At 7 weeks post op, is this normal?

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ljrami

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Had a RTKR 9/22/2010, while I know I have improved with my flexion and extension I still have problems. Still can't get straight or bend all the way. Still stiff and painful. My endurance is poor. After a couple of hours of up and doing chores etc. I am very tired and need to lie down. I still experience a great deal of pain. I have cut back on my pain meds. Percocet 7.5 mg every 6 hrs. Sometimes I do have to take 10mg. My pain is at the tibia and the inner aspect of the knee and my lower calf. At times it brings me to tears. (No it is not a DVT) I have yet, slept longer than 4-5 hrs at night. The pain wakes me up.

I am in outpatient PT 2-3 times a week. I do exercise on my days off.

My fear is, I am scheduled to go back to work 12/13 2010 and I don't know if I will be ready. I work as a Home Care Nurse and today I do not see myself working at all.

Am I behind or where I should be with rehab? I had no idea this was such a long and painful rehab. While I have taken care of patients with TKR, it was only for a few weeks and I never knew what happened to them after they no longer needed us.

I feel like I have hit a wall and not progressing anymore. I have done everything that I was asked to do and I am so discouraged. I am supposed to have a LTKR and I don't know if I can go through this again. I have had other surgeries and felt I was prepared physically and mentally for this, but, wow was I in for a shock!
How were you all at 7 weeks? I have read the threads and can't believe how wonderful some of you were at 3 weeks!! I barely remember my 3rd week..ha!
I would love input, suggestions, whatever information you can give me.
Thank you so much
 
Hi, ljrami....welcome to BoneSmart! I'm glad you decided to join our forum.

Hon, you are being way, way too hard on yourself. You are well within the normal recovery range. Sure, there are some folks who pop back quickly, but most folks take months before they begin to feel human again. A majority of people say that occurs around the 6-month mark.

I am sorry to hear that you weren't properly informed of the recovery process for a knee replacement.....these doctors sometimes make way too light of the time needed! It is possible that you could return to part-time work in December, but you would be MUCH better off to let yourself recover for at least 3 months. Even then, IF you are up to work, you should phase yourself back in. You're still going to get tired even at that point.

Now, my biggest question is...why are you cutting back on your pain meds??? You are in pain! You need them. Please don't do this to yourself. It just makes recovery more difficult when you hurt. Also, if you are having significant pain, scale back your activity. You have PT 3 days a week.....rest on the other days. You don't need to do exercises every day.

You didn't mention icing....are you applying ice to your knee? If so, how often and for how long? It works wonders on swelling and pain.

Don't worry....we're here to help and support you as you go through the recovery process. Post anytime you want to with questions or concerns. Or tell us your milestones. Or rant if you're having an especially bad day. We're here for ALL of that and more if you need it.
 
Short Answer: All Normal.

Long answer. All Normal.

**About Pain: You can do NOTHING if you are in pain. Your body is telling you you are not taking enough pain meds. You will not gain anything by denying yourself comfort (I learned this the hard way...)
Go back to the dose that worked.

**About PT/Exercising: Cut back on one of these. You must have recovery time. Ignore those who tell you you must work this everyday or you will "get stuck" They lie. Either stop PT or stop exercising on your days off. Rest ice and elevate your leg on your rest day.

**About ROM. Allow it to come on its own. DO NOT let anyone push your knee. Gentle ROM will do. Rom is gained gradually and will likely take a while to return. Just day to day activities will do for now. You CANNOT bend a swollen painful knee, so don't even try.

**About your shin pain/back of knee pain: Normal and a real annoyance. Jo told me to wrap my calf in moist heat. It went away over time. I still deal with pain where my hamstring inserts.....

**About being "prepared":: None of us are really 'emotionally ready' to cut out a joint and replace it with metal and plastic. Orthos have overly optimistic expectations, and we believe them, then they look at us like we are from outer space when we don't recover on their schedule. Shame on them.

**About work: You aren't going back till December. That is 2 months away. Take each day as it comes and don't freak out about work. As the time to return nears make a realistic evaluation and go from there. It is way too early to tell what you will be doing next week, so don't plan too far out. It keeps you out of the looney bin.

**About comparing yourself to anyone :STOP! DON'T DO IT!!! We all recover at different rates, some people don't have measurable pain, can get their rehab done, get back to work, run a marathon, whatever. GOOD FOR THEM. They aren't you. You aren't them. Reminder, this is a FORUM. We can say anything we want without having to prove it. Don't fall into the trap. You will end up jealous, bitter and in the looney bin again.

At 7 weeks: I was just like you. Relax.
Best
Sandy
 
Listen to Jamie and Sandy, they are absolutely right.

You should be resting, not doing all that PT and all those exercises. That's what's giving you pain and poor flexion. By the way, what on earth do you mean by "bend all the way"? It'll never bend fully like the other one. What are you expecting the bend to be?
Then you stop the pain meds and complain about the pain:shk:. What do you expect to happen when you stop taking the meds !!

All in all, you are progressing the same as everybody else, but you would do if you would stop overexercising, and starts the meds again.

Please be patient, and be gentle with yourself:thmb:
 
Thank you so much for your replies,very greatful.
It was my surgeon that cut back the pain meds. When I was in his office he encouraged the use of them, but then when I asked for a refil, he cut me back. I had not over used them, I was in the correct time frame for a refil but maybe he is weaning me off. I see him again in 2 weeks and will discuss it with him.
I do use ice and love it. I am going to try to not exercise on my days off and see if that helps with the pain as well
I love this site and again thanks so much y'all
 
Ijrami I am right ahead of you at 8 weeks. I also am much like you. I still hurt, get very tired and frustrated. I have just this week FINALLY taken the advice of Jo, Jamie, Tykey and others and have stopped trying to push myself so much with the exercises. I am doing just a very small amout between my therapy visits. I am also icing and elevating more as my knee is just like yours with the bending. I am gonna stay on this for a few weeks and see how I do. Sandys post was dead on !!!!! It is not a race . I hope things get better for you very soon. Keep checking back. This is a wonderful site where you can get so much info, rave and rant as needed. Hope you feel better soon.:cnsl:
 
My advice: Once you hit the 12 week mark you will see a marked difference. It does take that long! You need to pace yourself and know you are doing all you can to recover. Don't allow yourself to wallow in depression. I know it is hard work, but it is worth it all in the end.
Do what you can and you will improve daily......
My very best to you!
 
ljrami.....surgeons have a bad habit of backing off pain medication too early. You certainly can discuss it with your surgeon when you see him, but you can also contact your GP or a pain management clinic to obtain the meds you need during recovery. Don't let anyone scare you with stories of addiction. You MUST have proper pain management during these recovery months and you'll be able to stop them just fine once your body doesn't need them any longer.
 
If you are in pain, it keeps you from making progress. Check with your GP if you OS is not willing to refill your meds. Most docs have NO idea about the pain involved in this recovery. (Newbies, don't panic when you read this). The discomfort can easily be managed...and you will be amazed that at about 12 weeks you will feel a lot better!!!
 
I want to reinforce all the good advice about getting the meds. My OS cut me down when I left inpatient rehab, my GP did reluctantly give me more, but he has known me for years and knows that I am pretty smart about my own body. I tell you though, if I hadn't gotten the meds from him I would have gone to a pain management specialist. I really needed the pain pills and doing without them was terrible for me. As I mentioned in another post at about 8 or 9 weeks, the pain stopped waking me up at night and I found that the daytime pain had subsided. I switched to Alleve and kept my remaing Oxycontin and Tramadol for the periodic times I did too much and exacerbated my pain.

Believe me it will improve, you will slowly become more functional and feel more hopeful, however, healing takes a long, long time - and that requires patience. You need to learn to do less, rest enough and let it be. I am at almost 7 months post surgery and don't have any real issues, but I still do have some soreness sometimes. I still have a little swelling and am aware that "it" is there almost all of the time, and I am hoping for the day to come when my knee will just feel like a normal part of my body.

Take care, get meds and relax.
:wink:
 
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