TKR 4 Weeks Post OP

[Susieqroo]

Today marks 4 weeks post op. I didn't think I would still have this much swelling and stiffness at this time. It seems that I've plateaued at week 3. My PT thinks I'm crazy and expect too much. I'm also suffering from a lot of nerve damage, I don't know if it was caused by the spinal or surgery. Surgery was on my right knee. My right baby finger and side of hand is numb. My Right calf is very sensitive to heat, when I shower, the water on my calf feels very hot, even though it's only warm. My left thigh is numb. For the first couple of days after surgery, they had me wear compression hose on both legs, and my left thigh would burn so much I had to lower the compression hose. This numbness turns into pain if I lay on that leg. My PT will not address these problems (says he will address the knee only). I see my surgeon on 10/30, if he shrugs this off again (as he did at my 2-week post-op visit) I guess I'll see my primary and get an order for additional PT or an MRI.

I'm sorry that I went through with this because it seems I'll have this swelling and stiffness forever. It's impossible for me to not do anything all day. I thought activity would help, but reading others' posts, it seems that too much activity worsens the knee. How do you know the limit? I don't think I overdo anything. The only PT exercises I do are quad locks and leg lifts a couple of times a day. I stand to cook, go up and down stairs a few times a day, I went clothes shopping over the weekend, which was a lot of standing/walking. Before surgery, I could be very active, my knee would only go out occasionally, it would be a temporary thing, not permanent like this.

One last thing. My PT told me to follow an anti-oxidant diet and not have any sugar, salt or flour; no alcohol or smoking; drink half my body weight in ounces. I was very good until this last weekend, where I had some pizza and 2 beers. I won't be able to sustain this diet forever. The only permanent changes I'll be able to make are no more lunchmeat (even low sodium) and no cottage cheese, which I loved, and no more canned soup. Other than that, I never used salt in cooking. So, I don't think the modified diet works, either.

I'd like to hear how others faced swelling and stiffness and when it finally began to subside (or not).

 

[sistersinhim]

I'm sorry that I went through with this because it seems I'll have this swelling and stiffness forever.

You aren't even 1 month out of normally a year-long recovery. All you are feeling and going through is completely normal. Please read the recovery articles that I'm leaving for you. Also, you can go to the September Team Thread and see who else has had their surgery in September. Read their threads and lots of others, too. You will find reading those will be comforting, letting you know that you are in the same boat they are.

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.

If you want to use something to assist with healing and scar management, BoneSmart recommends a 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.

KNEE RECOVERY GUIDELINES

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, and 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 the 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.

 

[Susieqroo]

I'm complaining because I've scheduled a 3 day cruise departing 12/1. My surgeon said I would be fine by then. That is 9 weeks post-op. I just don't know if that will be the case, the swelling and stiffness doesn't change, no matter what I do. I stopped using walker/cane and compression hose 2 weeks after surgery. I ice 5/day, elevate about 2 hours/day. I never had these nerve problems before surgery. Finger and thigh are constantly numb. I'll see the surgeon in 2 weeks and see what he says, then probably go to my primary. I'm not diabetic and have never taken vitamins/supplements of any kind. Blood tests are always normal. Don't know where spinal was administered on spine.

Before surgery, normal for me was walking 3 MPH for 2 or more miles at a time. Now I can barely walk 1 MPH.

Another problem I have is that my right calf is sore to the touch. It seems atrophied, too, but PT won't address that.

 

[Jockette]

I'm complaining because I've scheduled a 3 day cruise departing 12/1.

There’s a good chance you can still go on this cruise. It may not be all you originally intended, but it could be good to get away and relax for a few days. You probably won’t want to do a lot of waking, other than getting from one place to another on the ship.

I didn't think I would still have this much swelling and stiffness at this time. It seems that I've plateaued at week 3. My PT thinks I'm crazy and expect too much

You are definitely not crazy, but you are expecting too much, too soon. Swelling, even a lot, is common at this early stage of recovery, which takes an average of a full year. And it’s not really a plateau, this recovery is like a roller coaster, which has lots of ups and downs, and two steps forward and one step back.

I'm sorry that I went through with this because it seems I'll have this swelling and stiffness forever.

Almost all of us felt this way. It will get better.

Post op blues is a reality - be prepared for it

Post op blues is feeling depressed, weepy, nervy, shaky, fearful of the future, anxious, overwhelmed by what is happening to you, convinced it's never going to get any better and finally, uttering that most intense of all cries "I wish I never had this done!" It arises out of a variety of...

bonesmart.org

I'll see the surgeon in 2 weeks and see what he says, then probably go to my primary.

I do hope your surgeon will take you seriously and find answers to your symptoms.

 

[mendogal]

Today marks 4 weeks post op. I didn't think I would still have this much swelling and stiffness at this time. It seems that I've plateaued at week 3. My PT thinks I'm crazy and expect too much. I'm also suffering from a lot of nerve damage, I don't know if it was caused by the spinal or surgery. Surgery was on my right knee. My right baby finger and side of hand is numb. My Right calf is very sensitive to heat, when I shower, the water on my calf feels very hot, even though it's only warm. My left thigh is numb. For the first couple of days after surgery, they had me wear compression hose on both legs, and my left thigh would burn so much I had to lower the compression hose. This numbness turns into pain if I lay on that leg. My PT will not address these problems (says he will address the knee only). I see my surgeon on 10/30, if he shrugs this off again (as he did at my 2-week post-op visit) I guess I'll see my primary and get an order for additional PT or an MRI.

I'm sorry that I went through with this because it seems I'll have this swelling and stiffness forever. It's impossible for me to not do anything all day. I thought activity would help, but reading others' posts, it seems that too much activity worsens the knee. How do you know the limit? I don't think I overdo anything. The only PT exercises I do are quad locks and leg lifts a couple of times a day. I stand to cook, go up and down stairs a few times a day, I went clothes shopping over the weekend, which was a lot of standing/walking. Before surgery, I could be very active, my knee would only go out occasionally, it would be a temporary thing, not permanent like this.

One last thing. My PT told me to follow an anti-oxidant diet and not have any sugar, salt or flour; no alcohol or smoking; drink half my body weight in ounces. I was very good until this last weekend, where I had some pizza and 2 beers. I won't be able to sustain this diet forever. The only permanent changes I'll be able to make are no more lunchmeat (even low sodium) and no cottage cheese, which I loved, and no more canned soup. Other than that, I never used salt in cooking. So, I don't think the modified diet works, either.

I'd like to hear how others faced swelling and stiffness and when it finally began to subside (or not).

PTs are not nutritionists and have NO BUSINESS prescribing diets. Just make sure you get fluids and protein.

 

[mendogal]

I'm complaining because I've scheduled a 3 day cruise departing 12/1. My surgeon said I would be fine by then. That is 9 weeks post-op. I just don't know if that will be the case, the swelling and stiffness doesn't change, no matter what I do. I stopped using walker/cane and compression hose 2 weeks after surgery. I ice 5/day, elevate about 2 hours/day. I never had these nerve problems before surgery. Finger and thigh are constantly numb. I'll see the surgeon in 2 weeks and see what he says, then probably go to my primary. I'm not diabetic and have never taken vitamins/supplements of any kind. Blood tests are always normal. Don't know where spinal was administered on spine.

Before surgery, normal for me was walking 3 MPH for 2 or more miles at a time. Now I can barely walk 1 MPH.

Another problem I have is that my right calf is sore to the touch. It seems atrophied, too, but PT won't address that.

Finger and hand symptoms may be from awkward intra-operative positioning especially if IV was on that side; after my first TKR I had a nerve palsy affecting my right elbow to hand that lasted several weeks. I had noted this as a possibility in the preop literature I had been given. Check with your surgeon.
Also....clothes shopping at four weeks? I wasn't doing community walking that early. SLOW DOWN and let your body heal.

 

[Susie-Q]

I'm sorry that I went through with this because it seems I'll have this swelling and stiffness forever. It's impossible for me to not do anything all day. I thought activity would help, but reading others' posts, it seems that too much activity worsens the knee. How do you know the limit? I don't think I overdo anything. The only PT exercises I do are quad locks and leg lifts a couple of times a day. I stand to cook, go up and down stairs a few times a day, I went clothes shopping over the weekend, which was a lot of standing/walking. Before surgery, I could be very active, my knee would only go out occasionally, it would be a temporary thing, not permanent like this.

You are not even 1 month into a 12 month recovery and at this early healing stage of course too much activity worsens the knee. How do you know the limit? Your baby knee will tell you. Too much activity during the day will result in swelling, stiffness and pain. You have just had major carpentry work done on your knee joint and you need to give it time to heal. Please cut back on all the extra activity and yes, it's too early for clothes shopping (unless it's online). You should be icing and elevating as much as you can.

Take it easy for the next few days and let us know how your knee is doing.

 

[Layla]

it seems I'll have this swelling and stiffness forever.

You won't have the swelling forever, but it may, or may not, last for weeks, to months. My OS once shared that there can be swelling up to one year post op, most often gradually easing over time.

It's impossible for me to not do anything all day. I thought activity would help, but reading others' posts, it seems that too much activity worsens the knee. How do you know the limit?

Try using this as a rough gauge -> Activity progression for TKRs
It should help keep you comfortably mobile, without overdoing it in these early weeks.

While a healthy diet is beneficial to wellness, I am guessing it is difficult to suddenly cut out all you mentioned above. Possibly doing it gradually over time will make it easier and more sustainable.

I do hope you're able to get answers to your questions and some satisfaction out of your visit with the OS on the 30th. Your thoughts on scheduling an appointment with your Primary if your OS fails you again is a good idea.

I wish you comfort and gradual relief from the nerve related sensations you're struggling with. I'm sorry, it has to be disappointing and difficult. Take good care...we're here for you.

 

[Susieqroo]

I am now 8 weeks post-op and I still have much pain, stiffness and swelling in my knee. I wake up with a swollen knee. Minimal activity makes it swell more. Today, I went to the gym and rode a stationary bike for 15 minutes, followed by 5 minutes of stepping up and down. I went up and down 14 stairs in my house 2 times. I did 60 quad squeezes. I don't consider this a lot of activity. My knee is swollen and in pain. Tylenol extra-strength does not help. I'm very sorry I had this surgery done, I was in much better shape before the surgery than now.

 

[Jockette]

The pain and swelling in your 8 week old knee is telling you that it is, indeed, too much activity for your knee. This recovery takes an average of 52 weeks (one year) so in that light you can see how early you are in recovery.

I was in much better shape before the surgery than now.

That is true because before the surgery you didn’t have all the trauma of the surgery. Once the trauma heals, you’ll feel much better. Where you are now is not where you’ll end up.

 

[sistersinhim]

It took me about 4 months before I was better than I was before surgery, so it is a time-thing. Some feel better in a couple of months and some don't feel better for 6+ months. Not only is it a time thing, it's an individual thing.

 

[CatieViv]

You and are are along the same timeline. I had my surgery a week after you. You are definitely doing too much. Just the bike would be enough in one day. Instead of pushing through quad sets, try gentle walking. I know when I do too much, Miss Knee really lets me know.

 

[mendogal]

You're definitely a member of the Overdo It Club!!! (ODIC.... you are in good company; many of us are members in good, or not so good standing!)
My thoughts....
If you are regularly doing stairs at home, the repetitions at the gym are WAY overkill, and overstressing your tendons and muscles.
Personally I like quad sets and incorporated them into my informal home therapy on both knees... however, again, your knee is telling you you're ovdoing the reps. Try cutting back to doing 6 to 10 at a time just 2 or 3 times a day.

 

[Layla]

Happy Two Month Anniversary, Susieqroo!
I am sorry you are struggling.
I believe the pain and stiffness is a result of the activity you're engaging in. Pain Is Your Body Asking For Change.

Sadly, it doesn't matter if you don't feel it is a lot of activity, your body does and it's letting you know through pain and swelling. Wondering if you're still icing and elevating? If not, consider trying it, you might find it very beneficial.

You mentioned that you wished you didn't have your knee replaced. If you allowed your body the healing time it needs to recover, you likely wouldn't feel this way. Stepping away from some, or all, of that activity temporarily may allow the Tylenol to be more effective, OR, it may allow you to eliminate the Tylenol because the pain eases. Consider giving the excess activity a break and see if it works. Best Wishes for a good week! I hope you feel better soon.
@Susieqroo