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TKR Elcee's Recovery time....

Elcee

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RTKR 11-28-18
Little background on myself...a basketball injury to my right knee occurred in 1977 with surgery in 1978. ..I've known all my adult life that 1 day this knee would need surgery again.

Well here I am...57 years young with major joint surgery. I've been a nurse for over 20 years and my ortho doc said it's time! I joined the gym 3 months prior to surgery hoping to get my right thigh as prepared for what was to come.

Needless to say, I don't think anyone can truly prepare themselves for the aftermath of a TKR!:yikes:
First off in the hospital, no PCA pumps are currently being used due to some type of shortage and my nurses did not keep my pain under control that first 24-36 hours. It was pure hell. :gaah: The exercises and discussions given to me from PT sent me home feeling like a failure because a week out, ...I'm still not able to do a small simple leg lift withh my right leg.:beg:

I'm thankful to have found this site because in reading here it has helped me realize I need to relax and give my leg healing time before worrying over how well I can bend and straighten my leg or lift it off mattress. My 2 week follow-up is Dec. 11th ...and I will see what my Dr. thinks about my recovery this far and when and how PT will be involved.:chris-win:

I've had several pain meltdowns and just want to start feeling normal again! :dancing:
 

Jockette

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Hi and Welcome to Bonesmart!

Yes, TKR and PKR (what I had) are a total shock to our body and mind!

I’m also amazed at all the medical professionals who missed the class on swelling and healing! :heehee:

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.
 

Softtail

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No doubt the pain is a killer especially the first 2 to3 weeks. Taking the pain meds religiously is a must and ice and elevate frequently. You can read many threads here, but nearly all will follow this routine to give you the best shot at dealing with your discomfort. Now as for PT, everyone approaches this a bit different, but all agree that you need to take charge of your therapist day one so they don’t push the archaic no pain no gain theory. The heel slides ,leg lifts, extension exercises, and butt squeezes are pretty much the universal approach along with some minor walking the first 2 to3 weeks of recovery.. There are examples of the exercises you can find here on the forum. None of these should push you to the point where they cause you pain, just some discomfort. Need to find that point and don’t let anyony push you by it.

Paitience is definitely a virtue in this recovery, and that’s coming from a not so paitient guy. You are unique, and your body will respond in its own time, so try not to compare your recovery exactly with someone else’s here. It will happen.
 

Larryhg3

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Welcome to BoneSmart. You are absolutely correct that nothing can prepare you for the pain involved in TKR. However that pre surgical work should pay dividends as you progress. I did not get pain meds via a pump in either of my procedures always with pills so that may just be how your surgeon handles pain management. The fact that you can’t do the PT exercises in week one is absolutely normal. In early recovery you should be focusing on ice,elevate, rest and pain management. If you can tolerate Very gentle stretches they are okay and small walks around the house will probably be sufficient. As Softtail said this is a long process and it requires patience, a lot of it because your knee will heal on its schedule. It does not care how fast you, your doctor or your PT wants it to go it has its own plan. Discuss PT openly with your doctor explain what you will and will not accept early on so that you go into PT with a plan. If you do go for PT, before they even start the evaluation explain that you will not tolerate an aggressive approach if they can not guarantee that thank them for their time and find someone else. PT can be very helpful if done correctly but very bad if done incorrectly. There are many posts about how we have dealt with that conversation here. Good luck with your recovery.
 

kmak81230

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I'll jump in and agree with the others before me. Your job now is to get your pain under control, rest, rest, rest, and ice and elevate. Don't worry about the :censored: exercises at this point. I could not lift either of my legs until at least two weeks post surgery (my first TKR is 19 months old and #2 is almost 4 weeks old). I would guess that your 2 week appt will be focused on making sure your incision is looking good, etc. Don't worry about your ROM at this point - despite what your OS or PT might say - it will come if you take good care of your healing new knee. I hope you will find a PT who is also on board with the gentle approach to recovery. You got this! :flwrysmile:
 
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Elcee

Elcee

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Thank you all for your input back when I was in the deep depths of recovery when I posted this.

Thankfully, I had read the posts on not allowing therapist to be overly aggressive but I still experienced a horrible therapy session nonetheless.

On New Years Eve day, 12/31/18 I was a week out from a Dr appt and the therapist had asked me twice when I saw Dr again. I had been stuck at about 80 to 85 degrees flexion and I believe this therapist wanted me to be at least bending 90 when I saw the Dr. I was on the paddle cycle machine where feet sit down into the paddle like pedals and the seat has a back to it so if the seat is bumped forward a notch it's your knee that will have to bend.

I'm sure some of you are already guessing where this story is going to .... YEP .. as therapist was going to measure my flexion after 30 min exercise my knee was flexed as far as was painless for me to flex. As he was ready to measure without me knowing he pushed seat forward 1 notch!!!

Let's just say that everyone at PT that day knows this woman can cuss like a sailor. It hurt sooo bad I cried huge tears. He handed me a tissue and said "you did great, you made it to 91 degrees" I was in such a state of shock that he did that and being a nurse who has dealt with this staff in a professional setting for many years, I bit my tongue from saying more than the cuss words that flew when it happened. I cried silently during the ice down.

My outer right knee became very swollen and sore and unstable that night, so much I had to return to using my walker for stability instead of just the cane. I went to see my Dr that Friday ahead of the next weeks appt. He moved knee around and didn't feel xray necessary and said to rest, elevate and ice it.

I told my Dr in NO uncertain terms would I allow that therapist anywhere near my knee again but I knew I needed to continue therapy because of the lack of mobility I was having. My Dr said "then go to one of the other PT guys there. Trust me, the one who hurt you won't lose any sleep over it". And so I called and talked with the head PT who took over my care and therapy. I am a very strong and outspoken woman/nurse but if I hadn't read the posts here about standing up to overly aggressive PTs, I'm not sure I would have stood up for myself in that situation.

The head PT guy's wife does the acupuncture at my local hospital and that is what I ended up doing to get muscle fibers firing full on in thigh again. So I'm glad I didn't burn all my bridges there when I was hurt by a misdirected therapist!!!
 

Josephine

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as therapist was going to measure my flexion after 30 min exercise my knee was flexed as far as was painless for me to flex. As he was ready to measure without me knowing he pushed seat forward 1 notch!!! He handed me a tissue and said "you did great, you made it to 91 degrees"
What a bozo! I would have hit him where it hurts! All that for an extra 5 degrees? And clearly he has no idea that the only number that counts is that which you can achieve on your own! Numbers obtained 'with assistance' don't count.
 

winemama

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Your story is like many others, taking control of your own recovery. Good luck
 

Jockette

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My knee was force bent for the first time at one week post op. I had not found Bonesmart yet, and as painful as it was, I thought that was how it had to go.

I’ve learned a lot and come a long way since then.
 

sistersinhim

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What a hateful therapist. I have said many times that I wish all PT and OSs would have to have knee replacements!
 
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Elcee

Elcee

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...exactly, Josephine!! I wanted to yell .."No I DIDNT make it to 91 you forced it". It was all I could do to regain my composure from the sudden pain..and he held it there for at least 5 seconds too! Felt like 5 minutes!

I'm so excited everyone... today was my 1st day outside riding my new bike with full flexion of knee. full rotation on pedal and NO pain! ‍♀❄Icing it down !!!
 

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