TKR Hello from the UK!

[Mutley]

Hi everybody! I found this FANTASTIC website yesterday, while I was in what seemed like a black hole of despair a few details to put you in the picture. My name is Jaki, I'm 48 (just!) and I had a RTKR on 1st December 2012. I am currently 9½ weeks post op and I also under went a MUA last week. I know there is a bit of a debate about having this procedure, when is the right time and even if you should have it, but lets just say I'm rather 'determined' and having seen & spoken to my surgeon and my physio,we BOTH agreed this would be best for me & my knee!

No matter what I did this knee would not budge past 80 degrees. It wasn't even pain stopping it, more like a brick wall. Anyway, my surgeon got it to 120 degrees and about 5 on the flexion ( this being a problem too) He also managed to sort out some mega thigh pain I've been suffering with since having the TKR performed, probably trapped nerves. I was prepared for some discomfort and swelling afterwards, but NOT the amount of pain. I would say worse than the original op!

This brings me to my next problem...pain relief...or the lack of it as I'm allergic to nearly ALL Analgesics :-( It hasn't been fun trying to use ibuprofen & paracetamol, codeine sulphate & oxynorm, which in my opinion don't actually have much effect, to recover from a TKR and then a manipulation.

The last problem? SLEEP...or should I say LACK OF IT! I'm a light sleeper anyway but these last 9+ weeks have been awful and I can honestly say that some nights I have been awake ALL night. You just can't get comfortable, pillow here, turn over, swap the pillow round. Then you would try and straighten the leg, then unbend it...it has driven me NUTS!

Yesterday was a BAD day :-( I can't even explain why really but I spent most of it in tears. Every time I did something, the knee would swell. Back on the sofa, ice, elevate. Go to clean the bathroom, knee swelled or felt stiff, back on the sofa, ice. I think what got to me is that I "thought" that by 9 odd weeks I would start to feel like I was capable of doing a bit more WITHOUT the knee swelling. I know everyone and their knees are different, but you can't help read about those people who are driving by 6 weeks, back at work, walking a good distance and think, why ISN'T that me? I feel like I've been recovering for 9 months, not weeks and keep thinking I should be on a guideline of what I should/could be doing at various stages. Having read a lot of posts on here yesterday, for the 1st time it's made me think if I have NO expectations then I WON'T be disappointed...as hard as that may be :-(

Being an active person (I own 2 hunting dogs and we were out for a good 2 hours walking a day, sometimes through GRITTED teeth due to the pain!) I find it very hard when the mind & the rest of the body is saying "lets go!) and this blooming knee won't let me. I think yesterday EVERYTHING got to me including a good regime of pain management and a complete lack of sleep and the realisation that I have NO IDEA when I will see the light at what seems like a VERY long tunnel.....

 

[RICBAK1]

Hi i was just like you it, is called doing to much,my physio kept telling me 1 why was i not using 2 crutchs, 2 why was i using stick 3 why is my knee still swollen.He is a great believer in rest and take it easy .When i finally took his advice i started improving,like you i have 2 bikes not dogs and i also have loads of steps and live on a hill.My problems was my bike and me trying to ride it and to many walks to soon.I m afraid it is time you need ,at 9 months now and still improving,but i swim 120 lengths of pool every week and ride bike indoors or out if weather good also walk miles but still want more,good luck and TRY to take it easy hard but works.

 

[hapiheylo]

I can totally relate, I have had a difficult time emotionally as well as the physical, many set backs. Talking to people helps. I found for myself keeping busy (even if it's on the computer) really helped me. Talk to your Doc. he should help more with your pain and depression

 

[Mutley]

Thank you RICBAK1 and hapiheylo for your replies! It's really difficult to decide what is 'Too much' as I sometimes feel I'm not doing enough! My challenge has been to see if/when I could pedal a rotation on a stationary bike. I've been given a real old crock of one and I've managed to get the seat up as high as it can possibly go before it falls out! I've just managed to do a couple of minutes this morning but this evening? No way, even after rest & icing. I see it as another set back as it's not like I've done too much today apart from a 'little' walk around town today! Maybe I've answered my question! I 'forget' all those little things you do in a day. I suppose they all add up and that's what my knee is telling me. I've got a session on the CPM machine at physio tomorrow and already I'm thinking, ' what happens if I can't manage the 106 degrees I got to on Monday?" I continually feel guilty that I'm not up and about,out shopping or walking the dogs, even though NO-ONE has said anything to make me feel this way. My husband, bless him hasn't once moaned about having to fit the time in to walk the dogs twice a day and even said to me he has pretty much accepted that I would/will be out of action for 6 months. Maybe it's a 'Woman' thing thinking I should be better now and taking back control? Thank goodness I don't have to worry about being back on my feet by a certain time as I have to be back at work. I think that would totally see me in a BIG black hole
Linda, I notice you've not long had your new knee. How are you doing & how are you feeling? Richard, I'm glad your recovery has gone well and your very HAPPY!

 

[speccybecky]

Mutley you cleaned the bathroom!? Why? Let someone else do it!
Try not to stress about sleep just read or watch tv, the more you try to sleep the harder it is and everything always seems worse in the dark of night. Just accept you're not going to sleep and do something else, just nap whenever and wherever you can. When I finally accepted I wasn't going to be able to rush this recovery and just relaxed I felt better. I did eventually get prescribed an anti depressant.
Is there really no painkiller you can take to help? Lots of ice, elevation and gentle exercise. Most of all I wish you patience

 

[60mom]

Our recovery is very similar except I can take pain meds but my doc is stingy. I had RTKR 12/11/12 and MUA 1/18/13. I have more pain now then after the TKR. Extremely frustrating! In fact I had PT today and she is new and is so gentle. But for what ever reason I am having an increased amount of pain today. Not sure why. Must have over done it in some way but I have done a whole lot more and not had it be this painful. I have found there is no making my knee happy, lol. So I think that is part of the frustration. But over all if it is hurting then I have done too much. As much as we want to get our life back to normal our knee is very much in control over how fast it is going to let us do that. I find I have to back off and rest it, otherwise it will spiral out of control. I am finally resigning to this taking 6 months to get some semblance of normalcy but probably a year to be the way I want it. Ice and elevating are my best friends right now and probably will be for some time.

 

[Mutley]

Hi 60mom. Sorry to hear your in more pain after the MUA. I would say I was in extreme discomfort rather than pain and this comes and goes. Since having the TKR I had terrible problems in my thigh which was probably down to trapped nerves. My surgeon said he would give the whole leg a good check over while doing the MUA. This was great as the pain from my thigh went away but I was then left with a very sore quad muscle which was probably down to being rather roughly 'man-handled' during the manipulation. This has taken a week to subside enough to be able to do my exercises. I managed to get up to 106 degrees on the CPM machine today although if measured with a proper ruler, this is actually about 100 degrees. So long as I can maintain my ROM I'll be happy but mentally it's good to see a little increase don't know about you but I really wish I was 6 months further down this tunnel! Wishing you all the best for the rest of your recovery

 

[Josephine]

Mutley, you and I have got to have a serious, sit-down talk!

I know everyone and their knees are different, but you can't help read about those people who are driving by 6 weeks, back at work, walking a good distance and think, why ISN'T that me?

Then a) don't pay any attention to them and b) don't pay any attention to them! This recovery is a long, long business, a marathon, not a sprint. so pace yourself and concentrate more on rest than activity. You've just undergone a major, MAJOR operation and you don't recover from that in a few weeks.

Yesterday was a BAD day :-( I can't even explain why really but I spent most of it in tears. Every time I did something, the knee would swell. Back on the sofa, ice, elevate. Go to clean the bathroom, knee swelled or felt stiff, back on the sofa, ice. I think what got to me is that I "thought" that by 9 odd weeks I would start to feel like I was capable of doing a bit more WITHOUT the knee swelling.

Read this Swollen and stiff knee: what causes it?

The last problem? SLEEP...or should I say LACK OF IT!

Read this Sleep deprivation is pretty much inevitable - but what causes it?.

It's really difficult to decide what is 'Too much' as I sometimes feel I'm not doing enough!

Read this to learn what is about right Progression of activity for TKRs. You could also try this instead of anything more aggressive which is largely counter-productive and was probably more than a bit responsible for your adhesions in the first place. Angry, hot tissues tend to stick together much more easily than 'normal' ones!

My challenge has been to see if/when I could pedal a rotation on a stationary bike.

Only when you can do it without causing any pain! First rock back and forth and then try pedalling backwards. You might find yourself able to do full rotations backwards quite a time before you can do them forwards. Remember too, there is no timetable for any of this. It happens when it happens.

I continually feel guilty that I'm not up and about,out shopping or walking the dogs, even though NO-ONE has said anything to make me feel this way

That's fairly normal in you "A" type personalities!

Since having the TKR I had terrible problems in my thigh which was probably down to trapped nerves.

the pain from my thigh went away but I was then left with a very sore quad muscle which was probably down to being rather roughly 'man-handled' during the manipulation.

Not trapped nerves, the consequences of having stuck down structures. Let me show you ....

This is an xray of my own knee. What's unusual is how it shows the muscles with such clarity so I used it to show how and where adhesions occur - where the red dots are. so you can see that having those ripped apart would give you pain in your thigh.

So I am going to give you some more information to read which is all about knee recovery

First are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!

And here are some very crucial articles

The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Healing: how long does it take?
Chart representation of TKR recovery
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling

Home physio (PT) and activity progress: suggestions
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it

And wise words from members who have shared their experiences ...

Where are you in recovery?? (TKR)
Five “P’s” of knee recovery
TKR: work “smarter” and not “harder”
Recovering a knee - from one who knows!
It's never too late to get more ROM!
It's worth the wait for ROM

 

[Mutley]

Josephine, thank you so much for taking the time to read through both my posts and earmark various comments with good, no nonsense explanations! I had read through a lot of them previously but have clicked on every link today and taken on board the findings! The good news is I have been resting & icing my leg while doing so! 10 weeks post op tomorrow so I'm TRYING to adopt a more positive and PATIENT attitude towards my recovery! Reading people's recovery stories has been good for me too. I really hope in months to come I'll be able to add a happy ending to that link too!

 

[Josephine]

 

[Buddhabear]

I am grateful to say I have followed everyone's advice here but also started to really listen to my knees and understand that this is my journey, and it is a big one. I have slowed to a dead halt in the past week - and I am sleeping again. The blues and emotions are so much worse and out of control when we compound it with no sleep. I didn't find this site until well into my recovery too, but I tell ya, it has chnaged my whoe outlook on the pace of my recovery. I hope too that you can look back on this next year and smile, but don't be surprised by potential setbacks. I too could not tell I over did until I over I'd. I keep saying that I keep a diary and now I can look back on what I have done that ended up being too much. Rest and ice. We are having a blizzard today in Massachusetts and I am doing little more than staring out the window. It's a good thing!

 

[Mutley]

I'm not sure if I should ask any questions here or start a new thread? Anyway this is probably aimed at the veterans of TKR! When do you actually feel like your leg & new knee feel 'normal'? 10 weeks post op today and even though I said I'm trying to be more positive in regards to my recovery, I'm feeling a bit down again today. I always ice my leg before getting out of bed in the morning ( my lovely husband always brings me up a cup of tea and a bag of frozen sweetcorn!) I also do some static quad contractions & knee bends etc but then I get out of bed and immediately feel like my leg is really heavy & stiff. I'm still walking with a limp and still getting the most awful pains in my thigh muscles. I know it's VERY early days still but it would be lovely to just have even a few 'moments' of feeling normal

 

[Roy Gardiner]

What Josephine said above is spot on, of course.


Nothing new from me, just a different way of saying it, if it helps.

Your knee was damaged during the operation. You cannot fix this by exercise, any more than you could help a broken leg by walking on it, or a scab to heal by picking at it.

Every time you do something and your knee swells or gets sore, you are setting your recovery backwards.

This stuff really is key:

- If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it. No huffing and puffing on that bike!
- If you won't die if it's not done, don't do it. Don't clean no bathrooms!!!!
- Don't stand if you can sit; don't sit if you can lie down, don't stay awake when you can go to sleep

Rest, relax, watch telly.

There is no need yet to do any training exercises, just ROM ones. For instance: when you do the rotations on your bike, one rotation is enough! And only that if it doesn't hurt. Then get off, wait an hour, get back on and do one rotation. You don't need to do any more than that for ROM, and it's too early to train. When you can get on the bike and do that rotation easily, with some discomfort but no pain, lower the saddle a bit. A tiny bit 1/4" at most.

 

[SAS]

I am 13 weeks post-op with my RTKR and my knee still does not feel normal I still have a numbness down the right side, which my surgeon said may go and may not. I can now do all my own housework, but need to rest when my legs feel they have had enough, I then elevate them for an hour. My ROM is still useless I got it up to 95 but now seems to have gone backwards more like 85, I have feeling when I see my surgeon on the 25th February he might suggest an MUA. I ride my exercise bike for 15 minutes in the morning and hoping next week to do the same in the afternoon. The first few pedals are painful but once over that I am fine pedalling. I can walk for about a mile and today was my best day for walking, I carried my stick but did not use it , my stride has got better and I am getting quicker. So all I can say Mutley is keep up the good work, it is not easy in fact flipping hard at times. I am also a very determined person and might not have rested quite as much as I should but we are all different and I find I am better off working and then sitting for the day.

Keep going.

Sheila

 

[Mutley]

Thanks Roy & Sheila for your replies. Sheila, I was going to say my recovery stage seems to be pretty much the same as yours but having just had a little walk outside, I realise I'm not. I've just popped down to see my sister who lives at the bottom of my road. Normally takes about 4 minutes...not today though! It's the 1st time I've gone out without using a crutch or a stick. ( my physio wants me to still use something to help with stability due to my limp) Anyway, it takes quite a bit of concentrating to seem like your walking normally. Coming back after a nice cup of tea and my leg just felt heavier & heavier. So, this makes me think I HAVEN'T been doing enough daily outside walking and if I had maybe the leg would be feeling stronger? I couldn't imagine walking a mile...unless someone told me there was a pub at the end with a drink waiting on the bar for me ! Roy, I've just clicked on your link for the basic exercises you've posted. I've got to go and have a route about in the garage now to find a board on wheels my husband has for moving various items! Thanks for the skateboard tip!

 

[SAS]

I found at first when I started walking out each day, I would start off quite well, but got slower and slower but I persevered and eventually (it took a long time) it has got better, I came home today and did twenty minutes ironing at one time I would have come in sat down and elevated me legs. Use your sticks if you feel you need them, I still carry one with me just in case, I find hills difficult.

Sheila

 

[Florida 1]

Mutley, just because someone is driving at 6 weeks, back to work and walking long distances doesn't mean they don't still have swelling and such. I'm at 8 weeks after my last TKR, been driving for a while, back to work a few weeks and walk through the mega-store now with only the shopping cart for support. I've just this week began wearing my jeans because I missed them. But I can tell you that yesterday my knee swelled so much I thought I was going to bust through my pants like the Incredible Hulk! My first TKR is about 19 weeks and still swells, though not as much and as uncomfortably as the latest but it does still swell.
Your problems with your TKR and then having a subsequent MUA put you almost back at the beginning. So you're more 2 weeks out, recovery-wise, than 10. Let the leg heal first, and do your gentle stretching exercises to help with your extension and flexion. When you are about 6-8 more weeks out, you can probably start working on strength.
Don't be discouraged! The end result will be worth it. Now where is roy Gardiner with his "Patient, Grasshopper" post? You're doing great!

 

[bottomshollow]

"Patience, Grasshopper" is referee54"s (Tim) post. But Roy Gardiner would agree with Tim's take.

TIME & PATIENCE are two elements you cannot escape with this recovery. It's going to take what ever amount of TIME the knee wants and needs to recover. And we have to find the PATIENCE to use the time wisely in terms of PT and our regular activities so the knee can heal properly.

And the most important thing is that YOU CAN DO IT!!!! Take deep breaths and relax and go with the flow of recovery. How long did it take you to get to the point of a replacement? I suspect a lot longer than it's going to take to recover.

Take care and keep us posted. We care.

 

[robynhood]

Hi Mutley. I have been off the site for a while because of no laptop. Just catching up now. Read through all your threads and you are doing great. The first one I read of yours was giving advice to someone not coping with her progress so that means you are understanding yours more. We just cant hurry this process no matter how much we want to. Im 18 weeks out and sometimes feel like 8 weeks some days. The cold weather hasnt been helpingMy physio was awful. I dont know how you are finding yours but its denitley different here in the UK. 3 times I saw my physio. No exercises just measured my rom and said keep on doing what you are doing. My right knee is still very swollen. Im suposed to be having my right knee done sometime this year but I really dont want to. Im exercising this knee as well as my operated on and hopefully it will last a little longer. Glad you found this site. Its a godsend. Take care.

 

[Mutley]

Hi robynhood & thanks so much for replying I think my biggest problem is myself! I like lists and order and time keeping none of which is suitable for a TKR. My physio I have to say has been great! We started off with just gentle exercises, just covering the basics really, but it became very apparent that this knee was going no-where, hence the need for the MUA. Since then my physio sessions has just been hour long sessions on the CPM machine although my physio is always going over what I could/should be doing at home and offering suggestions to help my walking etc. I've been very lucky although EVERYONE should be receiving the same standard of service. Things seem a lot different in the USA, and unfortunetly not always for the better Again, I've been reading about other people's experiences & then I think what the hell am I moaning about? Sometimes you just get caught up in your own tiredness, emotions, lack of what we perceive to be progression and you forget about everyone else! I said to myself if I need the other knee doing I WOULDN'T have it done...but then sometimes that decision is taken away from you due to the pain you've been trying to live with.
This site has been FANTASTIC and i only found it a week or so ago! So wished I knew about it BEFORE my op as then I might have taken on board a bit better what I was going to have to deal with! The least I can do now is when people have taken the time & effort to reply to me & offer they're comfort or advice, is to soak up the information then APPLY it or make changes as is necessary. Is there anyway you can ask to see another physio 'just to get a 2nd opinion' so to speak? I do think there is a distinct LACK of information both pre op and afterwards. I was just given a sheet of A4 with about 5 exercises on, no mention of walking and how much or little to do. Here's hoping you get that swelling under control and maybe with the arrival of the daffodils everything will seem much brighter! Jaki x