TKR TrueNorth’s new knee!

[TrueNorth]

Well I discovered the importance of not letting pain control lapse. I was trying to increase the interval for the Dilaudid and rely more on icing and OTC meds but woke up night before last at about 4:00 AM in considerable urgent pain. The Ossur Cold Rush had warmed up and my last pain meds were mid evening the night before. My wife quickly got the icing machine topped off while I popped 6mg of Dilaudid and 30 minutes later the pain had receded to the point I could sleep. We set an alarm for 3:00 AM last night which avoided this gap. I guess welll see where I am in a week before we try to drop this step.

The knee is still quite stuff though not overly swollen. I was given a long list of post-discharge exercises. I’m finding some of them painful so have listened to the voices on this board and moderated the routine to keep the pain tolerable. Hopefully I’m not hindering my ROM recovery by doing that... it’s hard not to have that running through ones head.

 

[dogwalker2]

Welcome TrueNorth. My ltkr was 5 june and i am feeling so much better than those very early days. Make sure you take your pain meds on schedule.

 

[sistersinhim]

I was given a long list of post-discharge exercises. I’m finding some of them painful so have listened to the voices on this board and moderated the routine to keep the pain tolerable

Good. You'll have a less painful recovery this way, without the setbacks that over exercising gives you. This early in your recovery you definitely need to stay ahead of the pain. Playing catch-up is a real pain...literally!

 

[TrueNorth]

Day 16 update... it’s been a real roller coaster this past couple of weeks, both physically and emotionally. At a low a point at night around day 10, I wished I could have clicked an undo button and just gone back to before the surgery. A few better days followed though and I am pretty much on Tylenol and ibuprofen, taken on a schedule and supplemented by Tylenol 3s at night and first thing in the morning.

Discovered that 17 by 24 inch disposable underpads make great icing machine barriers as they are thin enough to transfer cold well, and are waterproof.

Still relying on the walker and having foot pain... like the toes were sprained or something, and some discomfort on the bottom of the foot just behind the toes... a feeling of pressure when weight bearing. I hope this improves soon as makes walking extremely difficult. Any tips?

 

[snowdrop]

Hi @TrueNorth and welcome! You will love spending your recovery here because you will learn so much and get fabulous support! I am a fellow Canadian...seems to be a good number of us here! That’s a good thing because as you know, we navigate the health care system differently from other countries and can offer each other practical suggestions. I just moved to a small town near Ottawa a few months ago, but my tkr was scheduled over a year ago back in Oakville. Doing the long distance thing is not easy...and the waiting list for a family doctor here is averaging four years. Soooo, I kept my doctor in Oakville to get me through this recovery time.

Bonesmart is the best place to be...glad to see you found your way here.

 

[TrueNorth]

A new lesson learned to share. Was doing so well with the walker on day 18, I switched to my cane yesterday. Discovered I was stiff and tired by bedtime and have now been lying awake for hours from the pain around my knee, even with the Ossur running and pain meds. Sigh. Back to the walker for a while longer I guess. So frustrating!

 

[Jockette]

I hope the walker will help things settle down. Try to hang in there, you’re in very early days.

 

[tabbykit]

Hi @TrueNorth, I also had my revision TKR done on June 17th! I hope you will have a smooth recovery, and will be watching your thread with interest. I am still alternating between crutches and sticks, varying them, but both give me good support and allow me to have better posture while walking. My other knee also needs a TKR so I am trying to be mindful of that too. Better to go back to your walker if it helps at this stage.

 

[marieltha]

Welcome & Bienvenue!

 

[Rockgirl4]

I think the transition to walking is super individualized like so much else in this long, wacky recovery.

When I was about 3 wks I transitioned from the walker to no aide, as my gait was fantastic and my extension was "almost" 0. Walking was fairly normal once I had taken a good 15-20 steps. However, it all went out the window around 6-7 PM at the end of the day, and again in the middle of the night.

My PT had said not to bother with a cane as I'd need it all of 15 minutes. She was mostly correct, but it took a good week to get off the walker 100%. First, I was simply too tired around 6 PM to walk normally, so back to the walker I went or limp terribly and aggravate my hip. I also noticed if I woke up in the middle of night and needed the restroom (which 2-3 times a night is my normal!!), I was WAY too stiff to walk normally without help. I definitely needed the walker each time.

This lasted a good 4-5 days until it felt like I had enough strength back in my hip/glute and a little more extension upon standing up (meaning I didn't need 15-20 steps to get the leg straight). I don't think I was completely off of it though until a day or two before my 4-wk post-op mark.

 

[Jockette]

I really liked the support my walker gave me.

I used my cane for months. Do what makes you most comfortable. I love to quote Celle, as she likes to say there are no prizes for giving up your walking aid early.

Just because someone else gave these things up in the first month doesn’t mean we all have to.

 

[Denny39]

We were both done on the same day, and I am at this point experiencing frustrations and annoyances very similar to yours. Don’t worry about getting rid of the walker too soon. I also tried to switch to the cane a couple of days ago, and quickly realized the error of my ways. When I use the walker now, I try to just keep it in place if I need it, but walk as if it isn’t there. Sometimes, I still have to lean on it a few times a day. I think I will be ready to try the cane again in 2 or 3 days. Last time, even after I abandoned the walker, I still kept it by the bed for nighttime bathroom trips because my leg was a bit unsteady for the first few minutes of having weight on it. It was just after 5 months that I completely abandoned the cane, even when walking my dog.

I’m also having an issue with foot pain. I have an almost constant ache in the Tibia, and that sometimes extends into the foot. But in the foot, its more dull and subdued, like a toothache about to explode. Very uncomfortable, and between the two, enough to keep me from sleeping at night.

But, in spite of all of this and a few other miscellaneous quirks here and there, we are only 3 weeks into the short-term recovery range of 8 - 12 weeks, so this is all “normal”. Every now and then, I put my full weight onto my Left leg and savor its pain-free strength, remembering that 6 months ago, it was just like the right one is now. The light at the end of the tunnel is NOT an approaching train! This will pass, and we’ll be fine.

What are you most looking forward to being able to do with your new knee strong again?

 

[TrueNorth]

Thanks to all for your sharing and advice. Coming from others who are living this journey, it means so much! @Denny39 i think the ability to walk on the sometimes uneven trails of our local dog park without pain, and to be able to do hiking again are the little things I look forward to most.

 

[sistersinhim]

I was thrilled to finally get back to hiking! I find I'm still afraid to go down a steep hill and do it 'sideways'. But, I couldn't do it for years, so I'm not complaining!

 

[TrueNorth]

Checking in on my 4 week-a-versary today. Following @Denny39 ’s recovery description, I’m leaving the really rotten weeks behind and heading for merely miserable. I only use the walker at night and first thing in the morning as the knee is stiff for the first few steps and use a cane during the day. I can comfortably take a few steps now and then without it so that’s definitely progress since the first week. Pain is better overall. Using T3s as needed but mostly just before bed and middle of the night as that’s when the pain is worst. Sleeping has been a challenge and am often up every couple of hours and need to stretch, take a shower or take some meds to get back to sleep. Occasional regular Tylenol during the day but frequently able to go without any meds for times.

Trying to keep up with my prescribed home PT exercises but trimming them if they start to hurt. I’ve walked down to the post box a few days running. This is only about 6 houses away and to be honest, it’s quite enough for now.

ROM is worrying me though. Extension is pretty good, maybe a 3 or so, but flexion has been stubbornly stuck at 75. The OS did mention that he had to do quite a bit of work to remove and bend some old screws left over from an old broken leg repair so maybe I have some extra healing to deal with. I wish I could be confident that the flexion will come as it has for others here, but our minds can be cruel to us when we’re laying awake in pain at night, hour after hour, and imagining that it may never improve.

Any suggestions as to exercise and PT are most welcome.

 

[KarriB]

At this point, 4 weeks post op, the best thing you can do for ROM is ice/elevate to get the swelling down and walk a bit every hour or so. Once the swelling is gone your ROM will improve. It does take time though. I continued to gain ROM 12-18 months post op.

 

[suejan]

Hi TrueNorth
A west coast Canadian here! Nice to see so many of us on here by the responses you've received.
Im 6 weeks out (RTKR) and during week 5 and now 6 I have a similar foot pain, and ankle pain
I just try to ice that too!!

 

[Denny39]

@TrueNorth Our nights are almost carbon copies. I also keep the walker by my bed at night for the same reason. When I first stand up during the night, my knees need a little time to figure out what is going on, and exactly what they are supposed to do next. Usually, by the time I reluctantly decide to actually turn over and get up for one of those often necessary night-time trips, the urgency factor no longer allows for that time lag. So, I just keep the walker pointed in the right direction. I do also find however, that sometimes walking around a little bit helps. I’ve been taking Hydromorphone and Tylenol every 6 hours, but I have eliminated the Hydromorphone from the daytime doses. This is the second day for that, so we’ll see how it works.

I do the same thing with exercises. If they become painful or overtiring, I trim them, and resort to icing and elevating. We are still very early in this process. As you said, “merely miserable” is ahead, but we ain’t there yet. Getting that time(including the 2 miserable weeks) behind us will make a difference.

Our weather here has been crazy the last 2 weeks. Our barometric pressure graphs like an agitated polygraph. That probably isn’t helping things either.

I really don’t think you should be overly concerned about your ROM. There are many things going on in there at this stage, and the fact that your OS had to do some extra work, may or may not be a significant factor. I have been very blessed by a fairly rapid ROM recovery, although not as fast this time as the first one. One of our neighbors did not regain her full ROM for almost a year, but now you would never suspect she had a knee replacement, and she says very emphatically that as soon as that other one starts giving her a problem, it’s gonna get done immediately. PATIENCE, for me, is one of the hardest ingredients to stir into this formula.

So, I keep my I-Pad beside my bed. I find that if I find some good music, or something to concentrate on other than my miserable leg for awhile, it sometimes helps. From what I remember last time, this sleepless problem will hang on for awhile, but it will go away. So . . . Hang on. Before we know it, we’ll be improved to the point of being miserable.

 

[TrueNorth]

5 week thread check in. Entered week 5 feeling pretty good! Had a couple of days where it was really starting to feel like MY knee, not just a surgical site. Am able to lay on either side in bed for short periods which is great as I am a side sleeper. As I hit the start of week 5 though, I tried to do more stretching as I am stuck at 75 ROM for weeks now and am getting frustrated. Had also been doing stairs more and going small distances without the cane. Similar to @Denny39 5 week report that I just read though, my knee is a bit swollen and more painful than last week. Will be trying to take it easy and get back on track this week. I do have a PT appointment booked for tomorrow morning to get some answers as to why I’m stuck at 75.

 

[Celle]

I do have a PT appointment booked for tomorrow morning to get some answers as to why I’m stuck at 75.

I think your answer is in what you said, below.

Had also been doing stairs more and going small distances without the cane. Similar to @Denny39 5 week report that I just read though, my knee is a bit swollen and more painful than last week.

You've been doing more than your knee is ready to do and, consequently, it's more painful and swollen - and that swelling is preventing your flexion from developing.

Ease off the activity and spend more time resting, elevating and icing your knee. It will bend more as its swelling goes down.