Bilateral TKR I'm on the other side and looking for the handshake.

[kneeper]

Sounds like you're doing great! I know what you mean about turning over. I am so happy that I'm more and more able to do that and even sleep on my side for a short while now. You'll get there too.

 

[Big Tuna]

Eight days post-op and this AM my swelling is up and my ROM is down. PT has not been difficult and
I don't feel we are over doing it but how much swelling is normal often one week. I'm having a hard time getting my ROM to 90. Pain management is good, I just can't get the bend.

 

[referee54]

Eight days post-op and this AM my swelling is up and my ROM is down

Do not worry---this gig called recovery is somewhat like a roller coaster---ups and downs. These things happen---and don't try to figure out why---I could never pinpoint anything---it is all part of the game.

I'm having a hard time getting my ROM to 90.

You are are just at eight days---take it easy and be patient---there is a loooooong way to go yet, and recovery is not linear---it looks more like this:

There are peaks, valleys, and plateaus during this recovery---so just be patient and be gentle---ice, elevate, and rest, and understand that you will get to your destination of being fully recovered.

 

[Big Tuna]

I haven't been posting a lot but I am at the three week post-op mark. Everything has been going better than I expected. I did spend one week in rehab but got bored and informed them
I was checking out at the end of one week. It was a nice place with a private hotel style room, a staff that constantly asked if there was anything I needed, and meds that arrived on time. I just wanted to go home and back to leading a normal life. So at two weeks post-op I was at home mowing my lawn and cooking dinner for my wife. They gave me a walker when I checked out of rehab but the only thing I've used it for is hanging my laundry on. I did start going to PT three times a week and that has left me a little sore. They get me warmed up with 10min on a stationary bike followed by a number of exercises to improve ROM. Last Friday he wanted me to stand up from a regular chair with out using my hands to push me up. I don't think I've done that in the last three years! The first time I tried it the pain was almost unbearable. He raised the seat height about 4inches and asked me to try again. I did make it the second time but with a lot of pain and declined his instructions of doing ten more reps. Does anyone know how soon after a BTKR a person should be able to do this? I'm also trying to cut back on my meds. I have been taking two Hydrocodone(Norcos) every six hours but they make me sleepy at odd times of the day. I'm trying to only take two Tylenol (650mg) and one Tramadol every 8 hours and only subbing the Norcos before PT. I hope this works out for now but I can't wait to get off the Tylenol as well because I really miss having a few drinks with dinner when going out with friends on these warm summer nights.

 

[Pumpkin]

Does anyone know how soon after a BTKR a person should be able to do this?

Everyone is different, with the pain you are having, I would say not yet for you.
You are still very early and need to take it easy, and do not do anything that hurts.
@JustJeff when did you stand up with out pain?

Here is a link to all the recommended reading, the articles are short and won't take much time. TKR recovery article compilation

 

[Josephine]

So at two weeks post-op I was at home mowing my lawn and cooking dinner for my wife.

Not good! Sadly no-one left you the recovery articles so you'll not be up to speed on activities. But you should not be doing anything like this for the first few weeks! Progression of activity for TKRs

Last Friday he wanted me to stand up from a regular chair with out using my hands to push me up. I did make it the second time but with a lot of pain and declined his instructions of doing ten more reps.

Very wise of you! Keep that up and you will do fine. Do read the mantra below

I'm also trying to cut back on my meds. I have been taking two Hydrocodone(Norcos) every six hours but they make me sleepy at odd times of the day. I'm trying to only take two Tylenol (650mg) and one Tramadol every 8 hours and only subbing the Norcos before PT.

Please note this - you cannot do this recovery without adequate pain meds. You must take them as prescribed to enable you to progress. If you don't the swelling and stiffness will get worse and next thing you know, you'll be fretting that your ROM isn't improving! Read the articles, specially the first four which deal with this. This is so important, I cannot emphasise it enough.

As for the meds making you sleepy, there is a reason for this: because it makes you rest a lot and stop doing crazy things like mowing the lawn! So take your meds, as prescribed, and just go with the flow. This was not only major surgery you had, it was DOUBLE major surgery, so you need to take it slowly and follow the mantra to the letter!


First are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

Next is a FAQ (Frequently Asked Questions) thread.

And here are some very crucial articles
The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Activity progression for TKRs

Healing: how long does it take?
Chart representation of TKR recovery
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling

Home physio (PT) and activity progress: suggestions
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

And then some wise words from members who have shared their experiences ...
Where are you in recovery?? (TKR)
Five “P’s” of knee recovery
TKR: work “smarter” and not “harder”
Recovering a knee - from one who knows!
It's never too late to get more ROM!
It's worth the wait for ROM

 

[Big Tuna]

Thank you Josephine for taking the time to read my post and offer your always helpful advice. I don't know how you find the time to help so many people on this web site. Thank you for sending the links to all those helpful articles. However over the last 5 months I've taken the time to read a lot in preparation of my knee replacement and I'm a big believer in that everyone heals differently. I've been lucky to have a very easy recovery. This is my 4th week post-op and I've been almost pain free from day 1. I'm still mowing the lawn every week, going on shopping trips, PT three times a week, and last Sunday I went on a 3 to 4 mile walk. What a joy to walk that distance without any knee pain. I haven't been able to do that in years. ROM last week was 0- 118 in both knees. I will admit to being a little sore Monday after the walk and PT but feel great today. Found the time to spend about 30 min spinning on my bike.

 

[kneeper]

Well, you seem to be the exception. I hope things continue to go well for you. Don't forget to listen to your body and rest when you need to.

 

[Lu.winslow]

Wow your progress is amazing! But mowing the lawn! That's just showing off! LOL, I also had a Bialateral TKR and have to agree with the pain med's I just take them in anticipation of pain in therapy. Today is day 7', been in rehab 3 days, I did not get out of bed till day 5, I kept passing out! You have a positive attitude. It sure is nice to read your posts! I also agree that rehab is "drooling old people", but I know I need more strength ! Please keep posting and know you have a follower! Thanks

 

[Big Tuna]

In honor of being seven weeks post-op I went on a 25 mile bike ride last Sunday and now I feeling pain in my knee cap area when I stand-up or walk up and down stairs. It's funny that during PT I can still do sets of 120lbs for each leg on the leg press without any pain or discomfort. I guess my quads are not what I hurt. I hope this improves soon. I have to be back at work full time the week after next with a full week of teacher meetings. Rehab had been going really well until last Monday and I did'nt think the bike ride was pushing it too much. I may have to re-think my plans to ride into Chicago from the Northshore suburbs on Friday to watch them practice for the weekend air show.

 

[Jamie]

Big Tuna, my friend......you have overdone it!!! Yes, a 25 minute bike ride at 2 months is too much for those tender knees. Actually, you aren't doing yourself any favors by using that leg press with weights this early either. Machines can be hard on the soft tissues around the knee cap and we usually don't recommend folks use them until at least 6 months out.

Hope you do rethink your plans for another ride tomorrow. I'm going to tag @referee54 who is another BTKRer and bike rider. He can tell you about his recovery.

 

[referee54]

In honor of being seven weeks post-op I went on a 25 mile bike ride last Sunday

Uh Oh! You have done too much, too soon. I did not get on a bike--- a real bike---until the weather broke in April---I had my BTKR in November of the preceding year.

It is difficult to compare the sets done in a weight-training exercise to that of cycling---but think of how many revolutions that your knees made over that 25-mile ride. You have. most likely, used your quads, hamstrings and the surrounding soft tissue way too much---and that soft tissue, at this stage, is easily inflamed.

I would ice, elevate, and rest excessively.

Think about it---25 miles is probably close to two hours of riding time, and think of the fact that you were not able to maintain the constant pressure on the pedals as you can on an exercise bike---you probably pushed really hard in spots.

After things settle down, I would stick to the exercise bike unit at least October---give yourself at least 12 weeks to relax---perhaps sixteen weeks would be better. Then, go gently for six-eight miles at an easy pace without hills or inclines---see how that feels, and then increase things ever so slightly each time.

It is better to take things a little too slowly than to go too fast.

Do not worry, though---I just finished getting 120 miles in this week. Down the road, a 25-mile ride will be a piece of cake.

I may have to re-think my plans to ride into Chicago from the Northshore suburbs on Friday to watch them practice for the weekend air show.

I would can that idea at this time---remember, riding a real bike and accelerating and handling even the slightest inclines is way more different than riding an exercise bicycle.

 

[Big Tuna]

Hi @Jamie,@referee54

Thanks for your helpful advice because I have to admit I'm not good at always doing the right thing. After my Sunday ride and PT on Monday my knees were telling me I over did it. My recovery really has been easy and I did not think at the time that the ride was pushing it too much. That was not my first ride having done several at shorter distances.

Had my final PT last Friday along with my final ROM measurement. After being sore all week I would have bet money that I would be below 115 degrees. I was shocked when he said I was 0/128 on both knees. I would have been happy at 115. I felt so good about things that I decided to go to the lake front beach to meet my wife and watch this weekend air show practice. You get to see the whole show without the weekend crowds. In Chicago the Lake Michigan shore is almost all parks and beaches. It's one of the good things about this town. However there is little parking that doesn't cost an arm and a leg. So I once again rode my bike to the beach. I had the bike in the car after PT and used good judgement by parking only 4 miles away. A short 20 min ride.

At the end of the day I was sure I was going to have a bad night. Like many of you I haven't been able to sleep over an hour or two without waking up. I would sell my soul for a good nights sleep. I have not taken any of my Hydrocodone in the last 3 or 4 weeks but took 2 last night and had the best nights sleep that I've had in the last 8 weeks. I felt great this morning! I would do it again tonight but I don't want to become dependent on meds to fall asleep.

I think I've had an easy rehab because my knees were my only medical problems. I've have strong legs from 30+ years of bike riding and working as a scuba diving instructor and I didn't wait until my knees were really bad. During one of my first meetings with my OS he told me I could but this off with pain meds and knee gel injections. I did get one gel injection in my knees and I felt it made things worse. 4 months after being told I was bone-on-bone I asked for the store bought knees. Operation time was under 90 min for each leg and I lost less then half a pint of blood. Having a good OS and not waiting to long might be a trick for easy recovery.

 

[Big Tuna]

Almost 13 weeks post-op and everything was going great. I went back to work three weeks ago, teaching high school math and my knees feel like I'm back at week 7. We are short staffed and almost the whole department is teaching extra classes which means I'm on my feet 6 to 7 hours a day. The soreness is not as bad as before the operation and it's not the knee that's sore but things around my knee. I can deal with a longer recovery but I hope I'm not doing any soft tissue damage that's going to stick with me forever.

 

[Jamie]

This kind of pain would be expected if you are trying to stand 6-7 hours a day at this point in your recovery. There is a risk of developing chronic pain problems if you push and push yourself. But most likely, you will just increase the time it's going to take your body to heal. Can you make some adjustments to help your knees for the next critical months? Like maybe taking some time to ice and elevate in the teacher's lounge during the day? Or getting a stool to sit on instead of standing? Or having students or aids run errands in the building for you? Or getting a parking place close to the door nearest your classroom? Your body is still healing and you need to treat it with care!

I also suggest that you take Extra Strength Tylenol for the pain on a set schedule. You need a 1000mg dose each time you take it, at least 4 hours apart, with a total of no more than 4000mg in 24 hours. Be sure to count any other meds you might take with acetaminophen (cold or sinus medication primarily) in that 4000mg total.

When you get home, be sure to ice and elevate for as much as you can throughout the evening. It would also be a good idea to ice while sleeping if you can.

If you make some of these adjustments and still experience the kind of pain you are talking about, you may need to make changes to your teaching schedule. You really do not want to allow your body to be in this constant state of irritation and pain.

 

[VancouverUSAgal]

Please be careful. I was going along great until I developed pes anserine tendinitis/bursitis in one knee (other is great) and 2 months later I am still having a lot of pain when I put weight on that leg. You may not have a choice but if you do I'd advise taking it a little easier. Granted my knees were really bad by the time I had surgery so that may be part of it. Just take it as easy as you can.

 

[kneeper]

See if you can get a stool. I use one--at least part of the time. It helps a bit.

 

[Shmi47]

You sound like the lady in rehab I am jealous of. Just kidding. Sounds like you are really off to a great start. I totally relate to rehab. The one thing keeping me here (besides having two crazy young boys, 9 month old puppy, and a stressed out do it all Dad) is that I get the PT/OT 3x during the day. I am lucky if insurance will give me 2x per week. So I keep weighing pros and cons. congrats and keep up the good work.

 

[Big Tuna]

Hi @Jamie,@Shmi47
Busy day for me yesterday. Open house at school for parents to come and meet their children's teacher. That made for a 14 hour day for me at work and my knees were not happy. I'm trying to spend more time off my feet but with 30 students in each of my 6 classes and all looking for some personal attention, I'm not worried about wearing out the back of my pants. My one and only prep time during the day is spent talking to counselors about problem students, dealing with other projects, paper work, and generally running around the building. No such thing as a teachers aid. It's not all as bad as it may sound but sometimes it's a long day. I do need to remember to take some meds. I normally take 3 - 200mg ibuprofen after I get up and then forget the rest of the day. So maybe I really have nothing to complain about. It's my own fault. I would like to know if anyone is off all pain killers after 3 months, even over the counter meds.

 

[Jamie]

Take a look at that ibuprofen bottle....I'm betting it says the maximum dose should be 2 tablets not 3. When you put that much ibuprofen in your tummy at one time, you're risking stomach problems. Besides, the pills only last 4-6 hours no matter how many you take. A better plan would be to take 1000mg of Tylenol (2 extra strength tablets) every 4-6 hours with no more than 4000mg in 24 hours. Of course, you must count any other products with acetaminophen like cold a sinus meds in that 4000mg total.

If you don't try that, maybe switch to Aleve and take 1 tablet in the morning. They are slow release and last 12 hours.