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TKR I should have had the TKR 10 years ago

Surf&ski

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Hi everyone,
I'm 9 days past surgery and have been meaning to start a thread. I'm 53 years old, and have had knee problems since I was a teen. I'm a very avid skier and surfer, and did quite a bit of hiking and free climbing when I was younger. For the past 10 years, one by one I had to stop activities. Golf, running, climbing, all became impossible. I knew for a long time a complete knee replacement was in my future but for a bunch of reasons I waited. 'The tech will get better'; 'I only ever want to do this once'; 'I'll wait until it really affects my lifestyle'; etc etc etc

So October 6 I had a left TKR, performed at NYU Langone in NYC by Dr William Macauley. I walked into the surgery theater at 730am, was out cold by 735 and woke up around 1045. I walked out of the hospital at 145pm. Truly, it's a miracle. I know I have a long road ahead, but my extension is already better than it's been in 10 years!
 
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Surf&ski

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I had so many questions and worries, and when I found BoneSmart, it was exactly what I needed. I've spent quite a bit of time digging through old threads looking for info on recovery, setbacks, challenges, tips, etc. I figured I should give back by pointing out things I couldn't find here, or just adding to what's been said.

It's too early to comment on recovery but here's what I do know, based on today's PT-my first really tough session.
1: Get active before the surgery. I dropped 25lbs in the previous 4 months and was pretty strong (my problem was more with lateral movement than strength; I could still squat a reasonable amount of weight). I'm sure it's impossible for some, but if you can-get fit for recovery! In today's session I did much more than I imagined possible.

2: It's going to hurt when the nerve block wears off. USE YOUR MEDS as directed-stay ahead of the pain. If you're hurting it takes a while for pain relievers to bring you back. For me, it was about 36 hours after surgery. This procedure is rough on the body and there's a decent amount of trauma.

3: it goes away! by day 4 I was able to just use tylenol and miloxicam to manage it-and ice. Lots and lots of ice. I read it here from so many people-Ice is your friend. So is elevation.
 
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Surf&ski

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here's the famous scar reveal: it curves to line up 2 old surgical scars from previous reconstructions. The dressing was removed after 7 days-I didnt realize how much it was restricting me until it came off! what a relief.
 

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Surf&ski

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A few more comments ...first, sleep is tough. I definitely need to nap whenever I can. I didn't sleep the night before or the next couple nights and really paid a price. I've been taking at least 2 naps a day the past few days.

Also, I need to be careful not to overdo the recovery. I felt so good after I got past the rough days that I stayed on my feet for a good part of the day. Then swelling and pain set in and I had to just rest and Ice for another full day. For me, I've set out a limit on how much I'm allowed to do in a certain day. When I reach it, I'm done. we'll see how it goes....
 

newlybionic

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:welome: to Bonesmart. We are glad you found us. You’ve already have found the key that you can overdo activities which your new knee will object to. That also goes for too much PT too.

Here is your copy of your TKR guidelines.
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. 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

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.
 

Jockette

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Best wishes for your recovery. Don't over stress your new knee, give it the time it needs to heal and you’ll be back to doing the things you had to give up.
 

leejaa

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Hello and welcome. Listen to your knee and your body and you will do fine. Recovery is not a smooth road always but doable and such a prize at the end when you can get more of your life back. Have a peaceful night.
 

lovetocookandsew

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This recovery takes, on average, a full year to complete, but most people feel much better around the three month mark. Let your knee be your guide, it'll let you know, and in no uncertain terms, what it's ready for and what is better left for a later time. Icing and elevating are your new BFFs; as long as you have a cloth next to your skin you can ice for as long as you like. Just remember to get up each hour to walk around your house to use the restroom, make a snack, etc. I used to ice all day; anytime I wasn't up walking I was icing, and I iced solidly all night long. As time goes on you'll find yourself naturally walking around more and more until one day you realize you haven't iced or elevated in a while, and don't really need to anymore.
Just take it slowly, don't overdo and you'll do well.
 

DJL1967

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@Surf&ski Sounds like you and I enjoy much of the same things and have been dealing with knee issues for about the same time. Good to hear that you are doing well so early on in your recovery.

I am waiting for a date for BTKR as I was expected to have it done in June but that is now pushed back to early next year now.

Keep us posted on your progress.
 

allin1

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I'm almost 5 months into my own recovery. I'm not sure I was quite as happy 2 weeks into my recovery as you appear to be, but I do agree I'm very happy to have had mine done. I easily could have done mine 5 years sooner, but I'm glad I didn't push it back anymore,
 
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Surf&ski

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I was hurting pretty badly...there wasn't much downside in my eyes. How close do you think you are to 100%?
 

Freestyle

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Like you, I was at a dead-end by the time I had my surgery--so it didn't take long to realize that I had done the right thing. What helped me make my decision--other than all of the limitations that had crept into my life--was talking to people. I was surprised by how many people I met who told me that knee replacement was life-transforming. I talked to everyone I could about TKR and the stories were inspiring.

What no one prepared me for were the first days after surgery and the incredible discomfort. I didn't find Bonesmart until the day before my surgery, so didn't have time for a deep dive. But it has been a lifesaver since then. I'm almost four weeks since surgery and the good days are very good. The bad days are a lesson--they always come because I overdid it. But there is a real pleasure in learning to listen to your body that closely--pain is information! Good luck with your continued recovery.
 
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Surf&ski

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Thanks Freestyle,
Yes the 48 hours after the nerve block wore off were rough. The amount of trauma your body goes through is pretty high-I waited until after the surgery but I finally watched a video of the procedure and there’s nothing gentle about it....luckily, with the nerve block and a lot of ice, by the time I could feel it the real shock had worn off. The doc had explained to me that’s the biggest advancement in this surgery the past 10 years-the nerve block to get you over the hump of days 1-2.

I’m sitting here this morning icing up after a rough night’s sleep...I was on my feet too much yesterday. I’m getting flexion back and started doing squats and other light exercises and didnt count on how much that wakes up the injury. I’m feeling ok now, so I guess I overdid it just a little.

DJL, yes mine was scheduled for March 18th but then we had an unscheduled pandemic...so much for skiing this year. Either way, it’s a day at a time for now.
 
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Surf&ski

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Lovetocookandsew, thank you for the advice. I’ve been icing quite a bit and you’re right-it makes all the difference. I need to get the discipline to get out of bed when the pain wakes me up and change ice packs. Last night I was just a bit too lazy-and now I’m tired from lack of sleep.

You’re spot on also-I need to be careful not to overdo it. I live in a surf town and the thought of missing the hurricane season swell is driving me a bit nuts...what keeps me going is that already (12 days post-) I can tell it’s going to add many years to my active life so I need to be patient for now.
 
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Surf&ski

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Here's something I read about but hadn't really experienced yet..fatigue. I am getting stronger and more flexible but I run out of gas pretty quickly. My body is in overdrive getting the repairs done I guess.
 

allin1

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I was hurting pretty badly...there wasn't much downside in my eyes. How close do you think you are to 100%?
Not sure if this was pointed at me. It's a good question, I would estimate I'm somewhere between 85 and 90%. I have less pain that I did before, but sometimes after a bike ride it gets sore. Once that stops I'll call it a 100%.
 

kneeper

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Here's something I read about but hadn't really experienced yet..fatigue. I am getting stronger and more flexible but I run out of gas pretty quickly. My body is in overdrive getting the repairs done I guess.
Very true. You have permission to rest and let your body heal. So many people are used to being "on the go" and find it hard to take a nap or rest when needed. :zzz:
 
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Surf&ski

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Update:
staples out Tuesday, the nurse had my Freshman Nursing major daughter do the honors. Fun for the whole family!
I'm almost at 0 extension and about 100deg flexion...taking the advice of this board, I'm not pushing it. I have started walking the neighborhood which is a bit hilly; it's like training for taking stairs! Also got on the bike today at PT. 7 minutes at a mid-resistance. It felt good to breathe again, but was a little uncomfortable. All in all, it's been a pretty good recovery. I just have to be careful to not overdo it and end up not sleeping due to swelling and pain.

Allin1, yes, that was for you. I'm looking forward to getting on the bike again; glad to hear you're doing so well!
 

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