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Bilateral TKR BTKR post op 4 hours<

Thanks everyone...had a really good yesterday then BAM, pain, emotions, swelling...I guess you get the little feel good breaks to help when the bad pain comes again. Really really wanting to sleep on side. With both knees done is this possible?


L arthroscopy 5/2013
BTKR Dec 1, 2015
 
It may be a bit early to sleep on your side as you've had both knees done, and you probably should still be elevating your knees. But I don't think it will do any harm to try for a little while. Put a pillow between your knees and experiment. You may need some help at first to get into the most comfortable position.
 
Hi Scooper, I had a BTKR just 4 days before you, and although I intended to sleep on my back, I end up on my side every night, I do wake up regularly, but I do manage to get some sleep as its my natural sleeping position. I don't seem to have suffered for it and firmly believe that getting a decent sleep will do me more good than lying there awake on my back! I move position every few hours or so (this causes the waking bit). Hope everything is going well, its a slow mountain we climb!
 
Merry Christmas Everyone.. Hope you can be distracted from pain for a bit today. My steri strips are falling off and I was just wondering what is the best thing I can rub on my incision. Is coconut oil ok? My PT said Mederma. Just watched my grandbabies open their gifts. Can't wait for next year when I can be more involved.


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I actually waited almost two months before my pt started massaging my knee with Palmer's Coco Butter. It was amazing!
 
I was told not to put anything at all until after 6 weeks and then use a vitamin E lotion/cream
 
I also was told to wait until every little scab was gone and everything was closed. Then I was to open a vitamin E and use that on the scar. It is sticky!
 
4 weeks post.. Trying to walk more outside. My knees feel like thick tree trunks. I am also very shaky and jittery. Other than that I can feel improvement daily.


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I love that description- thick tree trunks! It is VERY accurate. Spellcheck keeps changing "leg" to "log" when I mistype and I have to laugh because it is true! :rotfl: Feeling shaky and jittery can be from your drugs, being dehydrated, or just being weak from your surgery. Be careful so you don't have a mishap. You will get your strength back. I am proud of you for your walking and for recognizing improvement! Having a good attitude means a lot! Happy New Year!
 
Just wondering what is an acceptable timetable for a BTKR to be able to take a trip. I had mine Dec 1 and we were wanting to plan a trip to NO in April. The car drive will be about 10 hours. Is this reasonable or a big wish?


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I had mine Dec 6 2011 and had two weeks' cycling in Majorca, including aeroplane travel, the following April. I'd say plan on stopping a lot and maybe sitting in the back a lot (except when driving I guess...).
 
ScooperTR said:
I was trying to read your post to my husband and broke down in tears. I am 7 weeks post op BTKR and I feel everything you're saying. It does seem now I am hurting more now that I've started OP PT. They do not hurt me at all and I do all my exercises in pool.... But it completely takes everything out of me.
Click to expand...
@ScooperTR I saw this in someone else's thread and copied it here to reply to it.

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. And don't compare this with the bone-on-bone pain you had before surgery! :no-fin:) Also don't forget to include other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness

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. how swollen is your leg?
[Bonesmart.org] BTKR post op 4 hours<


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

8. what kind of PT exercises and exercises at home are you doing? How much and how often?
This is the most crucial question so please use these examples to frame your list when you reply ..

Exercises done at home: 3 sessions a day
Heel slides x10 (reps)
Straight leg raises x10
Steps x10

At PT
Squats x5 (reps) x2 (sets)
Wall slides x5 x2
Clamshells X5 x2
 
My pain level is usually 1 or 2 but a couple hours after PT 3 or 4

Pain med is oxycodene 5 mg but I break those in half and take every six hours. I usually take 2 advil middle of day

I am icing after exercising and PT for 29-30 minutes

I have to be honest and say I have not elevated the past two weeks

My ROM for flexion is about 100 on both knees and 5 on extension.

My leg is moderately swollen

I feed my dog and let her out, make breakfast, rest... Do exercises, ice then shower and usually get out for an hour. I then nap or rest in afternoon doing second set of exercises and walking

Exercises at home twice a day
Foot pumps x 20
Quad set x 20
Heel slides x 20
Toe raises x 10
Leg swings to side x 10
Squats x 10
Leg bends x 10
Calve stretches x 10

OP PT

Pool exercises
Walking back and forth front and sideways x 2
Marching length of pool x 2
Riding bicycle 3 minutes
Toe raises x 20
Squats x 20
Rockettes kick x 20
Jumping jacks in deep end x 20
Calve stretching x 3 for 20 sec

I think there is a few more I just can't remember. Then they massage scar and back of legs( feels good)

Then ice and tens machine for 10 minutes

I can tell by answering these questions that I'm not doing all I can and some too much. It's such a fine line and my OS said let pain be your guide. Well you don't know usually that you have overdone until after!



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ScooperTR said:
My pain level is usually 1 or 2 but a couple hours after PT 3 or 4
Click to expand...
Okay
ScooperTR said:
Pain med is oxycodene 5 mg but I break those in half and take every six hours. I usually take 2 advil middle of day
Click to expand...
Well to start with, Advil is not really a pain killer, it's just an anti-flammatory which is something else altogether. Don't believe all the advertising. And 2½gms of oxycodone is not an effective dose. Either take what's prescribed or don't bother. But you could boost the oxy with Tylenol 1,000mg 3-4 times a day.
ScooperTR said:
I am icing after exercising and PT for 29-30 minutes
I have to be honest and say I have not elevated the past two weeks
Click to expand...
You accomplish little or nothing in 20 minutes. Ice for at least 40-60mins and more than 4 times a day. And elevate the same if your leg is swollen.
ScooperTR said:
I feed my dog and let her out, make breakfast, rest... Do exercises, ice then shower and usually get out for an hour. I then nap or rest in afternoon doing second set of exercises and walking
Click to expand...
That's not bad. Keep it up!

My comments in bold
Exercises at home twice a day - try once a day and none at the weekend
Foot pumps x 20 - these are only anticlot exercises and at 8 weeks and being active, you really don't need to do them any more!
Quad set x 20 - do 10, that's plenty
Heel slides x 20 - these are very easy to do incorrectly - read this Heel slides and how to do them.
Toe raises x 10 - these are very punishing on your knee. I suggest you stop doing them
Leg swings to side x 10 - unnecessary for a TKR
Squats x 10 - absolutely don't do these - bound to cause pain in the knee!
Leg bends x 10 - same again
Calve stretches x 10 - okay

OP PT
Pool exercises
Walking back and forth front and sideways x 2 - I've never seen the point of these
Marching length of pool x 2 - marching is very hard on the knee and on the IT band and such. I suggest you don't do them
Riding bicycle 3 minutes - that's fine
Toe raises x 20 - these are very punishing on your knee. I suggest you stop doing them
Squats x 20 - absolutely don't do these - bound to cause pain in the knee!
Rockettes kick x 20 - you are joking! I really cannot see any benefit in these, not at 5 weeks out, anyway
Jumping jacks in deep end x 20 - in the deep end or not, this is not a good idea for a 5 week old knee!
Calve stretching x 3 for 20 sec - okay

In summary, you're doing far too much, it's not the exercising that gets you your ROM, it's time. Time to heal, 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 mobility and stretches are the key to success.

You're 5 weeks out - you should still be resting your knee and allowing it to heal, not doing all this. If you need confirmation of this approach, I recommend you read my recovery threads to see how little exercising I did!
First knee. Knee recovery - UK style
Second knee. Josephine's 2nd knee story - short version where I did even less!
 
I have a question.. I'm about 13 weeks and doing great but within the last week my right knee has a swollen lump right by kneecap. I have iced, elevated, massaged.. Just wondering if this is just all part of the healing process and do you still get swelling for a few more months? Love my new knees.. So happy


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Can you post a photo that shows the lump?

It is normal to still have some swelling for a while longer yet. You'll probably find that your knee swells if you do more activity than usual, but it should go down overnight. I used to look on that as a warning - my knee was telling me that I had done a bit too much for it.

13 weeks is still only a quarter of the way through this year-long recovery journey so your knee is still only a toddler.
 
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