ALMOST FIVE MONTHS WITH NEW KNEE

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backstreet110

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I have been working hard in physical therapy, but today had too much pain to go through the exercises. I cried because I feel I can't get through this. I have tried to stop my pain meds at night because I was sleeping better, but wonder if I need them to stay at a certain level to get up and go to therapy. I take two pills before therapy, but it just isn't helping. This is so much more difficult than I ever expected. I am very depressed and scared I will not improve. Any help will be so very appreciated.
 
I have been working hard in physical therapy
That could be part of your problem. You are about 5 weeks post-op and you need to concentrate on healing right now! You should not be doing any exercises that cause pain. If it hurts, don't do it again! Rest, elevate, ice, elevate and ice some more and continue to take those pain meds. Of course you will "improve" but you don't say in what area you are looking for improvement? Is it the lessening of the pain? Is it more range of motion that needs to improve?
 
Don't stop the pain meds, stop the PT! You don't need PT but you do need the meds!

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!
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)


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 50kg 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.
 
Congratulations on the new knee. You should be on medication around the clock, that means every 4 to 6 hours. Sleep is elusive for everyone. Its part of the package deal. I believe the worst is behind you. Now slow down at PT. Why allow someone to hurt you. Would you allow someone to hurt your child. ?? You need to heal ! My pain level never went over a 4 and thats because I never ever missed a dosage till week 6 and I literally elevated and iced for 16 hours a day for about 6 weeks as well. It way too early to put your knee through the mop wringer. Slow it down , do not allow your PT to hogwash you about MUA and ROM. Ride stationary bike and bend that knee in due time. Best of luck , Iceman
 
First of all, thanks for the replies. Just hearing from someone who has or is sharing this experience makes me feel better.

I do basic pt. I started a bike that just pushes my feet, not a complete circle. Then I go to the torture table where they put a cylinder under my legs and I have to lift my knee 30 times. Couldn't lift at all today. I am almost completely straight and my flexion was 90 and sitting up is over 100. That is because I push my leg back while exercising at home as far as I can.

I am having trouble walking normally. I am still on a walker. I take Percocet (2) every four hours but don't have enough to take round the clock. I think this is my problem. I tried to cut back on pain meds too soon. Just hearing that I am not being a baby is great. This is very difficult. I wish all of you luck.
 
Your flexion is good. I had my surgery a day before you and they haven't had me do 30 repetitions of anything--it's been 10 at the most.
You need the meds as long as you need them. And be sure to time a dose close to bedtime.

I, too, tried to cut back the last couple of days--to one Norco every 5 hours. :doh:It didn't go well. I'm going back up to 2 every 4- 5 hours.

like tiredwife said, push past your comfort zone but not OMG Pain.
 
I have been working hard in physical therapy, but today had too much pain to go through the exercises.
Don't do anything that hurts, it doesn't help recovery.
I take two pills before therapy
Don't take painkillers before therapy, if you do it means you simply can damage yourself more.

Gentle stretching exercises to the point of discomfort only, not pain, are all you need. Then rest, ice, elevation.
 
I couldn't agree more with the poster who cautioned you "If it hurts (any activity) don't do it." I am 7 weeks post op and still in a great deal of discomfort. My local doctor wants me to stop pain medication and get on Aleve, but I will continue to use Vicodin to alleviate the pain. I have been taking 7 - 8 daily, but I am trying to cut down. Be Patient, is my advice. Continue to take it slowly. My Buddhist daughter advised yesterday, "But taking it slowly, you will recovery more quickly."
 
I am now close to 3 months with my new knee. I will be returning to work on Sept. 2, 2014 and a bit worried. I still walk with a cane for some balance, maybe security. When I take walks, I get so uncomfortable and want to return home. The tightness and discomfort stops me from going past 2 or 3 blocks from my home. Therapy is over and I am hoping I will continue to get better with doing the exercises they taught me that I can do at home. I have a bike but cannot pedal fast. I can get the pedal around, backward and forward, but I go slowly. I just still do not feel right. I still get pain and am taking aleve and Percocet (rarely now. ) My husband wants me to,stay on the Percocet because I can do more on it. I guess my patience needs help. Also, I cry a lot. I just want to feel normal again. I feel like I am 80. Hope this is all normal. Sometimes I don't want to walk around because of how weird my knee feels. I am afraid it will pop out of place or something silly like that.I really hope that can't happen. Any advice from someone at my level will be so appreciated.
 
Even though it has been almost 12 weeks since your surgery, you are still healing! Some folks lose the swelling faster than others. It sounds to me like you probably still have some swelling going on. Even if you cannot see it, it can be in the knee compartment....very tight space in there and it doesn't take much fluid for things to tighten up and hurt.

Are you icing? If not, I suggest that you ice your knee front and back as much as possible. You cannot over ice. Just be sure you have a towel between your skin and the ice source so that your skin is not damaged. It will also help to elevate your leg (toes above the nose) as much as you can too.

Taking the pain pills is fine if you are in pain. But....don't fall into the trap of doing more just because the pills are keeping pain down. If you overdo the activity, you'll cause inflammation and swelling.

You are early enough in recovery where I wouldn't expect you to whiz around on the bicycle. Just take things slow and gentle. Keep your activity reduced until the pain is not so constant. Once you start back to work, let that be your activity and do nothing else when you leave work. No errands, housework, cooking, cleaning, exercising (other than gentle bends and stretches which are always a good idea). Explain to hubby that this is a looooong recovery. Most people don't begin to feel normal again until 6-9 months. And then complete recovery can be a year or more.
 
I had right knee replacement 6/13/2014. I'm retired so I don't have to worry about going back to work. My flex is about 120, but I have problems getting my knee straight. Been in outpatient PT since 7/14. Saw my PA at surgeon's office today. He's ordering more PT for me, and I'm going to get a Knee Extensionator to help with the straightening. When measured it's about 10 and should be 0. Hubby has been pushing on knee to help and I have been doing hanging off the bed with 5lbs weights around my ankle. Can only do about 10 minutes of that. I have 9 weeks until a Viking Cruise for 40th anniversary and hoping I can get in shape for that. Got a cortisone shot in left knee today to help pain in it. Planning on getting it done after the cruise or first of next year. I must say my surgery was pretty pain free. Only time I had pain above 5 was at home a few days after coming home and I took a tramadol and pain was gone in 30 or so minutes. But pain is a personal thing, I think I may have a better tolerance than some. I started out taking Norco 10/325, but at home it caused hallucinations, and I was falling asleep while talking to the home health nurse, so I stopped that as soon as possible and have just been doing Tramadol when I go to PT and 650MG Tylenol twice a day. Maybe half a Tramadol at night if I'm having a bit of pain. Ice at PT and some at home, not much.
 
I'm at 11 weeks now. I still have swelling and pain. But I can walk and hike miles. I got out walking 3/4 mile a day early on at the 2 week point. They stopped PT at 6 weeks due to Medicare payments but one can do exercises at home. When they took me off of blood thinner he told me to take Aleve. That made a big difference within a couple of days reducing the swelling so walking,etc. was so much better. I still take one in the morning and one at night. No pain killers for weeks now even then it was only at night.
It takes many months and even over a year to get totally healed and in shape. Remember even then you always know you have a joint replacement. You can feel it and sometimes it clicks or clunks. But sooo much better then the bio knee.
I would try to walk more while holding the cane in the air just in case and develop you muscles,etc. Walk focusing on smooth heel to toe and develop your muscles,nerves and train your brain again. Your body was so out of wack before the surgery do to the knee being bad. Do this early in the morning before you work it for the day. I'd walk my 3/4 mile then come back and ice it and rest. Then do things around the home,etc. PT exercises so on. Unless your surgeon did it wrong which I doubt you need to work at it to get stronger.
 
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It takes time to regain stamina and healing is still continuing. @truckinguy has some great points.
 
Hi @backstreet110

I know it's a bit late, but it occurs to me that you have not been given the BoneSmart mantras and the recommended library reading list. These summarize the BoneSmart approach to recovery from knee replacement:
First are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

Next is a FAQ (Frequently Asked Questions) thread.

And here are some very crucial articles
The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Activity progression for TKRs

Healing: how long does it take?
Chart representation of TKR recovery
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling

Home physio (PT) and activity progress: suggestions
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

And then some wise words from members who have shared their experiences ...
Where are you in recovery?? (TKR)
Five “P’s” of knee recovery
TKR: work “smarter” and not “harder”
Recovering a knee - from one who knows!
It's never too late to get more ROM!
It's worth the wait for ROM
 
God Bless all of you for your help. Jamie, you helped me beyond words. You understand. Thank you. Celle, I do know the mantras, I read it often, it is wonderful. Thank you too. This site is wonderful.
 
@JTH ... Your post above seems more like an update on your surgery and comments like this would probably be more appropriate in your recovery thread so that anyone responding to you does not derail backstreet110's thread. Please do post encouragement and support here, though......or any comparisons of your experiences with hers!!! That is always helpful!
 
I still get pain and am taking aleve and Percocet (rarely now. ) My husband wants me to,stay on the Percocet because I can do more on it.
Well that's not a reason to take pain meds! But you should adjust what you are taking. For starters, Aleve is an NSAID. One of the better ones tis true but still only an NSAID. Therefore, its effectiveness is, gram for gram, about 40% that of Tylenol. Plus you can only take it twice a day. So I suggest you take Tylenol 1,000mg 4 times a day (max) and keep the Percocet on hand for more severe pain. Try it for a week of so and let me know how it goes.

However, I have to confess that I was still taking Tramadol and paracetamol (Tylenol) all day every every day for 4 months!

I also notice that I asked you some questions in post number 3 and reminded you in post number 10 but you still haven't responded. Guess this was your way of ignoring me!
 
Hi @backstreet110 --I see you're just about a surgery buddy with me (I was june 2).:wave:
Everyone is different in their need for pain meds. One thing you always want to do is listen to your body--you don't want to be masking pain and then overdoing and causing more swelling.
Non tkr-ers may not believe it, but we're still healing.
Keep us posted on how you're doing.
 
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