TKR Just wondering on my progress?

[Josephine]

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?
We called nurse last night and she thinks it could be morphine.

That was my thought. You can find a soothing remedy for bruising/itchiness in witchazel. Bruising after surgery

I still have about the same amount of swelling. Still concerned on the movement in the joint.

Then stop being concerned. You're 10 days out. Swelling is par for the course. But it also interferes with the ROM. Had we not made that clear to you by now? Swollen and stiff knee: what causes it?

Did you ever read the recovery articles that were left for you THREE times in posts 5, 26 and again in post 29 of this thread? You have read them right?

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

Utter rubbish! Even I've lifted more that that and at my age!

 

[sjm1027]

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.....

So as the story goes a day later
Stopped taking Morphine and because it was the weekend I went through the night without pain meds. VN was called but nothing really happened there. I called my Dr office and they told me to take 800mg Advil so I started that tonight at 5:00. I know Advil raises heck with my stomach so I will take them with meals only also on Benadryl for the rash. Rash is almost as bad as the knee at times.

So tomorrow I am scheduled for PT and VN to stop by tomorrow. First day alone too. My wife has to go back to work. I was very lucky to have her home for over a week.

 

[sjm1027]

How many days from your surgery did you let your incision get wet?

 

[Josephine]

Advil (ibuprofen)? at 2 weeks out? And with a dicky tummy? That's crazy! I'd say try Tylenol 1,000mg 4 times a day but that's not really strong enough for a TKR either. Advil is certainly inadequate for a TKR - you might as well take vitamin pills! I strongly recommend you don't do any PT until you get some decent pain meds.

As for getting your incision wet, it depends upon the dressing. Most surgeons I know of require a pressure dressings of wool and crepe bandage for 4 days, then a fully occlusive dressing until the staples/stitches are removed. However, you could cover the wound and dressing with a plastic sleeve to shower. I did this from day 3 just as shown in the picture (but with a much bigger dressing!). I think you should ask before you do.

 

[sjm1027]

Hi I am 3 weeks and 2 days out from having my right knee replaced.
I am wondering what others are feeling at this time. I am feeling the following:
* I am walking around the house without a cain or crutches most of the time but not walking good enough to not think about using them.
* I ride a stationary bike total of 20 minutes a day 10 minutes in AM and 10 minutes in PM
* My leg is still pretty swollen at this time about 2x the left leg.
* I am doing heel slides myself and getting 88 degrees without help.
* PT typically gets me with help to 100 degrees, with pain
* When I first wake up I use a crutch for 5 minute until the muscles loosen up.
* When I walk I seem to notice one leg longer than the other.
* I have movement or clicking (feeling) in my knee. PT says it could be a weak muscle.
* My knee is so stiff feeling, the pain is different each day, yesterday was better than today.
* Started using vitamin E on my scar, today.

So just wondering if others that are 3 weeks out are doing the same or am I having problems. My walking is not that great, I wouldn't feel very comfortable going out without a crutch.

Thanks,
Steve

 

[Texan]

I am at 8 weeks but I remember the 3rd and 4th weeks. Tough 2 weeks, then I started seeing progress. I, too, walked around in the house without the walker or cane but used one or the other when I went out. My p/t didn't put me on the bike until 7 weeks. 20 minutes sounds like quite a bit for 3 weeks. That might be why your leg is swelling. Don't let the p/t push you to a number that is going to cause you pain. That also causes swelling. I had a lot of ups and downs during these two weeks, with lots of crying, then things started settling down a little. I felt like I turned a corner at 7 weeks. Are you icing and elevating throughout the day? For me, if I had stiffness, it was caused by swelling. I use vitamin E oil even though I have read that it doesn't help. I'm not taking any chances!!! Things will get better! This is a slow recovery and you have to learn to not push too hard. Keep posting so we know how you are doing.

 

[Roy Gardiner]

* I am walking around the house without a cain or crutches most of the time but not walking good enough to not think about using them.
* I ride a stationary bike total of 20 minutes a day 10 minutes in AM and 10 minutes in PM

Too much; what you are doing is training, which you don't need. What you do need is mobility stretches.

Get on the bike; turn the pedal. If you can turn it easily without discomfort, lower the saddle and keep lowering it until you struggle (it's uncomfortable but not painful) to turn the pedal. Now, pedal the bike on zero resistance for about 20-30 secs. Do this many times a day until there's no discomfort. Lower the saddle and repeat.

* My leg is still pretty swollen at this time about 2x the left leg.
* I am doing heel slides myself and getting 88 degrees without help.
* PT typically gets me with help to 100 degrees, with pain

Don't do it with pain! Do less. Pain is counterproductive

* When I first wake up I use a crutch for 5 minute until the muscles loosen up.
* When I walk I seem to notice one leg longer than the other.
* I have movement or clicking (feeling) in my knee. PT says it could be a weak muscle.
* My knee is so stiff feeling, the pain is different each day, yesterday was better than today.

Your training and PT regime might be contributing to this, it for certain isn't helping to improve it.

* Started using vitamin E on my scar, today.

Otherwise, par for the course, well done.

 

[sjm1027]

I believe my selling problem is 2 fold. Maybe I am pushing a little bit but never to much where it hurts like hell.

MY PT is good, she was tough until I told her to talk to me before she just does something. No surprises. We went for a walk outdoors the other day, 1 crutch for 1 minute then she asked for the crutch.

My second swelling problem is this, I lost 291 pounds about 4 years ago and i have some extra skin around the side and back of each knee. It's an easy place for fluid to go says the PT and VN. So I have to deal with that.

Roy, I do exactly what you said with the bike seat. I now have the seat exactly normal riding height. So I now have to just focus on keeping my foot on the pedal and not sliding it back to the heel (cheating)

I do feel a bit better today. Funny how one day you're good, next day you're worse and you're mind gets down in the dumps. Today I am up.

Thank you all for your help as I go through this tougher than I thought surgery. I have my left knee to do yet... I will wait to see how this turns out before I do anything. I am told the swelling is throwing off the way the patella is gliding in its space. That is the pain I am feeling and the clicking or looseness. As I build up the thigh muscles this should go away. Keeping my fingers crossed. I go to my surgeon on Tuesday 4/1. Cant wait to find out how things look and I want to see my X-rays too.

Steve

 

[Roy Gardiner]

Roy, I do exactly what you said with the bike seat. I now have the seat exactly normal riding height. So I now have to just focus on keeping my foot on the pedal and not sliding it back to the heel (cheating)

You can keep lowering below normal riding height to get that bend!

 

[sjm1027]

Ha, ok Roy, now you sound like my PT I will give that a try later today.

 

[Josephine]

@sjm1027 I merged your threads as per this request One thread for your recovery please?
Please don't keep starting new threads about your recovery

 

[referee54]

Maybe I am pushing a little bit but never to much where it hurts like hell.

Please remember that Less is more." Every time you want to do more, fight that urge and do less---you will have fewer problems

Thank you all for your help as I go through this tougher than I thought surgery.

Many of us---I would say almost all of us---found out the very same thing---take it easy---you cannot rush these recoveries---time and patience are the keys.

So I now have to just focus on keeping my foot on the pedal and not sliding it back to the heel (cheating)

In the early days it is absolutely OK to cheat!!

PT typically gets me with help to 100 degrees, with pain

Do not wrry about the degrees of ROm---that will come, all in due time---but do not allow anybody to hurt you or to force yourself to do something that will bring pain to you.

 

[Josephine]

I am doing heel slides myself and getting 88 degrees without help.
PT typically gets me with help to 100 degrees, with pain

You shouldn't need help to do your flexion. Totally unnecessary. Heels slides and the bike are quite sufficient.

My knee is so stiff feeling, the pain is different each day, yesterday was better than today.

Do remember that stiffness is pain. Pain comes in many guises including soreness, burning, stabbing, throbbing, aching, swelling and stiffness

Started using vitamin E on my scar, today.

Massage post THR

I ride a stationary bike total of 20 minutes a day 10 minutes in AM and 10 minutes in PM

I agree with Roy - far too much.

I am told the swelling is throwing off the way the patella is gliding in its space. That is the pain I am feeling and the clicking or looseness.

The swelling is temporary so therefore, so is the interference with the patella. The pain is not connected with clicking and looseness which will settle down in time as your muscles heal and regain their tone.

 

[kneeper]

I had clicking & a strange feeling too for a while as the muscles were healing and gaining strength--just as Josephine says.

 

[sjm1027]

Tomorrow will be 5 weeks since my TKR 3/6/14.
I am walking without assistance but can't do stairs without pulling on railings to go up and going down seems worse, I can't seem to bend my knee enough to clear the step.
My leg is still very swollen, calf and thigh both. a little less that double the normal size. The knee itself started to hurt a little more than normal. Not sure it's because I am doing a little more now or if there is a problem. Today I walked slow pace for .8 of a mile with no assistance. Took it slow. I am also doing my standard leg lifts, heel slides, ankle pumps... I can drive again and that means my Home PT went away and I have to wait for outpatient till 4/22/14. I am working daily and my wife helps to stretch. We are getting to 115 to 120 degrees (with help) I an get to 105 alone. I ride the stationary bike 30 minutes a day, 15 in AM and 15 PM, Rowing machine for 5 min and elliptical 5 minutes. I am doing these things VERY easy and slow. I do have some clicking feeling in the joint but I am told it's because of the swelling.
Tonight I am getting some pinching feelings on the knee towards the side. I have been icing and elevating a few times per day. Do you think it's because I am working it to hard or it's part of the healing process?
I have a desk job but really don't think I am ready to go back on week 5. I may stay out 6 weeks.
Thanks
Steve

 

[beth1954]

Someone will probably be on here soon that knows a lot more than I do. It seems to me that you are doing quite a bit. The rowing machine and the elliptical would kill me, I know that for sure. I personally would change the bike to three ten minute sessions. Seems like a long time between the home therapy and the outpatient therapy. I would tell you to be sure you keep moving your knee good, but I don't think anyone needs to tell you that. Don't rush going back to work. 6 weeks at the minimum -- if you can do that......Good luck!
Ice a lot.....sounds like you are plagued by swelling like I have been. That can cause lots of problems....

 

[Jamie]

Steve.....I merged your latest thread into your original recovery thread. Please do not start new threads when you have a question come up. We need all your recovery information in a single thread so we don't have to go back and try to find out what you've been through and identify advice given in multiple threads. If you find you'd like a different title for the thread, just post what you want and we'll get it changed for you. All questions, concerns and updates on your recovery should be posted here.

You are doing way too much for your poor knee! You are only 5 weeks out. We usually recommend that folks not go back to work until 10-12 weeks. So at 6 weeks, you're really pushing it. Desk jobs are every bit as hard on a new knee as a more active type of work. The sitting can be just as painful as a lot of activity! The more time you can take off, the better you're going to do.

I suggest that you cut way back on your exercise. Now that you are up and around, you really don't need a lot of "therapy." Some gentle bends and stretches twice a day along with your walking about the house and maybe ONE small errand a day can be your therapy. We usually don't recommend that folks go back to using machines until three or four months out....with the exception of a stationary bike for maybe 15 minutes ONCE a day. The rowing machine and elliptical are too hard on your knee....I recommend you stop them completely for now.

A ROM of 115-120 (and even the 105) is quite in the normal range for 5 weeks. The fact that you have swelling indicates you're working your knee too hard. Your ROM is there and your main job should be to reduce swelling and pain. You do that, not by pushing on your knee (or having your wife push), but by resting, icing (constantly), and elevating (toes above the nose). It's even good to ice through the night when you're sleeping. Just be sure to keep a cloth between your skin and the ice source so that you don't damage your skin.

Walking is good for you as well. But I wouldn't worry about trying distances just yet. That can get to the point of pushing your knee too and cause some of the swelling you're experiencing. If you are able to walk at a good strong gait with no limping, I'd say it's fine to walk with no aids. But....if your stride is shorter than normal and/or you have the slightest limp, please go back to a cane or walker until you are strong enough to do those good strides.

 

[sjm1027]

Looks like I am doing to much. Thanks, I will slow it down a little and do more icing.
Thanks

 

[Jamie]

 

[Josephine]

can't do stairs without pulling on railings to go up and going down seems worse, I can't seem to bend my knee enough to clear the step.

That's okay. It can take 4 months or more before you can do stairs normally.

I am walking without assistance My leg is still very swollen, calf and thigh both. a little less that double the normal size.

If your knee is very swollen, then you need to use a cane. You are stressing it too much.

The knee itself started to hurt a little more than normal. Not sure it's because I am doing a little more now or if there is a problem.

You are stressing it too much(!!)

Today I walked slow pace for .8 of a mile with no assistance.

¾ of a mile at 5 weeks? Guess you never read this then? Activity progression for TKRs

We are getting to 115 to 120 degrees (with help)

By this do you mean your wife is pushing on your leg? Please don't do this. It's best you achieve this on your own and never cause yourself pain.

I have been icing and elevating a few times per day.

Define "a few"

Do you think it's because I am working it to hard or it's part of the healing process?

I am quite sure it is!

I have a desk job but really don't think I am ready to go back on week 5. I may stay out 6 weeks.

I usually have my patients stay off for up to 12 weeks. I find they don't do well if they return any earlier. Do be careful about when and how you return. Read this Phased return to work.

Rowing machine for 5 min and elliptical 5 minutes.

You really shouldn't be using machines like this at 5 weeks out. I would suggest they be kept until well after 12 weeks. Totally not advisable, they stress the knee far too much.