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TKR Hawkie's 2nd Knee

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hawk2go

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I am 10 weeks post op on Monday and still having trouble sleeping, my scar is very sensitive, I am going to try cling film wrap tonight & hope it helps.
I read back through my left TKR journal and found that I tried the cling wrap around week 4 but it took a few tries before it starting to make the knee feel good overnight and when I woke. After a while I used the cling wrap and abandoned the pain meds. I know it was the cling wrap that did the trick because I complained about pain on the nights I did not wrap.

In support of "every knee recovery is different" - my right TKR recovery is ahead of the the left timeline and that's a good thing. On the left TKR, I had a couple weeks setback from aggressive PT (I fired that guy and got a PT more experienced with TKR recovery) and also pretty consistently jammed myself up by overdoing it back then. When I see my surgeon tomorrow, I'll spend lots of time discussing the med routine and hope to get that resolved so that I can sleep. Everything else is coming along - nearly 4 weeks done.

Note to self: slow and steady ...
 
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I got a good report from the surgeon, for this point in my recovery. He eyeballed my extension and flexion and thought both were good. He didn't even look at me walk and I was all ready for my big moment but I know I am doing well with stability on the cane and short distances without any device. He helped me figure a new plan for pain (prescribed new meds) and sleep (different med schedule). No scar massage for a couple more weeks. I'll continue daily activities, increasing outside walk distances and outpatient PT. He also ok'd returning to work partial days for a few weeks since I work a desk job from home. Oh, and I can ignore the compression hose unless swelling becomes an issue, so far so good.

We'll see how it all goes. I was pretty wiped out when I got back home.
 

Scanne

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Good news all round hawk2, keep up that progression.
 

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@hawk2go, indeed, it sounds like you are healing well! I had major sleep issues with TKR#1, and some this time, but I was much better prepared this time, as it sounds like you were. My docs didn’t prescribe opioids this time as they don’t help me with pain, so the Tramadol/Tylenol combo worked for me… l also did the scar massage too, and I think this time I was at 7 weeks before it was done… Glad to hear you are doing well!
 

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@hawk2go Its good that you are doing well. You know what to expect so that you are progressing quicker this time. I hope you continue towards full recovery without too many bumps in the road.
 
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hawk2go

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You know what to expect
Hey Newly {she waves wildly from Philly}, I hoped that you'd pop in on my new thread:wave:
I had to go back to my journal because after 6 years, I really didn't remember what to expect. What I did recall was the trauma of too tight compression hose, too aggressive PT and pain unmanaged. So with those emotional memories and my journal notes, I did prepare myself for success this time around.

Today I did my first walk around the square block without difficulty. The knee was a bit tight when I finished and I went through my home exercises then elevated and iced. I'm very happy with the bend and the extension for my 5th week out.

I see you had to have a revision this year. I hope all is settled now and you are back to a full life. I hope your girls (women) are doing well.
 
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I decided to add the recovery from my perspective to connect to the surgeon's perspective:
I still am managing pain, mostly at night, and have sleep challenges, probably because of pain. My mobility, flexion and extension are all decent and allow me to do most of my own daily care, though I haven't resumed cooking at pre-op levels (I'm a foodie and live with a retired chef - so, ya know, we cook!). My daily walks extend every week and my big challenge is being careful to manage overdoing it and underdoing it. I do my PT exercises daily, except on rest days when I've overdone it. I plan to start outpatient PT next week (I needed a mental break, so I took it) and also will begin working from home part time.

I take meloxicam and tylenol round the clock. I also take 1-5mg oxy with a companion colace when I wake in the middle of the night as a recent experiment to see if that allows me to resolve the midnight-ish pain and help me get back to sleep (day 5 and it seems to work). The cling film solution was my go to remedy for my LTKR when I found I didn't need the constant pain meds, I think it may be time to start that again. It solved the scar sensitivity, night time pain and the waking stiffness all in one. Per my surgeon, it's too early to start scar massage but I have starting using a bit of face lotion to help with the itch.
 

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My longest walk has been 9 houses out and 9 houses back. My block has 20 houses so I think I will tackle that today since the weather is sunny and no rain. My recent UTI put a damper on outdoor walking so I need to get that going again. My scar is almost completely healed, just a couple of scabs left to fall off. It's pink and raised, however. While it's not too sensitive, I don't think I'll be wearing jeans for awhile yet, it will be looser knit pants for me. I'm only a week ahead of you.
 
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I'm up to a square block but didn't have the health complications @Susie-Q. My square block is hella uneven - it's uphill, downhill and has a few pavement squares pushed by tree roots, so it's quite enough challenge for me right now. Next week or so, I'll see if I can extend to walk to the park (3 blocks away) and back. If needed there'll be a nice bench for me to rest a while :)
 

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Wow, yeah that sounds challenging. I'd be wary of tackling that too. My block has a gentle slope down and then back up towards my house but it's mostly flat. It was challenging enough, I was tired and my heart rate was definitely up.
 
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I made it the 3 blocks and a bridge to the park today (in some ways easier than the square block because of a more even path). At a really slow pace, I was sweating when I got back home, lol. I iced and elevated and have no swelling, so will see where I land tomorrow. Actually swelling has not been a problem this time around.

I also saran wrapped The Knee last night and it felt pretty good this morning. I'll have to get used to the sound and feel again.
 
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I made it across the street and into the park to sit on a bench yesterday. I also have starting going up the stairs with both feet (and my cane), occasionally. When I'm on one floor, I have often gotten up and just walked to my destination across the room or to a different room - then panicking, I look for my cane. I'm no worse for the wear today. So my stamina and strength are improving as is my mobility. I'll try rocking my floor pedaler or my stationary bike later this week.

I also tried to to see if I could go without the daytime meds - uh, that's a big NO. I took the meloxicam as prescribed but dropped the Tylenol on Saturday and yesterday took 1/2 dose. The pain is still fairly consistent, though much lower level during the day and even the night time pain is easing and flaring only when I'm in certain positions. I've also saran wrapped The Knee for the last few nights. Today I went back to the full dose regimen and will try reducing meds again next week.

I returned to work this week - 4 hours per day with breaks. Sitting at my desk is tough and it's now time for a nap:heehee:. No PT exercises needed today. We'll see how it goes tomorrow.
 

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That's brilliant @hawk2go , sounds very much like my status too. I know what you mean about forgetting the walking stick - i think I do more steps trying to find it than i do usually. Amazing that you are going back to work already -- well done. Very ambitious to try and drop the daytime meds!! I have managed to drop one dose of paracetamol and my nightime nervepain tablet, but that is as far as I have got yet. Might try and drop one more dose next week. I too struggle to sleep, although i can now lay on both sides and my back. I have sorted stairs now ☺
 
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Yeah, the pain is like a steady hum but it's no longer distracting. If I think about it I know it's there but it no longer is the first thing to get my attention. It doesn't occupy most of my brain power.

I work from home, at a desk, so the big challenge is sitting at my desk for a couple hours at a time. I've been practicing sitting up for longer periods and also not napping as frequently. Sounds weird when I say it out loud.

As to the meds, I remember my sis-in-law saying she was taking the meds on schedule after THR and one day forgot them and realized she was no longer in pain. The meds throw me off, in general, so I'd love to not need them but will use them until that day. I test the med levels periodically like I test my physical boundaries, checking to see what I can do without negative impacts.

I can lay on both sides, too, so along with the midnight-ish oxy, have been sleeping better. I need a pillow between the knees but it's not necessary for the leg to be level to the foot anymore. I can use the pillow to just protect the medial part of my knee that had the most surgical trauma (I read my surgical notes, fascinating!).

eta: I've also been successful going upstairs with both legs, as long as I'm not too tired or swollen. I tried downstairs but need more time because I swing my right hip out in anticipation of pain.
 

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I asked my PT about that yesterday, she said that going up always happens first before being able to go down. It has to do with your glutes (butt) helping when you go up (easier) and the extra pressure and gravity when going down and your quad having to lengthen to accommodate (harder). I'm probably not explaining it right but just know that it's totally normal for going up to happen first and going down will happen later.

I'm having trouble during the night with my leg ending up in bent positions and then I wake up with it hurting and I have to straighten it. This morning my knee is stiff and sore, more than usual. Not sure if it's from PT yesterday or sleeping in weird positions overnight. I think it's also telling me not to cut back on the Tylenol and Advil yet and I should keep taking what I was taking. Just another up/down on that roller coaster.
 
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hawk2go

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I'm having trouble during the night with my leg ending up in bent positions and then I wake up with it hurting and I have to straighten it.
I have that exact same challenge, especially when I get into a very deep sleep. I tried my pre-op 1:1 THC/CBD tincture a few weeks back when I wasn't taking oxy and the sleep was really good but I woke up with The Knee very sore. I imagine that I typically sleep lightly and protect The Knee all night, but when I got that deep sleep, it was all about the zzzzzs. So I haven't tried the tincture again, went back to the oxy at midnight but occasionally am so tired that I go deep and wake sore (almost like a crook/crick in the neck but in the knee).
 

Susie-Q

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Yeah, I think my body is just going back to old habits and bending into positions I would do prior to surgery. Then my knee wakes me up after it doesn't like whatever position it's in. I'm able to get back to sleep but doing that a few times at night and the knee is more sore/stiff than usual in the morning.
 

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