TKR Hello and thanks

[Josie1054]

I discovered these boards a few weeks ago and feel like I’m headed in the right direction.
i appreciate all the words of wisdom and first-hand experience shared by everyone. I had a L TKR on 22 Jan. Surgery went well, have a great surgeon and his team is wonderful as well. As mentioned by others, the first 2-3 weeks saw many ups and downs, lots of tears but am so well supported by a patient and understanding hubby. I also have a sister (younger) who has gone through a L TKR as well and we talk frequently. Am lucky. Have been going to PT for three weeks now and have three to go. It seems to be going okay though my biggest hurdle at the moment is trying to “lose” the rocking gait I developed after years of knee pain. It’s been a struggle. I also try to deal with the pain, esp after PT and very active days, with elevation and icing, as well as Naprosyn and the occasional hydrocodone (mostly as night). My surgeon had me on 30 days of Celebrex which was up yesterday. Sorry to go on and on...I appreciate all of you and your shared experiences.
All the best.

 

[lovetocookandsew]

Welcome to BoneSmart!

If you're in a lot of pain during PT, or after, it's a sign you might be doing too much each session. Pain and swelling are your knee's way of telling you it's not ready for that activity and needs to be put on the back burner for a time, to try again at a later date. The same goes for your daily activities. We don't want you to sit around and do nothing all day; on the contrary, we want you up and moving around regularly in between sessions of icing and elevating. But if your knee protests an activity, save it for a later date.

It's great you have a husband who is patient and understanding; that's something that's so helpful and a great blessing. Please keep us up-to-date on your progress and again, welcome!

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:

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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

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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

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the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

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Activity progression for TKRs​

6. Access these pages on the website

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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.

 

[Roy Gardiner]

I also try to deal with the pain, esp after PT and very active days

Don't let them hurt you in PT, it's counterproductive. It's not helping mobility, but is compounding the surgical damage.

 

[Jockette]

I agree with the others, painful PT does not help you. Though most PTs will tell you it’s necessary, it honestly isn’t. Most of all, don’t allow your PT to bend your knee for you, especially if they push it to a painful place.

 

[Josie1054]

I so appreciate the above responses. Here I am again at 6 PM icing as usual and too much discomfort to do very much for the rest of the evening. I know I need to find patience but it’s running thin. I look around and there’s so much I want to do but being up and around at the end of the day gets very uncomfortable. Thanks once again for listening.

 

[aperture]

I’m with you Josie...I am on the couch downstairs, finally in a relatively pain free position, but I know when I get up in a minute and head upstairs to bed it’s going to be like climbing Mt. Everest and seems so daunting. I am just four weeks out. I just don’t seem to be able to tell why I am having a decent day or bad day. Hope you get some sleep!

 

[Josie1054]

Aperture, I’m just a few days ahead of you, my surgery was on Jan. 22. I understand what’s going on (mostly) but am so tired of the discomfort and inability to do what I want. I actually sleep mostly ok, probably since I can get by on less sleep since I’m not working. I’ve been trying to figure out how to have a lighter morning and early afternoon so that I’m not wiped out in the evening. Sorry for the complaining, hope you have a good sleep!

 

[Andypandy]

@Josie my surgery was 21 Jan and I can relate to everything you are experiencing. I get so annoyed, upset and so confused as to why this knee is repeatedly swollen, stiff and hot even though I am doing the rehab exercises and ice is my constant companion. My PT gave me a couple of strengthening exercises to do as he was pleased with my progress but after doing a couple , back to where I started. Stiff, swollen, hot. ARGH!!!!!!!!!! So not being doing those, just rehab ones. And yes, the frustration, just to walk around is a marathon. No dancing then. I have been told this requires patience but mine is incredibly thin now. I know it's not nice to say but when you hear of others experiencing similar, it does help a little. Thank goodness we have this wonderful site. I wish you well, stay strong and let's smile. X

 

[Lindylee]

As you'll see I've had 2 TKR's a year apart in January 2019 & 2020. My first was painful even if I did no exercise, slow to recover from and the fatigue was awful so I understand where you're coming from. Having had no previous experience I assumed it was all perfectly natural. A year on I still have more pain doing certain things from that one over the latest one. I'm told it's the IT band and should settle in the next 6 months.

This one is a totally different experience. I've far less pain, able to do more and have far more energy. My conclusion, which may be wrong, is that being in pain in itself causes fatigue.

Hang on in there. It will get better, but each knee has it's own agenda and, although it's frustrating when it doesn't move along as fast as we'd like it to, there doesn't seem much we can do about.

 

[Helizabug]

And, I’d like to add, that it feels like forever when you’re going through it. Time just drags its feet when you’re suffering. I found it helpful to create some ‘rituals’ to help the time pass. I did my gentle Tai Chi warm ups and sit ups. It took an hour because slow is the aim, and I felt more whole afterwards. I also tried to spend time each day working on a blanket for Project Linus, which gives blankets to children in the hospital. I think my mother-in-law, while recovering from hip replacement, knit prayer shawls for her church’s ministry to people needing healing. And, I watched loads of television on my iPad, the Great British Baking Show was perfect when I couldn’t focus; Father Brown Mysteries were just complex enough to keep me interested; Lucifer was just silly, though, some might find it offensive because it’s very racy; and, now, when I’m trying to carve out time for ice and elevation because I’m out and about so much, I like Inspector Lewis because they’re complex and longish, so I want to stay put and stick with them. Maybe good entertainment and some gentle, whole-body practices will help?

 

[henrietta]

Helizabug, you do like British tv don’t you? Have you seen Endeavour, which is a prequel to Inspector Morse. Different person of course, but still good. I spend a lot of time on my iPad, and just resumed meditation.
hope all is going well with you.

 

[Josie1054]

Helizabug, I do meditate and it helps me to stay calm. I think I would enjoy TaiChi. Will look online. Thanks,

 

[Josie1054]

Hello again, figured I’d document a little progress report. Today is 6 weeks since the surgery, and most of the time I feel pretty good and I’m satisfied with the progress. I have an appointment with my Ortho surgeon tomorrow, hopefully he’ll be just as happy. PT is going well although two days ago I started with the air squats and working with some light weights. I did work on quad strengthening exercises preop and I think they helped somewhat. I’ve been a little sore I’m guessing from the weights. Maybe it’s too soon for that. I’m walking quite a bit, trying not to overdo, doing my recumbent bike twice a day for 10 minutes, and icing in between activities. I still occasionally wake up, maybe once a week around 4 AM, just too uncomfortable to remain in bed. Fortunately the Naprosyn/acetaminophen combo seems to work at this point. Probably my biggest challenge this moment is working on my gait and getting rid of the side to side wobble I developed because of the bad knee. Thanks for all your advice and hang in there to the rest of you. ❤

 

[Josie1054]

I have a question for those of you who are out 6 or more weeks postop. Some days I feel like I’m barely making it with the Naprosyn/acetaminophen combo every few hours. I did occasionally take a hydrocodone, I’m wondering if everybody else is just getting by on the above or do you occasionally need a little something extra? Like at bedtime? Thanks.

 

[Lindylee]

All knees are different and I've needed less pain relief this time over last year. I can only take paracetemol or the lowest dose of cocodamol as I have a bad reaction to most others so I've been on paracetemol during the day - 2 x 500mg 3 times and 2 cocodamol at bedtime.

This week I've reduced to 2 x 500mg paracetemol 8 hourly, but my pain is controlled and hasn't been anywhere near as bad as last time. It might not be the same for you and you might need stronger painkillers for longer. We're all different so I wouldn't compare yourself to anyone else.

As far as the wobbly walk goes, I had that last year after my first and to a lesser extent this year if I walk without a stick. I was advised to use some hip strengthening exercises and standing on one leg whilst keeping my hips level. This operation doesn't just affect our knees it seems!

 

[Andypandy]

I am still taking oromorph 2 x as I definitely need the edge taken off. 1 in morning 1 bedtime. I also have bad reaction to many meds. In between it's ice. My uneven walking is affecting my back so just something else to test you. X

 

[Sara61]

PT is going well although two days ago I started with the air squats and working with some light weights. I did work on quad strengthening exercises preop and I think they helped somewhat. I’ve been a little sore I’m guessing from the weights

I'm quite shocked that you are doing squats and weights at 6 weeks - no wonder you are a little sore- remember this is healing from a major operation and not a sports injury.
I'm almost 5 months and to this date I have never done any squats nor weights and I'm walking fine, have no difficult in standing from a sitting position.
Be careful that you don't do more harm than good xx

 

[Josie1054]

@Sara61 the “squats” are not done in a standing position, you’re semi-reclining and pushing on a large plate with both feet (they call them air squats. Weight was only 10 lbs.
Just meant for gently strengthening quads postop. Went for my 6 wk checkup yesterday and Doc was pleased with progress. He encouraged me to continue with a home program when PT is done as some stop and progress is diminished. I have 7 more visits, will have to be motivated at home. Hope all going well with you!

 

[Andypandy]

@Josie1054 I was given squats but really put me back. Saw my PT today and agrees to concentrate on just rehab exercises and my gait. I am 6 weeks post op. Happy with all my measurements, but still need to keep working as long as I am happy to do them. If I get an off day I just take a break. Sounds like you are doing well, it's not easy though is it. X

 

[Josie1054]

Today marks 8 weeks since surgery. What a rough ride but very happy with the progress. I may be impatient but still don’t have the tolerance/stamina I thought I would. Knee gets sore (burning sensation) after spending a few hours shopping/walking. Guess this is to be expected? Others experience this as well? Have been discharged from PT after 10 visits, mostly due to pandemic and encouraging me to stick close to home. Am continuing to take Tramadol 1-2x/day alternating with Acetaminophen. Hope everyone is doing well and staying healthy!