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[TKR] I have a new knee!

regulus

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So I had my first knee replacement surgery this past Wednesday (Sept 5) and everything went smoothly. I had my surgery at Sentara Leigh hospital in Virginia.

While everything went well with the surgery, recovery is a completely different thing. I haven’t slept in just under a week and I am in severe pain. I do take my pain meds as instructed (Roxi every 4 hrs) along with plenty of walking with my walker but I have to say that sleeping is next to impossible. I get a couple of hours after a pain pill at night then I’m awake. They want me to keep the leg straight when sleeping which is not comfortable to me at all. I’m icing the knee as well and PT has come twice to my home to work with me. The pain is crazy and I’m terrible about keeping my leg straight. I never could before either as they were both always bent in the back and so it’s a struggle now. It HURTS keeping it straight and is next to impossible. PT gave me exercises to help straighten the knee but gosh they hurt. I also cannot lift my leg on my own yet. I know it hasn’t been long since surgery but I guess I’m just frustrated.

I knew the recovery would be difficult but it’s making me reconsider getting the other knee done...which, it really does need doing. I’m 37 yrs old and I have to say, this is the most difficult surgery I’ve ever had.

Also the thigh high TED socks are horrible and hot and with a hurricane coming (Florence) I’m worried about not having power and being over heated as well as not being able to ice my knee.

One good aspect is I had to get these knee replacements for knee deformity which over the years, wore my knees down and after giving the left knee a good look over, I do see it’s less knock kneed than the other one now. Everyone says it does look 100% better and much less deformed. Doctor said he had to leave it slightly knock kneed or I’d have issues and also my kneecap dislocates and he can’t fix that either without it making me miserable for the rest of my life but hey! It does look less deformed.

Just wanted to vent. ❤
Kat
 
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Celle

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Hello @regulus - and :welome: to recovery.

I'm sorry you're in so much pain.
There are two things you can do about it. first, phone your surgeon and let him/her know that the pain medication regime is not working for you.
Second, cut back the exercise you are doing. Your poor knee has been through major surgery and it needs time and gentle treatment, so it can start to heal and recover. There is no need to stress it with exercises or with trying to keep it straight all the time.

At this early stage, just walking around your house is all the exercise your knee needs. As it heals, you will be able to do more.
It's not exercising that gets you your ROM (Range of Motion) - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.

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
Your knee will eventually straighten completely, but it's not at all unusual for straightening (extension) to take longer to achieve than bending (flexion).

The insistence of some PT therapist and surgeons on keeping your leg straight all the time is the cause of much pain and it's totally unnecessary. It's perfectly fine to have your knee bent a little at this stage of recovery.

Are you trying to sleep n bed all the time? Unfortunately, sleep disturbance is part of this recovery, but you can try sleeping wherever you like. Sleep where you can, how you can, and when you can.

Here is the post-op reading we give to everyone - lots of informative articles:
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
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
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. Here is a week-by-week guide for Activity progression for TKRs


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

Please don't be overwhelmed by the list. The articles are not long and they and contain information that will answer many questions and help you make your recovery much easier on your knee and on you.

We are here to help in any way we can: answering questions and concerns; supporting and encouraging you from start to finish.

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 a 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 history before providing advice.
 

SusieShoes

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Hi @regulus! :wave: I agree with Celle that you should call your surgeon to talk about your pain control. He wants you to be in less pain because that will be better for your healing as well as your comfort.

My nurses also told me to always sleep with my legs straight. I had researched ahead of time and knew from BoneSmart that I didn't need to do that, so as soon as they left the room I would get rid of the rolled towels they put under my ankles and let my knees bend just a little. Such relief! :yes: I rested better that way and my knees never suffered for it. I have full extension now. You don't have to keep your legs straight to achieve good extension; extension (and the bending too) come with time.

This is a good place to vent, so vent away! We know how you feel! :friends:
 

InkedMarie

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Welcome @regulus ! I had my TKR two weeks ago; sleeping isn’t always easy. The first 6 nights were great, I slept on my back with legs on my Lounge Doctor wedge. Then, that wasn’t comfortable and I found I was able to sleep on my side with pillow between my legs. Maybe give side sleeping a try.

@SusieShoes I’ve been trying to keep my leg straight while side sleeping. You’re saying I can bend this leg in bed??
 

sistersinhim

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Trying to keep your leg straight at this point will be painful and so unnecessary. I used a leg elevator all the time. It kept a nice little bend in my knee, which is much less painful.

I had my tkr at St. Mary's, so we aren't that far away from each other. I, too, am worried about the power going out. Can you make ice way ahead of time and have coolers available to help keep it cold if the power goes out? I was blessed and didn't have to wear TEDS. I don't think I would have anyway. I can't stand anything tight around my knees!

Many of us never took formal PT or did exercises. I am one of them. I had 11 knee surgeries, 2 of them kneecap removals and 1 tkr. Even after those I never took PT. But, I didn't just sit around and do nothing. I took care of myself, my house and yard as my knee allowed me to do. As I healed, I did more. But, my knee was always in control! This was enough therapy for me and would be for any tkr patient. All the awful pain of PT is so unnecessary.

All you have to do is use it in your daily living! Your knee knows how to rehab itself and doesn't need anyone telling it how. Just use it and it will come back like new! You have to be patient, though, it doesn't happen quickly! ADL,(activities of daily living), going to the bathroom, brushing your teeth and bathing, fixing a light meal, getting something to drink and or a snack, those kinds of things will be all the exercise your knee needs. If you just use it daily in your living, you can have a less painful recovery. We know what works, we've been there!
 

SusieShoes

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I’ve been trying to keep my leg straight while side sleeping. You’re saying I can bend this leg in bed??
Yes, @InkedMarie, that's what I'm saying. You might find it more comfortable to keep it straight, in which case do it, but you don't have to keep it straight. I couldn't sleep on my side for months (maybe because bilateral) but when I started doing so I bent my knees. After my sleeping knee(s) were bent for a while, they'd hurt a little to straighten (bending can bring on a small bit of stiffness because the bend can cause some fluid to gather) but the stiffness would go away very quickly. Like right after straightening them. I much preferred it to the pain of trying to sleep with straight knees. My Lounge Doctor was a lifesaver early on because it has built in a slight bend to the knees. :thumb:

But it's not that bending your knees is going to cause any loss of ROM or other problem. Your knees will regain their extension naturally by doing knee-things like walking or biking, or some very gentle exercises like pressing the back of your knee down on an ottoman or bed.
 

Roy Gardiner

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It HURTS keeping it straight
Don't do it!
PT gave me exercises to help straighten the knee but gosh they hurt
Do them gently so they don't hurt, if that's not possible, don't do them.

Are you getting the message :) we are all saying the same thing No Pain More Gain :loveshwr:(we are not training, and we are not Jane Fonda).

it’s making me reconsider getting the other knee done
Hah! I bet you a BRAZILLION dollars you won't say that in a month.
 

InkedMarie

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@SusieShoes thanks! I would love to bend this leg a little, it would be more comfortable for me. I press my knee into the couch all the time. I have a good bruise under my knee and if i put a towel roll under my ankle for extension, I can only handle it for a few minutes. I stopped and do what you said often.
 

KitKat64

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I had a difficult time keeping my legs straight after both my TKRs. It was just too painful. After my right TKR, they told me to keep a rolled up towel under my ankle, to keep the leg straight. I just couldn't get comfortable that way, so I stopped doing it. With the left TKR, I was told not to put a pillow under the knee, or it would hinder the leg from becoming straight. I used a pillow length wise under my leg, and it was much more comfortable that way. Both of my knees eventually wound up being totally straight. Sometimes you just have to listen to what your body is telling you!!
 
OP
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regulus

regulus

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Thank you everyone for these replies! I’ve been so worried about having a messed up knee because I can’t keep it straight, that reading this is really reassuring to me!

I’m super tempted to call the PT and tell them I don’t need their services any longer. The pain is just too much. I can do little workouts without them, I feel.

I’m going to try the pillow longways like suggested here! See if that helps, as well as side sleeping with a pillow between the knees!

Thank you again you guys!
 

sistersinhim

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When you call them, they will put you on a guilt trip, but don't let them control you. They want your income and can't get that unless you go in for their services. You will do just fine without them. This recovery is common sense. Let the knee be your guide.
 

Jockette

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Physical Therapy can be helpful, but is NOT necessary to do in order to recover from a knee replacement. Not all surgeons prescribe PT. It all depends on their opinion about it. And there are many opinions. Which means there is not just one way to recover. Which then means that you get to choose how you will rehabilitate your knee.

Physical therapy is an option, not the requirement we thought it was.

Many people have not gone to PT but have used the movements within the normal course of their activities to rehabilitate their knee. It’s done as they are able, as they heal.

Also keep in mind, it’s not exercising that gets our range of motion back, it’s Time:

Time to recover.
Time for pain and swelling to settle,
and Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Exercise as in strength training is counter-productive and in the early weeks does more harm than good. Normal activity is the key to success.
 

Roy Gardiner

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so worried about having a messed up knee because I can’t keep it straight
You can't mess up the knee yourself (to the best of my knowledge, anyway) it's just soft tissue needing stretching to work properly, simple but time consuming
I’m super tempted to call the PT and tell them I don’t need their services any longer. The pain is just too much. I can do little workouts without them, I feel.
Sounds good to me. You can do loads of stretches and stuff all by yourself.
 

Onward

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Do not despair over the sleeplessness. I read a lot of good books. Suddenly at Week 4, I started sleeping 2-3 hours back to back during the night. I did used meditation tapes by Emmett Miller that really helped. Everything looks better with sleep!
 

Camsmimi

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I will be at 6 weeks on Thursday. I had my ltkr revision surgery on 9/6. I started sleeping this week finally all night thru but only if sleeping on my side with a pillow between my legs. I'm also walking without a walker or a came. I realized this morning when I was walking from the bathroom to the kitchen I forgot the cane in the bathroom.
It does get better is what I'm trying to get to. I still take dilaudid 2mg in the morming and 1 at night before bed but I also take 1000 mg of Tylenol every 6 hrs. I am doing light exercises and a little bit of walking bit basically juat icing and elevating. I have discovered time is the best healer..
 
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regulus

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So I finally had my second knee replacement this time on the right knee! Surgery was Jan 31 and so I’m just at 2 weeks post-op. Pretty miserable pain wise but I’m hanging in there! Just wanted to say hello and let everyone know I finally got the other one done!

Right now, I’m at 108 degrees bend and my extension is not as good as that’s at 15 but I had issues with that last time also so...I’m trying not to stress it!

After reading a lot of information here, I decided to only do PT at home for a few with a with the home health PT people but I will not be going to outpatient PT this time. They were far too aggressive for my liking and it was miserable. I know what exercises to do now and can do them here in my own time without these pushy PT people hurting me. I will say my at-home Therapist is wonderful and she is the same one I had last time. I haven’t told her yet that I’m not going to be going to PT after she stops coming so I’m curious as to how she’ll react.

Also is it normal for my other knee to hurt suddenly since I’ve had the other replacement? that knee had a TKR this past September so I’m worried I’m putting a lot of strain on it since having the other one just done. It’s just been sore.
 

Jockette

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The first knee is still young, not halfway healed yet, in this year long, on average, recovery, so it’s bound to feel stress right now. But it will also benefit from all the rest and elevation the second one needs.

I’m glad you have such a good home PT that you like and trust. Some of us never had that. It will be nice if she understands/approves your choice of home/self PT, but it really doesn’t matter if she doesn’t. I won’t go to PT next time either.

As a refresher, here are the updated Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

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
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
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
the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy
5. At week 4 and after you should follow this
Activity progression for TKRs
6. Access to these pages on the website
Oral And Intravenous Pain Medications
Wound Closure

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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