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TKR 2 days post-op

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I hope you are right, and today was a very good day. Once I was done with PT. I was able to sit at the kitchen table for about 30 minutes and then got to go outside for another 30 minutes. It was so nice to be outside on a beautiful day with the sun shining brightly. I wouldn't have believe this last week with all the problems I had. But just reading what you guys are telling me, it gives me a lot of hope.
 
@Hopeful6592 Glad you had a better day! Almost everybody complains about how long it takes to get back your energy after TKR, you've got to remember that all your bodies energy is going to heal your knee. Make sure you are getting enough protein to eat. Your muscles need protein. Take care of yourself and don't overdo it.
 
Wow, serious set back the last 2 days. Unable to sleep more than 2 hours at night. Whenever trying to go to sleep, the whole joint feels like it is separating from the bones. Feels just like a Charlie Horse in the knee. Can't move it at all, I have to get help to straighten it out. This is really taking a toll on my nerves. Is anyone else out there feeling similar pains?
 
I'm going to ask you some questions and it would be very helpful if you would answer each one individually in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't compare this with the bone-on-bone pain you had before surgery!
[Bonesmart.org] 2 days post-op
)


2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how often are you icing your knee and for how long?

4. are you elevating your leg, how often and for how long?

5. What is your ROM - that's flexion (bend) and extension (straightness)

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. what kind of PT/exercises are you doing? How much and how often? (and detailed details would be appreciated, please! Reps, sets and session and all that)

Note:
If you're not familiar with this, it goes like so:
1 lift of a 500kg bell bar = 1 rep or repetition.
Doing 5 reps and then a brief rest = 1 set of 5.
And doing 5 sets and finishing = a session.
 
Josephine, to answer your questions,

the pain level is averaging around a 4 most of the time. Except during and after PT, then it goes up to between a 6 & 7.

Pain medication is Percocet 10 mg. I take 2 pills every 6 to 8 hours, unless I can make it a while longer. I try to stretch it out.

As far as icing goes, I do it about 12-14 hours each day. This helps with the pain considerably.

My ROM is at 83 degrees, but I can't remember what the straight leg was.

My activity level isn't what it should be, I have been so tired from not sleeping and I don't have the energy to go out, clean house or cook. I am only walking around the house and doing my exercises. I am hoping to be off of the walker by the end of next week, and maybe just use the cane when absolutely necessary.

I am doing my PT exercises several times a day, but nothing that is too much to handle. Ankle pumps, straight leg raises and the heel slides. When sitting in a chair, I also try to keep it bent as long as possible. I walk around the house with my walker, it gives me the stability that my doctor said I needed.

Each time I start an exercise, I complete 1 set of 10. I am doing these knee bends, straight leg raises, abductions, and heel slides at least 5 times per day.
 
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Hopeful, you are just a few weeks out from your surgery. You have significant pain. It is way too soon to try to cut back on your pain medications. I suggest you try going back to the maximum dose for a few days on a regular schedule and see if that helps you. Also....please don't set time schedules for yourself to be off the walker (or to do anything else, for that matter). Your knee must heal on its own timetable and you can't set goals like this.

You may want to go back to the first page of your thread and read the articles Jo posted for you from our BoneSmart library again. You'll see that you are just beginning your recovery journey. Patience is the name of the game right now.
 
Welcome to Bonesmart, I hope we can help you during your recovery.
 
I will refresh my memory with those articles. I know that I can be a very impatient person, but I also know that reading about other's experiences will help with that too.
 
the pain level is averaging around a 4 most of the time. Except during and after PT, then it goes up to between a 6 & 7.
Okay
Pain medication is Percocet 10 mg. I take 2 pills every 6 to 8 hours, unless I can make it a while longer. I try to stretch it out.
You're two weeks out. You cannot - must not - cut back on pain meds. This is why your pains scores are so high. Take it exactly as prescribed. Not managing your pain properly now can cause more pain and stiffness, difficulties with ROM and more.
As far as icing goes, I do it about 12-14 hours each day.
Well not bad but you haven't said anything about elevating. Do you elevate while you are icing?
My ROM is at 83 degrees, but I can't remember what the straight leg was.
Not good but quite possibly due to inadequate pain management.
My activity level isn't what it should be, I have been so tired from not sleeping and I don't have the energy to go out, clean house or cook. I am only walking around the house and doing my exercises. I am hoping to be off of the walker by the end of next week, and maybe just use the cane when absolutely necessary.
It 'shouldn't be' anything right now. Did you ever read the artilces I left you in post #2 of this thread? Be honest now, did you? Because in there is this article Activity progression for TKRs which defines exactly what you should be doing at 2 weeks - NOTHING!

And don't set a date to get off the walker. Time enough for that when you find yourself walking across the kitchen and forgeting it! Then you'll know! Same with the cane. No 'when absolutely necessary'. I was using a cane for about 3 months and had it nearby for two months after that. Don't set dates when to do things.
I am doing my PT exercises several times a day, but nothing that is too much to handle. I walk around the house with my walker, it gives me the stability that my doctor said I needed.

My comments in bold
When sitting in a chair, I also try to keep it bent as long as possible - not a good plan. Your knee needs a rest, in fact it needs lots of rest! So put it up (toes above hip) and let it rest.

at least 5 times per day - do them once a day
straight leg raises 1 set of 10 - for now, do 5 only, increase in week 4
knee bends 1 set of 10 - for now, do 5 only, increase in week 4
abductions 1 set of 10 - for now, do 5 only, increase in week 4

heel slides 1 set of 10 - do 5 of these every couple of hours, but don't ever cause yourself pain, slide your foot back until your knee feels tight, slide it back a about one inch more and hold it for about 10 seconds. It should never ever cause you pain.

Now please go back and read those articles.
 
I have been elevating my leg, and continue to do so. I guess I am afraid of running out of my meds again, so I have been trying to cut back whenever possible. I know this isn't a great idea, but in the 2nd week, I ran completely out and never want to run out again. I have read the articles that you sent, and completely understand why I need to rest as much as possible. However, when PT started, all therapists started me out at 1 set of 10 of each of the exercises in the first week, 2 sets of 10 in the second week, and now, just 3 weeks post op, with outpatient PT, I had to do 3 sets of 10 of all those exercises in addition to a few more. The reverse leg bend started today. Needless to say, this one was the most difficult. I have been resting since therapy, got home at 3:00 pm, and have only a couple of times done the quad press. I did discover that I have been doing this exercise without even realizing it though. I'm going to try to pay more attention to this and see if it makes a difference. I appreciate your assistance on this and I will try my best to do as instructed.
 
I had to do 3 sets of 10 of all those exercises in addition to a few more.
Actually, no you don't. Your PTs are obviously of the 'work'm hard' variety which is not a good idea. It's entirely up to you and you don't get anywhere more quickly or better by doing so much. That I can promise you. But it's all a question of consent. You are perfectly at liberty to decline to do so many sets or reps of any exercise or even to decline to do an exercise at all if it causes you pain. Your body, your choice, your consent. You don't have to make a big issue of it, just say "I'll give that one a miss if you don't mind" or "I think that's enough of that one for now, thank you" and stick to it.


1 set of 10 of each of the exercises in the first week,
2 sets of 10 in the second week
3 weeks post op in outpatient PT, 3 sets of 10 of all those exercises in addition to a few more.
In my opinion this is far too much for 3 weeks. Far too much.

And how often each day are you doing these exercises at home? If it's more than once a day, that's also too much.
Plus do make sure you take at least one, preferably two, days off each week with NO exercises at all.
 
@Hopeful6592
Those first days can be oh so painful! Don't suffer! let your doc know and get the meds you need! When I stood up the first 2 weeks, I felt pain like I had never felt. It does get better, it really does.
The mantras are so important. I can't stress that enough.
The best to you,
Post often. We are here.
~hopefaith
 
I must have had the perfect PT from what I read here.
She told me exercises like knee slides were to assist the muscles to stretch, not to force them.
I was to make sure I was stretching them, and stop before it gets from uncomfortable to pain.
To do less reps, but more often if it became an issue, but to keep working at it rather than let the exercise take over. If I pushed into pain I was warned I would suffer! Dont push into pain.!
In other words make what you do count rather than just do specific things.
 
That sounds like I could handle that. I go back to PT tomorrow and I'll see what his reaction is to that's enough of that one. I do the ankle pumps and the heel slides frequently, without pain. I just try to get the motion back. Sitting in a straight back chair and bending, I am now just holding it for 2 -3 seconds. I have read and re-read all the posts that are similar to mine, and I've had enough of this guy. There is nothing wrong with me taking a little longer than expected. After all, I'm not 20 years old anymore.
 
Quite so! Glad we've empowered you to dictate your own progress! Incidentally, ankle pumps are just circulation boosting activities and contribute nothing to your knee rehab.
 
Ok, since I am 4 weeks post op now, does anyone have any helpful advice on stopping the Charlie horses that come everyday now? I have asked the OS about it, he just said that this happens sometimes and that it should pass. This poses a serious problem because I can't sleep and wake my husband up when it happens, because I can't straighten my leg by myself. Any advice would be most appreciated. :yawn:
 
Hi there @Hopeful6592 - I had to google the term 'charlie horses' - not a familiar term in Australia :)

However, now I think it is the following..

A charley horse is a popular colloquial term in Canada and the United States of America for painful spasms or cramps in the leg muscles, typically lasting anywhere from a few seconds to about a day.

You may like to read these articles..

https://bonesmart.org/forum/threads/magnesium-is-a-star.20301/

https://bonesmart.org/forum/threads/restless-leg-syndrome.22392/
 
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