TKR I Feel Like the Tin Man these Days

[Laurenkate]

Here's another thing I don't remember after the last surgery; I cannot get my body temperature straight. Either freezing to death or burning up & have to wear a sweater when using the ice packs (which is mostly all day long). Then I get really hot getting up to walk around or go to the bathroom, take it off, put more ice packs on and then, freezing again.

I've also pulled several muscles and those things hurt - one in my hip, shin, and under the arm. (?) Between the muscles jumping & cramping, nerves tingling, skin dry and itchy and the body temperature thing, it was a long night and day today.

My husband is getting really goofy too; he must be really for this phase to be over. Apparently, he's never heard the term "let sleeping dogs lie" because after an endless, restless night I finally got the pillows just right, my legs straight, blah, blah, blah, about 5:30 a.m. He came in about 7:30 to ask me something which could have waited. Finally drifted back off to sleep & started hearing this weird squeaking noise and then an occasional "thump". After a few minutes, I realized the squeaking noise was the mail slot in the door - not a mouse as imagined. Anyway, someone was standing outside opening and closing the mail slot and then slamming the storm door. ?? I finally got up and yelled for my husband and he opened the mail slot and said he'd locked himself out. (He couldn't remember where the hidden key was outside). What was he going to do? Stand there all morning opening and closing the mail slot in hopes I would hear it? It was so weird and really funny now that I think about it. Hope next week gets a little closer to "normal". We're both ready for it....

 

[Jockette]

Men!

 

[Dzina]

Here's another thing I don't remember after the last surgery; I cannot get my body temperature straight. Either freezing to death or burning up & have to wear a sweater when using the ice packs (which is mostly all day long). Then I get really hot getting up to walk around or go to the bathroom, take it off, put more ice packs on and then, freezing again...

I’m with you Laurenkate - it’s hot and humid outside and I’m in sweats! With the ac in the house and using ice packs I’m freezing. Then the ice comes off and the sweatshirt or jacket comes off cause I’m too hot. Either drinking hot tea or having iced coffee even find when going to P/T I’m dressing like its fall weather- think it’s has something to do with how anesthesia can mess things up but like everything else assume it’s temporary

 

[Laurenkate]

When I had this tkr, I was determined not to make the same mistakes as last time and, for the most part, have stuck to that. I've iced and elevated much more, started wearing the dreaded TED stockings last week, tried the kt tape (which helped a little with the swelling; a lot for the pain), etc. The only "exercises" I'm doing is walking in the house for 10-15 minutes each day, standing out on the porch for 5 minutes, and a few gentle stretches when I think about it (which isn't often). We did make two quick excursions but I checked the swelling afterwards and it didn't get bigger.

Last night was a good example of why i'm frustrated. Slept with the pillow stack under my leg, iced from 9 p.m. until about 4:30 a.m. After measuring my leg this morning, the swelling hadn't gone down at all during the night.

Overall, this recovery has gone a little better than the last. The measured ROM is better; not much, but it's something. I can get on my side for a few minutes each night if I want to (couldn't do that for months last time), even "cut" my toenails on the operated leg although "whacked at" might be a better description. It takes a while for my leg to want to straighten after getting up, but that was the case previously.

It took 8/9 months for my left leg to stop swelling and remotely resemble "normal". It's probably going to be that way for my right leg too. Is anyone else a "sweller"? Did anything (other than the normal icing, elevating, etc) help you? Like everything else, time will have to take care of it. Hope I don't have to listen to any guff from the surgeon's assistant about it at the end of the week though; the anticipation of that is stressful.

 

[lovetocookandsew]

Can I ask you why you keep measuring your leg? It isn't going to keep coming down every time you ice and elevate, and measuring like that will only frustrate you. There will be times you've done too much and your knee swells more as a result; that will usually come down again after a day or two of icing and elevating, but the usual swelling is going to take a while to go down and won't generally be noticeable daily. I suggest you put away the tape measure and measure progress by how you feel, and by how your walking progresses over a long period of time, not every day. You're not quite three weeks and still have a very long road ahead. What I suggest is adding some PATIENCE to your daily activities and look backwards to where you were day one, week one, etc, and where you are at one month, six weeks, etc. By looking back to the early days, you'll see you have progressed, it may not be a huge difference looking back yet, but at three months, four months, a year, you will see a lot of progress when you look back.

 

[Jockette]

anticipation of that is stressful.

I was always pretty stressed about going for my checkups. I was following Bonesmart, not my surgeon’s recommendations, after I found Bonesmart at 4 weeks. This is my first experience with joint replacement (and it has not been a good one) so I was totally overwhelmed and not confident of standing up for myself.

However, next time I will have actual experience to support my choice of recovery approach, as you do this time around. Just tell that PA that this is not your first time around and you’ve figured out what works for your body, and you know what you’re doing! (I will try to do the same thing next time around!!)

 

[lovetocookandsew]

I guess I'm a strange one....going to my post op check-ups with my OS doesn't stress me out at all. I'm of the mind that my knee is recovering at it's own pace, and it is where it is. Granted, I have a great OS, but even if he were the kind who pushed for massive ROM day one, etc, he'd hear about my beliefs and the fact that it's my knee, my recovery, and it will go at it's own pace, not his.

 

[Jockette]

@lovetocookandsew
I wish I could be more like that!

I don’t do things they say if I don’t agree with it, but I don’t like having discussion about it.

I plan to stand up for myself better next time, but even so, it will not come easily for me.

Next time I interview a surgeon I will tell him in do Volunteer Work for Bonesmart and I fully agree with their approach and that is how I plan to recover. I would love his blessing, but I will settle for agreeing to disagree. If I can’t even get that, I won’t hire him, unless there is a specific reason that he has a particular skill that I will need.

The worst part of my recovery has been the emotional/mental struggle of following my choice of recovery approach against all opposition from the people, in and out of medical circles, who don’t believe the Bonesmart way can work. The pain has been nothing compared to that struggle.

 

[Laurenkate]

Love; some of the reason I measure it is out of curiosity. If icing and elevating aren't going to help the swelling, then I'd rather be doing something else. But more importantly, the home health care nurse (required by insurance) is somewhat freaked out about the difference in my legs and the fact that the "new" knee leg is getting bigger, not smaller. My resting heart rate is below normal (great if I was Michael Phelps) & she's concerned the swelling might be the result of other issues heart, not knee, related. She asked me to measure both legs, feet and ankles & is keeping track of it for several reasons.

Jockette, I'm like you. You've certainly had your struggle with doctors, etc. and I've had several unpleasant experiences with them too. All you need are a few of those to be stressed before visits. And....as much as the Bonesmart philosophy makes so much sense to me - and I will do what I want to do insofar as recovery is concerned - there's always a little bit of doubt when making decisions based on our "gut instinct" instead of the medical knowledge & advice of my very good and competent surgeon. Also, I have to question if it's fair to my husband and family if they're worried I'm making a mistake by not following advice and protocol. (No, it isn't).

Ok will stop wandering in the weeds for now and change the ice pack. Again.

 

[sistersinhim]

@Laurenkate, are elevating toes above your nose? The higher up you can get your knee, the better it will drain.

 

[Laurenkate]

Yes; toes above the nose. Flat on my back. Boring. Told my husband I just didn't think I could do that for hours on end anymore. A couple of hours in the morning (of icing and elevating) and a couple in the afternoon plus all night is going to be what I try this week.

The in home physical therapist was really informative today. We talked a lot about ROM and why the emphasis on it was so "nervousing" for those of us who just had surgery. You know how you can read something over and over again and then someone finally explains something in a way that makes the lightbulb in your head finally turn on? That's what she did today because I always wondered why there was this insane push by some in the medical field about ROM. Anyway, she asked if she could try something and after measuring it - still stuck at 90 degrees - she got on the floor and very gently pushed my leg back to 100 degrees. It was uncomfortable, not painful, and she was very pleased with the result. She said the swelling was fighting her but she could tell I wasn't developing any of the "stuff" (like adhesions or "scar tissue"). The p.t. and I talked some more and she basically believes in finding the balance of what you can do and what your knee doesn't want you to do. She and the nurse (who'd visited earlier) encouraged me to do a few more normal activities - and keep wearing the stupid TED stockings and kt tape.

All in all, a good way to start the week. My daughter wanted to be here for my surgery and we talked her out of it so she's visiting this upcoming weekend which will be wonderful. We rarely have her to ourselves anymore so that will be a treat. She'll give her dad a break and they can go to lunch together which will be VERY good for him.

Hope everyone has a good week. Onward and upward.....

 

[Laurenkate]

Since our daughter is coming for a visit and I'm tired of things being out of place, just did a 20 minute "let's get stuff back where it belongs" pickup. I'm pleased to report that, so far, my husband hasn't lost any pans but the toilet brush has gone missing. WHAT does he do with this stuff?

 

[lovetocookandsew]

My husband often likes to put things in the first open spot he sees; the fact that he just took something out from it's proper place two minutes before that doesn't seem to matter. But I will say it's easier in the long run to have his help now and deal with re-organizing everything later on when I'm back "in charge".

 

[Celle]

It took 8/9 months for my left leg to stop swelling and remotely resemble "normal". It's probably going to be that way for my right leg too. Is anyone else a "sweller"? Did anything (other than the normal icing, elevating, etc) help you? Like everything else, time will have to take care of it.

You're right that time is the cure. There's no need to worry about swelling at this very early stage. It certainly won't go down noticeably overnight.
You really aren't a "sweller". What you're experiencing is normal and it happens to most of us. Your knee is wounded and that's why it's swollen. As it heals, the swelling will also decrease - but it's a gradual thing.

If icing and elevating aren't going to help the swelling, then I'd rather be doing something else. But more importantly, the home health care nurse (required by insurance) is somewhat freaked out about the difference in my legs and the fact that the "new" knee leg is getting bigger, not smaller.

If the nurse is freaked out, that's her problem. It's perfectly normal to still have the operated leg much larger than the other leg. She's expecting too much, too soon, and that's making you do the same.

That's what she did today because I always wondered why there was this insane push by some in the medical field about ROM. Anyway, she asked if she could try something and after measuring it - still stuck at 90 degrees - she got on the floor and very gently pushed my leg back to 100 degrees. It was uncomfortable, not painful, and she was very pleased with the result. She said the swelling was fighting her but she could tell I wasn't developing any of the "stuff" (like adhesions or "scar tissue"). The p.t. and I talked some more and she basically believes in finding the balance of what you can do and what your knee doesn't want you to do.

I'm glad your PT explained, but she shouldn't have pushed on your knee,no matter how gently she did it. Yes, it is the swelling that's preventing your knee from bending further, but at only 3 weeks post-op you are already at 90 degrees, which is about where most surgeons expect your knee to be by 6 weeks. So you're ahead of the game already.

The dreaded adhesions that PTs seem to worry about so much are actually quite rare and they seldom develop as early as this in recovery.
There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

 

[Laurenkate]

Celle; you're right about all of it and the p.t. has never touched me until today. She made it very clear she would be slow and would stop when I asked her too so that was fine. It gives me something to use as back up if I get a lot of vague threats about MUA's and adhesions and scar tissue from the physician's assistant at my appointment on Friday. It's going to be much easier to say "oh thank you for your concern, but I'm not worried about any of that. The physical therapist has checked it and assured me....." In some respects, I'm also very lucky because my left leg still swells (and will probably be a bit swollen by the afternoon appointment) but my ROM is fine although it took a good 12-14 months to get where it is today.

 

[Jockette]

so far, my husband hasn't lost any pans but the toilet brush has gone missing.

It’s a plot to get out of cleaning!

 

[KitKat64]

You really aren't a "sweller". What you're experiencing is normal and it happens to most of us. Your knee is wounded and that's why it's swollen. As it heals, the swelling will also decrease - but it's a gradual thing.

I had issues with minor swelling after my RTKR. It lasted for several months, but my OS said it would eventually go away, which it did. I had no pain, and no edema. I really only noticed it when wearing my skinny jeans, the right leg always felt tighter in them than the left. With my current recovering knee, I have been getting some minor swelling too, mostly at the end of my work day. I work in a day program with special needs people, so there is a lot of activity in my job, moving around, bending down, walking a lot, etc. I usually ice and elevate in the evening after dinner, which is my relaxing time. I also sometimes get minor aches in both my legs, but I think that is a combination of working all day, plus the high humidity we've been having. Icing and elevating always seem to help reduce both the swelling and the aches.

 

[Laurenkate]

Good morning everyone. Hope you had a few hours of sleep last night.

Here's another sign of old age. I'm beginning to like my TED stockings. "Like" might be a strong word but I don't mind putting them on in the morning - especially since I can do it myself. It's also absolutely wonderful to take them off in the early evening....reminds me of what it used to feel like to come home from work and take off that girdle. (side note: Can you believe some of us (a certain age) used to wear girdles and sleep in curlers at night....were we crazy? )

Question: how long does it take you to put your entire foot down on the floor in the mornings? I didn't have that issue last time but my leg isn't as straight this time either. It wants to flop over to the right at night and Josephine (I think) assured me that was ok but the first couple of hours in the morning are miserable....maybe because it's elevated but not straight (as in toes looking at the ceiling) at night.

Going to go for a half block walk when my husband gets home - hopefully before the heat and humidity become unbearable. Then back to icing and elevating. Cheers....

 

[Spex10]

Can't believe you like your TEDs! I have to say that I've never even thought about my foot on the floor. It just goes down. That said, it certainly didn't last time and I remember the morning after my MUA being so happy to have my foot firmly down there next to my other one. Pre MUA my ROM was down to 50 and after it was 85 and steadily upwards from there.

 

[Laurenkate]

Ha! I can't believe it either! As wonderful as it is to take them off, my leg and muscles feel a little jiggly or something without them. And my leg swells another inch between early evening and bedtime but that's ok.
Yeah, I have to walk on tippy toes for about an hour after getting up in the morning and for about 5-10 minutes after sitting for more than 20-30 minutes because it gets so stiff. Flat shoes are really uncomfortable now too so I probably need to order something with a wedge. As much as I love shoes, it's becoming challenging to find some which address all the foot and knee issues; at this point, I'd even wear REALLY ugly old lady orthopedic shoes if I could find some which were comfortable.