TKR Lisa G's 2nd Knee Recovery Journal

[ElanorG]

Hi everyone!

Well, I made it to the other side! Surgery went well and I came home Wednesday. This time I have had much more swelling so they had me cancel my outpatient PT that was scheduled for Thursday and told me to stay quiet and ice and elevate until my Monday appointment. They said if the Monday outpatient appointment is too much for me then they will do home PT.

The meds are doing OK, although walking is pretty painful in the afternoon and evening. Unfortunately I have to do a few steps to get to the bathroom so I have determined that I make 7-8 trips to the bathroom in a 24 hour period so I end up doing 28-32 steps each day. This is pretty much the extent of the walking and activity. I spend the rest of the time in the recliner with the ice machine (which has been an absolute Godsend). Is this enough activity at this point? There is not much I can do, short of not drink anything, if it is too much activity.

My friend who is staying with me is an absolute gem and so my spirits are much better than they probably would be. I just hope I can manage the out patient PT by Monday, more due to my home help situation over the next weeks rather than just wanting to get out.

Anyway, it is good to be on the recovery side.

Lisa

 

[ElanorG]

@Josephine How do I get [TKR] put into the title of my recovery thread?

 

[alexthecat]

I just added it for you. Thanks for mentioning it!

 

[ElanorG]

@alexthecat Thanks alot!

 

[Celle]

Welcome to recovery again, @ElanorG .

Walking to and from the bathroom is good, gentle exercise and it's about what your knee needs right now.

It's been a while since you had your first knee replacement, so here is the recovery reading, to refresh your memory:
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. At week 4 and after you should follow this

Activity progression for TKRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications
Wound Care In Hospital​

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.

 

[ElanorG]

@Celle Thanks for all the reference links!

My actual walking distance to the bathroom is very short (8 to 10 steps), this is the problem with town house living one floor does not contain much distance! My issue is that I have to step up 2 steps from the living room, walk through the dining room, then step 2 steps down to the bathroom. So I do that over and over again throughout the day and night. With 7 to 8 trips to the bathroom a day, I am doing 28 to 32 steps (like stairs) a day. That was my worry with the level of swelling that I have, not so much the actual walking.

 

[Celle]

There's not a lot you can do about the layout of your house, so work with it. Look on going up and down those steps as a form of heel slides, because your knee is having to bend a bit. Go very gently when you start doing formal exercises.

It's still very early days and your knee swelling is going to take quite a while to decrease. You're doing all the right things now.

 

[Jockette]

Welcome to Recovery!

 

[luvcats]

Glad to see you have a thread up!

It's wonderful that you have great support at home just now. I'm so glad I could spend the whole first week doing nothing but managing back and forth to pee.

Good luck with outpatient PT. I'm surprised they didn't give you more at home. I start out patient on Wednesday.

 

[Jockette]

Good luck with outpatient PT. I'm surprised they didn't give you more at home. I start out patient on Wednesday.

I didn’t “qualify” for home PT. I had my first out patient PT 48 hours after surgery. (I was discharged after about 36 hours after surgery.)

In my ignorance, I went to the appointment. That won’t happen next time. In fact, next time I’ll do my own “PT” at home on my own, and I’ll avoid the set backs my PT caused me.

Be very careful with PTs. Not all of them have your best interest at heart. Some are more interested in their agenda.

If you don’t feel up to going, reschedule. Give your body a chance to calm down from the surgery. There’s no rush for lots of exercises this early in recovery. Use your common sense and do what you feel is right for you.

 

[ElanorG]

@luvcats My last surgery 7 years ago was at Reston Hospital, not part of the Inova system, but this time was at Inova Fair Oaks. I would have to say that the pain management at Inova was better than at Reston, although Reston was not bad. The food at Inova was great! I couldn't believe how good it was! Perfectly steamed broccoli like I would make at home! LOL! But this time I felt I had to watch the staff like a hawk, lots of mistakes, not putting my booties on right, forgetting to plug in my IV pole, etc. I got to where I would tell them the things they needed to do. Most of the nurses were good but not the nurse assistants. The physical therapists were great. But 7 years have gone by since the last surgery and I felt that they were a little understaffed.

@Jockette Thanks! I had decided yesterday that if it is too much of a struggle to get out to the car on Monday morning that I will cancel my PT and ask for home PT for a couple of weeks. Things have improved but very very slowly so if it is all too hard on Monday then I won't do it.

 

[ElanorG]

The last knee I had a 90 degree bend right after the surgery and never lost it. For whatever reason, bending was never an issue and never hurt. So doing things like heel slides, etc. was a piece of cake, no big deal.

This time I get my foot on the floor, not 90 degrees, but the leg just sits there. My mind says "ok heel slide" and my leg says "I am a tree therefore I am planted and don't move". My expectations are low, I am not wanting it to move much, just to move a little. But nothing happens. Now if I lift my leg up I can move the knee in a short arc. It is very stiff, hurts a tad but not bad.

But the worst is transitioning from sitting to standing, especially afternoon and evening. There are times I wish I did not have to go to the bathroom as the anticipation of the pain to stand is rather dreadful. Once I am up, the pain of the walking and standing is much less. It is that transition that is really bad. I have tried ankle pumps, rotating my ankles, anything to just kind of get the blood flowing, but it doesn't seem to make much difference.

If anyone has any thoughts on this I would appreciate it.

This surgery is definitely harder on me than the last time. I am 7 years older and now diabetic (although not bad, I am not insulin dependent) and I was not as fit and strong as the last time. I know things will improve, but there is a part of me that fears they won't, that I will stay in this weak, debilitated state forever. Maybe having a bit of a depressed morning I guess. The slow improvement in pain scares me I guess.

 

[Benay]

I'll watch your thread, it's so soon after surgery, keep the faith!

 

[luvcats]

I can imagine the extra stress and fear from log leg. In the hospital I had no trouble getting my leg back on the bed. About the second day home I suddenly couldn't and had to dig out a belt to lift my leg with. Fortunately that passed in just a few days. I hope yours will do the same.

I'm sorry you're having a rough day. Do you have a nurse pet keeping you company? Is your caretaker someone who would be good for a hug? The simple things can make a huge difference when we're in that depressed state.

Do you have Amazon Prime? I highly recommend Corner Gas. It's funny but very undemanding as a diversion.

 

[Jockette]

Maybe having a bit of a depressed morning I guess. The slow improvement in pain scares me I guess.

Here’s an article about the post op blues:
https://bonesmart.org/forum/threads/post-op-blues-is-a-reality-be-prepared-for-it.7591/

 

[kneeper]

It sounds like you are doing about the same as most of us did in the first several days of recovery. I think just trying to bend it a little even if you can't do much is fine. Remember no 2 knees are the same so even if you feel like this one is a "slow starter," keeping on with the ice and elevation the swelling will start to come down and the bend will increase.

Sorry your hospital experience was such a mixed bag, but good for you for keeping on top of things. A good CNA is worth her (or his) weight in gold, but a bad one is so disappointing.
The people I remember most from my first tkr are a really kind and effective night nurse and one of the CNAs who helped position me to be more comfortable (as comfortable as you can be right after tkr.) I gave them both rave reviews when the hospital sent me an evaluation form several weeks after my surgery.

 

[ElanorG]

@luvcats My nurse pets are having nothing to do with me! I have 2 kittens just a little over a year old and I think they are too overwhelmed by this whole situation, having someone else living here, etc. and they have checked out. I suspect they are still too young. So no nurse pet like the last time around. I am going to check out that comedy later today as it looks like fun.

@kneeper Thanks, I will just keep doing what I can.

 

[winemama]

Both my TKR’s were night and day. On my last one, my experience of just trying to stand was painful, I found out the Dr straightened my leg, which caused way different pain, I could walk, but everything else hurt.
Take it hour by hour, don’t count steps, just put all your energy into healing. We are here for you

 

[luvcats]

Oh no! No wonder you have a sad if your Booboo kitties are too young.

 

[Benay]

My 20 pounder had been a very faithful friend during recovery. Frighteningly oversized