TKR Lovely's Recovery Thread

[Lovely]

Hello fellow Bone Smarties!

I am 10 days post-LTKR and what a roller coaster it has been already. I haven't had the presence of mind to begin my recovery thread until now, so here it goes!

The spinal was not effective, so I underwent general anesthesia. I was a bit nauseous that afternoon, but was as up and walking an hour after arriving to my room and achieved 90 degree flexion in the hospital. Since I was getting around well (perk of life-long mobility issues), I was released from the hospital the next afternoon.

Since then, I have been elevating and icing (Polar Care Ice Machine) 24/7. My bathroom breaks and trips around the house have been every 1 1/2 - 2 hours (pretty normal for me). As the swelling has been intense, I have not been able to get anywhere near 90 since being home. I have been to outpatient physical therapy once and was expecting to have increased swelling, but it actually helped move the fluid some. I haven't been resting well, so meeting the medication schedule has not been an issue as I tend to be awake when it's time for meds. My recliner is home base for me and has been quite comfortable.

We weren't expecting to have company for Thanksgiving, but 3 of our 4 adult children came to lunch. They were so precious and brought their plates into the family room so that I could eat with everyone. What a sweet family I have!

My emotions have been all over the place, too. I am hoping that I can level out now that my meds are starting to decrease. I am also hoping to lean on my BS family and read the threads for encouragement and following others' recovery road.

Thanks for reading! Happy recovery!

Cheers!

 

[Starsfan22]

Family support is so important. We should all count our blessings, even the blessing of knee surgery. We've been given a second chance haven't we? Hope your recovery goes well!

 

[Celle]

Welcome to recovery, @Lovely .

It sounds as if you're managing well now you're home. How sweet of your family to share eating their dinner with you.

Here's the Recovery guidelines we give to everyone with a new knee;
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

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications​

Wound Care In Hospital​

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 a 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 history before providing advice.

 

[Sara61]

Wishing you a good recovery having BS as a support network really helped in my earlier days and still now nearly 8 weeks post op there is always someone online ready to cheer you up, answer any queries, etc eventually you will make a whole lot of great virtual friends.
Read my past threads I promise it does get better each week you will achieve something new.

 

[Lovely]

We've been given a second chance haven't we?

@Starsfan22 - Yes, I am so grateful for the possibility of a better quality of life. The grand babies visited yesterday, and although I was limited to visiting with them while in my recliner, they brought such joy and laughter and I am looking forward to having better mobility to play with them in the months to come!

It sounds as if you're managing well now you're home.

@ Celle - I feel like I am managing pretty well. I am finding it difficult to walk correctly (I am swinging my leg to the left to avoid ROM because that's how I walked pre-replacement). I am curious whether rehab is relative to any pre-surgery ROM and limitations? I didn't much ROM at all pre-surgery and my muscles are fighting against the new alignment. I feel like I'm having to learn to walk all over again. lol

Read my past threads I promise it does get better each week you will achieve something new.

@Sara61 - Thanks for the encouragement! I will check out your thread for sure.

 

[Roy Gardiner]

I am curious whether rehab is relative to any pre-surgery ROM and limitations?

Yes it is to start with, but as all the obstructions are now removed it's just a question of adjustment.

I didn't much ROM at all pre-surgery and my muscles are fighting against the new alignment. I feel like I'm having to learn to walk all over again

Exactly. Physiotherapists are invaluable here, identifying issues with gait and helping you to correct it. But you can do much yourself, just trying to walk 'properly'. Takes a while, the worse you were before, the longer it takes. Be prepared for aches and pains.

 

[Lovely]

Day 11: Today, I managed to do some small household chores: cleaned the toilet and sinks in the bathroom; gathered three separate loads of laundry for Darling Husband to put in the wash' and cleaned my nest area. I also began online Christmas shopping. It's so interesting to me how drastic the difference when the pain/brain fog lifts. I can actually complete sentences without struggling to find words. I managed cat nap as well. I am thankful for a relatively good day.

 

[Roy Gardiner]

I managed to do some small household chores: cleaned the toilet and sinks in the bathroom; gathered three separate loads of laundry for Darling Husband to put in the wash' and cleaned my nest area.

Delegate, please. You should be resting or moving gently, not working. DH can do all these jobs, indeed should be Telling You Off for doing them. Please show him this message: Hey fella, look after her. It's your job.

 

[sistersinhim]

I agree with Roy. Your knee is way too young for you to be doing household chores. You are not helping your healing and very possibly slowing it down. For the first month all you knee needs is just gentle movements and lots of TLC, such as icing, elevating and resting.

 

[Celle]

To reinforce what Roy Gardiner and sistersinhim advised you, this article may help you to rest without feeling guilty about not helping your husband.
Nurturing mother: how to let go and accept help

You know that you'd gladly do these things for him, if the situation were reversed.

 

[Lovely]

@Celle, sistersinhim and Roy Gardiner - Thank you for the gentle nudge back to healing reality. Thankfully, I didn't pay for my momentary lapse in better judgement. I will do my best to lean into allowing others to nurture me, for a change. The article was a terrific reminder of the many reasons why I need to take this time to heal and allow others to help me along the way.

I have a wonderful husband who has been a terrific help. He prepares my meals (including Thanksgiving spread!), changes my ice machine, helps me get settled in my recliner, makes sure that I am comfortable, encourages my progress, does the grocery shopping - all while working full time (he is a UPS delivery driver and this is their busy season). I didn't do the chores because he wouldn't. I did them because I thought I needed to prove that I am not helpless and am still contributing to the household. I am a strong-willed person and my husband has been conditioned over the years not to argue with me when my mind is set on doing something. He would have cleaned the bathroom and washed the clothes, if I had asked him - but I didn't. I am thankful for my precious, nurturing husband and darling oldest daughter. They have been taking great care of me. It is I who needs to release control and allow them to take care of household things. That doesn't come natural or easy to me. I will do my best to rest! Again, thank you for the gentle nudge, friends.

 

[Lovely]

Does anyone have suggestions for correcting gait? Pre-TKR, I would raise my hip and swing my leg out to accommodate the lack of ROM when walking. I find that I am still doing that now. My muscles are fighting against this new alignment and I am finding it difficult to correct. Any ideas?

 

[Roy Gardiner]

Please show him this message: Hey fella, look after her. It's your job.

I have a wonderful husband...

I apologise for my judgemental remark above. New message: well done sir.

Does anyone have suggestions for correcting gait?

Physiotherapy may well be able to help. Otherwise, persistence. I had to re-learn both to walk and to pedal my bike. Just keep at it, concentraing on correct form.

 

[Lovely]

@Roy Gardiner - No worries, friend. I know that your heart was to help.

 

[sistersinhim]

Your gait should be a heel to toe. Step down on your heel and roll on to your toes. I had to really concentrate on doing this, and still do. It's hard to break old habits.

 

[Lovely]

Your gait should be a heel to toe. Step down on your heel and roll on to your toes.

I have the heel to toe down ok. My problem is that pre-surgery, I used my hip to lift my leg in order to then swing my foot/leg to the outside in order to avoid painful bend. I find myself still swinging to the outside and raising my hip. When I asked my PT about it, he seemed to think that as ROM increases, the hip will correct itself, but I've doubled my ROM since my first therapy session and am still lifting my hip. I also feel like my foot is a little tilted. Pre-surgery, I also turned my foot outward and kind of rolled in as a result. Now, I feel like my foot is a little slanted when trying to walk heel to toe. I'm curious what techniques, if any, others have used to correct previous gate habits.

 

[Lovely]

When can I expect the muscle spasms to stop? Sometimes, they are so strong that they make my entire body jolt! I am hoping to be released to drive tomorrow at my post-op appointment with my OS - since the TKR was on my non-driving leg. Fingers crossed! Not that I have anywhere to go, but it would be nice to know I could if I wanted to.

 

[sistersinhim]

I think concentrating on not lifting your hip will probably correct it. I limped for over 20 years because of my right knee pain. I still catch myself doing this at times and have to make an effort not to.

 

[Lovely]

I had my first post-op appointment with the OS today. The staples were removed. Based on what my PT told me, I was expecting him to measure my ROM and then get a lecture on working hard in rehab (to get to 90 degrees). Instead, he said that I was one of the worst and most complex cases that he has had (which says a lot since he is the chief of surgery of the hospital and does hundreds of these each month). He told me that since I had so much scar tissue pre-surgery, I could expect the recovery to be slower than most. He addressed all of my concerns and encouraged me to continue to do what I can, as I am able. I was so relieved! Whew!

I was exhausted by the end of the outing! So, back to the house and my recliner, I went... for a nap!

 

[sistersinhim]

Your doctor sounds like a winner!