TKR Amy's Right Knee

[RunwithSmoke]

I found this website a few days ago, and I'm so glad! I had a right TKR five weeks ago, and wish I'd discovered all of you earlier. But it's still fairly early in the healing process, so I could still use plenty of support.

I want to write a short description of my first five weeks. I actually had some difficulties with my surgery. First, I had a lot of trouble with the spinal injection. It was awfully painful and took them about 5-6 attempts. Then they were late with the sedative, so I lost consciousness for surgery under a lot of fear and pain. Then, after I woke up, I had no feeling in my thumb and forefinger. My surgeon sent me for an MRI, and it turned out that I had a stroke. I was in the hospital five nights and had scans of my legs (for DVT), carotids and heart. Everything came out normal, so they are classifying it as a cryptogenic stroke (of undetermined origin). They say my chances of having a second stroke are no greater than anyone else's chances of having a stroke, so that's wonderful news. Then, the oxycodone suppressed my breathing so much that it scared me very much. I would stop breathing as I fell asleep, and the machine would beep, even with oxygen tubes in my nostrils.

When I got home, I had two gall bladder attacks in the first two weeks. These were not new to me, and I knew what they were, but I previously had had only one every couple of years. So I need to have my gall bladder removed. Also, the oxycodone continued to take my breath away and made me very scared, so I stopped it. That sent me into the most horrible, terrifying depression. I'm sure pain contributed to that as well.

Okay, today I'm doing pretty well. The staples came out two weeks ago and my scar looks okay. I am walking without a walker or cane. I am taking half doses of the oxycodone (2.5 mg at a time), at noon and before bedtime, and that helps with most of my pain and helps me sleep without shutting my breathing down. I have decent flexibility in my knee although I don't remember the numbers. I stopped going to my PT because he was pushing me way too hard and I thought it was counterproductive. Some of the feeling has returned to my thumb and finger from the stroke.

Well, that's my introduction. I'm sure I will have questions, but I just want to say hi right now. Thank you all for being here!

Amy

 

[Celle]

Hello Amy,

I'm glad you decided to join us.

It sounds as if you are doing well.. Well done, for stopping the PT when you felt it was counter-productive!

I'm going to give you our recovery reading list - everyone gets it!
First are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist (PT) - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

Next is a FAQ (Frequently Asked Questions) thread.

And here are some very crucial articles
The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Activity progression for TKRs

Healing: how long does it take?
Chart representation of TKR recovery
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling

Home physio (PT) and activity progress: suggestions
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

And then some wise words from members who have shared their experiences ...
Where are you in recovery?? (TKR)
Five “P’s” of knee recovery
TKR: work “smarter” and not “harder”
Recovering a knee - from one who knows!
It's never too late to get more ROM!
It's worth the wait for ROM


Please will you create a signature, in which you put your surgery and its date? That way, we don't have to keep going back to your first post to see what you had, and when.
Here's how to do it;
How to create a signature
Thank you.

Looking forward to hearing more about your progress.

 

[RunwithSmoke]

Thank you Celle! I have already devoured those articles, since I've been reading everything I can find on this site, lol. I was happy to read about not pushing things in PT, waiting for ROM, and about Postop Blues. I sure have had those. I've also been using my ice blanket and elevating my knee more since I read the articles. There is a wealth of information there!

 

[RunwithSmoke]

I have a question about walking. I like to walk because it helps my mental outlook and makes me feel better, even for just a short distance, like 2-3 houses away and back. But walking worries me because my knee is not completely straight and I have a little bit of a limp. Should I wait to walk?

 

[Celle]

Just a little walking is fine now. Just don't try to walk too far.
Your limp should start to go away once you can straighten your leg fully. However when you walk, do try to use the correct gait, as shown in the picture below. Lengthening your stride a bit may help with straightening your leg, too.

 

[SarahJane]

Glad you found us.

I asked to switch physical therapists because the first one I had was a physical "torturist." I don't know whether you have the option to see someone else. As you probably know by now, if you've read a lot on the site, there's a national difference in the attitude about physical therapy. Josephine, our British nurse adviser who had two knee replacements had no physical therapy. I, on the other hand, found it reassuring to have a few visits with a physical therapist who was in sync with Bonesmart principles. It worked out well for me to have someone I could trust to check in with on occasion. But I'm sure a lot of that was because of my personality; others may not need that reassurance and gentle PT tips.

You certainly had a challenge first couple of weeks there! I hope your gall bladder behaves itself. You don't need anything else to cope with right now. How are you doing mood-wise? I went through the recovery blues. I was already on a SSRI for depression before the surgery; my psychiatrist increased my SSRI dose, and I'm also doing what I can to help boost my mood -- doing nice things for myself, making an effort to connect with people, doing exercise as I am able.

 

[RunwithSmoke]

Celle, thanks, I will pay attention to how my foot performs when I walk. Heel, midfoot, toes, it looks like.

Sarah Jane, thanks for your reply. My therapist was definitely too pushy. He wouldn't give me an easy day when I asked for one. I think I will be okay doing PT on my own. I am motivated because I do dog agility and can't wait to get back to it. I am going to wait until I'm at least 10 weeks out before I even start training again though.

Mood wise, I have been reasonably okay. I am bored and frustrated at times, but the intense anxiety, fear and depression hasn't returned. That was horrible. I wonder if my stroke might have played a part. I too take an SSRI, and did not stop it for the surgery or recovery.

 

[RunwithSmoke]

Today is my five week surgery anniversary. I'm a little discouraged because the knee is swollen and painful. It seemed better a few days ago. My ROM is less, it seems. I have my legs elevated and my dh is getting the ice wrap. Maybe I was on my feet too much yesterday. I raked leaves for 15 minutes and then stood and talked to my neighbor for about 20.

 

[jmdearras]

Recovery is full of plateaus and setbacks. It will continue to improve on it's own schedule. And depression early on is very common.

 

[RunwithSmoke]

It was a really deep, black, scary, anxious depression. I hear the stroke may have deepened it. It took a week to emerge. It was an awful week.

I have a better mindset for patience on some days than others, lol. Patience is hard for me because I'm so on the go with my dogs, training and trailing. I also have this gall bladder surgery coming up and I hope I don't have another attack in the meantime. They are painful.

I rested all day. But I need to keep my expectations reasonable, because resting today doesn't mean I'll be better tomorrow. Patience...

 

[cairistiona60]

I know what those gallbladder attacks are like. Most pain ever until I had my TKR. Got it removed about 8 years ago. I think most of the planet are on SSRIs. I was before surgery for several reasons, mainly a bad marriage break up in 1999 and a bully of a boss in 2008. My down days are becoming fewer but I have to pull myself out of the mud almost every day or I would just stay in bed.

I am now 11 weeks post TKR and I still have quite a bit of pain. It's not the kind of pain that requires a lot of meds but it is enough to keep me off my feet for most of the day. I'm told it eases and the 12 week mark seems to be the point that pain is less of an issue. So just one week to go then! I can't wait!

Hope,you start to feel better soon. Hang in there!

 

[RunwithSmoke]

Cairistiona60, they are awful. I sure hope your pain eases quickly now. I'm not far behind you. I am so tired of pain and stomach aches and just not feeling well. But this will pass.

 

[Celle]

Today is my five week surgery anniversary. I'm a little discouraged because the knee is swollen and painful. It seemed better a few days ago. My ROM is less, it seems. I have my legs elevated and my dh is getting the ice wrap. Maybe I was on my feet too much yesterday. I raked leaves for 15 minutes and then stood and talked to my neighbor for about 20.

I agree - your did do too much and your knee is letting you know that. Raking leaves was rather ambitious so early in recovery.
Never mind, no permanent harm done.

The knee is boss, so it's good to have learnt how to listen to the knee.

 

[Josephine]

I would stop breathing as I fell asleep, and the machine would beep, even with oxygen tubes in my nostrils.

What machine would beep?

I stopped going to my PT because he was pushing me way too hard and I thought it was counter-productive.

Good for you!

But walking worries me because my knee is not completely straight and I have a little bit of a limp. Should I wait to walk?

Absolutely not unless it's painful. Walking is the best therapy.

I'm a little discouraged because the knee is swollen and painful. My ROM is less, it seems

If I may, I'm going to ask you some questions and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are. Please answer them carefully and in detail

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't compare this with the bone-on-bone pain you had before surgery!

) Also don't forget to include other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how often are you icing your knee and for how long?

4. are you elevating your leg, how often and for how long?

5. What is your ROM - that's flexion (bend) and extension (straightness)

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. what kind of PT exercises and exercises at home are you doing? How much and how often?

Can you detail it like this

Exercises done at home: 3 sessions a day
Heel slides x10 (reps)
Strait leg raises x10
Steps x10

At PT
Squats x5 (reps) x2 (sets)
Wall slides x5 x2
Clamshells X5 x2

 

[jmdearras]

What machine would beep?

I would assume Sp02, I had a monitor, too.

 

[louie]

Welcome to this forum! Everyone on here is great, and helps you out anytime you need!
Wow, sorry to hear about the stroke, although it sounds like you are doing better! Don't be discouraged if you have to rest more one day than another! I am 11 weeks post op, and have started back to work, which I am a dog groomer!
Last week I had gone to pt, and then off to work! I was bathing a dog, and couldn't even finish, I felt lousy, and had to sit, and that is where I stayed, and when I was at home, iced rest, elevate! So give yourself time, it does take at least a year before you are back to normal, I know, cuz my other knee was a year old last week.
Patience is hard, when you like to be active. But you can only do what your knee will allow! Just do a little atta time, and if you have a day you just wat to relax, just do it! Your knee will thank you for it!!!

 

[RunwithSmoke]

Hi Josephine,

Thanks.for your interest.

What machine would beep? A machine that monitored respiration.

I am glad that walking is okay.

1. what are your pain levels right now? At the worst times now I would say about a 5. I get very sore with aching and swelling, and it's bad enough that I can't stay seated or lying down, and I have to move around. I try to stretch my body to ease it up, but that doesn't help. Other times it's about a 3 and i can tolerate it better. I get stabs of pain sometimes. Icing really helps the swelling and stiffness.

2. My pain has not been well managed. I was initially prescribed 5mg oxycodone and 10 mg OxyContin, and Tylenol as needed. I couldn't take the OxyContin because it reduced my breathing. I took the 5mg oxycodone for the first three weeks, usually one or two every 4-5 hours. I found that it was also causing me shallow breathing, made my stomach hurt, and made me anxious. I stopped it and went into a very terrible depression for a week. I called my surgeon's office and told them about it and they prescribed Celebrex. Celebrex didn't do anything for my pain and it also made my stomach hurt. In the meantime, my pain was very bad and my husband had some hydrocodone tablets leftover from another procedure. I'm not sure of the strength, but the label says 10-325 sub for Norco. I took a half tablet of the hydrocodone. It helped a lot and I've been taking a half tablet twice a day for three days. I called my orthopedist and asked for a prescription for codeine and they are sending one, to arrive Monday.

3. I ice my knee 4 times a day for 20 minutes.

4. I elevate my leg 5-6 times a day for 30 minutes.

5. What is your ROM - that's flexion (bend) and extension (straightness) I don't remember. I can bend my leg very well, and it seems like it was at about 125, but straightening is hard. I work on it a lot though.

6. My husband has been taking over most of the housework and grocery shopping. We have five agility dogs, and I have to take two of them out on a leash. The others we can turn loose in the backyard. When I take the two out on leash I take them one at a time, and they want to walk all over the yard which is a fairly unlevel surface. Also, I really enjoy being outside and doing yardwork, and I have done some sweeping and raking in the driveway and front yard and picked up branches in the woods on the side. Also, I go upstairs, a full flight, about six times a day.

7. what kind of PT exercises and exercises at home are you doing? How much and how often?

Exercises done at home: 2 sessions a day
Heel slides x24 (reps)
Quad presses x30
Straight leg raises x10
I stand on step with heels hanging and stretch the back of my legs. x30
Toe taps, front back, side x30 each

Thanks,
Amy

 

[RunwithSmoke]

@louie - thanks for your reply. It would be hard to groom dogs with a recovering knee. I have five furry dogs (aussies, aussie mixes and a border collie), and they are barely getting brushed these days, but don't seem to mind. But they do mind taking a break from agility. Luckily, my male aussie loves the ball, and I can sit in a chair a throw it for him. It's just hard to feel motivated because of the pain. Pain makes you not want to do anything and it really takes away the zest for life. It's getting better though. Good luck to you!

 

[louie]

Oh for sure, pain stops you in your tracks! We groom a lot of aussies, and border collies! We had a male aussie, and also horses at one time! Randy, our aussie, love to herd them, and the horses wouldn't let him! And he got kicked really good a couple of times! He loved our gelding, and it was funny to watch them play! We also had 3 jack russels, and what a crew we had!
Now I just groom, and yes it can get very physical, and I can't work all day yet!
I think giving your dogs exercise throwing the ball, is perfect!! It won't be for long, and you will see a big difference in a few weeks! My ortho said a smiley face at 12 weeks! My first knee took longer, and you can't compare to others, cuz we all heal differently! I would drive myself crazy, cuz I would get so impatient, I wasn't where I should be! Or someone would make a comment that I didnt like! This forum is really great, and really helps!

 

[Celle]

Pain makes you not want to do anything and it really takes away the zest for life. It's getting better though.

So true!
However, if that pain stops you from doing more than you should, it's providing a useful warning, don't you think?
Your job in the first few weeks is to do very little, except rest, ice, elevate, take your medication by the clock and just walk around the house a little.

Since this is an international forum and most countries don't use the US method of writing dates, please will you modify your signature to " RTKR Sept. 2, 2015" ? To me, 09/02/2015 means 9th February 2015.
Thank you.