TKR Carol68's Recovery

[Carol68]

Hello everyone.
I’m new to this group and I’m so glad I found you.
I’m losing my mind.
I had TKR 5 and half weeks ago and I underestimated this surgery massively!
I have nausea daily, I’m struggling to sleep, I have no appetite, I’ve lost 10lbs (very much needed as I’ve put on 2 stone due to both knees being painful) and I’m constipated due to co-codamol.
To top it off I now have a suture abscess.
I saw my consultant today at Guys Hospital. He is amazing but concerned. He wants to see me again Monday and Thursday.
Infection started a week ago. I’ve been on antibiotics for 3 days. It’s extremely sore and stinging.
God it’s just one big party!
My physio quite reluctantly told me ‘the first 8 weeks are pretty rough’ and oh boy he’s not wrong!
Of course we’re all very different and we recover at different rates.
I need the left knee done too……I’m scared!
Wishing you all lots of luck in your recovery x

 

[Layla]

Hello Carol, Welcome to BoneSmart. Thanks for joining us.
Please give us the exact date of your surgery and which knee you had replaced so we're able to create a signature for you.

I will leave Recovery Guidelines here and type more in a post below.

KNEE RECOVERY GUIDELINES

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

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​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

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

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

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 a 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 history before providing advice.

 

[Carol68]

Hello Layla
I had a TKR on my right knee on 23rd January at Guys Hospital.

 

[Layla]

I am sorry for all you're enduring. When it rains, it pours, or so it seems.
Much of what you are experiencing is common, which is cold comfort, but it is temporary and will pass.
The nausea, loss of appetite, lack of sleep, constipation.

Consider speaking with your surgeon's care team about the nausea and see if they will prescribe something short term. Also, a stool softener for the constipation. Stay adequately hydrated and see if smaller snacks seem more appetizing, as opposed to a meal. Protein is important in the healing process so I'll leave a few suggestions.
Nuts,Trail Mix. Turkey roll ups (cheese or veggies rolled inside the turkey) Tuna, or Chicken Salad, Canned Salmon on Crackers, Beef sticks.
Greek Yogurt, Cottage Cheese or Cheese slices. Hard Boiled Eggs. Veggies & Hummus
Peanut Butter on Celery or on an Apple.
Protein Shakes or Protein Bars or No Bake Energy Bites (many recipes online)
Hopefully reading all that didn't turn your stomach.

As far as sleep goes, best advice is to sleep whenever you're able, even if it means napping temporarily.
You are under care for the suture abscess and it sounds as though your Consultant is on top of it so take comfort in that. Please take it easy in Physio also. It really isn't necessary, especially since you seem pretty stressed right now which is understandable. When we're feeling crappy physically it IS stressful! Try not to dwell on a Left TKR at this point and realize no two recoveries are alike, even for the same person. So prayers the next one is an easy peasy dream.

Sending a warm hug with best wishes. Stop back often, we're here for support and encouragement always.

 

[Carol68]

Ahh Layla thank you so much.
All that info is so helpful.
It also makes me feel better to know all this is normal.
I was starting to feel really defeated. I just couldn’t understand why I was feeling so poorly.
I’m desperate to get back to work (supporting SEN students in college) but I need to be realistic. My job is extremely challenging, so I guess that’s a long way off.
I have been napping when my son goes off to school in the morning. It just messes my whole sleep pattern up.
I’m not going to bed til 2am! Getting about 4 hours sleep, when I’m used to a good 8-10 hours.
I have to keep reminding myself this is not forever. It WILL get better.
Thank you so much for your advice and support.
It is so so appreciated

 

[IndigoKnee]

Just saying hi mainly because I am also in the UK (Cornwall) and had my knee done 6 weeks ago. Like you I totally underestimated how tough this journey is especially as a lot of the info on the NHS suggested that 'after 6 weeks you can resume all your usual activities…..' yeah, right. My physio suggested upping the codeine after a couple of weeks when I was not coping with the pain but as well as ghastly constipation I was dizzy and faint all the time so had to reduce it to a minimal amount. I am gradually starting to feel a bit better but everything is still extremely hard and very tiring. Awful that you the added problem of the abscess. There are many experienced people on this site that can offer good advice, so I am just adding my post to say hi.

 

[EalingGran]

So sorry to hear of your troubles.
I am in UK also and now at 4 months just beginning to feel generally better- although it has been a rough ride and I am still not 100%.
I do understand your fear about infection as I was in hospital recently with unrelated sepsis and I was very scared about my knee getting infected. But it seems your surgical team are on top of things and Guys is a really good hospital. After all it's where all the MPs go!
As to the nausea. I had that with some of the heavy duty antibiotics I was on in hospital. I was given odansetron and later cyclizine- which did help. Also just eating little but often. Feeling low after a few weeks into this surgery is totally normal. You just feel you have had enough and can't believe it is still such a struggle. Having an infection on top can only make it harder.
It does get better. I can now walk further and faster than I did before surgery. I am still seeing improvement but still have some soreness and warmth by nighttime. But it is definitely getting better. Reading posts here of people improving up to a year is encouraging.

 

[Carol68]

Just saying hi mainly because I am also in the UK (Cornwall) and had my knee done 6 weeks ago. Like you I totally underestimated how tough this journey is especially as a lot of the info on the NHS suggested that 'after 6 weeks you can resume all your usual activities…..' yeah, right. My physio suggested upping the codeine after a couple of weeks when I was not coping with the pain but as well as ghastly constipation I was dizzy and faint all the time so had to reduce it to a minimal amount. I am gradually starting to feel a bit better but everything is still extremely hard and very tiring. Awful that you the added problem of the abscess. There are many experienced people on this site that can offer good advice, so I am just adding my post to say hi.

Thank you so much.
Sounds like you’re going through the same feelings and emotions as me.
Let’s try and think of why we had this surgery done and the outcome.
I’ve been in pain for two and half years. It has drained the life outta me. I knew nothing else.
Now I’m looking forward to a pain free knee once I’m recovered.
Plus I need to pluck up the courage to have the other one done

 

[Carol68]

So sorry to hear of your troubles.
I am in UK also and now at 4 months just beginning to feel generally better- although it has been a rough ride and I am still not 100%.
I do understand your fear about infection as I was in hospital recently with unrelated sepsis and I was very scared about my knee getting infected. But it seems your surgical team are on top of things and Guys is a really good hospital. After all it's where all the MPs go!
As to the nausea. I had that with some of the heavy duty antibiotics I was on in hospital. I was given odansetron and later cyclizine- which did help. Also just eating little but often. Feeling low after a few weeks into this surgery is totally normal. You just feel you have had enough and can't believe it is still such a struggle. Having an infection on top can only make it harder.
It does get better. I can now walk further and faster than I did before surgery. I am still seeing improvement but still have some soreness and warmth by nighttime. But it is definitely getting better. Reading posts here of people improving up to a year is encouraging.

Thank you for your lovely message.
I cannot fault the team at Guys. They have been and continue to be amazing.
I was in hospital for 4 days and the nurses were so caring and supportive.
I’m just hoping the infection is a little better by Monday when I go to the hospital again.
It’s a vicious circle with the meds isn’t it.
I take the co-codamol for the pain (mostly before bedtime), that makes me constipated and causes nausea. So it’s a choice between which symptom I prefer ‍♀️
My physio suggested I start taking the Oxycodone again……I think I’ll give that a miss.
The co-codamol is more affective for me.
It’s just so nice to talk to others who understand

 

[beachy]

Sorry you're having such a difficult time!
I felt the same way for at least 5-6 weeks. Just started to feel better around 7 weeks. The nausea and loss of appetite were awful. I've lost 7 lbs and can't afford to lose more. Just started to eat better now that I can cook meals easier.
It will get better, just hang in there. And its worth it to have a strong, pain free knee.

 

[Maximoo]

Hi there I’m also in the UK and 5 months PO. My op was at Epsom and like you, the hospital experience could not be faulted- just the expectation was unrealistic. I’m still learning to walk after my quad being inactive for 3 months. I can ‘waddle’ indoors but have a real fear outside even with a stick so my progress is very slow. I came off ‘oxy’ after 2 weeks but I still take co codomol at least once a day and still haven’t solved the constipation problem. I was thinking about asking my GP about naproxen which I believe @EalingGran takes, to see if this is any better. Hope you feel better soon. I read all posts on this site on a daily basis xx

 

[trinket]

I had a terrible time with the constipation. After several different drugs that didn't do a thing I started eating prunes every day. That did the trick and was certainly more pleasant than taking the drugs.

 

[EalingGran]

Try either Dulcoease ( stool softener and more gentle) or Dulcolax ( a bit stronger!) - both available over the counter in UK. Have used both and they do help for constipation.

 

[Carol68]

Hi there I’m also in the UK and 5 months PO. My op was at Epsom and like you, the hospital experience could not be faulted- just the expectation was unrealistic. I’m still learning to walk after my quad being inactive for 3 months. I can ‘waddle’ indoors but have a real fear outside even with a stick so my progress is very slow. I came off ‘oxy’ after 2 weeks but I still take co codomol at least once a day and still haven’t solved the constipation problem. I was thinking about asking my GP about naproxen which I believe @EalingGran takes, to see if this is any better. Hope you feel better soon. I read all posts on this site on a daily basis xx

Good morning
Thank you for your message.
My daughter bought me some dried prunes. Still unopened. I’ll give those a try.
I too have Naproxen but I try not to take them unless I need them.
I’m also on heart meds for cardiomyopathy and HRT medication, so I get a little paranoid about taking so much.
When I came out of hospital I was on 9 different tablets.
No wonder my tummy is so delicate.
I actually had the best nights sleep last night since my surgery. Around 6 hours. With a few position changes involved, but I didn’t wake up fully.
I’m guessing that’s because I had a busy day yesterday. Lots of walking, 2370 steps to be precise. Not a huge amount in normal circumstances, but that’s a lot for me in one day.
So that might be the answer. I need to be more active so my body is more tired.
Sorry to hear you’re still a little unsteady outside.
I have to agree going out into the big wide world is extremely challenging.
I felt a little shaky n light headed yesterday.
Especially in the centre of London with the hustle n bustle of so many people.
It’s very daunting. I’ve literally been either in bed or on my sofa (exercises thrown in when I feel up to it) for nearly 6 weeks.
I’m usually on my feet from 6:30am til 5pm every day.
Thank you again for your message of support.

 

[Carol68]

Try either Dulcoease ( stool softener and more gentle) or Dulcolax ( a bit stronger!) - both available over the counter in UK. Have used both and they do help for constipation.

Thank you.
I might get some of that and see if that helps.
Constipation is awful isn’t it, what with all the other symptoms.
It’s weighing up which is worse……the pain or the constipation and nausea! ‍♀️

 

[EalingGran]

Know what you mean and I found the Movicol sachets the hospital gave me both useless and revolting!

 

[beachy]

I totally agree that the amounts of medication we're prescribed wreak havoc on our guts. When I stopped pain meds and started regular Tylenol 1000mg it helped my gut. Then stopped muscle relaxer. Finally tapered off gabapentin. Appetite came back. Regularity is a work in progress.

@EalingGran funny about movical. I've used that occasionally for a few yrs. Always worked well for me.

 

[Carol68]

Good morning all you lovely people
So I’m back up Guys Hospital today to get my knee checked out again.
Three times in a week is a bit much, especially on crutches, but I’m very grateful they are looking after me so well.
We had very heavy downfall of snow yesterday and I was dreading the journey today, but it’s all disappeared overnight.
I’m not very optimistic as there’s blood/pus coming through the dressing ‍♀️
So it looks like it’s still not healed. It’s been two weeks now. I’ve finished the antibiotics.
No idea what they’ll do today.
My knee has been really aching the past two days. I hope this isn’t a sign that the infection is deeper than I thought.
Fingers crossed it’s a positive outcome today
I hope you are all well (as well as can be expected).
Have a lovely day
Carol

 

[EalingGran]

Good luck!

 

[HaylingIslander]

Good morning Carol,
Read your thread and get where you're coming from.
So sorry to hear about this infection. Hope it's good news today.
Update us when you can.
Will be thinking of you