TKR 12/5 Surgery

[Angelfromak]

Hi its Angel
Since I got terribly sick from my hip surgery in May, I was first case this morning. I didn't get sick this time !
I tried carb loading the night before. I also tried drinking gator aide the day before with sugar. Some doctors are trying that out to help with getting sick po.
My anesthesia doctor also said my bp dropped and he gave me meds to have it higher. I can't tell you what worked but night and day difference.
Home by 1230.
I did my home pt already, walked every hour and using my ice machine. I know tomorrow I will hurt more. I already dod a schedule for meds. I am trying Dilaudid and tramadol.
Thanks for tbe read

 

[mendogal]

Oh YAY for a smoother start!!!!

Here's your "refresher course." I want to start by reminding you that in the initial weeks, to quote my ortho team, Less Is Better. Hourly short walk, some ankle movements for reducing the risk of clots, some quad sets now and then to help the quads wake up.

I just did the ankles and the quad sets while icing and elevating.

Welcome to BoneSmart! You are in the very early stages of an average of a yearlong recovery. I will leave you our Recovery Articles that have helped tens of thousands of other knee replacements. We are here to help you through this journey the best we can. The very best thing for your knee right now is to rest, ice, and elevate. Exercises can come later. There is no rush to achieve ROM because it will come naturally as your swelling decreases. Your OS was able to bend your knee while checking for movements during your surgery, so it will be fine. It just takes time.

Each person is different as is their recovery. Most find that the Bonesmart approach works best for them, but others find that a more aggressive therapy helps them more. It's your recovery and your choice on how you recover. As you read more on other members' recovery threads, you’ll get a better perspective of what to expect. The following are our basic guidelines and should help get you started.

KNEE RECOVERY 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.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

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.

 

[Angelfromak]

Thanks for the reminders
I did ankle pumps, elevate, ice and also having my leg on a chair straight for 5 minutes, like a quad set. He said they would rather me the first few days work on that more than flex. I did do 1 set of heel slides too!
I'm surprised I'm still awake lol. Leg elevated with ice in a recliner watching football.

 

[Angelfromak]

Checking in ! I just got a box of collagen dressing to use from my doctor. Supposed to help with healing.
Day three today. I do hurt but staying on top of meds. It's a dull pain.Using ice and I just bought a elevate pillow from amazon.
I just walked to get my mail with my cane..I feel good to do even 1 normal thing. Emptied dishwasher too.
Angel

 

[Layla]

Go s-l-o-w, dear Angel. I'd hate to see you land in the ODIC (Over Did It Club)
You're an ambitious one, I don't think I would have unloaded the dishwasher two days after surgery...even if I felt I could, lol.

Good that you are icing and elevating! All you really need to be doing this early on is -
Week 1
Walks around your home - trips to the bathroom and kitchen to get a snack normally cover this.
Be up on your feet several times a day, as you need to. A 5-6 minute walk every 3-4 hours is plenty
Spend most of your time resting and elevating

Week 2
Add this to the instructions from Week 1
Start on a plan of walks around the house 3-4 times a day for about 5 minutes, but don't push through too much pain, or wear yourself out. Stop before you reach that point.

I hope you sleep well tonight and have a good day tomorrow.
@Angelfromak

 

[Angelfromak]

I really felt fine with the dishwasher. Small kitchen cabinets above it lol.
I know how to take it easy but it's good for my mental health to try a bit of normal
I have been falling asleep all day. I slept pretty good last night too.
Thanks and I will try to not overdo it

 

[ingsurfs]

Hi Angel,
I identify with you feeling sick after surgery. My sickness, like being poisoned, lasted for 10 days; was unbearable. Turns out to be a sensitivity to the opiates they give which contain codeine. Thus, I've learned to take Mirlax each day, and change to Tramadol which doesn't make me sick.

What's fascinating is that these opiates actually activate the chemoreceptors in the brain and for some people, I believe, it signals being poisoned. I experienced this when receiving chemotherapy. Thus, it's really the last thing we want after traumatic surgery, to be throwing up, nauseous and not eating.

Best,
Ingrid

 

[Angelfromak]

This is my 3 week update. I have thought about not posting but feel that others should know it's your journey not others. This is what works for me. YMMV (your mileage may vary)
I used walker for 2 days then just cane when I left the house.
Started pt on day 4. My pt ( who recovered my hip in May) I trust.
Uncomfortable but not to tears. They have a machine you hand crank up and down for flex and extension. You determine not anyone else.
My day 5 and 6 were the worst so I canceled my Weds and just did Monday and Friday. By Friday ( day 8 ) I was able to bike all the way around.
The next week I did my 3 days plus my home exercises. Again uncomfortable but not to tears. I pushed myself as much as they pushed me .
This week and next week just 2 days a week due to holidays.
Yes,I was sore the day after pt. Yes, still had trouble sleeping. Getting better with sleep.
I was 120 on Friday and 1. Still need to work on being straight.
Did leg press on Friday at pt. I think it's 10bs or even less. I had no issues. I can also do down steps like a normal person.

I think it's important to trust and check out your surgeon.
I think it's important to pre rehab the best you can before.
I think it's important to really trust your pt.
I think it's important to eat enough protein not just before but after.

This doesn't mean I don't hurt. I still ice, elevate and take pain meds before pt. I was totally exhausted the day after Christmas. I am still cold. I still wake up during the night. I know I can still hurt if I do too much. I went back to work remotely the next day. I am a 1099 and need to work.
This is not a post to make anyone feel bad. Everyone will get there in their own time. It is a post to remind people that some do recover faster. That isn't bad either.

 

[Layla]

Angelfromak,
Thanks for the account of your recovery to date. Although we advise against comparing ourselves to others, we still do. It's difficult not to. We like to read how others are doing and we encourage sharing progress on the forum. While healing, I enjoyed reading of others progress so I could roughly gauge when I may be doing this, or that. So thanks again for sharing your update!

Each recovery is unique due to current health, pre-existing medical conditions, severity of damage pre-op, age, extent of surgery...to name a few. I believe our mindset factors in also and trying to keep a positive attitude over feeling anxious or depressed will enhance our recovery. You're doing very well, Angel!

Wishing you the best as you continue healing and many blessings in the New Year!
@Angelfromak

 

[Angelfromak]

Thanks. I did think before posting as I am doing things differently than Bonesmart.
My recovery is not perfect for sure, but I feel like sometimes there is just as much shame on those who push themselves as those who don't.
We all have our own journey. This way works for me.

 

[mendogal]

Good update @Angelfromak !

I do generally caution against leg presses at 3 weeks, even 5 or 10 pounds, as it takes muscles 6 weeks to heal; tendons take 12 weeks. It's so easy to overstress them.

A lot of American PTs think that once our range of motion is really good, which yours is, the next phase is strengthening. My opinion, coming from both experiencing and watching lots of martial arts injuries, is we have to respect the natural cellular level physiology of healing.

That's my two cents, and I promise not to stay on a soapbox about it. Frankly, I have been on the more active side of the post op spectrum myself, though deferring strength training other than daily life for a longer period (I did things like semi squats to do cat litter scooping or light garden tasks).

Yes, we have had members rehab more actively and yes, many have turned out just fine with no setbacks. And for our younger or more athletic members it's important to read of such successes!

So I encourage you to keep posting progress updates. Best wishes for the new year!!!!

 

[Angelfromak]

Thanks! I definitely will watch the leg press. All of my pt exercises are 3 minutes but the bike. So far so good for today.
I agree it has to do with many variables. I'm almost 63 and was bow legged due to bone spurs and damage. The first thing I noticed after surgery was straighter leg lol.
Not a hiker biker or runner, but did spend this summer working on stronger legs at the gym.
Happy New Year to my knee and hip warriors!

 

[Layla]

Happy One Month Anniversary, Angel!
Happy New Year too. I hope 2025 is one of your best!
@Angelfromak

 

[Angelfromak]

Thanks!. Still doing well, extension 124 but a stubborn 2 on straighting. Actually went to gym today first time. Just 15 minutes on bike but so happy to be back.
Not driving, not because I can't but I kinda like dh driving me lol

 

[mendogal]

124 is flexion! Extension is straightening. It's not at all unusual for it to take a couple of months.

We advise against driving before six weeks (and both fully of opiate meds and cleared by your surgeon) as if there's a need for sudden braking or maneuvering it could injure your healing knee.

 

[benne68]

@Angelfromak Having a flexion of more than 120 at only one month post-surgery is fabulous! And, extension of 2 at this stage is also very good. As mendogal said above extension does tend to take longer than flexion.

You are doing really well for so early in recovery. But be careful not to try to do too much too soon, because you can set back your recovery. Keep in mind that your soft tissues have not yet healed from the trauma of surgery. It takes muscles about 6 weeks to heal and bones, ligaments and tendons need 10-12 weeks. So it's best to avoid any weight training until then. The bike is fine as long as you don't add any tension this early.
Wishing you a continued smooth recovery.

 

[Layla]

Great progress! It sounds like you're enjoying having someone else take the wheel for now, so don't rush it.
You can use the time to strengthen and recover while DH chauffeurs you. Nice company too!
Thanks for the update, Angel, stay in touch!
@Angelfromak