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TKR JamesN’s recovery

For some reason I did not qualify for home PT, so, surgery was Monday, I went home Tuesday evening, and had to go to outpatient PT at 1 pm on Wednesday. :doh:I went because I didn’t know any better. I do now. Next time I’ll do my own without the “help” of a therapist. Some of the PT I did set me back 2 and 3 days.
 
Yikes, the jumping jacks comment made me wince.

My OS is very good and I really like him but that group really discourages the use of ice machines. Apparently the philosophy is that it's better to get up and get moving than to stay on the ice machine which is a little strange for a variety of reasons. I envy everyone here who gets sent home with one - but it is interesting how each OS approaches these things so differently.

Had 35 staples removed yesterday and it wasn't as bad as expected. It's a relief to have them gone.
 
@JamesN,

To give you some additional perspective, I went home the day after surgery with a cooling machine that I used for two weeks. No PT of any kind until after my first follow up 2 weeks post. Only had a few home exercises (heel slides, etc) that I was to do. During my first f/u, my OS confirmed my swelling was down to a point where I was able to bend and move my knee within an acceptable range (no idea what that was as he didn’t measure). Was placed on outpatient PT, 3 x a week for 4 weeks. During my f/u I spoke with my OS about my concerns with forcing my knee to bend and he was emphatic NO! His focus for PT was to simply work on swelling reduction and flexibility without forcing anything. At my first PT session, I had the same discussion with my assigned therapist. Once I was assured we were all in agreement we proceeded. My pt focused on minor exercises that tested my knee flexibility and strength. When my knee said “not yet”, we stopped and did something else. In the end, my pt said that I progressed through the program and achieved better results than any of his other patients. He also said that was typical for patients who had the same OS as I did. Proved to me that the BS approach works, especially when you have an OS who is supportive.

Regarding pain meds, I didn’t completely get off mine until around week 7 or 8. Wasn’t taking them all the time, but when needed. Haven’t taken any since week 9 and I’m now at week 15. Still take Tylenol and Aleve when needed though. Listen to your knee and you’ll know when you are ready to cut back and stop.
 
Laurenkate said:
Yikes, the jumping jacks comment made me wince.

My OS is very good and I really like him but that group really discourages the use of ice machines. Apparently the philosophy is that it's better to get up and get moving than to stay on the ice machine which is a little strange for a variety of reasons. .
Click to expand...

I assumed the jumping jacks comment was in jest!

My surgeon recommends ice machines & prefers the Cryo Cuff. I will use one at the hospital but my insurance doesn’t cover it. I called asking that, twice; bought my own so it’s ready to use when I get home.

My plan is to ice any time I’m sitting. I pee, a lot, and figure every time I get up to pee, I will take a walk around the house. I figure that’s a happy medium, so to speak.
 
Agree, Inked Marie. Between going to the bathroom and getting up to move at least once an hour because the stiffness becomes unbearable, it's not like anyone is going to lay in bed all day hooked up to the ice machine.
 
I’m not a recliner person, but I do like my spot on the couch! I was only in bed if I was sleeping.
 
Well, it's probably too early for me to make a definitive decision, but based on my 7th day post-surgery, I cannot imagine going through this again for my other knee. Ever. In order for me to even think about this again, I'd have to be wheelchair bound.
 
Most people probably think the same thing James. I certainly did until it was obvious the other knee was going to have to be replaced. Will say that having the second surgery before my knee was as bad as the first one has made the first days of recovery a little easier.

FWIW - Days 7-10 were my worst with the first tkr. You'll start feeling a little better two weeks out because by then you'll be able to do some things for yourself. And you will have figured out how to do some things too.
 
Hang in there James. For me, I have found that ice and elevation is magic. And I don’t elevate to a point where it is painful. I find a spot that is as high as I can get it without hurting, and if I have to bend my knee a bit to get comfortable then I do. I bought one of those ice coolers off eBay that I use daily, but I also have one of those old school ice bags with a screw on cap that I can fill with ice. For me it works really well because it kind of falls around whatever area I put it on and gets it really cold really quick. I quit taking my Vicodin around day 7 because I did not like what it did to my brain and quite frankly, for me, frequent ice works 100 times better. I am still taking tramadol and Tylenol though ! Like yourself I am needing to get back to work as soon as possible but two weeks post surgery, I think my plan of returning to full time work after 3 weeks was a little ambitious to say the least. Maybe if I can bring my lazy boy to the office.................
 
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[Bonesmart.org] JamesN’s recovery Hello JamesN. I too had TKR on July 24, so I literally feel your pain! I was encouraged when I read LaurenKate’s comment above that days 7-10 were the worst. I believe it and sincerely hope that is true. I did find one helpful trick for elevating my leg. I bought an inflatable leg elevation ‘pillow’ from amazon and already love it. I stick one more pillow under my foot to boost it up and straighten my knee a bit. I’ve attached a photo and info to this reply. Ice/elevate 20 minutes on then 20 off, continue to elevate another 20, then get up and walk to bathroom, etc.... then back to ice/elevation for 20. Repeat. This has made a Huge difference in my swelling, bruising and pain. I do use an ice cooler but still adhere to the 20 on / 20 off. I hope this helps a bit!
 
JamesN - I agree with you on all the conflicting info out there re: ROM, PT or no PT, timelines, etc.... I have my own thread with my own personal story re: PT and it has not been good. Started oupatient PT 6 days after my surgery. I’ve had 2 PT sessions and after many helpful discussions with my new best friends on bonesmart.org, I’m canceling further PT until I see my OS next week for post-op appt. I’m not afraid of pain having been through broken ankles, broken foot and foot surgery in the past. But this is crazy! Of course our knee and leg needs to heal first after horribly invasive procedure. So please keep posting your experience as several of us are paying attention and healing / suffering right along with you. Oh and you are crazy funny so keep that up too! Perhaps we should start a thread for our spouses to sound off about what a pain in their behinds we have become!:heehee:
 
I can second the wedge pillow. I bought one the same shape but made of foam. Beats having to keep repositioning pillows and picking them up off the floor. Much more comfortable too.
 
Well, went to OS today for my 9 day checkup and to get staples removed. Was a bit leery of the staple removal procedure, but it was really nothing too bad. Doc said that it was healing perfectly, no more shower restrictions, but I should avoid hot tubs and standing pools of warm fetid water. I think I can accommodate that. While I was grimacing bringing my foot up to the table and they were taking staples out, the nurse asked about pain meds. Note: I have two kinds of pain meds: Oxy (the good stuff) and Norco (also good, but not as powerful). I told them I was taking the minimum to get by, and mostly was Norco.
Long pause.
Nurse "um, why?"
me: "well, I thought I'd save the Oxy for when things really got bad"
Nurse: "You are writhing around on this table like some kind of reptile, clearly in pain. That is what the pain medication is for. It says you can take 1/2 to 2 pills every 4 hours. Take what you need, and you can get more when you need it."
Wife: "gimme that Norco. Only Oxy until you have things under control."
So now I am feeling better. Also, I don't know where the Norco is. Hopefully if I behave I will get some in the future!

I was also feeling like things weren't "lined up," meaning when I was standing, it felt like the knee was out of alignment and if I put full pressure on that leg, that the leg and Stryker Triathlon (really?) knee replacement would just all come crashing down in a heap, with my brand new knee sticking out of my skin and a trip to the ER. Good thing is that they knew exactly what I was talking about, and convinced me that no, there was no chance of that happening. Turns out my bow-leggedness was fixed, and my body had to adjust to the new (correct) alignment, even my foot would be pointing in a slightly different way. X-rays were done, and OS commented that it was a "medically perfect" TKR. Big bruise on the left side of my knee because she had to make adjustments to make sure that my patella lined up too. She also commented that unlike others (mainly post-menopausal women) who have bones that are brittle, my bones were super hard (so much that she was bending a saw when sawing away - okay, enough detail). I got a big packet with all medical notes from the surgery (and appointments leading up to surgery). Kind of neat to read.

Continued recommendation to ice & elevate, which I am doing. They did say "you will hate us for approximately 2-3 months, at which point you will like us again. Hang in there until then!"

Every day gets a little better. Still not near walking without walker, but that will come at some point when my knee says "get rid of that damn walker, you aren't 90!" Right now, my knee is saying "you actually might be 90, so walker it is."
 
I have my operative report and understood more than I thought I would, thanks to what I’ve learned on Bonesmart
 
Congrats JamesN. Great news on your healing!
 
JamesN said:
Well, it's probably too early for me to make a definitive decision, but based on my 7th day post-surgery, I cannot imagine going through this again for my other knee. Ever. In order for me to even think about this again, I'd have to be wheelchair bound.
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I said the same thing after my RTKR in 2015, especially after the bad experience I had with the p/t!! I put it out of my mind at the time, because the left knee wasn't really bothering me much then, just some occasional aches/stiffness. I guess you could say I was in denial of sorts, lol!! As time went on, though, the left knee began to be more achy/stiff, walking/standing became more difficult, until Dec. 2017, when I got to the point walking/standing became impossible. I had to go out on medical leave from my job, and finally faced reality and said to myself, "this one has got to be replaced too"!! I really didn't have much of a choice, I knew if I kept putting it off, eventually I'd wind up in a wheelchair, and I was not ready for that!! I wanted my life back, so decided to just get it done!! Best decision I ever made!! It is pure joy to be able to walk/stand with no knee pain, after living with it for so long!! I can enjoy my life again!! Give yourself time to heal and recover. To quote your words, "Every day gets a little better". You are doing great, keep on being positive!!
 
One of my biggest surprises during recovery is how much I had to learn to walk properly again. We learn how to compensate for the deteriorating knees in various ways and then when we have new ones, everything that got out of whack has to get back in place again.

This sounds goofy but look at your shoes and make sure they don't hurt when you start wearing them again. They can get worn down in the wrong places (when compensating) and be uncomfortable to wear with your new knee.
 
Short update: surgical pain is mostly gone (I'd say 80%). Now I just have to deal with ROM (very tight knees as others have said) and swelling. Ice & elevation are my two best friends at this point.
 
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