TKR izzy's new knee-post op

[izzy]

Oh anyone have a theory about using a pillow under your knee or ankle? The PT did not advise it? any thoughts?

 

[rightsidelimper]

Take it easy izzy my pt guy didn't show either. Just more sleep time

 

[NightQuilter]

Hi Izzy - just found your thread. So sorry you hit that wall - it can be so frustrating when things have been going smoothly. As many here will tell you, our knees recover on their schedule, not ours. And sometimes it is two steps forward, one step back. You probably did something that just tweaked your knee a tad too much, which set it off. It will get back to normal ... your "new normal."

On the pillow thing, I had a wedge for a bit under the knee and ankle, to keep things elevated at night - back slept for some time. When I started sleeping on my side, a pillow between the knees, which I still generally do, 4 years later! Good luck and keep working with the BoneSmart mantra - ice, elevation, and keeping on schedule with the meds.

 

[tiptonits]

@izzy : I had my tkr on 11/1 and i did not swell much at all until like Sunday the 6th or even monday. I thought it was just me - but I guess not. and you are doing all the right stuff - icing and reclining and staying out of pain. Even if the pt guy comes back - you are not going to feel like doing a lot - at least I did not. The nice thing about the lateness of my swelling is that it is going down quickly now, but I am having some new pains from my PT - he is wanting to get me to 90 by my doctor's appt which is Friday. I told him today that it was not a big deal to me and he tried hard to convince me to push harder - but I am not doing something that hurts this knee. We will see how Wednesday goes. These will be some tougher days so do what these Bone Smart people say and ice, gentle stretching and not much else. Your knee will love you for it. ~~Lee

 

[newlybionic]

Here's how you should elevate your knee to get the swelling down. Ice it at thhe same time.

 

[izzy]

One week post op. Ups and downs, mostly to the positive side. I know that we talk about pain meds a lot! My ortho gives me 30 pills at a time. I take 8 in a 24 hour period. 1 every 4 hours during the day, 2 at night(11pm and 3pm), so I'm getting almost 4 days out of one refill. The crazy part is I am almost embarrassed to keep asking for a refill. By Friday, I'll have to get another script for another refill. My dr. appointment isn't till next week and while I know I certainly won't be pain free before talking to him, I am having a hard time asking for more. Why do we feel so bad about asking? Is there anything over the counter I can safely take inbetween to make my Norco script last longer? Maybe I'm just being totally naive about taking the pain meds! Does anyone else deal with these thoughts?
On the funny side, I asked my PT yesterday to write down all the exercises I need to be doing to make sure I don't forget anything....his response, nope, no writing them down, I only want you to do the ones you can remember....ME: I can't remember half of them!, His response: just do those! I thought that was funny. His approach is RELAX and stop worrying! Thanks for letting me ramble on.....

 

[KarriB]

I like your PT! When I went to a different PT group after the infection surgery they didn't give me any exercises to do at home. I did have some to do right after TKR surgery, but mostly stretches and heel slides.

We are made to feel bad about meds because we have to jump through hoops to get them, not because we want them, but because we need them. When my next surgery is scheduled (gulp) pain management will be on the top of my discussion list. Opioid distribution has changed in PA state since my TKR, making things difficult.

 

[referee54]

am having a hard time asking for more. Why do we feel so bad about asking?

I think that there are multiple reasons for this---the addiction factor---which is very, very negligible, the "law" and the "hoops" that we have to jump through to get them to ensure the safety of ourselves and of "society." We have read so much about the pain medication issues in society (Southern Ohio is horrible) that we forget that we are taking these pain meds for legitimate reasons. I guess we may delevelop a guilty feeling for need ing them. I, myself, was worried about taking them, and my OS put me at ease about them.

I asked my PT yesterday to write down all the exercises I need to be doing to make sure I don't forget anything....his response, nope, no writing them down, I only want you to do the ones you can remember....ME: I can't remember half of them!, His response: just do those! I thought that was funny. His approach is RELAX and stop worrying! Thanks for letting me ramble on.....

It is important to understand that recovery is something that simply happens---it is not something that you have to work at. Your PT "gets it"----it is not what you have to do that matters---it is all about taking things slowly, gently, and easily and develop the patience needed. Relax---you will be fine and you will reach that destination of being fully recovered! Your recovery will not be slowed down by the exercises you do not do---nor will it be sped up by doing more exercises.

 

[ks1960]

Izzy - you are doing great, you are not going to be a pain pill addict, and you can continue to be your own best advocate to your dr and physical therapist. My worst days were 5 - 11, and I shifted between thinking I was going to die from the pain, and wishing I would. I cried, and yelled, and was generally miserable. So you may be smack dab in the middle of your darkest hours, and I promise you: it will get better!!

At day 16, I finally have pain under control at 5 mg Percocet every 6 hours, and asked my dr, if I could step down because as much as I want out of the pain, I hate how the narcotics make me feel . You are going to feel like a real person again soon, hang in there!!!

 

[Dancing Fool]

I hope you won't feel bad about asking for whatever pain meds you need; you're being given a really limited amount at a time. I'm taking far more than you are, and it's what my OS typically prescribes. I take 1 oxycodone every 3 hours (2 at night), 2 tramadol every 6 hours, 2 acetaminophen every 6 hours and Celebrex every 12 hours. I'm sure I wouldn't be at all comfortable with what you're taking; can't imagine cutting back.

On another subject, would you share what exercises your PT has you doing (that you can remember)? I'm just curious since you said he doesn't push you. I've opted out of home PT due to a bad experience in the hospital with my last knee replacement. I'm not comfortable with no exercises, but definitely learned from this site to not do anything that's painful.

 

[izzy]

Thanks for the support. After PT today, decided that cutting back on pain pills is not an option! My skin is so sensitive due to the staples and incision ....working makes it burn! ouch....Dancing Fool.....Here are the excercises that i can remember...ankle pumps, moving each leg back and forth( windshield wiper motion)actually my hubby puts his hand under my heel to help with this motion, bum squeezes, pressing knee down to a count of five, gently...sitting on my bed, with bend at knee, he holds my leg by ankle (ony for support) and I just kind of let the leg dangle,,,gravity does the work, then i push back toward the bed a few times to get a ROM, currently at 70.....thats all I can remember. I am still using a walker and need some assistance getting up out of my recliner. Why is 90 the magic number and why does it have to be achieved in such a short time??

 

[newlybionic]

Most OS are looking for approximately 90 degree flexion at 6 weeks so you still have a lot of time to gain more. Getting enough pain medication is getting harder and harder as fewer pills are being dispensed at one
time. After my revision one of my daughters had to take a half day off of work to go get the script for more for me. I had initially about a week's worth and the OS was an hour away from me. He had no problems writing a new script when needed.

 

[Celle]

Why is 90 the magic number and why does it have to be achieved in such a short time??

Once you reach 90 degrees, almost all surgeons are happy that you will not need a manipulation to help your knee bend. It's only a number, though, and really there's very little difference between 85 and 95 degrees.

You don't have to achieve 90 degrees in such a short time. My surgeon didn't expect it until about 6 weeks post-op.
Somehow, some PTs get the idea that the faster you increase the number of degrees, the better their ministrations have been. It's like a pass mark in an exam for some of them.

They're quite wrong, of course. There's no need to rush to get ROM, because it can continue to increase for a year, or even longer after a TKR.
Myth busting: the "window of opportunity" in TKR
[URL='https://bonesmart.org/forum/threads/rom-its-worth-the-wait-for-rom.10703/']ROM: it's worth the wait for ROM
ROM: it's never too late to get more ROM![/URL]

 

[KarriB]

I'm glad you decided not to cut back, it's probably far too early in your recovery for that. I found that by weeks 3 or 4 I had begun to forget doses and just cut back naturally.

 

[Dancing Fool]

Thanks for the info on your exercises; that's pretty much the same things I've been doing. I was given a booklet of exercises at the hospital and I've been doing the first few, not all of them. Now, if the swelling would go down . . .

 

[zzevi]

When I mentioned at one of my early appt's with p/t that I wasn't doing all the prescribed exercises on their part, they wrote in my medical notes that I was uncompliant. The fact of the matter was I did do the exercises daily once, usually no more than that, and some I did skip over a day here or there, but did always do what was asked some. In the end I can't say it was beneficial as I stalled out for a time with my ROM, when reading over my medical notes, I was a bit ticked to see that written as for the most part on my end I did everything that was asked. The harder I pushed myself, because of their asking, the longer everything took to get there. Guess what I am getting at, do what your comfortable doing, don't let them push you. I hate to lie about anything, but I hated seeing the words that I was uncompliant, think it just goes to show a lack of understanding on the p/t end of things.

 

[Jamie]

Ok, PT was here. First thing he said was we do not work thru pain. If it hurts we stop. We want those muscles to relax not tighten up. So if your foot touches the ground it's going to tighten up, remember to relax, relax, relax. Pretty good start to the day! He's has been at this for 30 years and he pretty much said the same thing the Bone Smart forum recommends. Made my day Oh and my ROM will get here when it gets here--happy words!

This makes our day too!!! Hooray for the great therapists out there!

 

[izzy]

Staples out today, ROM at 100, knee looks really good. Using a cane now and I see the light at the end of the tunnel. I'm still resting, elevating and icing and plan on taking it easy for a few weeks longer....gradually increasing my activity level. Still have PT for 3 weeks.....this knee thing is an intense journey, but well worth it to get my life back. This is an exceptional site for encouragement and support. The advice is spot on! Thanks to all who have offered encouragement....the journey continues.....

 

[KarriB]

Just an FYI since you mentioned upping activity. Even though I didn't know about BoneSmart during my recovery, looking back I followed the chart very closely. It is a great resource in my opinion.

https://bonesmart.org/forum/threads/activity-progression-for-tkrs.14334/

 

[newlybionic]

You're ROM is great! You are doing very well and I hope that you continue to progress well during your recovery.