TKR Feeling sorry for myself and frustrated. LTKR ten days ago.

karenl

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Hello, You are being hard on yourself, you are only a few weeks out. It will take weeks and weeks of rehab to get your range of motion and it will come and go. If your current PT is not helpful or giving you good excercises then switch PT...I switched an am much better off. I had my surgery in February and did all the research etc and it really can take up to a year. I can say I was not going out of the house at two weeks except to rehab which my husband drove me to...its been 9 month for me and I just am starting to feel like I am coming out of this surgery. I purchased a stationary bike and it helps tremedously especially with getting your range of motion back. Biking is the best thing you can do. Also you can try a CBD Pain infused oil and that really helped me along with a Tumeric Hot Tea first thing every morning. Most importantly do what feels right for you, don't let anyone admonish you ever. This is hard and everyone has a different experience. Just keep moving for sure and if you have a bad day take some rest. Rest is really important. Don't worry about meals etc, I had a lot of chicken broth frozen and simple healthy sandwiches, yogurts, protein drinks. I normally heal very fast and this has been a challenge but you have to push thru it, really you are only two weeks out, rest and just keep doing rehab. AND rehab should not create excruiting pain. Good Luck
 

karenl

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Oh my, two weeks is so soon. If you knee is warm it is still healing. I used my walker for at least a month and I am strong. Dont push yourself and do any damage. Your hubby will have to be more patient and eat simply. I started making simple meals within a few weeks with my walker by my side if I needed it. Breakfast is easy, he can make that. Lunch can be soup and sandwiches or salads. For dinner I picked up already roasted chicken and had frozen rice etc. Don't let anyone tell you how to feel, your body knows how it feels and you have to rest and do rehab.
Luckily I was able to laundry every few days, I did it more than normal so loads were easier to handle. You will laugh but I was able to put the laundry basket on the top of the handles of the walker and walk to the laundry room....and I gave my hubby a list of groceries and he went once a week. I literally text him the list and took picture of exactly what I wanted so he knew what to buy. I promise you it will get better. If you would have asked me even a month ago I would have told you I was discouraged too. For the the key was not to over do it but ask for help and keep doing rehab. If you finish your initial rehab ask for more rehab. Ride the bike, walk backwards around your kitchen island it strengthens your muscles, keep doing all the exercies they gave you to do before the surgery too.
 
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karenl

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I had to go out to do my pt one day after my surgery. I think it is better to go out as there is more therapy tools for you at their offices. No one really tells you it takes a full year to feel better it really does.
 
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wander03

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@Nanmo1228 I had a right TKR on July 19, 2021. Then I had a right THR on March 23, 2022, and a left THR on June 27, 2022. All of this is shown below. Having had bothknee and hip replacements, I can tell you with no reservations that recovering from a TKR is more complex and takes longer than recovering from a THR, at least my THRs because they were anterior. The articles that are listed above are excellent.

I joined Bonesmark after I did everything the physical therapist, who was an advocate of "no pain, no gain" told me to do or rather did to me. That included letting his PT assistants bend my knee so far back toward my hips that I screamed at the top of my lungs every time it was done. I suffered as a result of the overly aggressive physical therapy.. As you will read in the articles, do not let anyone bend your knee except you and do not do anything to the point of pain; some discomfort, yes, but NOT pain. I quit physical therapy with that rehab clinic and changed to home health therapy. After my daughter found Bonemart, which I joined on September 27, 2021, it made all the difference in my attitude and my progress. I realized there is no one time table; we all progress at our own rate. I found that overly aggressive PT creates trauma in the joint and slows down recovery. I so wish I had found Bonesmart before my recovery was compromised. There are others on this forum who have been the "victims" of overly aggressive physical therapy who learned the hard way, as I did.

I live alone, with my rescue black Manx cat Willabelle, so I did not have anyone telling me when I should be able to do anything. I progressed at my own rate of recovery. My sister came over every day for about five weeks except when my daughter came in from out-of-town on weekends. I elevated my leg and iced it a lot during the first few weeks. I spent nearly all my time in my recliner. My recovery was a bit more complicated than normal because, unknown to me before my TKR but shown by radiographs after my TKR, my left hip was end-stage DJD and my right hip was AVN collapse. You are fortunate that you do not have those complications.

Please be patient with your recovery and let everyone in your life know that you need tender loving care while you are recovering, no matter how long your recovery takes. No one else can know exactly what your recovery is like, not your husband, your daughter, your son, or your son's wife. And for your son's wife to have said you should be off the walker by now is not acceptable. And it's a bit ludicrous. Most people I know who have had a TKR use the walker for up to six weeks, and sometimes longer. If you push yourself to quit using the walker and start using only a cane before you are ready, you might become discouraged. It is only 2 weeks and 2 days since your body suffered extreme trauma . A TKR is extreme trauma for your entire body, not just your knee. Be kind to yourself and tell that your family and friends that they need to be kind and supportive.

When I changed to home health physical therapy, I was fortunate to get Chris, a physical therapist that is of the discipline that one should not be pushed to the point of pain. He was aghast that the first physical therapist had insisted on my having pain. He said that is old-school and not the prevalent attitude today. Because of the complications of my hips, my therapy required Chris to research and come up with ways to deal with my unique situation. Before my right THR, he did deep muscle and tissue massage on my right leg, which I think made a great difference in my recovery from the right THR. I am so fortunate to have his expertise and caring. I am still working with Chris and think we are on the verge of the constriction in my knee completely releasing. We have made great progress. I have not had pain in a very long time, but the constriction that resulted from some muscles overcompensating for others for four or five years because of the weakness of the other muscles has been challenging. It is all worth it. I can see the light at the end of the tunnel.

My situation is unique. I think that your recovery from "just" a TKR will be a cake walk compared to mine with complications. I tell you all of this because I want you to know that recovery is just something you have to do. Be kind to yourself, be patient, and do not push yourself beyond what is comfortable for you. Help others in your life, most if not all of whom have not had a TKR so they have no concept of what is involved in recovery, to understand that pushing you and trying to perhaps make you feel guilty for all they are having to do, is not going to speed up your recovery in any way. As you will read in the articles, your body will still be making progress after a year. Just give it time. That's what you need.

Once you have been through the recovery, and as you experience it, you will be able to help others in their recoveries through this forum. That is a wonderful thing to be able to do. Onward and upward! Brighter days are ahead!
 

Abbylayla

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Everything your hearing here is so spot on @Nanmo1228 .TKR is a fairly slow recovery. And it really does take a full year to be back to full speed.
Concerning physical therapy. As Bonesmart advises, don't let anyone push you!! No pain no gain does not apply here and for the life of me I don't understand why PT has not gotten fully on board with that.
My situation is a perfect example. Had a TKR August 2020. Right out of surgery I had a full extension & 90 degree bend. BUT, that bend differed every day multiple times a day depending on amount of swelling.
I had out patient PT. Quit after two sessions because my hips are horrendous & prevented me from doing the exercises. Whole there they did all that painful pushing my knee back, which I didn't understand. How is a swollen knee going to move more than the swelling will allow?? So I went on my own doing my little, heel slides, leg lifts, seated marching in place...all the stuff they teach you in the hospital. Very simple exercises. Guess what? My knee is as good. As flexible. As strong as everyone I know who did the whole painful PT routine. I don't even think about it sometimes. AND I know more than a few who've done the PT routine & have many problems with their knees. So just something to think about.
I do believe PT is absolutely necessary & beneficial in many circumstances. But I'm proof that it's not in others.
 
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Nanmo1228

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Thanks for the advice everyone! I finish home PT next week then move on to outpatient. I don’t feel like the home PT is pushing me too hard. She seems to cheer me on more than push me. Yes she did show me how to use the cane, but she didn’t say I couldn’t still use the walker. I know my outpatient PT will push me harder. I have worked with her previously for OA. I have seen her work with TKR patients and haven’t heard them cry out in pain. My outpatient PT is the one who swayed my decision to have surgery. I truly appreciate any and all advice you can give me. I have never been through anything like this before. My parents had health issues, but no joint issues. None of my friends have had TKR. This is new territory for me.
 

Jcx

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@Nammo1228.My advice would be keep posting the good the bad and take it from me there will be plenty ugly. But given time and patience your recovery will come slowly but surely. Take care Jcx
 

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@Abbylayla You know what's really a shame about physical therapy? It probably could be better for the vast majority of people to go to physical therapy if the physical therapists were gentle and understood their job. I really don't understand why physical therapists are dim-witted bullies when it comes to TKR. Don't they get any training in this specific area, or is it just that training in this area has never reached out to TKR patients to get some insight?
 

Abbylayla

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@Zanza I agree with your statement. I had to have PT after a badly broken ankle due to a sports injury. Three months of PT! I say to this day, I never could have brought my ankle & frighteningly atrophied leg back without a lot of hard work & my amazing physical therapist! But my experience with PT after TKR was a whole other experience. The pushing the leg for ROM made absolutely no sense to me. Its swollen! How far do you expect it to go?? My surgeon would push it.....but not to the point of pain! Plus, the exercises they had me doing really did not require a physical therapist. They were basic to say the least. I know some disagree with me but my experience has been, my knee, without a therapist is as good or better than anyone I know who had weeks or months of PT visits.
 

Zanza

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@Abbylayla Yeah, we do rage on physical therapists a lot on this forum because when it comes to TKR, they seem to be thick-headed and ham-fisted, but I had to have hand reconstruction on my right hand and no way would I have regained function without the wonderful physical therapist. I wouldn't even have had an idea of where to start to get my hand working again. If only they had better training with TKR! As you say, what good does it do to push on a swollen knee? That's like peeling open a bud to try to get a rose.
 

FCBayern

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I know my outpatient PT will push me harder. I have worked with her previously for OA. I have seen her work with TKR patients and haven’t heard them cry out in pain.
Please don't let anyone make you cry out in pain! They are not helping you at that point, they are slowing your recovery by making the swelling worse. One of our members provided the guidance below for talking to your PT at the first visit and I think it's brilliant.

At the first visit you say to your PT therapist:
  • I expect discomfort. I DO NOT expect actual significant pain.
  • The definition of what is painful is owned by me, not you.
  • When I say stop, we're crossing the line into pain. I expect you to immediately stop.
  • Trying to force me past the pain point or not listening to me will completely break my trust in you.
  • I want us to be partners in this. I'm willing to try almost anything, as long as I can continue to trust you.
  • If I trust you, I will go right up to the line between discomfort and pain. If I do not trust you, I will likely start tensing up as soon as any discomfort starts. At that point I may as well get a new therapist.
 

Zanza

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At the first visit you say to your PT therapist:
  • I expect discomfort. I DO NOT expect actual significant pain.
  • The definition of what is painful is owned by me, not you.
  • When I say stop, we're crossing the line into pain. I expect you to immediately stop.
  • Trying to force me past the pain point or not listening to me will completely break my trust in you.
  • I want us to be partners in this. I'm willing to try almost anything, as long as I can continue to trust you.
  • If I trust you, I will go right up to the line between discomfort and pain. If I do not trust you, I will likely start tensing up as soon as any discomfort starts. At that point I may as well get a new therapist.
Excellent!
 

kneeper

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One thing to consider with your family's impatience for you to be back to normal is that when people push too hard in recovery, they have more swelling which slows down their ability to get back to normal. Finding the "sweet spot" of PT and activity is the challenge.
 
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Nanmo1228

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What is the deal with the insomnia after TKR. I am on day 19 post surgery and the only way I can get some sleep is if I take an OXY, which I don’t really want to do, I have tried Tylenol pm and it did nothing. I have tried half an oxy and no luck. If I don’t take the oxy I am up all night going between the bed and reclining loveseat. I don’t know if I should ask my primary doctor about trying Ambien? During the day I only take tylenol and advil. Unfortunately, I get migraines when I don’t sleep.
 

Zanza

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What is the deal with the insomnia after TKR.
Good question. I've had other surgeries and I don't ever remember the kind of sleep disruption I had after the TKR. It took me ten weeks to get back to my normal sleep, and I still have the occasional night when I just can't sleep.
 
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Flashlight

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I know what you mean. Tomorrow I am at my 7th week post op and just recently was able to get comfortable in bed. I'm not a back sleeper and that is the most comfortable position. If I am able to sleep for 3 1/2-4 hours it is a miracle. I did try Costco's sleep aid with a melatonin, Tylenol and ibuprofen. It worked but for some reason it doesn't work every night. I'm going to talk to my PCP to see if she has any ideas. You are young and while going through menopause you don't sleep that well.
 
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Jockette

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This article is in our Recovery Guidelines that everyone gets, if you haven’t read it, please do. There are a lot of helpful articles in those guidelines.

 
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Flashlight

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I read the article and agree with some of it. I had my surgery at a self-outpatient center, had a spinal, and returned home the next day.
Pain and Discomfort: First and foremost, whether you’ve had a hip or knee replacement, you’re going to be in pain.
Narcotic Pain Medications: It seems there are several vicious cycles you’re a part of when it comes to joint replacement recovery and sleep. ... Some narcotics can give you insomnia over time. Who knew?
Depression and Anxiety: It’s not uncommon for someone who’s undergone a joint replacement to have feelings of depression. Everyone wants instant relief to return to normal activity. It's a long road and not all of us are patient enough. I didn't realize. It all happened so fast for me.
I think it's a combo of these even though I'm no longer on the narcotic. Discomfort in bed definitely adds to my insomnia. I hope I can start to be more active during the day. I think that will help.
 
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JusticeRider

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You may have already tried this, but Tylenol PM was a lifesaver for me!
 
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