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[TKR] Jellycats' Recovery

Discussion in 'Knee Replacement Recovery Area' started by jellycats, Apr 16, 2019.

  1. jellycats

    jellycats junior member
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    Left TKR. Surgery went well and I’ve had three successful shorty walks (2 to the bathroom and 1 to just outside room and back). First “official” PT tomorrow morning. If I continue to manage pain, very good chance I can go home tomorrow afternoon. I have walked with a limp for years, sort of hiking up left leg and swinging forward, so it’s a real education to try and walk slowly but correctly. The only exercises I am doing are ankle pumps, tightening butt muscle, and tightening quad. “Don’t do anything that hurts” is the message. I know tougher days and weeks are ahead, but I’m trying to stay focused on one day at a time. Continue to heal well, my friends!
     
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  2. Celle

    Celle FORUM ADVISOR Forum Advisor

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    Hello @jellycats - and :welome: to recovery.

    “Don’t do anything that hurts” is an excellent message, and it's right in line with the approach that BoneSmart recommends.

    Here is the Recovery reading that we give to everyone with a new knee:
    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. At week 4 and after you should follow this
    6. Access to these pages on the website

    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.
     
  3. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Best wishes!
     
  4. Bionic

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    @jellycats
    I'm so pleased that everything seems to have gone well. I too have walked with a limp for years and it's quite difficult to retrain. With a knee that isn't bending a lot at the moment I find I need to concentrate hard when walking.
    Physio advice yesterday was heel first and then roll right through the foot imagining the toes digging in sand as you walk. This last piece of advice is really making a difference and my toes in the sand gives a bend to the knee as I walk.
    Wishing you well
     
  5. Irish471

    Irish471 senior

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    @jellycats , you made it! Sounds like things are going well :) It's amazing how despite this intense surgery, you can walk on your new knee right away, isn't it? Hallelujah for pain meds!!! Hoping you will soon be nested in your own cozy bed at home later today. The first week is tough for most. Stay ahead of the pain :thumb:
     
  6. swmrgirl

    swmrgirl senior

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    Congratulations knee sister! I hope you get to go home today where you can rest comfortably.
     
  7. ApricotPie

    ApricotPie member

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    Good luck with your recovery.


    Sent from my iPad using Tapatalk
     
  8. jellycats

    jellycats junior member
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    Day 6. Hello, Knee Friends! A few notes on the first six days post-op. I liked reading how others prepared their homes for recovery, and some of those “tips and tricks” I adopted. Following is what I’ve learned works for me. Every patient, knee, surgeon, home, family, etc. is unique so what worked for me might not be right for you! (I’ll try to post photos if I can figure out how to do that.)

    PLAN AHEAD. I am a planner by nature so investing time in researching my post-op needs was a given. If you are a procrastinator, or just super busy with life in general, please find the time to read the forum, take notes, and see what products and/or processes feel right for you.

    LEG LIFTER. These are fairly inexpensive, available through Amazon. I “made” my own from a rigid rubber strap that I use when stretching. I used a Velcro cable tie around the strap to create a loop for my foot. With a leg lifter, I can get into/out of chairs and bed without assistance. Three cheers for independence! I can now lift my leg from floor to sofa or footstool without strap. A great measure of progress!

    WALKER WITH BAG. I made my own bag and designed it to hold my favorite Hydro Flask water bottle. Here’s what I carry in my bag or attach to the walker: leg lifter, plastic grocery bag, notebook and pen, Kindle, water bottle, cell phone, Beats headphones, grabber, eyeglass case w/cleaning cloth, gripper socks.

    CREATE “STATIONS” THROUGHOUT HOUSE. I keep water bottles on my nightstand, in the bathroom, on small table next to my chair, and in my office. I have tissues in these locations, too. I have power strips with chargers by my bed, my chair, and in my office.

    CATS. I have four, didn’t need to get any more! Many of us have pets and have worried about pet logistics. I have two human helpers, my husband and our 25 year old son who works as a data analyst and is living at home right now. But the cats are my babies, and I wanted to make their care an early goal for me to work towards. I bought a long-handled poop scoop and a cheap bucket for transporting waste from utility room to bathroom. So I can clean the boxes if I plan this as an activity. I can also pick up and clean food bowls (transport in bag on walker!). I can’t manage water bowls so I call on my humans to do that. (I use Pretty Litter cat litter, which is delivered to house once a month. Excellent litter.)

    ICE. I chose not to use one of the pump options. I have three Elasto Gel gel packs, two bags of homemade ice, and a basic wrap (I’ve had for many years) with four refreezeable inserts. I repurposed an old flannel sheet to makes bags or cloths to use to keep ice bags one layer away from skin. I’m drinking a lot of water so I have to get up and move frequently, which is good for the knee. I put my “used” ice bag in my walker bag, visit the bathroom (with insert in toilet to raise seat—highly recommend), then go to refrigerator to put used bag in freezer and get a new bag out. Then back to chair to elevate and ice!

    I could post more but it’s time to make one of those bathroom/kitchen/ice circuits!
     
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  9. Bionic

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    @jellycats
    You sound as if you have really worked at making things as simple for you as they can be.
    Well done. Anything that makes you feel more independent at this stage is a bonus.

    I highly recommend the raised toilet seat too. In fact I bought 2. One for upstairs and one down.

    I hope you continue with a good recovery.
     
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  10. Irish471

    Irish471 senior

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    @jellycats , loved your post! I am going to have to check out that Pretty Litter!!!
     
  11. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    @jellycats, planning ahead is certainly the key. I am a cat rescuer and at the time of my tkr, I had 13 to take care of. I bought that long handed scooper, also and big boxes of litter that I could scoop out with a cup. I use storage tubs for litter boxes and have 2 cat doors so they could go in and out without me being bothered. My wonderful neighbor cleaned the boxes the first week or so, then it was up to me. I bought a large bottle water fountain that she refilled the first week, too. Then I did it, but could quite fill it all the way up! Taking care of me and my kitties gave me all the PT I needed, so I didn't take any. Our pets give us a huge reason for healing without overdoing. Any setback we have also affects them.
     
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  12. Rather

    Rather junior member

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    I'm reading your comments about the raised toilet seats and I have to ask this. I have a comfort height toilet that is higher (3-4 inches) than regular toilets. Should I plan on getting a raised toilet seat on top of that? I'm thinking that I might need a step stool to ascend the throne.
     
  13. jellycats

    jellycats junior member
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    Day 11. I have been afraid to post because I feel that the good things happening are overshadowed by what seems to be a very poor ROM. I’m stuck at 70. On the other hand, I have full extension, something I did not have pre-op for at least three years as the arthritis worsened. The PT feels there is a “pocket” of swelling just above my kneecap—we both can feel how this one place is very hard to the touch. She said the swelling here is being stubborn and I am now “spot icing” this area in addition to regular icing. Overall, even with frequent (6 to 7x daily) icing and elevation, the swelling in general is taking a long time to go away. I am using a walker and taking walks outside, I can use a cane on steps with no pain. The various strengthening exercises do not cause pain and the PT is very pleased with overall leg strength. But I can’t get past the 70–in my mind I will be here forever or something will have to be “done” to make me bend. And now here come the tears! As the PT was leaving yesterday, my husband said that when my OS spoke to him after the surgery, he told him my quad muscles were very well developed. That’s it—no explanation. I’m jumping to the conclusion this is bad. This is the third surgery on my left knee. 1974 as a healthy active teenager and 2013 to remove some free-floating cartilage and trim tears in meniscus. I have heard that knees with prior surgeries may recover differently. Thank you for being a place to share my fears.
     
  14. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Your flexion of 70 on Day 11 is fine. Your knee/leg had just been through a surgery that causes a lot of trauma to the body. Swelling can take several months to go down. Patience is the name of this recovery.
     
  15. jellycats

    jellycats junior member
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    @Rather — just saw your question about raised toilet seat. We also have taller commodes in our house but I found the extra inches of raised seat helpful. I’m 5’10” so height might determine if you need the raised seat. I have used a folded beach towel under my feet (I scoot it under once seated) to make sitting a little more comfortable. Hope this helps!
     
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  16. FCBayern

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    @jellycats the ROM will come with time. Mine has been slow to develop but continues to improve, you really are early days yet. It can be disconcerting to see some people post great ROM numbers in days or even 3-4 weeks but there are many more stories of much longer times to get ROM. We all heal at different rates so don't compare your results to others. There are a few Hares out there but I think most of us are Tortoise's! :heehee:
     
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  17. Celle

    Celle FORUM ADVISOR Forum Advisor

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    You're only at Day 11 post-op and already worried about ROM.
    For goodness' sake, why?

    Actually, I know why.
    Your PT is making you worry. He/she has an agenda that says your knee should be bending more. That's wrong.
    You have very good ROM for so early in recovery and you have all the time in the world to achieve more flexion. There are many here who will envy you the full extension, too.

    In spite of what your PT is telling you, there's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
    Myth busting: the "window of opportunity" in TKR

    Tell your PT to stop fussing about ROM and about swelling. Both will improve, given time, but right now your poor knee needs some time to start healing before it's expected to do anything else.

    It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.

    My surgeon doesn't allow any PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house.
    After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home.
    His patients all do well and achieve good ROM, as I did, and he hasn't had to do a manipulation to help with ROM for the past 4 years. I think that speaks for itself.
     
  18. jellycats

    jellycats junior member
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    Thank you for the replies. It does feel good to know we’re all in this struggle together, no matter the ROM or extension. On April 26 I saw my PCP for a post-op visit (will see the OS on May 3). She has been my PCP for over 20 years and she has referred many patients to my OS. One of the first things she said was, “That knee is really swollen!” Then she said what you all have said: “Don’t worry about the number. There’s no way you’re moving that knee until the swelling comes down.” Her advice: rest, ice, elevate, and do activities and exercises that feel good. (Hmmm. Sounds familiar.) So this weekend we went early to our local Starbucks and one of the regulars took one look at me and my walker and said, “You had a knee replaced.” He had a knee done in December and said his first six weeks were tough but then everything got better and now he doesn’t even think about his knee.
     
  19. Softtail

    Softtail senior

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    Jelly cats, had the exact same hard lump above the knee. I would rub and rub it thinking it would go down . My surgeon said it was just a reaction to my surgery, and should soften over time. Well here it is 7 months later and turns out he was right. I can still feel a bit of hardness but much smaller and until I read your post completely forgot about it. My flexion is maxed out over 135 so whatever it started out to be has become a non issue now. Hope your takes the same route mine did. Mostly swelling kept me from getting good flexion ,but as it went down bend went up.
     
  20. jellycats

    jellycats junior member
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    Yesterday was 12 weeks (LTKR on April 16), and I decided to check in. But first, "thank you!" to all who share their journeys, suggestions, and experiences (both positive and not-so-positive). At times this has seemed like the longest 12 weeks ever, but it's great to have this forum to read.

    ROM. I wanted to be at 90 the day after surgery and 120 two weeks later! Didn't happen.
    • 2 weeks--70. Still LOTS of swelling. OS asked me to see him at 5 weeks.
    • 5 weeks--80. Discouraged. OS explained MUA, did not push for it, said to see him in three weeks for new x-rays. He gave me the green light to swim! For three weeks, I iced, elevated, and discovered creative ways to allow gravity to stretch my quad. PT focused on massage and low rep/low weight exercises. Also did exercises in pool.
    • 8 weeks--105! I felt reborn! OS ecstatic, assured me more ROM would come. No MUA!
    • 12 weeks--107 with no assistance. With a yoga strap, 118 and NO PAIN, but I can't hold this position--my foot slides back out 'cause the muscles and tendons have a mind of their own right now. (OS measured my ROM prior to surgery at 105 and post-op at 130. So I am 2 degrees more flexible than before the surgery! Yeah!)
    Extension. I feel fortunate that post-op extension has not been a problem. Pre-op, I could not straighten my leg, was at about 5. I've limped for 3+ years and felt off balance.

    Pain meds. Still take Tylenol (2 x 500 mg) four times a day. Post-op, the NSAID I was prescribed was Celebrex, and after that my OS put me on Meloxicam. About day 21 I had to stop the Meloxicam due to stomach upset/heartburn. I try to avoid NSAIDs because of the potential for gastro problems. For the last few years, I've explored ways that diet and lifestyle changes can reduce inflammation.

    IT band, butt, hamstrings, calf. Sometimes I have tightness across the top of the knee, or IT band feels sore, or both hamstrings revolt when I stand up in the morning. With each passing week, these periodic "muscle injustices" are more infrequent and of shorter duration. If I do too much, I will aggravate all these muscles that are still recovering. Ice remains my friend, and I keep my hydrocolator in a soup pot on the stove because moist heat feels good on hamstrings, the back of the knee, and calves.

    Activities! I don't do everything in the same day (that would be nuts), but here's what I can now do comfortably.
    • Pilates twice a week
    • Stretching in pool. Swim 1250 yards. A mile is 1650, my usual pre-op swim, so that's my goal.
    • Riding my Schwinn Airdyne for 15-20 minutes.
    • Walk 3/4 mile on our high school track using Exerstrider poles so I can focus on my gait and stride.
    • Once a week massage (hmmm--does a massage count as an activity??)
    • Driving returned pretty quickly as surgery was on left knee.
    • Work. I work from home and have a very flexible schedule which has made this Knee Adventure significantly easier.
    • Doing nothing. An important activity because napping, relaxing, watching mindless TV, etc. are important to the healing process, too.
    Still using cane. Need a cane to help with curbs, inclines, and steps. I can go up and down steps "normally," but we are talking slow, slow, slow. My right knee grinds and grates so I avoid steps without any railings because I don't really trust my right knee without additional support. I have a walking stick that the family bought me many years ago when I was diagnosed with chronic synovitis in my left knee one week before a hiking trip in Maine. I now use my walking stick as I maneuver around our gardens to fill bird feeders.

    I've got many weeks to go in this year-long healing process, and I am sure there will be good days and bad. But on April 15, had anyone said, "Let's go for a 3/4 mile walk," I would have declined--I could not walk from my car into the grocery store without extraordinary pain in my left knee. That pain is gone!

    Sigh. Now I have to think about when to have the right knee done. Not until 2020.

    (P.S. Clearly no longer Day 1, so maybe I should change my thread name to "Jellycats Recovery.")
     
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