Help

[KarriB]

I'm sorry you weren't prepared for the length of this recovery. My OS was up front with me, saying it would be 12 weeks before I'd feel remotely ready to return to work and full year before I'd feel 100% like myself. But even that honest info didn't help the boredom. What kind of timeframe did your OS give you?

At 5 weeks you could defintely visit your favorite restaurant for a meal, just prop your leg up on an extra chair or beside you on the bench. Some of our members have theaters nearby equipped with recliners. They take a bag of ice, enjoy a movie and get an ice refill if theirs melts.

 

[Jennszoo]

Yup. I'm only at 3w. My recovery is going better than expected, in terms of ROM, pain levels, etc. but it's still just long days of resting & icing, feeling exhausted after doing simple chores like switching laundry, feeling useless bc I can't go to the store or manage all my kids activities, and watching the world go by from my recliner. Blah. And I've got another surgery looming. Keeping your head in this long mental game is the hardest part of this experience, I think.

 

[SuperSnapper]

Actually, it's a few weeks out of your life and I know it's a pain and boring but in a few months with your new knee you will be out and about and pain free - it's really worth the downtime now and fighting against it will not help. I'm so glad I had my partial as it's broadened my life, given me back my ability to walk pain free and enjoy life so I consider the weeks I spent being a bit bored as money in the bank which I am enjoying now.

 

[Josephine]

I expect you won't mind answering my questions!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine)

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?

4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[Jujubee73]

Thanks for responding

1. My pain levels fluctuate between 3-8. I would say it is mostly in the 6 range.

2. I have hydrocodone 5mg, and ocxycodone 5 mg. I only take ocxycodone at night.
The hydrocodone, I take during the day as needed, so usually once or twice.
3. Knee is moderately swollen. I am starting to see some of my knee cap
4. I am able to walk down stairs, so probably 120-125. I can get my knee close to straight but not quite there. I have not had it measured for a couple of weeks
5. I ice my knee everyday, and where from 3-7 hours
6. I elevate my knee daily for about 30 minutes at a time, a few times a day. Any longer than that and my back starts hurting.
7. I walk around my house, go up and down stairs a few times a day. I will dust, start or fold laundry, empty the dishwasher, wipe down counter tops. I will ride my bike 3-5 minutes
8. I am not doing formal PT.
Heel slides 8-10 reps three sets
Tighten my quad hold for 10 seconds 3 sets, 3-5 times a day.
Leg lifts 8 reps, three sets
Ride my bike 3-5 minutes, sometimes longer, but not more than 10 minutes, every other day.
General walking around the house outside, 5-8 times a day.
I hope this is helpful to you. I will say I was very active prior to my surgery on April 3. I walked and jogged 3-5 miles 3 times a weeks.
Managed all the house work and most of the yard work.
I tore out my acl 17 years ago after a traumatic sports injury. I have had 4 surgeries to repair meniscus during the past 17 years and finally my knee replacement. My OS said my knee suffered a lot of damage over the years, and would take time to heal.

 

[Josephine]

@Jujubee73 sorry I've been so long responding - I've been unwell

1. My pain levels fluctuate between 3-8. I would say it is mostly in the 6 range.

That's high for 6 weeks out.

2. I have hydrocodone 5mg, and ocxycodone 5 mg. I only take ocxycodone at night. The hydrocodone, I take during the day as needed, so usually once or twice.

I would suggest you need to be taking it on a regular schedule for a few more weeks. Now is not the time to be doing an 'as needed' basis.

3. Knee is moderately swollen. I am starting to see some of my knee cap

But still swollen?

4. I am able to walk down stairs, so probably 120-125. I can get my knee close to straight but not quite there

Okay

5. I ice my knee everyday, any where from 3-7 hours
6. I elevate my knee daily for about 30 minutes at a time, a few times a day. Any longer than that and my back starts hurting.

You accomplish little or nothing in 30 minutes. Ice for at least 40-60mins and more than 4 times a day.

7. I walk around my house, go up and down stairs a few times a day. I will dust, start or fold laundry, empty the dishwasher, wipe down counter tops.

That's rather a lot for 6 weeks. Did you read your recovery articles? Specially the one on activity progression?


My comments in bold
Heel slides 8-10 reps three sets - not a good way to do heel slides. Besides which, with a ROM of 125, you really don't need to do these now
Tighten my quad hold for 10 seconds 3 sets, 3-5 times a day - same here
Leg lifts 8 reps, three sets - and here
Ride my bike 3-5 minutes, sometimes longer, but not more than 10 minutes, every other day - bike's okay for general loosening and your schedule is okay but you don't need to do this for ROM because you're already there!

In my opinion, you are doing perhaps a little too much but the main issue is that you are undermedicated. If you don't care to use more prescription meds, the try taking Tylenol 1,000mg 4 times a day. That will help you a lot.

 

[Jujubee73]

6 weeks post op

 

[Jujubee73]

I'm now 9 weeks out and I'm concerned about when I will be able to straighten my leg. I have been feeling better, but can only manage about 4-6 hours of activity and then I am beat. Still on pain medication at bedtime and wondering if that will change. Almost every night I tell my husband I am so over this, but I continue to hope it gets better.


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[KarriB]

4-6 hours of activity is quite a lot at this point in recovery. Take a look at theActivity progression for TKRs to see what actvity should look like at just over 2 months. It's very normal for the energy drain to still be present at 2 months. When I went back to work part time at 3 months I spent most afternoons elevating and resting. The energy drain gradually disappeared, but I was still feeling it around month 6-7.

 

[kneeper]

It will be getting better and better, but like KarriB say, the energy drain will continue to affect you (though less and less) as time goes on. I was back to work at 12 weeks, but came home and crashed afterward every day for at least a couple of weeks more.

 

[Celle]

I'm now 9 weeks out and I'm concerned about when I will be able to straighten my leg. I have been feeling better, but can only manage about 4-6 hours of activity and then I am beat. Still on pain medication at bedtime and wondering if that will change. Almost every night I tell my husband I am so over this, but I continue to hope it gets better.

It is still only 9 weeks. I know it seems as if you've been recovering for ever, but truly this recovery is more like a marathon than a sprint. Patience is going to be your best friend. Everything is going to get better, but you had a major operation and recovery takes a long time.

"Patience, Grasshopper."

Don't worry about your extension. It's not unusual for extension to take longer to achieve than flexion. That's because it takes time and gentle treatment for the muscles and tendons at the back of your leg to stretch. Most people find that they have shrunk prior to surgery, especially if they have been limping. This article suggest a few exercises that may help. Just choose one or two that you like, and do them gently. Don't use weights until at least 3 months post-op.
Extension: how to estimate it and ways to improve it

There's no need to worry about getting good extension and flexion because there are no deadlines you have to meet:
Myth busting: the "window of opportunity" in TKR

4-6 hours of activity sounds like too much at this stage. The Energy drain for TKRs is still in effect and will linger for quite while. Read this article again and check what your activity should be:
Activity progression for TKRs

If you only need to take pain medication at bed time now, you are doing better than most. Many people still need their pain medication during the day as well, for up to 4 months.

You really are doing well. Give your body time to heal and try not to expect too much of it this early in recovery.

 

[Josephine]

I'm now 9 weeks out and I'm concerned about when I will be able to straighten my leg.

You're worrying unnecessarily. You told me earlier your flexion is 125 though you did also say this

I can get my knee close to straight but not quite there

Since your flexion is so good, I doubt that your extension will be a problem.

Almost every night I tell my husband I am so over this, but I continue to hope it gets better.

Oh my you are being impatient! You probably have another 6-8 weeks of recovery yet. And Karri is right - 4-6 hours of activity at 9 weeks is asking for trouble! So stop it!

BTW, did you read my replies in post #26? It almost seems like you didn't.

 

[Jujubee73]

Would like some input. I went to see my OS today for a follow up visit, I am 11 weeks post op.

I ended up seeing the PA. He asked me to straighten my leg, and I complied by straightening it as much as I could. He then proceeded to push down on my knee to straighten it. I told him to stop because it hurt. He told me I need to work on it. I am working on it, but I was not going to allow anyone to push or bend my knee to the point of causing severe pain.

I also told him about the pain I was having on both sides of my knee and the shooting pain down my leg. He told me most patients are pain free after 4 weeks. I truly don't believe that is right. I have not had one pain free day in 11 weeks, and I told him so. He did give me more pain meds but really didn't want to and indicated I probably wouldn't be getting any more refills.

I don't think I will need more as I only take them at night and maybe 3 times a week I will take one during the day if I am struggling.

I guess I am ticked off right now. I felt like he was a jerk. I am mad he pushed on my knee to straighten it. I am also mad that he acted like I should not be in pain any longer. Would like to hear what this community has to say and thanks for letting me vent


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[Jujubee73]

Here is a picture 11 weeks post op

 

[flyaway79]

Pain free at 4 weeks

All I can say is clueless

Next time ask to meet with the surgeon. This PA sounds quite uniformed on TKRs.

 

[KarriB]

Not too many here are pain free a 4 weeks. The PA was a jerk, you may want to be sure you don't see him again when you return. I had an issue with a PA in my Infectious Disease group and told her not come back (I was in the hospital) unless she had something else to say to me and knew what she was talking about. I'd had it. But it may be good to ask @Josephine about the pain you're experiencing daily. It could just be that you're going to take longer to recover, but let's see what Jo says.

 

[sistersinhim]

That PA was just plain mean. I would do every thing I could to never have to see him again. He obviously has little experience in tkr patients and you don't need to be his first!

 

[Josephine]

I so agree with you.
a) it's not good for anyone to be pushing on legs like that.
b) Even on my best recovery I wasn't pain free until 6 weeks out
c) if you're taking so little pain meds, you might be able to manage with 1,000mg Tylenol 4 times a day. Just a thought

 

[kneeper]

I found taking the Tylenol regularly, not just once the pain was bad worked well for me. I was definitely taking it beyond 11 weeks, though by 12 or 13 I was mostly off the hydrocodone before bed (that was the last narcotic dose to go for me.)

Oh, and that PA was just clueless. No pain at 4 weeks? Pushing on your leg?

 

[sistersinhim]

At 4 weeks your knee is an infant and needs lots of TLC. If PT hurt you Monday night, then you did too much. Cut way back on all movements and follow our guidelines.