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[BILATERAL TKR] Dickybird’s rehab in Sydney Australia

Dickybird

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I am so glad to have found this forum. Now just over three weeks from my TKRs (Nov 8, 2018) I am home, drug and mostly pain free, and much encouraged by the information I have read so far on this website.

No complaints about my ops. My surgeon is rated on ratemds.com as #4 out of 168 orthopaedic surgeons in Sydney so I know my knees have been in very good hands. And my post-op experiences in the local Prince of Wales private hospital and the Wolper Rehabilitation hospital were first rate. Oh well, the food was rather bland!

The physiotherapists at the Wolper ease one into exercise, avoiding over flexion and advising one to stop as soon as pain is encountered. And the nurses were very firm about medicating for pain control so I had few problems. Plenty of staff day and night so there was always someone to administer pain relief or ice packs at any time. Highly recommended.

And now the long slog back to normality. Very encouraging to learn that fatigue is inevitable and healing goes on however slowly and the commonest advice is don’t push your limits and don’t be in a rush. Helps with the morale when progress seems so slow.
 

Pumpkln

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@Dickybird,
Welcome to BoneSmart, glad you joined us!!!

Sounds like you are off to a good start with your surgeon and rehab.

Please post your surgery date, a moderator will add it to your signature for you. Having the exact date will help us properly advise you. Thanks!

Here is your copy of the recovery guidelines, the articles are short and will not take long to read.

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
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. At week 4 and after you should follow this

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.
 
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Dickybird

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Just over 4 weeks since my operations. Daily progress seems slow, but I am now quite mobile, though slow, and generally pain free. I am off the painkillers I was dosed with in my rehab hospital. The deal I have from my health insurance fund includes 8 half days of outpatient physio therapy at my hospital. No suggestion that I should be on my feet at work any sooner than 6 weeks post op. My therapists are very conscious of avoiding pain unlike some of the experiences I have read of on this forum. It is very reassuring to read the reports of successful recoveries on the forum.
 

sistersinhim

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Welcome to Bonesmart! This is the best thing to learn all about knee replacements! I wish you a very uneventful, and low pain recovery! Be sure and read the articles that Pumpkin left for you. Following our guidelines will be most helpful in your recovery!
 

SusieShoes

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Sounds like you're doing great, @Dickybird. Listening to your knees and making sensible plans. Play the return to work by ear and, if you can, return part time or on shorter hours at first just to test the waters.
 
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Dickybird

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On Thursday it will be 6 weeks post op. I have progressed; I can walk without an aid and can manage stairs enough to move back upstairs to the main bedroom. But my knees still feel quite stiff and they are still swollen. Do I have it correct that two issues in recovery are 1. Resolution of the tissue damage and swelling resulting from the operation and 2. Strengthening the muscles around the replaced joint? Because again, if I have it right, Resolution of the damage and swelling is promoted by rest and elevating the limb and strengthening the muscles is promoted by exercise. These are opposing treatments and I am interested to know how to find the right compromise between rest and exercise.

I welcome your suggestions.
 

NavyGunns

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@Dickybird, in general, you are correct. They are opposing treatments, however, exercise to gain strength is not your top priority right now! Letting the damaged tissues heal and letting the swelling go down is first and foremost! Strength you gain from your normal daily activities will suffice for now. Once you get past the three to four month mark and no longer see any residual swelling, you should be able to slowly introduce an exercise routine. I stress this because if you start to see swelling recur, you will need to back off. That was my experience. I was never able to get back into a regular exercise routine until I was past 6 months. Every time I tried, my knee protested. Not the joint, but the soft tissues around the knee (ligaments, etc).
 

Breadman

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G'day Dickybird. Glad to hear your surgery and hospital experience went well except the food. I didn't eat much in the hospital. Best thing I had was a cold roast beef sandwich. You are one week ahead of me with your new knees. Sounds like we have had the same experience so far. Good luck with the rehab. Take it slow is the most important thing I have learned from everyone here.
 

79newknees

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@Dickybird, hello fellow OZZY, you seem to be going well. I found by marking the weeks on the calendar, and making three months and six months the goal, that I had more realistic expectations! I kept telling myself, "well don't expect too much before three months!", but the time passes quickly, once you can get out and about!
As it is Despite a set back at about ?three weeks post op, I really forget about my knees, except when I wake in the morning...a bit stiff till I get going.
Look forward to following your progress.:SUNsmile:I can do three times as much as before op!
 
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Dickybird

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So you are now about 4 months post op. How do you mean your knees are stiff in the morning? Mine are fine while elevated (in bed say) but feel tight (or stiff) as soon as I stand up and stay that way until I sit or lie down again. No pain, just a tight feeling. It rather slows my exercise down and I look forward to a time when they free up.
 

kneeper

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That's very much par for the course and will improve bit by bit with time. It can take months.
 

Celle

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No pain, just a tight feeling. It rather slows my exercise down and I look forward to a time when they free up.
It's normal for your knees to feel stiff right now. That stiffness could take months to fade away - it's a gradual process.

Right now, it's a good thing that the stiffness slows down your exercise - it's stopping you from doing too much, too soon.
 
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Dickybird

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Tomorrow it will be 9 weeks post op. Yesterday had my last physio/pool therapy session. They tell me I am doing well, I still have stiff knees, but no other pain and I can see the progress, ROM now 127/125 0/2 and riding the cycle for 10 minutes no problem. 36 sit/stands. Gratifying that the advances are occurring although I have not been exercising at home, just light daily routines and 20 stairs up and down several times a day. Otherwise enjoying the comfort of elevated legs. Of course have had 2 weekly physio sessions but mostly strengthening exercise. I will be so grateful once my knees let me sleep on my side again. Getting a comfortable sleeping position is my biggest regular challenge.
 

sistersinhim

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You are doing so well for just 2 months! I know the sleeping problem. You and just about everyone else who has had this surgery! It's one of the side effects of it, unfortunately. The first times I was able to sleep on my side was only for a few minutes at a time. But, those few minutes eventually became longer!
 

CAB

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Hi @Dickybird, i am a side sleeper, and found having to sleep on my back the pits!
I practiced getting onto my side whilst in rehab. And could sleep on my side for a bit before leaving. And have been doing it easily ever since. I do put one leg way forward tho..ie not on top of each other. Sleeping through the night was a nightmare tho.
Lucky you to be off pain meds and have no pain. As others say stiff knees hang around for a while. I liken it to crampy muscles around my knees.
Good luck with your recovery. It does take some time. But you've got it.
Cheers
Carol
 

NavyGunns

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Regarding side sleeping, I spent most of my early weeks (seems soooo long ago) sleeping in my recliner which forced me to sleep on my back (for the most part). When I did get to a point where I could lie in bed, I found putting a large pillow between my legs greatly helped. It provided a nice cushion between my knees, yet also provided support to both my knee as well as my back (which by then was feeling well abused).
 
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Dickybird

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Dear fellow rehabilitationists, thanks for sharing your experiences. I have tried, and keep on trying to roll a little away from sleeping on my back. But rolling right onto my side, with my knees a little bent and with a pillow between them seems still to work for say only 20 minutes before one or both knees start to ache. Like stiffness I suppose this will improve. I suppose if I went back on painkillers I might be able to do better, but I’d rather not. Thanks for all your encouragement.
 

donnag1108

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I know how you feel. I hate trying to sleep on my back. I have been able to doze off from time to time with a pillow as you described but not for much longer then you. Patience I suppose is our friend.
 

Jockette

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I was also a side only sleeper before surgery but I have successfully learned to sleep on my back, and still do now, almost 2 years later!

What helped me most was to elevate both legs. My particular elevating wedge has a cut in trough for one leg, which is pretty hard to come out of in my sleep. My wedge is only designed for one leg, but I put the other leg on it also.

I also use my pillow to prop my head up somewhat straight.

I now fall asleep much faster than I did when I slept on my side, (I don’t know why) so that’s an added bonus!
 

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