TKR Hi! New Here - My RTKR Recovery Thread

hawk2go

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Welcome to the other side, again. We're rooting for you!
 

Jockette

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Here’s a refresher course for you:

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!)​
If you want to use something to help heal the incision,
BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.​

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.
 
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VegasGirl

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Good morning. I made it through the night. Of course, you don't get much sleep in a hospital, but I got an hour here and there.
I did wake up with a little pain and they gave me some meds. That nausea patch was amazing! No nausea at all and I'm able to eat.

Doc was here and said it looked great. PT will be here soon, I'm sure. And then I head home at 11.
 
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VegasGirl

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I got home today at noon. Feeling pretty good, other than a lack of sleep. The pain did get a bit worse today than yesterday, but I'm sure that's normal. They gave me pain pills when I asked. And I have pain pillsfor home. I can already bend to about 90 degrees, so that's good!

PT was pretty simple. They went over my home exercise. Then we walked through the hospital a bit and I went up and down some stairs so that she knew I could handle them.

I have my first PT session on Friday. If was like the first knee, the first therapy is just to check where I am with flexion and extension. And maybe go through some of the home exercises.

I am so thrilled that I did not have any nausea this time or the horrible heartburn I had last time. I was able to eat just fine. If I ever have to have surgery again, I will definitely as for the patch that they used. Now I'm just hoping I can sleep tonight. I'm a stomach sleeper, and that's not possible right now.
 
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VegasGirl

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Day 3 post-surgery. It is definitely true that no two surgeries are the same. I'm having more pain this time around than the first one, mostly in the thigh, even with the pain pump attached and the meds. However, on a plus side, I'm seeing no bruising, at least not yet. The first knee had a lot of bruising!

PT tomorrow for the first one. I'm going to request that it's a very simple PT, especially if this pain is still sticking around.
 

sistersinhim

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I'm going to request that it's a very simple PT, especially if this pain is still sticking around.
Don't ask, tell them:
  • I expect discomfort. I DO NOT expect actual significant pain.
  • The definition of what is painful is owned by me, not you.
  • When I say stop, we're crossing the line into pain. I expect you to immediately stop.
  • Trying to force me past the pain point or not listening to me will completely break my trust in you.
  • I want us to be partners in this. I'm willing to try almost anything, as long as I can continue to trust you.
  • If I trust you, I will go right up to the line between discomfort and pain. If I do not trust you, I will likely start tensing up as soon as any discomfort starts. At that point, I may as well get a new therapist.
 
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VegasGirl

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I had my first PT session today - 3 days post surgery. I have the same therapist as last time, so I was pleased to see that. She was always very good about not pushing me when I couldn't do something. I have been having a little more pain this time around, but it seems to be getting better, although I still have that leg-log feeling (which I didn't have the last time).

This first session was basically just measuring and seeing where I am at, and then going over some of the exercises for home! I am super happy with where my numbers are, and she was also surprised at my numbers.
My extension is already at 0 and my flexion was at 102. I'll be going into PT twice a week for 4 weeks and then will evaluate.
 

sistersinhim

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Wow! Those numbers are very unusual for only 3 days. Be careful to not overdo and make those numbers worse. You know the deal and what to do. You'll do great!
 
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VegasGirl

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Wow! Those numbers are very unusual for only 3 days. Be careful to not overdo and make those numbers worse. You know the deal and what to do. You'll do great!
Yes, that is the one thing I don't want to do, is overdo it and start regressing on the numbers! I know the numbers will fluctuate some, but I'd like to keep it close to what it is now.
 
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VegasGirl

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Happy Sunday! I'm on day 5 post-surgery. It does seem to be going better than last time, and the biggest part of that is NO nausea! I'm able to eat and feel stronger. It's amazing to me how 2 surgeries, same doc, close together can be so different! The no nausea is due to the patch they gave me. But I'm also sleeping better, not great yet, but better than last time. my ROM seems to be much better this early. The pain is a bit better and in different spots, sort of. And last time I had major bruising, and NONE this time. Interesting!

The one thing about feeling better is that I have to constantly remind myself to not overdo it!!
 
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VegasGirl

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I have been pleased about the lack of bruising this time around. However, tonight I noticed a bruise starting to form on the back of my knee. My knee had been feeling really tight and swollen today and I assumed it was because I was up and down a bit more today and overdid a bit. But now I'm seeing bruising starting.

Is it normal for bruising to not show up until day 5 after surgery? I guess I'm.worried that something else is going on.
 

sistersinhim

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Yes, it is completely normal for the bruising to show up later rather than earlier after your surgery. Mine did and then lastest for almost a month after my surgery.

At this time in your recovery, all you should be doing are a few ADLs, (activities of daily living), and icing and elevating all the rest of the time. Healing should have the #1 place in your mind, so try and limit the activities you do. As long as you do your ankle pumps and very gentle knee bends.

We all have overdo it at times and joined that dreaded club, the Over Did It Club. To recover increase your rest time, icing and elevation times, too.
 

Jockette

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Years ago I tripped over something in my garage and fell head first into the front wall. That was Sunday. The resulting black eye didn’t show up until Thursday! I was also concerned at the time that it took so long, but all was fine.
 
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VegasGirl

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So today was an unplanned, not what I wanted to do adventure. I went to PT this morning. Everything had been going fine. My knee had been pretty tight all weekend, at times it felt like the skin was too tight to bend, but nothing I hadn't had before. PT was easygoing. Just light stretching and leg lifts. And then during the heel slides (again, not pushing very hard), my therapist noticed that I was bleeding. We checked the bandage and it was soaked. YIKES! It was gushing enough to be pouring out of the bandage. So she started wrapping it in layers and I called my surgeon's office. And off we go for the 45-minute drive. Thankfully, as long as I kept pressure on it, the bleeding was almost stopped.

Once the doctor looked at it, it turns out that all the staples were intact, no tears or anything major. There was just one tiny spot in between 2 staples that had decided to seep, a lot! It was mostly the serous fluid and not actual bleeding. He would get it to stop, but every time I bent the knee a bit it started again. So I am now tightly wrapped with tons of padding. I am not supposed to bend my knee for the next 2 days, but he does want me to move around still. So this should be fun! And I can go back to PT on Friday if things are in good shape. We'll see. Of course, unless I totally unwrap it, I can't tell if it's still seeping, unless it really starts gushing again. Hopefully, that's not the case! He also put me on antibiotics for a week, just as a precaution! I will say, after all that drained, my knee felt much less tight.

I am very thankful though that he is so responsive and I got in to see him right away.
 
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Jockette

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Wow! Be careful with this knee and rest and elevate and let it heal. Short walks will be good for you.
 
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VegasGirl

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Keeping the leg straight is really annoying me after having it drilled into me that I should work on the flexion. Hopefully this doesn't set me back on my ROM. Although my doc didn't seem concerned about it. He was however impressed that my extension was so good already.
 

sistersinhim

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Keeping the leg straight is really annoying me after having it drilled into me that I should work on the flexion.
Did he say to keep it totally straight? We have found that having a slight bend in the bend is much more comfortable than keeping it straight. A slight bend in it shouldn't pop it back open, but you should ask him first if it'd be OK. By the way, you won't lose your bend when you are released to bend again. It'll come right back.
 

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