TKR From Liverpool UK, 6 weeks post op.

[Anfield Lindy]

I was so happy to have come across this site, as I felt so sad, low, in pain with no one to turn to. I had my LTKR on 28th July 2012. I have had problems with my Left knee for years [starting in my teens] I am 53 now and after numerous arthroscopys and lateral release, a ortho consultant finally decided that there was nothing more to offer and TKR was my only option. I am now six weeks past my surgery and although the inital pain of surgery has gone I am still in great pain. PLEASE is this normal ????? I try very hard to get the knee to bend further back [as per physio exercise sheet] but I find this gives me agony. I am still pulling myself up the stairs using bannister rails. I cannot stand up from sitting, without experiencing pain in my knee, hip and thigh. My knee is very swollen, however the scar from surgery has healed beautifully. Is all this normal ? Am I expecting to much to soon ? I am sick of waking up each day and the pain does not seem to be improving. Please if anyone can mail me back and give me a bit of hope for the future, as I feel like I am at the end of my tether. Thanks Lynne.

 

[KathyH]

Hi Lynne, welcome to this wonderful site. I'm sorry to hear you have been feeling so down. But everything you describe is quite normal and remember you are only six weeks out from major surgery. We all expect too much too soon, but we have to learn to be patient. Are you getting enough rest and are you elevating an icing a lot? You need to do these things to help the swelling.

I know only too well that excruciating pain when you stand up from sitting. This is normal and it does pass after walking a minute or two after.

Others will be here to tell you the same thing and more. Just come on here whenever you want advice or suggestions - everyone is vey supportive.

 

[Josephine]

Hi, Lynne. Welcome to BoneSmart. Which hospital did you have your surgery in?

I have some questions to ask you:
1. what pain meds are you prescribed, what dose are you taking and how often?
2. how often are you icing your knee?
3. how often and how high are you elevating your leg?
4. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping and exercises - and I want detail!


When you answered these questions for me, I can better advise you how to proceed from here ...

 

[tuli]

Hi Lynne, I too am at 6 weeks - and I too am still having my share of pain - I did more today than I've done since the surgery, but still with pain. I understand your frustration - I was feeling it too - I've been reading a lot of posts - it sounds like we all experience it around 4-6 weeks. We think we should be feeling better and that our healing has stagnated or we've hit a plateau - the incision looks great - so why don't we feel better? But we've been through a major surgery and as the bonesmarties here have described they were not gentle with us - what we can't see is still healing so we need to still be gentle with ourselves, still take care of ourselves and still be patient with ourselves. We should still be icing 3-4 times a day, it's still ok to be taking pain meds, and our activities and exercises should not be causing pain.
Hang in there, read and post on this forum (I for one have found it very helpful in the past few days especially) people here do care and be gentle with yourself.

 

[Anfield Lindy]

Hi Josephine,
to answer your questions. I had my TKR at Aintree Hospital in Liverpool UK.
1. Co codamol 30mg/500mg up to 8 in 24 hours also 1 500mg Ibrophen daily. I take up to the max.
2. Not icing my knee at all.
3. I only elevate my leg when I do my daily exercises. To stretch the ligaments and strengthen the quads.
4. I can do some vacuming and high level cleaning [cannot do bending down low] I feel like I may go off balance and fall. I try and cook a meal each day, but its to much sometimes. I am glad when my husband is in for his 6 shifts on, then I don't have to bother cooking. I still cannot drive the car so when my husband is off work [he works 6 off 6 on] I go to the supermarket and walk around on my crutches. I do one full repetition of the exercises given to me from the physios at the hospital [off a sheet] I go to see the physios every two weeks at the hospital to check my progress, however I did not attend the last session as I was physically unwell with a cold. I am due to see them on Friday 14th Sept. I still have not recieved a letter from my OS for my check-up.
I just feel in so much pain Josephine. In my ankle, shin bone, all the knee joint, thigh and hip and also my lower back. Around the house I don't use my crutches, as the palms of my hands were getting very sore and blistered. I have also found my shoulders and elbows are hurting and I can only put this down to me using the crutches. To tell you the truth I just want to stay in bed till all the pain goes away, but I know thats no good I must get up and motivate myself.
Thank you for your care and kindness

 

[Anfield Lindy]

Hey Tuli,
Thanks for getting back to me and your kind words. I realise everyone is individual and we all have different experiences and different pain thresholds. Maybe ice is the hope and I have a bag of peas for just this occasion, I must label them so no one tries to cook them. Yes, I will stay in touch with the Bonesmarties site for help and inspiration.
Lindy x

 

[Anfield Lindy]

HIya Kath,
Ah ha a fellow Brit. Thank you for getting back to me. Kath I just feel so low. I am trying to keep myself occupied doing one of my favourite hobbies cross stitch, making Christmas cards. I hate day time TV and one can only listen to music on ipod for so long. I feel guilty for sitting around [as I have always been so independant, doing everything for me and everyone else] I finished my degree in Mental health nursing back in april 2011 and I had just started new long term bank work in Liverpool. I really hurt my knee back in April [three weeks into new job] and had to give it up. So I also have that to come to terms with, as I don't know whether there will be a place open to me when I am well again ? I tend to spend a lot of time sitting on my bed with my leg up, as I have no pain then. Oh I have waffled sorry. Thanks again Kath.
Lindy

 

[KathyH]

Oh Lindy, you haven't waffled at all, don't worry. I'm really sorry to hear about your job and I do hope that they can find something for you when you are ready to return to work. Don't feel guilty at all for sitting and resting. This is all part of recuperating. Please makes sure you ice and elevate as much as you can.

Feeling low is all part of this slow recovery and is perfectly natural, so you are not alone there. If you read a lot of other people's posts you will see that you can relate to most of them.

I spend most of my time on the sofa with my left leg on a leg elevator, a special wedge shaped cushion I bought from eBay, just before my op. I feel I am part of the furniture now, lol.

I was very interested to hear about your hobbies. I too love card making and turned out smallest spare bedroom into my craft room. Prior to my op when I knew I would be off work for a good few weeks, I thought I would get most of my Christmas cards done during this time and I was quite excited at the thought. Wrong! I just haven't had the inclination to do anything like that, anything that takes concentration. Everybody else is the same at this stage. I think it's the combination of the major surgery plus the drugs we are taking. I am taking Tramadol and Ibrobrufen and the Tramadol certainly makes me feel sleepy all day. The plus side is that I sleep well at night.

You sound like you are making good progrees for six weeks out, Lindy

 

[Roy Gardiner]

Please if anyone can mail me back and give me a bit of hope for the future, as I feel like I am at the end of my tether. Thanks Lynne.

Lindy, hi, welcome to BoneSmart.

You will get better, you are in the worst part right now.




That's that bit, now the telling off just what you need, right? to if you follow all our advice, mind.

You are I think doing far too much, not taking it easy enough.

- If it hurts, don't do it nor allow anyone -- especially a physiotherapist -- to do it to you..
- If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it.
- If you won't die if it's not done, don't do it.
- Don't stand if you can sit; don't sit if you can lie down

"I tend to spend a lot of time sitting on my bed with my leg up, as I have no pain then" Good, do that a lot, it's good not to have pain.

" I feel guilty for sitting around " This is your time, you are seriously hurt, you should under no circumstances feel guilty about engaging in optimum recovery, which 'sitting around' is.

"To tell you the truth I just want to stay in bed till all the pain goes away, but I know thats no good I must get up and motivate myself." Actually, wrong. Staying in bed pain-free is good for you, go for it.

"I try very hard to get the knee to bend further back [as per physio exercise sheet] but I find this gives me agony." DON'T do the exercises if they hurt. Gentle discomfort OK, but no pain.

Elevation isn't for exercise, it's to get your foot up high (relaxed, supported) to help fluid run out of the knee, to reduce swelling.

Yes all the ankle, hip, shoulder, thigh pain is because of your knee. It will go away as your knee gets better.

Please do as little as you can, stay as pain free as you can. That's the way forward.

Frozen peas on the knee, perfect.

Relax, take it easy. It does get better, much better.

 

[tkrme]

[ Is all this normal ? Am I expecting to much to soon ? I am sick of waking up each day and the pain does not seem to be improving. Please if anyone can mail me back and give me a bit of hope for the future, as I feel like I am at the end of my tether. Thanks Lynne. [/quote]

I hope that today is finding you better. Ice and elevation with support is very important to reducing your pain. Take the pain med as often as needed as prescribed. I know the frustration of feeling like you should "do something". I decided to vacuum one day and found that was a mistake!!! I will not try that again for weeks. As hard as it is, just rest, ice, elevate, walk a little every now and then, and try to enjoy others taking care of you for a change.

 

[Josephine]

to answer your questions. I had my TKR at Aintree Hospital in Liverpool UK.

Nice hospital! (But you never said "hello fellow Brit" to me - I'm hurt! )

1. Co codamol 30mg/500mg up to 8 in 24 hours also 1 500mg Ibrophen daily. I take up to the max.

Co-codamol is totally inadequate for a TKR. You need to have a talk with your GP and see if he won't put you on Tramadol and paracetamol instead. Cry if you have to but you need better than Co-codamol!
Read this The importance of managing pain after a TKR and the pain chart

We have a mantra on here - it's rest, elevate, ice and take your pain meds by the clock!

2. Not icing my knee at all.

Icing is essential and helps with the pain. Read this Using ice.

3. I only elevate my leg when I do my daily exercises. To stretch the ligaments and strengthen the quads.

You don't need to strengthen quads now. Your quads aren't weak, they are injured so they need rest, just like you do!

And elevating is the second most important thing to do to control pain and swelling which causes pain! Elevating your leg to control swelling and pain

4. I can do some vacuming and high level cleaning

NO housework of any kind, Mrs! Not for a good while yet. You have just had major surgery and need up to 12 weeks to start feeling fully recovered!

I try and cook a meal each day, but its to much sometimes.

No making meals either. You should still be being looked after and taken care of.

I still cannot drive the car so when my husband is off work [he works 6 off 6 on] I go to the supermarket and walk around on my crutches.

No shopping yet. if you really, really must, then use one of the supermarket electric karts to get around the store.
And read this Progression of activity for TKRs.

I do one full repetition of the exercises given to me from the physios at the hospital

That's okay up to a point but don't over do it. You should never do anything that hurts or makes you feel washed out. You might like to read the potted version of my recovery to see how little exercising I did! Knee recovery - UK style

I still have not received a letter from my OS for my check-up.

Don't worry about it. If your surgeon is anything like mine, he never sees his 'knees' until about 3 months post-op.

I just feel in so much pain Josephine. In my ankle, shin bone, all the knee joint, thigh and hip and also my lower back.

I'm not surprised - you have inadequate pain meds, you're doing far too much, you're not icing or elevating anywhere near enough, nor resting enough. You need to read all our knee recovery articles to learn how you should be managing your recovery.

And the first lesson of the day is that KNEE IS IN CHARGE NOT YOU! Knee will tell you, very loudly sometimes, when you are doing too much of something. Be told, stop and rest..

How Long Does Healing Take ......
Chart representation of TKR recovery
Energy drain for TKRs
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Progression of activity for TKRs

Knee Replacement - Where Am I in Recovery?
So What Is It Going to Take? The Five “P’s” of Knee Recovery
Work “Smarter” and not “Harder”
About recovering a knee - from one who knows!
Some suggestions for home physio (PT) and activity progress
Myth busting: The "window of opportunity"

MUA (manipulation under anaesthetic) and adhesions
It's never too late to get more ROM!
It's Worth the Wait for ROM
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it

Around the house I don't use my crutches, as the palms of my hands were getting very sore and blistered. I have also found my shoulders and elbows are hurting and I can only put this down to me using the crutches.

.Then you were using your crutches incorrectly. Were they underarm crutches or elbow crutches? Either way, you should never put your weight on your hands or armpits. Put weight on your legs, the crutches are just for support and balance, nothing more.

To tell you the truth I just want to stay in bed till all the pain goes away, but I know that's no good I must get up and motivate myself.

And I am giving you permission to do just that. It's exactly what you've needed to do since day one.

Now make up for time: veg out on the settee all day, do no housework, order your groceries online and have them delivered, eat snack foods so you don't have to cook, use paper plates so there's no washing up! You will make up time eventually but in the meantime, spoil yourself!.

By the way, next time you go to see the physio, get her to tell you what your ROM is (range of movement) and let us know.

 

[Anfield Lindy]

Hi Jo, Pet, my North east friend,
Thank you for all the great information. I spent most of yesterday afternoon on the site reading peoples stories and the valuable info that is on here, THANK YOU.After icing and elevating last evening I found that my knee felt less tight and swollen, what a difference. Another bag of cheap peas being bought today, so I can alternate between bags. I know I have to get over the guilt thing, its doing me no good.... DOING. I am back to the hospital tomorrow for Physio and not looking forward to it. I think they expect to much of you at times and therefore, I feel that I must prove that I have made progress when I go. Jo, I am not able to take Tramadol it makes me feel sick and sleepy all the time. I think I have tried most of the heavy duty analgesics in the passed, any other ideas? I have taken on board all the info in your mail to me. I will ask about my ROM and post to you. You are a > xx Lindy

 

[Anfield Lindy]

Dear Tkrme,
thank you for your mail. I hope you a feeling well today as you only had your surgery on the 27/8 just a month after me. I did the ice and elevate last evening and it made a huge difference when I got up this morning. It is obviously the way forward for me. And I am also doing no vacuming [I have a 18 year old daughter and husband that don't see the dust or muck] so why should I care . Its time to take care of me. speak soon Lindy

 

[Anfield Lindy]

Hi Roy,
Thank you for all your kind words of wisdom. I intend to take them on board. I felt so awful and had no one to ask or chat to that had, had the surgery. So when I found this site I thought fantastic.... people like me that have been through it and got the scars to prove it. I have learnt so much its great. Obviously what I am feeling and going through is quite normal !!!!!! whatever, you get the gist, normal for TKR bods. Thanks again Roy

 

[Anfield Lindy]

Hiya Kath,
I hope this finds you feeling much improved [well maybe a little] I didn't buy anything like that? maybe I should have instead of trying to prop myself up with pillows which invariably fall down .

I started doing my cards a couple of weeks after my op and bought a lot of Christmas card kits on ebay very cheaply and I have been merrily stitching away. I get about two little Christmas designs a week done. So Kath as you sit with leg up, keep your hands busy cross stitching.
I to have no appetite for food? and like your self not bothered about it as I have lbs and lbs to loose, so its all good. I guess we are not expending much energy, so don't need much food. Are we allowed to exchange personal email address's ? its nice to find a fellow cross stitcher plus TKR buddy. I could scan some of the Christmas graphs and send them to you, may motivate you a bit. Ok keep in touch Kath xx Lindy

 

[KathyH]

I can feel a slight improvement today, thanks Lynne. Any improvement at all, no matter how small, is great. My leg wedge cost £20 and I have found it invaluable. If I can find the link I'll send it to you.

You are lucky that you have the concentration to allow you to do cross stitching. I'm hoping that I can make a start on my Christmas cards soon.

You're right about the lack of energy and appetite and I'm not in any hurry for my appetite to come back. I'm not even eating half of what I usually do. I weighed myself the morning I went into hospital for my op, but I haven't weighed myself since and won't bother for a while as I think we put too much store into the number on the scales.

Hope you're feeling a bit better today too, Lynne. Take care for now

 

[Josephine]

USING THE REPLY ICON - OR RATHER NOT USING THE REPLY ICON!

Folks, it's really not necessary to use the "Reply" icon in someone's post to reply, specially when that post is going to be the one right before yours.
Just scoot on down to the bottom of the page and start writing in the window, okay?

 

[Josephine]

You don't have to prove anything to them. They are only physios and not masters of all! Their job is just to assess you and give advice if needed. Did you read my recovery post? I had no formal PT at all, did it all on my own and did pretty well. You can too. But the only person you are accountable to in all this is YOU. Let the rest roll off your back like the proverbial duck!

If you can't take Tramadol (which inevitably makes everyone drowsy so your problem is only the nausea) at least get your GP to prescribe you codeine and paracetamol separately instead of co-codamol. Co-codamol is just paracetamol with a small quantity of codeine but you need 30-60mg of codeine at a time. Co-codamol is just for headaches and stuff! Just tell your GP that it's not enough and you are still in a lot of pain.

 

[1ELISEA]

I started doing my cards a couple of weeks after my op and bought a lot of Christmas card kits on ebay very cheaply and I have been merrily stitching away.

Just wanted to say Welcome!
And what a great idea to use some of the time to do Christmas cards.
Hope you are feeling better and better every day!

 

[Anfield Lindy]

Hi Josephine,
Well I attended PT this am they measured my ROM when I got there and it was at 90 degrees. After exercise session ie. stepper, trampet [boing, boing] bed exercises, wall lunges and other stuff, I then achieved 95 degrees. I did explain to the Physio lady that I was never able to twist around and pull my leg bent half way up the back of my thigh before I had the surgery?????? therefore I was not going to try this manovre in the near furture [well really I will never do it] but I gave her some hope < this is what I felt like doing at the thought of it. I told her about your wonderful site and how lonely, sad and ill informed I had been before I found Bonesmart. I told as many of the other patients as I could about it too. Its been great coming on here and finding out that other people all over the world, are in the same boat as me. Well my next appointment is in 2 weeks [oh the joy] and I look forward with hope that my ROM is more than 90 degrees.
Lindy xx