TKR Left TKR Recovery---Now I Have a Matching Set
- Thread starter Rockgirl4
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Small sensory nerve fibers are cut with the incision. The burning is a temporary sensation that normally resolves over a period of six months to one year post op. While healing you may experience sensations of tingling, pins and needles, itching, burning and even the feeling of a minor electrical shock. These are usually good signs that the nerves are spontaneously firing through the regeneration process.
Can't blame you for soaking in all that family time, it's not easy becoming an empty nester, at least I didn't think so. After so many years of kids and all it involves, the silence was deafening. Enjoy it while you can!
Keep up with your sensible recovery listening to your body! You've got this!
OP
OP
Rockgirl4
Former BoneSmart staff member
@sistersinhim Now I'm wondering if I'm doing something NOT so sensible. This morning's wakeup was NOT fun. My leg felt heavier, more achy, harder to move, and just more swollen. I keep asking myself what day is the swelling supposed to peak at? My bruising is showing up more and more each day, and the skin everywhere is just more sensitive.
I'm still sleeping with my legs elevated "toes-above nose." I ice once or twice in the night. Then I try to ice every hour for a good 30 minutes during the day, though it probably comes out to once every 90 minutes to 2 hrs. We're having trouble keeping up with the ice machine this time for some reason. My husband is trying to do it all, and he is wearing out more and more each day. He won't let me lift a finger though.
I started the 5 sessions on the RomTech Bike today, and #1 was very easy. I'm not increasing the pedal distance for more bend until later in the day. I think this is where the extra tightness/swelling is coming from, so my philosophy is that some movement is good, but too much bend, too soon, is NOT good. I will see what the next 2-3 days bring and go from there. Every time I move though, I'm reminded of that tourniquet. Some days I think surviving the tourniquet is the REAL struggle in this recovery!!!!
I'll be back later to report on the other biking sessions. I'm more awake in the afternoons and hope to watch some TV or read a book today.
I'm still sleeping with my legs elevated "toes-above nose." I ice once or twice in the night. Then I try to ice every hour for a good 30 minutes during the day, though it probably comes out to once every 90 minutes to 2 hrs. We're having trouble keeping up with the ice machine this time for some reason. My husband is trying to do it all, and he is wearing out more and more each day. He won't let me lift a finger though.
I started the 5 sessions on the RomTech Bike today, and #1 was very easy. I'm not increasing the pedal distance for more bend until later in the day. I think this is where the extra tightness/swelling is coming from, so my philosophy is that some movement is good, but too much bend, too soon, is NOT good. I will see what the next 2-3 days bring and go from there. Every time I move though, I'm reminded of that tourniquet. Some days I think surviving the tourniquet is the REAL struggle in this recovery!!!!
I'll be back later to report on the other biking sessions. I'm more awake in the afternoons and hope to watch some TV or read a book today.
JDinCT
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I freeze 24 of the small water bottles and put enough water in the ice machine to provide good circulation. This allows me to reuse the same "ice" all the time. For the Game Ready, I can put six of the small water bottles in the reservoir. I've found this cures the ice supply chain issue.
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Rockgirl4
Former BoneSmart staff member
@JDinCT We have the smaller Breg Polar Cube, and he's cycling through 4 of the small water bottles, as that's all we can fit in it. I think last time we just kept switching out the bottles instead of the water/ice combination, so I may try that instead tonight. He starts over with fresh ice, water, and frozen bottles every 7-8 hours, which I think is overkill.
JDinCT
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I don't change the water except once very 3-4 days and I only change out the bottles. I make sure they are frozen SOLID. That's the reason I have 24 in my arsenal.
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@Rockgirl4 please try icing at least 45 minutes at a time, preferably an hour. Less than that can result in rebound swelling!!!!
I agree with @JDinCT - I have the smaller Bregg - don't change the water just swap for other frozen bottles. No ice ! No water change! Just swap the bottles. I don't think we ever did that more than 3x a day.
The bruising can easily continue to slowly spread for a while as small capillaries ooze and it's not a problem. Once it seems to have stopped increasing, the areas well away from the incision can receive a little topical arnica gel to somewhat speed the resolution but it's not necessary by any means.
I agree with @JDinCT - I have the smaller Bregg - don't change the water just swap for other frozen bottles. No ice ! No water change! Just swap the bottles. I don't think we ever did that more than 3x a day.
The bruising can easily continue to slowly spread for a while as small capillaries ooze and it's not a problem. Once it seems to have stopped increasing, the areas well away from the incision can receive a little topical arnica gel to somewhat speed the resolution but it's not necessary by any means.
WFD
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I find if I don’t change the water once a day it gets slimy and clogs the filter. Then again I have well water which is not chlorinated.
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Rockgirl4
Former BoneSmart staff member
Thanks for the advice--we started rotating just the frozen water bottles. My husband already feels like he's doing less work each day. 
I'm making him go to bed earlier too, as he was wearing out quickly.
OK! It's been a ROUGH 2 days.
First, I felt like I was sliding back towards the days of old on Wed/Thurs!!! The RomTech bike kept adding to my pain/swelling. My entire leg became unhappy. I talked to the nurse at my surgeon's office who said to do only as much as I could tolerate without making myself miserable. That was the extent of their advice this morning, after I'd sent a message regarding new break-thru pain strong enough to keep me up at night. I mostly wanted to know if I should change anything regarding the bike, but they didn't really give me an answer.
As for details-- I needed oxycodone at 4AM & 5:00 AM for the first time in this recovery. I'd definitely gotten behind the pain. I took my usual oxy at 11 PM (bedtime). It helped, but severe pain woke me at 3AM, 4AM, then 4:30 AM. I took an oxy at 4:30PM, but it didn't help at all. I took another at 5:30 AM---that worked like magic until I took my usual Tramadol/Tylenol dose at 8:30-9 AM. I did manage to make my point to the nurse that losing sleep in the 2nd week because of extra pain means I must be doing too much of something--- the PT bike (with now Passive AND active peddling as of 2 days ago) was the only thing that was new. This afternoon has already been better because I'm using the lower bike settings and will do so the rest of the day. I refuse to join the ODIC!!
Second---Let's talk bruising!!! My bruising is becoming quite the Rorschach ink blot on my calf and ankle. My husband is fascinated how it changes day by day. I notice the changes because it's directly related to my pain in those areas....and my ankle is killing me!!!!
This is my bad ankle anyway, and it wasn't happy all summer, It was inflamed from a flareup of an osteochondral defect on my talus bone. I couldn't get a cortisone shot because it would have set back my TKR by 3 more months. It's been a stable defect for 5-6 years, but I reactivated it in July after walking on a lot of uneven ground. My aunt had passed away, and we were at 2 different cemeteries that week with family. I learned my days of walking on uneven ground are over without bracing. I damaged thank ankle severely 33 yrs ago and will eventually have to decide whether to fuse it or replace it. I'm now going to wear the ankle brace when I'm riding the PT Bike, as it's A LOT of ankle motion (15 mins a session, at 5 sessions/day now).
Finally---I'm not sure I avoided the dreaded fracture blisters after all. There appears to be a blister along the middle of my incision, about 3/4 of an inch long. It's too close to the incision to be sure. I'm not taking any chances by touching it either. This fancy Dermabond Prineo dressing covers the entire incision to aid in wound healing, but I can't see much underneath it. The entire area burns much of the time too, like the nastiest sunburn ever--bad enough to wake me up day & night. I'm even having bad dreams about it. (( I can now say Tramadol gives me vivid nightmares too---I won't miss it taking it))
OK---enough negative!!!
The Positive Stuff: I have more strength in the leg, I get around with the walker more easily each day, I can get in/out of bed easier every day, and I don't feel like I've lost my fitness/strength this time around. My husband and son will be gone most of tomorrow, and I plan on proving to them how well I'm getting around and don't need to be coddled anymore. Food is my biggest issue, as there's no way I could cook yet. We have plenty of things in the refrigerator/pantry though.
I hope everyone else is having an uneventful day and has a pain-free weekend. For those in the path of the Hurricane, I hope everyone is safe.
I'm making him go to bed earlier too, as he was wearing out quickly. OK! It's been a ROUGH 2 days.
First, I felt like I was sliding back towards the days of old on Wed/Thurs!!! The RomTech bike kept adding to my pain/swelling. My entire leg became unhappy. I talked to the nurse at my surgeon's office who said to do only as much as I could tolerate without making myself miserable. That was the extent of their advice this morning, after I'd sent a message regarding new break-thru pain strong enough to keep me up at night. I mostly wanted to know if I should change anything regarding the bike, but they didn't really give me an answer. As for details-- I needed oxycodone at 4AM & 5:00 AM for the first time in this recovery. I'd definitely gotten behind the pain. I took my usual oxy at 11 PM (bedtime). It helped, but severe pain woke me at 3AM, 4AM, then 4:30 AM. I took an oxy at 4:30PM, but it didn't help at all. I took another at 5:30 AM---that worked like magic until I took my usual Tramadol/Tylenol dose at 8:30-9 AM. I did manage to make my point to the nurse that losing sleep in the 2nd week because of extra pain means I must be doing too much of something--- the PT bike (with now Passive AND active peddling as of 2 days ago) was the only thing that was new. This afternoon has already been better because I'm using the lower bike settings and will do so the rest of the day. I refuse to join the ODIC!!
Second---Let's talk bruising!!! My bruising is becoming quite the Rorschach ink blot on my calf and ankle. My husband is fascinated how it changes day by day. I notice the changes because it's directly related to my pain in those areas....and my ankle is killing me!!!!
This is my bad ankle anyway, and it wasn't happy all summer, It was inflamed from a flareup of an osteochondral defect on my talus bone. I couldn't get a cortisone shot because it would have set back my TKR by 3 more months. It's been a stable defect for 5-6 years, but I reactivated it in July after walking on a lot of uneven ground. My aunt had passed away, and we were at 2 different cemeteries that week with family. I learned my days of walking on uneven ground are over without bracing. I damaged thank ankle severely 33 yrs ago and will eventually have to decide whether to fuse it or replace it. I'm now going to wear the ankle brace when I'm riding the PT Bike, as it's A LOT of ankle motion (15 mins a session, at 5 sessions/day now).Finally---I'm not sure I avoided the dreaded fracture blisters after all. There appears to be a blister along the middle of my incision, about 3/4 of an inch long. It's too close to the incision to be sure. I'm not taking any chances by touching it either. This fancy Dermabond Prineo dressing covers the entire incision to aid in wound healing, but I can't see much underneath it. The entire area burns much of the time too, like the nastiest sunburn ever--bad enough to wake me up day & night. I'm even having bad dreams about it. (( I can now say Tramadol gives me vivid nightmares too---I won't miss it taking it))
OK---enough negative!!!
The Positive Stuff: I have more strength in the leg, I get around with the walker more easily each day, I can get in/out of bed easier every day, and I don't feel like I've lost my fitness/strength this time around. My husband and son will be gone most of tomorrow, and I plan on proving to them how well I'm getting around and don't need to be coddled anymore.
Food is my biggest issue, as there's no way I could cook yet. We have plenty of things in the refrigerator/pantry though.I hope everyone else is having an uneventful day and has a pain-free weekend. For those in the path of the Hurricane, I hope everyone is safe.
Toothfairy
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That sounds very tough @Rockgirl4 I hope things settle down soon
JDinCT
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Hey Rockgirl... sorry to hear about the two steps back event.
A couple of points from my experience.
When I had breakthrough pain in the beginning, I was taking TWO oxy (5 mg each) every four hours. That helped me stay ahead of the pain curve. I slowly tapered to two every six hours and then 1 every four hours and then none over a two week period.
My recovery team told me to NOT take tramadol at the same time I was taking Oxy. Not sure why, but that was their direction. I was and still am taking tylenol concurrent with either the Oxy or tramadol. I try to stagger them so the pain relief kind of layers in.
One other thing that provided me significant pain relief was almost constant icing all day and night on a 30 minute ON and 30 minute OFF interval. I was fortunate to have an ice machine that I could program for this schedule. I managed to sleep with the knee cuff on and let the machine do it's thing overnight. Usually had to change the ice bottles 1-2 times overnight, but I was up anyway.
Hope some of the above helps.
Hang in there!
A couple of points from my experience.
When I had breakthrough pain in the beginning, I was taking TWO oxy (5 mg each) every four hours. That helped me stay ahead of the pain curve. I slowly tapered to two every six hours and then 1 every four hours and then none over a two week period.
My recovery team told me to NOT take tramadol at the same time I was taking Oxy. Not sure why, but that was their direction. I was and still am taking tylenol concurrent with either the Oxy or tramadol. I try to stagger them so the pain relief kind of layers in.
One other thing that provided me significant pain relief was almost constant icing all day and night on a 30 minute ON and 30 minute OFF interval. I was fortunate to have an ice machine that I could program for this schedule. I managed to sleep with the knee cuff on and let the machine do it's thing overnight. Usually had to change the ice bottles 1-2 times overnight, but I was up anyway.
Hope some of the above helps.
Hang in there!
selketine
senior
I've been catching up on your recovery - you're like a week behind me surgery wise! I also had a tourniquet for both surgeries (right TKR in January and left TKR was 9/11) and I agree about the pain and bruising from it. However the January knee for me was WAY more bruised and painful from the tourniquet than this knee. Not sure why but I think this surgery was a bit shorter - surgeon said it was easier or quicker or something. In January the entire back of my leg was a wall of purple and I had a ton of swelling. The whole leg was more sore. It was impossible to sit in a regular chair (like my kitchen chair or my desk chair) for many weeks and even then I could only tolerate 15-20 mins and had to work my way up. It's just interesting seeing how different the tourniquet aftermath was for me for two different surgeries. Sounds like you have something similar to my January knee so you have my sympathy on that cause it was a struggle. I just thought it was normal at the time.
That bike sounds like it's causing a lot of pain for you. I know people like them but it sure does seem like it's making it very painful for you. I think if it was me, I'd back off to like using it 1x a day and if that went ok I'd try 2x the next day or something and see where my wall was with it. Of course our knees are sometimes worse one day and better the next. Seems like yours needs a break from that bike though!
I'm one of the rare people that icing seems to make me worse somehow - or I just don't like it. I also have Raynaud's (in cold weather my fingers/toes can turn white and painful from being exposed to the cold). More icing makes me more stiff and painful. Sounds like that's not an issue for you but just mentioning it - if you respond positively to it then keep doing it!
Both of my sons left home in the past 3 years. One moved close by so he is easy to see - the younger one went to Orlando to do the college internship program at Disney World and didn't come back. He ended up getting a full time job with them and he is loving it down there. It's definitely a transition. What helped me was having some definite plans to visit (if your son is moving farther away). That gave me something to look forward to. I'm also a Disney nerd so I don't need much of an excuse to go to Orlando - haha! I go to visit him often and we do the parks some but also just hang out and visit. Anyway...hugs to you for that - I know it is emotional to think about.
Just be careful not to overdo! You are still very early days -- and a bit of coddling is good for all of us!
OP
OP
Rockgirl4
Former BoneSmart staff member
@benne68 I should have listened to you!!
Between getting out of bed this morning, getting my own breakfast and meds, brushing my teeth, letting the cat out, then situating myself in my little nest--I was DONE!! It's easy to take for granted how much another person can allow us to rest, ice, stay elevated, etc. By the end of the day, I was asking them for help with everything.
@JDinCT I think you've pinpointed my problem.
It's clear I'm not icing properly or enough--I need more sessions with my toes above my nose. My swelling/inflammation is out of control and not improving AT ALL. I wasn't going to use the PT bike at all today, but I finally talked myself into 1 session at 3 PM. That just added insult to injury----It was sheer misery! I sent an email to my surgeon's office for Monday morning, reminding him of our pre-op discussion (my psoriatic arthritis, tendency to rebound swell severely from any activity, possibility of oral steroids to limit inflammation). Something has to change, as tonight was the most pain prior to bedtime I've experienced yet. I hate idea of standing up to use the bathroom or walking to the bed.
I've gone from Days 1-5, thinking this would be much easier than last time, to now fearing this recovery is going to be exactly like last time. I allowed myself the huge crying fit I needed to purge the frustration, and I'll start early Monday morning with pointing this ship back in the right direction.
Between getting out of bed this morning, getting my own breakfast and meds, brushing my teeth, letting the cat out, then situating myself in my little nest--I was DONE!! It's easy to take for granted how much another person can allow us to rest, ice, stay elevated, etc. By the end of the day, I was asking them for help with everything.@JDinCT I think you've pinpointed my problem.
It's clear I'm not icing properly or enough--I need more sessions with my toes above my nose. My swelling/inflammation is out of control and not improving AT ALL. I wasn't going to use the PT bike at all today, but I finally talked myself into 1 session at 3 PM. That just added insult to injury----It was sheer misery! I sent an email to my surgeon's office for Monday morning, reminding him of our pre-op discussion (my psoriatic arthritis, tendency to rebound swell severely from any activity, possibility of oral steroids to limit inflammation). Something has to change, as tonight was the most pain prior to bedtime I've experienced yet. I hate idea of standing up to use the bathroom or walking to the bed.I've gone from Days 1-5, thinking this would be much easier than last time, to now fearing this recovery is going to be exactly like last time. I allowed myself the huge crying fit I needed to purge the frustration, and I'll start early Monday morning with pointing this ship back in the right direction.
Toothfairy
Insider
Sorry to hear you are having such a tough time @Rockgirl4 I hope you can have a restful day with lots of ice and elevation and will soon start to feel more comfortable. Sending a hug.
Sending hugs and prayers for you. 
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Yes, you need to right the ship and I have faith you can do it 
and do it quickly, Rockgirl.
I'm sure your loved ones aren't feeling burdened by helping you out, just as you'd do the same for them.
Ice as frequently as you're comfortable to aid in the reduction of pain and swelling. We recommend icing for at least 45 minutes each time you ice and to ice several times per day.
Icing for up to twenty minutes only is what most of us have heard or been advised to do following an injury. Following joint replacement, ice is a critical part of pain management and should be used not only on the joint, but any surrounding areas of discomfort for as often and as long as you're comfortable doing so, always placing fabric between your skin and the ice source. Icing helps bring relief from the soft tissue trauma and internal swelling. Icing is a great natural pain reliever and best of all, it's free. While some care providers do put a maximum time on icing, others suggest you ice as often as you see fit.
Icing after therapy, exercises, or prolonged activity that challenge ROM and endurance should help ease any discomfort, or preventively keep pain at bay. You may find relief through icing for weeks to months post op.
Elevation plays a key role since it is our lymph system that rids the body of fluid (swelling). So you want to get the fluid to the lymph nodes in your torso area so your body can more quickly process it. The lymph system works rather slowly on its own and much more efficiently with the assistance of gravity. The fluid isn’t draining into the hips, but contained with the lymph system and moving to the torso and lymph nodes located there.
Then...there is meting out activity proportionally with rest. I found the Activity Progression article helpful as it helped me remain comfortably mobile, getting enough activity, without overdoing it and landing in the ODIC (Over Did It Club) article here -> Activity Progression Some excel, some lag behind, it is only a rough gauge.
I do understand this isn't your first rodeo, but as you have read many times, each surgery recovery has its own challenges even with the same person. Allow yourself the TLC you deserve, its's very early into the healing process for you. Focus on the quickly approaching holidays and envision how well you'll be doing by then!
Happy Sunday...wishing you a wonderful week!
@Rockgirl4
and do it quickly, Rockgirl.I'm sure your loved ones aren't feeling burdened by helping you out, just as you'd do the same for them.
Ice as frequently as you're comfortable to aid in the reduction of pain and swelling. We recommend icing for at least 45 minutes each time you ice and to ice several times per day.
Icing for up to twenty minutes only is what most of us have heard or been advised to do following an injury. Following joint replacement, ice is a critical part of pain management and should be used not only on the joint, but any surrounding areas of discomfort for as often and as long as you're comfortable doing so, always placing fabric between your skin and the ice source. Icing helps bring relief from the soft tissue trauma and internal swelling. Icing is a great natural pain reliever and best of all, it's free. While some care providers do put a maximum time on icing, others suggest you ice as often as you see fit.
Icing after therapy, exercises, or prolonged activity that challenge ROM and endurance should help ease any discomfort, or preventively keep pain at bay. You may find relief through icing for weeks to months post op.
Elevation plays a key role since it is our lymph system that rids the body of fluid (swelling). So you want to get the fluid to the lymph nodes in your torso area so your body can more quickly process it. The lymph system works rather slowly on its own and much more efficiently with the assistance of gravity. The fluid isn’t draining into the hips, but contained with the lymph system and moving to the torso and lymph nodes located there.
Then...there is meting out activity proportionally with rest. I found the Activity Progression article helpful as it helped me remain comfortably mobile, getting enough activity, without overdoing it and landing in the ODIC (Over Did It Club) article here -> Activity Progression Some excel, some lag behind, it is only a rough gauge.
I do understand this isn't your first rodeo, but as you have read many times, each surgery recovery has its own challenges even with the same person. Allow yourself the TLC you deserve, its's very early into the healing process for you. Focus on the quickly approaching holidays and envision how well you'll be doing by then!
Happy Sunday...wishing you a wonderful week!
@Rockgirl4
