TKR Indygo's thread<

[Josephine]

My husband has been doing so much for me, and I worry about him overdoing it.

So when you married and exchanged your vows, did you not have this in amongst them?

"I take thee to be my wedded husband/wife, to have and to hold, from this day forward, for better, for worse, for richer, for poorer, in sickness and in health"

That doesn't apply in 2019? And like Celle said, you know if the situations were reversed, you'd be doing the same - and probably more - for him!

Would going to the Y and riding a stationary bike be better than PT?

Absolutely not! You're only 2½ weeks out. Read this again Activity progression for TKRs

 

[Indygo]

Thanks, Josephine. The sickness and in health reminder is good. It's a tough one. My husband has serious heart issues, so I worry about him. He never complains. I have to remind myself that taking it easy now and allowing my knee to heal will give me the ability to take care of him. I never quite realized how much seesawing with health issues a married couple goes through as they get older. I help him up and then he helps me up. I guess I have to let him when it's my turn. That's a tough one.

On another note: I live in a state with serious opioid drug problems and so it would probably take a governor's decree to get that third week of Oxy. So I kept cutting back on pills and am now dow to two a day. That will only last a couple more days. Now and then I think I will call the OS on Monday and beg for more. There's more pain in the knee but also more pain in other areas (base of thumb, ankles, other knee) that were painful from arthritis before the surgery. The Oxo masked that pain. I also realize that I liked the floating/sleepy feeling, of nodding off while listening to cello music. That's not a good reason to keep taking it, and it set of alarm bells when I realized it.

On the other hand, having less of it in my system seems to help with my general outlook on things. I feel a bit closer to the world than I did a few days ago. So that's good.

 

[Celle]

It's very similar to the Bonesmart way, except he does think a few basic exercises are beneficial early on.

The BoneSmart way doesn't say do no exercise at all. For many people, walking around the house is their exercise at first - and walking is a very good exercise.
I don't think a little bit of bending and stretching does any harm either, as long as it doesn't cause pain and you don't do it to excess.

 

[Josephine]

On another note: I live in a state with serious opioid drug problems and so it would probably take a governor's decree to get that third week of Oxy.

Oh gosh, that cuts me to the quick. When my loose implant was diagnosed, my GP let me have a whole boxful of Tramadol but now I find I don't really need it (until the revision!). I so wish I could send you some! (No, don't want to get done for drug running, do I!)

 

[Indygo]

Hope, drug running isn't a good idea! So what I'm doing is icing much of the day and trying to cut the Oxy. I find the icing helps so much with the pain that my main issue seems to be withdrawal. I just took one pill yesterday morning and the ice was doing so much good that I thought I could just stop cold turkey after that. Nope! About 14 hours later, it felt like I had restless leg over my entire body. Finally gave in and took an Oxy and the need to shake my arms and legs out stopped. So now I've got to figure out how to spread the last pills out in a way that will keep that horribleness from happening again. I'm calling my pharmacist later to see if increased spacing or cutting the pills in half will work best. This recovery thing is relentless!

 

[Celle]

Stopping cold turkey is never a good idea, as you've found out. If you can, it's best to reduce gradually.
Thus is a schedule that Jamie suggested (although you may not be able to do it as slowly as this, it does give you some idea).

"Here is a suggested schedule for cutting back on prescription pain medications. Stay at each level for 3-4 days or even longer if you notice the pain symptoms increasing. This schedule assumes you are starting with one pill every 4 hours before beginning the reduction process.

1 pill every 6 hours and 2 at bedtime
1 pill every 6 hours and 1½ at bedtime
½ pill every 4 hours and 1½ at bedtime
½ pill every 6 hours and 1½ at bedtime
½ pill every 8 hours and 1½ at bedtime
½ pill every 8 hours and 1 at bedtime
1 pill if you are really doing something active during the day and 1 at bedtime

It is usually better to wean off these meds over several weeks, not several days. But.....if you are still having pain, then your body is healing and you still need pain relief. And in this case, I would discuss your pain management with your GP instead of your surgeon."

I copied the above from this article: Weaning off pain medication​

 

[klinkmcbear]

I've gone to the Y a few times. I do the bike for about 10 minutes - I still can't get a full revolution, but I'm working the ends in both directions. I then either do some of the normal daily exercises, or preferably, some upper body weights - that makes me feel normal again and gives me a big emotional boost. I'm sure this doesn't help with how tired I've been, but I don't go too hard or for too long, and the mental boost it gives me is definitely worth it!

 

[Indygo]

Well, I went to my first PT appointment after all and have to say it was very gentle and good to get out of the house for the first time. I was armed with 'don't push on that!' phrases but didn't need them. It was, at least the first time, all stretching and a couple of very easy strength exercises.

This Wednesday it will have been three weeks since the surgery, and what a strange journey it continues to be. That first weeks feel like a blur of pain with occasional lovely drifting naps due to the pain meds. I'm now off the oxy with the exception of one at night and that will only last through tomorrow. I think I'm going to cut them in half because there's some restlessness I'm not used to. It may be the lack of oxy and it may be that I'm just getting tired of resting and elevating but don't have a lot of energy yet to do anything else. A regular sleep schedule seems like heaven.

Luckily, I'm a teacher and don't have to do anything until mid August. I truly can't imagine having to go back to work any sooner than that.

 

[Josephine]

it will have been three weeks since the surgery. I'm now off the oxy with the exception of one at night and that will only last through tomorrow.

Have you tried asking for a refill? Three weeks is awfully early to be stopping your pain meds. If your doctor won't help, then at least take Tylenol 1,000mg 4 times a day at 6hrly intervals to a maximum of 4,000mg per 24hrs.

I know the FDA has ruled that 3,000mg acetaminophen is a safe maximum but that would be assuming that the patient is taking another medication that also contained it and thereby inadvertently take an overdose. Assuming that this is not the case, the maximum safe dosage per 24hrs 4,000mgs.

 

[RAD]

I had surgery the same day! Glad you had a good PT experience, I did too! I’ve been off the pain meds for 2 weeks and doing the 4000 mg of Tylenol and it works pretty well. I really hated the pain meds. Lucky you re: being off work until August. I go back on Monday, fortunately I have a desk job and can elevate and ice at work!

 

[Rockgirl4]

@Indygo I'm glad the PT appointment went well. I know the feeling of going in, armed with our "You will NOT..." speech and attitude. I also understand the restlessness now. I'm one week behind you, and the last 2 days have been more boring, and my nights more restless. I want to do more, but I just physically can't yet. I think some of mine is too much daytime napping, but considering how uncomfortable certain nights are, I know we need our sleep to heal. Thankfully you have this time off from school. I still can't imagine knowing I had X number of days/weeks before having to return to work. Regardless of the physical part,the mental is HUGE too--I think the sleep deprivation is just sheer torture.

 

[kneeper]

You might ask your doctor about a schedule for using tylenol alternately with the oxy. Or even changing to hydrocodone or tramadol. It's been a while for me, but my OS prescribed oxycodone for the first week or so and then automatically dropped it to hydrocodone (vicodin). As I started stretching time between doses I added tylenol into the mix---but you need to be very careful to watch your total tylenol and not take too much at once.

 

[Indygo]

Thanks all! I slept well last night, which was a gift. My range-of-motion isn't very good, and that's frustrating. Of course, I haven't had much range of motion in this knee for years, so that may be part of it. I don't think the pain when trying to do heel slides helps much, so I'm going to talk to my surgeon about that when I go in next week.

Good luck going back to work, Rad! I'll be looking forward to reading how you're doing.

 

[Celle]

It's very early to be worrying about Range of Motion (ROM). Yours may take longer than most, because it wasn't good pre-op, but remember this:
There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

If the heel slides hurt, don't do them. Your knee isn't ready for them yet. Just make sure you walk around the house, because walking is good exercise.
Try to follow this:

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.​

 

[Jockette]

I still had plenty of pain at 3 weeks post op and ROM was not impressive. It’s very early days. As Celle said, it’s way too early to be frustrated about your ROM. Concentrate on resting so you can heal.

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.

 

[kneeper]

Thanks all! I slept well last night, which was a gift. My range-of-motion isn't very good, and that's frustrating. Of course, I haven't had much range of motion in this knee for years, so that may be part of it.

First of all, like Jockette said, it is very early.
But I think there may be an element of truth in what you say as far as having limited range before surgery in that it may take an even more "slowly but surely" approach than some others may experience given that your muscles, ligaments etc. aren't used to the bend. (I think that was somewhat the case with me, though I was never told that by a doctor.)
Nonetheless, the real key to bend is for the swelling to come down. Once mine did the bend followed.

 

[Indygo]

Just checking in. It's been three weeks now, and I'm still spending a lot of my day with my knee iced and elevated. I am walking several times a day and doing the gentle exercises. We went out for breakfast this morning--first time out of the house that wasn't for PT--and it was lovely. I had vowed that I'd never go into a restaurant with a walker, but there I was with a walker and it was fine! Good to see our every-Saturday waitress and have a normal start to a weekend. My main complaint right now is sleep. I'm fine all day but when it's time to go to sleep it's like I suddenly get restless legs and restless arms and have to keep changing positions and moving around. Not fun! I'm cutting out all caffeine and sugar after noon to see if that helps tonight. My friends keep bringing lovely meals that always include pies and cookies, and I'm completely helpless before sugar. I dread the nights, but the days are fine.

 

[Celle]

Unfortunately, sleep disturbance seems to be part and parcel of this recovery. It was about 4 months before I started sleeping properly at night.
Sleep deprivation is pretty much inevitable - but what causes it?

I moved into the spare bedroom and spent many a night watching mindless TV. Sometimes, I'd even fall asleep with the TV going.

Until your night time sleep improves, make up for lost sleep by taking daytime naps. Sleep where you can, when you can, and how you can.

 

[Rockgirl4]

I'm glad you were able to get out today and go to breakfast. That had to feel wonderful!!! As for sleep, I hope things improve. I knew it would be challenging but not THIS challenging.

I'm following your recovery closely since you're just a few days ahead of me. I wondered how many people were still using a walker at this point, and I feel better knowing I'm not the only one. I am also spending a good part of the day icing and elevating.

 

[Indygo]

Well, tomorrow will mark four weeks since the surgery. I've been feeling better but today feel pretty discouraged. I know I need to be resting and elevating more, but as soon as I get the pillows just right and the ice machine just right and my leg up, I get incredibly restless and need to move. I'm pretty sure I walked way too much today and my knee feels worse, but I just can't seem to sit still.