TKR Update on Slower Recovery

Mar

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Had my surgery yesterday. Doing way better then with my RTKR 8 years ago. Changed doctors and so far a better experience. PT said I was doing great. Able to walk with the walker really well. I’m doing pretty well with pain but the block they gave me hasn’t entirely worn off I don’t think. Worst pain has been a 4. They did give me Tramadol and 1000mg of Tylenol every 6 hours and that’s been sufficient. I did take an Oxycodone 5mg an hour before discharge.

Home now elevating and icing. So praying things continue on this path. I had the block, a spinal, and IV sedation but also ended up being intubated. Saw the doctor before discharge but forgot to ask what happened. So hopefully I’ll remember when I see him.

FYI, one thing that was a bit funny was the first time up to the bathroom when I stood up urine just ran down my leg. Apparently even though your legs have woken up my middle section did not. Ended up being cathed but didn’t feel it Eventually everything woke up. So far I’m a happy camper.

He did tell me the 3rd day is usually the worst. But maybe it won’t be
 
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Welcome to recovery!

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are here to help, but you are the final judge as to the recovery approach you choose.

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
ice
take your pain meds by prescription schedule (not when pain starts!)​

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

5. At week 4 and after you should follow this

6. Access to these pages on the website

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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 
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Haha, I had same issue with my crotch still being numb and I told the nurse I think I am peeing! She grabbed a bed pan and they had filled me full of so many fluids that I filled it and had to be taken to the restroom to finish!!
 
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Congratulations on your new knee and here’s praying for a smooth recovery. Remember to be patient!
 
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So I’m day 2, I think that’s how the doctor counted it. Block has worn off. I was able to lift my leg with the block without problem but now knee cap pain is too severe to lift so I have to put my other leg under it to lift. Is that a common problem?

I’m walking every hour suppose to be 2 hours but my bladder won’t let me go much more then 1 1/2 hours at most.

I’m doing pretty well with the pain as long as I take them every 6 hours, I have break through med if needed. Just doing heel slides, and sitting up doing a little extension. Keeping both to just 5 reps after I’ve walked but not every walk.. Much better then 3 x day with 15.

This site is a God send for figuring out what to try or change when something isn’t working. Had my first bowel movement so very happy because last time I was so constipated. I have an arsenal of things to take. My daughter works in a Rehab hospital and she gave me a drink that they call a brown cow (coffee, butter, and prune juice). Worked really well, lol. If anyone else is having issues.
 
Hi @Mar - you'll see that I have moved your post above from your pre-op thread to your recovery thread.

Please post any updates or questions about your recovery in this thread from now on. We'll see them here, as someone checks all the new posts every day.
If you need an urgent response to a question, just tag a member of staff.
Tagging other members and answering tags

Just in case you couldn't find your thread, here are the instructions on finding your thread,
How can I find my threads and posts . Many members bookmark their thread, so they can find it when they log on. It might be helpful if you do that, too.
 
Block has worn off. I was able to lift my leg with the block without problem but now knee cap pain is too severe to lift so I have to put my other leg under it to lift. Is that a common problem?
Yes, that's very common and you're doing the right thing in using your other leg to help.
 
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Had my first PT appointment yesterday post op day 4. Pain is well controlled with Tramadol and Tylenol every 6 hours and Oxy every 6 hours so I have something to take every 3 hours. Has worked well. Very slightly itchy with the Oxycodone. Icing and elevating pretty much unless I’m walking. I walk around every 1 1/2 hours while awake. Sleep between meds at night. I do take a Kirkland sleep aid at night to help, it has worked well. Much better then I expected. PT said I was doing good. Bend is 80, and she said my extension is already pretty good for this point so she said that will get there fairly soon. Didn’t give me a number.

I am having problems with urine retention. Is this an issue for others? Just can’t seem to empty completely. Had issues in the hospital with this but thought it would resolve. Last GYN exam the doctor told me my bladder is prolapsing a little. But said if no issues don’t worry about it. So not sure if this is why it’s happening? I guess I need to call. The getting in and out of bed so much is making my right leg a bit mad. I still can’t really lift my new knee by itself without a great deal of pain. Any suggestions on how to get the muscles working better? It’s also causing issues with my abdominal muscles when using a strap to lift it when I’m moving. Was using my other leg but my stomach was really hurting so had to find another way to move my leg. All a bit of a learning curve isn’t it, lol. Pretty happy over all on how things are going this time.
 
Yes, it may be worth checking in with your doc about the bladder situation.
You're right that there is a learning curve in tkr recovery. I'd say just experiment with how to get your let on and off the bed. My guess is that pretty soon you won't need a strap or to use your other leg to help.
 
Question for those of you who did both knees but years apart. My RTK was is 2012, I’m one week into my recovery for my LTK. My right one is having some discomfort, slight swelling with a little difficulty bending. It’s been totally fine once it healed until about 4 months ago when I bought a treadmill. With the gyms closed I was gaining weight through inactivity, so I thought it would be a good solution. I also live in the northwest so I can’t walk outside for half the year. Neither knee liked that treadmill, lol. My OS took X-rays and it checked out ok. So I went ahead the LTKR, the right was fine once I stopped using the treadmill. I’m hoping just because it has had to take on a lot more work load and it doesn’t like treadmill’s that it’s actually ok. Did any of you with older TKR’s have the other one act up at all once you were in recovery for the other knee?
 
The knee may not like the treadmill until its more recovered. That's what I found. Start with short amounts of time on a slow-ish speed.
 
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Congratulations!! My middle was sore for a few days after surgery. Still cannot figure that out. I even thought I had a UTI but went to the doctor and that was all clear. It finally went away but it was very odd and strange. Hope you have a great recovery!!
 
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I also live in the northwest so I can’t walk outside for half the year.
Same here. Please, feel free to talk privately if you want. It’s nice to talk to somebody who is going through the same thing. Sent you a personal message.
 
Hi Mar, I think I pulled one of my ab muscles when I sat up when my leg was elevated, so it was a super crunch... hurt for a while so I decided to grab my loose pj pant leg to lift my leg in and out of the bed! The PJs are soft, loose knit cotton and pretty stretchy but it’s working...
 
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Had my 3rd PT appointment today 11 days post op. The pain in my knee cap when lifting my leg is probably 75% less pain now:happydance:When I went to PT on Wednesday, I pushed too much. My fault not PT. She was very gentle. She put me on a machine that I control myself and it just moves your knee back and forth. My flexion when doing the heel slides had decreased so I got worried. I was able to push it to 80 and boy did I pay the next day. Iced a lot and elevated most the day but my pain was the worst I’ve had since my surgery. So mad at myself.:umm:

Today I went for my 3rd PT and flexion was only 75. Extension is good! I got worried when she said we will have to work harder and really push to get better numbers in the future. Ugh! So I see the PA for the removal of my Zip Closure on Tuesday. I don’t want to really push as I will just swell and have more pain and it won’t help those numbers. I know my doctor is more concerned with walking so should I just say I want to skip PT for 2 weeks and let things settle down more. I get up and walk every 1/1/2-2 hours when awake. My husband just made me a smaller version of a skateboard. So I thought I’ll just do the heel slides with that and do some flexion stretches and walk. Just a bit frustrated right now.
 
I was able to push it to 80 and boy did I pay the next day. Iced a lot and elevated most the day but my pain was the worst I’ve had since my surgery. So mad at myself.:umm:
Yes, you overdid it and your knee let you know. Listen to your knee and respond to the messages it sends you.
Today I went for my 3rd PT and flexion was only 75. Extension is good! I got worried when she said we will have to work harder and really push to get better numbers in the future. Ugh!
The reduced flexion was a direct result of overdoing your exercise last time. It made your knee swell more, which reduced your knee's ability to bend.

Please don't get trapped into thinking that the harder you work, the better your results will be. It doesn't work like that, and doing too much work can actually slow down your progress.
Knee recovery - Lose the Work Ethic!!

In any case, 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

So I thought I’ll just do the heel slides with that and do some flexion stretches and walk. Just a bit frustrated right now
I think that's a good idea. Just exercise gently, do plenty of icing and elevating, and your ROM will increase naturally.
 

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