Bilateral TKR Concerned Wife

[concerned wife]

For me, PT twice a week was all I could manage and I can't imagine going 2 days in a row as it takes at least one day to rest and recover. It seems especially hard for men to take the slow and gentle approach as they seem to feel they have to "work really hard" at recovery and get back in shape fast, etc.

I'm highlighting this with the hope that he reads through the thread. It did seem like 2 days in a row was too much and yes, most men I've known are wired to think that harder is better (no dis' intended to all you wonderful men; it's good in some circumstances, but not universally). Even in strength training, where no injury is involved, you're supposed to rest a day to let your muscles rest.

This surgery requires a lot of patience and the recovery can be slow and much longer than we wish. Most of us go thru periods of thinking something must be wrong because we aren't bouncing around doing everything we'd like to do and as pain free as we'd like to be. I would suggest you just be there for him and do whatever you can to encourage him to take the slow approach and understand that it's going to be a long road that can't be shortened by pushing hard.

Great advice. Our motto will be "this is a marathon and not a sprint"

 

[tiredwife]

@Jozilla Thank you! I have to add to your reply that any exercise that causes pain is bad. Each person heals at their own rate. Now I must admit my husband's therapist has had my husband pushing weights (light ones). We wouldn't let him do it if it hurt but it doesn't bother him. He doesn't get more than a 3 pain level when he is at PT. He rarely takes anything before PT, in fact he only takes an occasional tylenol now, and zquil at night. He still has some sleep issues.

 

[tiredwife]

OH, he still ices and elevates a lot!

 

[Jamie]

These folks have given you some great advice!!! I don't really have anything new to add, but I'd like to reinforce a few points.

Two days of therapy back to back is never a good idea. You and your body need a day to recover. And, nothing in therapy should EVER be painful. The worst any movement should be is just a mild discomfort. Doing otherwise invites swelling (and pain) which are counterproductive to the recovery process.

Weights should not be used in therapy. The exception to this rule is exercise to increase extension where VERY LIGHT weights are used as shown in this article. Most people are not ready for strength building exercise until after 6 months or so. Your body is healing during that time, as you'll see when you read the articles provided.

Please be sure your hubby is taking something for pain at regular intervals. It can be prescription or even Tylenol. But at 4 weeks with a BTKR, he has some level of pain. It most likely is worse at night, so time his doses so that he takes them throughout the night. I was on a 4-hour schedule for several months and woke up to take my meds when sleeping. Also, it is very important to ice an elevate his knees both front and back when sleeping. I used gel packs (2 per knee) and replaced them once during the night. Just be sure to have a kitchen towel wrapped around the ice source so his skin is not damaged.

I'm a side sleeper too and found I could simulate that by banking pillows on one side and kind of leaning into them. Also, it helps to have pillows between your legs when you are lying at an angle like this. Experiement with lots of pillows until you find some positions that work for him.

When my legs would start jerking, I'd get up and do a few laps around the house with my walker. Or I'd ride my exercise bike gently for five minutes or less. Usually that would calm the muscles down. I also did massage on my legs working in circlces from the ankles, over the knee, to the thigh. If there is any swelling (you may not even see it but it can be there), this can help move the fluid through the lymph system and out of the body.

 

[TheHistorian]

Hi ConcernedWife, lots of good advice here, but I want to share some of my experience as one of the token men on BoneSmart, and as someone who had a bilateral knee replacement.

First, post surgical depression is normal, and it hits very hard at times. If you go to my "Recovery Diary" you will see I won the World Cup of Whining. It should pass as your husband becomes more active. I found one of the best ways to deal with surgical depression was to plan things I'd do, both day to day and long term. Get involved in planning his first walks, hikes, bike rides..... because he can do all these things with the new knee.

As far as pain management goes, everyone is different. I was on Tylenol exclusively four weeks after my surgery and subsequent PE. I had a friend accuse me of trying to be "macho", but in reality I had a high pain tolerance and I didn't want to take drugs that didn't help me.

Hope this helps you, and him.

 

[Roy Gardiner]

Do you think that masking therapy-related pain via meds taken before PT could actually be doing damage?

Yes.

PT twice a week was all I could manage and I can't imagine going 2 days in a row as it takes at least one day to rest and recover.

If one has to recover from exercise aimed at improving mobility, then that exercise is too hard.

 

[Jamie]

It depends on your definition of "damage." The prosthesis will not be damaged in any way. But....pushing too hard on soft tissues that are inflamed and trying to heal can set a person up for chronic pain problems. It is good to medicate consistently to combat pain, but not good if you use that pain relief to push yourself with exercises or activity.

 

[ChubbsterPT]

Take a look at my posts from last March onwards and I only had one knee. It doesn't matter who you are and how you think you will get better quickly the fitter you are (I am a Personal Trainer) it makes little difference to recovery time. First 4-6 weeks were to me horrendous with depression, pain , lack of sleep and no appetite. drugged to the eyeballs with Tramadol. Now 20 weeks later I am enjoying pain free right knee, getting back to fitness. Gained over 8lbs in weight having lost eighteen pounds and I am not a overweight. One good thing was waist dropping from 34-32 inches, not so good having to buy new clothes that fit!!! Also back on my beloved Triumph motorcycle, though it's not too comfortable at the moment. Just tell your hubby to persevere and in 6 months he will be fine. Keep doing the extension and flexion exercises and enjoy life. We all go through the same terrible first few weeks and I have not met one person yet who, a month post op wishes they hadn't had it done!!
ChubbsterPT


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