PKR Calm Alice's Recovery

DEL2022Jun-25

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Hi,
Surgery for partial knee replacement was May 9 at UCLA. I'm not sure what I was thinking but I didn't know it would be this tough. I had surgery after years of waiting through the covid shut downs. Prior to surgery I took strength and mobility classes to work on gait, upper body and core strength. I also did 8 rounds of Aqua Therapy. The results of it paid off when I needed the core strength right after surgery.

PT started 3 days after surgery (!!!) with gentle stimulation of the muscles surrounding the surgical site. Everything was going well with a constant pattern of icing (Breg Polar Ice Cube), elevation, pain medications, gentle massage, and CBD cream (5000 mg) to the local area. I had good motion, gait and the ability to pick up my foot and move my leg, until this past Monday when the PT hooked up the electrodes to my quads and also asked me to flex and tighten for 15 mins. This was followed by a whole day going to the post-op (1.5 hour drive each way) and other activities that day, when I had limited ability to elevate and ice.

Sigh. I now have a tight band where there was minimal one before, the band is in a consistent spasm. I feel like I've backslid by about a week or so.
On Wednesday, my post op went well, and the surgeon was pleased with my ability to bend my knee and overall condition, though decided to give PT a rest until next week. I'm tapering off the tramadol and am on Tylenol, baby Aspirin, colace and miralax. I can't take NSAIDs due to the havoc they wreak on my kidneys (I have regular labs done).
I won't let the PT do that electrode thing on my quads again.
Anyway, this forum was a godsend. Last night I woke up to ice and was in pain and everything I read regarding the overuse of PT was music to my ears.
I love exercise and hiking, as well as swimming. All of that is on the back burner and I hope I'll be fit enough to return to it all by September. I am working with bands and hand weights to continue upper body strength for now. I fashioned a yoga strap into a sling to rest my leg when I go to PT and sit in a low chair and have to wait.
 
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Jockette

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The tight band you are now feeling is swelling, from two days of doing more than your healing knee was ready and able to do. It’s a common occurrence, our knees are very sensitive early in this recovery and they don’t hesitate to complain, sometimes very loudly!
I’m glad to read that you are willing to put this on the back burner for a while, so you can give your knee the best opportunity in which to heal. Taking time to heal will reap great benefits in the long run. This recovery is temporary, and if you keep that in mind, you’ll do well, and will get back to your activities. Add those back in gradually as you feel better.
This is a great idea! Well done! I wish I had thought of that.
 
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Jockette

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Which partial did you have, Lateral, Patellofemoral or Medial? I’ll add that information, along with your surgery date, into a signature for you.

I also had a partial, a Patellofemoral, and was shocked at the recovery, after all the reading I did beforehand about how quick and easy recovery from a partial would be.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​


4. PT or exercise can be useful BUT take note of these

5. At week 4 and after you should follow this

6. Access to these pages on the website

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 
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DEL2022Jun-25

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Thank you for the great resources and the nice welcome! I had a medial pkr, after having osteoarthritis for years, which got worse after my cancer treatments in 2019.
I'm wondering --is the login for the iphone app the same as the one we use for our online account?

As far as the yoga strap sling on the walker: The secret is to make the right knots so that the pressure doesn't make them come loose. I made adjustable hitch knots on both ends while I was waiting.

I really like the piece on elevating the leg. I was told by the nurse navigator to buy that awful foam slope. It was costly (around $159) and that's what put awful stress on the muscles behind the knee. Fortunately, massage has worked with that, and the PT showed me that I can still use that foam piece if I put a small rolled towel under the knee. But for now, I have 3 stacked pillows.
Again, thank you so much for all the info!
 

Jockette

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I’ve never used the iPhone app, so I don’t know. Have you tried it? I always come here via the internet.

What foam slope did you buy, was it the Lounge Doctor? I didn’t have that one, I had a wedge that my hospital sent home with me. It took me a few weeks to like it. I had to work up time spent on it gradually, it did hurt at first to have my leg on it. But, I came to love it, and still use it today!
 
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DEL2022Jun-25

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It's a wedge that goes straight up with a channel for the leg so that it doesn't roll in or roll out It keeps the leg straight but forces enormous strain on the muscle band in the back of the knee. Anyway, three old pillows is fine, works well, and that other thing --the dog will play with it someday.
 

WFD

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The login for your phone is the same as the one you use on your PC.
 

Jockette

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The wedge you have is similar to mine, but mine does allow a slight bend to the knee. Keeping the leg totally straight is painful because, like you said, it forces enormous strain on the muscle band in the back of the knee. A slight bend is fine, and more comfortable.

 
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DEL2022Jun-25

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Stopped the tramadol, and also stopping the colace to go back to Benefiber. All of the drugs were just gutting me, and the pain has greatly subsided, which can be managed with tylenol.
My ortho recommended trying Voltaren rub around any areas that flare up, since I can't take Celebrex. Both are NSAID's but the Voltaren stays localized and won't hit my kidneys.
Also, now that I can move around more, I'm doing laundry again swiffering a bit, using the Dyson stick to vacuum and am engaging with our pup, Apollo. He's still going to the boarder for the 24 hour shifts my husband works in the ER 2x a week, because at 9 months of age, he's handsome but a total doof (and there's only so much doof I can deal with 2 weeks post-op). I'm still in the small bedroom downstairs, though now the cat thinks I live here at his pleasure, and so who knows when I'll go back upstairs again.

I'm starting with my upper body strengthening again. I miss my workouts, and need to keep the upper body stuff going.
I am a bit depressed not being able to drive. When were you able to drive?

Photo: Apollo. 9 months old and huge.
 

benne68

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When were you able to drive?
Driving depends on a couple of factors.
  • If the surgery was on your left knee, you are generally allowed to drive once you are off opioids and feel up to it.
  • For the right knee, however, you want to wait until your surgeon clears you. That usually around 6 weeks or so, depending upon when you have your followup appointment. It's important that the knee be strong enough to slam on the brakes in an emergency. (Of course, you also need to be off the opioids!)
In my case (I had a RTKR), my OS cleared me to drive at 6 weeks but I did not feel ready until 8 weeks out.

Let us know if your PKR was left or right now so we can add it to your signature.
 

InkedMarie

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Hello! Just wanted to mention Smooth Move Tea to help things....err...move!

Marie
 
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DEL2022Jun-25

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Let us know if your PKR was left or right now so we can add it to your signature.

PKR was on my right medial knee.
Bummer.
Hello! Just wanted to mention Smooth Move Tea to help things....err...move!

Marie

Thanks Marie! I know about Smooth Move tea. I've used benefiber for a couple of years. 30 grams of fiber a day and it's the most expedient way to ensure I get it. It mixes easily with whatever I'm drinking. I worked with a registered dietician on meal planning for some time, and really need to get back in touch with him now.
I'm also using Hello Fresh who delivers 3 simple meals to cook (my husband does it). It's a time saver, and we worked it out that it's cheaper than ordering in or going out and they're nutritionally balanced as well. Then all I gather is breakfast and lunch. I lost weight prior to surgery and I'd like to keep it off. A bit of a challenge when I'm kinda stuck right now, so watching food intake is important.

Nights are the hardest because I wake up 3 hours into my sleep needing to change position, or turn on the ice machine. As far as ice machine, someone tipped me off to just put 4 frozen water bottles + water in it and it's good to go for 6 hours.

Tonight my husband has invited his brothers over for his birthday! That was a surprise!!! I've ordered party platters off Uber Eats to be delivered, and I'll just sit in my room downstairs and they can rotate through and visit! Right now I'm seeing if I can get a birthday cake delivered. (The things we do).
Have a nice weekend everyone!
 

InkedMarie

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Hi! How is Hello Fresh? I see the commercial for it on tv. I’m 5 weeks post op and sleep is not good. I got about 4.5 hrs last night and that was with going from bed to recliner to futon to bed. Took a 1.5 hr nap this afternoon. Hope the birthday party went good!

Marie
 
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DEL2022Jun-25

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How is Hello Fresh?
Hi!
I've used Hello Fresh and SunBasket in the past when I got sick of cooking. I like them both and have lost weight on both. Sun Basket has loads of ways of narrowing down what someone might want: Keto, paleo, vegan, gluten free. Hello Fresh is also very healthy, but their marketing is more for the busy person coming home, who just wants to cook without a lot of fuss. I felt that the Sun Basket meals were a bit fussier. Hello Fresh has really slimmed down on the packaging, it's much less than it used to be.
Each week we choose 3 different meals, which are delivered in a cardboard box with an ice pack and it's very well insulated. All of it is recyclable. Meals have listings like "Carb smart" "Calorie Smart" "Mediterranean" "Vegetarian" "Easy Cleanup" etc. The proteins offered are chicken, ground beef, fish, chicken, pork, and steak (which is extra). What's really nice is that the meals are incredibly easy, and we waste far less food. On average it'll take me about 30 mins to cook and the cleanup is minimal. For the basic meals we're averaging $69 a week for 3 meals, and lately I've been choosing breakfast items as well.

They offer pretty irresistible start up deals with hefty discounts for the first few weeks. It's really a win-win situation! I do have a code if you want to try it. Just PM me. I don't work for Hello Fresh. Just am very glad to have their services while I'm in a situation needing nutritious meals and not being able to shop, and with take out food being so high in calories and carbs, as well as expensive (both food and gasoline are rising).

For the other four days a week, I try to eat light, especially now!
 
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DEL2022Jun-25

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Hi, They also offer shrimp.
If you have anyone who is diabetic, or lactose intolerant, you might want to look at SunBasket, who breaks down their choices even more.
I can also recommend working with a Registered Dietician online. I did this for 9 months and gained a lot of insight about food, emotions, and gut health. Really excellent. There was even modules and homework to go through, and online support. Just ask, and I'll tell you the name.
 
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DEL2022Jun-25

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Just wanted to mention that if you specifically lactose intolerant or you avoid soy, or you want to have your ingredients really broken down, then go with Sun Basket. Their meals are a lot healthier, but Hello Fresh is tastier. But both are good!
What's usual is at some point I'll jump ships and stop on delivery service and go to another for the variety. It's sort of like trying different restaurants. So in another month or two, I'll go over to Sun Basket or maybe try Blue Apron.

For the past two nights, I've slept 6-7 hours, but I'm noticing that only happens if I nap adequately during the day! The day before and yesterday I got in some good nap times -that's when bones grow (when you're young) and heal. So I hope you can get your sleep issue solved. Is the futon comfortable enough? Can you put a memory foam mattress pad on it?
 
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InkedMarie

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The futon is horrible but I figured I’d try it anyway. We only have it for grandkids. Sleep will get better. Am I correct that you sleep better if you DO nap? I’ve been trying lately NOT to nap, in fear I wouldn’t be able to sleep at night.

Marie
 
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benne68

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You are still early enough in recovery that you should nap/sleep whenever and wherever you can, @InkedMarie. Sleep is essential for proper healing and fatigue can slow your recover. So, nap away!
 
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DEL2022Jun-25

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Am I correct that you sleep better if you DO nap?
Okay, I'll guess you're downstairs, which is why you're on a futon. Consider getting of that futon mattress, and replacing it with a memory foam mattress purchased off Amazon! Just make sure you have someone around to unbox it and set it up. Just buy a twin size, it should fit on the futon, or get a full size. It'll have the lump-free support you need. a 6" or 8" thick mattress should do. Worry about the futon mattress at a later date. They really are dreadful.

Yes, in order to sleep well, it helps to be rested! So nap away! Recovery (and growth in young people and pets!) happens when the body is rested (that's why they sleep so much).
 

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