TKR Mangie’s Giant Step towards healing

[X2mangie]

hi all! Surgery went perfectly, except they will NOT let me elevate! Knee must be kept straight or I will lose “window “ to be able to ever do it. What? My calf got in just such a spasm that I begged to be able to move to my side, which they just helped me do. It has helped a lot! This window thing seems silly to me… Any suggestions? Other than being the rebel I am in already have been elevating

 

[donnag1108]

No suggestions but so happy to see you made it!! Rest!!

 

[X2mangie]

Thanks @donnag1108 !! Happy to healing! The knee is very doable.....3-4, but calf is around 7-8. I will be glad to see PT tomorrow, so I can walk! I am on my side now, but robe turned soon as my hip isn’t happy either. You ahead of me.., how are you?

 

[Roy Gardiner]

Knee must be kept straight or I will lose “window “ to be able to ever do it.

This window thing seems silly to me

It is nonsense, utter nonsense. Elevation is good; basically as of now just rest and relax.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now; they are almost certainly temporary
2. Control discomfort:

rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.​

3. Do what you want to do BUT

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy​

5. Here is a week-by-week guide for Activity progression for TKRs


The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?

Energy drain for TKRs
Elevation is the key

Ice to control pain and swelling
Heel slides and how to do them properly

Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[donnag1108]

Glad to hear your doing well. There's lots of ups and downs I'm finding out and today was a down day for me. Insomnia is rough but I don't regret it. Hopefully you go home quickly. One thing I learned the hard way is stay ahead of your pain. It all gets better!

 

[Larryhg3]

Welcome to BoneSmart. My experience with the hospital is just nod your head at them a lot. For my first knee they put a pillow under my ankle to about halfway up my calf. At shift change the new nurse came in lifted the blanket saw the pillow, yanked it out and gave me the keep it straight speech. She rolled a towel and put it under my heel for the rest of my stay. When I got home the visiting nurse showed me how to properly elevate my leg and cautioned against putting something Only behind the knee for a while. Moral of the story it gets better when they send you home. The nurse at home is more likely to give a better explanation of what you can do and why. There is a lot of great info here to fact check the pros with as well. Good luck in your journey

 

[sistersinhim]

I was so blessed to be in a hospital that believes in the elevating of the leg. Keeping it totally straight was terribly painful. Having just that slight bend in the knee makes all the difference in the pain level! Try to sneak in the elevation. It will help with the pain and swelling.

 

[X2mangie]

A few things surprised me about the surgery. First off, that I was AWAKE! I had a spinal and caudal blocks, but I was given something so that I could converse. I could hear the sawing and pounding, but I just didn’t care. Being an old surgical vet tech, I loved it! I ended up elevating my knee when ever I could sneak it past the nurses! I would pile a blanket on my lap and knees and kinda disguise it! Only got “caught” once! Home now for 3 days now, mostly alone, but it is working. I think I am keeping the pain fairly minimal, except when walking to the bathroom. Elevating and icing constantly. I am using gel packs as I can’t seem to manage the ice machine on my own. PT was out yesterday, but he was here 2 hours! I was just exhausted and my knee really swelled up. He is coming back Monday and I am gonna put some restrictions on this. He was fairly gentle, but it still really hurt. My friends have been amazing! I am using the Takethemameal.com website and my days are all full with people kindly bringing or sending food. Since I have a wound vac, I can’t shower , so I bought these great wipes on Amazon, as well as shower caps for shampooing my hair. I gotta say....both are pretty great products! No rinse, just towel dry. All in all, pretty ok there. I sure get tired easily. No kidding, a trip to the bathroom is a biggie! Drinking lots of water and eating apricots, plus stool softener, but still no poop fairy visit. Hopefully, soon. My little dog somehow just knows to stay off my right leg. She is very careful around me and also when I am using my walker.. She sure hasn’t let me out of her sight! Hubs is actually more supportive that I imagined he would be.....yeah!

 

[maryo52]

I keep my leg elevated AND straight. That's not so hard. Not terribly comfortable but I'm managing. Dogs are amazing. This is my second surgery on this leg and my dog as usual seems to understand. The little things that go right are big, aren't they?

 

[Jockette]

I’m glad things are going well!

Stay firm with PT!

Keep in mind, it’s not exercising that gets our range of motion back, it’s Time:

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Exercise as in strength training is counter-productive and in the early weeks does more harm than good. Normal activity is the key to success.

 

[sistersinhim]

PT was out yesterday, but he was here 2 hours! I was just exhausted and my knee really swelled up. He is coming back Monday and I am gonna put some restrictions on this. He was fairly gentle, but it still really hurt.

Oh my goodness, 2 hours is way too much for a newborn knee. PT should never hurt or cause swelling. Tell your PT about it and then put your foot down and do only about 1/4 of the time you did before. All that swelling has just set your recovery back by inflaming your knee even more than it already is. Slow, very gentle movements is all you need. I never even took PT after any of my 11 knee surgeries and ended up with great recoveries!

 

[Bike4Fun]

@X2mangie Thank you for your after-surgery report. Since we are both "January Jackpots," it is very helpful to know your experiences, especially with physical therapy. I really want to avoid the physical therapy over-exercise syndrome. I have printed out the "BoneSmart Philosophy for Sensible Post Op Therapy" which has photos of the worst exercises. I want to show these to the physical therapist that is sent to my home, so we are on the same page.

 

[X2mangie]

PT is coming today and I dread it. My surgeon was adamant that I do it and since I have another knee to go, I am worried about upsetting him. I know it is silly and that I am in charge. I think I will print off the protocol here and give it to my PT today, like you suggested @Bike4Fun ! It doesn’t help that hubs doesn’t agree with me. On the good side, that lovely, adorable poop fairy arrived!! Maybe she got lost.....I do live in the sticks! LOL!

 

[Jockette]

I will be seeking a surgeon who is not adamant about PT, because next time I won’t be going and I don’t have the emotional energy to deal with a surgeon’s vocal displeasure, but I will if I can’t find a surgeon I can work with.

 

[Jockette]

Only you can decide what you do in PT and what you allow.

 

[sistersinhim]

If you don't go to PT and your OS refuses to do your next knee, then you'll be better off with a different one! You really don't want a doctor that is that controlling. He works for you, not the other way around! You are the boss of your OS and PT! Take control and protect that baby knee! You are the one that has to deal with the pain and swelling and no one else!

 

[Celle]

PT is coming today and I dread it. My surgeon was adamant that I do it and since I have another knee to go, I am worried about upsetting him. I know it is silly and that I am in charge. I think I will print off the protocol here and give it to my PT today, like you suggested @Bike4Fun ! It doesn’t help that hubs doesn’t agree with me.

You can still do PT. Just make sure it's the sort of PT that doesn't hurt or over-exercise your knee.

You don't have to discuss this with either your PT or your surgeon. It's usually a waste of time, because you won't change their opinions. Just do what feels right for your knee. Tell your PT what you will allow and what you will not do.

If your surgeon asks, tell him "Yes, I'm doing my exercises". You will be, too. You just won't be exercising aggressively.

You are in charge of your knee's recovery - not your PT, not your surgeon, and not your husband.

 

[X2mangie]

Doing my walking around the house and gentle PT. I am seeing slow improvement. My wound vac alarm went off, so I called Home Health... they told me to go ahead and remove it. Staples come out next Tuesday. All looks good, though I am getting sick of sitting in front of the TV! And my butt is sick of it, too! Hubs has been a pain all day. We have had no power for 2 days and he has lost all patience..... even tho we have a generator which gives us all amenities.
Not much of an appetite..... just can’t eat much and that isn’t like me. Continuing to take pain meds, so am assuming that’s why. I also have areas of numbness in the side of my knee. Is that normal?

 

[sistersinhim]

Can you get away from your husband and do your own thing? I know quite well about the sound of those generators when the power is out. That would grate on anyone's nerves! I hope you get it restored quickly. Are you still able to ice?

 

[Celle]

I also have areas of numbness in the side of my knee. Is that normal?

Yes, it's normal.
This article explains:
Numb area after TKR: how long will it last?