TKR Johnny’s LTKR Recovery, blood clots post op

[johnnynikon]

Hi all hope everyone is well. I’ve been reading through a lot of the threads for some time even pre surgery and decided to finally join.
I had LTKR on 9/22/21 so 3 weeks ago this past Wednesday. Recovery has been going fairly well I do light exercises per PT on my own at home and also attend the outpatient PT sessions as well.
I achieved 136 ROM at just under 3 weeks and I don’t feel like I’m pushing too hard or the PT is.
It’s not all puppies and chocolates however there are many challenges and it’s nice to be able to relate to others here going through the same. Sleeping is challenging at best. Very frustrated and actually it’s starting to become a psychological problem in that I look forward to sleep however I get anxious at the same time knowing it’s not going to go well. I find myself waking up with pain through the night as well as having to pee a lot!!
I am supposed to be having RTKR in Nov however they are trying to cancel it on me as I developed clots the day after going home from my LTKR (I was only at the hospital for an overnight before being discharged) I was scanned by vascular and after the clots were discovered they put me on Xarelto for a month to dissolve them. I’m annoyed because I have a follow up ultrasound on the 5th and my surgery isn’t until the 17th so I’m not sure why they don’t wait to see how that goes before giving my date up but I guess we’ll see.
Has anyone else here developed clots after surgery? What was the outcome ? Sorry I’m rambling but had a lot to get out.

 

[Pumpkin]

@johnnynikon
to BoneSmart!
Sorry to hear you developed blood clots after your surgery, glad that the Xarelto was able to dissolve them quickly. I updated your title adding blood clots post op, so members who had a similar experience will respond to you.
You will want to ask if they plan to keep you in the hospital a few nights to be sure you do not develop blood clots with your other knee, and what preventative measures will be taken.
Suggest that it will be better to error on the side of caution when deciding about your upcoming TKR in November.
Ask about the possibility of your having a genetic condition that may increase your risks for blood clots. We have had members in the past that had genetic conditions requiring extra precautions prior, during, and after joint replacement. They did well with surgery.

I achieved 136 ROM at just under 3 weeks

Great to hear your ROM improved quickly, everyone is different, every knee is different even on the same person. Hopefully the other knee will respond the same way.

I get anxious at the same time knowing it’s not going to go well. I find myself waking up with pain through the night as well as having to pee a lot!!

Sounds like you are under medicated, be sure you are taking pain meds as prescribed at night, including setting an alarm so you do not wake up in pain. If you are using OTC take them on the recommended schedule.

Here is your copy of the Knee Recovery Guidelines, the articles are short and will not take long to read.

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:

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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

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the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

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Activity progression for TKRs​

6. Access these pages on the website

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Oral And Intravenous Pain Medications​

Wound Closure​

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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[johnnynikon]

Thanks and yes I should have mentioned I have hemochromatosis which apparently means with the high ferritin it’s also thicker blood ?

 

[Pumpkin]

Thanks for the update, helps explain why you had blood clots.

You may want to check with your hematologist for the best way to proceed with your TKR to avoid blood clots after your surgery.

 

[Reader525]

@johnnynikon I completely understand the night dread, I felt that way too. If you haven't taken a pain pill before bed, maybe that will help.
I will say that I am a little over 3 months out from surgery and while I am definitely sleeping pretty well unmedicated, I do find lying in the same position for a period of time, such as we do when we're asleep, will wake me up in pain which is alleviated as soon as I change position. I also find using a pillow between my knees really is the best thing ever for comfort.

 

[johnnynikon]

I’m happy to report that I had a re scan of my leg the other day albeit early because I thought clot came back even tho I’m on xarelto but it turned out clear. It looks like I will be able to proceed with my RTKR on November 17th. I’m excited and nervous at the same time because as I’m sure most of you know the recovery is not easy.

 

[johnnynikon]

Well it’s been one week since my RTKR and this time around definitely way more pain than my left even taking the clots into consideration.
I’m still at 2 Oxy every 4 hours a week out where as with my left I had already dropped down to one and that was only at night. The swelling will not go down on this one and has me concerned.

I have been doing light PT 3 times a day at home where I can heel slide back to around 115-120 if i have to but was warned by home PT to not push it and they would be satisfied with at least 90 for now until the swelling goes down.
This also has me concerned because I ultimately want my right to be a s good as my left.
I guess the bottom line is here we are again with major frustration and concern and I’m praying that the outcome will be good.

 

[BBCG]

Hi @johnnynikon and welcome!

Yes: the two legs/knees are not likely to recover the same, at least for me, either! In my case #2 was far easier than #1 though, so I lucked out. I am pretty sure both will recover well: mine both have, but just at different paces and over different time periods, that’s all. Your new baby knee will get there, and it’s really best not to compare them, since #1 was so far ahead of what’s often normal amongst us kneezers!

It rather sounds like this newer knee needs a bit more TLC a bit longer, so it might be worth backing off some of the PT exercises to see if that helps this new baby one? One of mine needed lots more time for every bit of progress and the other cruised through it all like a shrug!

Hang in there! They will both heal well, but just not at the same pace I bet!