TKR Adg11 Recovery Journey

[adg11]

Thank you. It went very well. My surgeon was able to replace the knee, straighten my leg and realign my kneecap. My anxiety caused my blood pressure to spike in the pre-op area but the anesthesiologist was able to manage it, even bring it down somewhat before surgery started by his calming presence and comforting words. The exercises I did before surgery allowed me to do things like raise my leg onto the bed without support and bend my knee to almost 90 degrees within a day of surgery. The pain comes and goes and I was prescribe oxycontin for severe pain, which I limit to using right before bed. Ice seems to be the best help to manage any pain not controlled by Tylenol. I have been able to sleep on either side since a day or two after surgery. I stayed with family for the first 10 days and returned home Saturday. My pet sitter has been helping with my kitties for a few more days. I have been able to manage without the walker as long as I am next to counters and I see improvement daily. The pain is no fun of course, but I am hopeful that that will shift soon. My 2-week follow up with my surgeon is on Thursday.

 

[Jockette]

@adg11 Welcome to Recovery!

I moved your update to the Recovery Forum, since your surgery is done. It sounds like things are going pretty well.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Knee Recovery: The 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
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 to these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[Layla]

Welcome to the healing side and congrats on your new knee! It sounds like you’re off to a good start with all of the positives you shared. It’s nice you were able to spend the first ten days in the care of loved ones. I’ll bet you’ve established a comfortable routine
at home already also.
Best Wishes for your appointment on Thursday…let us know how it goes.
@adg11

 

[Susie-Q]

Welcome @adg11 !

Congratulations on your new knee! You are in the very early stages so rest, icing and elevating are your best activities. Keep on top of your pain meds so you don't have to play catch-up. You are lucky you can sleep on your side, that took a long time for me to be able to do, months!

Good luck at your appointment this week and let us know how it goes.

 

[adg11]

Thanks so much. My 2-week follow-up appointment went very well. The surgeon had used staples so that was a uncomfortable to have some of those pulled but it didn't take him more than a few minutes. He was pleased with the way my incision is healing and I was able to bend my knee to at least 90 degrees. I see him again in 4 weeks. I was told I could switch from meloxicam to Motrin at this point. And I asked about tramadol to replace the oxycontin but it's the weekend so I expect I'll get a response in my online portal on Monday. So far I take the smallest dose just at bedtime, as the pain gets worse in the evenings. With icing, elevation and Tylenol, the pain is manageable during the day. I am back to taking care of my 5 kitties by spacing out their care throughout the day. I definitely rest a lot during the day because of the fatigue. Knee swelling is noticeably less but definitely still there. I am now able to walk without the walker as long as I am near counters and furniture. Certain PT exercises are definitely challenging, especially those targeted to the back of the knees. I would like to get off the oxycontin as soon as I can but I still seem to need that support for sleeping without pain. How long are people typically on the narcotic. I am about 2 and a half weeks post surgery.

 

[Jockette]

There really isn’t an answer as to when people don‘t need the prescription pain medication, because we are all different. And these days, I’m sure there are quite a few who need them but current protocols don’t allow them to stay on it.

I stopped mine a few days before 2 weeks, but that was because I was having vision problems and my doctor, and I, thought it could be the medication. (It wasn’t, my vision never returned to normal, so I had to get new glasses.) I never got a lot of pain relief from it, anyway.

I switched to extra strength Tylenol, and ibuprofen. I took each medication 6 hours apart, but staggered, so I took one or the other every 3 hours.

Certain PT exercises are definitely challenging, especially those targeted to the back of the knees.

Don’t do these at this point if they are causing you to need strong medication at night. There is no need to do any exercise that causes pain, either at the time you do it, or later on.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.

 

[JojoFitness]

How long are people typically on the narcotic. I am about 2 and a half weeks post surgery.

Sounds like you're doing great! You hit on what was hardest for me to understand - medication and how and when to stop. But we are ALL DIFFERENT. I slowly weaned off Oxycontin, and at three-1/2 weeks I stopped them completely and did just fine. I went to just Tylenol and Advil. I'm coming up on seven weeks in a few days, and my surgeon and therapist are all thumbs up. But I sure didn't expect to stay on opioids that long! Do what is best for you.

 

[adg11]

Jockette & JoJoFitness. Thanks for replies. I have one home physical therapist who pushes me too much and I have adjusted how I respond to what she asks of me. The others are very aware not to push too hard and conscious of the need to move gently. I think some of the issue is also from surrounding muscles that are tight. I tried massaging gently upper thigh muscles last night and could feel knots there. I dropped right off to sleep after that. I walk frequently and focus my energies on that. As to the meds, that's helpful to know that being on the opioids for a bit longer is ok. I did switch out the meloxicam for Motrin and I already feel better and less foggy. I like the idea of alternating Tylenol and Motrin. I took them close together this morning but will switch to alternating every 3 hours.

 

[Susie-Q]

I started weaning myself off the oxy at around 3 weeks and it took about a week to go from every 4 hours, then every 6 hours, then twice a day and finally none. I continued the alternating Tylenol and Advil every 3 hours for at least a month or two after that.

If you're having intestinal troubles with the oxy, I highly recommend Smooth Move tea by Traditional Medicinals. You can find it at your local grocery store.

Yes, make sure you tell your home physical therapist that you are in charge of your recovery, not her!!

 

[Jockette]

I think some of the issue is also from surrounding muscles that are tight.

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.

 

[adg11]

Thanks, Jockette. Since they not only did a total knee replacement but also had to reset my kneecap, it was a more intense surgery than is typically done. Applying heat to the muscles away from the knee has helped as has some targeted gentle massage.

 

[adg11]

Thanks, Susie-Q. It's helpful to hear about your experience getting off oxycontin. My doctor has prescribed tramadol to try instead. The pain is much less today so I'm hoping that I will be able to taper off the oxycontin and not need to go onto the tramadol at all, but I want to have it on hand in case of a flare-up.

 

[adg11]

I am now 4 weeks post surgery. I am doing well overall (mobility, range of motion, pain minimal today). I did notice that the area around the knee is redder than I remember though there is no swelling, it's only mildly warm, and it does not hurt. I do have anxiety and so I worry probably more than I need to. Any suggestions on how to monitor this and lessen my anxiety as well.

 

[sistersinhim]

You can always call your doctor and ask. But, I think as long as it's not having increased pain and swelling and not hot to the touch you are probably fine.

 

[adg11]

Thanks @sistersinhim. I will watch it for a day or 2 and contact him if things change.

 

[sistersinhim]

That's a good idea.

 

[adg11]

My cat just ran over my leg and hit the calf of my surgical leg with one of his claws. It bled for less than a minute. I cleaned it thoroughly with Dial soap, rinsed for a minute, put antibiotic cream on it and a bandaid. I did send a message through the doctor's portal but they don't check those on the weekend. I am really anxious about this. Please help - words of comfort would be greatly appreciated.

 

[Jockette]

I would think you’ve done all you could for it, good job! Watch it, and try to relax, while you wait for an answer.

It might be a good idea to make a phone call, there must be someone on call over the weekend at your surgeon‘s office, just to be sure.

 

[adg11]

Thanks @Jockette. I can't find any number for the surgeon but I have left a message for the nurse on call with the health care office that helps with home health support post surgery. I have not yet heard back from them. I am trying to be patient and calm but my anxiety has definitely been triggered. Thanks for the supportive words.

 

[MaryCat]

adg11–

We have a few things in common for our recovery. We have two kitties and they insisted on helping me. And they scratched me a couple of times while I was recovering. I think you did all the right things tho, should be fine. They did help me sleep tho during the day. If I stared at them when they were sleepy then I got a good nap.

Sounds like you’re lucky tho if you have a little heat in your knee and not a lot of swelling. I had heat and swelling in my knee and it felt like it took a lot longer to gain ROM and endurance.

I struggled a lot with getting enough sleep for the first 6 weeks. Could not get comfy to sleep for any length of time but eventually figured out what worked for me (lots of pillows, hanging with the cats, listening to music or mindfulness apps, podcasts, reading textbooks, sleep gummies. Also TENS therapy machines.

I also figured out that if I could get fresh air or a workout I would sleep better. That, and watching the whole Seinfeld series while I did PT at home, kept me in a good place. I also gained 12 pounds eating late at night, oh well.

I set some basic goals for each day, cut myself some slack if I didn’t get to all of them, and slowed my pace and expectations.

I was struggling for the first couple of months and came to this forum to read about what everyone else was doing. I read everything and came up with maybe 1 idea a week that I wanted to try. And that helped.

So maybe keep going as you are. I had some dang small goals for the first couple of months, and it worked out ok.

Last weekend I had a magical weekend. Doing everything I wanted to do and no one knew I had knee surgery yesterday until they asked about my scar.

So keep plugging along ? ‍