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TKR Knee Number 2!

Happy One Month Anniversary, Penelope Anne!
We haven't heard from you in a few weeks. Hopefully you're pleased with the progress you're making.
Please consider leaving an update, we'd love to hear how you're doing and support you as you continue healing.
I hope you have a nice weekend! :)
@Penelope Anne
 
Thank you Layla for your kind message! It has been quite a month but that was to be expected. The biggest problem has been pain relief as I have been unable to take anything except paracetamol, however in the last few days there is definitely light at the end of the tunnel! A huge relief as, just as after the first knee, I felt as though I was in physical shock for the first two weeks - I had to keep reading the article on Post Op Blues to reassure myself I wasn’t going mad! I cried randomly everyday!
Put it this way - this is my second TKR and I’m really really glad I only have two knees! I’m using one stick now when I go outside and walking unaided inside. Sleep is still a problem as it is really hard to get comfortable. But I am getting there! I reread over and over again, all the advice you gave last time and , as before, it kept me going.
I’m not out of the woods yet but I’m now feeling optimistic!
This forum is invaluable and I have passed the details on to several people going through similar. Thank you!
 
You're welcome! I am sorry to read you struggled with so much pain. Thankfully it sounds like it is easing, right along with the post op blues. You're also making good progress on getting closer to walking unassisted. Hopefully sleep improves soon. It's good to read you're feeling optimistic. Your future looks bright, Penelope Anne! :yes:
@Penelope Anne
 
Hi!
We've not met before. It sounds like despite pain and blues you're managing good mobility at a month out.

Insomnia is a real bummer for many of us after knee surgery. Definitely sleep whenever (and wherever it's safe and comfy!)

Icing, elevating, napping.... All help, but for some of us it was endangering our mental health. Before it gets there consider some nonprescription remedies....

If you're lactose tolerant, a glass of warm milk! If you're not diabetic, a teeny bit of honey makes it even more comforting... plus milk is high in magnesium! Helps us relax!

If you aren't a milk drinker, or want an easier way to, an evening magnesium supplement has been very helpful for some members.

OTC diphenhydramine, an antihistamine also used as a sleep aid (Benadryl) because it makes you drowsy; it's also included in some cold, flu, etc "nighttime" combination meds.

Low dose melatonin, sustained release - not for long term use but I have used for a week at a time without ill effect. It should be taken an hour to hour and a half before going to bed, and during that time stay in a dimly lit area to allow this hormone to activate.

Valerian root - an herbal remedy, it can be taken in capsule form but that dose might be high compared to my preference, herbal "sleep" blends that include a smaller dose of valerian and make me pleasantly drowsy. Plus the other tea flavorings make it nice tasting! Celestial Seasonings and Traditional Medicinals sell teabags by the box. Their sleep blends without valerian have never ever made me sleepy.

Be aware: even benign herbals and supplements can interact with your routine or post op prescription meds, either making their effects weaker or stronger. If you're on meds you may want to check with your doctor or pharmacist, or even check online for interactions.
 
Thank you so much, EalingGran, for your advice! I’m going to try magnesium I think. I take Valerian in small doses already for stress relief during the day. We sometimes end up drinking ‘sleepy tea’ at 4 am - my lovely husband makes it if I’m having trouble getting back to sleep. All in all I just want to get through the next few weeks somehow! Like all of us, I’m longing for some better weather - warm sunshine would be such a boost. today I couldn’t even go outside for my normal totter as the wind and rain were atrocious... anyhow, things are gradually improving- I have to keep telling myself that!
 
My PT says that my knee is not straight yet - I am perhaps a few degrees off. He pushes down on it even though it is painful. I am being told that if it isn’t straight within the 6 week frame it won’t heal properly and that the surgeon will want to manipulate it under anaesthetic. This terrifies me!! is this first 6 week window true?
 
Extension definitely comes later than flexion.
I don't think I was fully straight at 6 weeks although my surgeon never worried about it. I have full extension and good ROM now. ( 150+ flexion/ 0 extension). I had pretty good flexion from early on but I definitely got another 10-15 degrees after six months. So I don't believe the 6 week "window of opportunity ". My leg just moved a bit more when the last bits of pain and swelling disappeared.
I definitely would not allow anyone to push down on my knee. That is only likely to aggravate and inflame things and make any movements worse. Don't be bullied.
I think the best exercise for extension is one I learnt here. It was to just lie on the bed on your tummy with the lower leg hanging off the end of the bed- so that it gently extends under its own weight. That definitely helped.
 
Extension definitely comes later than flexion.
I don't think I was fully straight at 6 weeks although my surgeon never worried about it. I have full extension and good ROM now. ( 150+ flexion/ 0 extension). I had pretty good flexion from early on but I definitely got another 10-15 degrees after six months. So I don't believe the 6 week "window of opportunity ". My leg just moved a bit more when the last bits of pain and swelling disappeared.
I definitely would not allow anyone to push down on my knee. That is only likely to aggravate and inflame things and make any movements worse. Don't be bullied.
I think the best exercise for extension is one I learnt here. It was to just lie on the bed on your tummy with the lower leg hanging off the end of the bed- so that it gently extends under its own weight. That definitely helped.
That sounds like a much gentler option!! There is still considerable pain and swelling especially as I can’t take anything except paracetamol! I will try the bed thing - it feels as though my leg is being broken when he pushes down on it!
 
He pushes down on it even though it is painful. I am being told that if it isn’t straight within the 6 week frame it won’t heal properly
Please, please don't let him do that! He is working for you, not the other way around. This is YOUR knee and YOUR recovery and you have every right to say no.

It makes me angry when PTs threaten us with the "6-week window of opportunity." That was debunked years ago! He clearly doesn't stay abreast of the research, so please don't let him upset you.

With my first knee, it took me six months to get to 0 extension -- but I finally achieved it. You will too!
 
You are still very early in recovery, which can take an average of a full year, so you have lots of time for your leg to get straight, and bend, which it will do, as you continue to heal.
 
Since you are now in a new recovery, would you like to have a different title? If so, just let us know what you’d like, and one of the moderators will change it for you. :flwrysmile:
 
On my second TKA, I realized that two factors were interfering with extension:
1) swelling - so I iced and elevated a lot every day
2) muscle tightness - so instead of trying to stretch my way to extension, I just started focusing on truly relaxing quads and hamstrings.

Every time you let PT force your knee area, it increases the swelling. You can't get there that way.
 
How is the best way to relax those muscles? Because it absolutely is muscle tightness. Is there any benefit in alternating ice and heat?
 
. Is there any benefit in alternating ice and heat
I wouldn't use heat anywhere near the actual surgery site for several months- l think it would just aggravate the heat that is there anyway. I did use heat for other muscle/joint issues at a distance from my surgery- in my case it was my back. I found it helpful there.
 
One of the reasons you feel so tight is because your surgeon did major carpentry work and disturbed every millimeter of soft tissue in this area. You aren't tight because your muscle is underused and needs to be stretched and rehabbed. You're tight because your tissue has been disturbed and is healing.
 
How is the best way to relax those muscles? Because it absolutely is muscle tightness. Is there any benefit in alternating ice and heat?
What I figured out that seems to have helped me, and certainly didn't hurt... Sitting up with the leg out in front of me, I would do my best to let the muscles relax.
Then I placed one hand on each side of my leg, palms in, four fingers under the knee and thumb alongside the kneecap, but just supporting very lightly, not grasping. I would gently and passively shake the leg up and down, not more than a couple of inches.
If I felt the quads or hamstrings start to contract, I stopped moving my hands until they relaxed. But that didn't really happen much.
The gentle shaking wasn't at all uncomfortable and after doing it the leg was more extended out with the back of the knee less bent.
I never timed it but guess it was between1 - 2 minutes at most, a couple of times a day.
 
Happy Two Month Anniversary Penelope Anne!
I hope you’re doing well two months in and enjoying steady progress.
Please let us know as time allows, we love updates.
Have a wonderful Spring! :flwrysmile:
@Penelope Anne
 
Hi there and thank you for asking after me. So, I’m gradually getting my life back - I’ve been given the go ahead to drive two weeks ago and that is making a huge difference. The lack of anything stronger than paracetamol is still hampering recovery. I’m hoping that they will take me off the blood thinners soon and that I will then be able to take ibuprofen. ( they found a ‘very tiny’ clot in my lungs two days after surgery). I feel that with slightly better pain killers I would actually be doing very well. Meantime I’m able to do about 4000 steps a day and 13 minutes at very low resistance on the exercise bike. I think I’m getting there, or at least there’s hope!
 

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