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TKR Good morning! I’m new here.

Jenn3319

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I’m so glad to find such a fantastic resource as I recover! I had a TKR (left knee) on January 15th. I’m doing ok so far; I just finished home PT with 0 degrees and 110 degrees. I know I have more work to do. First doctor’s appointment post-op is today; I’m so ready to get my staples out! Still having lots of pain.

Is fatigue normal at this time post-op? I’m working from home part time and go back to the office full time next Thursday. I’m trying to imagine how I won’t fall asleep on my desk - or even how I will sit at my desk comfortably for 8 hours.

Happy to meet you all.
 

Tykey

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Fatigue is virtually compulsory.
If it was an Olympic sport, Bonesmart would have a cupboardful of medals. I'm now 5 months in, and my fatigue is just about gone.

Back at work after 2 weeks is an enormous challenge. Most people need to wait about 10 weeks, and even then ease into it slowly.

You really are asking a lot of yourself.

But it's nice to have you join us
 

Jockette

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Hi and Welcome!

You will most likely have fatigue for a while yet, it is because your body is sending most of its energy to healing your knee and there’s little energy left over for anything else.


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: The 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
ice
take your pain meds by prescription schedule (not when pain starts!)​

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. At week 4 and after you should follow this

6. Access to these pages on the website

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.
 

Jockette

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You may have a very hard time stirring at a desk for 8 hours. You will need to take frequent short walks, and find a way to ice and elevate throughout the day.

Here’s an article about sitting:
 
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Jenn3319

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Thank you all! The article on sitting was very helpful. I am definitely going to have to be up and moving regularly and am going to have to figure out the icing and elevation. To be honest I’m feeling pretty overwhelmed at the thought of it.

While this is clearly my fault as I decided and arranged everything, I think my dr may have underplayed how hard this was going to be. He had me convinced I should and could effectively do this as an out patient (which I did not do) and would be out walking and driving quickly. He also approved my work plan and felt that it would be no problem. I should have done a bit more research! As it is, my job is flexible so I may end up having to modify the amount of time in office. Has anyone else here returned to a sedentary job relatively quickly? Any other pointers from anyone?

I also have a question about icing. I’ve been medically advised that I shouldn’t ice for more than 25-30 minutes at a time a few times a day. Does this seem right to you?

Finally, I’m primarily walking with a cane around the house and am trying to decide whether I need to use the walker when out of the house or if the cane is sufficient. Any advice?

Thanks again for the welcome, information and advice!
 

Rubyroo

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My vote is to use the walker when out of the house. You could always take the cane for short distances around the office but the walker made me feel secure and stable when I would just need to hang on to it with both hands and rest for a moment or two!
 

Jockette

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This article is in the Recovery Guidelines I gave you.

Please read through all those articles, there’s really a lot of good information in them. Continue to ask us all your questions, that’s what we’re here for.

Many surgeons underplay the recovery, or they missed that class:heehee:

Recovery from a knee replacement, partial or total, takes an average of a full year, though you will feel much better long before that year is up. Returning to work at 4 weeks can be done, depending on each person’s situation and individual recovery, but we recommend taking 12 weeks off, with a phased return. We have an article about that, too, I’ll go look for it for you.
 

Jockette

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Here’s a link to the whole list of articles is the Bonesmart Library. Lots of topics there!
https://bonesmart.org/forum/threads/library-index.14830/
 

Roy Gardiner

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Is fatigue normal at this time post-op?
Absolutely yes; the body takes over to HEAL and leaves as little as possible over.
I had a TKR (left knee) on January 15th
go back to the office full time next Thursday
Dear Lord...
I’m trying to imagine how I won’t fall asleep on my desk
BoneSmart says 12 weeks from surgery to return to work. If you are driving and doing a full day, you will be in big trouble IMO. The brain is not excluded from the body commandeering resources to devote to healing, you will be tired and less effective than usual.

IMO you really need to reconsider and renegotiate as much time at home as you can. Your knee needs it.
 

sistersinhim

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I shouldn’t ice for more than 25-30 minutes at a time a few times a day. Does this seem right to you?
I iced the whole time I was down. 25-30 minutes isn't long enough to help you much. As long as you have a cloth between your knee and the ice pack, you can ice as long as you want. When the water in the ice bucket got warmer, then my knee would start to ache. I would refill the bucket with new ice and my knee pain would ease off. Ice also keeps the swelling down. Swelling is another form of pain and it restricts ROM. Ice as long as you want to.
 

Celle

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I also have a question about icing. I’ve been medically advised that I shouldn’t ice for more than 25-30 minutes at a time a few times a day. Does this seem right to you?
I know that's the usual advice, but recovering from a knee replacement is different.

After surgery, ice is frequently used as a means to minimize pain and swelling because of the surgical trauma. It's not the same use as you might do after an injury. Following injury, it is common practice to tell patients to ice no longer than 20-25 minutes several times a day. But with a surgical incision, it is perfectly fine to ice your wound as much as is comfortable for you, providing that you do not allow your skin to chill to the point of damage. That is why we recommend that people use a towel between the ice source and their skin or clothing. It's also why the ice machines like Game Ready or DonJoy have pads that don't get quite as cold as you can do with an actual ice pack.
Icing is an excellent means to control pain following surgery and each individual needs to find out what schedule works best for them.

I used gel packs through the day and night for weeks with both my knees because it felt better than not icing. Obviously, during the day there were periods where I was not in bed or on the couch, so I wasn't icing then. But at night it was both front and back of the knee all night long. When I woke in the night, I replaced the thawed gel packs with fresh-frozen ones.
It really helped me sleep.
 

Celle

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You really are going back to work far too early. You'll still be very fatigued and you may still have the "brain fog" that affects many of us. It's difficult to make important decisions at that time.

In addition, going back to work usually increases swelling and pain.

It's not just how physical you'd have to be at work - it's also the physical demands of getting to and from work, as the article that Jockette gave you explains:
having to get up earlier in the morning
getting washed/showered, putting on the 'face',
getting dressed
getting a fast breakfast and eating it in about 5 mins instead of casually
getting out the car
driving to work
walking from car to office
actually being up and about and unable to take intermittent proper rests during the day
walking from office back to car
driving home
putting car away
making an evening meal
probably feeding pets and/or others
washing up and then finding it's almost time for bed!
 

InkedMarie

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As others have said, it is very very early to go back to work. Can you delay your return? Explain to your surgeon that you are still having pain and are Exhausted....being that exhausted, how is your mind even ready for a job? A phased return is much better.
 

Helizabug

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So much good advice already, and all I can add is that I found an old fashioned ice bag to be really convenient. My workplace has an ice machine so there’s always plenty of ice.

At home I use my beloved Polar Care Cube, but the overhead of carrying it back and forth to work and home, and the whole process of wrapping it around my leg than unwrapping when I need to get up, then rewarding, etc . . . It’s too much work. The ice bag is great for time away from home if you have access to ice.
 
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Jenn3319

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Thank you articles and great advice. I’ve been icing more this afternoon (Staples were taken out early this pm) and intend to keep doing so as it provides so much relief! I haven’t figured out of yet. I’m currently working 4 hours a day but its at home. id Like to take more time off but there are a number of reasons that would make that difficult. I am thinking that I may postpone going back to the office until the week after next and the only do a part day. The points you all made certainty made me think about what was realistic- and better for me long term. Thank you all again. I hope you have restful evenings and good sleep!
 

sondrals

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I returned part time at 3 1/2 weeks on my left and 4 on my right. It was not easy. I worked part days at first and now I’m back to full time at 8 weeks. I was really tired, swollen and sore at first but it’s gotten better. I’d ice before and after work, I get up lots and walk around a bit. I can also elevate at my desk but found it uncomfortable to do so. Honestly I’m still really tired. I end up heading for bed about 9 every night and on the weekends I often go back to bed for 2-3 hours.
 
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Jenn3319

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Thanks Sondrals. I think you are amazing to have done two TKRs. I seriously can’t imagine. And to have gone back to work so quickly after - wow. I’m going to follow your protocol with icing, movement and early bed- but I’m still dreading it. Thank you for sharing your experience.
 

sondrals

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No problem. Like I said it hasn’t been fun or easy (and I’m probably headed for surgery #3 ugh). I’m just now able to sleep a good 6-7 hours straight without my knees bugging me. I’ve actually worked from home since about day 3-4 on both surgeries, not much mind you and I may have messed up more things than I accomplished in the early days. But we have a pretty small office and they have been super supportive and generous so I feel obliged to pitch in as much as I can.
 
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Jenn3319

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PT made me cry today. It was the first day of PT out of my home. Most of the exercises weren’t bad - uncomfortable but not to the point of tears. However one of them (bending knee and aggressively pulling in towards my body) hurt like crazy. i was teary but therapist wasn't bothered and told me it would be painful. He pointed out that I got more than the 110 degrees I had reported at the beginning of the session. I’m not sure I can stand doing these twice a day every day. I know that the thought here is to not do PT to the point of pain. Is there something else I should be doing to work on flexion? He though I’d be at 120 plus in a could of weeks and could the stop regular PT (although not the exercise). I have to admit that if like to b done with it (and him) as soon as possible.)
 

Tykey

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So he's intending to continue hurting you for some more until you reach the 120 which has no basis and he has pulled out of the air?
if you stop doing it now, you will get to, and beat, that figure just by doing gentle activities at home. You are already doing brilliantly!!
The choice is yours to make.
 
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