TKR Total Left Knee Replacement

[tlfiore]

@flacie1 I feel for you, I do. I haven't felt well enough today to post yet but I had to respond to your post...I am following your thread.

I am 1 week, 1 day post op and last night/early morning had to be the 2nd or 3rd most difficult day yet. My issue, too was thinking I had to and/or I hoped to manage my pain without a narcotic aid. @flacie1 I just cannot seem to do that, I am nowhere near that place yet. Tylenol helps for a while but it just doesn't quite touch my pain.

In my head, I keep repeating over and over and over again the "Bone Smart" mantra...rest, sleep, heal, elevate, ice, manage pain, don't over-do things, rest, relax, take it slow. My husband returned to work today and several times, I've been in tears, teeth gritting, crying out in pain. But this is the next step, Week 2 and I'm just figuring it out, learning ho to manage things.

The afternoon is MUCH better than early morning.

My first home-based full PT session was yesterday, so I'm sure that didn't contribute to lessening pain.

I'm just letting my body & mind, rest, letting myself be. I'm literally taking it 1 hour at a time.

@flacie1 What untoward symptoms and side effects are you having with the narcotic analgesia? Is there some way to manage the side effects, just so you can get a few more days of narcotic pain relief?

 

[flacie1]

@tlfiore I seem to be managing with just the Tylenol. I’ve been taking oxycodone 5 mg 1-2 tabs every 4 hrs as needed. I developed constipation. It’s awful and very painful. So I figured best to do without. Same thing happened when I had my hysterectomy earlier this year. I was on Percocet and stopped those 2 days after coming home.

I too have been following your recovery since we are so close. Hubby went back to work yesterday I welcomed being alone at first but today has been rough. I’m just glad to have control of the tv, lol.

 

[tlfiore]

@flacie1 hang in there as best you can. Your above message sounds much more upbeat than your earlier one. Early mornings are the WORST for me, they really are. Keep a positive attitude. Although it is relentless and wicked, hopefully this post-operative pain for most of us is a temporary condition. In the long run, we'll be okay.

Without boring you to tears, I have additional tummy/constipation woes. Back in 2013 and just prior to my metastatic breast cancer diagnosis (September 2013) and treatment (ongoing, still on oral Arimidex, which docs believe contributed to my severe osteoarthritis), I traveled ALONE to Tijuana Mexico and had a Bariatric Sleeve, Gastric Weight Loss Surgery performed. Can you imagine? I lost nearly 100 pound, going from approximately 235 lbs to 139 lbs.

So, I have all sorts of NSAID, aspirin, dietary, gastric reflux, constipation, regurgitation issues. List goes on 'n on.

@flacie1 My hospital discharged me on Senna 8 mg tabs twice daily as a stool softener. After about Day #6 based on what I was reading, I became a bit more concerned about no BM and I took OTC Senokot x 2 tabs, which is identical to Senna but in a non-harsh, "laxative" dosage. A few days later, my constipation was relieved. My OS still has me on the low-dose Senna but my plan is to take 1-2 of the higher dosage Senokot every few days, if I see my system slowing down. Once I'm off the narcotics, I think I'll be good.

 

[flacie1]

@tlfiore wow, you’ve been thru it. Great job on your weight loss. I started weight watchers last year and have so far lost 50 lbs. I have more to lose but the knee got in the way. I have Colace here at home but I didn’t take it regularly because I had some BM’s prior to getting all locked up so I figured I was in the clear. No I’m taking it 2x a day to get things moving. Also I hadn’t been eating much of anything which added to my issue. So I made it a point to actually eat a breakfast and a lunch today. Even though I didn’t want to.

@tlfiore how does your leg look? I’m all bruised and it’s still swollen and feels hot.

 

[sistersinhim]

Icing hurts andicany figure out why. So I just do it for about 10-15 mins a time. Work on my therapy exercises.

Do you have a thin cloth between the ice pack and your knee? The longer you can keep the ice on, the better it'll help your swelling and pain. Make sure your therapy doesn't hurt your knee. It's a newborn baby and needs to be treated as such. Just gentle movements.

 

[kneeper]

I do wonder if I have over done the icing? Seems like a strange question but I can barely stand icing my knee right now. I have many layers of towels between the ice and my knee. I have been using a combo of the hot ice machine and ice packs. I can only stand having the ice on for maybe 15 mins.

I generally went about 20 minutes on; 10 minutes off. Also when I used gel packs I sometimes felt like I needed to let it warm up for a few minutes before putting it on.

 

[flacie1]

Regarding icing, I have the polar cube and I was using it all the time. Always with a barrier between my leg and the pad. Now I’ve switched to gel packs and I time how long they are on. I did use my polar cube today for limited amounts of time. The strange thing is prior to surgery I would put one of these gel packs on my knee (wrapped in a dish towel) until it would thaw.

I finally got brave enough to get in the shower tonite. I’m so glad I did. I feel a thousand times better. It was tricky but I did it. I do not have a walk in shower.

I can’t say enough about how amazing this forum is. Im so glad I found it and got the nerve to post.

 

[Jockette]

I can’t say enough about how amazing this forum is. Im so glad I found it and got the nerve to post.

I read this forum for 5 months before I had the nerve to join!

 

[caredFL]

I seem to be managing with just the Tylenol. I’ve been taking oxycodone 5 mg 1-2 tabs every 4 hrs as needed. I developed constipation. It’s awful and very painful. So I figured best to do without. Same thing happened when I had my hysterectomy earlier this year. I was on Percocet and stopped those 2 days after coming home

Sorry you are having a rough time with pain....I am a few days ahead of you 10/28, I've been on the same dose and have taken 2 colace a day since day 1 and it has kept everything moving! Yes, constipation is miserable. I plan to stay with it even though I seem to be able to manage with Tramadol at least until PT starts up again on Tuesday. Regarding icing, my OS told me yesterday can't ice too much. I have Iceman and use a small towel between pad and skin.

 

[Jlc66]

Hi. I am at week three today. The first few weeks were pretty bad and I Took 10mg oxy every 4-6 hours. Sleep was almost impossible. I was only sent home with 40 tablets so it didn’t take long to run out. Very important to medicate before therapy. I have read a lot of comments here and I don’t feel alone! We all recover differently but we do recover! Hang in there!

 

[Jockette]

Wow you are doing great. I just got home from therapy and I’m on day 8 post op. My bend was 58. I know OS wants to see 90. That gives me 11 days to get even better. I’m not going to push myself but I’m going to work harder.

I read this on another thread and I have to comment. There is no need to stress about your ROM on day 8. Your knee is brand new out of surgery. By working harder it sounds to me like you are going to work harder on all your exercises. This is not the way to encourage ROM. Doing more exercises or trying to force the bend will increase your pain and swelling, which in turn will hinder your bend, not improve it

What you should “work harder” at is resting, icing, elevating, and taking your pain medication as it is prescribed. This will help your swelling go down. It is swelling that is preventing your bend

If your PT has told you there is a limited time frame to regain your ROM, they are incorrect. My ROM increased after my one year anniversary and after my second anniversary.

Regaining our ROM is more about Time than repetitions of a list of exercises.

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. Normal activity is the key to success.

 

[flacie1]

@Jockette thank you for your reply. What I mean by work harder is work more on my exercises, I have not been good about doing them here at home. I usually pick and choose the easy ones. And I don’t do them every day. I know I can’t compare my recovery to anyone else’s and I am only a week out of surgery. But I honestly thought I would rock this recovery. I didn’t expect the pain and swelling to be so bad. I figured at my age staying active and moving would be easy, but this has knocked me down.

 

[Jockette]

What I mean by work harder is work more on my exercises, I have not been good about doing them here at home. I usually pick and choose the easy ones. And I don’t do them every day.

You don’t need to do more exercises. Yes, you need movement, but a list of exercises is not the way to do it. At this very early stage short walks around the house and gentle bending movements are all you need.

I’m glad you are just doing the easy ones and not even every day. Your surgeon did major carpentry work and disturbed every millimeter of soft tissue in your knee area. Right now you need to focus on healing, and full healing takes a full year or more.”

 

[tlfiore]

@flacie1 See...the shower is a great victory for you! You are doing great! I like to notice all the victories involved with this recovery, victories big and small!

Because we live in a very old (c1872) house with 15 very steep steps to the second level and the bedrooms, for recovery DH and I decided to assemble our futon mattress on the first level. We just purchased a great futon mattress for guests but I didn't want husband to disassemble the big old bulky wooden futon frame and lug it downstairs.

So, we purchased this folding metal futon bed-frame from Walmart online for $59,99 and placed the futon mattress on that at the far end of our living room. The original old bathroom is on the first floor, just a few feet from where my bed is now assembled. The area where my now bed is once was one of the original 3 bedrooms in this house. However the last owners, who lived here for 38 years, blew out the first level wall between the bedroom/living room in order to extend the living room. Previous owners did this when they added an approximate 1000 sq foot second level addition to the house.

Due to the nature of the first floor tub, I bought one of those slide in bathtub benches and I've used that to shower. I still feel way too compromised to manage standing that involves anything more than a few minutes.

You are making lots of progress. You sound so much more confident. We will get there!

 

[luvcats]

I figured at my age staying active and moving would be easy, but this has knocked me down.

At only 2 years older than you, I had hoped for the same thing. I have discovered, from my own experience and following others here at bonesmart, that age has absolutely nothing to do with it. It's all about how much was done, and how our own, personal bodies react to the surgery, the anesthetics, the pain meds, and all the other very personal details you just don't know until they happen. I found it very frustrating.

 

[flacie1]

You don’t need to do more exercises. Yes, you need movement, but a list of exercises is not the way to do it. At this very early stage short walks around the house and gentle bending movements are all you need.

You are right and that is exactly what I plan on doing.

 

[flacie1]

Today has been a better day for me. Got up came downstairs hubby made me some coffee and got some breakfast for us. I wound up taking my pain meds last night to help me get comfortable to sleep. One thing we did at therapy yesterday was the bike. I was terrified of it, but once I got on it, it felt great. My PT thought I would hate her for it but I loved it. I hate her for the stretching. She did say my swelling seems to be going down which is a plus. I rested and iced then did my gentle exercises and I felt great after doing them. I did not push myself too far.

One thing I’ve been wondering about....I was sent home with the battery operated plasma flow leg cuffs. I.Hate.Those.Things. At first they felt good but now I see them as some sort of torture device. I usually just use them at night but I wind up waking up and taking them off. What is everyone doing to ward off blood clots? I try to keep my feet moving when I’m sitting on the couch so I won’t need them.

 

[Jockette]

I hate her for the stretching.

Just say no to the stretching, it’s not necessary. She’s obviously pushing you too far. The bend will come as you heal and your swelling goes down.
Saying no to therapy - am I allowed to?

I did not have those leg cuffs after leaving the hospital. I did ankle pumps and walks every hour or so. I also was told to take a baby aspirin but to be honest I forget why, maybe to prevent a blood clot. @Celle is that what the aspirin was for?

 

[Celle]

Yes, Aspirin is an anticoagulant, so it helps to prevent a Deep Vein Thrombosis (DVT).

 

[tlfiore]

@flacie1 It's great reading your update today! Sounds like you had a much better day! I am petrified of outpatient PT, especially the stationary bike but ANYTHING has to be an improvement over this ridiculous home-based PT.

I do believe the lower leg cuffs are used to keep the blood flowing & moving (returning) in your calves. Isn't in funny how the leg/knee/incision "tolerance" for stuff changes on a nearly daily basis? Not sure why you would need the leg cuffs if you are moving like you say you are. I mean again...your managing the stationary bike and you need leg cuffs?

PT is funny. If it weren't so painful, it would make for a great comedy routine. I just cannot find much humor in PT yet.

Keep up the great work! I'm rooting for you!