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[BILATERAL TKR] Carol's Recovery<

Discussion in 'Knee Replacement Recovery Area' started by CAB, Oct 16, 2018.

  1. CAB

    CAB junior member
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    Hello and thanks for this forum. Its nice to see others with similar problems i.e., freezing cold for weeks after op. Seems to be nearly gone now thankfully.

    Sleeplessness, still got it.

    My knees and thighs seemed to be in constant cramp although not quite sure how to describe this, I felt like they were constantly in a vice, this always seemed so painful. Although seems to be easing now.

    I've been going well with my knee bend 130 on my left and 120 on my right, at week 4½ weeks. (well fancy that I still have a good and a bad knee!)

    Just when I was going so well, I had an extremely painful near full collapse, while taking the last step with my right leg. It was so bad I thought I had dislocated my right knee. Thankfully I can walk, I now have bruising on my knee cap and a couple of muscle strains in my quad. I can't lift my leg because of the pain in my quad. Although I am getting a "little" lift at times.

    I'm so frustrated that this has happened, right about the time I'm supposed to be able to start to drive again!

    Anyone had similar, any idea of time to jump this hurdle?
     
  2. Bismitmom1

    Bismitmom1 junior member

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    @CAB my outer thigh muscles hurt and my outer calf/shin muscles too. After talking to OS yesterday he commented that my leg had alignment issues before, and now it is straight again. Muscles are trying to retrain themselves to be correct again after being wrong for so long. Could it may be the same in your case? Just a thought!

    Sent from my Pixel 2 XL using Tapatalk
     
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  3. Bismitmom1

    Bismitmom1 junior member

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    Oops! I didn't quite read all of yours correctly. I'm sorry! It stinks that you had this happen right before being cleared to drive!

    Sent from my Pixel 2 XL using Tapatalk
     
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  4. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Hi and Welcome to Bonesmart!

    I’m sorry to hear about your fall, I think we all fear that happening!

    I am going to tag @Josephine
    our forum administrator and nurse director to address your concerns.

    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.

    Knee Recovery: 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
    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
    5. Here is a week-by-week guide for

    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.
     
  5. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Tell me where you have pain using this chart

    aa knee-references-horz.jpg


    After that, I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
     
  6. CAB

    CAB junior member
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    Thanks @Jockette I have read all those guide lines from others before posting. There is good advice to be had on this site.

    I didn't have much alignment @Bismitmom1 but did wonder about that in the beginning of my recovery.

    I'm miffed to find that I've woken to a very stiff right knee that doesn't like to straighten to zero. Hmmm something I've never had trouble with.

    Oh well I'll try to be kind to my legs today! I have an overseas visitor who wants to meet in Manly today. Looks like a bit more icing and elevation this morning and I might need another breakthrough tablet today!

    B C RF1 pulls when moving in certain ways

    Yep ask away

    Oh and @Josephine both knees but right more so hurt when straightening from bent after sleeping.
     
  7. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Isn’t it amazing when both knees are done the same day and each recovers differently!

    I never had a problem straightening my leg before surgery, at least not that I’m aware of, but I did for a few months afterward, all due to the swelling caused by the trauma of the surgery. It will sort itself out in time as you heal.

    Best wishes as you continue healing!
     
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  8. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    So your pain is here?

    cab.jpg

    I'd say that is ITB (ilio-tibial band) issues


    Here y'go then!

    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 forget to factor in 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 swollen is your leg compared to these?
    ai63.tinypic.com_eta39s.jpg

    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.
     
  9. CAB

    CAB junior member
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    1. Lying here icing and elevating zero pain.

    2. Pallexia SR 100mg morning and night. ATM I'm supposed to be on 50mg x last weekend but after accident I'm taking a few more days to come down to 50mg x twice daily.
    Also take 75mg Lyrica x twice daily, Panadol osteo 2 x 3 daily often only take 2 doses daily . Plus Mobic 7.5 mg daily. (wow a lot huh?)

    3. Left slight. Right bit more than moderate.

    4. before accident Left 130/0 Right 120/0. Not sure now on both. Today seems pretty good bend really.

    5. Yes still icing often 3-6x daily usually 15 to 20 mins

    6. Yes but not high enough often enough probably. Maybe once a day. But always sit with legs up.

    7. I make own breakfast and some lunches. Husband does dinner, shops, most housework. I've been following your guides.

    8.
    Heel slides x30 1 daily
    Toe raises x30 1 daily
    Hamstring stretch - often when leg gets tight daily
    Calf stretches 1-2 daily.
    Step up and overs 10 x2 x 1 daily but are difficult to impossible for right leg ATM due to strained muscle in front of thigh.
    Leg lifts x30 1 daily plus some whist sitting
    Right leg cant do ATM
    20 walking outside 1 daily
    Walking around our home often.

    Outpatients rehab x twice weekly
    50 mins in gym doing similar to above plus
    ball rolling on bed x30 reps
    Ball rolling on wall x30 reps.
    Sit to stand reps up to x30.
    Balance walking on foam
    Walking 6 mins
    Cycling not happening ATM
    50 mins hydro

    All similar to gym plus
    wobble board x30 small squats
    Cycling on side 3mins
    Straight leg kicking 3 mins
    Legs out to sided x 3 mins.

    Bit hard to list all as exercises change daily

    @Josephine i think my pain is in front muscles that I strained whilst stepping up a step and I thought my knee had dislocated. I had about 3 areas initially that were screaming. I think they are settling down day by day. They only yell at me if I'm trying to lift my leg.
     
  10. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    You mean you never have any pain?
     
  11. CAB

    CAB junior member
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    Ahhh @Josephine no. I'm sorry was thinking of at this minute, answering like I was still in hospital!

    Yes I have pain. Sitting at a table is serious trouble for me and then I'd say 5 out of 10.
    and I get quite nauseous to go with it. It's mostly the cramping and vice like on my legs at night. I don't know how to put a number on that.

    I'm waking in bad pain when straightening legs after sleep. Then like a 6 or 7 but only for a few minutes.

    The muscles I injured are serious pain (7) when I move in the wrong direction. But again only for a short amount of time.

    I can sit to stand today with only a small amount of discomfort.

    Right leg still says no to leg lifts.

    I hope this might make some sense...
    Cheers
     
  12. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    That's better! And I can definitely assure you, you are NOT in hospital!

    However, now you've told me you can have pain scores of 5 and 7, can you tell me this again
     
  13. CAB

    CAB junior member
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    @Josephine I just checked and I've listed meds in question 2 above. And they are all correct. But wont let me cut and paste.

    All was going well yesterday afternoon and evening, elevating, icing, resting etc., started to be able to leg lift as the muscle strain was settling nicely. Going to bed feeling great when down I went. My shoe was slightly ascue and caught on the carpet. Before I could think I was on the floor. How frustrating is that!?

    The muscle on right side of right leg strained a bit higher. I iced immediately. I'd say rf1 abc.

    I'd like to say I may have dodged a bullet as at 4am I can move my leg side to side and heel slide on bed with not too much discomfort. Slept for 4 hours reasonably comfortably.
    Not up walking yet!
     
  14. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    THat's odd because I can! However, perhaps you'd be better using this tool How to use the quote feature

    What I was asking was, are these the drugs you are taking considering you have now declared a pain score of 5-7.
    Given that Lyrica and Mobic are not really effective pain meds, that means you are left with Pallexa abd Panadol Osteo which seems to me to be a somewhat inadequate coverage.
     
  15. CAB

    CAB junior member
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    Yes that's it for pain relief. As per schedule I should have cut down to the 50mg SR Palexia by now. I'm aiming for that in a day or 2 all being well if I cant get out of pain by rest and ice etc. (I try this first)
    I can take a 50mg IR Palexia anytime.
    Occasionally I take a half if I have a coffee date.

    This is to help me get through the hamstring pain when sitting on seats! Always there! Sometimes easing.
     
  16. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Well, I think you'd get better relief if you took 1,000mg paracetamol instead.
     
  17. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Okay
    That is most excellent! And you're only 4½ weeks out! Incredible!
    You accomplish little or nothing in 20 minutes. Ice for at least 40-60mins and more than 4 times a day.
    The rule is "toes above nose"!
    Good!

    I've crossed out ALL these because a) they are totally, over the top excessive and b) you don't need them anyway as your ROM is excellent! Also c) your pain levels are excessive, unnecessarily excessive. And it's all caused by this crazy regimen of exercising you are doing. PLEASE, do stop it completely! It will do you no good at all and in fact, may even cause your progress in time. I kid you not! I've seen it happen countless times on this forum which I why I always promote against it.

    I should tell you that a number of us on here did our recoveries with NO exercising whatsoever. I was one of them! I recommend you read my recovery thread to see how little exercising I did for either knee! Knee recoveries UK style Parts I & II (Josephine)

    If you are concerned about refusing to do therapy, you need to read this Saying no to therapy - am I allowed to?
     
  18. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    I am one never took formal PT or did exercises. I had 11 knee surgeries, 2 of them kneecap removals and 1 tkr. Even after those I never took PT. But, I didn't just sit around and do nothing. I took care of myself, my house and yard as my knee allowed me to do. As I healed, I did more. But, my knee was always in control! This was enough therapy for me and would be for any tkr patient. All the awful pain of PT is so unnecessary.

    All you have to do is use it in your daily living! Your knee knows how to rehab itself and doesn't need anyone telling it how. Just use it and it will come back like new! You have to be patient, though, it doesn't happen quickly! ADL,(activities of daily living), going to the bathroom, brushing your teeth and bathing, fixing a light meal, getting something to drink and or a snack, those kinds of things will be all the exercise your knee needs. If you just use it daily in your living, you can have a less painful recovery. We know what works, we've been there!
     
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  19. CAB

    CAB junior member
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    Panadol oesteo is 625 of paracetamol (funny how everything is called something different around the world). So I'm taking 1250mg paracetamol 3x daily.

    I've read your recovery and will take it easy with rehab at home. Some tho help my stiffness in the morning.

    I'll be kinder to myself and see how I go.
    Thanks girls!
     
  20. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    You miss the point, CAB. Paracetamol is only effective in the system for about 4-5 hours so no matter what dose you take, at 2-3 times a day, you end up spending up to 3-4 hours with no medication cover at all. Taking 1k every 6hrs means you have an almost constant cover of paracetamol which is far more effective.
     

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