TKR 7 week exhaustion

[Pooters]

I am 7 weeks post op, left tkr. I have been reading threads about exhaustion and pain. Everyone tells me I need to just get moving but it hurts and I am tired. My job is very demanding, but I am being pressured to return. I went in yesterday for 2 hours , came home, took a pain med and crashed. I feel awful, like maybe I should move more. But, I cant.
I am sleeping about 3 hours at a time. I am faithful with PT, 0/135. Ice often and elevate. I just cant stay up very long and then I get depressed for staying in bed all day. Any suggesstions?

 

[amymj]

Pooters I too have a tendency to get this way. A couple things I do is to rest when needed, but also I am very prone to dehydration. I take Nuun electrolyte tabs (in a bottle of water). It helps!

 

[Pumpkin]

Pooters,
Welcome to BoneSmart, glad you joined us!
You are still very very early in the year long+ recovery, though most start feeling better around 3 months, some sooner, some later.
It is normal to be exhausted, you had a major surgery.
If you are up to it, here are some photos, TKR surgery - WARNING: real life photos .

My job is very demanding

We usually recommend members wait until 3 months to return to work, with a Phased return to work .

I am faithful with PT, 0/135.

Your ROM is fantastic, you do not need to go to PT, the walking around the house that you do is plenty right now. You are not weak you are injured, as you heal your strength will be there.

All and all sounds like you are having a normal recovery, we all think we should be further along, when in fact we are right on track. Where are you in recovery?? (TKR)

Most of your other questions and concerns will be answered in the Knee Replacement Guidelines below.

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​

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.

 

[Pumpkin]

Please post your surgery date, a moderator will add it to your signature for you. Thanks!

 

[Rayna]

I'm with you. Exhaustion + a case of "I wanna get going" is tough to manage. One aspect I find puzzling is that things I did at 4 weeks, which I could recover from in a short time, are now making me crash a day or two at a time at 6 weeks. Clearly, we are not in charge of our recovery; we're just along for the ride. I'm trying to pay close attention to what my body is telling me as I go about my day so I can stop and rest before I hit the point of crashing. I'll let you know how that goes. I just recovered from a 2-day wipeout following a stint of several hours at my desk.

It sounds like you're recovering very well. The tiredness comes on because most of your energy is going to healing your knee. If you can, delay your return to work a while longer and resist the pressure you're under from others to move more -- and be patient with yourself! I know it's not easy to do that because I'm struggling with it too, as are most of us in early recovery.

I also think staying hydrated is an excellent idea.

 

[kneeper]

I'm not surprised you came home and crashed after 2 hours at work. Remember there's the getting yourself there and back to add in to the activity. I had to go in to work for about two hours at 8 weeks (just one day luckily) and I was wiped out as well. Just walking in from the parking lot and so on--then people wanted to chat when they saw me in the hall (nice-- but I had to get off my feet!) I came home and napped.

 

[Celle]

My job is very demanding, but I am being pressured to return. I went in yesterday for 2 hours , came home, took a pain med and crashed. I feel awful, like maybe I should move more. But, I cant.

That your job is very demanding is one more reason not to go back for a while yet. Can you get a medical certificate that gives you sick leave until 12 weeks post-op?

Your knee and your body need more time, so they can recovery properly. Trying to do too much, too soon, could actually slow down your recovery.

At the moment, you have very little energy because most of your energy is being directed towards healing your knee.

 

[Mumu]

I found exhaustion and fatigue to be the most vexing part of recovery. I went back to work at 9 weeks, and it was very tiring.

 

[PolarBear60]

Fatigue is a very normal part of recovery. Your body is working so hard to repair your knee as fast as it can, it pulls resources and energy from other areas to do so. This means you are going to get tired more easily. You may experience brain fog (one of the main reasons I wouldn't have wanted to go back to work so soon -- I'd have hated to make a critical mistake because my thinking process wasn't clear).

Ideally, you are able to arrange a phased return to work, and until then, you rest when you body tells you to rest, because it needs you to shut down everything else so it can take care of the very important reconstruction process.

Especially if you're trying to return to work you don't need to be doing PT on top of that. It may not feel like it, but everything you've described is very normal for where you're at right now.

 

[Pooters]

This is Pooters. I forgot to post my surgery date. Nov. 27th, 2017.

Not sure how to follow and post , but..wow, I love all the great information!

 

[Celle]

Hello again, @Pooters .
Thank you for the surgery date. I've made a signature for you.

Not sure how to follow and post

Just go down to the bottom of the page and start typing in the box where it says "Write your reply".

We do have a section where it tells you how to do lots of things - https://bonesmart.org/forum/view/how-to-use-this-forum.74/

These two article might be useful to you:
How can I find my threads and posts?
https://bonesmart.org/forum/threads/how-to-use-the-quote-feature.14729/

 

[cannygirl]

One aspect I find puzzling is that things I did at 4 weeks, which I could recover from in a short time, are now making me crash a day or two at a time at 6 weeks. Clearly, we are not in charge of our recovery; we're just along for the ride. I'm trying to pay close attention to what my body is telling me as I go about my day so I can stop and rest before I hit the point of crashing.

This makes such sense of my experience too. Things seem to be easier for a few days and then knock me out again with a drop in energy and a bit more pain. There seems no rhyme or reason to it. We just need to trust that the graph is generally upwards.

 

[sistersinhim]

This is a real rollercoaster ride. And it continues to be so for at least 6 months for most or us. Just know that it's normal. The down times will slowly become less and less and the up times longer and longer! You know, patience!

 

[Pooters]

Hello again. I am in my 8th week . My tkr was Nov. 27th, 2017. After my 7 week exhaustion post, I was hoping to feel as though I could move forward. However, the exhaustion continues and now my pain is to the point of needing scheduled maintenance, again. I feel so frustrated and depressed. PT told me to continue strengthening exercises at home. The pain is so bad sometime I can hardly bend. I feel like I am going backwards! I feel as though I have hit a wall. Anyone else feel as though they progressed and then just stopped?? What should I do? I am trying to push through this, but some days I can only lay in bed, cry and question what I am feeling! Help!

 

[Jockette]

Unfortunately I don’t have a lot of answers but I SO know how you feel!


8 weeks is so early in recovery, it seems we’ve been at it so long, but we still have a longer way to go. I was so discouraged at 8 weeks. Pain in my leg, energy drain, I cried a lot.

I would stopp doing the exercises, and anything else that hurts. Your body is not lazy, it been surgically injured and needs gentle treatment so it can heal in spite of what your therapist and surgeon tell you.

Welcome the Bonesmart where you will find a gentler approach to recovery that works!

And I love the kitty in your avatar!

 

[Pooters]

Thanks! And....I am glad to know that you cried! I cry daily.

 

[Jockette]

Oh I did, too! I didn’t even always know why I was crying, other than it was just so hard and awful and I knew recovery wouldn’t be a picnic, but still it was way worse than I ever thought it would be.

It does get better, though. But it takes a while, I’m sorry to say.

 

[Josephine]

Pooters, you will notice that I have merged your two threads together as we prefer that members in recovery only have one thread.

This is for three reasons
1. if you keep starting new threads, you miss the posts others have left you in the old threads
2. it often ends up that information is unnecessarily repeated
3. it's best if we can keep all your recovery story in one place so it's easily accessed if necessary

 

[Josephine]

I feel like I am going backwards! I feel as though I have hit a wall. What should I do?

I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?

 

[kneeper]

Hello again. I am in my 8th week . My tkr was Nov. 27th, 2017. After my 7 week exhaustion post, I was hoping to feel as though I could move forward. However, the exhaustion continues and now my pain is to the point of needing scheduled maintenance, again. I feel so frustrated and depressed. PT told me to continue strengthening exercises at home. The pain is so bad sometime I can hardly bend.

So maybe the PT is wrong and you should back off the exercises a bit. I'm guessing you're doing a lot of daily activities too--IIRC you went in to work for a few hours last week?
I actually found it most useful to not really work on strengthening until after week 12 and then very gradually.