TKR Right knee replaced, glad to share with other TKRs

[Kdub77]

TKR 8/11/14
54 years old
As of 9/12/14: 127 degrees bend

Glad to join the forum! I wish I'd thought to look around for a forum before now.

Briefly, 29 years ago, I tore my meniscus & cartilage in right knee. Had scope, cleaned it up, heard "you' ll probably have arthritis In that knee." Oh, yeah.

So, I just over a month out from the TKA, and it's mostly going pretty smoothly. I did as much presurgery PT as I could handle, and then, post-surgery, have been diligent about pain meds and exercises. Or so I've thought -- I'm back to feeling a fairly constant ache in my whole knee, accompanied by some sharp pains here and there around the patella. Asking the obvious question: "I've been doing too much, haven't I?"

As I write this, I have the ice bag on, and I'm resting. Just a bit discouraged, though. I am scheduled to see my surgeon this week, and obviously if I'm still feeling this way, I'll talk to him about it. Can't sleep w/out a Vicodin, and with this constant pain, I'm back to taking a vicodin during the day occasionally. I'm only taking 2/day, but don't want to keep taking the high-powered stuff, but nothing else seems to work.

Anyway, mostly just writing to an understanding crowd. Is this all reasonable for four weeks out?

thanks!
TKA 8/11/14

 

[dovemck]

Darling, you're WAY AHEAD of many people at 4 weeks. You'll have aches and pains coming and going for months and you have to be mindful not to do too much which will leave you achey. Keep using your ice and for the love of pete, why are you trying to get off the pain meds already? It's too soon and your body is telling you that in the simple fact that lower powered stuff doesn't touch it. You had part of your bones sawn off, muscles spread and posts pounded into your legs!! You are NOT going to become addicted if you're using the drugs to get relief from pain. You will also not get a star, elephant stamp or a medal for being the first to get off pain medication and it's just too soon to be thinking that way. This is major surgery and it will take most of a YEAR to get back to 'normal'.

A moderator will come along soon and post to you a list of readings and the Bonesmart mantra. Once you read them you're going to see you might be expecting too much at such an early stage.

 

[Kdub77]

Thank you, thank you!!! I have found my people . Cheers.

 

[HerbM]

Welcome. You are doing great and still it is easy to get discourage at times.

This is a marathon not a sprint. Lot's of ice and PROPER ELEVATION (see the links the moderator will post for the best ways to elevate -- they aren't what many people expect or use.)

You can ice almost continuously as long as you don't put the ice right next to the skin or otherwise allow frostbite.

Take it slow with the exercises and keep them to things that don't actually HURT. A little difficulty might be ok as long as it doesn't cause swelling, inflammation, or pain TOMORROW (err on the low side at first.)

Don't push past what your body tells you is appropriate. (And don't let anyone else push you past that point either.)

 

[skigirl]

It sounds like you are doing great, but this is a time to keep perspective about activity. At this stage, my doc recommended one hour down for every two hours up. I will give you our post op reading list too---it has lots of short articles.

First are the 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 - 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!

Next is a FAQ (Frequently Asked Questions) thread.

And then the articles in order of importance .
Group A
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?
Progression of activity for TKRs

Group B
How Long Does Healing Take ......
Chart representation of TKR recovery
Energy drain for TKRs
Elevating your leg to control swelling and pain
Using ice

Group C
Knee Replacement - Where Am I in Recovery?
So What Is It Going to Take? The Five “P’s” of Knee Recovery
Work “Smarter” and not “Harder”
About recovering a knee - from one who knows!
Some suggestions for home physio (PT) and activity progress
Myth busting: The "window of opportunity"

Group D
MUA (manipulation under anaesthetic) and adhesions
It's never too late to get more ROM!
It's Worth the Wait for ROM
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?

 

[jeano]

I have the kewpie doll for rapidly getting off narcotics, but if and when I need them i'll take them. To me, pain in my knee means I have done too much, too soon, that I have not been icing and elevating enough, and that I may have missed a dose of Tylenol.

There are many roads to Rome, and to pain relief. Do try icing and elevating more along with meds that work for you, and see if your knee doesn't calm down. And consider being a lot less 'diligent' about those exercises.

I'll tell you a dirty little secret. With my first knee, I started outpatient PT the day after surgery, and tackled it as a personal challenge where I would make world class progress and Amaze Everyone. Did my exercises as though my leg depended on it. Five days a week, plus did everything a second time at home some weekdays, and nearly always twice a day on weekends. I iced and elevated religiously. I got off daily narcotics within a week or so, but took them sporadically for several more weeks. I graduated from a walker to a cane after 2weeks. And I DID do really well, impressed the tar out of everyone. I was exhausted and slept poorly for weeks, and it took me a while to stop limping, but by God my PT told me I was having a 'textbook-perfect recovery '.

So, that was my left knee. When I had the right done in August, I told PT in advance not to look for me before a week after surgery. I did NO exercises that first week at home other than a heel slide or two and a few turns on a pedaling contraption. PT this time was ordered only 3 x a week and the only 'knee exercising' I do happens at PT, other than some bending in the shower or seated in a rocking chair, and a few minutes of pedaling if the knee gets stiff. At PT I give myself permission to slack off if I don't feel like superwoman that session.

And guess what--this time I quit narcotics completely after 3days, my flexion at the end of the first week at PT was over 120, I am already starting to sleep all night (last night I didn't even take Benadryl), my gait is excellent, I'm not even bothering with a cane, and I am much less exhausted. In short, I'm doing less and doing better.

 

[happymum]

Hi Kdubb77,
Sounds like you are doing really well but start taking your pain meds so you can sleep and recover well. I'm going into week 11 still taking all my pain meds at night and when rqd during the day. Still icing and resting and trying to do my PT everyday. I am improving every week but if I over do it my knee lets me know it!
Take it easy and be gentle on yourself,
Cheers from Deb

 

[dtmbf]

Oh my goodness, you're doing just fine! I made the mistake of trying to cut down or come off my narcotics too soon m- it's really not worth it. I set myself back about a week & got majorly depressed. Went to see my OS at 5 weeks & he reminded me of everything he did to my knee & told me to keep on the narcotics & exercise to discomfort, not pain. I routinely iced & elevated till about 10 weeks. I was definitely not a "superstar" in terms of speed of recovery but this is not a competition. You do what's right for you - not what other folks tell you what you "should" be doing.

 

[Kdub77]

Thank you so much, everyone. Honestly, I'm not trying to be a hero, lol, I'm just usually an active person, and this process is good for me - learning how rest and slowing down is important, too. Thanks.

 

[Lovestoread]

@Kdub77, yes, this surgery is a character-builder, isn't it? You sound like you are making great progress. I hope by reading some stories here, you know you are still in the early days and that you still need some good meds to help with your pain. Don't worry about becoming addicted.....you need them!


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[HerbM]

You are definitely doing great. Even though I had a very easy THR my surgeon was adamant to use the vicodin to feel better and to make sleep comfortable.

Check with YOUR surgeon but don't feel bad about using your PRESCRIBED medicine as prescribed.

 

[Josephine]

And guess what--this time I quit narcotics completely after 3days, my flexion at the end of the first week at PT was over 120, I am already starting to sleep all night (last night I didn't even take Benadryl), my gait is excellent, I'm not even bothering with a cane, and I am much less exhausted. In short, I'm doing less and doing better.

Another success for the BoneSmart way! Great stuff Jean!

 

[Kdub77]

TKA 8/11/14

Thanks again, everyone. Saw my surgeon today (9/19) for follow-up, and I'm feeling good about my progress and current situation. Doc is pleased, too, and reassured me about taking the pain meds. So, I'm carrying on, a bit more relaxed about it all. Good luck, fellow recoverees!!

 

[Reebok]

Some good advice been given here.
Even better, it comes from experience.



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[Dulcimer Diva]

Back on track! Gastroc pull disappeared as suddenly as it came on, after a month of worsening. Flex 140, ext 0 right, 1 left. Officially discharged as a patient. Wore 3-1/2" peep-toe heels tonight to dinner at Mandarin Oriental (Twist by Pierre Gagnier)--outside, not just w/in a carpeted hotel hallway. Left my cane home; brought a trekking pole for Hoover Dam or Red Rock Canyon.

 

[Jamie]

Bravo!!! Well done....and VERY cute shoes!!!

 

[jul]

@Dulcimer Diva I would love to be able to wear shoes like that.

 

[1ELISEA]

Wore 3-1/2" peep-toe heels tonight to dinner

Nothing is a better motivator than a cute pair of shoes!

 

[Dulcimer Diva]

If anyone had told me before my TKRs that I could ever wear even tiny kitten heels again, or that I’d be fitter and healthier at 63 than I was at 50, I’d have had them committed. Granted, stilettos are not just a no-no but a never-ever (and when I tried 4” wedgies in June, I needed my cane--only to realize from puzzled looks of fellow diners as I timidly minced my way along that those shoes and a cane were a ridiculous oxymoron--so I gave the wedgies away). And for walking along the Vegas Strip Sat. night (1/4 mi. from hotel entrance to theater and 1/3 mi. from theater to dinner), I sensibly decided on cushy though blingy flat sandals.

EDITING previous post, which lacked an “Edit” button: The correct name of the restaurant was “Twist by Pierre Gagniare.” It’s his only U.S. restaurant. Highly recommend it--and a window table--if you are visiting Vegas. Don’t do the wine pairings if you’re still on your pain meds, of course.

And for hiking up the hill to and across the Hoover Dam bridge (that trekking pole came in handy), sturdy padded hiking sandals (if not sneakers or hiking boots) are a must. I wore flat slide sandals, and temporarily lost my balance and nearly fell on some “scree” taking an unpaved shortcut for the last 10’ to the parking lot; I stupidly decided taking that last sloped switchback down rather than a flight of stairs plus said shortcut would be too wussy.

 

[Dulcimer Diva]

Oh, and DON’T feel obliged to quit your narcotic pain meds so precipitously. If you don’t stay ahead of the pain, you might as well be flushing those tabs down the toilet for all the good they’re doing you. Twice a day, unless you have successfully and gradually ratcheted downward to the point where you aren’t hurting at rest, seems unnecessarily stoic. You’ve made fantastic progress as it is!