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TKR Life in Recovery: cynof4’s RTKR

Cynof4

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Fellow BoneSmarties,

I am 4 days out from surgery. I was discharged from the hospital on Wednesday evening. My biggest challenges continue to be pain management and lack of sleep. I’m not going to sugar coat it- 48 hours after surgery my baby knee was screaming in pain. Fortunately, I have meds on hand to help. And the Game Ready 2.0? It’s been a lifesaver!

So, does anyone on this forum have experience with sharp nerve pain that jolts through your body and wakes you up from a deep sleep? It’s so frustrating and takes my knee ( and me) about 30 minutes to calm down. When does this go away???

I’ll post more tomorrow when I have less brain fog :zzz:

It’s good to be on the “other” side!

Cynthia :flwrysmile:
 

jeffjob

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Hi Cynthia, yes most of us have these zingers and they can last a few weeks. That do get less intense and you can get a bit used to them. Understand they are part of the healing precessions.

They feel different to us all but a good description on here that i heard was like getting a bee sting out of no where. Some people twinge, some may shout from them.

They are normal and your body telling you that you are healing!

Be well.
 

Jockette

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Welcome to Recovery!

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Knee Recovery: The Guidelines
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
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
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. At week 4 and after you should 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.
 

Rockgirl4

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I had those zingers from Day 1, then they eased off around week2 only to come roaring back during weeks 5-6-7. It was bizarre!!!! I was one who would describe it as a bee stinging me or someone stabbing me out of the blue with an ice pick. I yelped many times!!
 

luvcats

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Welcome to recovery!
Don't worry about the brain fog. It's perfectly normal and should only be a few weeks.

Did you have any trouble with food while in the hospital? I remember that was a big concern for you.
 

fenway09

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Hi Cynthia.......I have been keeping my eye out for you to have your surgery as I noticed that your original date was postponed. Congrats for having it behind you. This first week is a bear for sure but slowly it improves...just stay on top of pain meds! I was hooked up to my ice cuff 18 hours a day.......still use that machine daily for several hours. I am anxious to see how your recovery goes with your prior TPF. I have some improvement but still dealing with the tight band around my knee which I have felt since 5/26/2018. :umm: Please take good care and rest, ice, rest, repeat! :angel:
 

kneeper

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Congrats on the new knee. Wishing you lots of :ice: and :sleep:
 

newpartial

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Yay .. I have been looking out for you on this side.
Lack of sleep and the zingers all common but you gave now started the journey. Keep up with your pain meds and things will get better.
Wishing you an uneventful recovery :flwrysmile:
 
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Cynof4

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So it's been awhile since I've updated my recovery thread. I learned a lot and experienced a lot in the past few weeks of getting to know and manage my knee replacement.

I am 4 weeks out, still at home recovering and not yet ready for the real world, but I am close. Here are some topics I had an interest (ok, anxiety) about in pre-op and how it turned out for me...

Blocks/ Anesthesia:
I chose a nerve block and general anesthesia. The nerve block had to be done twice. They had difficulty putting me deeply to sleep, but they eventually figured it out. I did have a slightly sore throat for a few days, but it didn't really bother me. I have no memories of recovery.

Hospital food:
My first meal out of recovery was a "soft" diet? I had potatoes, finely chopped up chicken in gravy and pudding. Nobody seemed worried about my blood sugar- just feeding me. I was able to choose my meals the rest of the time from a daily menu brought each morning by the nutrition staff. I was put on a "carb consistent" diet until I spoke with the nutritionist about my preferences and then I was allowed to put together meals from all their menus. The carb consistent meal wasn't bad. It was a tad too high in carbs and way too low in fat for me. We fixed it.

CGM (continuous glucose monitor):
After we calibrated my sensor with a blood sample in preop (they differed by 1), they were content to use the readings from my Freestyle Libre for the rest of my hospital stay. No finger sticks! Yay! They did insist on giving me insulin instead of my normal oral meds, but in such small amounts it didn't really matter.

Pain Control:
I had moderate pain upon waking up on the surgical day with the block in place. I was given dilaudid via my IV through the night and started oral pain meds the next morning. Then I went back and forth between the diaudid and NORCO 10/325 depending on my pain level. This surgery is no joke. I was uncomfortable to say the least and in tears multiple times for the first 3 weeks. The 4th week things got a little easier and I am now down to Percocet 7.5/ 325 as needed, usually just at night because I cannot get comfortable to sleep- EVER!
I do not feel like my pain was well controlled when I left the hospital. In fact the first night at home was horrible. I'm grateful my husband was patient and kind and did what he could to help. And yes, he stayed with me 24/7 in the hospital- sleeping on a single bed in my room. It was what we both wanted and I took great comfort in him being with me. Neither of us got much sleep for about 72 hours.

PT:
They did not attempt to get me up the first day. My hemoglobin was low, sodium was low and potassium was high so they let me be. It was after 5 pm by the time I got to my room anyway. The next day I was up and in a chair and walking with a walker. No one touched me without asking or caused me any pain. Just lots of encouragement to get moving. I saw PT twice daily for supervised walks for the duration of my stay. I was discharged to home health care with nurse visits 2x weekly and PT 3X weekly. The home PT guy was interesting. I had a little chat with him about my PT philosophy and he complied for the most part. He was obsessed about measuring at the end of each session, so I let it him. It didn't hurt me and I didn't push. My husband and mom were in the room with me most of the time and kept him chatting. We did the normal leg lifts and heel slides. I insisted on more practice walking and tried to use up most of our time on my agenda, not his! LOL I start outpatient PT today with a therapist I've been seeing for a year and am looking forward to a nice tissue massage! My knee is currently 110 bend/ 5 extension. I'm very happy with that and plan to continue to PT with a focus on function instead of numbers!

Since being home I have received a bunch of surveys about my surgical and hospital experiences. Everyone seemed interested in making sure my needs were met and that I was treated with dignity and involved in my care. I can't really ask for more than that!

Cynthia:flwrysmile:
 

kneeper

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Sounds good!
 
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Cynof4

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Updating from my 6 weeks check up:

My incision is completely healed over and looks wonderful! I would definitely recommend surgeons who use ziplines to close. I had no stitches or staples. It both decreases the chances of infection and provides a more desirable cosmetic result. When I figure out how to post pics, I'll show you what I mean.

I am walking unassisted with a moderate limp. It is slowly improving. My flex is about 115 and my extension is 2. I continue to go to PT 2 times a week. My exercises are gentle bicycling and quad arcs. I spend about half the time getting deep tissue massage and some scar manipulation. According to both my PT and OS, I am doing better than expected in both healing and function at this point. However, all is not a bed of roses...:giggle:

I am still struggling with sleep at night. I was completely off narcotics and trying my own remedies... a warm shower, elevating and icing, an occasional glass of wine, but, nope- Destiknee was having none of that! I was lucky to sleep for 2-3 hours a night and then could not find a comfortable position for more then 20-30 minutes at a time. I spend the wee hours begging Destiknee to calm down:roseshwr:. At my appointment yesterday we decided I needed to go back on pain meds (Tylenol #4) at night and add an anti-inflammatory (Celebrex) during the day. Last night was the first night I tried it and although I did wake up at the usual 2:00 am, I was able to go back to sleep for longer periods of time. We will see if the trend continues...

Another issue I am having is medial pain right at the joint that radiates up into my groin. Sometimes its just sore and other times its sharp and jolting. Heat gives some relief. I was taking Flexerol to help with it, but I don't want to rely on meds long term. Does anyone else have experience with this?

Yet another annoyance is my scar! It is sensitive to materials and anyone else's touch. I wear compression sleeves because I cannot stand anything to brush up against it. I can touch it, rub it, and move it myself, but anything or anyone else sends me over the edge! Help?

My stamina is still building. I'd rather be in my recliner, on Game Ready with ice and compression and elevated than anything else. You can usually find me there by 7:00 pm each night...and headed to bed by 9:00...

I'm longing for the day when I can honestly say I'm glad I did this. Not there yet.:bored:

~Cynthia
 

Jockette

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All that sounds like the average recovery many of us have. Believe it or not, you’re doing great!

You can try to carefully “rub” ( for lack of a better term) different textured fabrics over your scar to desensitize it if you want. I didn’t do that, it felt bad enough without deliberately making it worse.

I remember that incision sensitivity and it’s gone now. However, I do still have issues with anything touching my knee, but the feeling goes deep into the joint now. I dread winter coming when it will really be too cold to wear shorts. And my knee aches when it’s cold, even in the refrigerator aisle of the grocery store. I’m 2.5 years post op. My knee really needs to get over itself! Thus I refer to it as a Drama Queen. :heehee:
 

AmyfromCalifornia

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Yes, to that area of pain. I'm 5 weeks tomorrow and for the past 2-3=weeks especially, probably since increased activity, I have painat joint line, tenderness sometimes along muscles from joint line to groin, and sometimes pain at groin area, but no obvious lymph nodes. I can think of several natural explanations: muscles, lymph channels running from knee to groin. It isn't always there but last night it woke me and the joint is stiffer the last few days. So I can't say why it is but I have that at times too
 

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I also experience deep aches in my groin when at rest. Keeps me awake.


Sent from my iPad using Tapatalk
 

LindaO

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I don’t remember when I was finally able to tolerate anything touching my knee but it was a long time! It does get better...just keep rubbing it yourself and that will eventually help.
 

luvcats

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I'm glad you are going back on meds for a bit. On the first knee I was happily off the heavy drugs during the day, but it was almost another week and a half before I could sleep without them. Sleep is so important for healing.

You say you dont want to rely on drugs for the long term. But do remember you are still in the very short term. I think we need to think about drugs the way we do about our canes and walkers. It will be good when we dont need them, but there really isnt a need to rush to be rid of them. They are here to help us through the hardest parts.
 

sistersinhim

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Another issue I am having is medial pain right at the joint that radiates up into my groin. Sometimes its just sore and other times its sharp and jolting.
Check this out from our library: https://bonesmart.org/forum/threads/pes-anserine-and-mpfl-pain.8723/ I had the same symptoms and this is what mine was. Yours might not be this, but it could be. It does go away after a while.

When I read my surgical report I discovered that the OS had done a medial relief. That also explained the pain I had there. You might want to check yours out, too.
 
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Cynof4

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@sistersinhim ,

Thanks for the link to the article. It sounds exactly like what I am experiencing. Most of my PT on Wednesday was devoted to deep tissue massage on the whole leg trying to calm down the fascia irritated by the surgery. I'll definitely be asking if a medial relief was done. If so, it is the source of a lot of pain!
 

sistersinhim

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I requested my surgical report and that's where I found out I had a medial release. I had had two previous lateral releases through the years, and sure didn't expect to read about a medial one. But, that explained a lot of my lingering pain there.
 

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