TKR 3 weeks Post TKR

[Abro in NJ]

Today is the 7th day since I had TKR on the left knee. So glad I found this site as needed some commiseration, lol. I used the same surgeon as my sister had good results with, and will have the first follow up on Feb 16. So far it's tough, the pre PT heel slide exercises are painful. I read in another thread here this morning not to push it to the point of pain, which I had been doing. The Docs group had me put a 'mymobility' app on my phone to follow exercises , read educational blurbs, and ask questions thru, so that has been helpful.

I will turn 69 in March, a bit overweight, knee didn't bother me until about 1 1/2 years ago, about a year after I retired (Pharma sales). Was even playing tennis last summer but with knee pain slowing me down.

One of my biggest concerns is using Oxycodone. I tried to stop after day 5, but found that tough, now using 1 or 2 a day just to get thru the heel slides. They also prescribed Extra Strength Tylenol, Lyrica and Celebrex for pain, but nothing as effective as the oxycodone. Using Ice Wraps A LOT. Inside of thigh is black and blue, foot also discolored.

I am trying to get to 90 degrees on the heel slides when sitting on a hard chair, but that's a challenge, although getting close. One thing that stuck to me reading other threads here this morning was the 'no pain, no gain' fallacy. That surprised me. I'll back off a bit now after reading that. Another thing that surprised me was not to sit in a reclining chair, but to use an elevation pillow or cushion. I'll have to go on Amazon and look for a good one.

I will get an Rx for PT when I see my surgeon on Feb 16. Considering a few different places in N NJ. Kessler, Atlantic Health, Jag1, and another. Need to make a decision soon.

Anyway, on this 1 week in from the surgery, I have ups and downs with pain, and emotions. The last 2 days I only took 1 oxycodone in the morning to get the exercises started (3x a day) and thru the exercises, especially the Heel slides. By evening my feet are ice cold, the knee, thigh, and incision are aching a bit, and trying to get by on only Extra strength tylenol, and Ice, but not comfortable, although able to get to sleep. I wonder if I should be taking second Oxycodone after dinner to make the evenings more tolerable? I guess I will ask the Nurse Practioner who answers the questions on the mymobility app, but would appreciate feedback here.
Thanks for listening all, and again, love to online support group site.
PS- Here is a pic of the knee after the wrap and dressing came off on day 3. Since then, the inner thigh as turned black/blue/purple.

 

[Susie-Q]

Welcome to Bonesmart, @Abro in NJ !

One of our moderators will be along shortly to give you a list of articles that are very informative.

I would definitely check in with your Nurse Practitioner about your medication schedule. I found the pain ramped up quite a bit for me after the first few days when the nerve blocks wore off. You want to be sure you are being covered for pain. If you are in more pain at night you are probably doing too much during the day. Back off and listen to your body. I found heel slides very painful at first too. I frankly didn't really bother with them much until I healed a bit more. This is very early days for you in this year long recovery. Don't worry about trying so hard to get to 90 this early. It will come with time. It's impossible to get much ROM when your tissues are so swollen. You have plenty of time to get that ROM when things heal. Make sure to ice and elevate frequently throughout the day.

 

[Abro in NJ]

Thanks for the quick reply, Suzie. I will heed your advice about not getting to aggressive with the heel slides this early in the recovery. I thought this would be a 2-3 month process, now realizing after reading a lot more that it is a 1 year process. I'll also be messaging the NP about the pain meds schedule.

A Physical Therapist that I was talking to was saying she would speed my mobility process by having me in 'tears' with the heel slides and other exercises. After reading your post, and other threads here, i think I won't consider her for PT at this point.

I am walking about 5-10 minutes an hour now with a cane or walker. No pain there which is good, but the new joint feels so darn strange, and the incision so darn tight still. I guess all to be expected.
Thanks for listening and respoinding.

 

[Roy Gardiner]

to BoneSmart.

First, some general reading
Knee Recovery: The Guidelines

We are all different, as are the approaches to recovery. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart will offer advice and are there to help. The advice may vary, but YOU are the final judge as to the recovery approach you choose.

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

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​

6. Access these pages on the website

Oral And Intravenous Pain Medications​

Wound Care In Hospital​

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.

 

[Roy Gardiner]

A Physical Therapist that I was talking to was saying she would speed my mobility process by having me in 'tears' with the heel slides and other exercises. After reading your post, and other threads here, i think I won't consider her for PT at this point.

The BoneSmart view is that pain hinders progress. I've never had anyone credibly explain why pain might be good in healing. Healing and training are different http://bonesmart.org/forum/threads/post-operative-exercise-–-the-bonesmart-view.25463.

 

[mamallama]

Hi, Abro, I'm also in NJ. Wondering where this therapist is so I can skip her! I'm in Bergen County and will have surgery in Valley Hospital on April 6.

 

[Abro in NJ]

I'd rather not give out her name, but she is not in Bergen County. I had my surgery at Morristown Medical Center. Nurses, staff, anesthisologists all great. I was home that evening, not sure if I was sent home so quick if they needed the beds, but I was feeling ok, and the PT/OT had me up and walking about 5 hours later, although it was a quick demo.
The spinal block is a strange sensation, no pain getting it, but you have no movement at all from the waist down about a 1 minute after getting it, not even wiggling the toes. And waking up after sugery, still no movement from waist down for almost an hour, a bit disconcerting.
I'm probably going to use a Kessler outpatient facility close to my home for PT after seeing the surgeon on Feb 16, which is the first follow up appt.
Good luck to you !

 

[Susie-Q]

A Physical Therapist that I was talking to was saying she would speed my mobility process by having me in 'tears' with the heel slides and other exercises. After reading your post, and other threads here, i think I won't consider her for PT at this point.

Any PT who promises you'll be in tears while visiting them is definitely a PT NOT to go to!!!

I had a spinal too and it was weird waking up in recovery and not being able to move my toes. Speaking of tears, I was in tears about 3 hours later when the spinal wore off and the nerve catheter they had put in my thigh had slipped out of position. I was in agony! Thankfully they put a new one back in and all was well....

 

[Jockette]

but to use an elevation pillow or cushion. I'll have to go on Amazon and look for a good one.

Hi and Welcome!

Many of our members like the Lounge Doctor leg elevator:

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If you prefer to get one from Amazon, please consider going through Amazon Smile.

If you choose to make any purchases through Amazon (not just this item, but anything you buy), sign up for the smile.amazon program. This allows you to have Amazon donate a small portion of your purchase to BoneSmart. You pay nothing extra! You get products you want and we get help to keep BoneSmart up and running. Here is a link to smile.Amazon:

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Any funds go directly to BoneSmart through them and you are allowed to take a tax donation deduction.

Thanks for your support of Bonesmart!

Here is our article about elevating, take a look at it, as the position of your leg is important, and not all elevation wedges/pillows are created equal.

Elevation: Doing It the Right Way

Updated September 11, 2022 by Jamie Proper elevation is one of the best ways to help with pain and swelling following either hip or knee surgery. Many people elevate improperly, which can dramatically lower the effectiveness. In the weeks following your surgery, make sure you elevate your...

bonesmart.org

I agree to stay away from that PT who promises pain, even if she was kidding. There is no reason to do a rehab that increases the pain you already have. Some of our members have done their own rehab at home, and some have not even done formal exercises, they have let the activities of their daily life be their exercises. (I call that “natural PT.”)

Best wishes to you, stick with us, we‘ll help you through this recovery.

 

[Jockette]

I am walking about 5-10 minutes an hour now with a cane or walker. No pain there which is good, but the new joint feels so darn strange, and the incision so darn tight still. I guess all to be expected.

Actually, this is excellent, and all the “PT” your brand new knee needs, this early in recovery.

Stiffness/Tightness is a normal occurrence after this kind of major surgery. Your surgeon did major carpentry work and disturbed every millimeter of soft tissue in this area. You aren't tight because your muscle is underused and needs to be stretched and rehabbed. You're tight because your tissue is healing...and full healing takes a full year or more.

 

[hawk2go]

Hey @Abro in NJ (I have to admit to my goofiness in pronouncing that name - abro, like after, instead of A Bro - hahaha). Anywho, welcome to this side of the surgery! Was your LTKR on Feb 1st?

That's a great list of articles to give you the real deal on this recovery. You are now armed (or legged) with good info. At one week, I was still a-crying and a-moaning, wondering why in the heck I'd done this to myself. I had a significant turn at about 3 weeks and more recently at about 4 months. I am able to do most of what I want without much pain and have been off meds for several weeks. With that said, I recently recovered from overdoing it just last week on this baby knee. It's a rollercoaster.

Meds are tricky because so many services are restricting the narcotics that give the most relief. Staying ahead of the pain by keeping to a strict medication schedule will keep you from having to chase the pain after the fact. Take 'em if you got 'em. It is much harder to calm the high pain levels than it is to just keep them at bay. You can work with your surgeon or your GP if you need more meds later. I set alarms on my phone, others have their caretakers keep the schedule some folks write down what they 've taken. Whatever works for you - take it easy, be kind to yourself, stay on your meds schedule, ice as often as is comfortable, and sleep when you can. You got this and we're rooting for you!

 

[PegGar16]

Hi @Abro in NJ ! I think I am a week ahead of you. Those heel slides are the worst!! My first week I spent controlling the pain and swelling. I did a few exercises with the PT but nothing major. They were the best at giving the deep massages to my thigh. The bruising and swelling was awful. Things are mellowing out for me this week.

 

[Golfer1]

Hi @Abro in NJ -
While shopping for a wedge to elevate my leg prior to surgery, I discovered there are SO many options available, but most have a major bend at the knee. I know how important it is to keep the leg straight after surgery while resting, so I was able to quickly rule out most of the wedges available. There were a lot of positive reviews on the Rolyan from TKA patients. That is what sold me, and I have not been disappointed.

It has a trough where are your leg goes. It nicely cradles a refreezable clay (I think?) pack. When I ice, I put the clay pack under my knee and then strap on my knee wrap (which covers the top and sides of my knee), plug it into my ice machine and get a nice “frozen” knee all the way around. Then I get to just lay there and read for 45 minutes.

I recommend you check it out on Amazon. FYI, I also have a lounge doctor and it is not nearly as comfortable as the Rolyan wedge, in my opinion. Also, the Rolyan is MUCH less expensive!

 

[Abro in NJ]

Thanks for the good vibes, Hawk. Abro are the first 4 letters of my last name but I do like it looks like 'A Bro'. lo. Some of my friends call me 'Bro', and I like that too.

I hear you on staying ahead of the pain. With Extra Strength Tylenol, and other non opiods I do stay ahead. Just trying to wean off of the Oxycodone now, and finding that 1 a day not quite enough, that 2x , once at 8am, then at 7 pm is good for comfort, exercising and sleeping. It sounds like from the Nurse at my surgeons office that IF i need a refill they will refill no problem, I am just hoping I don't need the refill.

It's funny the knees never bothered me until about 8 months after retiring in early 2019. Probably sitting around too much, not being active wasn't a good thing those old knees lol.

I played football and baseball for 8 years each, never had a single knee injury. Guess father time and genetics (dad and sister had knee replacements), as well as gaining weight after retirement did not help at all.

 

[hawk2go]

Sounds like you've lived a life @Abro in NJ. I have to admit that I stretched my Oxy script out way beyond the 5 days prescribed with my RTKR. At around 3 weeks I found that a single Oxy when I woke in the middle of the night with pain was what I needed. At my 1 month surgical checkup, the OS prescribed 15 pills to cover me for 15 days. Definitely do what works for you.

 

[Jockette]

Please post your surgery date so we can make a signature for you.

 

[Abro in NJ]

As I wrote in my first post, the surgery was Feb.1, 2022, 9 days ago!
TY.

 

[Abro in NJ]

Sounds like you've lived a life @Abro in NJ. I have to admit that I stretched my Oxy script out way beyond the 5 days prescribed with my RTKR. At around 3 weeks I found that a single Oxy when I woke in the middle of the night with pain was what I needed. At my 1 month surgical checkup, the OS prescribed 15 pills to cover me for 15 days. Definitely do what works for you.

Good to hear ! The NP in the Surgeons office said to call a few days before I need a refill, so guess it won't be a problem. I have about 15 left, and see the doctor next Thur or Fri. Feeling better this morning knee wise, so hopefully I can stop the Oxy altogether in the next day or 2. We shall see.

 

[Abro in NJ]

Thank you. 10 Days post Op now. Slow, but steady progress. Have cut down on the Oxycodone to 1 or 2 a day, feel I will be able to stop soon and still do some exercises and sleep ok. Using the cane or walker with no problem now, do about 10 minutes an hour of walking inside the house. The Heel slides continue to be painful, but taking them easy now after reading the falllacy of 'no pain, no gain'. I enjoy this site for the forum discussions, as well as the articles.
I also am on a Facebook group for Total Knee Replacement and Recovery Group, but that group is huge, with discussions all over the place. Sort of the Wild West of Knee Replacement and Recovery sites, lol.

 

[ski_bum]

@Abro in NJ
Is this the black & blue you refer to?
It's from being clamped down during surgery I was told.
I will try a personal message to you.