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TKR Hello everyone

ozrick33

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Hello everyone. I found this forum after searching for information to try and gauge whether my recovery is on track. On had a TKR on June 2nd 2021. My recovery has been slower than I hoped pain wise so I am keen to get feedback from others.
 

Jockette

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Hi and Welcome!

This is a slow recovery, an average of a year, for complete recovery, but they usually don’t tell us that before surgery. If you read the experiences of others here on Bonesmart, you will likely see that your are coming along like most everyone 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.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

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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Tell us a little more about your recovery. What concerns do you have and what accomplishments have you had? We are all different, so it’s not good to compare, but there are also many similarities.

Hang out here with us, Bonesmart has a wealth of advice, information and support.
We will offer helpful suggestions, :idea:

Cheer your accomplishments :happydance:

And send hugs when you are feeling down. :console2:

Best wishes!
 
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ozrick33

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I would really appreciate some feedback from others who are further down the TKR journey. When I was discharged after 3 weeks in hospital I was supposed to be having 2 X 3 hour PT sessions but Covid shut that down when the hospital closed its doors.

I was discharged with 150mg of slow release Palexia twice a day and 50mg of Palexia 4 times a day. I was also prescribed panadeine.

I have managed to get the slow release down to 100mg and have tried switching some of the IR 50mg Palexia with straight panadol but its not holding the pain off.

Is this normal? Am I right in thinking that some pain should be tolerated and I must try and push through?

I am also discovering that my pain levels seem directly tied to the amount of steps I am doing. Am I being too ambitious trying to get in 8000 - 10,000 steps?
 

Roy Gardiner

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some pain should be tolerated and I must try and push through
The BoneSmart view is that one should not push through pain; pain indicates damage, it's a survival system.
Am I being too ambitious trying to get in 8000 - 10,000 steps?
IMO yes. Let your body be the guide, don't do stuff that causes pain and/or swelling, it's not productive.

Time is the healer
 

Sisterpat

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Welcome ozrick! That’s a LOT of steps so early in the game! My suggestion is to back WAY down and actually backtrack to no real walking for a few days, ice the knee, elevate and do gentle stretching. How long have you been doing this kind of walking? You are very early in this year long recovery. Don’t “push through” anything, especially given your pain. Try 3 days of rest and let us know how you’re doing.
 

beesknee

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I would really appreciate some feedback from others who are further down the TKR journey.
There are hundreds of TKR posts here dating back years. I found it helpful to read through many of the older posts from start to finish to get an idea what the TKR journey was like for those that made it through a year or more.

When I was discharged after 3 weeks in hospital I was supposed to be having 2 X 3 hour PT sessions but Covid shut that down when the hospital closed its doors.
3 weeks in the hospital - did you have some complications? I got 3 hours at the surgery center before I was on my way home.

Did your doctor give you PT exercises to do at home since your PT sessions were shut down?
 

patriciad

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@ozrick33 - You have found the right place for knowledge and support. Start by reading through all the articles- you will learn a lot about achieving a good recovery from a knee replacement. It does take time and I remember it being around 10 months on my first one before I was unaware of my new knee and it finally felt natural if that makes sense.
I am wondering if your surgery had complications or if there was a typo with the 3 weeks in hospital? I am 10 weeks out and I would be doing far too much if I aimed for 8,000 to 10,000 steps a day. Your pain is telling you it’s too much. See how you feel after a full day of ice and elevation again.
Feel better.
 
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ozrick33

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I would really appreciate some feedback from others who are further down the TKR journey.
There are hundreds of TKR posts here dating back years. I found it helpful to read through many of the older posts from start to finish to get an idea what the TKR journey was like for those that made it through a year or more.

When I was discharged after 3 weeks in hospital I was supposed to be having 2 X 3 hour PT sessions but Covid shut that down when the hospital closed its doors.
3 weeks in the hospital - did you have some complications? I got 3 hours at the surgery center before I was on my way home.

Did your doctor give you PT exercises to do at home since your PT sessions were shut down?
I am not sure why the 3 weeks. Normally in a private hospital here in Australia its 10 - 14 days. Public hospital is 3 days. Because of previous issues with bleeding I think they kept me in longer just to be sure. They did give me exercises to do at home. Stretching and bending. And I am doing 45 minutes with a physio once a week.

I am starting to think maybe I have overdoing things and letting my Type A personality getting the better of me.

Rick
 
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ozrick33

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@ozrick33 - You have found the right place for knowledge and support. Start by reading through all the articles- you will learn a lot about achieving a good recovery from a knee replacement. It does take time and I remember it being around 10 months on my first one before I was unaware of my new knee and it finally felt natural if that makes sense.
I am wondering if your surgery had complications or if there was a typo with the 3 weeks in hospital? I am 10 weeks out and I would be doing far too much if I aimed for 8,000 to 10,000 steps a day. Your pain is telling you it’s too much. See how you feel after a full day of ice and elevation again.
Feel better.
Thank you. 10 - 14 Days is the average stay in private hospitals in Australia. 3 Days for public. I think there were being extra cautious plus also pain was pretty bad in the hospital.
 

patriciad

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@ozrick33 - wow that’s amazing I guess. Many here in the US have early morning surgery and are discharged home after a PT evaluation later in the day. I had an overnight with both my replacements as react to anasthesia and am diabetic. One overnight was more than enough but I hate hospitals and couldn’t wait to get home.
Hope you are slowly improving.
 

BBCG

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Hi and welcome! You are certainly in a place here for support and camaraderie! I found Bonesmart in 2016 when my first TKR went so badly at first, when I didn’t respond to the opioid drugs they give for pain here in the states. I got such wonderful support here, that once I knew I was having TKR #2, I got back onto the forum to see who else was here and my second turned out SO much better than #1, mostly because I followed the Bonesmart protocols.

Something I did was to find someone who had some similar situations to me then follow their journey, reading their stories. It was quite educational, as things are certainly done differently in different places, and there is a wide range of speeds for recovery, and some of us need to learn to be patient and that turns out to be a primary lesson.
I am very fortunate this time in that I’m 5 months out from #2 a d really have very little residue of pain or discomfort now. I took it VERY easy and did not let PTs push me, as I tend to swell following this surgery. The PTs didn’t like that but it’s my knee! Im now easily able to walk 2+ miles without issue, and I even just got a puppy a month ago, so really brave…or stupid, right! Puppy requires walking, throwing toys, training games, etc! But, my new and old-new knees are doing well without problems. But, I know I am fortunate, and my first TKR was not like this! I was still in lots of pain at this point with #1…

DO read the articles, find kindred spirits to ask questions of, as folks here are very happy to share ideas of what worked first them, I find!

Welcome to the crew!
 

dogwalker2

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Hi there. Have just had my 2nd TKR and have definitely learned a lot from my first one!!! This forum is brilliant. I was doing way too much the first time around, mainly because I needed to be feeling back to normal asap. I pushed on with exercise and allsorts before discovering that I got better faster if i relaxed and slowed down. Not easy for me to do, but it was worth doing as my knee healed well. Trying not to fall into the "push on to get better quicker" trap this time around and I am happy with progress. I guess what I am saying is to echo the others - take it slower to get better quicker!!
 
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ozrick33

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Its been about four and a half months since my surgery so I thought I would update you all. It seems some of the biggest challenges on my healing journey has been to do with medication. In the hospital they gave me endone (OxyContin) but it had absolutely no effect. Might as well have been a placebo. So they tried Panadeine forte (Paracetamol and codeine), this worked pretty well. Palexia (Tramadol) was also given and that seemed to work very well.

6 weeks post op my surgeon wasn't happy with my swelling so prescribed some form of anti-inflammatory. Unfortunately this reacted very badly with my existing medication for depression and diabetes and ended up with acute kidney acidosis. My GP took my off many existing meds and slowly I got well.

I recently consulted my GP as I have lost 10 - 12 kilos of weight (22 - 26 pounds) of weight without any changes in diet. After many diagnostic tests my GP doesn't know why this is happening. I have still been taking slow release 100 mg palexia morning and evening and immediate release palexia 50mg four times a day. I expressed concern to my GP that I was still having to take so much pain meds. About 6 weeks ago I stopped taking some palexia and became incredibly unwell. My GP said I should not cease it suddenly. When all my tests came back clear in trying to locate the cause of the weight loss I did ask if Palexia could cause this. Turns out it is a very uncommon side effect but has been noted.

So, I have reduced my daily intake of Palexia to 25mg from 50mg and I am managing the pain ok but I also feel much better in myself. So, bottom line, its a mystery. Was Palexia making me ill? I don't know. On a positive note I have more movement in my knee, its starting to feel somewhat "normal".

Here's hoping for better days.
 

Jockette

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Wow, I’m sorry you got so sick from medications that were supposed to help you feel better, but I’m glad things are improving at this point.

Interesting about your weight loss, I’m sure that was a bit scary, since you weren’t trying to lose weight.

Great news that the actual knee is coming along well!
 

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