TKR Back to square one?<

@Mumu I’m really torn about the PT! Part of me thinks that I would be fine just resting and icing (along with all the walking I already do). But everyone I see in real life (meaning outside this forum LOL) says the PT is the only way. The first questions everyone asks is “Are you doing all your exercises?” My right leg is already atrophied from years of arthritis in the knee. I’m just terrified that I’ll have a less than successful recovery.

I really need to get a handle on what my limit is.
 
The ride might be uncomfortable. If you decide to go ahead with it, take along some ice packs (or bags of frozen peas or corn) in a little cooler. Ice packs help a lot with any pain.

At five weeks I took the short 1 hour drive, each way, to my SIL's house. I was really happy to have ice packs along. I sat in the front seat, so no elevating. I was very stiff when I got to SIL's house, and again when I got home. If the trip is two hours each way, I recommend a stop at one hour to walk and stretch. You'll be glad you did it.

I also skipped doing PT exercises at home, though I did gentle ones at PT itself. No machines! I can see you found out why. :umm: Just some gentle bending and stretching, and a bit of walking, is all you really need. Of course, if you do certain exercises and feel great with doing them, that's worth continuing. But avoid that step machine.
 
Ah! The step machine!!! That’s why this forum is so great - I never even made the connection on that one!
 
You'll have a fine recovery. I skimped on the PT (did some, but stopped cold anything painful) and never did the exercises at home they told me to do. Walking and just doing daily activities like going up and down the stairs a few to several times a day has been my go-to exercise and it's worked great for me. Five months out and completely pain free, sleeping well, and walking so naturally people are surprised I had both knees replaced.

My Mom (herself with two replaced knees) told me to do all my PT or my knees would "freeze" and I would never get straight legs. I just told her I was doing all my PT. It was easier than trying to justify what I really was doing. It helped that she lives 900 miles away. No one can tell by phone what the heck you're doing. Or not doing. :heehee: When people in person told me to do all my PT, I just smiled and nodded.

They just want to feel helpful. You just want to have happy knees that can do all the things knees do.:tada:
 
Have any of these people telling you to do all your exercises had a tkr? All of us have! The vast majority of us know that very gentle exercises, mainly just taking care of yourself with your daily activities, is enough to rehab these knees. Don't let those that don't know mislead you. Just smile and say that you are doing your exercises. They don't have to know which ones you are or aren't doing!
 
You really only need to do very little exercise at first. Your daily activities supply all the exercise a new knee needs. And, as your knee recovers, you will naturally start doing more in your daily life.

It's important that you allow your knee to get a good start on healing, before you stress it with additional exercise.
As you use it, you muscles will start to strengthen again.
We recommend waiting until at least 3-4 months post-op before starting any strengthening exercises.

If any of my friends or relatives asked if I was doing my exercises, I smiled and told them "I'm doing all the exercises I need to do."

It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.
 
What if I have to keep taking the Tramadol?
Honey, you're only 3½ weeks out! For my first TKR, I took Tramadol for 4 months!
Will I be able to drive?
I think you shouldn't be attempting to drive just yet. 3½ weeks is much too soon - mainly because you need you pain meds and cannot drive with the Tramadol on board.
But everyone I see in real life (meaning outside this forum LOL) says the PT is the only way. The first questions everyone asks is “Are you doing all your exercises?”
They asked me that too and I would just smile and nod! My attitude was "It's my knee and my body and I'll do what I jolly well like with it!"
I’m just terrified that I’ll have a less than successful recovery.
I've yet to see anyone have an unsuccessful recovery using our guidelines. However, I have seen LOADS of members have bad recoveries and a truly horrid time going the PT's way!
 
Two months down!

You were so right that the path of this recovery is NOT a straight line. Luckily, the bad days are no longer as bad as they were.

It’s been a long time since I posted so there’s a lot for me to catch up on.

I was really conflicted about my Physical Therapy sessions. After my second appointment I messaged the OS’s Nurse Practioner and asked what reason there was for the PT to hurt so much. I explained that for two days after each session I couldn’t do any of my at home exercises and was unable to get past the pain.

The answer I received was that it is NOT supposed to leave me in pain and incapacitated, and they’d be happy to call the PT for me.

Since my PT already seemed a bit defensive, I said I’d do the talking and report back to them.

Well, the PT pushed my knee again and I told him I just couldn’t handle that and he had to stop. I also wanted to know WHY this (and the higher tension on the exercise bike) was a good thing for me when it ruined me for days after.

He explained that I’d start to lose ROM and that his pushing on my knee wasn’t hurting me because he could tell how far it would bend. He said the pushing was a “passive” exercise - I said it felt pretty aggressive to me.

Two days later was my first post op appointment with the OS. I went in pretty nervous - either he would tell me that I needed the pain to get better or that the PT was wrong.

Hallelujah!!!

My surgeon said that recent research shows that a self motivated patient doing exercises at home doesn’t need to visit a PT. He said I was progressing beautifully (at that point my ROM was about 123 - extension almost 0).

A week later I had to drive 6 hours away to help my elderly mother move. The drive up wasn’t too bad - I had been feeling really good and made sure to stop and stretch. I had hired packers and movers, but still ended up doing way too much, not sleeping and being VERY stressed out for the 5 days I was there. Every time I had a moment alone, I cried.

I’ve been back home almost a week now and have started to feel a bit better. I’m back to doing the prescribed exercises. I’m supposed to keep a log of them on the App my surgeon had me download. Don’t tell anyone, but when I’ve done a lot of walking or just feel to tired and achy, I check off the exercises as completed. (Usually I do at least two of the three daily sessions.

I take pictures of my bent knee and it seems to be improving but without my sadistic PT and his device I can’t be sure.

(Sorry to bore you all with so many details, but I thought I’d want to look back on this later.)

As it happens, I have two questions for the group.

1. My post op X-ray showed that I have “small periarticular heterotopic ossification along the medial aspect of the medial femororobital compartment and popliteal region”

I googled the words - it seems that this describes bone growing outside the skeleton- I think.

I asked the Nurse Practitioner about this - she said they were very small and nothing to worry about right now. (Right now?! - what does that mean?!)

I guess there is a second part to this question - Why can’t these medical teams just EXPLAIN what is going on? It seems that all my questions about pain management, PT and medical terms are brushed aside as if I couldn’t possibly be made to understand what they’re doing!

OK, sorry, enough of that.

2. Today at the grocery storeI took a bit of an awkward step back and to the side. I felt as if my new knee started to slip out of place - like it used to when I had a torn ACL ligament. No pain, swelling or loss of balance, but it did freak me out a bit.

Has anyone experienced something like this? Could it just be my out of shape muscles?

Now I’m going to take some time to see how all of you are doing....
 
All that slip feeling was, was weakness in muscles. The more you use your knee is daily living, the more those muscles will strengthen. You can't rush it. You are still in the early stages of healing.

With a bend of 123 and near perfect extension, why are you worrying about exercising? You are already successful! And those numbers will continue to improve!
 
My surgeon said that recent research shows that a self motivated patient doing exercises at home doesn’t need to visit a PT. He said I was progressing beautifully (at that point my ROM was about 123 - extension almost 0).
I like your surgeon. Sensible man!

I’m back to doing the prescribed exercises. I’m supposed to keep a log of them on the App my surgeon had me download. Don’t tell anyone, but when I’ve done a lot of walking or just feel to tired and achy, I check off the exercises as completed. (Usually I do at least two of the three daily sessions.
With a ROM Of 123/0, you don''t need to do any exercises. Just your ADLs (Activities of Daily Living) are sufficient exercise. You won't lose the ROM you already have and it will keep on improving slowly, because ROM can continue to increase for at least a year post-op.
I take pictures of my bent knee and it seems to be improving but without my sadistic PT and his device I can’t be sure.
Exactly!
Don't worry about the numbers any more. You have a good ROM, with which you can do almost everything you want to.

My surgeon doesn't worry much about the numbers. He says "Show me what you can do." Function is more important than the numbers.
I felt as if my new knee started to slip out of place - like it used to when I had a torn ACL ligament. No pain, swelling or loss of balance, but it did freak me out a bit.
Yes, just muscle weakness. Those metal components are most unlikely to slip out of place with minor things like that.
 
I think it is terrible that we hear so many conflicting plans of action from so many surgeons and their helpers! Obviously we are all different and they should start everyone out slowly and reassure us that we don't need pain to get better. We all need to listen to our bodies and not expect miracles overnight. Let's all promise to pass the word along about this wonderful and informative website. At least we get different ideas and approaches that we can take with us on our journey to normal.
 
Thank you for all this information. I am 6.5 weeks out and still have a lot of pain at night, though ice and tylenol on schedule, help a lot. Very stiff in the morning, but it gets better after stretches and moving knee by sitting on my glider chair outside. I use ice off and on all day long and that helps. I too, find that after a PT day, I can't do my at home exercises the next day. Heading off to a PT session as soon as I finish this post! Wish me luck!
 
Wow.. what a fantastic thread! I learned so much from each and every post!!!! Thank you so much.. it's been great hearing about everyones physical recovery that didn't involve pushing and pain!!! I will continue to follow your recovery @emmysmom - You are an inspiration!
 
I think it is terrible that we hear so many conflicting plans of action from so many surgeons and their helpers!
That's because they have all been taught different things and they continue to practice what they have been taught.
Even in my own small country (New Zealand) different surgeons have different approaches.

There is no one right or wrong way. Some people (very few) do benefit from aggressive PT therapy, but the majority of us need a more gentle approach.
 
I had a lot of that "slipping" feeling in the first 4 months after surgery - I called it "the wobble" and was glad to have my cane nearby when it happened. As my quad got stronger it stopped happening. It happens very rarely now - unless my leg is really tired (e.g., after a long hike).
 
I’m having issues with my pain control. I’m not in serious pain - maybe a 2. The problem I have is the reaction my body is having to the over the counter pain medications.

I tried Motrin but it didn’t seem very effective for me. For the past week I’ve been taking one dose of Aleve in the morning and 50 mg Tramadol with 1000 mg Tylenol at bedtime.

I also have been taking Famotidine since the Motrin gave me sour stomachs almost immediately.

This morning I took my Aleve and Famotidine (after eating a yogurt for breakfast) and spent the day with stomach cramps and a horrible gassy bloated feeling.

The NSAIDs work so well on my knee discomfort but really seem to disagree with me.

Should I not be taking them in combination with Tylenol?

Two days ago I experienced two hours completely pain free - I was so happy to get a glimpse of what hopefully is in store for me. Now this stomache upset has me down again.

Advice please?
 
Aleve helped my knees before surgery (not much else worked at all) but after surgery it's not a particularly useful med. It's notorious for causing gastro-intestinal problems, so I think you should stop using it and other NSAIDs on that basis alone.

Many people have had great success combining Tramadol with Tylenol. I read through your thread and Josephine has provided you with a chart for using these two medications. Did you try that?
 
NSAIDS are not for after surgical pain, they do very little for that. Plus, you're seeing how bad they are for your tummy. They also can cause heart problems and increased bleeding, including stomach. BS doesn't recommend them. You can take up to 4000mg of Tylenol a day, which is a much better pain reliever. If you take anything else with Tylenol, be sure to count that into your daily total.

Getting a glimpse of painfree times is so uplifting! Please stop the Motrin. Your tummy's reaction is a warning sign!
 
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Definitely stopped Aleve and Motrin yesterday morning.

I used Josephine’s schedule for a brief time to get past the last really painful period. I have 8 Tramadol tablets left (50mg)- after that there will be no more.

I had tried Tylenol alone for four days and it didn’t seem to do anything for me (except at night when I combine it with my precious Tramadol.)

When I started the Aleve last week it was a noticeable improvement- so maybe it’s ligament pain or something to do with my Heterotopic Ossification?

At any rate, my surgeon sent a scrip for topical NSAID cream - hopefully it will be effective. Does that seem like a safer way to use the NSAIDs?
 
So my prescription is for 2 grams of Diclofenac 1% 4 Times a day.

I read all the articles on the site about Heterotopic Ossification (how much I understood may be another story) and it seems to me that the topical NSAIDS might be a good idea.

Opinions?

#heterotopicossification
 

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