TKR Left TKR Recovery---Now I Have a Matching Set

[Rockgirl4]

So what is everyone's advice on ice at 6 wks post-op???? I know I obviously have extreme swelling preventing my bend. My surgeon suggested moist heat, but when I tried it a few days ago, I swelled horribly and hurt badly the next day. I think I'm icing 3X a day now, but I feel like the week would have been better if I was icing 5-6X a day still.

I'm also disappointed the anti-inflammatory isn't decreasing the swelling--it's only helping with pain. I'd considered asking the surgeon if I could just go back to Celebrex and see what happens. I wondered about a TENS unit also, an whether than can improve swelling (???)

This is all coming from my mistake tonight in reading my old recovery thread from 2019. I read that I'd made forward revolutions on the bike at this point last time around, and I'm nowhere close. with this recovery. The medication definitely hasn't been the saving grace I'd expected, and I feel like nothing is ever going to get rid of this swelling. I'm still using the elastic tubular compression bandage with no improvement either.

((Big Sigh))---I'm all up in my head and know I see the surgeon again in 4 wks. Nothing has changed with my motion these last 2 weeks other than less pain. Just add me to the Pity Party Club, asking once again why can't anything be easy??!! I really thought what worked last time would help this time, but once again, NOPE!!! It's a complete mystery of trial and error, like usual.

 

[EalingGran]

OUCH! At six weeks I couldn't have tolerated that long with my leg down, and I didn't have a lot of visible swelling. But I bet that all things considered the benefits of that salon visit made it well worthwhile

Absolutely agree with @mendogal on this. No way could I have tolerated that long with my leg down and I had little or no visible swelling at 6 weeks- just the tightness sense of internal swelling.

 

[Toothfairy]

No advice @Rockgirl4 but just a reminder that every knee operation is different. You have got through all these difficulties before and you will do it again. I know that doesn’t help right now at all. Just sending you love and strength to keep on experimenting and finding what works for you. Maybe increasing the icing frequency will help. I’ll also keep my fingers crossed that the nearer college works out.
Hope you soon feel much better. Have a good day. Xx

 

[EalingGran]

think I'm icing 3X a day now, but I feel like the week would have been better if I was icing 5-6X a day still.

I would listen to your body and ice as much as you feel like.
At 6 weeks I was taking a good walk in the morning ( I actually managed 10,000 steps on one day at around 6 weeks- on the day of my surgeon appointment)- but the rest of the day/ evening/ in bed at night I was resting/ elevating and using my Aircast Cryocuff. I even slept with my knee resting on the cold water jacket. I would refresh it in the night when I woke.

 

[selketine]

I'm sorry to hear about your continued struggles with swelling and discomfort. It's hard to compare one knee to the other (although we all do it who've had two!), but I'm sure most of us had a slow one and a quick one. You also have health conditions that are impacting recovery and your body's response to surgery I think - which makes it harder to figure out. And comparing to other people - oof! Like @EalingGran walking 10k steps at 6 weeks - I would literally be dead trying to do that - haha! I was managing only 1200 steps a day more or less before surgery so 10k seems like a far off dream. I watch people walking nonchalantly at the mall or something and just marvel at it. I'm still penguin waddling with a cane and having to sit down a lot.

My January knee had a lot more swelling and I struggled to sit for long with it down. This was a problem when I started back to work cause it felt awful after awhile. Have you thought about or asked the doctor about wearing full on compression hose on that leg? I wore a thigh high stronger compression stocking on my right leg up until I had surgery in Sept. on the left. If I didn't wear it - my leg/ankle was all swollen at the end of the day. Wearing that really helped but I didn't start wearing it until I went back to work around 8 weeks I think?

I hope your son loves the close by university! I know how it is wanting something for your kid but trying to give them some space to figure it out. Sounds like a good fit for him - but 6 hours away isn't bad either!

 

[mendogal]

Icing is an individual "do it as much and as long as you need to" therapy.

Adding heat (and I write this as a devoted fan of moist heat) while there is unhealed tissue with active post op inflammation and swelling simply doesn't make sense physiologically.

Sure, it's fine to ice more.
Here's an experiment: why not pick a three day trial period when you don't have prebooked plans. elevation (not leg propped; full toe over nose ) and ice 45 - 50 minutes on, then 10 minutes very light activity, at least 4 times during the day (more if you can do it without going stir crazy) plus ice continually in the evenings. During these three days, cut back on overall activity by about a third, doing light stretching and frequent short walks. Use your acetaminophen on a schedule, prescription med as needed.
See where things are on day 4.

Just a quick brainstorm on my part.

 

[EalingGran]

Like @EalingGran walking 10k steps at 6 weeks - I would literally be dead trying to do that - haha! I was managing only 1200 steps a day more or less before surgery so 10k seems like a far off

The first day I walked 10,000 steps was actually a mistake. It was my 6 weeks check with my surgeon and parking at the hospital was difficult- so my husband used a parking app to buy parking "near" the hospital; which turned out to be anything but! We also went out that evening.
Everyone is different. I could walk early on-albeit with a crutch, but I couldn't stand for even a few minutes. I didn't do housework or cooking for months as my knee would complain and I needed medication and ice to sleep. I also iced for months

 

[Jockette]

I’m sorry you’re in Pity Party mode right now. Remember, the post op blues are very real and often show up around now. 6 weeks is a long time to feel intense post op and all that entails and we just want to be done with it! Sending lots and lots of hugs! !

 

[Layla]

Just add me to the Pity Party Club,

Ok...will do, but you can't stay long.

I think the frustration you are feeling is normal. Try to focus on and celebrate the small milestones you've achieved rather than compare where you are this time, as opposed to last time. Consider taking note of those changes once a week to see the progress you've made from the week prior. The ups and downs and even the boring stalls are all normal. I hope you have a good week, Rockgirl! Thanks for your support of others even though you're having some struggles yourself.

 

[WFD]

This may explain why my psoriasis popped up in odd places & in abundance over the last 8-9 days.

I developed nail psoriasis for the first time in my life during the last year in the middle of a bunch of surgeries. The cuticles are sore and swollen and the symptoms wax and wane roughly in step with the level of general pain in my knee and shin as well as success or failure in treating my knee infection. When I suggested to the doctor that the surgery and infection was somehow triggering or exacerbating the psoriasis, all I got was a puzzled look. @Rockgirl4 , your comment is the first I've seen that made this connection and may help explain where my case of psoriasis came from.

I see from reading online that psoriasis is often found with rheumatoid arthritis (for which I have many genes that increase the odds of having the disease [though I don't actually have it] and presumably code for abnormal proteins) and both diseases are associated with increased inflammation and scar tissue growth, the latter of which has been the bane of my knee-surgery-existence.

 

[Rockgirl4]

@WFD Isn't it amazing when people come together and find similarities?! I'm glad I gave you validation, even if Drs don't want to agree with us. I keep stumbling across more and more information showing people with autoimmune diseases tend to have longer/harder recoveries from ANY surgeries, with a much higher risk of complications. I don't know if Drs don't want to look for any correlations, or if they're just so focused on moving to the next patient/surgery. It's sad though because that validatin would really help OUR peace of mind.

 

[Rockgirl4]

7 WEEK UPDATE!!!!!
Hey everyone! Today is 7 weeks post-op on TKR #2, and I'm sorry I've been MIA. The last week was VERY interesting:

The Bad
1) I'm fairly sure I was sitting on a low-grade sinus infection that blew up last weekend. Killer headache and sinus pressure, ear popping and congestion, hurting all over, nothing tasting right, and the pressure in my face was awful. I started a strong round of steroids and antibiotics Sunday night, and have finally turned a corner. I think sitting out all night on Halloween (handing out candy), pushed me over the edge.
2) I haven't been able to sit and type at my laptop due to severe back spasms, shoulder pain, neck pain, the horrible headaches, and just hurting all over---not being able to get comfortable. I had to sit and watch TV for 3 days to get a bit of improvement, preventing any slouching or bad posture. I had a chiropractic appointment Wednesday AM and a massage this morning--both have helped a little. I'm slowly adding my lower-back stretches in, but the TKR leg is making that VERY hard. I simply don't have enough movement in that hip or bend in the knee yet to do what's needed to keep the hip in alignment (from an old injury). We'll get there eventually. I'm thankful I can afford massage and chiropractor appointments at times like these, as I know many aren't as fortunate.
3) My husband got his Covid vaccine Wednesday morning and has been so sick since. This has happened with every Covid vaccine and a Shingles vaccine, but tomorrow should be better if things follow the same path as other years. He hasn't been able to help with laundry, dishes, etc, so I'm adding back more chores each day.
4) I still have a crazy amount of swelling in my knee.
5) The insomnia of the last 2 years is back, meaning I'm sleeping at odd times again---WHEN I sleep. I worry that's going to slow down my overall healing.
6) Oh my GOSH----The NERVE pain!!!! It's been awful. I didn't realize how lucky I was after my first TKR and the ACI surgery in 2016. I had almost none of the long-term nerve pain so many here describe. This is always directly below my knee (patellar tendon area), and then goes down the shin towards my ankle. It feels exactly like the stim one gets at the end of a PT session, how you can feel the electrical charge moving through the tissue. It's bearable most of the time but driving me absolutely insane.
7) The WORST one yet--I went off of the narcotics too quickly. My pain had dropped so significantly that I went from 3-4 Tramadol and 1-2 Oxycodone a day to maybe 1 Tramadol a day and 1 Oxycodone at night. That happened over 3 days. On Day 4, I was getting major shaking, nausea, body aches, anxiety.....it was awful!!! I wouldn't have thought 6.5 weeks could create the need for a "weaning" schedule, but apparently it did for me. Thankfully I'm past it!!! I took a 1/2 Tramadol today and 1 oxy at bed-time, and I'm hoping by Sunday/Monday to be done with them both unless there's a day I overdo things and need a something for sleeping. I'm still keeping the Tylenol in my system 24/7 though.

The Good
1) I got my new piece of exercise equipment last weekend. I've been using it 2X a day for 5-10 minutes only. It's a hybrid elliptical/recumbent bike. The "pedals" are actually flat plates (for lack of a better term), and they keep my ankles from torquing so much on the leg with the limited range of motion. I just can't use typical bike pedals anymore because of the bad ACI adhesions from 2016, as my ankle had to compensate in a way that created other foot pain, so this has solved that problem. It will help so much with cardio too once I get to that point next year. It's made me feel SOOOOO much better about my bend in this TKR knee. I can use the equipment easily and do revolutions in both directions. It's not pretty, but it's doable.
2) Somewhere in the last 5 days, I've turned a corner with pain. I get out of bed more easily in the morning and don't struggle with those first steps. I can stand longer and move around longer without needing to sit. I can shower without the shower seat if I'm fast.
3) I can go up a few shorts steps, but I wear out after 4-5 due to pain and limited strength. I'm able to do quad sets very easily most days though, and that came back without any effort. One day I could barely do 6-7, then the next I could do 2 sets with almost no effort.
4) The BEST one yet-----I'm driving again!!!!! That has helped with the cabin fever.
5) I bought a TENS unit and have been testing it to see what setting helps and the best location to help with swelling. It's still a work in progress. I think it has made the nerve pain BELOW the knee worse, so no I've switched to using it on my quad area, hoping it can get some of the swelling down.

The next few weeks are going to be interesting! My husband and son will be gone this coming Sun/Mon for a college tour 6.5 hours from home. I'll be fine overnight, as my neighbor next door is always a call away, but they're taking my car instead of my husband's truck due to the gas mileage and overall comfort. That means I need someone to drive me to an appointment Monday. At least I won't be trapped at home totally. My son's car will be here for emergencies, though it's hard to get in because it sits so low. There's no way I'd be able to get into my husband's truck because neither knee bends much right now.My husband then leaves for a 7 trip to Chicago on Nov.17. The kiddo will be around though, so I won't be alone for 7 days. I'd hate that right now, as some days are still harder than others, plus I never sleep well when Shawn travels. Considering how messed up my sleep is though---I think it won't bother me.

Last but not least-----it's been a very depressing week for our family. We're all struggling with some things we can't change or control, and we are very worried for some extended family members-----medically, politically, and financially. I want everyone to know that we know EVERYONE has things in life that are a struggle...and I empathize with all of you. I'm sending out the same cyber hug that I've been receiving from others lately, as we could all likely use a little extra in the hugging department. I'm off now to catch up with everyone else.

 

[EalingGran]

Overall a very positive report. Great to be back driving! Sorry it is so tough for you with all the inflammation.
Just one suggestion I find really helpful.
If I have a bad cold with blocked sinuses and can't sleep. I find diphenhydramine ( a sedative antihistamine marketed as Nytol in the UK) really brilliant. It is not only sedative and anti inflammatory but it has an extra anticholinergic effect which dries up secretions and helps me breathe. I hate feeling choked at night when I try to lie down. I wouldn't mix it with any opiates or other sleeping pills but should be fine with most other meds- just check with the pharmacist if you are unsure.
Hope your sinuses settle soon.

 

[Rockgirl4]

Thanks @EalingGran . I've been taking Mucinex (12-Hour) 2X a day, which has really helped. I can't take most decongestants because they raise my blood pressure too much, but the Mucinex (Guafenesin) helped open my sinus within 2-3 days. That's part of what was scary last weekend---my blood pressure kept getting higher and higher. We're pretty sure now that it was from the massive headaches, as it's finally come down considerably. I did take our version of diphenhydramine a couple of nights though, as I just couldn't sleep.

 

[sistersinhim]

Yay...freedom, you are driving! That and riding my outside bike were my biggest thrills during my recovery.

 

[selketine]

Sounds like you are making great progress! Driving is a HUGE one and it is just so nice to get out! My mood lifts a lot just going somewhere and doing something every day.

 

[mendogal]

Sinuses: don't forget the symptom relief of steam, via the old head and towel over a bowl of hot water or being in (or even in the same room as) a steamy shower. I use meds, but steam is totally my first non-medicine go to for any sinus or bronchial congestion.

Congrats on driving!!!!!! One of the finest milestones!!!!!

 

[Toothfairy]

Wonderful to hear that you are driving @Rockgirl4 and brilliant that you have your new exercise equipment . Hope that nasty sinus infection is totally gone now. Take care. Don’t overdo things when you are home alone.

 

[Layla]

Happy Two Month Anniversary, Rockgirl!
I hope you're feeling better than you were last time you posted.
Have a great week!
@Rockgirl4

 

[Rockgirl4]

10 Week Update post Left-TKR
Hello everyone!!! I've been MIA the last few weeks helping my 18-yr old son with a lot of homework and test prep, extra college planning, plus my husband was out of town for 8 days. I was literally back to doing IT ALL!!!! I found it's nice to have some benchmarks to know what some people can/can't do at certain points in recovery, as EVERYONE is so different, so I'm back with a few lists. ((I'm a slow healer and swell a lot after every knee surgery, so this is my perspective as one of those who needs more time to return to normal activity and be pain-free.))

The Good
1. I'm back to driving as long as I want & running short errands that don't require a lot of walking.
2. I can clean in short bursts, but I wear out quickly and the knee gets angry quickly.
3. I can cook in longer spurts as long as I sit down frequently, as standing in place still isn't fun.
4. I can sit in most chairs/cars/furniture without needing to prop my leg up any longer---as long as I haven't overdone it or been standing too long.
5. Life is ALMOST back to normal. For the week my husband was out of town, I had to really pace myself and just let some things go. I didn't do much cleaning for 7 weeks, except the basics like bathrooms, laundry, sinks, kitchen counters, etc.
6. The only pain meds I take are an occasional tramadol at bedtime when the knee is throbbing too badly to sleep.
7. Best of all----My recent TKR leg bends more than my 2019 right-TKR leg already, and that's a huge win for me. I can slide my recent TKR leg much closer to my body when riding my Hybrid recumbent elliptical/bike machine. I struggle with socks and dressing myself still, but the knee loosens up MUCH better than the knee with the arthrofibrosis from 2016-2019. This gives me even more hope that all I need is time!!

The Bad (Actually the NOT-so-bad!)
1. I need the occasional oxy/tramadol to sleep. After I spread out my cleaning over 3 days this week, each night was horrible. The swelling was severe, and the throbbing set in on Night 2 of my 3-day cleaning spree. I went back to taking Tylenol (acetaminophen) every day around the clock, knowing I had 3 days of this coming.
2. I can't walk long distances yet. I tried grocery shopping, but after 15 minutes, I could barely stand in the checkout line for 7 minutes and make it to my car. I'm sticking to online shopping and store pick-ups for a few more months. I CAN walk more if I spread things out every other day, but it's a VERY fine line.
3. Stairs are quite the problem still. My leg and hip strength needs a lot of work.
4. I stopped taking my special anti-inflammatory due to severe stomach upset. It didn't seem to be helping anyway.
5. My stamina and strength is awful.
6. I'm still very tired all of the time.
7. For anyone who swells a lot--I now know for sure that diet plays a role in my swelling. I have a direct correlation with increased salt intake leading to increased knee pain with significant, measurable swelling the following day. This has now happened 3X, with no other increase in activity those days to blame. It's been a good lesson.

The PLAN!!!!
I'm finally returning to limited exercise this weekend to rebuild my leg & hip strength. I wanted to wait for the 10-12 week mark post-op, and I think I'm at a great place to do basic leg stuff that doesn't require too much standing ((In the name of swelling prevention!!!!)). I know a lot of what I'm experiencing now with mobility is major muscle weakness, so I need to get on that immediately. I'll just start with the usual exercises/stretches from the other 11 surgeries and take it slow. Thankfully, I build muscle very fast and see improvement very quickly. I see the surgeon again in 2-3 weeks and plan to ward off any further nagging about PT by proving to him AGAIN I didn't need it. I could care less about my bending. It will come when this nasty swelling is under control again, as it had improved drastically before the cleaning spree.

For the record----I only joined the ODI{C}C (over-did-it-CLEANING-club) because we had 2 sets of company coming this week. Luckily no one stayed the night, but because of our cats and my husband JUST getting back in town, I had to do most of the work. We had let so many things go over the last few weeks. It was simply very bad timing, and he knows I'm taking it easy the rest of the weekend.

Thanks to everyone who wished me a great 2-month anniversary, and I'll be around again. Life is calming down after today, and I should be online more. I hope everyone had a wonderful Thanksgiving if you're in the USA.