TKR TKR Mid May - Charlotte's recovery journey

Danceteach

new member
Joined
May 29, 2018
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13
Age
65
Location
Kent
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United Kingdom United Kingdom
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Hi everyone! I'm so glad to have found this forum.

I had a TKR on my right knee on the 15th May. I'm in the UK and I'm lucky to live near a specialist hospital which only does knees, hips and the occasional shoulder. The care I had there was really good and very supportive. The first few days were really difficult though - I had been warned it would be painful and my goodness it was!

I left the hospital after three days and am now at home recovering. I'm really thrilled by how quickly I'm recovering and getting about. I'm walking around the house with no sticks or crutches at all and my gait and posture is getting back to normal. It helps that I'm a dance teacher so I'm very fit and I have good balance, strength and flexibility. Also, the style and layout of my home is such that it's easy to get about without crutches (wooden floors, no steps, minimalist decor and lots of handy walls to reach out to if necessary).

I'm doing the exercises I've been given, but not quite as often as prescribed (they say three times a day but I find twice is as much as I want to do and I prefer to listen to my own body) I'm resting as much as possible and find that every afternoon I totally crash out and sleep for two hours.

The pain in the daytime is decreasing fast, but the nights! Oh the nights! My leg aches so much I can't sleep. Why is it so much worse at night than the daytime? I'm taking extra pain medication at night but I don't find it helps at all. Last night I went walkabout to try and calm the aching down - just walking round and round in circles to try and ease it up, but it didn't help.

My main worry is that I have to start working again from today :beg: It's not actual dance teaching I have to do, but I have a big show on tour around the UK and I have to do press releases and advertising for our next show at the end of June. I also mentor ten professional dancers and I have meetings with them all this month to determine their goals and development programme for the coming year. It's all sitting down stuff this month, but even so, it does take up energy and focus.

My consultant had insisted I mustn't work for at least six weeks, but of course I thought I knew better! Also when you're self employed sometimes you just don't have much option.

I honestly thought I'd be climbing the walls and be desperate to do some gentle work by now, but honestly, it takes all my energy just getting from one room to another or making a cup of tea :mcoffee: So I really regret being so gung ho before my op and arranging for work to start again so soon.

So, that's me. I'm going to take things as easily as possible. I'm glad to see that this forum is supportive to the idea of not overdoing the PT, and I'm going to speak to my assistant and let her know that I'm not as able to work as much as I had expected, so she will need to take on more of the workload. She also needs to make sure I'm protected so people don't call on me for stuff too much (a big problem with my job).

Any advice on how long the aching at night goes on for?

TIA
 
Hi @Danceteach I am 10 weeks post op and can still remember the pacing at night. Just trying to get comfortable in the first few weeks was a challenge. A good nights sleep is still evasive but I'm not pacing, early on I used to elevate and ice to get me through the night as well. Now I wake up after a few hours and take pain medication, I have a few things to fill in the next hour or so until I can get back to sleep and then have another few hours. I don't worry too much as I am lucky and can stay in bed as long as I like in the morning.

I have learnt so much off this forum the most important thing is to take your time and be gentle with yourself.
read as much as you can and ask as many questions as you need. There are some great people on here that can give you advice.

Wishing you all the best for your recovery.
 
Hi @Danceteach and :welome: to BoneSmart. You've found a community of people who have gone through, or are going through right now, the same surgery as you've just had.

You have such a good, sensible plan. Yes, going back to work is ambitious at this point. There's an article in the reading I'm giving you that talks about energy drain. You've noticed it and it's the main reason even working from home is difficult at first.

The aching at night could be due to a number of things. For me it was positional. My legs did not like to sleep normally positioned in bed! I'm a side sleeper, but the only way I could sleep comfortably and ache-free at night was on my back with my legs elevated on a foam wedge. Anything else and my knees HURT! That way I was fine. You might need to do a little experimenting with position just in case that would help.

In many cases, though, people never figure out the why. Sleep disruption and nighttime pain are frequent complaints, but both get better with time. :friends:

Here is some reading to help you with your recovery. The links lead to short, useful articles about many aspects of TKR recovery.

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
5. At week 4 and after you should follow this

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.
 
Thank you both!

@SusieShoes Thank you for all the info - it's all really useful! And as a result of reading through lots of stuff on here I've ordered myself a foam leg elevator and I'm hoping that will help.
 
Hello fellow dancer I am sure your dancing is different to mine. I only did the bear minimum exercises and spend all my time icing and elevation and cat napping.

I returned to work two weeks for half a day and week three was there for the whole day. I found walking fine but having leg down more of a challenge. I could find a place to have my leg up.

If you must go back find somewhere where you can elevate. I had several ice pack that I could strap to my leg. Your leg is the boss and it will let you know if you can do more particularly in the early days.

Good luck.
 
One little word.....ICE
I used my" ice machine" of and on all night long in the first couple of months.
SO helpful with pain..
 
@Danceteach, I’m 6 weeks post-op PKR and still have difficulties sleeping. What I find is that, as I begin to relax and am ready to fall asleep, I become much more aware of all the aches and pains and little muscle twitches that are due to nerves and other soft tissue healing. The side of my knee that was actually replaced hardly ever bothers me, it’s the opposite side where the incision is that does.

Like you, I find that getting up and walking a bit helps, but that just means it’s now 2 or 3 am before I actually fall asleep. In time it has to get better.
 
@VonnieN yay, another dancer! :egypdance:
And I can see from your reply that we’re all as bad as each other for refusing to give up work :yes: I guess it’s because we’re lucky enough to do a job that we love. But thank you, your reply makes me feel a lot better.
 
@Hopetohike tell me about this ice machine! Do you just mean that you use a lot of ice packs?

I use something called Physicool which is brilliant. It’s an elastic bandage which you soak with a liquid coolant and then wrap around your knee. You can leave it on for far longer than an ice pack (it lasts up to two hours) and the coolant effect continues for ages after you’ve taken it off.

I hadn’t considered using it at night but I’m definitely going to give it a go tonight.
 
You set it up with ice cubes or frozen water bottles. Circulates. Easy on and off. Pure bliss. Day or night!
There are many brands. This is the one I used. I'm surprised no doc, pt or anyone told you about this! Got mine on Amazon.

Ossur Cold Rush Compact System and Pads (with Knee Pad)
 
@Hopetohike tell me about this ice machine! Do you just mean that you use a lot of ice packs?

I use something called Physicool which is brilliant. It’s an elastic bandage which you soak with a liquid coolant and then wrap around your knee. You can leave it on for far longer than an ice pack (it lasts up to two hours) and the coolant effect continues for ages after you’ve taken it off.

I hadn’t considered using it at night but I’m definitely going to give it a go tonight.
I have a cryocuff machine which has an electric pump. It applies pressure as well as cold. Sometimes I use it with room temp water to have the feel of the pumping action it does.

But use whatever works for you.
 
The pain in the daytime is decreasing fast, but the nights! Oh the nights! My leg aches so much I can't sleep. Why is it so much worse at night than the daytime?
Pain at night is an indication that you are doing too much during the day. Cut back on your exercises and use ice as much as possible. I iced the whole time I was sleeping or sitting down. I had a ice water circulating machine. You load the container with ice and water. This would stay cold for at least 4 hours. I made sure that I had a cloth between the pad and my knee, as everyone should, to prevent freezer burn.
 

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