TKR At home TKR recovery questions<

[Josephine]

1. Pain level 6 higher at night when stiffness and pain kick in. Or after exercise

Ouch! That's nasty!

2. Percocet 325mg 1-2 tablets every 4 hours. Been taking 1 approximately every 6 hours unless pain too intense as only prescribed 30 pills and have to go to drop office to pick up prescription

That's not really enough. If you are prescribed 2 every 4 hours, then that's what you need to take. Don't let your pain go uncontrolled.

3. Swelling according to your chart moderate though feels like right leg is 2 thighs

Yes, I know. There was a time members would refer to this as "log leg"!

4. ROM - was told by home PT about 95 and Dr said in 90's.

That's pretty good for 2½ weeks out! You can estimate your extension using this Extension: how to estimate it

5. Icing as much as possible
6. Haven't done lots of elevating as it really hurts. Husband orderd me a elevating pillow that will be here by Monday

Are you elevating with a totally straight leg? Because that's why it will be excessively painful. Look at this and see the good and bad ways of elevating Pain and swelling control: elevation is the key
If you are icing/elevating for 20-30 minutes that's useless. Ice for at least 40-60mins and more than 4 times a day.

7. Activity level normally is very active, since surgery not too much due to pain and stiffness. Will walk around apartment using a cane which at times is rough. Will sit in front of computer for a bit until I can't take it any more. Going downstairs etc. Is rough and extremely tiring. Energy level is not the same as before but everyone tells me it's still early.

Yes, I would imagine so.
1. you need better pain management
2. you need to ice and elevate more (but don't elevate with a totally straight leg)

My comments in bold
Ankle flex 10 reps 2 sets - these are ankle pumps and only required for anti-clot reasons. Since you are fairly active, you don't need to do them any more
Swinging leg - 10 reps 2 sets - never heard of these before. They seem pretty pointless
Putting leg out to side 10 reps 2 sets - same with these
Standing on toes 10 reps 2 sets - you shouldn't be doing these at only 3 weeks out. Very hard on the knee. I suggest you stop them
Etc - what's 'etc'? There are more you're not telling me?

9. Out patient physical therapy starts Tuesday. 3 times a week for 3 weeks - I've long considered that PT is unnecessary for TKR. But if you do go, don't do squats, lunges, steps, ball or board balancing, bridges or anything with weights or straps or let the PT push on your leg at all. You don't have to be confrontational just say you're not going to do anything that causes you any pain.

You just need to remember this: It's not the exercising that gets you your ROM, it's time. Time to recover, time for swelling and pain to settle and time to heal. One thing that seems to be missing from all the PT's protocols is that all your ROM is there right from the start, just waiting for all 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. Exercise as in strength training is counter-productive and does more harm than good. Normal activity is the key to success.

 

[Bebita]

Thank you very much. I will use what you said and will not let pt basically abuse me. At home pt stated that my left leg compensated for the right for so long that muscles in both legs are very weak.
They gave me a walker as well and told me to use that until legs were stronger but I've been using the cane though not sure which is better choice at the moment. Can't wait to be able to do the things I use to. Ever since this tkr, my left knee has been doing a lot more clicking then usual.

 

[kneeper]

My muscles were weak before my first tkr--but I found going slow with the exercises was better than trying to rush it. When I let them have me do things like squats I wound up with tendonitis.

 

[Josephine]

They gave me a walker as well and told me to use that until legs were stronger but I've been using the cane though not sure which is better choice at the moment.

It depends. If you're a bit unsteady on your feet, it may be good to continue with the walker for a bit longer.

 

[Bebita]

I hate that my energy level seems so low. I can walk from bedroom to kitchen and get so flustered, pouring with sweat just from that walk. Husband says I'm getting upset for no reason and that it takes time.

I have a recumbent exercise bike but don't know when I can or should attempt to start using it.

 

[sistersinhim]

My nurse told me to not touch my bike before 4 weeks after surgery. I did that and as of last week was finally able to petal frontwards. You will have to start just rocking back and forth and then eventually be able to go backwards for a week or so before you can go forward. Right now all you have to worry about is healing.

 

[Josephine]

Bebita, it's just your Energy drain, that's all. If you try to fight it, you will only make matters worse.

 

[Bebita]

As usual thank you for your support. I guess I'm just blah, feel like I'm on some sort of lock down, tired of being tired.
Some days very positive knowing better days ahead while others I get down wondering what's taking so long for those days to come.
How long are the steri-strips supposed to stay on ? Dr said about 3-5 days. They are still on and it will be a week tomorrow. Once they do come off can that area get wet or does it still have to be covered during shower?

 

[PolarBear60]

Don't worry about the steristrips. When they fall off, they're ready to come off.

The energy drain may go on for a couple of months, gradually improving. It can be one of the more frustrating aspects of recovery. Your husband is correct in advising you not to worry about it too much. Save that energy for the things you want to do.

Oh, yes, and post-surgical blues are very normal and will pass. Don't be surprised if you're irrationally emotional sometimes. If they don't pass, or you you think they are worse than mild, do discuss treatment options with your doctor. Sometimes a brief prescription helps.



Jean

RTKR (Stryker Triathlon): 21 June 2016 LTKR (Stryker Triathlon): 21 April 2015
Right Knee Arthroscopy: 25 July 2006 Left Knee Arthroscopy: 10 February 2005

 

[Josephine]

How long are the steri-strips supposed to stay on ? Dr said about 3-5 days. They are still on and it will be a week tomorrow.

Oh pull them off! I've no idea why that stupid rule to leave them till they fall off came to pass or why! In the UK we take them off after about 5-7 days. They've well done their job by then.

 

[newlybionic]

@Josephine I was taught to always leave steri-strips on until they fall off. It's something I have repeated myself too. We usually would only covered areas where there wasn't complete closure of an incision.

 

[Bebita]

Looks like I have one spot that may have opened a little though no bleeding.
The scabs hurt bad, feel like they get caught on things and wI'll rip off.

 

[Bebita]

Had very rough night. Less sleep then normal. Intense tightness in my upper thigh and feels like a knot behind my knee with the pain radiating up my thigh area. I have to massage it to get it to stop.
I think I may have stretched during the night. Also didn't help that during my little bit of sleep in i guess I attempted to sleep on my side which knee did not agree with. Was moaning and crying as I tried going back on my back
These painful, sleepless nights are the worst.

 

[Pumpkin]

Sleep can be elusive in the early days, try icing behind your knee, and be sure you are taking your pain medications around the clock as prescribed, set an alarm if need be.

 

[lgobrien]

https://www.amazon.com/gp/baby-reg/aynsley-born-matt-born-october-2016-traversecity?tag=ate362da-20

My surgery was two days before yours... I slept much better in the first weeks because I set my clock every four hours and took 2 oxycodone. The last week or so, I've been taking 2 oxycodone before bed (icing for the last hour before bedtime) and can usually fall asleep for a couple hours straight. But it is the pain that wakes me back up. I do not set my alarm anymore and the pain wakes me up around 3am. I get up, take 2 xtra strength Tylenol and grab another ice pack and can usually get back to sleep for another 4 hours.

Not sure if that's what I should be doing, but I wanted to see if the xtra strength Tylenol would do the job. Not totally sold on it, but I wasn't sure if there was anything else I could take. Motrin/Aleve has always worked better for me, but for some reason, I was thinking I could not take that yet because I take two aspirin a day (375 each) until my one month check up next week.

Does anyone have suggestions for either of us?

 

[Bebita]

This is truly a pain in the butt. Certainly doesn't help with activity level. I've been taking the percocet 325 mg 1 tablet every 6 hours and then 975 mg Tylenol every 6 hours alternating them. But will be going back to every 4 hours with the percocet especially at night cause it's not cutting it. My 1 month check up is next week.

Can anyone tell me how to sleep on your side. Is there a proper way to do ithe or a side thats better than the other?

surgery 2 days before mentering wow congrats. We are basically up around the same time at night though you seem to be getting more sleep lol
Have you been going to pt and if so how's that going?

I love this forum and knowing that I'm not alone and I can talk to others who've been through things I am or similar.

 

[lgobrien]

Nancy - When I lay on my side, I put an icepack on my knee with a small bed pillow over that and my other knee on top of that to hold it in place. I sometimes have to switch back and forth before I get comfortable enough!

I have had in-home pt twice a week since my surgery. This is my last week at home. Not sure if I automatically go into in office PT or if the PT tells me I've done well enough. He has not once measured my extension or ROM, but can't believe how well I'm doing.

If I'm doing so well, I feel like I should have more energy. I've been very depressed, my mom died last November and it's given me way too much time to miss her. I keep thinking if I start getting busy again, I'll snap out of this, but I'm too tired all the time to get busy. Am I tired because I'm depressed or am I tired because my body is healing. I'm beginning to feel like it's my "pity party" that's slowing me down. Catch 22?

 

[lgobrien]

As usual thank you for your support. I guess I'm just blah, feel like I'm on some sort of lock down, tired of being tired.
Some days very positive knowing better days ahead while others I get down wondering what's taking so long for those days to come.

Nancy - I just reread some of your earlier post and I think we are both in the same place emotionally. I KNOW it will get better, I think I'm just being impatient. Let's do this together!

 

[Josephine]

We usually would only covered areas where there wasn't complete closure of an incision.

@newlybionic Well I know that! But such tiny openings are usually well healed within a week or so. Being taught something like that doesn't always make it right. It's nonsense!

Not sure if that's what I should be doing

It's perfect, my dear!

Motrin/Aleve has always worked better for me, but for some reason, I was thinking I could not take that yet because I take two aspirin a day

And you are quite correct - NSAIDs can thin the blood. And aspirin is and NSAID too, so there's your reason why not to take them at the same time.

 

[sistersinhim]

Being extremely tired is normal. Look at the article about energy drain. I'm almost 7 weeks and I still run out of energy much quicker than I'd like. Your knee has a lot of healing to do and your body is concentrating on doing that first. Take this tired time to get lots of sleep. When you're sleeping your body is healing even better! And boy, do I know about the patience thing! I'm far from being that, but I know the knee is in control of my whole body and mind and I just have to live with it until it's ready to turn me loose! Try and enjoy this time you have. I know, easier said that done!