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[TKR] IronGirl6’s Recovery<<

Discussion in 'Knee Replacement Recovery Area' started by IronGirl6, Nov 7, 2018.

  1. IronGirl6

    IronGirl6 member
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    Hi Everyone,

    Boy my nerves almost had me disappear to Italy rather that actually go through with this... but my husband, Doctor, and physician’s assistant held my hands and got me through this. Surgery was 6:30am on 11/6, now it’s 3:45am 11/7. I’ve walked 4 times, put a fair amount of weight on it whilst standing to wash my hands & brush my teeth, and i am doing ankle pumps (the stretch feels oh so good) and attempted 2 knee slides (2”). The physical therapist may be shocked when I meet them?

    The one thing I can tell you is that I was in so much pain before, that fresh out of surgery with pain meds has less ache of how I felt just sitting around with no pain meds before. From what I hear the next few days may be the “hazing week” as far as pain is concerned, but knowing there’s an END DATE to pain and disability is really exciting. I’ve had a bad knee 16 years from sports, last 10 debilitating from meniscus removals... and 7 years of doctors telling me I was too young for a TKR. Now, this cyborg is ready to work!

    Thanks to the folks who gave me support here too.

    I opted for general anesthesia with regional nerve block rather than the spinal. Have a Stryker Triathlon installed by phenomenal sports medicine surgeon via robotic Mako table. I’ll add more details after I see this hero during his rounds today.

    Blessings to all the other November Nimbles!
     
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  2. Roy Gardiner

    Roy Gardiner FORUM ADVISOR Forum Advisor

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    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

    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.
     
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  3. CorgiLover

    CorgiLover new member

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    @IronGirl6 Glad to hear that surgery went well. :yes!: At the rate you're going, I bet they release you today. I'm up to bat for my new knee tomorrow (yeah me!) and soo ready to be on the healing side of pain. If you don't mind me asking, what made you opt for general anesthesia versus spinal? I had L4-L5 lumbar fusion with hardware back in 2011 and have this gut feeling that the anesthesiologist will recommend general even though I don't do well with the side effects coming out (shakes, chills, nausea and vomiting). I will admit though, in past surgeries, the surgical teams have been really good in trying to circumvent my side effects. We'll see what tomorrow brings!:)
     
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  4. SusieShoes

    SusieShoes FORUM ADVISOR Forum Advisor

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    Sounds like you're doing great! Sometimes those of us who find the post-op pain not too bad do manage to surprise therapists and nurses. It's fun to do. :) Just enjoy your new knee and see where it takes you.

    It's true the pain will, often, be worse after the nerve block from surgery wears off. You're prepared for that, though! Just keep on your pain med schedule and you'll move along through the first week(s) until you start getting to the "better every day (or week)" phase.
     
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  5. IronGirl6

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    I opted for general because A I do very well with it, and B I had disturbing visions of waking up on the table in nightmares. Happened to me eons ago in an elective plastic surgery and was awful, but nowhere near the same procedure level. The anesthesiologist and I spoke, and she said with my anxiety it would be best. Also that the diff in post op pain would be one point different, not five. They still did the regional block too, and so far so great.

    Sleeping off and on this am post PT - she was great and showed me 3 little exercises to do if tolerated and we walked and talked. I was able to take hands off the walker and put my substantial weight on the knee fully. Not straight yet but that will come over time and relaxation as the inflammation calms down.

    So while I was terrified, I’m sure happy I did this. Doc said I was really bad off in there. Can’t wait to ride my bike / elliptical / walk long distances without pain!!!! I know it’ll take a while, but now I know I’ll get there!


     
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  6. JJ65

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    Glad to hear your surgery went well and you are doing so great. Here is to quick healing for you. Enjoy and stay on the pain med schedule. Glad you are on this site, it is good and people have great info.
     
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  7. IronGirl6

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    Question for the experienced - just got home late last night after one day in hospital: Any Tips for sleeping comfortably? In my usually very comfy bed, knee is kinda screening even w game ready on. Getting a recliner tomorrow - thinking I might wind up sleeping in that instead. The hospital bed was so much better... so was the nerve block before it wore off. Yikes. Anyhow any advice would be a Godsend. Thanks so much.
     
  8. Softtail

    Softtail senior

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    Iron girl, you will get any number of suggestions about sleeping , and what to sleep on, but your bed will probably not be the most likely winner. I wanted to keep my leg elevated and I found that very difficult to do in bed. I wedged myself into my couch putting my foot and leg up on the lounge doctor with that leg braced against the back of the couch so it couldn’t drop off the support and that is a no-no early on. Others swear by their recliner. I don’t have one ,but at 6 ft. 3 inches tall ,I don’t think I could use one and get my leg elevated correctly.

    I don’t know how many actually worried about elevating their leg while trying to sleep, but I wanted to keep mine elevated as much as possible to get the swelling down ,so that worked for me. I am sure you will get some other ideas, and then pick the one that works best for you. Get sleep anyway you can cause early on it can be tough to get more than 2 or3 hours at a time for most.
     
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  9. Lefty57

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    Good luck with sleep, I have tried numerous ideas, most I get is about 2 hours at a time,, I usually sleep in my recliner.
     
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  10. IronGirl6

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    We are actually getting a dual recliner loveseat today delivered - nice w console so we will have home thester seating when is all done. Thanks y’all!! Oh and I’m 6’1, but this particular loveseat recliner from Ashley seemed to fit me fine.
     
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  11. beachy

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    I bought a recliner before surgery. After reading the library article here about the right kind. I made sure it has the right angles and It's electric. No struggling with the side handle. It has been a godsend. I am so comfy in it in the living room with the tv and my nest all around me.

    I elevate and ice and sleep all night in it.
    I knew hubs needed his sleep and I would wake him and vice versa. The bed hasn't been comfy for me. I might try soon, but my recliner is the best for now.
     
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  12. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    I slept when I could between the bed and the recliner. A couple of hours in bed, then a couple of hours in the recliner. This went on for weeks. I would nap off and on in the 24 hours. It doesn't matter when you sleep as long as you sleep! Get it when you can! I also iced and elevated the whole time I was sitting or laying down. This helps a lot with reducing the pain and swelling.
     
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  13. Softtail

    Softtail senior

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    Yep what sistersinhim said .
     
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  14. IronGirl6

    IronGirl6 member
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    Another question that I’m sure is entirely premature - how long did it take you guys to get to straight enough to walk evenly? I can lay with it semi straight, but when I get up it’s hard (I’m 2 days out so I don’t expect this yet). Just curious. I know not to force it. Spent an hour in my CPM today, very mild settings so it felt fine, icing w my game ready diligently.
     
  15. Softtail

    Softtail senior

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    Walking correctly heel to toe can take weeks depending on your flexion and extension. Trying to straighten your leg out probably feels tight on bottom of knee, so this restricts your stride . You will need to get to at least 90 degree flexion also and probably further to get a sense you are walking correctly. Someone may be able to give you more accurate description, but I know that’s how it worked for me
     
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  16. SusieShoes

    SusieShoes FORUM ADVISOR Forum Advisor

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    Glad you're not expecting too much yet! The first couple weeks are best approached with low expectations. That way you can be pleasantly surprised by all the little victories.

    How quickly extension and flexion return to more "normal" ranges is so diverse and individual there are no guidelines for when it "should" happen. Surgeons and PTs like to state ranges. It's what they do. In truth, you might wake up tomorrow and find that you can walk quite well. It all depends on your knee's individual healing.

    I had both knees done, and the right knee was practically perfect right out of the gate. Straight, good flexion, and less pain. The left knee wasn't as straight, had slightly worse flexion, and had more pain. It took a few months, in my left knee's case, to get completely straight.

    That's not to say I couldn't walk evenly, though. Daily walks with focus on a good stride helped. After a while I started taking longer walks. Walking is a great knee exercise. It strengthens and balances all the muscles around the knee. It's these muscles, as much or more than the implant, that stabilize the knee and give a good stride. As you recover and use your knee more, that stability and even stride will become your norm. :friends:
     
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  17. IronGirl6

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    Well I had my first interaction with an in home PT Doing an Intake to set me up w a therapist. I drew my lines in the sand regarding force and felt like I was treated like an idiot rather than a healing athlete. Tried to do some stretches in flexion and extension, kept thinking it was the compression wrap keeping me from moving, but it’s just how swollen I am. My surgery was Tuesday, I don’t want to let scar tissue increase but after reading things here I also don’t want to push myself back into excruciating pain like I’ve had during injuries. Sigh.
     
  18. Softtail

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    Give yourself a break girl. It’s new , it’s swollen and everything hurts. It’s supposed too. Any flexion ,like gentle heel slides and straightening your leg this early on are fine. It probably feels so tight ,you wonder if it will ever go down and bend. It will guaranteed. As an athlete , believe me , I know how antsy you are. I remember how swollen and black and blue I was first week. My wife thought there was something wrong, and wanted me to call doctor. I read on bonesmart that it was normal, so I just waited and it all went away. Just not in the first few weeks. My extension was 8, my flexion was 75 or so first week. Couldn’t stand long enough to brush my teeth, and sitting hurt like hell. Fast forward to 9 weeks out . Flexion 130, extension 0. Played 3 games of pickleball, and golfed 9 holes of golf at week 8. Can sit and walk normally, and stand long enough to brush my teeth lol.

    Point being ,I know how being athletic before surgery makes you worry that you won’t get it back, because of how you feel now. You will. Being an athlete, I am used to working out, so I took the approach of pretty aggressive PT. I did it on my terms, where I was very specific, no pain just discomfort, and it worked for me. Others here have been just as successful ,doing no PT. You will have to choose which route you want to try. Do not know what your goals are post healing, but unless you are a marathoner, or extreme sports nut, then you will be fine. You may not get to where I am at 9 weeks, then again you may get farther along. You will heal at your own rate, and you will heal. I was practically a cripple pre surgery, couldn’t support my weight with left leg going up stairs. At 8 days post, our freezer alarm went off in basement, so I scooted down stairs. While down there, phone rang upstairs. Without thinking I started up stairs normally and voila I was actually able to take a step with my left leg. It blew my mind. Okay this is getting long winded, so just know it gets better, just not as fast as us athletes think should.
     
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  19. IronGirl6

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    Thank you for your message! I feel so confused - I don’t intend to go back to competing / heavy lifting / heavy impact anything - but I do want to climb stairs / walk in hills / do cardio and pilates and light maintenance gym stuff. I’m so swollen today it was hard to believe there isn’t some knee wrap in my way when I move! Trying to get my heel slid toward the chair to achieve 90 degreees nearly made me hurl. I can do leg raises and stand to brush teeth etc, but my rom is limited by the swelling.

    I’d like to be somewhat aggressive with PT, but also focus on the therapeutic parts since I’m good at the other stuff. Today I don’t think I could tell the line between discomfort and pain - and it hurts more to walk after this PT came along and made me feel like a wuss for wanting to be careful. I’m sure I’m this guys youngest TKR patient, but pushing boundaries is how I GOT the bad knee in the first place. So, I want to get some good work in and improve w these visits, but not at the demise of my sanity, or pushing pain on a joint that already feels blown up like a balloon...


     
  20. Softtail

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    When you indicate PT is it in home PT ? I had in home PT up till my first out patient PT on October 4.
    The in home PT for three weeks consisted of extension exercises, flexion , and leg lifts, and if you were to read my thread you would find I started at 75 , and knee was tight as a drum. I would try and flex a little on and off during day , each day, and slowly it crept up. If what you are doing hurts , I just gotta believe you are looking for too much too soon. Don’t get depressed , and look for minor positives each day , but don’t be surprised if one day your knee feels good and next day it diesn’t. Par for the course. Two steps forward one back.
     
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