Bilateral TKR July 1 LHop - Bilateral TKR Recovery Thread

[LHop]

Hello Friends, it's been a while! I started back to work yesterday and it has been interesting. I am starting at three days this week, but still eight hour days. My job is mostly sitting, and I'm thankful for that, but I am definitely having some side effects. My knees are quite swollen and my ankles are joining in. During lunch, I have been elevating and icing, but my knees are used to being up for extended periods of time and are protesting. The good news is that my pain level hasn't increased. Just the swelling that is causing stiffness. Don't get me wrong, I still have to hold on to something to get up, it still hurts and is often accompanied by a grunt or two I still look for chairs with arms, and if there aren't any, getting up can be quite a production; usually involving my bracing myself on the desk, table, or even the seat of the chair and hoisting myself up. I agree with you @jbrooklyn, I could use a crane.

I keep singing to myself (in the tune of "Someday My Prince Will Come"), "someday the pain will be gone". I sure hope that I'm right!

 

[KarriB]

I'm not a BTKR, but the pain will be gone eventually. I still have problems getting up from a seated position, but that pain is in my non-TKR leg.

 

[jbrooklyn]

@KarriB, bless you for that encouragement. LHop (hello, dear comrade!) and I are in similar places. There has been lots of improvement--I can take baths now without sobbing in a drained tub unable to get up. That is good! I can walk several miles without pain and swelling. Good stuff. But like LHop and our contemporary @Rob 68 , there is still more discomfort than I wish to deal with. For me it is mostly at rest and at night--my right knee aches so much when I'm lying down or sitting that I often need to move it manually to change position--so discouraging! When I'm getting into a car, I use my hands to lift my right leg in, joking that it is my pet leg. Blaah, who wants that as a way of life. And, there is the matter of the cranes LHop and I need to stand up--grunt, push, so elegant and graceful. UGH. So it is good to hear it keeps getting better.

@LHop, I went back to office yesterday, too! I worked only 5 hours because my knees rebelled, and my official start back date is Sept 22--so right now just building up hours so I can ease into f/t work over several weeks. Do your knees feel like concrete if you sit in one position too long? Ugh, the worse. And the swelling is really rough. I hope you are icing and elevating like the dickens later at home. Let someone else get you dinner. We have been taking care of others all our lives--time for payback a bit, eh?

I want to share 2 possibly helpful recent discoveries 1) My knees really hate being in one sitting position, so I tried a coworker's little exercise pedaler that she keeps under her desk. Brilliant! For me it is less about spending calories than about keeping my knees happy. I used it for 4 hours on and off yesterday, and it definitely helped! I researched for the quietest model, and ended up ordering this one with a can of WD-40 to keep it quiet: FitDesk Under Desk Elliptical Trainer. There are cheaper models, but this one is especially for use under desks, and it was a big, big improvement to sitting stationary. I used it for a few min at a time. 2) acupuncture. I've had 2 sessions for the tendonitis and general knee aches/swelling, and it really has been a striking success. I will have one more session in a week, and then lay off as it's $100 per session. The therapist says 3 sessions will likely help, as they build on each other. I tried it out of desperation--might as well, right? I don't feel skeptical nor convinced, and don't pretend to understand how it works . . . but I have without a doubt had some relief from this and wanted to share.

Sorry for the blathering length of this. But one more thing: How was the shower? Fun? Hard? Hope it was memorable and wonderful, and well worth the effort on your part.

 

[MsBlue]

oooooo THANK YOU for the recommendation on the under-desk elliptical. I think I am going to try that. I had the continuous passive motion machine (CPM) in the hospital, and I thought it was great. I did not have it in rehab or at home, and, in retrospect, I wish I had "dug in" and insisted they get me one. I really wonder if it would have made a difference on the right side where I am so much stiffer. I know the literature says that long-term outcomes do not differ with/without CPM, but I am still in the short-term window by that definition, and I need more help on the right. I do think that more movement helps.

 

[Rob 68]

oooooo THANK YOU for the recommendation on the under-desk elliptical. I think I am going to try that. I had the continuous passive motion machine (CPM) in the hospital, and I thought it was great. I did not have it in rehab or at home, and, in retrospect, I wish I had "dug in" and insisted they get me one. I really wonder if it would have made a difference on the right side where I am so much stiffer. I know the literature says that long-term outcomes do not differ with/without CPM, but I am still in the short-term window by that definition, and I need more help on the right. I do think that more movement helps.

Same thing they told me about the CPM, @MsBlue. According to their studies, it only makes a positive difference in about 2% ofall cases. Well, what if we happen to be in that 2%? I got to use it the only night I was in the hospital, and the night nurse tried to take it away after about two hours. I am also looking into the under-desk elliptical or mini-bike. Makes sense to stay active as often as you can, without overdoing it, of course.

 

[LHop]

@jbrooklyn the shower was lovely, thanks for asking. It was worth all the work. Amazingly, my knees did so much better getting all the shower prep done, than they are this week at work. They are swelling horribly along with my ankles (I should call them cankles). I might try something like the pedals. My knees do feel heavy and

 

[LHop]

oops, did something funky. Anyway, they feel heavy and stiff after sitting upright. Why are they so much stiffer from being in a sitting position than they do stretched out on the couch? As soon as I get home I'm stretched out with my ice machine until it's time for bed. One of the wonderful facility workers made me a footrest so I could elevate under my desk so I'm hoping that will help.

If anyone has any suggestions on how to help with the swelling, I would love some advice. Thanks everyone!

 

[Celle]

Why are they so much stiffer from being in a sitting position than they do stretched out on the couch?

It's gravity! Plus, possibly, this:
Pain: Movie sign in TKR

 

[LHop]

This is my second week at work. This week seems to be better about the swelling, however I have had something weird start to happen. I have had some sharp pain in the back of my "bad" knee. I kept thinking I'd pulled a muscle, but it works itself out after a while. Sometimes it hurts for a short while and sometimes it hurts for half a day, and while it's hurting that leg seems weak. Right now I have a heating bad on the back of my knee and I'm icing the top. Anyone know what this is @Celle or @PolarBear60 ?

 

[Celle]

It could be just the result of the extra load imposed by going back to work. Or it could be something like a Baker's Cyst - Baker's cysts and other knee bursae

I'll ask @Josephine for her advice, too.

I think you're doing the right thing in applying heat or cold, whichever feels better. Rest and elevation will help, too.

 

[jbrooklyn]

Hi, LHop. Happy 12-weekiversary! Mixed reviews, eh? But it does gradually improve. So glad to hear the shower was a success! If I remember right, you have a wedding in October, yes? I think you will be dancing there.

Could your behind-knee pain be uneven muscle strength? When you regain strength, it takes a while for all the usual muscles to work in concert the way they need to. If you are still in PT, perhaps ask about how to balance the gain in strength. Or maybe it could be tight hamstrings. Have you tried gentle hamstring stretches to see if that helps?

Ice on top and heat on bottom sounds wonderful--I might be trying that myself!

 

[Josephine]

Why are they so much stiffer from being in a sitting position than they do stretched out on the couch?

Because that's how the knee reacts to being bent. Do remember that stiffness is a form of pain! So it needs to be medicated.

I have had some sharp pain in the back of my "bad" knee. Right now I have a heating bad on the back of my knee and I'm icing the top

Never, ever treat pain with heat, especially not on a knee fresh out of surgery. You will increase the swelling and therefore the pain. Ice it at the back instead. And take your pain meds more assiduously!

 

[Wanttobebiking]

@LHop and @jbrooklyn I have been thinking about you both. I am still waiting for my Deep Relief to arrive and I ordered the Sombra cooling gel and the Sombra heating gel today. I need them both. Seems that as I pick up my activity, the knee stays the same or reverts a bit rather than improves. Went off Tylenol a few days ago and now back on it. I am glad that the two of you sound like you are making progress. Will let you know when the oil and gels arrive. Are you still using them? I have embarked on a "be really really nice to me" campaign.

 

[LHop]

@Wanttobebiking Yes, I still use my Deep Relief every night. I have a questions for you @jbrooklyn or any other TKR/BTKR, at what point did you stop taking prescription meds? I am still feeling the need to supplement my OTC meds with Tramadol. I called today to get my bi-weekly refill (I only get 30 at a time), and was told this is the last refill my doc will give me, she wants it to last 30 days, and if I still feel like I need a prescription, I should see my OS. This has been a constant battle with her from the get go, I am just so frustrated. Before my surgery she was much more sympathetic to my knee pain, but now that I've had the surgery she expects me to be pain free at 12 weeks.

 

[SDkate]

I'm at about 9 weeks and I still supplement my ES Tylenol with Tramadol - or do I supplement my Tramadol with Tylenol? I usually take them both together. So far my OS hasn't had a problem with refills, will need one next week. If he balks then I will go to my GP. About the only time I'm pain-free is when I first get up in the morning. Some days are pretty good, this week my knee has been stiff and sore.

 

[KarriB]

At 4 months I was taking 5mg of oxycodone once a day, usually in the late afternoon or early evening after work and PT. I had stockpiled pain meds because they had been prescribed while I had the infection and not allowed to bend, I had no pain at that point.

 

[Rob 68]

@LHop - Still taking some Tramadol, and my OS and his assistant have been very generous in prescribing it. That may change Tuesday, when I see him for the last scheduled time. Only take it on an as-needed basis, and some days that's 2 tablets twice a day and some days none. On the doctor-patient relationship, I think we are still his/her patient, even when we pass the magical 12-week milestone. They all call this major surgery and say the recovery is long and arduous, so they should be willing to treat us as long as the recovery takes. I can see their wanting us off the heavy drugs - I didn't want to stay on those , either - but Tramadol as I understand it is nowhere near that class.

That's my nickel's worth of advice, with the caveat that as a retiree I don't face the rigors of work on top of the recovery process. I admire and applaud those of you who take on both challenges.

 

[Wanttobebiking]

Hi Lhop, I no longer take oxy at 11 weeks, but I only had one knee done. The other day, I took a look at the Bonesmart recovery chart for TKR and BTKR and they are quite a bit different. If I recall correctly, 10 weeks for BTRK is similar to 5 weeks TKR or something like that. I started to wean myself oxy at about 5 weeks and found it was easier than I thought. What was harder is that when I couldn't sleep my OS gave me lorazepam which is very addictive and recommended for short-term use only. As my pills started to run out I cut them in half because I knew he wouldn't give me a refill and I was panicking that I would not be able to sleep at all without them. But somehow it all worked out, and I'm now sleeping on my own, and I still have 1 lorazepam left, which is now cut in half. I bet in 30 days or longer if you stretch out your last prescription, your pain will have subsided—at least that's what I'm hoping for you. I wish I could put a link to that chart in here, but I am not sure how to do that. After 10 or 12 weeks for BTKR, if I remember correctly, recovery starts to accelerate. For TKR, I think it starts to accelerate at 8 weeks or so, which is about what I have experienced. Still waiting on the Deep Relief but I did order, and like, the sombra cooling gel that JBrooklyn recommended.