TKR Mouser's recovery

[Jockette]

My Rom needs a little help on bending. It is only at 80

Still some swelling which I think is the problem with flexing the knee.

Swelling is definitely the factor, but it is not a problem. It is way to early to worry about ROM. When the swelling goes down, and as you heal, your ROM will improve. Healing will continue well past a whole year. There is no number you need by any particular date.

Myth busting: "window of opportunity" in TKR

This "six week window of opportunity" surgeons often speak about is little more than a myth. It presupposes that all patients have the ability to create adhesions which is far from the truth. It also ignores the simple fact that in the first 3-4 weeks after surgery, swelling reactive to the...

bonesmart.org

 

[Mouser]

Had a strange thing happen during the night. Got up for a bathroom run. Once I got back in bed my knee started throbbing. I had to take 2 oxcycodone and ice to settle it down. It is amazing that the pain can go from 0 to 9 in a matter of minutes. Pain is fine this morning so I believe when I was sleeping my leg was in an awkward position.
Thank you all for your support and wisdom. This place helps so much.

 

[benne68]

Hi @Mouser. Are you taking your pain meds at regular intervals? It's really important to stay on schedule so you keep ahead of the pain. Once the pain starts, it takes much longer to get in under control.

What worked for me was taking 500 mg Tylenol (acetaminophen) every six hours (4 times a day). Be careful that none of your other medications contain acetaminophen -- you should not exceed 4000 mgs/day. I set an alarm to be sure I took them on schedule.

Here is a link to the pain management chart that may be helpful. https://bonesmart.org/forum/threads...ing-pain-after-a-tkr-and-the-pain-chart.7969/

 

[Flashlight]

Hi Mouser, I had my left knee done on 8/15 and had my staples out last Thursday. I still can't tolerate lying in bed and elevating my leg. I'm still trying to sleep in the recliner. I just ordered a wedge to see if that will help get the swelling down more. I was surprised to learn I am at 90, but still having some issues with straightening. The online therapist gave me more stretching exercises to do. I had a hard time at first but now I am getting better at it. You are dealing with the pain better than me. I just started with taking 600mg of ibuprofen every 6 hours along with a dilaudid. I try to walk every hour around the house, heel first, not to feel so stiff. I'm going to ask if I can try the bike. My doctor wouldn't order anything for the nerve/muscle spasms. I take a magnesium at night which also helps with constipation and b-complex during the day. Last week I was tearful. My doctor said at the 6 weeks mark I won't hate him so much. Looking forward to that! Just getting outside for a few minutes really helps. I ordered old fashion jellies from Amazon to slip on. The best of luck to you. We can do this!

 

[Mouser]

Thanks @benne68 I have been taking the tylenol every 6 hours. I had backed off the oxcycodone because my pain had improved. I have been taking 1 oxcycodone every 6 hours. I usually need one in the middle of the night before the pain gets bad. So you maybe right and I just missed the opportunity to get it before it escalated.

Hey @Flashlight seems like we are opposite. I can lift my leg and straighten it out to 0 but having a tough time with bending it. I have been able to lie in bed without an issue. First week it was uncomfortable to prop up on pillows but that has gotten better now. I have been up walking around every hour. I also fix my meals. I still have steri strips on my incision which will fall off on there own. My doctor gave me the ok to ride my exercise bike gently. I have a couple of times very gently going back and forth. Will be a while before a full rotation but I am fine with that. Yes, we have this. Take care.

 

[Mouser]

Just curious how long others were on pain meds. I don't seem to need them as much and usually just one ocxycodone takes care of the pain. I can go any where from 5-8 hours without needing the med. My latest refill the total amount of meds was decreased. Just worried if I get cut off from meds to soon. Thanks everyone

 

[benne68]

curious how long others were on pain meds

When I reached 4 weeks, my OS wouldn't do another refill, so I started to wean myself off the Oxy.
I had a couple of tough nights without it, but found that as long as I keep on schedule with the Tylenol, my pain was pretty well managed. I saved a few Oxys for days/nights when the Tylenol didn't cut it -- like when I overdid it!

 

[InkedMarie]

Just curious how long others were on pain meds. I don't seem to need them as much and usually just one ocxycodone takes care of the pain. I can go any where from 5-8 hours without needing the med. My latest refill the total amount of meds was decreased. Just worried if I get cut off from meds to soon. Thanks everyone

I had no pain with either knee, hips either. I took them for four or five days, mostly at bedtime, for “just in case”.

Marie

 

[sistersinhim]

Your knee should be your guide on when to get off the pain meds. Some need them longer than others. Some can get off them sooner. It just depends on the person, their activity and their pain level.

 

[Mouser]

Thanks everyone. Guess I should just not worry yet as I am at week 3 and see the doc again in a couple of weeks. I am sure we all panic a bit when it comes time to wean off the pain pills-oxcy. Hopefully when I see the doc I won't need anymore.

 

[Jaycey]

@Mouser - here is a bit of information on reducing your medication gradually.

You can do one of two things to begin reducing the amount of drug you are taking:

1. Begin spreading out the times when you take the drug. If you are currently taking it every 4 hours, for a couple of days make it every 5 hours, then 6 for a few days and so forth until you reduce to one pill a day (usually at bedtime, cuz that's when we seem to need the pain relief most). Then at that point, you can start taking half a pill for a while and then no pill. At that point (no pill), you would take them only periodically when you have pain that over-the-counter medication won't take care of.

2. You can stay on the same schedule (like every 4 hours) and cut back on the amount of the narcotic with each dose. That can be done by asking your doctor for a lower-strength medicine or by cutting pills in half. Only reduce the amount by 1/2 pill at a time if you are staying on the same schedule - not a whole pill. Then when you get to the point that you're taking a half pill at each dose time (that's about as small a dose as you can get), start spreading out the time between doses. This approach works if you need the pain medicine during the day for PT appointments or other activity where over-the-counter meds won't work.

As you're cutting back, expect that you may have to use NSAIDS to fill in the gaps for pain.... Aleve (Naproxen), Advil (Ibuprofen), Motrin or try Tylenol (Paracetamol).

Just be sure you don't try to cut back too fast. You'll feel it if you do and will need to make adjustments accordingly to slow the taper. The whole process can take several weeks, so be patient and make sure you are stable for a day or so at each level before you make another reduction.

Or....you can contact your doctor and ask what schedule THEY prefer you do. But I believe a person will do just as well taking care of this yourself. Only YOU know how you feel at any given time. You want to cut back just enough so the over-the-counter meds work and not so much that you get those flu-like symptoms or have pain.

 

[Mouser]

Thank you @Jaycey are really good tips. I have already spread out when i take the oxcy.

 

[Mouser]

It is hard to believe it will be 4 weeks on Thursday since my surgery. Big improvements occurred last week including pain has subsided again so 1 pain med in the day and 1 at night along with tylenol, my flexion went from 80 degrees to 94, walking with a cane, and sleeping better at night. I think the sleeping is really helping my mental state so much. I finally feel rested after waking up. I usually get a couple rounds of 3-4 hours a night which is wonderful.

Also want to give a recognition to my awesome PT team. I had a day last week that I was a little down. They listened and offered advice to make me feel so much better. I feel like we are a team working towards the same goal to get my knee better. I am honored to have such a great team.

For all of you just starting this journey, it will get better. The first two weeks are so difficult but once you get past them you will see a big difference. Hang in there and happy healing to all.

 

[benne68]

Thanks for the great update, @Mouser. I'm sure it will help ease the anxiety of member who are just having their surgeries.

Wishing your recovery continues to go smoothly.

 

[Mouser]

Had my first test with the new knee this weekend. Went to a get together last night then a picnic today. Walked quite a bit today. The knee held up very well no swelling just a little more pain after I got home today. I am very excited since it is so early in my recovery. I realize, I still need to take it slow. It was just so nice to be with people.

I have 2 questions. First, I had my incision glue then steri strips. The doc told me they would fall off on there own. It is 4 weeks post op, can I take so.e off where there is no scabs?

Second, this is rather funny one. Has anyone else named their knee replacement? One day for some reason I called it Ronnie and it stuck.

 

[Mouser]

So here we are in week 5. ROM is at 110-0 keeps improving every week. Had PA remove my steri strips yesterday. Crazy thing is I have had more pain in my knee since. Can really notice the spits that ate numb. Only taking oxcy at night and tylenol during the day. Finding it a little difficult to just take it easy as I start to feel better. Still exhausted if I try to go the the store. Also find myself sweating up a storm if I exert a little.

Hope you all are doing well. Happy healing.

 

[Mouser]

Will be 6 weeks post op on Thursday. Saw the doc today and he is thrilled at my progress. He thinks all the exercises and riding my stationary bike really helped make my recovery better. His assistant says my knee looks like a 3-6 month pre op not 5 1/2 weeks. I have some clicking in the back of my knee but the doc thought it was just swelling. They put me on meloxicam for the swelling a discomfort.


Milestones so far:
1. flexion is now 115 extension at 0 (0 from 1st day post op)
2. Now able to do full rotations both forward/backward on stationary bike
3. Walking 10 minutes outside weather permitting
4. Haven't taken pain meds in a few nights. Last night was a tough on though
5. Walking with a cane. In house, not using anything.

I know I am one of the lucky ones to have a great outcome so soon. Even though I am doing so well, I know I am early in recovery so I need to take it easy. I do my exercises once a day and ride my bike for 6 minutes. I am still afraid to push it so if I got out always ice when I get home.

I just want to send good vibes to all who are struggling with your recovery. Keep pushing through and never give up. You will see a huge difference once your swelling goes down. Also if you can ride a stationary bike please do so. It has made such an improvement in my Rom. Happy healing to all!

 

[Mouser]

At the 7 week mark as I write this. What a difference a couple of weeks make. My Rom is now 0-120. Sleeping is so much better now. I have even managed a couple of nights this week with 8 hours. Walking about 10 minutes or more depending on if I go to a store. Riding my exercise bike 7 minutes. PT going well with new exercises introduced this week. Have some stiffness and discomfort in my knee but not really pain unless I over do it. My swelling has gone down quite a bit now. Have a few more weeks of PT left. All in all, this was definitely a good decision for me to have this surgery done. My knee is moving smoothly and farther than before the surgery. Pain before the surgery is non existing now. I believe it is important to report on a good outcome as well.

Sending good vibes to all that are having a difficult time during your recovery. Keep plugging away but don't do too much. Happy healing to all!

 

[benne68]

Thanks for sharing your update, @Mouser. Sounds like you are doing very well.

 

[Mouser]

The last couple of PT visits they have added some new exercises. My knee is visibly swollen again. It seems more stiff as well. I only have a couple more weeks of PT. Should I tell them I need to back off a bit? Not sure if this is normal when adding new exercises. Thanks