TKR Just wondering on my progress?

[referee54]

Way too much on that first day of PT---that bending went too far and you need to set limits as to what you will do and what you will not do.

This wasn't easy or without a lot of pain.

Take any exercise or stretch to the point of discomfort and no further. Please remember that the PT works for you!!!

I went to bedroom and iced my knee for 20 minutes.

You also need to ice longer, too. Twenty minutes is not long enough---this is not the case of "20 minutes an hour." I would ice it for at least 30-45 minutes---even longer.

Please remember one of the Bonesmart mantras---"If it hurts, don't do it."

A TKR recovery can take longer than we would like it to. Aggressive PT does not speed anything up--it merely slows things down, makes things more painful, and causes more frustration.

 

[icep707]

You are diffenetlly doing too much . Im 4 weeks out , and just because you can do stairs , walk, peddle, toes raises, quad sets etc, at this point does not mean you should be doing them . Take it from experience. It will only cause internal swelling and maybe even serious damage . My first 3 weeks were amazing but my internal swelling was preventing my bend . So for the last week I have cut my activities by 2/3. Presto !! Swelling down , bend much better ! However on Monday a different PT bent my knee causing me to jump off the table. He was slick, as he gently started bending than , out of nowhere WHAM!!!. Now I have like a sharp pain, while before I was relatively pain free. I go back tomorrow and for the past 2 days I have been rehearsing my speech to him. For some reason I have 2 therapist , one a nice gentle guy the other the jerk ! Ill be talking to the jerk tomorrow. As for iceing and elavating I did both my first week for almost 20 hours a day . Ive been on tramadol and tylenol ever since and 1 celebrex daily . Mainly cause im iceing and elevated at home all the time . I drove by week 2, shopped , mopped , vacuumed, stairs etc. Way too much to soon !! I hardly do anything now . Just rest , elevate and ice and pt. May go to park and catch some rays as we are having beautiful westher in california. Take it from me !! Less is best !

 

[sjm1027]

Thanks for all of your comments and I agree with you all. Sorry I have been away but today I spent the day icing and elevating. The just walking and mild stretching. Yesterday my PT set me behind a day because of her aggressive attitude. Not going to happen tomorrow. Thanks for your support everyone, means a lot to me. This is a huge lifestyle change for me but I am taking it day at a time. I never sit around. Great to have this forum to vent and meet nice people.

One more thing I read today. Is it true that after a TKR and your 100% healed that you should only carry or lift 20 pounds. Over 20 pounds wears your replacement out quickly?

Thanks,
Steve

 

[icep707]

I drew a unhappy face with the word OUCH , on my knee. " HANDLE WITH CARE ". plus I had a talk with him. He started talking about MUA and this and that . I told him im 4 weeks in . And that I need to heal . Well he didnt bend my knee. I told him I will work my butt off, just dont bend my knee again !! Best of luck !

 

[referee54]

One more thing I read today. Is it true that after a TKR and your 100% healed that you should only carry or lift 20 pounds. Over 20 pounds wears your replacement out quickly?

I have never heard that---i work at a farm part time and also fell trees to heat my home and routinely carry things heavier than 20 lbs.

I did hear about not carry really heavy objects, though.

 

[skigirl]

Wow, it sounds like your pt was a dragon--and a very unprofessional one at that. I have not been impressed with the home pts---frankly I think you could just stay home for three weeks and recover and then go to an outpatient pt who is trained to handle knee rehab.

I will give you the post op reading list which has lots of short articles for you.

First are the mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!

Next is a FAQ (Frequently Asked Questions) thread.

And then the articles in order of importance .
Group A
The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Progression of activity for TKRs

Group B
How Long Does Healing Take ......
Chart representation of TKR recovery
Energy drain for TKRs
Elevating your leg to control swelling and pain
Using ice

Group C
Knee Replacement - Where Am I in Recovery?
So What Is It Going to Take? The Five “P’s” of Knee Recovery
Work “Smarter” and not “Harder”
About recovering a knee - from one who knows!
Some suggestions for home physio (PT) and activity progress
Myth busting: The "window of opportunity"

Group D
MUA (manipulation under anaesthetic) and adhesions
It's never too late to get more ROM!
It's Worth the Wait for ROM
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

 

[Roy Gardiner]

One more thing I read today. Is it true that after a TKR and your 100% healed that you should only carry or lift 20 pounds. Over 20 pounds wears your replacement out quickly?

Doesn't seem reasonable to me; persons of 400lb have had TKR, that seems like a bit more than the 20 you're talking about

 

[NuNe4Me]

One last thing: Everyone's recovery is a little bit different.

Don't be afraid to stick up for yourself with your PT! I ended up firing mine because they hurt me bad twice. I went home and got on the computer to do research, and I found the BoneSmarties - they saved me. Read and reread everything here. Don't let your PT hurt you.

Keep the Faith. Remember: Elevate! Elevate! Elevate!

 

[Josephine]

Heel Slides: Difficult can only slide 6 to 7 inches
Short Arc Quad: Cant do
Straight Leg Raise: Cant do
Passive Extension: Cant do 20 minutes only 5 to 8 minutes

Not surprising! You're not even one week out yet! Give your poor knee at least a week to settle down and heal before you start all that. In other words, don't do any of them yet! And don't worry about not doing them. Many surgeons in the UK forbid any exercises for three weeks except foot rotations, ankle pumps and a few gentle heel slides.

I have some questions to ask you:

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 compare this with the bone-on-bone pain you had before surgery!

)

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

3. how often are you icing your knee and for how long?

4. are you elevating your leg, how often and for how long?

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

6. what kind of PT/exercises are you doing? How much and how often? (and detailed details would be appreciated, please! Reps, sets and session and all that)




Here are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

And here are some very crucial articles
The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Activity progression for TKRs

Healing: how long does it take?
Chart representation of TKR recovery
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling

Home physio (PT) and activity progress: suggestions
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

And wise words from members who have shared their experiences ...
Where are you in recovery?? (TKR)
Five “P’s” of knee recovery
TKR: work “smarter” and not “harder”
Recovering a knee - from one who knows!
It's never too late to get more ROM!
It's worth the wait for ROM

 

[sjm1027]

1. what are your pain levels right now?

Pain Level 4

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

15 to 30 mg Morphine every 4 hours. (15 is what I take every 6 hours) sometimes I can stretch a little more
3 325 mg Tylenol

3. how often are you icing your knee and for how long?

5 to 6 times a day. Today after PT I iced it foe 90 minutes leg raised above my heart.

4. are you elevating your leg, how often and for how long?

As of today yes more than I have been. Saw PT and VN today and they told me to do it more often.

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

Nothing now except walk around house with crutched every 2 hours for about 5 minutes. The rest of the time it's leg up

6. what kind of PT/exercises are you doing?

Ankle Pumps: 3 times per day10 reps per session
Quad Set: : 3 times per day10 reps per session
Glut Set: 3 times per day10 reps per session
Heel Slides: 3 times per day10 reps per session
Short Arc Quad: 3 times per day10 reps per session
Straight Leg Raise: 3 times per day10 reps per session
Passive Extension: 3 times per day10 reps per session
Walking with crutches: She watches that I do heel toe

That's about it after we had our talk today things were better.

 

[Josephine]

3 325 mg Tylenol

why that little? Did you now know you can take 1,000mg up to 4 times a day? I'm sure you will find that much more effective.

Ankle Pumps: 3 times per day10 reps per session - that's okay
Quad Set: : 3 times per day10 reps per session - also okay
Glut Set: 3 times per day10 reps per session - and these
Heel Slides: 3 times per day 10 reps per session - better if you do it 5 times every couple of hours. But only ever to the point of discomfort, never into pain
Short Arc Quad: 3 times per day 10 reps per session - too much. Do these twice a day and only 5 reps
Straight Leg Raise: 3 times per day10 reps per session - too much. Do these twice a day and only 5 reps
Passive Extension: 3 times per day 10 reps per session - too much. Do these twice a day and only 5 reps

 

[Josephine]

Oh and by the way, I merged your threads as per this request One thread for your recovery please?
Please don't keep starting new threads about your recovery

 

[sjm1027]

Today is 8 days since my surgery 3/6/14. My leg is double or larger in size. Doesn't hurt except very uncomfortable from the swelling and stretching of skin. The black and blue seem to be changing colors like I was told it should. But my leg is so swollen. I have been icing all day off and on and elevated it in a chair and about 2 to 3 times in bed for 45 minutes. Does this sound normal?

 

[skigirl]

If you are that swollen, you need to elevate more or less constantly. Elevating in a chair does not really work very well unless your leg is higher than your heart. at 8 days, I was in bed for 90% of my time with my leg propped up on three pillows

Elevating your leg to control swelling and pain
Using ice

Right now, your tissues are trying to heal---they and you need rest. Just give in for a few days, lie down, get the leg up and rest yourself---allow the swelling to go down instead of pushing forward. You do not need to do any exercises right now--you need to rest and heal!!

 

[Josephine]

Oh yes - that's normal and will be for about two weeks. Your sole job right now to make sure you follow the mantra which - in case you didn't get around to reading the linked articles in my previous post (#29) is this

- rest, elevate, ice and take your pain meds by the clock

 

[kymammovanner]

Steve, I just read your thread for the first time today; you are 2 days behind me in recovery. I also had the redness with what seemed like extremely dry skin on my behind, after only 3 days in the hospital. I'm pretty sure I also could have been beginning a bedsore. It kind of scared me because it I was getting up to use the restroom, therapy, etc., but it's fine now-hope yours is also! And I agree, it's hard to balance the PT-what they want you to do versus what you actually can do without setting yourself behind. If you are like me, you want to do the necessary work without overdoing it, and this early in recovery I usually don't realize it until I've overdone it. (This is my second TKR). I keep telling myself as long as I take more steps forward than backward, I'm doing OK.

 

[sjm1027]

I still have about the same amount of swelling. I seem to be getting itchy where the bruising is. Bruising is changing colors today but slowly. Not sure I read others were having itching? Anyone have any ideas?
Today I got a little more PT in on my own. I went nice and easy. Still concerned on the movement in the joint. Hope all went well.

 

[Karringtyn]

I just read your thread and I am blown away as to what your PT did on your first day. I wouldn't have been able to do much at all,, and I probably would have went off.

Take it easy....everyone's recovery is different....but it takes time...

 

[sjm1027]

So the itchiness turned into a rash. On my chest, my operated leg high on the thigh and on both of my sides just above my belt line. My wife does't think it's shingles. We called nurse last night and she thinks it could be morphine. I stopped Morphine and will see what happens. This morning rash is a little worse but waiting to flush meds from my system. We will make a call this morning to try to get VN here today. No I'm not frustrated

 

[Karringtyn]

I had the same reaction to morphine while I was in the hospital. Please tell me you are taking another pain med and not going cold turkey tho.....