PKR Freya's Recovery - Second PKR

[FCBayern]

hawk2go is right, staying on schedule with your pain meds is really important in the early days of recovery. Just make sure you are also working to prevent constipation.

 

[Freya34]

hawk2go is right, staying on schedule with your pain meds is really important in the early days of recovery. Just make sure you are also working to prevent constipation.

I know I should've known better with pain management. A couple of nights before were good and I think I got this false sense of "security" haha.

Pains under control right now so I'm going to do some stretches. Waiting for PT referral to get approved also.

 

[Jamie]

Please don't try to rush yourself. You can't. Your body is in charge and, if you listen to it, you'll know when you can try to start scaling back on pain meds and/or increase activity and exercise. Most certainly a few days after surgery is not the time for either. I know with having two knees done it must seem like you've been in recovery forever. Hang in there. In a few months things should be a lot different for you.

 

[DEL2022Jan-23]

@Freya34 , please follow your medication schedule so you aren’t in intense pain, you need it right now. Gentle stretches are fine up,to a point- don’t go so far it hurts, discomfort is ok but no pain. If you are swollen which it would be natural to be at this stage it is very difficult to to get ROM, it makes more sense to let things recuperate and swelling to recede more. You will be able to exercise ,and regain your ROM , just not right now.
There is no quick fix with this surgery, it is a marathon not a sprint which is something I had to learn myself. I was one of the “No Pain No Gain” brigade and pushed myself too hard, I ended up with a setback and even though I am over 10 weeks out from LTKR I have had to start again at about a week 4 level - learn from my mistake!
Now is the time to take things easy, baby your new knee, doing so will also help take the pressure off your other knee. Your husband will do whatever you need doing- this isn’t a permanent thing- it’s only a few months. Let everything you do be dictated by your knee- if it’s swelling up after doing something then don’t do the thing for a while, take your pain killers on schedule so you are less likely to face having intense pain, follow the R.I.C.E. plan in other words rest, ice, compress and elevate.
When you have questions we are here to help, learn from the posts on here- there are people on here who have been through a lot and there are no foolish questions. You will find support here, I know I did and we do our best to cheer each other up too!
Truly wishing you happy healing

 

[Freya34]

@Freya34 Your husband will do whatever you need doing- this isn’t a permanent thing- it’s only a few months. Let everything you do be dictated by your knee- if it’s swelling up after doing something then don’t do the thing for a while, take your pain killers on schedule so you are less likely to face having intense pain, follow the R.I.C.E. plan in other words rest, ice, compress and elevate.
When you have questions we are here to help, learn from the posts on here- there are people on here who have been through a lot and there are no foolish questions. You will find support here, I know I did and we do our best to cheer each other up too!
Truly wishing you happy healing

My poor husband is amazing in taking care of me, our home and our cats while I'm out of commission.

And thank you for kind words. I wish I found this forum the first time. I had so many different concerns and was worried about every single thing. I swear I've asked me therapist "is THAT normal...?" dozens of time haha. Things I remember asking about:
- is this bruise covering my whole leg normal?
- is it normal that I can't lift my leg?
- is it normal that I can't kneel on my new knee?
- is it normal my knee is numb still?
- is it normal I can't walk downhill?
- is it normal I can't do extensions without a horrible pain?
- is it normal that I just hate doing clamshells???

Well speaking of "Is that normal....". The more the swelling goes down in my May suegery knee the more I think something is wrong. It start to hurt even when I'm putting weight on that knee. It feels like the bones and joints are just... not falling into place. I struggled with outer knee pain the whole PT and they kept telling me it's normal. Doesn't feel normal anymore. But I don't know. Maybe it's just weird because the swelling is down and I'm finally feeling the pieces in my knee? But why would it hurt?

I can't wait for my follow up appointment to ask those questions. I just have to vent here too because I'm scared this is permanent.

 

[Jockette]

The issues in the “is this normal” list are normal. (I was never asked to do clam shells and I won’t if I am asked!)

I hope you know now that you don’t have to do anything in PT that hurts, or that you think is not in your best interest. I have learned that there are so many different opinions between PTs and even surgeons, about how to do this rehab. Pain in this rehab is counterproductive. We here use the phrase, no pain=MORE gain.

It’s too early to fear this issue is permanent. You still have lots of healing to do.

 

[Freya34]

@Jockette Clamshells is an easy exercise at first glance but I just hate how much pressure it puts on both my knee and hips! I'm in a really good shape and I still struggled with it a lot.

Now I know all those things were normal. But back then I was panicking! I wish the process was explained better to me prior to surgery. I had to go to this pre op class about knee replacement before my first surgery and it was so pointless. The nurse didn't really explain anything.

 

[Sara61]

@Freya34 I don't think any of us had a clue what the post surgery is like, On my 1st surgery in 2019, I hadn't got a clue, I suppose if the doctors /surgeons told us the truth, very few of us would have gone through with it, and unless someone has experienced a knee replacement, it's easy for them to think, what is all this fuss about.
But in the long run, it does get better and one can return to a healthy enjoyable life.
I recently had my right knee replaced and even thou its 2 years since my left knee was replaced, it is still healing and gets quite tired from being the stronger now of the two.
Your May knee is still healing 7 months is quite early so right now it is feeling the force and strain as it has to be the dominant.
My surgeon for both replacements was adamant that PT was not necessary and that the knee will heal on its own, many of his patients have followed his advice to a successful outcome.
Worldwide everyone has different opinions, but one thing for sure - the term "no pain no gain" is totally contradictory in this recovery.

 

[Jockette]

This is an article from the Recovery Guidleines, and clam shells are mentioned:

People are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

BoneSmart philosophy for sensible post op therapy

You will have noticed there is a significant opinion here about the potential hazards of PT. You may feel that your therapists are experts and know what you should be doing. However, over the last several years I've been here, I have observed that the more intensive the regimen of exercising...

bonesmart.org

 

[Freya34]

This is an article from the Recovery Guidleines, and clam shells are mentioned:

People are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

BoneSmart philosophy for sensible post op therapy

You will have noticed there is a significant opinion here about the potential hazards of PT. You may feel that your therapists are experts and know what you should be doing. However, over the last several years I've been here, I have observed that the more intensive the regimen of exercising...

bonesmart.org

I've done all exercises mentioned in this article doing my PT. And I kept doing them despite pain and struggles because I believed that physical therapists have knowledge and experience and they just now what they're doing. I trusted their judgment. 100% believed the pain is a necessary part of the process.
Everything I read on this forum really blows my mind. I want to do exercises (as one of the reasons why I wanted surgeries is to exercise pain free) but now I firmly believe thr pain should not be part or a deal.

 

[Jockette]

I also believed my PTs knew best and I struggled to do what they asked, but I was really struggling. At 4 weeks post op I started googling “stopping therapy” and thankfully found Bonesmart. It took me all of 2 seconds to agree with the Bonesmart recovery approach.

I‘ve been a member of Bonesmart for 4 years and I’ve read countless member’s accounts of their “therapy” and the pain and setbacks it caused them. I’ve learned there are so many differing opinions among PTs and surgeons, about this rehab. Which means, to me, that there isn’t just one right way to recover.

We each have to do what we feel is in our own best interest. Some people can handle those exercises in that article but some of us cannot. The main focus of Bonesmart is to educate members to listen to their body. If an exercise or activity causes increased pain and swelling, even 24 hours later, then your knee is not healed enough to do that. Stop doing it, give your knee more time to heal, and either don’t do it again at all, or try again at a later date.

There is nothing wrong with exercise, it just has to be appropriate for your body and your current stage of healing, and that differs for each of us.

 

[FCBayern]

@Freya34, this is my recovery experience. Prior to my TKR I was aware of the BoneSmart gentle approach to recovery as opposed to rigorous PT. I was lucky enough to find the site before my TKR. Even though I knew about the BoneSmart approach my OS was all about PT and "whatever ROM you have when your scar turns silver is all the ROM you will ever have." He was the trained surgeon that has done many, many replacements, he must know what he's talking about right? So off I went to my first visit to PT, about 2 weeks out from TKR. The next day when my knee was more swollen and I was in much more pain I opted for a BoneSmart recovery. I never went to another PT session. That was one of the best decisions of my life. Not only did I suffer less pain, but my ROM has continued to improve over two years. I've been hiking over rough terrain for good distances, scuba diving, and just living a happy active pain free life with more ROM than I ever thought I would have again after many painful years. I've now had a hip replacement with equal success following a BoneSmart approach. You don't have to suffer needlessly to have an amazing recovery. It is a long journey but if you stick with the BoneSmart approach the journey will be less painful and you will still reach the same final destination. Ultimately you get to choose the path, the tough rocky road through painful PT, or the BoneSmart path through the meadow with the pretty wild flowers.

 

[Jamie]

@Freya34 .... it's not unusual for therapists to tend to push joint replacement patients too hard, especially early in their recovery. It happens. And it's normal for us to want to trust their judgement about what exercises and activity need to be done. But there is no "one size fits all" for any recovery and the better approach is to consider your own body's response to whatever exercises are proposed. Real pain is never going to be a good thing when you're healing from surgery. It's not like strengthening exercises at the gym when you're healthy where you "break down" the muscles slightly so they can mend back stronger over time.

This is why we tell people the most important thing is to listen to their body and respond accordingly with any exercise or activity. Stop before it becomes more than just mildly or moderately uncomfortable. If pain or swelling shows up during the 24-48 hours after the exercise, it means your body isn't quite ready for that level of activity just yet. Rest, let the swelling and pain dissipate and try again at a later time. You and your feelings about how things are working are a critical part of your recovery. It's a team effort with you, your therapist and your surgeon to get the job done. In no way should a person just lie around all day and not do much of anything. Movement from Day 1 is critical to a good recovery. Things just need to be done in a way to gently stretch and bend your new joint and not to the point of causing pain or swelling.

You are on the right path now and you should be just fine with some time. Your May knee is having to assume the "strong knee" role and it's normal for it to complain a bit. It hasn't regained normal strength yet and probably won't for several months. Not having swellling in it is a good sign. Just try not to push it too hard either. Continue to take things easy for a while. Everything will get better as you progress with your new knee.

 

[Freya34]

Thanks everyone for great advises! Everyone here is so nice and helpful.

 

[Freya34]

So I'm about 1 week post surgery and I can 100% tell that this recovery is going way better compared to my first surgery.
- less swelling
- less bruising
- I can put weight on surgery leg and kind of "walk" even without a walker
- I sleep better (there was a couple of sleepless nights but less than 1st time)
- mentally I am at the better place because I don't constantly worry about exercising hard.

I believe those differences are because I don't do aggressive exercises. All I do is stretching, hip abductions, and gentle ankle slides. I don't have a way to check it accurately but I think I passed 45 degree bend (just based on my observations haha).

Staples removal is on the 28th and I plan on slighty increasing exercising then. But nothing crazy.

I'm still actually more worried about my other leg and the pain outside of a knee and this weird weakness I feel since the numbness came down.

 

[Jockette]

I understand the worry about the first knee, but try not to. It’s still healing and now has more stress on it, being the stronger leg, when it’s not really fully ready to be the stronger leg. Give it time.

 

[Freya34]

I understand the worry about the first knee, but try not to. It’s still healing and now has more stress on it, being the stronger leg, when it’s not really fully ready to be the stronger leg. Give it time.

Thank you. I keep telling myself that the right leg is also still recovering. I think my concerns are based on a fact that I had pain and issues with outside of my knee throughout the whole recovery and I don't feel like my worries have been acknowledged by anyone. :( but we will see. Scheduled my initial PT evaluation for the 29th so hopefully I'll get some answers.

But so far, so good.

 

[Jamie]

You might try keeping a log of the pain you have in your right knee for the times when you see your surgeon just in case it is something more than just a "time and healing" issue. It does happen sometimes. Most surgeons don't like to get serious about post op pain until a patient is almost a year out. Add to that the stress on your first knee of having a second surgery and I can see why your surgeon might not get to excited to hear your complaints. But if you have a log of weekly pain locations, what activity brings it on, and pain levels it would be something to share that could be more meaningful than just you telling him it hurts.

 

[Freya34]

So this morning I went to have my staples removed (like last time) and turns out I didn't have any staples, just sutures... No one told me they're not doing staples anymore so that was surprising haha.

Knee looks good so far, PT evaluation tomorrow!

 

[Freya34]

16 days post surgery - 95 degrees bend on left leg without too much effort. Good, I think?

New therapist confirmed that my right knee "looks odd" so I'm going to schedule an appointment with my doctor to talk about it. Super nervous about that one. Therapist also said that my right quad appears very weak. Despite my attempts to strengthen it in past few months. :(