LTKR 8-week Post-Op Status Report (Sorry, it's kind of long but there's lots of info)
For the benefit of those who are just starting on this TKR journey, I thought I’d summarize where I’m at now that I’m 8 weeks post-op. Just remember – you aren’t me and your knee will heal differently, so don’t compare your recovery to mine. I almost feel guilty with how well my recovery is going when I read all the stories here on BS about everybody having severe pain, infections, and all kinds of other issues. I just want people to realize that not every TKR goes badly. It’s never easy, but it’s not always a horror experience either.
A little background – I’m a 59 year old female, 5’5” and weighed 205 at time of surgery. (An unexpected benefit of the surgery – I’m now at 195 due to lack of appetite) Both of my knees have gradually gone bad over the years and both were bone-on-bone. I chickened out of doing a bilateral and decided to do my left knee first and the right one a few months later. I’m still up in the air over whether that was the right thing to do. There were pros and cons either way and I’m not about to try to talk anybody into or out of a bilateral – it’s a very personal decision.
I had total anesthesia for the surgery and didn’t have any issues at all with that. Post-op pain was reasonable and the hospital did a great job of keeping it under control with morphine the first day and then switched to 2 Percocet 5/325s every 6 hours. Spent 2 nights in the hospital during which I was dragged out of bed twice for some gentle PT and a couple of times for bathroom trips. Then the OS sent me home with prescriptions for iron supplements, stool softener, blood thinner, and Percocet 5/325 to take 1 every 4 hours. They gave me a nice ice/gel pack kit to ice the knee (I didn’t even know there were ice machines until later when I read about them here on BS, but I liked what I had and doubt I'll get a machine when I do the right knee). No external stitches or staples, just internal sutures with the incision glued shut and held with Steri-Strips and covered with a bandage. No compression stockings because my OS doesn’t believe in them. They told me to remove the bandage after a couple of days and then it was just open to the air with Steri-Strips covering it. They did give me some gauze and a tubular stocking-thingy to cover the incision if I went out, just to protect it from our germy world.
The first couple of weeks at home I was surprised at how tired I would get. Taking a shower was absolutely exhausting. We had a stool in the shower that I would sit on, and we also put a kitchen chair in the bathroom to give me someplace to sit when I wasn’t in the shower. Even after I didn’t need the chair in the shower any more, the chair in the bathroom was still great to sit down on while drying my hair and doing other things that would have meant too much standing. My blood thinner prescription required giving myself an injection in the stomach twice a day and I definitely needed to sit for that! (Just a note – the injections were almost totally painless and not at all as bad as I thought they’d be.) I also couldn’t lift my operated leg for a couple of weeks without help because the muscles were unresponsive – my PT said that was normal and it did eventually get better. I did the exercises they gave me at the hospital and for the most part didn’t have any problems with them.
I started PT about 1 week after surgery. My OS doesn’t believe in in-home PT and prefers his patients get up and move so he had me go to an outpatient PT center. That worked out fine, and I do think the moving to get in and out of the car, plus the
little bit of walking required, was good for me. The 15 minute ride in the car was painful on the back of my legs, but that got better after a couple of weeks.
I left the hospital with ROM of 5/85 and after 6 weeks of PT I was at 0/120. My PT was pretty gentle, and the only time he really hurt me was when massaging the ligaments and muscles next to the knee. He said was trying to smooth out the lumps of glue left under the scar, but luckily there weren’t many lumps and it was already pretty smooth. Once I got the ROM to 120 he announced he was done with me and released me. Frankly, I felt it was a pretty abrupt “release” with him announcing during a session that I was done and didn’t need to come back. I thought I’d have a few more weeks. I suppose his goal was me hitting 120 and after that he didn’t really care. I might look for a different PT when I do the other knee. Anyway, I still feel like I need more exercise so I’ve started going back to the gym 2 or 3 days a week and doing a couple of very gentle leg machines and mostly doing arm exercises. The farthest I’ve walked so far was one trip to the mailbox, about 600 feet each way, and it was my non-operated knee that really complained about that (remember, it’s bone-on-bone too).
I was driving at 4 weeks, but only because Hurricane Matthew created a couple of situations where DH just couldn’t do everything and I had to take care of a some things. If I didn’t have an automatic transmission, or if my surgery had been on my right knee, or if we weren’t in the middle of a potential natural disaster, I never would have attempted it. But I survived (and the hurricane missed us at the last minute) and have gradually increased my driving. My problem now is I can’t walk very far once I drive someplace, but I’m getting better at learning which stores have motorized carts and, better yet, how few places I REALLY need to go.
I went back to work at 4 weeks, but I work from home at a desk job so that wasn’t too strenuous. No driving, getting dressed up, standing for any length of time, walking to/from a parking lot, or anything like that. It’s still a little hard for me to sit in the chair for hours at a time so I get up a lot and walk around. I also suffer from lack of sleep and have been known to fall asleep during conference calls. Nobody noticed and I’m not sure that’s an entirely good thing, but that’s a different conversation……
Sleep has been a BIG issue for me. Starting around 4 weeks or so I started getting spasms in my knee at night. They were pretty violent and would throw me across the bed. I’d have to get up and prowl around looking for someplace comfortable – the couch, the recliner, the guest beds, anything that I could think of. I had been tapering off the Percocet but still took 1 before bed and another 1 when I woke up in the middle of the night. I called my OS’s office to see if they could prescribe anything for the knee spasms and their suggestion was to take 2 Percocets before bed. I was skeptical but I have to say it seems to be working – since I started doing that I have been sleeping better. I still wake up sore around 1 or 2 in the morning and have to get up for another Percocet and a few minutes of watching TV or coloring or something, but I can mostly sleep in the bed without having my knee throwing me around. Maybe it’s just waiting for the next time I really over-do it, but for now I seem to be sleeping OK and have had very few knee spasms. Still, for those of you who are getting ready to do this procedure, one piece of advice that I haven’t seen anywhere is to have something planned to entertain yourself while you’re up in the middle of the night. Personally I took up coloring and have found it very relaxing. But you’re probably going to be up a lot at night and there’s no point fretting over it – just find something to do.
Some observations regarding my current situation at 8 weeks post-op, in no particular order:
· Still hurts to stand up out of a chair. The longer I’ve been sitting the more it hurts, but if I give it a minute or two it gradually loosens up and I can walk.
· Sometimes I use the cane and sometimes I don’t. If I walk very far without it I find I start limping and then I end up with all kinds of strange pains, especially in the non-operated leg. Using the cane helps even out my stride so I don’t get all the extra pains.
· Still can’t take long car rides – a 2 hour trip to my son’s house Sunday was agony by the time I got home, even with getting out halfway through the trip and walking around. Also got my hair done last night and couldn’t sit in the salon chair for more than a half hour without getting up and walking around.
· Still icing, especially at night, but probably not doing it as much as I should due to spending most of the day sitting at a desk.
· Still taking Percocet, usually 2 before bed, another one around 1 or 2 am when I wake up, and maybe 1 more during the day if I overdo it. Averaging 3 or 4 a day. OS hasn’t said anything yet about getting off of it.
· Appetite hasn’t really recovered and I just don’t eat as much as I used to (not that that’s a bad thing).
· Occasionally still get tired during the day and have to take a break from work for 20 or 30 minutes of downtime in the recliner.
Other than that I’ve been doing absolutely great with no infection, no unbearable pain, no weird noises coming from the knee. Of course, I keep telling myself that the other knee might not go so well but it’s hard to believe it when I’m recovering so nicely from the first one. I guess we’ll see – I’m aiming to do the other knee in late March after taking the family on a cruise in mid-March. We’re also planning a long-awaited trip to Yellowstone for Sep 2017 so hopefully both knees will be up for a stroll along the boardwalks!
Overall I think I’ve done really well and consider myself one of the lucky ones. It really helps to remember this is a long process and just stay patient.
Oh – one more piece of advice for those of you who haven’t done this yet. Try to write down, or have somebody else write down, all the instructions the nurses give you at the hospital. You will think you are completely awake and aware of what’s happening but trust me – the drugs will make you totally forget. You might remember they told you something but you won’t necessarily remember what it was. My main complaint about my hospital is they didn’t give me written instructions and when I got home I didn’t remember things. Most of it my DH remembered and apparently I survived without whatever I forgot, but it was still kind of scary. Next time I’ll keep a notepad by the bed so I can write things down.
Good luck to everybody who has already come to this side of recovery and best wishes to those of you still getting ready for the journey. If you’re reading the forums here on BS you’re already doing the right thing!
United States
Great report! I'm glad you are doing so well. It's important to hear about a good recovery.
