TKR I’m baffled by this

[Mutti3]

@Wilsomasan
I noticed you talked about pain control on another thread. I didn’t want to hijack that conversation/ thread. Pain control is a stressful issue. Volteran is not an effect for pain management. Have you spoken to your OS for maybe a step down pain medication? Or your PCP? Knee replacement is major surgery as we all have experienced. I hope you find pain relief that helps you heal.

 

[Josephine]

@Wilsomasan are you going to respond to my questions or not?

 

[Wilsomasan]

1. Pain level is 5-6. Seems to get worse at night.
2. I was prescribed Hydrocodone10-325. Was taking them every 4 hrs. Now every 4-6. Just got meds after about a week. Dr was slow to prescribe which caused a lot of suffering for me.
3. moderate
4. I don’t know. I am unable to straighten my leg very far. I have had trouble with pain control and have not exercised consistently.
5. I ice my knee constantly.
6. I elevate my leg a lot.
6. My activity level is not good due to lack of pain control and meds.
7. Exercises are sliding foot under me, flexing muscles on quads, toes flexing, etc. probably should be doing more.

 

[Wilsomasan]

I did not know that Voltaren wasn’t a pain reliever. It was all I had and mostly just took my appetite away and made me sick. I finally got some Hydrocodone today. Dr was slow getting them to me.

 

[Mutti3]

Now you have some pain relief! I don’t understand OS basically saw your knee in half, pound it, cement it back together, and they think you don’t have high level of pain. But glad you got hydrocodone.

 

[HappyCatTX]

As others mentioned, hang in there, it gets better. Much better. I had TKR March 4, it has been less than two months and I am already planning another one for my left knee. At the beginning you will feel miserable, but it gets better, much better. Follow the suggestions presented here. I found the elevate is really important. I found seating in a recliner is not the same as elevate, that created a lot of swelling for me. My knee/leg was like a balloon. With real elevation swelling went down. To that add ice, meds and rest. Good luck. Keep posting your progress.

 

[SusieShoes]

Now that you have the hydrocodone, that should help your pain. With your pain under better control you will be able to move around more. Walking is wonderful for your new knee (don't have to walk far, just around the house and for your daily activities) and do some gentle bends and stretches to keep your knee mobile. That should help any stiffness in your knee. I hope you soon feel better!

 

[Josephine]

I did not know that Voltaren wasn’t a pain reliever.

That's not what was said! Voltaren is an NSAID which is a rather poor pain reliever and quite ineffective for something like a knee replacement. Plus is does have bad side effects on the stomach which include appetite and nausea. I suggest you read this Medications: acetaminophen (Tylenol, paracetamol) and NSAIDs, differences and dangers

7. Exercises are sliding foot under me, flexing muscles on quads, toes flexing, etc. probably should be doing more.

Would you be kind enough to give me more details on these?
I did ask for

- how many sessions you do each day
- enter exercise by name then number of repetitions of each​

 

[Wilsomasan]

7. I have just started walking outside a couple blocks at a time. Started that today.
I do
quad strengthening exercises 2x day
knee flexion stretch 2x day
knee flexion stretch in chair sliding foot under me 3-4 times a day.

Sorry.

 

[Josephine]

I'm sorry - but I do also need to know how many reps you do each time
Also how you do the quad strengthening

 

[Wilsomasan]

I do about 10 reps. Quad strengthening is just tensing the quad muscles in a lying down position and releasing the tension. Squeeze and relax.

 

[Josephine]

I really everso sorry but I need yet more information. Should have read your post more carefully

Now I need

5. I ice my knee constantly.
6. I elevate my leg a lot.

How much time do you spend elevating and icing and how often each day?

6. My activity level is not good

Please give me more detail.

 

[Wilsomasan]

I probably ice my knee for an hr at a time 5-6 times a day. Especially in the morning hours when my pain is the worst.
I had quite a bit of pain elevating my leg today so I don’t know if I’m gonna continue it.

My activity level consists of me walking around the block a couple times a day and the house and physical therapy 2 times a wk. I’m taking pain pills 2-3 times a day but sure so feel it when they wear off. Anyway, the rest of the time I’m in my recliner. I want to start walking outside more starting tomorrow. It hurts to sit for too long and My knee gets really stiff.

Btw I watched a youtube video of you on Bonesmart. You waved a blue flag at the end. Very cute!

 

[Josephine]

1. Pain level is 5-6. Seems to get worse at night.

That's often a sign of doing too much during the day

2. I was prescribed Hydrocodone10-325. Was taking them every 4 hrs. Now every 4-6. Just got meds after about a week.

I'd say you shouldn't be considering reducing your meds right now because you pain levels are too high.

3. swelling moderate

okay

4. I don’t know. I am unable to straighten my leg very far. I have had trouble with pain control and have not exercised consistently.

You can estimate your extension this way
1. put your leg on a bench, seat, bed, floor or anything similar but preferably something fairly firm.
2. with not too much pressure, press the back of your knee down - use your leg muscles, not your hand!
3. slide your hand, palm down, under the back of your knee
a) if you can get your entire hand under easily, it's probably about +10 degrees
b) if you can get just your fingers under, it's about +5
c) if you can get your fingers under but it's a push, it's +0
d) if you can't get your fingers under at all, it's -5 or more


Here's a graphic to explain the degrees involved

5. I ice my knee constantly probably for an hour at a time 5-6 times a day. Especially in the morning hours when my pain is the worst.

Okay

6. I elevate my leg a lot. I had quite a bit of pain elevating my leg today so I don’t know if I’m gonna continue it.

Okay but are you elevating with your leg completely straight, like this?

Because elevating like this is bound to cause you pain. You need to have just a bit of bend to take the strain off the ligaments at the back. Best way to do it is like this

My activity level consists of me walking around the block a couple times a day and the house and physical therapy 2 times a wk. I’m taking pain pills 2-3 times a day but sure so feel it when they wear off. Anyway, the rest of the time I’m in my recliner. I want to start walking outside more starting tomorrow. It hurts to sit for too long and My knee gets really stiff.

I should think so! That's far too much at only 6 weeks. You said you read the articles but in this one Activity progression for TKRs there are instructions about how much to do week by week. I suggest you read it again as at 6 weeks it says
"Weeks 6 and onward - add to all the previous
Start taking car trips to the shops but keep them short and sweet at the start, no longer than 15-20 minutes
Take at least one 5 minute rest while you are out"
So you shouldn't be walking 'round the block a couple of times a day'.

Exercises:
quad strengthening exercises 2x day - okay
knee flexion stretch 2x day x10 - these are heel slides and doing them like this is harmful. I suggest you read this Heel slides and how to do them properly.
probably should be doing more - absolutely not! You are doing too much anyway

 

[Josephine]

Btw I watched a youtube video of you on Bonesmart. You waved a blue flag at the end. Very cute!

Thanks - that was a promotional for BoneSmart. If you go onto YouTube and do a search for 'flaglady' you can see a lot more of me!

 

[Wilsomasan]

Thank you Josephine! Glad to hear I’m doing too much cause I was feeling like a lazy slug and like I should be doing more. I’m in my 6th week and am going to have to go back to work soon so I am worried I won’t have recovered enough. I will read your articles highlighted here and take your advice. Thanks very much.

 

[sistersinhim]

@Wilsomasan, you don't have to quote a whole post to answer to it, just go down to the bottom of the page and start typing!

 

[Wilsomasan]

Thanks sister

 

[sistersinhim]

 

[Josephine]

Glad to hear I’m doing too much cause I was feeling like a lazy slug and like I should be doing more.

Lot's of people do and it's mostly because they are told, or read, that it takes hard work to rehab a TKR, that you have to work through the pain and all that rot! It's not true!

There are many on this forum who never did any exercises at all - PT or otherwise - and yet got excellent outcomes. I predict there will come a time, soon I hope, when we look back on this time and wonder at how barbaric and unnecessary it all was. I recommend you read my recovery thread to see how little exercising I did for either knee! Knee recoveries UK style Parts I & II (Josephine)