TKR Both Knees -Long awaited surgery finally completed<

[Mrsjewben]

Hello everyone. I am so happy to have found this site. Reading other's threads has been helpful and made me feel like I'm not alone.

I was born with a defect that placed my knee caps improperly and caused me to wear away bone quickly. By the time I was 25 I had the knees of an 80 year old woman and was not yet a candidate for replacement due to my age. Finally I became a candidate and just in time...my patellae were close to thinning to the point of no treatment. My right knee was replaced 1/23/17 and left 1/26/17.

My therapy is progressing as I am impatient and push my limits. However, I am still in a lot of pain...muscle pain is combined with the discomfort of the replacement. Can anyone recommend something for muscle pain?

I have researched topical creams and these cannot be used due to they interact with the blood thinners and raise coumadin levels. I'm anxious to get off these pain meds...I am so done with being in pain already.

Also wondering if anyone really has an idea of the (average) weight gain caused from swelling and the prosthetics. My appetite has greatly decreased and I just curious how many pounds I can take into consideration when weighing myself.

 

[RMasano]

Welcome!!! There is a ton of great information here and people who can help you. No one likes to take the pain meds but you are going to find that you will be needing them. You are so early in your recovery and had both knees done, so you might need to rely on the meds for a while. There is a lot in this process that I expected-pain, discomfort and work, but the one thing that surprised me the most is, the amount of patience required. Good luck in your recovery. You came to a great place to ask questions and get support.

 

[Josephine]

Also wondering if anyone really has an idea of the (average) weight gain caused from swelling and the prosthetics.

You will be surprised to learn that the prostheses are amazingly light weight. Read this and see what they weigh. Weight of hip and knee prostheses

I'm anxious to get off these pain meds...I am so done with being in pain already. My therapy is progressing as I am impatient and push my limits. However, I am still in a lot of pain...muscle pain is combined with the discomfort of the replacement.

Oh Miss Impatient! I'm sorry to have to tell you that this recovery can take upwards of 4-6 months and often longer. You are, as yet, only 2½ weeks out which is what we call "slap bang in the middle of the angry tissue phase"! So you must resign yourself to many more weeks of this. Sorry, but that's how it is.

However, there maybe something I can advise for you to adjust your routine to better manage all this.

So I'd like to ask you some questions if you don't mind, and it would be very helpful if you would answer each one individually - numbered as I have done - 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)

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?

4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[Josephine]

I've also changed your thread prefix as the term bilateral is very specifically for knees that are done at the same time. Yours were three days apart which makes them two unilateral TKRs. Sorry but that's how we do it here.

I also need to leave you this list of recovery articles.

Here 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
BoneSmart philosophy for sensible post op therapy

The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs

Myth busting: no pain, no gain
Activity progression for TKRs
Heel slides and how to do them

Extension: how to estimate it and ways to improve it
Elevation is the key
Ice to control pain and swelling

Healing: how long does it take?
Chart representation of TKR recovery
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?

 

[Celle]

Welcome to recovery, @Mrsjewben

Having both knees done in such a short time span is challenging, but I think you will find it was worth-while in the end.

Just be prepared to take things slowly and don't do or allow anything that hurts your knees.

 

[jaschembra]

Patience grasshopper. Weight - due to having saltine crackers and peanut butter and bananas at multiple times day and night to prevent any nausea from pain meds and based on the body swelling from major surgery - I did not get on the scale for a month after my surgery. This is coming from someone who weighs every day. There is a wide variety of prosthetics but mine weighs 1 lb. 13 oz. (I asked my OS and he weighed his display pieces lol)

Yeah to you for getting them both done. I'm approaching 6 weeks and the old knee has started talking again.
You really are in the worse of your days and the one thing I can say is - it will get better.
Josephine will be able to provide good information. But definitely plan on taking your pain meds to stay ahead of/on top of the pain. Oh, and ice, if you haven't already figured it out, is your best friend!

 

[Red's Mom]

Welcome to the staged double TKR land! Mine were 4 weeks apart. PATIENCE girlfriend! Those muscles are going to hurt and spasm for quite awhile. I spent HOURS rubbing everywhere except my incisions. Also had "the stick' , the stretch strap, tennis balls, golf balls and this nifty device called "gofit' - very hard ball that rolls around in a rubber holder. Your soft tissues have sustained significant injury and need time to heal. The swelling, bruising, spasms and pain all are symptoms of injury. The pain meds, ice, elevation and rest are your friends! Take your pain meds on a strict schedule you will be happier in the long term. Please don't let anyone hurt you! Keep us posted on how your doing.

 

[Mrsjewben]

1. what are your pain levels right now?
I'm usually about 4

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?
I'm on Oxycodone(Percocet) 7.5 mg /acetaminophin 325mg. 2 tabs every 5-6 hours. I try to stretch it as close to 6 hours whenever I can...unless the pain is reaching higher than 4. Then I pop them sooner.

3. how swollen is your leg compared to these? I am the middle image

4. what is your ROM
my right ext is 128 flex -13. My left is the problem ....ext 115 flex is poor. I cannot straighten at all.

5. are you icing your knee at all? If so, how often and for how long?
I ice as much as possible.

6. are you elevating your leg. If so how often and for how long?
I elevate when I'm not walking or exercising.

7. what is your activity level?
I can walk a sufficient amount. I go up and down my flight of stairs several times a day. I attempt light cooking as just standing is painful ( need to keep moving ). Shopping is a task...so I utilze the electric wheelchairs in the supermarket. And i am not yet driving as i experience spasms frequently.

8. are you doing any exercises at home?

SITTING: knee bends,leg kick
STANDING:heel/toe rock, backward knee bends, side kick, mini squat marching
LAYING: ankle pump, heel slides, lower leg kick, knee press, leg raise
I have had in home PT through today. I start outpatient PT on Friday

 

[Roy Gardiner]

My therapy is progressing as I am impatient and push my limits

However, I am still in a lot of pain...muscle pain is combined with the discomfort of the replacement. Can anyone recommend something for muscle pain?

Cause and effect. If you do exercises - strength, endurance or stretching - that cause pain either at the time or later, you are compounding the damage done by surgery, not helping it. Your recovery is progressing more slowly than it should.

Healing is something the body does all by itself and needs no help, indeed doesn't like help. Pain-free stretching exercises will help to restore mobility, but won't actually speed up healing. Nothing can do that.

The cure for muscle pain is -- and I'm not being a smartiepants or smart-anything else here -- is not to do the exercise* that causes it. You don't need training, you need healing. No pain, more gain.

*Note that this applies to your leg muscles that have been involved in surgery. Any other training, such as upper body work, can carry on as normal.

 

[Josephine]

I cannot respond to your answers unless you reply properly.
You've not told me anything about the following as I requested

- how many sessions you do each day
- enter exercise by name then number of repetitions of each​

Please help me to help you by giving me the additional information.

SITTING: knee bends,leg kick
STANDING:heel/toe rock, backward knee bends, side kick, mini squat marching
LAYING: ankle pump, heel slides, lower leg kick, knee press, leg raise
I have had in home PT through today.

 

[Red's Mom]

@Mrsjewben how are you coming along?