PKR Hedgehog On The Mend

[hedgehog]

Hello, PKR (medial) was performed this morning and I’m at the beginning of the uphill climb that is recovery.

So far, so good. I’ve been up two toilet twice and took a walk about 30 feet down the hall and back with PT. A lot of buckling and she thinks it’s from the nerve block. We will do more tomorrow.

All in all no complaints. I do feel like there is a tidal wave of pain heading towards me and it won’t hit until the blocks and surgical meds wear off. So glad I have this forum to turn to.

Healing well wishes sent to all those in recovery. Onward!

 

[Jockette]

Welcome to the Recovery side! I’m glad you’re doing as well as you are. That’s great you took a walk, even if it buckled a little bit.

How long will you be in the hospital? I was only in one night for my partial.

Best wishes to you!!!!

 

[Celle]

Hello @hedgehog - and welcome to recovery.

Make sure that the nursing staff are prepared to give you pain medications when the nerve blocks start to wear off. Let them now as soon as your pain increases.

Here is some post-op reading for you:
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. Here is a week-by-week guide for Activity progression for TKRs


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

Please don't be overwhelmed by the list. The articles are not long and they and contain information that will answer many questions and help you make your recovery much easier on your knee and on you.

We are here to help in any way we can: answering questions and concerns; supporting and encouraging you from start to finish.

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.

 

[hedgehog]

How long will you be in the hospital? I was only in one night for my partial.

Best wishes to you!!!!

Hi. They are unsure if I’ll be here a second night. I have two PT and an OT sessions tomorrow, the last being at 3pm

I expect that sometime in the next 8 hours the nerve block will wear off. Then as reality sets in, we will see how it goes.

I’ll be home alone during the day, so if I’m remotely on the fence, I’ll stay versus being alone and possibly unsteady. One day at a time, that’s for sure!

 

[Marguette]

Hi. They are unsure if I’ll be here a second night. I have two PT and an OT sessions tomorrow, the last being at 3pm

if you are going to be home alone, better to stay longer and get pain management well established. Best wishes in your recovery.

 

[hedgehog]

Hello, quick update.

Things are going ok...both a good but challenging too. I’m keeping ahead of the pain wave, but also think it is made easier with the nerve block they gave me in recovery yesterday.

The bad: this morning was up to go to the bathroom, standing with a walker and I shifted my weight to the surgical side and my leg buckled. Down I went, but thankfully forward on to the walker frame. That frame allowed the nurse to grab me and keep me from collapsing to the floor. My elbow and ribs both took a blow and I experienced a bend in my leg that was not more than my measured ROM, but certainly bent it quickly. Incision is ok. They think the nerve block is still there.

A few hours after my mini-faux fall, I walked the halls with PT. The buckling wasn’t there when I began but by the end, I think fatigue stepped in and it reappeared. Unless there is a lot of progress, I’ll be staying another night. The instability worries me as I’ll be alone during the day. The PA thinks the nerve block is still active and that is preventing me from having full control of my quad, leading to the inability to keep control over the knee.

I feel good, despite the mini-drama and just taking it hour by hour.

 

[SusieShoes]

You certainly have had an interesting day so far! It makes sense that if the nerve block is still having an effect you might experience some problems controlling the muscles you need to keep your knee working properly. Some people do shed anesthetics less quickly than others. And sometimes it just happens that way for mysterious reasons. I hope you are walking without concern soon!

 

[manda124]

Hi @hedgehog! My nerve block lasted from Thursday surgery until Friday night, and that's when I started feeling the pain. It's normal for a nerve block to last that long, which is a great thing! Also, your muscles have been through a lot so that could be the buckling too... Mine still buckles 8+ weeks later! It'll get better! Best Wishes!

 

[Celle]

Yes, sty another day and don't go home until your pain is well controlled and you have more control over your leg.

 

[kneeper]

Don't worry if you have to stay another night. Better to make sure your leg is more stable as the nerve block wears off.

 

[hedgehog]

Made it home and had a rough first night and day upon arrival. I was terribly nauseous with the pain meds. My surgeon called in an Rx for anti-nausea meds and I’m much better.

Had my first PT visit yesterday (second one today). I really like him. He tossed out the list of independent exercises and prefers I take a different approach. His preference is for me to stand and using my body weight, gently move my body to simulate real life movements that will strengthen different muscle groups.

He said that PT should challenge but should never hurt. He also said that he would encourage me to gently use my joint, e had no intention of pushing me (as in physically putting his hands on me) to get more ROM. I’m encouraged.

Today was the teensiest bit better than any day so far. I took encouragement in that.

K

Hedgehog

 

[NavyGunns]

@hedgehog, glad things are starting to look more on the up side for you. I’m quite surprised by your experience with your nerve block. I was sent home with my block still in place and a portable pump in a shoulder sling. The pain meds for the block lasted until Thursday morning, my PKR procedure was Monday morning. I didn’t experience the challenges with the leg buckling like you did. Hope that’s all behind you now.

Sounds like you’ve got a great PT . He’s leading you down the right path, so stick with him and listen to him. I’ve been finding the key is to challenge your muscles to start working again and gently get them and your ligaments to stretch but not over do it. If you find it hurts, stop!

Keep up the good work.

NG

 

[sistersinhim]

You are blessed to have such a good PT!

 

[SusieShoes]

Looks like you’ve won the PT therapist lottery! I love his philosophy about PT for new knees never hurting, but using body weight and normal everyday motions to rehab the knee. Walking is one of those. PT can really help gait and balance as you get back up and about.

Now that your nausea is tamed and you feel better, you can embark on a more pleasant recovery.

 

[Smythe89]

Wondering how things are going for you. I hope you’re doing well!

 

[hedgehog]

Hello @Smythe89

It’s been a journey of ups and downs so far. I am two weeks post surgery, today.

I have made solid and steady progress since the initial rough few days of recovery. My PT (whom I love) has an approach that I love and I find he pushes me within boundaries that I am in control of. As of this morning, I’m at 105 flex and he hasn’t even bothered to measure extension in at least a week as I’m already able to fully extend. I”m off of crutches about 90% of the time, have been able to ascend stairs with reciprocating steps and then today, I have started to be able to descend stairs with reciprocating steps. By all measures, I’m in a good place physically.

The mental recovery has been the biggest challenge. I read so much in this forum related to post-surg blues and they hit me hard last week.

My pain management was a combination of Norco and Tramadol. I tried to back away from the Norco on Sunday last weekend. Was doing great, but PT and the the normal ADL on MOnday brought a tidal wave of pain on. I spent until late Tuesday getting leveled back out. I took a different approach on the Tramadol and was able to stop the Norco last Thursday. I tried to drop the Tramodol yesterday, but had a very bad night and moved back on to it. My post-surgical follow up with the OS is on Friday and I really want to be released to drive.

I’ve worked a little here and there each day since surgery, for the most part...mostly just trying to lurk in email and stay somewhat caught up. Last Thursday I planned as my first “official” back-to-work day (all at home) and my goal was 4 hours. I ended up working just under 10. It was way too much, way too soon. I got a very stern talking to from my daughter about my health and boundaries. Add to it the inability to see my guy, the love of my life, as much due to his work schedule and I slumped into the blues. Had an epic pity party, which lasted about 24 hours. I’m just so sick of depending on everyone else, for everything.

I’ve done a lot of thinking in the last two days. Two years ago, I was in better shape than I’ve been in since my 20’s. It all slid away when I started prioritizing work (new job at the time) ahead of my health and then when my knee really started to go downhill about 18 months ago. Exhausting myself with work at the end of last week was a reality slap. I can’t keep doing this. So, I’m a planner and I’m taking control of my health. I can honestly say that today, walking around the house, my knee *almost* feels better than it did pre-surgery. I have a breath of fresh perspective where I feel Ike I have a new lease to improve my overall health and well-being.

Sorry this is a manifesto, it’s hard to encapsulate all in a short note. The bottom line is that I’m physically progressing and mentally am trying to hold steady. I feel truly blessed at the results of my recovery. I’ve read enough on BoneSmart to know that it could have easily been 1000% different.

Wishing everyone well and Happy Memorial Day to all.

Hedgehog

 

[sistersinhim]

So, I’m a planner and I’m taking control of my health. I can honestly say that today, walking around the house, my knee *almost* feels better than it did pre-surgery. I have a breath of fresh perspective where I feel Ike I have a new lease to improve my overall health and well-being.

What a wonderful positive outlook you have there! Having a new, less painful knee will give you a great way to get into better shape! Just be patient and it will happen!

 

[Smythe89]

Sounds great! I too struggled with the post op blues a bit. The darn weather (raining constantly), not being able to get up and go when I want to, and having to rely on others is difficult!
Keep up the good work. I gained 30 lbs when my knee went. I am a yoga instructor. I used to walk 5miles a day too. I went from that to essentially sedentary. I’m with you. Back in the saddle ASAP. Health can be so fleeting and we take it for granted until we get this type of wake up call
Onward!!

 

[SusieShoes]

You’ll get back to the exercise and healthy habits you like best once your knee is feeling better. It’s amazing how much slides away when you organize your life around a painful knee. Once you don’t have that anymore, you return to those things. In my case it was walking. I’d all but stopped. About three months after my surgery, though, I was walking normally again and I started taking long (and increasingly longer) walks every morning. My weight dropped, my legs grew stronger and more stable, my bad back got better, and life just brightened up in every way.

The blues happen because our bodies and brains get hit hard and fast with a bad combo of physical stress (injury and pain in spades) and emotional upheaval. Our accustomed roles get turned inside out. It’s terribly difficult to cope with so much.

Soon you will emerge on the other side of the dog days of recovery and will find it much easier!

 

[hedgehog]

Thanks for the encouragement. Susie, I stopped walking my dog two summers ago due to knee discomfort...that discomfort grew to pain and that led to a fully sedentary lifestyle. I would joke that I gave up my FitBit and my new daily step goal was to walk literally as little as possible.

I’m thankful I had this done - in one of my early posts here, I reported how pre-surgery, there was a noticeable shortcoming of strength and flexibility. I know that would have gotten worse.

I’m hopeful that by the end of summer I can head out with my active pup for some walks!!