TKR Lark's Recovery Thread.

Welcome, Lark! It looks like we're nearly right TKR twins: my right TKR was on April 29, 3 days after yours... Hope you are doing well, but do ask questions of us here....we're happy to help others make their way through this TKR recovery journey!
 
Hello @Lark - and :welome:

I've started this recovery thread for you, so we can talk to you and get to now you.

How are you getting on?

Please post any updates or questions about your recovery in this, your own thread. We will see them there, as someone checks all the new posts every day.
If you need an urgent response to a question, just tag a member of staff.
Tagging other members and answering tags

If you prefer a different thread title, just post what you want and we'll get it changed for you.

Just in case you couldn't find your thread, here are the instructions on finding your thread,
How can I find my threads and posts .

A helpful hint - Many members have found it useful to bookmark their thread so they don't lose it.

Best wishes,
Celle
 
Here are our guidelines, to help you with recovery:
Knee Recovery: The Guidelines

People are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart are here to help, but YOU are the final judge as to the recovery approach you choose.

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary.

2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

5. Try to follow this

6. Access to these pages on the website

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 
Welcome, Lark and congratulations on your new knee! Folks are here to help support you!
 
Welcome, Lark! I’m a few days ahead of you in recovery and am so grateful I found this site. Support, answers to questions, and a place to vent!
 
Hello all! I’ve been spending the last few days reading posts. It has been very enlightening.
Now for the long post to hopefully give enough information that people can give me some thoughts & suggestions.

So, here I am finishing up 10 weeks post surgery. Best way to describe where I am is being frustrated, in pain, and not sleeping. Often on the verge of tears.

I’m 66, very active, often overly positive, logical, known to overdo things and usually cheerful.
Being where I am blows my mind. But, since I cannot could’ve, should’ve, would’ve, I can only go forward from here. Just don’t know where to go at this point.

Looking at posts and bonesmart articles, I see that I have been much too aggressive with the PT and exercise in general. I may have not let healing process work like it should as resting was only when I was icing, although that was quite frequent as the pain level has been high.

Most of the swelling is down and now icing is painful. It feels like the metal in the knee is getting cold and causing more pain. I even use multiple layers of towels so that it is barely cold to my skin.
I had extreme nausea for the first six or seven weeks. Occasionally have it now when I have over exercised. But it is manageable.

Stopped oxycodone at five days thinking that this was most of my nausea issue.

I have peripheral neuropathy not related to diabetes and I am taking 1500 mg of gabapentin per day. Also I have maxed out + on Tylenol daily since the surgery. This is giving me some concerns about liver issues.

I do use a prescription topical gel for pain relief that is marginally helpful.
My hip joint is also in a lot of pain. Nothing like this before the surgery.

I’ve gone to PT since the first week twice a week until the last two weeks down to once a week. My range of motion is at 126, although it was never forced to get that measurement.
It’s probably due to my consistent exercise program. My therapist has been very good about working with me for the last three weeks to manage/back off my excessive exercising and then having excruciating pain.

Unfortunately, it seems that I’m still not improving on reduced pain or able to sleep.
There isn’t a place on my knee that doesn’t hurt. Any kind of activity makes it start to get tight and hurt more.

Last week, three days I virtually did nothing outside of the normal around the house movement. Iced as much as possible but it’s painful for more than 8 to 10 minutes at a time.

Then I did a very light water aerobics class. More floating and gentle movement then actually aerobics.
That evening the pain was so bad probably at level 8 that I took 1 oxycodone. A couple of hours later I finally relaxed enough and I got the first nights sleep of more than 3 1/2 hours in weeks. The last few days I’ve taken it very easy. Not over exercised, but back to sleepless nights and consistent level of pain 4 to 5.

I am at a loss.
 
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Hi @Lark ,
With a ROM already at 126 degrees, I think that cutting back severely on your PT and exercises should bring about a reduction in your pain. You don't need to keep exercising for ever in order to maintain ROM.

You're trying to do too much, too soon. Certainly, from the after-effects you had, your new knee isn't ready for water aerobics yet.

You're only 10 weeks into a recovery that takes a full year, so try to slow down a bit. Your knee will thank you for that.

There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

In any case, it's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal.

And don't forget that just your activities of daily living (ADLs) are also exercise.

Since icing is hurting now, just elevate your leg without icing, and see if that helps.

Also I have maxed out + on Tylenol daily since the surgery. This is giving me some concerns about liver issues
How much Tylenol are you taking in each 24 hours? Tylenol is safe, as long as you stick to the recommended maximum daily dose.

The most effective way to take Tylenol is 2 x 500 mg tablets (Tylenol Extra Strength) 6-hourly, to a total of 4,000 mg (4 doses) in 24 hours. You need to take it regularly, to keep up the levels in your bloodstream. If you just take the odd dose now and then, it's far less effective.

Check all other medications you're taking, to make sure there is no Tylenol/Acetaminophen/Paracetamol in them. If there is, scale back one or two of your regular doses, so you stay within that safe 24 hour limit of 4,000 mg.
(The recommended safe daily total in the US is 3,000 mg. That's because the FDA was afraid people would not check their other medications for Tylenol content. )
 
Hi Lark - You sound a lot like me; active, positive, usually cheerful, and not used to sitting back when something needs to be done. This surgery challenges all those elements - the tendency is to work hard to get back into fighting form - and this forum and its moderators and members keeps reminding me that it's not hard to overdo things - and my knee reminds me with no reservations. The fact you can bend 126 degrees is amazing! Congratulations - and the fact you do it on your own is even more inspiring. I take Tylenol - mostly at night when the discomfort settles in. I ice a lot - and elevate. That being said, this afternoon I attempted to prune a few rose bushes (not on level ground), and now I'm feeling that, and looking at a swollen knee. Be patient with yourself - and I hope the pain starts to settle down.
 
I’m taking 3900 to 4500 mg of Tylenol a day. None of my other medication‘s have it in them.
I have been taking this much daily since 5 days after surgery. Most days it doesn’t feel like it’s really helping . Especially at night.
If it is indeed helping, I can’t imagine what it would be like without it.
I realize everyone is different, but I am shocked that I still have to take this much Tylenol at this point Just to function.
Especially, since I usually have a pretty high pain tolerance.
 
Have you thought about talking to your surgeon about all of this pain you are having? Sometimes getting reassurance can help.
I, too overdid it from time to time, only to take two steps back in my recovery.
I have learned, at 4-1/2 months, to slow down when necessary. I am icing right now, after back to back days of golf...not quite ready for that, I find...
It's hard when all our lives we were told to work harder if we wanted to reach a fitness goal...this is just the opposite!
Be well..
 
I’m taking 3900 to 4500 mg of Tylenol a day. None of my other medication‘s have it in them.
You need to cut down your daily Tylenol consumption by 500 mg. You mustn't take more than 4,000 mg in any one day.
Your liver can handle a certain amount, but it is very sensitive to anything over that amount.

And you do need to cut back on your activity. Your knee is telling you by being painful that you are doing too much for its stage of recovery.

You can't take more pain relief, so you do need to stop doing as much. Spend more time resting, icing and elevating. You'll need to do this for several weeks until your knee calms down.

You're only 10 weeks into a recovery that takes at least 52 weeks. You can't expect your knee to be able to take the load of a knee that has recovered for longer.

I know it's hard to be patient and relatively inactive, but doing so will be a wise investment in helping your knee towards a successful recovery.

Try not to think of resting as "lying around, doing nothing." Instead, think of it as working hard, to give your knee the best possible chance of healing well.
In other words, when you are icing and elevating and watching TV, you are not 'lazing around' - you are "engaging in a carefully considered, proactively designed, heuristically programmed, dynamically structured recovery programme".
 
As for sleep, I am only now beginning to sleep through the night and not even every night! My surgeries were before yours, so try not to be discouraged! Sleep will come but on it’s own schedule. Nap during the day when you can and do not overwork that baby knee :) !
 
I am trying to find the balance of exercising enough but not overdoing it. I have the long game goal to be able to downhill snow ski in 2022.
so I am taking all the great advice that I am being given and rest more.
 
As for sleep, I am only now beginning to sleep through the night and not even every night! My surgeries were before yours, so try not to be discouraged! Sleep will come but on it’s own schedule. Nap during the day when you can and do not overwork that baby knee :) !
Thanks for the input. I thought that there must be something wrong. Napping isn’t easy for me but maybe just relaxing will help.
 
Have you thought about talking to your surgeon about all of this pain you are having? Sometimes getting reassurance can help.
I, too overdid it from time to time, only to take two steps back in my recovery.
I have learned, at 4-1/2 months, to slow down when necessary. I am icing right now, after back to back days of golf...not quite ready for that, I find...
It's hard when all our lives we were told to work harder if we wanted to reach a fitness goal...this is just the opposite!
Be well..
My last appointment, we reviewed the pain and the sleeplessness. At that point I was given the topical prescription to help cut back on the Tylenol. I was told sleeplessness is just part of the process and it would get better.
 
I have done a lot of resting.
I actually got two nights sleep about seven hours. That was amazing!
Yesterday did nine holes of golf using a cart with friends. Had a great time. Was even able to par on two holes. My knee felt well although my golf swing needs a little polishing. I know that will come.
Uncomfortable night, but to be expected with increased activity.
Going to PT today. I will be working with her to back off on aggressive exercise and focus more on healing.
Today I’m feeling very positive. That’s so good. Not on the verge of tears.
 
Hi Lark,
Although my recovery thread sounds a glowing report, I too am not yet sleeping well at night.
Never a napper "napping means you are lazy", I have become one. I nap every day since OR,usually for 2 or 3 hours....sleeping is healing.
 
I'm inspired by the golf outing! Well done. I don't sleep through the night; up three or four times to get ice, due to some positional discomfort (from back to side, to back, to side, etc.). I ice more at night than during the day!
 
I woke up Wednesday morning with a rash on my knee. It does not itch or hurt.
It is in the area that I apply the prescribed topical gel from the OS. So, I think I’m having an allergic reaction to it. I washed it good keeping it dry and I’m not using the gel again.
When I went to PT yesterday, my therapist said that it was concerning to her and if it did not go away in a couple of days to contact the physician. F4CE92B2-FB61-4143-9768-F46E8FEC2BF1.jpeg
As for the PT session, I told the therapist I was going to lay off of any exercises and get my leg to not be completely exhausted/fatigued /painful. She smiled and rolled her eyes and said finally! She completely supported that so we put together a plan for the next couple of months. She eliminated all but four exercises and gave me strict instructions on how to do them yet not overdo it. And she emphasized listening to my body and resting.
My hip has almost completely stopped hurting, finally. The resting the last few days seems to have made it very happy.
My foot is still pins and needles about 50% of the time. I don’t know if that’s still due to the swelling in my knee and it will go away.
 

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