional equestrian in neighboring community who was working her horse in a corral, stumbled and was crushed to death against the rails.

As most say.....its my way of life and I'm going to enjoy it so I guess you choose your own poison.

You are right about the brain damage possibilities. I have mentioned may times about my wife's battle with Parkinson's. As he falls continue I'm seeing more and more signs of brain damage. Yesterday she had to ask what day it was 3 times in an hour and 1/2. Never did get it figured out. Our house keeper comes every other Thursday. Several times in the last 24 hrs she has asked if she will be coming tomorrow. She has fallen 3 times in 7 weeks, once hitting her head on the hardwood floor and once on the concrete patio. The 3rd time she didnt hit her head but has a nasty 4" bruise on her good leg. She broke her right hip and had a PHR in the fall 7 weeks ago. 79 and going downhill fast.

Very sorry to hear that...take care of her...

It's so difficult and completely draining physically, emotionally and spititualty when you see the person you love descending into a state over which you have no control.  The relentless helplessness as a full time caregiver...and then you youself are recovering from a painful TKR at the same time...

My wife has been through 6+ years of deep clinical depression because the brain aneurysm surgery screwed up her brain chemistry...saved her life but at what cost?  Tried every antidepressant and combination on the planet...just gets worse.  A month ago, she couldn't walk, fell 8-10 times in a few days, had hallucinations, talked incoherently and couldn't understand what was being said to her.  

Got her to the hospital and after tons of tests, they tried something novel...spinal tap with testing for ammonia.  Her symptoms where close to someone in 4th stage chirrosis of the liver (she's not an alcoholic; normal liver).  Turned out that removal of 15cc of spinal fluid and the administration of 15ml of Lactulose to decrease the ammonia in her blood, did the trick.  Normal Pressure Hydroencephalaitis,  Competely cured...no depression...no symptoms.  Got better in the next 30 days on her Lactulose and then she ran out of it.  Fell right back into hell.  Turns out that high ammonia levels in the blood can really screw you up...and inrcrease quickly.  In the elderly or after traumatic brain injury, it can be caused by too much brain fluid that cannot be absorbed by the brain and increases ammonia levels.  Rarely diagnosed.  Few ways to mitigate it: brain shunt, continued drugs and spinal taps with monitoring.  Her neurosurgen gets to give us the realistic options.

Now she's 4 days back on the med and starting to get back to normal.  Big sigh of relief.  After all the falling, she has a severe sub-acromial impingememnt and a 1cm hole in her rotator cuff...to be repaired on the 20th.  So we have to deal with her mental stability plus recovery from the shoulder surgery all in the next 30-60 days plus all the bruising from the repeated falls.

For caregivers, this is our life, regardless of what we personally have to go through...even TKRs.  We have to take second place to the person we love with all our hearts.  Whenever we reach the end of the line, we pull out a crayon and draw a longer line.  We are stronger than we can believe we are.  Plug more Energizers in my back...I just keep going...and all this dealing with a very difficult TKR recovery.  Our caregivers?  Ourselves...it's a lonely world but we do it out of pure love for partners and spouses and children and parents.  We do it because we were born with abnormal hearts...ready to give so much more than we can take...trying to make sense out of this literally on an hourly basis...making decisions on the fly that can result in life and death.  WE DO NOT LEAVE...WE DO NOT ABANDON our charges.  PERIOD!!!

If you ever wonder how much more you can take, the answer is: A lot more than you think.  God, The Universe, the Almighty Spirit, whatever you call it...the energy of The Universe is there at your command.  Tap into it and find the strength just when you think you have no more to give.  You will find it...you will use it.  Then, when it's all over, you can actually live with yourself knowing you never quit and did everything anyone ever could...ever.  I know I can live with that...

Fear is merely a disconnect from this Universal Energy...from Spirit...From God.  Never pull the plug.  Connect and love with all your heart and soul.  Be human AND spirit...you are loved even when it seems like you're all alone...you are loved.

Spent 5 years in a Catholic seminary...thought I wanted to be a priest.  Maybe I should have.......nah...the sex is just too damn good...and women are the best of God's work...ever!!!

Thanks.......those of us going through this fully understand your message. Dealing with a spouse with brain issues is most difficult thing I've been faced with. The Parkinson's and associated weaknesses were simple compared to what appears to be brain issues, probably from several hard blows to the head that have resulted from falls.

The faith of which you speak is the adhesive that holds us together.

I'm at 7+ months and it's still not back all the way yet.  Don't have the drive to do the outside yard work .  Concentrating on caring for my wife, exercising and finding a new job.  These take all my energy right now.

On the bright side, most people feel back up to speed in the 6-12 month range...some quicker, some slower...but 6-12 seems to be typical.  The problem is usually that people are completely unprepared for that recovery time.  Sociologists call it the "McDonald-ization of Society"...everyone wants it NOW!!!  The complete oppoiste of Zen masters: "It will be when it will be."

But you can help yourself.  Eat healthier (more salads and protein, less burgers and carbs), hydrate a lot, lose weight, exercise more, stay focused and positive, rid yourself of people and situations that drag you into THEIR holes of despair, walk in light not in shadow, show kindness to others.  It all helps a lot...

There are slightly different (more complete?) lists from lots of sites plus your doc will probably give you one.  The key is to do activities that avoid impact on or torquing of the knee.  For me, skating's gonna be fine but playing competitive hockey with all the quick stops, starts and twisting turns will destroy the implant in a few years.  No thanks.

Just asking people to use their judgment.  Some basic sports and ALL competitive sports are out.  Well, maybe competitive shuffleboard is OK.  Just don't jump up and down a lot when you win or kick something with your bad leg when you lose.

Someone on the forum told of a competitive skier they knew who had a TKR and went right back to the sport.  Jerk.  Ripped up his knee for good.  Just not worth it.  But everyone gets to make their own choices...good or bad.

Yeah...throw one at someone's head.  Let's see how "comptitive" it gets!!!  LOL!!!