TKR GlideFloss TKR Report - from Dec 06 '21 on

[Layla]

Hey there Congrats and welcome to recovery!
Great to read you’re home already resting in your own space. Wishing you comfort and a peaceful evening as you begin healing!

Knee Recovery: The Guidelines

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.


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
the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy
5. At week 4 and after you should follow this
Activity progression for TKRs
6. Access these pages on the website
Oral And Intravenous Pain Medications
Wound Care In Hospital


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.

 

[CricketHip]

Welcome back home @glidefloss ! What a day, right?
You look nice and settled in your couch, hopefully you have a decent night.
wishing you the best and look8ng forward to reading your updates, when you can.
congratulations!

 

[Catalien45]

Hi, @glidefloss ... good to see you are home & reasonably comfortable. I haven’t been on my pad all day, but, along with everyone else here, regularly sending good vibes. And you had a beautiful ( albeit Windy!) Colorado day to welcome you home. I never had the pain ball, but noticed several others referred to it. Hopefully that will help! I have to chuckle, as I am sitting with a heating pad on my back, in the ODIC corner, and no doubt you are on ice!
I wanted to thank you for sending the info on the article! I will get my husband to help me forward it to our son. He is in Italy with his girlfriend’s family for Easter for a week or so. Her parents sent us a photo of a hike they were taking near their home in the Bergamot area, near the mountains....it looked beautiful there, with spring arriving. I’ll be interested to see if David recognizes any of the names referred to.
I don’t want to tire you with a long post, so will make this short. Do take care, get plenty of rest, and listen to your wife! It occurred to me sometime yesterday, that you & I are both blessed with spouses who are wonderfully supportive, and, can keep us in line when necessary. I think it sometimes takes that for those of us who are a bit stubborn.
Many good thoughts still coming your way.....

 

[CricketHip]

I forgot that you were in Colorado! My son said the winds have been pretty intense. He lives in Co. springs.

 

[glidefloss]

Additional notes that I just remembered -

• Although a tourniquet was used just as with my right, my thigh isn't killing me, allowing me to (for now) lift the leg whichever way I want. Hopefully it stays that way!
• It's been around 3 hours after the pain ball was attached and the earlier 8 pain is down to maybe 3-4. Instead of carrying the ball around my waist as I did with my right, I have it slung across my shoulders - it doesn't get in the way it used to (which drove me crazy then!)
• My left hip flexor seems to be getting a good work out when I do my hourly walk. I suspect that due to it having to live with a "severely valgus" knee for years! As we've all heard on this forum, no two knees recover the same, even if attached to the same body!
• Per the surgeon post-op notes, they had to fine tune the new knee before final cementing of components and closing the knee up. Seems like aligning the knee wasn't as cut and dry as the other one. Good to know that he was very thorough about alignment! I did tell him before going in that my recent bike rides were odd in that my left knee would constantly hit the bike frame - that's how knock-kneed it had gotten. Am sure that tidbit might have played a factor in his extra alignment doings.
• When doing my hourly "walk" the knee sometimes feels like it wants to overextend. Never had that with the right. Might be due to the knee being hyperextended 5 degrees before surgery.
• Mozart piano sonatas are amazing as great healing mood enhancers! My daughter sent me links to the complete set performed by one of "her" artists.

All the best youse'll on your respective healing journeys!!

 

[CamGram]

Great report @glidefloss! Glad your pain has decreased and that you are home and resting. Isn’t it great to have not one but two new knees? Welcome to the other side!

 

[glidefloss]

2nd day post-LTKR
As expected, my LTKR is a bit more challenging than was my right knee (which, BTW, has been performing like a champ.) I hadn't been able to get ahead of the pain till last night when I finally broke down and took 1 tab of 50mg Tramadol. Once it kicked in, things felt a lot better ... I'll try minimize taking it, at the risk of falling behind the pain curve again.

The left leg has always been the weaker one and based on the surgeon summary report, it was definitely in a pretty cruddy state. The report said they had to remove quite a bit of fluid from the knee area - which really surprised me since that knee wasn't swollen and the only thing I could feel when I "inspected" it prior to surgery were bones, including a number of what seemed to be floating spurs. The knee was also "severely valgus" and that installing, testing, adjusting, and retesting the components added a lot more time to the surgery (vis-a-vis my right knee.) It probably explains too my there's a lot more pain.

On the bright side, my thigh is pain free unlike my right one which hurt like crazy for a few weeks whenever I'd swing or lift my leg. That has allowed me to elevate my left leg up in the air and allowed me to massage the lower legs and behind the knee downwards. I've been elevating a lot despite it hard to find a position that doesn't hurt after a couple of minutes. So swelling, so far, isn't an issue. I'd thought that it'd make heel slides easier but so far that's not the case - the knee area feels so "raw" that I'd best not force the issue for now. Maybe I'll give it a try tomorrow instead.

Whereas I can gingerly swing my left leg around, it's not the most comfortable feeling ... but I've found that if I rested my left leg on my right leg (19 weeks port-op on Monday), the right leg can swing it wherever I need the left to be. I'm super happy with the way my right knee has come along and hopefully the left will do so likewise.

All in all, I can't really complain. I anticipated a more challenging situation, prepared for it ... and have been putting my arsenal of doodads to good use. More to come in days ahead ...

 

[InkedMarie]

I just found your thread; hoping things continue to go pretty well for you!

Marie

 

[NewRightie]

Congratulations! Sounds like things are going great so far!!

 

[Shortstuff26]

You are prepared for this @glidefloss! Keep your head up and take things one day at a time! I always enjoy reading your posts. I hope your recovery goes smoothly.
Looking forward to more updates.
Good Luck

 

[glidefloss]

Day 3 Post-LTKR - 830 am

A good night’s sleep (although somewhat abbreviated) ushered in a good start to Day 3 post-LTKR. My pain meds regimen of 1 500mg Tylenol (4000mg daily - the recommended maximum) and 1 200mg Advil (1600mg daily - far below the recommended maximum) every 3 hours has kept me ahead of the pain curve. Apart from 1 50mg Tramadol taken the night of Day 1 and another one at the start of Day 2, I’ve not taken anything else other than Tylenol and Advil.

Smooth Move, Miralax, Colace, prunes, yogurt, kombucha, lots of cabbage and chickpeas (both in a stew) all combined for smooth moves. Chalk this up to good recommendations from bonesmart folks as part of my pre-op post-op game plan.

A couple of hours ago I removed the pain block ball and am still waiting for an increase in pain in and around the knee area. So far I haven’t noticed anything different but am anticipating it to come within the next few hours. I plan to use Advil to deal with that pain should it come up.

With the pain block ball gone, I finally “hopped” into the shower for the first time since early surgery morning. Great morale boost feeling so nice and clean!

My first week’s game plan was to aggressively address inflammation and swelling - not worrying about flexion or extension and not doing any exercise of any sort unless 100% pain and discomfort free. To that end yesterday (day 2) I spent -

• around 3 hours icing, 2 of which I had my legs semi-elevated. I’m not convinced that icing does any good for me but will continue to do so as it doesn’t hurt or set me back.
• at least an hour of straight leg up in the air elevation (using a yoga strap to pull the leg up and using one hand to hold on while the other hand kneaded my ankle, calf, knee area, back of knee, and beginning of the quads and hamstrings.
• another 2 or so hours just elevating using my inflatable wedge while seated.
• slept throughout most of the night with both legs on the inflatable wedge. (Having gotten ahead of the pain curve allowed me this luxury.)
• During the day, I’d get up every hour or two to take a few steps. Nothing major, no attempts to bend the knee, just gradually applying more and more of my weight on the leg. Morning through noon of yesterday, the leg was so unstable that going down and back up stairs was challenging. By noon, after having elevated and massaged the leg, it felt so much more solid. It’s been that way ever since … although I remain vigilant as I know that overconfidence is a great cause of mishaps.

Today I plan to continue the “reduce/control inflammation” program and might do a couple of exercises but will pull back at the first sign of pain or discomfort. I have to remind myself that Week 1 game plan is all about inflammation/swelling control and reduction. Again, the need to watch for overconfidence will be quite important.

I’m very pleased with the way things have turned out so far … despite the initial day and a half. I’m also pretty pleased at how my pre-op workouts have really prepared my body for the surgery and initial recovery.

That all said, I am fully aware that things can go south very quickly and unexpectedly. I sure hope not but will not lose sight of that potential.

All the best to everyone else going through post-surgery recovery and rehab!

 

[Susie-Q]

Congratulations on being done with knee #2! I guess I should really say that you're just starting with knee #2 but at least the surgery part is done. Slow and steady!

My pain ball lasted for 5 days and my hubby even put a hook on the towel bar across from the toilet so I could hook it there while on the throne. I waited until that ball was completely empty before removing it as it really helped! I had to wait to take a shower but it was worth it! Glad you are able to keep your pain under control.

 

[MSN58]

Two knees in 5 months? Wow! Healing vibes for you!

 

[glidefloss]

Two knees in 5 months? Wow! Healing vibes for you!

Thanks @MSN58 . My right knee responded very well to surgery and rehab and has been performing like a champ supporting the left. I had hoped to have had the left done in March - 3 months after the right - but since the floodgates of postponed surgeries opened up, April was the earliest. I used the extra month to prep both legs for their new roles.

All the best!

 

[glidefloss]

Day 4 Post-LTKR - 930am

As often mentioned in bonesmart, recovery is like a roller coaster ride - lots of ups, lots of downs, lots of in betweens! Yesterday morning I was feeling pretty good - swelling nicely controlled, pain nicely controlled, left leg a lot steadier than the day before, constipation a non-issue, pain block ball removed, and my first shower in days. This was a huge contrast to the start of Day 2 when my left leg was super wobbly that going down and up stairs was pretty challenging.

Yesterday (day 3), I removed the pain block ball around 630am and it wasn’t till early afternoon that pains the pain ball used to block started manifesting themselves - thigh area (all the way up and down) started aching and tightening, the quad area near the knee felt raw-ish and throbbed, the incisions had this sharpish pulling sensation, the calf started occasionally spasming as if it were ready to cramp and were super tight, the shin felt so overly tight as if very swollen (which it wasn’t). From a 2-3 pain level in the morning, it felt like different parts of my left leg had levels that ranged from 4-5 to 6-7. Better than day 1 … but from a mental perspective, it was sort of a huge let down given how well I was feeling earlier in the day!

To help take the edge off the pain, I took a 200mg Aleve tablet - in addition to my 3 hour regimen of 500mg Tylenol and 200mg Advil. I’ll keep the Tramadol in my “back pocket” for now, just in case … My new pain meds regimen is now Tylenol/Advil every 3 hours, Aleve every 8 hours.

As I was coming to terms with the new aches/pains, my cheap inflatable elevation wedge started a slow air leak. That was super disappointing as I’d come to rely on it for most of my elevation needs, moving it from one sitting/laying area to another - something I did quite often as my body’d complain about being in one position for any length of time. I’m going to have to order a better wedge … the Lounge Doctor looks tempting but I’m too cheap/frugal to go for it and will probably “throw away more good money after bad” with another cheapo. (It’s sort of sad to know that I'll likely make another bad decision but decide to go ahead anyway! )

The one major positive from yesterday was that my left knee continued to feel steady despite all the new felt pains and aches around it. As a result, by late afternoon I ditched the walker for the cane - after having done a couple of hourly “walks” with it. Through the mental funk I was going through, this switch provided an uplift. I could/can now go down and up stairs without the Mrs having to lug the walker down and up - and now the walker has been relegated to its designated parking spot.

So far, I’ve done Zero heel slides, Zero leg extension, Zero exercises, etc. With all the assurances from various bonesmart admins and advisors, as well as other posters, I’m not going to worry about flexion and extension at this time. My focus today (and for the next few days) will continue to be on inflammation control and healing (mainly by taking in plenty of protein and by not exercising.)

The journey continues …

 

[Susie-Q]

I'm sorry you had a resurgence of pain when the nerve ball was removed...... As you are well aware, you are still in VERY early days so don't worry if you have to resort to a stronger pain med here and there or even for a stretch of a few days straight. It doesn't make you less of a person! Your body just went through MAJOR surgery and is doing the best it can to heal.

Hoping your inflammation has eased up, don't forget that ice! Hopefully you were able to get another elevation wedge......

 

[jtrahan]

Hey Glidefloss,
I’m happy to hear things are going well for you. I purchased a Lounge Doctor prior to my surgery and was happy with my decision. They do make an inflatable model. I’m six weeks this Wednesday and I’m still experiencing stiffness and some swelling so I have come to appreciate those little expenditures I made prior to my surgery. I believe I purchased mine on Amazon.

 

[kiwicurls]

Hi glidefloss. I really enjoy your posts as you have such a great way of putting things and your sense of humour shines!
I still haven’t heard from the supposed home physio but I am in no hurry to arrange it! Thank goodness for the Easter break.
My memory foam leg elevator looks like the lounge doctor one but was much cheaper on ebay. Does the job and won’t deflate. ( Sorry but that made me smile!)

 

[glidefloss]

Hey Glidefloss,
I’m happy to hear things are going well for you. I purchased a Lounge Doctor prior to my surgery and was happy with my decision. They do make an inflatable model. I’m six weeks this Wednesday and I’m still experiencing stiffness and some swelling so I have come to appreciate those little expenditures I made prior to my surgery. I believe I purchased mine on Amazon.

Hi @jtrahan , thanks for your tip in re an inflatable Lounge Doctor. I should have looked closer at the options before ordering el cheapo wedge #2, this one a bit more than double the now defunct one and is not inflatable but foam instead. It arrives on Wednesday and I'm prepared to curse myself out again for having wasted more money again. Sometimes learning does not take place!

Right now I'm using several pillows but they collectively don't do half as good a job as the wedge did. And moving them around from room to room is a pain in the neck ... Although a good reason for me to move. Good thing I'm now on the cane and no longer walker-ing it.

All the best on your recovery/rehab!!

 

[glidefloss]

Hi glidefloss. I really enjoy your posts as you have such a great way of putting things and your sense of humour shines!
I still haven’t heard from the supposed home physio but I am in no hurry to arrange it! Thank goodness for the Easter break.
My memory foam leg elevator looks like the lounge doctor one but was much cheaper on ebay. Does the job and won’t deflate. ( Sorry but that made me smile!)

Thanks @kiwicurls . Am glad your own recovery is coming along nicely as well, staples removal adventure notwithstanding!

I have outpatient PT scheduled almost a couple of weeks post-op, unlike with my right when I had outside PT on day 2. For this go round, I'm focusing first on inflammation management before doing any exercises. If before my first PT session my in leg feels ready for action, I'll start doing some of the exercises that my right leg went through early on. That's a good advantage of having had one knee done earlier! Had I had a third knee, I'm sure my post-op plans will be even better!

All the best on your recovery/rehab!!