TKR Joy's Recovery thread<

[Jockette]

You’re welcome!

I have one of those things in the picture, I call it the leash thing. I forgot I had it!

My husband was always there to help me put my leg where I needed it until I could do it myself.

 

[Dizzy]

Joy77, you are experiencing all that the rest of us have gone through. We all feel your pain!!! Due to nerve block in the hospital I think you enjoyed a "delayed reaction" to your surgery. Please, get a raised toilet seat!!!! You will be so happy you did!

 

[Joy77]

Day 3 - I sleep in 4-5 hour segments and sleep very well. I only wake when the pain begins and it's going to be time for more medication. Last night I took my meds (2 ea. 5/325mg Percocet) went to sleep at midnight and woke up at 5am. Felt rested. Took another dose of pain meds and fell back to sleep for another hour. When I woke at 6am I felt pretty good. So I washed my hair in the kitchen sink then took a shower. I took my walker right into the shower. I have a large shower so it worked well. I have a build in seat and a hand held shower faucet. So I just sat and showered myself with the soap and warm water. It felt so good. I dried off in the shower then used the walker to get out and then get dressed. A good shower does wonders!

I went back to bed, propped myself up, and had toast and coffee. I put on some makeup and overall feel better. Yes my leg hurts but it's manageable. I haven't had a problem getting up/down from the toilet seat. Yes it hurts a little but whenever I do anything there's some pain. My knee constantly hurt prior to surgery so it seemed no different. It was only getting off/on the bed that was really bad. When I use the hook thing it helps getting my leg around.

Physical Therapy is supposed to come to the house today. But they haven't called so have no idea what time. My knee is swollen, of course. I'm only 3 days post op. I know my straight knee at extension measures at 0º which is good. It's the bent knee that I struggle. When I'm sitting up I can get close to 90º but laying in bed trying to bend it up is difficult. I feel my knee is too swollen to bend. But I have to remind myself I'm only 3 days post op and everything is still swollen.

Overall, I feel better today than I did yesterday. I guess that's the goal. Every day some improvement. Time for a nap now. Thanks to all of you for your support. I really appreciate it!

 

[Jockette]

What an excellent report!!

When the PT comes, do NOT let him/her bend your knee for you, it will cause pain and a set back.

PT is an option, not the requirement we are led to believe, and different therapists have different opinions on what to do, which means it is just that, an opinion, not a requirement.

Also keep in mind, it’s not exercising that gets our range of motion back, it’s Time:

Time to recover.
Time for pain and swelling to settle,
and Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Exercise as in strength training is counter-productive and in the early weeks does more harm than good. Normal activity is the key to success.

Don’t let them talk you into doing anything you don’t feel ready for.

 

[sistersinhim]

When I'm sitting up I can get close to 90º but laying in bed trying to bend it up is difficult.

In my opinion, it's silly to try and bend your knee while laying down. After all, you don't walk on your back! What you can do with your knee is what counts, not the numbers. So, don't stress it! Your knee will come back just fine without doing PT, so don't let them or you hurt that infant knee of yours! PT is strictly voluntary. I'm another of those that chose not to take it or do any exercises, just use it normally in my daily living.

 

[Josephine]

I've attached a photo of what the hospital gave me to help lift my leg

That's called a leg lifter . We have it in our list of useful item! Recovery Aids: A comprehensive list for hospital and home


Here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?

4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[Joy77]

1. 4-5 when I take my Percocet (5mg/325mg)

2. Oxycodone-Acetaminophen 5mg-325mg (Percocet) Directions say take 1 pill every 4 hours for moderate pain or two pills every 6 hours for severe pain. I'm taking 2 pills every 5 hours (not 6) and it controls the pain to a manageable level.

3. Huge but my knees are normally fat. I attached a photo

4. 12º and 72º per the PT today

5. I'm icing my knee a lot. I use an icing machine which makes it easy to ice. They want me to ice it 40 on and 20 off but I'm icing it most of the time because it feels good.

6. I wasn't elevating because it hurt so bad to do it. The PT showed me today how to elevate my leg (I thought I wasn't supposed to have anything behind my knee). He put a pillow lengthwise behind my leg from thigh to ankle/foot. He encouraged me to elevate which I will do now. He said knee higher than my heart.

7. Activity level is just walking around the house. Every couple of hours I will walk to the front door and back to my room (about 100 ft), or to the bathroom and back to my bed (about 20 ft). This morning I took a shower. Dr. wants me walking, with the walker, every few hours during the day. No housework, cooking, cleaning etc.

8. I did prior to PT : Ankle pumps at least 10 reps every hour that's it.

Per PT they want:
Quadriceps Sets 10 repetitions 3 x's /day
Hip Abduction 10 repetitions 3 x's /day
Straight Leg Raise 10 repetitions 3 x's /day
Heel Slides 10 repetitions 3 x's /day
Short Arc Quads 10 repetitions 3 x's /day
Sitting Heel Slides 10 repetitions 3 x's / day
Long Arc Quads 10 repetitions 3x's / day
Ankle Pumps 10 repetitions 3 x's / day

But today we did not do all of that. He was very easy on me. Didn't push me to do anything. He showed me each one and I did what I could do. He told me PT is my choice. I felt very good with this PT guy. He is coming to my home 3 x's week for 2 weeks then I will go to outpatient PT office.

 

[Joy77]

@Josephine I answered all your questions but forgot to tag you so you'd see them. See previous post.

Today is day 4. When the pain in under control I'm not feeling bad. It's just the swelling in my knee that bothers me but I assume that's to be expected. I heard somewhere, my surgeon, on here, I don't remember, that swelling is everything going to my knee area to repair it. So that's good.

I find I'm sleeping a lot off and on. I sleep very well.. a deep sleep. I feel rested. I get antsy just laying around but when I push myself the pain reminds me to lay back down and rest. So that's what I do.

My poor husband.. as I lay here I think of all the things that need to be done. lol. His list keeps getting longer. I think he's realizing how much I do that he didn't think about before. He really is a good caregiver and gets me what I need. I feel lucky.

My appetite is practically down to not much of anything. I just don't feel hungry. My surgeon said I'd probably lose weight, as most do. Now I see why.. I'm just not hungry. I do know that protein heals muscle so I'm focusing on protein and have at least 1 protein shake a day. I'm eating vegetables, bran and any type of fiber I can. I'm also trying to focus on anti-inflammatory foods and spices. I figure it can't hurt. But over all I'm eating very little.

PT comes back tomorrow. I plan on doing very little exercising today as I do want healing to take place.

So far, so good!

 

[Josephine]

I need a little more detail here

4. 12º and 72º per the PT today

Is the 12 plus or minus? I assume it's plus - meaning you can't put your leg completely straight.

When the pain in under control I'm not feeling bad. It's just the swelling in my knee that bothers me

And did you remember that swelling is also a type of pain?

I heard somewhere, my surgeon, on here, I don't remember, that swelling is everything going to my knee area to repair it.

Well it is true but it's a manifestation of pain all the same.

 

[kneeper]

I never lose my appetite but did after the surgery. Just try to eat at least little bits at a time.

 

[Joy77]

@Josephine

4. 12 + and 72 : I can’t completely lay my knee / leg flat and I don’t have a 90 degree bend yet on my knee

Yes, I accounted the swelling as part of the pain as it seems to be contributing greatly to it.

I think that was what you needed clarified.

Thank you very much!

 

[Joy77]

Day 5 -
Today was my 2nd PT appointment.

He takes my vitals and asks how I am feeling overall. He asks if I’m taking my meds as prescribed and inquires as to how I am sleeping.

Today he took my bandage off (see photo) He told me it looked good for a 5 day old incision. I can shower but not direct water on it but water can roll over it. He told me to just let it heal naturally.

On to exercises. The ones I could do we completed. I did more than I thought I could. Any that caused discomfort he held back. He watched me walk and reminded me heel toe heel toe and to try and raise my knee when walking. PT seems to be going well so far. He’s very encouraging, promotes rest, eating healthy and walking around the house doing normal things once every couple hours. He reminded me to ice and elevate. It was a good PT day.

I nap a lot, eat little but healthy. Instead of being constipated I have mild diarrhea due to over doing the bran, Colace and Lactulose. I was advised to drop the Lactulose but continue with the Colace and fiber diet.

I’m taking my pain med (Percocet) and hour earlier than prescribed to remain fairly comfortable. I spoke to a nurse today and she’s going to see if I might do better with something else added to bridge the gap. She rather me take the Percocet as prescribed (2 every 6 hours) but add on something to help me get to the 6 hours. She will be phoning me back with a recommendation from the Dr.

That’s all for now.

Blessings to all.

 

[Josephine]

1. 4-5

Yes, okay

2. oxycodone-acetaminophen 5mg-325mg. Directions say take 1 pill every 4 hours for moderate pain or 2 pills every 6 hours for severe pain. I'm taking 2 pills every 5 hours and it controls the pain to a manageable level.

Good!

3. Huge but my knees are normally fat

Yes, me too!

4. 12+º and 72º. I can't completely lay my knee flat and I don’t have a 90 degree bend yet on my knee

Well that's hardly surprising at only 5 days out!

5. I'm icing my knee a lot. I use an icing machine which makes it easy to ice. They want me to ice it 40 on and 20 off but I'm icing it most of the time because it feels good.

Jolly good!

6. I wasn't elevating because it hurt so bad to do it. The PT showed me today how to elevate my leg (I thought I wasn't supposed to have anything behind my knee). He put a pillow lengthwise behind my leg from thigh to ankle/foot. He encouraged me to elevate which I will do now. He said knee higher than my heart.

Doing it that way is okay. It's not good to have a pad or rolled up something just behind your knee. Read this Elevation: the do's and dont's

7. Activity level is just walking around the house.

Perfect!

Per PT they want: 3 sessions per day
Quadriceps Sets x10
Hip Abduction x10
Straight Leg Raise x10
Heel Slides x10
Short Arc Quads x10
Sitting Heel Slides x10
Long Arc Quads x10
Ankle Pumps x10
Don't do any of that. It's much too early now and none of them are good for you anyway.

But today we did not do all of that. He was very easy on me. Didn't push me to do anything. He showed me each one and I did what I could do. He told me PT is my choice. I felt very good with this PT guy. He is coming to my home 3 x's week for 2 weeks then I will go to outpatient PT office.

Good! I'm glad he said that PT is a choice. Just what we say! I'd never encourage anyone to do ANY exercises of any type in the first three weeks. This is because it will increase the swelling, increase the pain and DEcrease the ROM.

So my recommendation is that you decline the outpatient PT - totally! Let your knee heal on its own. It will do better than being brutalised by exercises!

I recommend you read my recovery thread to see how little exercising I did for either knee! Knee recoveries UK style Parts I & II (Josephine)

If you are concerned about refusing to do therapy, you need to read this Saying no to therapy - am I allowed to?

 

[DLR]

@Joy77 you’re doing great..enjoy the naps I still do...

 

[Jacimarble]

He watched me walk and reminded me heel toe heel toe and to try and raise my knee when walking.

At 4 weeks in my Pt was reminding me of this!! At 5 weeks in I think I'm just about getting it right - when I'm not too swollen!

 

[Jockette]

I understand the heel to toe, but not the raising your knee to walk. Why did they tell you that?

 

[Jacimarble]

I was walking very stiff legged and the PT encouraged me to lift the knee to get back to a more normal walking gait - its not a big knee lift just enough to encourage good walking habits.

 

[Joy77]

Thanks to everyone for being so supportive and encouraging. This site has really helped me move through a traumatic experience and make it bearable. I tend to focus on successes, no matter how small they may be. It’s the successes that give me hope and let me know I can do this.

We all know there’s plenty of struggles and pains that go with this surgery. I notice it, accept it, but move on. I focus on the goal. I know that when all is said and done I should feel so much better than how I’ve been feeling the past 20 years. Actually, even with all this pain, I DO already feel better. My “knee” has no pain. That’s amazing.

Some of my successes.. just 5 days out..
- I’ve been told by others my leg actually looks straight now
- I’m already experiencing no pain in my knee
- When I sleep now I have no knee pain - that’s a shocker to me
- I’m temporarily taking medicine that makes me feel less pain than ever
- I’m 5 days post op instead of waiting for this surgery to happen
- I don’t recall when the last time was I could take naps. I was too busy working and taking care of others... But I’m enjoying my naps now and embracing them.
- I have people coming to me to help me... PT at my home, PT encouraged “my choice” in treatment, phone calls from nurses to check on me, when I ask for help my Drs have listened to me and provided help.
- I found this great forum to help me normalize my experiences and feel supported.
- Reading everyone else’s successes make me feel good. It’s hard to imagine all the people on here getting relief from pain.

There’s more but overall I’m very grateful for this chance to finally get new knees and feel better.

 

[DLR]

@Jockette i was told the same about raising the knee, my pt sId like @Jacimarble many start walking stiffly or like a peg leg and the lift knee is simply a reminder your knee can and should bend as you walk

 

[Jockette]

Oh, ok.

I remember in earlier days, and even once in a while now, when I was really tired or my knee hurt I would revert to keeping my leg straight when I walked.

But it hasn’t become a lasting habit. I think over time as you heal you just naturally walk better without thinking about it.