TKR Bishop's Recovery Story

[Jockette]

Those emotional walls hit us all Here‘s why:

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

TKRsharon’s idea of a transfer bench is a good one, many of our members have used one and liked it. I never used one, I have a semi walk in shower, with about a 6” height that I had to step over, and that was tough, too, that first week or so!

I was able to have my walker right outside the shower, for confidence with getting in and out.

 

[Cococay]

I’m so sorry that your pain has been so high-and that you have felt depressed. I know everyone is different and just because one person experiences something doesn’t mean anyone else will. But- I will say my first few days it felt like that acute pain and ache was never going to leave and it felt overwhelming. People told me it will get better but it’s hard to see it when your in pain. I say this because truly- at 4-5 days it was like I turned a corner — you will get through this- and then every couple days you will notice feeling a little better. These first days seem to be the worse and you are getting through them- you have already gone through it!! I’m sending you lots of hugs.

I hear you on bathing. I love baths so much. It’s been a long time since I could. My bathroom is teeny as is my tub. Those shower chairs and a handheld shower sprayer work well though.

 

[Bishop]

Hi all! Well it’s 1 week today. I’m just sitting here crying. I have no change since the day of surgery except that my ROM is way worse. I get up and walk for 5 mins pretty much every hour.I do all my ADLs. I haven’t showered yet cuz I’m waiting for OT to get me a shower transfer seat. Twice a day I do to the best of my ability ( to the point of tears / pain) my PT exercises. I am so swollen so bruised and hurting that it’s...nothing is changing! I’m on the ice machine, the pt said maybe try heat. I have only 4 pain pills left and they vacillate between take more/take before pt/ should be done by now. My extension is “ great” 0, my ROM is 80 I just feel horrible all the time, my leg looks horrible. I’m trying not to compare myself,I’m celebrating that I am doing what I’m doing-but the pain and feeling of instability is IDK... whatever. PT later today at 2 and then hopefully OT tomorrow with a shower transfer seat. I’m just so sad!

 

[FCBayern]

Hi all! Well it’s 1 week today. I’m just sitting here crying. I have no change since the day of surgery except that my ROM is way worse. Twice a day I do to the best of my ability ( to the point of tears / pain) my PT exercises.

That PT is probably the culprit for your pain, swelling, and therefore lack of ROM @Bishop. Other than a few ankle slides and foot pumps you don't need to be doing PT this early. Extension is the hardest thing to achieve and you already have that, the flexion will come with time and the swelling reducing. In the mean time you should have enough pain control to be able to take your short walks and ALD's without being in such discomfort that you don't want to do it. You may have to be firm and stand up for yourself, but it would be ridiculous to deny you pain relief one week into TKR recovery.

 

[Jockette]

Twice a day I do to the best of my ability ( to the point of tears / pain) my PT exercises.

You don’t need to be doing exercises that cause you this much pain, not only one week into recovery, but ever, in your recovery.

I am so swollen so bruised and hurting

And this is why you don’t need a list of exercises right now.

That PT is probably the culprit for your pain, swelling, and therefore lack of ROM @Bishop. Other than a few ankle slides and foot pumps you don't need to be doing PT this early.

I totally agree. Stop doing painful exercises and just do very gentle movements.

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.

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

 

[Newkneenewme]

Hi all! Well it’s 1 week today. I’m just sitting here crying. I have no change since the day of surgery except that my ROM is way worse. I get up and walk for 5 mins pretty much every hour.I do all my ADLs. I haven’t showered yet cuz I’m waiting for OT to get me a shower transfer seat. Twice a day I do to the best of my ability ( to the point of tears / pain) my PT exercises. I am so swollen so bruised and hurting that it’s...nothing is changing! I’m on the ice machine, the pt said maybe try heat. I have only 4 pain pills left and they vacillate between take more/take before pt/ should be done by now. My extension is “ great” 0, my ROM is 80 I just feel horrible all the time, my leg looks horrible. I’m trying not to compare myself,I’m celebrating that I am doing what I’m doing-but the pain and feeling of instability is IDK... whatever. PT later today at 2 and then hopefully OT tomorrow with a shower transfer seat. I’m just so sad!

I am one week post op today and you are not alone!!!! Despite the fact that I just went through this 4 months ago, it’s still been daunting and devastating. The pain can be all encompassing. I know from experience that it gets better but somehow that doesn’t matter. When the pain takes over, logic leaves. But it’s going to get better for us. I know that. I hope you get your transfer bench and you are able to just sit in the shower and cry. Every day that passes is a day of healing, we can do this but I know what you are going through and it just sucks.

 

[DEL2021May-19]

I have to admit, I took sponge baths and washed hair in the kitchen sink for several weeks (over a month). Live alone and was too nervous. Then mentally put my big girl pants on and took a deep breath and had a shower lol. I was weak and held on for dear life but man it felt good. I had a hard time sleeping for almost 2 months. At 5 months, I am very careful in shower. Still have uncomfort when bending knee but not paranoid about the ROM anymore...see improvements each day but definitely not great # like others...but I can do what I need to do and expect slow improvements. I did a lot of self talk to just take each day one at a time. I know how you feel. Try to not over analyze and don't force yourself to do things. Would I have loved to have a shower the day I came home from the hospital...YES, but I just surrendered to sponging off. Would I have loved to be comfortable in bed and sleep through the night at first...YES, but I wondered around all day and night and slept when I could. Very frustrating especially when we are creatures of habit and that gets totally thrown out the window. My days were a vicious cycle of doing 3 sets of exercises, wondering around house, moving from bed to chair to try to get comfortable, icing, elevating...and worrying like crazy for ROM and over thinking every little pain or click. And always in a panic about going to my PT on Thursdays. I have improved exponentially since I finished formal PT, took a deep breath and tried to just get on with it. Once I was able to get a good night's sleep it made the world of difference to my emotions...but that wasn't until 6/7 weeks. I can see the light at the end of the tunnel and hopefully keep seeing improvements. Long winded, but I hope this helps you put things in perspective during your early days. Like I said, I am 5 months and still feel it is early days for me.

 

[Jamie]

@Bishop .... these folks are right on target. You are a mere 1 week out from this very major surgery. Your body is telling you that you're doing too much activity and exercise. Please slow down.

Is your therapy outpatient or through home health? If it's home health and you don't have the effort of getting dressed and going to a clinic, you might try cutting down the number of visits or stopping them entirely for a few weeks until things settle. You can do just fine at home with gentle bends and stretches several times a day for short periods.

"All your ADLs" makes me think you may be doing too much activity around the house. What types of activity are you talking about? At this stage, really all you need to be doing are VERY short walks every couple of hours from room to room about the house along with those gentle bends and stretches that can be done in a chair, on the sofa, or in bed. You want to keep the knee motion fluid, but not do so much as to irritate sensitive and traumatized soft tissue that's trying to heal.

Your problem sounds more like an issue with pain management. Are you taking something on a schedule through the day and night for your pain or just taking meds when things start to hurt? It's much more effective if you are on some type of schedule with your meds. If you'll tell me what you're taking (name of med, strength, dosing instructions on the bottle, how much and when you take it), perhaps I can help you with a schedule. Please include any over-the-counter medications like NSAIDs or Tylenol.

I wouldn't recommend putting heat on a new knee like yours. That is likely to make your swelling worse. Stick with the ice and just be sure you're keeping your knee iced on front and back any time you aren't up and around. Just be sure to put a towel between you and the ice source to be sure you don't get freezer burn on your skin.

 

[Roy Gardiner]

Twice a day I do to the best of my ability ( to the point of tears / pain) my PT exercises. I am so swollen so bruised and hurting that it’s...nothing is changing!

The BoneSmart view is that you have cause and effect right there.

Imagine exercising hard in recovery for a broken leg or a sprained muscle; counter-productive, obviously, and would worsen the damage. It's much the same with TKR, you have damage needing healing, not unfitness needing training.

All you need is to help retain mobility (not fitness or strength) until healing is complete. This is done with gentle stretching exercises, without pain.

Read full details here https://bonesmart.org/forum/threads/post-operative-exercise-–-the-bonesmart-view.25463/

 

[Bishop]

Thank you all for your support, good advice, and kindness. As far as pain management, I find that with so many appointments,both at home and telehealth on phone, 4 out of these 7 days-I can’t take the meds, as I need to be alert. Tomorrow for example I have OT coming at 10.PT coming at 11. Groceries delivered at 12 and a telehealth appointment at 2. So I won’t take meds till 3. This kind of schedule has become the norm for a week. As far as PT, yes I have stood up for myself,the first day when they pushed on the knee. They said they’d send someone else. This one says ok I won’t push, then did anyway. As I was doing my exercise she said I’m just going to help reposition and boom started pushing the knee back. It is with home health and I must comply-they say because everything is a process. I know what they mean-surgery was denied once because certain criteria had to be met with meds, injections,and pt even tho they knew and could see in the mri how necessary it was, you still must jump through hoops so, I’m having the next knee done 3/31/21 & I can’t rock the boat too much. I’m happy they are coming here as it’s snowing nearly every day and it’s below 0. As far as my ADLs I’m doing what I have to: make coffee, heat up foods friends have dropped off, cleaning the cat box, feed cat /water. I have to keep filling the ice machine. I walk for 5 minutes around the halls of my apartment building every hour, I wash up and change, I wash my TED hose every night. Just regular stuff. I just want to feel better. Thank you

 

[Pumpkin]

@Bishop,
It sounds like you have a full schedule, makes me want to take a nap. I hope your schedule is not that busy every day.

Rather than PT pushing on your knee you can do these two gentle exercises for ROM.
Heel slides and how to do them and Extension: how to estimate it and ways to improve it .

I am so swollen so bruised and hurting that it’s...nothing is changing!

Your ROM is blocked by all the swelling, like a full water hose it is hard to bend. Your ROM is there waiting to be revealed as your knee heals and the swelling goes down.
All the exercise and activity is only causing more swelling and inflammation blocking your ROM.

Right now you need to let your knee heal and should be spending as much time as possible, resting, icing, elevating, and taking your pain medications on schedule as prescribed.

Unless someone is watching to check you are walking 5 minutes every hour, you can adjust your time walking to how your knee is feeling. Same with your daily exercise program, make adjustments depending on how your knee feels.
With all your other ADL's and taking care of your cat you have plenty of activity.

During you Telehealth appointment tomorrow you can let your Dr. know that all the exercising is just making your knee swollen and sore, and that you are not getting anywhere.

All the best, remember this is a marathon not a sprint.

 

[lovetocookandsew]

Hi and congratulations on your new knee.

I noticed you mentioned you have to keep filling your ice machine. I learned, partly here and partly through trial and error, that using small frozen water bottles (my machine takes four of the 16 oz bottles at a time) works really well and lasts a long time. What I do is each morning I empty the machine, rinse it, then add 4 new frozen bottles. I then add water almost to the fill line, and then I add a little ice (making the water reach the fill line exactly) to get it instantly cold. This helps the bottles to be more efficient and last longer, plus the water starts out icy cold instead of needing to wait for the water to get cold. I go through three sets of the frozen bottles each day and each lasts about 8 hours. I keep 12 bottles in my freezer and rotate them in and out.

I have two ice makers in my kitchen fridge, and even so they'd never be able to keep up with the demand for ice, so using bottles really is a big help. I found doing it this way means the bottles stay frozen a lot longer than if I put them into cold tap water without a little extra ice added once a day in the am. I don't add any more ice during the day or night, one time is all it needs to get it going and stay cold.

 

[Bishop]

Great idea!!

 

[DEL2021May-19]

I didn't find narcotics did much for my pain. I also rotated 12 bottles of frozen water in my machine.

 

[sistersinhim]

It is with home health and I must comply-they say because everything is a process.

They are wrong. PT should never hurt or cause more swelling. That just creates a setback. You have to get over the PT before your knee can get back to its normal healing. I've had 12 knee surgeries and at my very first PT session in the hospital 30 some years ago, the PT pushed on my knee some causing internal bleeding. This led to me having to have it drained. That was terribly painful. Since then I have never had one minute of PT. I recovered from each of my surgeries by using my knee by taking care of myself, my cats, and my home. I have had great outcomes without the agony and setbacks of an aggressive PT.

So many people, even PTs think you have to have painful, aggressive exercises after a joint replacement That couldn't be further from the truth. Listen to all of us who have been through this surgery and know what works for them. We just want to help.

 

[kneeper]

Getting up to fix food etc. can count as a "walk."

 

[TKRsharon]

@Bishop The ideal situation would be to have a person visit you for a period of time each day in case you get loopy. Staying on top of the pain is so important. Ii's so difficult though with the Covid situation. Please try and convey to the PT/OT they need to be gentle with you. I learned this out the hard way; I was victim to some very aggressive PT - and suffered. Sounds like you are in a vicious cycle. I have been recovering on my own as well. I am just now at 4 months, ( on Saturday!) and starting to feel better.
Sending you good thoughts and hoping you get the help you need to get better. Oh, and do not go out if it snows and definitely don't try to shovel!

 

[Bishop]

Hi everyone! I can’t sleep again/still. So miserable. Icing, doing the bottles now with the ice machine helps a lot! Got into a better routine with meds schedule and rest since Fri afternoon. Someone was going to come over and help with a few things but it is so cold -20 more w the wind chill, they cancelled I don’t blame them! I had to vacume a little bit-with the snow and so many people in here there was street salt etc all in front and LR. Plus I had to change my sheets. I worked slow and sat down elevated, iced after each thing. Especially with the bed. I lay down and elevated after getting the fitted sheet on, then did the rest. I’m hurting so much all the time anyway, I don’t think I’m any worse for it. I just wish this pain would let up! Well I go for my follow up on Tues guess I ll se what he says. Thank you all I don’t know where I’d be if I didn’t have this forum for support! I just really need to start feeling better!

 

[DEL2021May-19]

Wow, I couldn't have even dreamed of vacuuming and changing bed that early into recovery. Part of the recovery for me was JUST doing what had to be done and leaving other stuff for a few weeks. Can drive you crazy with all the time on your hands to look at the housework that is getting under your skin. Recovering and feeling good should be the priority for the first little while. Housework will always be there lol. But I know it can drive you crazy when all you are doing is looking at the salt on the floor and wanting fresh sheets on the bed. Allow things to go right now and you will be so proud of yourself when you are eventually able to do things...measure your improvements down the road as you get stronger and feel better.

 

[Bishop]

I agree certainly I can let things go, & feeling better is the priority, but that salt on the floor-my cat ate some and threw up a few times. I needed to vacuume; that only took a couple minutes and better then making my cat sick or worse...I can let the other stuff go for sure! Thank you