TKR Harry's NEW right knee

[Harryrightknee]

Hi All,
Been meaning to get to my version of how my recovery is going. (Long version)

It started actually last October my left knee was really hurting so my PC Doc. Referred me to a ortho Dr. We started with the usual stuff xrays, my line of work etc.
So a week later he had me back in to look at my xrays. And treat my left knee, (drained and added cortisone shot, then he looks at me and says "so? When are we replacing your right knee?" Umm? What? Was my response...My right knee was bone on bone with lots of arthritis....Hoyy....☹
He said that I must be in incredible pain. I staited that with my spinal stenosis that it really doesn't hurt bad...I was on a daily regimen of 3 advil, 50mg tramadol, and 1 Terry Naturally Extra Strength Curamin...
Well here's a before pic of my knee...

It was really knock knee... The Dr. Explained about waiting and what could happen further down the road....So I decided that it was time....We scheduled the TKR surgery for March 9, 2020
A little bit about me...healthy 49 yr old guy, been in the restaurant business all my life. I'm sure that the hard tiled floors have done nothing good for my back or knees. Most of the time I am on my feet 10hrs a day...rarely do I get to sit much. I have some low back issues and diagnosed with spinal stenosis about 2 yrs ago. But nothing really slows me down... I am very active, lots of hobbies, gardening, working on my vehicles etc.
I have not had any major surgeries before up until 3 weeks ago...
Story continues next post >>>

 

[Harryrightknee]

Ok so months go by while awaiting my surgery.
Poof! March 9th is here!
So relatively by the book surgery Dr. Explained to me just how bad my knee was.

So day 2 they had me up walking. So far I thought not too bad. Interrupted sleep for meds. Etc.
Day 3 Tough times with BM's but eventually got better. More walking, foot slides, and started stairs.
Still interrupted sleep....but at least I was good enough to be able to go home in a more comfortable setting...pain was pretty minimal so far...I was like wow not too bad.
Day 4 and 5
Me and my wife had set up the house for me to make things easy. We have an adjustable bed, so that made things easier for sleeping I had plenty of ice packs ready. Wedge pillow, walker etc.
Then day 6 comes...hoyy....
Felt like the nerve block finally wore off...I was on 15mg oxy every 4 hrs, still barely able to sleep along with 1000 mg tylenol every 6hrs...BM's were challenging...lots of swelling, and pretty colors...
Day 7
Well I was melting through ice packs like crazy, so went on FB and found someone selling a Ossur cold rush machine best money spent....

Continued on next post>>>

 

[Roy Gardiner]

to BoneSmart

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​

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.

 

[Harryrightknee]

So day 8 now....
Well still doing Ok. But now problem with getting more pain meds....hoyy....Dr. sent in script but now my ins. Says I have to wait a day before I could get it refilled. Now mine you that I just started PT as well. i definitely felt very small in a big world that day...pain was very unbearable that night...the ice therapy machine helped me make it through...barely.
So wife picked up the script and they cut my dose and amount to be taken in half! I was not even a week and a half out of surgery...
Day 9 /10
The PT was good so I thought until I found this forum....he was a brute, very painful, pushing down on knee, kept pushing ROM.... the day after was spent in bed icing all day / night...
Day 11 to 3-24
Same with PT really pushing ROM he added 4 pound weight to dangle off my knee to get it to stretch...of course now I ran out of pain meds by 3-24 again...still lots of swelling and heat coming from above and below the knee even I think is as heat rash, small bumps, has anyone had that?


Some numbness around the knee, but what was hurting more was my ankle, very sore on the inside still some coloring. Has anybody had that issue?


Continue next post >>>>I told you this was long

 

[Sara61]

I will ask @Jamie to best advise you on the bruising of your ankle however I think you should try and change your PT instructor as his methods is way too forceful at day 11 you still need gentle PT not weights dangling off your legs you are healing from a major operation and not some sports injury!
The swelling will not reduce if you keep on forcing your knee what you need is " time" and RIME ( Rest.ice.medicate and elevate ) if you follow this the swelling will reduce.
Stay safe and Rest that poor leg xxx

 

[Harryrightknee]

3-24
Went to Dr. To get staples out...

I asked him about my ankle pain, he says...NORMAL
I told him that I was barely sleeping....NORMAL
Then I asked about pain meds and with PT, so he gave me 5 days worth morphine 12hr extended release and refilled my oxy for breakthrough pain
Well the morphine helped, with oxy to get through PT and sleep at night.
Today I called dr office to let them know morphine script is gone and that I am using the oxy as my main form of pain management. They said we'll call you back...which they never did...
Then the nurse came by to check my blood for the thinners, I told her about the pain meds, and she insinuated that the oxy is very addictive and that she highly doubts that they will refill anything but tylenol...What? So I said you think I'm some kinda junky? She's said well you should be off of the heavy pain meds by now? Oh yeah? I asked so you had your knee replaced? Of course she said NO....
So were up to today / tonight the morphine is gone I am icing, elevating, and using the last of the oxy, which tonight has kept me up...
I have NEVER Felt so judged today....I have never had any drug, alcohol, issues ever
So my last question for tonite is can I use my tramadol and Curamin, to help with pain management?
By any means did I think this surgery was going to be a picnic...but 3 weeks and down to just tylenol? Crazy...in my eyes... I'm going to call my primary physician in the morning to see if he can help.

If anyone has questions for me please feel free to ask...I'm sure trying to remember the past 3 weeks I forgot something....

Thanks for listening I know time is my friend, but unfortunately I do have to look at going back to work soon. So trying to put the pieces together and have some type of NORMAL for me.
My mental therapy is my 77 IH Scout...but it's a standard...so hopefully I can feel better soon so I can go out for a ride...


Harry

 

[Harryrightknee]

Ahh, I knew I forgot something, so I do have a new PT starting this Thursday, he checked my ROM today he's happy with with my starting points my extension is at 0 degrees and flexion is at 120 degrees all on my own...

Thanks again all! Glad I have found this site!

Harry

 

[Sara61]

Im surprised you have PT starting - are you not in lockdown due to the virus ?
@Jamie will advise you on pain medication but I took tramadol till almost the end of 3 months with the agreement of my surgeon, if you are in constant pain then you are unable to concentrate on gentle movements.
I'm sure due to this virus you won't or shouldn't be going to work anytime soon - take this opportunity to rest your leg, get the swelling /pain under control and once you have managed all that you will then be able to reduce your medication only then can you think about driving. - I didn't drive until almost 4 months.
The old saying stand in this recovery "Don't run before you can walk "
Take care x

 

[Roy Gardiner]

Then I asked about pain meds and with PT...

PT should not be painful. All you need is to help retain mobility (not fitness or strength) until healing is complete. This is done with gentle stretching exercises, without pain. Your knees is damaged and pain in PT is telling you you're compounding that damage. Drugs just mask the pain and the damage.

 

[Cjackso21]

Hello, thought I would let you know I had a similar rash but on my back after my last revision on 2/7. They thought it was the meloxicam, a mild anti inflammatory but stopped that and it was still there. Lasted about 3 weeks then slowly went away. I was able to control my pain with only Tramadol on a regular schedule. I don’t do well with any of the other opioids. My revision was basically a completely new knee so the PA didn’t think the doc. would allow it but I did fine. Was able to go to Advil at 4 weeks as I was getting headaches from the Tramadol. This is the first time my new doc. agreed with the advise here and did not start PT for several weeks, just worked on stretching. Made a big difference in pain management. Then my PT was not aggressive but let me do my own thing. I now just have tendinitis which is making walking tough. I go back to work next week but might be working from home. Good luck and listen to these folks, they are very helpful!

 

[Harryrightknee]

Im surprised you have PT starting - are you not in lockdown due to the virus ?
@Jamie will advise you on pain medication but I took tramadol till almost the end of 3 months with the agreement of my surgeon, if you are in constant pain then you are unable to concentrate on gentle movements.
I'm sure due to this virus you won't or shouldn't be going to work anytime soon - take this opportunity to rest your leg, get the swelling /pain under control and once you have managed all that you will then be able to reduce your medication only then can you think about driving. - I didn't drive until almost 4 months.
The old saying stand in this recovery "Don't run before you can walk "
Take care x

Hi Sara

Thanks for the help. Yes restaurants here in Massachusetts are limited to just take out food, no sit down dining. Our restaurant is a single owner 50s diner, I'm the Managing Partner there I created the menu, the owner makes all homemade ice cream. Since the world changed...we've been busier than if we were open regularly...its a good problem to have... Here's a pic of one of our dining room seats...

Sorry had to add something about my work, I love what I do for a living...
Yeah, I have quite a bit of my tramadol from before my surgery, I was thinking of using naproxen as well.
Yeah I had home PT for the past 2 weeks, last Friday I was discharged from the home PT. Yesterday I went to PT facility, they seem pretty nice there so we'll see. I start actual PT this Thursday.
Agreed when my pain is under control I feel almost "normal". I have been walking around pretty good with my cane. My basement stairs I'm terrified of but I do good with the 3 steps to get in an out of the house ...yes time is my friend, but unfortunately time doesn't pay the bills....I'm actually been doing some work from home, the owner covered my salary till 4-8. I'm planning on a slow start in April maybe a few hrs here and there. We'll see...I'm stubborn....not stupid...lol...

Thanks Sara

Harry

 

[Rockgirl4]

Something we're experiencing here in Missouri---the entire state isn't on lock-down (crazy governor!!), just the big cities/counties with lots of people like mine. However, our PT clinics are doing things very individually right now, so don't be surprised or worried if they DO cut your PT. It isn't necessary, as many people here will tell you, but some people panic without it.

Here in Missouri it is a changing situation daily. My son's PT is still open because they have enough post-surgery patients that the Director is worried about frozen shoulders, knees, and anyone who needs post-op care. He feels an obligation to stay open. My son has been dealing with a back problem for 6 months and has his last visit tomorrow to assess things and talk about the plan going forward. However, another PT clinic I usually go for my back (a favorite PT from 11 yrs ago!!) sent out an email stating they are cutting hours severely, as most people are canceling, and they aren't very busy. I imagine this will happen across the country, varying state by state.

Just know that time is your friend, and don't try to add things back in too quickly, regardless of what happens.

 

[Harryrightknee]

Something we're experiencing here in Missouri

Small world we live in, 2 years ago I bought my truck from a gentleman in Agency, MO...

Yeah just in my town in MA we went from 24 to 46 in a day.... people just gotta stay home...at my PT office me an 2 other workers were the only ones there, and one of them was cleaning and spraying everything....

Harry

 

[Harryrightknee]

Day 23,
Well Dr.'s office finally called me back today to let me know they changed my pain med. to Hydromorphone.
So productive day got on my recumbent bike zero resistance, 5 min, 1.4 miles.

Did my quad squeeze, glute squeeze, calf squeeze, and a few other very low impact but helpful exercises recommended by my new PT...uncomfortable exercises? Yes... painful NO.
I tried some bio freeze on my sore ankle, definitely helped, just not long lasting...which when I asked my dr. Again about the sore ankle today....yep that's NORMAL....‍
swelling getting better not as bad as it's been, and that's with exercise... Ice / elevation is your friend.
Thank you Bonesmart!
I will not let another PT hurt me like my past one....

So I have a tens unit, anyone using one?
If so what areas and time amount are you using the tens unit?

Thanks

Harry

 

[Rockgirl4]

I forgot to mention I had horrible ankle and calf pain that was just as bad as the knee pain. My surgeon explained some of it was the way they manhandle the leg during surgery, but a lot depends on where your swelling/fluid accumulates too. My entire leg was horribly swollen and bruised, all the way up, down, and around....from my foot to my groin. I figured this meant they manhandled the leg A severely and in various, forceful ways. I also swell a lot with each knee surgery, especially in the right leg, so I figured that was part of it too. All I know is there were nights I cried from the ankle/calf pain more so than the knee pain. I simply could NOT get comfortable until week 4 post-op, and that was barely an improvement.

 

[Harryrightknee]

I forgot to mention I had horrible ankle and calf pain that was just as bad as the knee pain. My surgeon explained some of it was the way they manhandle the leg during surgery, but a lot depends on where your swelling/fluid accumulates too. My entire leg was horribly swollen and bruised, all the way up, down, and around....from my foot to my groin. I figured this meant they manhandled the leg A severely and in various, forceful ways. I also swell a lot with each knee surgery, especially in the right leg, so I figured that was part of it too. All I know is there were nights I cried from the ankle/calf pain more so than the knee pain. I simply could NOT get comfortable until week 4 post-op, and that was barely an improvement.

Oh, so my Dr. Is right, its "NORMAL" I think that's his favorite word....yeah up right now waiting for pain meds to kick in....
I told my wife, I think they dropped me on the floor during surgery...
yeah the ankle and the bone hurts sometimes more than my knee...however I did try some BioFreeze earlier today while I was exercising. It worked pretty good, for as little bit...I almost felt "NORMAL"

Harry

 

[TrixieRuby]

@Harryrightknee hello! Greetings from Newton, MA! What a saga you tell. I had my surgery on 2/25, so I am 5 weeks out this week. The pain control situation in the USA and in my own experience is pretty tough. The docs do not want you to have drugs! I think we have to advocate in a mature fashion for ourselves, keep asking, and try different meds. My primary care doc knows me better than the OS, and she prescribed some additional drugs for me. My main caution to you is don't do too much. I am very pain sensitive, and when I over do it, the pain increases, as does the swelling. Swelling is the enemy. Take good care of yourself, and remember that your leg has endured a lot of trauma. Take stool softeners, ice a lot, massage down the swelling, and go day by day.

 

[sistersinhim]

One of the reasons for ankle and foot pain after this surgery is the different way we are walking now. This new knee changes many things about our gait. That ends up giving us extra pain in different places. Even my hip and back had different and new aches after this surgery.

 

[Harryrightknee]

Week 4 update-

Well Dr. has finally got me on a pain meds that sort of work. 4mg Hydromorphone, no more oxy, better sleeping except for days after PT. I find that I am taking less pain med. Which is good. I got rid of my cheap wedge pillow and picked up the Lounge Dr. with cooling memory foam, not cheap but now my wife can finally sleep in our bed without me having bed all the way up for my knee....she says its worth every penny....lol.

So I am still using tylenol right now, I want to switch over to Alieve (naproxen) for better anti-inflammatory control, I also want to start taking my Curamin.

I'm on my last dose of warfarin (blood thinners) anyone switch over and if so did you wait a couple days before doing so?

My swelling goes way down in the morning, but after moving around for a little bit my knee let's me know when its had enough... so I stop rest, ice.

I did get my Scout out of the garage today and went for a little ride around my block, definitely a spirit lifter! Felt good!

Thanks to all who have helped me, I wish everyone the same in recovery. It does get better, just stay the course. I will keep up with weekly updates.

Harry

 

[Jaycey]

I want to switch over to Alieve (naproxen) for better anti-inflammatory control

I would not recommend any NSAID medication. They have some nasty side effects. Scroll down to NSAIDs on this page. In any case Tylenol is a much better pain killer.