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TKR LTKR April 1 - bending knee hurts

SkiBikeHikeDude

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I had a LTKR early in the morning on April 1. The surgeon said all went well. He put a pain cocktail into my knee so I had very little pain that day. But I also had drop foot and numbness in my foot, so the hospital PT declared it wasn't safe to walk that day. I also developed a low fever that evening and felt a little sick.

By the next morning (yesterday) I had feeling in my foot again and could move my foot. Sometime late morning the PT came back and I got up to brush my teeth an then walk down the hall. My knee was very stiff and didn't want to bend. The first night I could pick up my leg no problem, but yesterday I couldn't move it. Trying to lift it is excruciating as the front of my thigh really hurts. While walking with the PT I started feeling like I might throw up or faint. They rushed me back to my bed and checked my blood pressure which had fallen to below 90/60 or so. The doctor and nurses thought I was dehydrated so gave me saline, but I felt I was having a reaction to pain meds.

I refused pain meds for he rest of the day and finally walked again with the PT, although it was very slow and painful. Finally I was cleared to go home as my BP had stabilized and I could walk. Going home and walking into my house was very painful as I didn't have any pain meds working, but I felt that was safer than risking getting lightheaded and fainting.

I was excited to get home because I have a fancy ice machine and I really wanted to start icing a lot to cut down the swelling. I used it for an hour and then it seems to have broken. Bummer. We can't get it to work.

I am still very swollen today and I can't lift my leg. Bending it hurts too.

My question is if it is ok if I don't walk for a few days, or should I push through the pain to try to lift and bend my leg? Standing isn't bad but sitting on the edge of the bed to stand really hurts.
 

Roy Gardiner

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:welome: to BoneSmart


My question is if it is ok if I don't walk for a few days, or should I push through the pain
The BoneSmart view is that you should never push through pain. Relax, take it easy, don't fight - recovery takes time.

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
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. At week 4 and after you should follow this

6. Access these pages on the website

The Recovery articles:

There are also some cautionary articles here


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.
 
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SkiBikeHikeDude

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Thank you. Is it ok if I just lie around in bed for a few days and don't try to get up unless I have to? Or is it important to walk around some?

I feel like I need to get the swelling under control and then can worry about walking. Sound ok?
 

Carmencita

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Hi. I wouldn’t worry too much about not being able to lift your operated leg - I believe this is very normal early on after the op. It was about a week before I could lift mine. It felt like a heavy lump of wood - log leg - don’t forget everything in your joint has been disturbed so has a knock on effect on muscles, ligaments, tendons etc......also don’t try to force a bend you are only on day 2 of recovery. Ice is your friend - if your machine has broken then use a pack or two of frozen veg - peas are brilliant.
 

Birdgirl

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I used a leg lifter for quite awhile to get in and out of bed and any major shifting around. Leg was like a log. Muscles and brain will work together soon. Take it easy.
 
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SkiBikeHikeDude

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Thanks. I got the ice machine working again and have a goal of icing like crazy to try to get the swelling under control. I did just get out of bed to go the bathroom and it was way less painful than yesterday, so that is a good sign. Yesterday just sitting up with my legs over the side of the bed was pretty painful. Today hardly any pain when doing that.
 

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In the first week or two, short walks, like to the bathroom and kitchen are all you need, every hour or two, when you’re awake. At the very least, when you’re not very mobile, ankle pumps are good to do.

Sitting on the side of the bed, or on a chair, with my feet down was very painful for me for quite a long time, but it eased as I healed.

I couldn’t lift my leg myself for a couple of weeks, then all of a sudden I could. I also had a low blood pressure issue while in the hospital. All par for the course.
I feel like I need to get the swelling under control and then can worry about walking. Sound ok?
This is very ok and is your main job right now. Just make sure you move the knee here and there to keep it mobile, just gentle movements.
 

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The first night I could pick up my leg no problem, but yesterday I couldn't move it. Trying to lift it is excruciating as the front of my thigh really hurts.
I am still very swollen today and I can't lift my leg. Bending it hurts too.
It's very normal to not be able to lift your leg. It was about 5 days before I could lift mine. Part of the reason is because your femoral nerve has to kick in again.

Meanwhile, have you tried lifting your leg with a belt, dressing gown cord, or leg lifter? (I used an old dog-lead.)
You can find one illustrated here, in Section 11, and order it through Amazon - follow the link in the article.
Recovery Aids: A comprehensive list for hospital and home

It's also normal for swelling to increase for a few days after you get home. You're doing the
right thing in icing as much as possible.

My question is if it is ok if I don't walk for a few days, or should I push through the pain to try to lift and bend my leg?
The BoneSmart view is that you should never push through pain.
Is it ok if I just lie around in bed for a few days and don't try to get up unless I have to? Or is it important to walk around some?
While we do tell people not to push through the pain, we also don't want you to lie in bed like a log, doing nothing. It is important to walk a little, to reduce the possibility of getting a blood clot (Deep Vein Thrombosis, or DVT). So when you get up to go to the bathroom, take a little walk around the house before going back to bed.

Also, do make sure you're doing your ankle pumps exercise, as that's good for helping to prevent blood clots.

I did just get out of bed to go the bathroom and it was way less painful than yesterday, so that is a good sign. Yesterday just sitting up with my legs over the side of the bed was pretty painful. Today hardly any pain when doing that.
That's great! Things are improving already.

Have you tried taking Tylenol for pain relief? Even though it doesn't seem to do much before surgery, it works quite well afterwards.
The most effective way to take Tylenol is 2 x 500 mg tablets 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.
 

SPFX guy

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I had the same thing in the hospital (Orthistatic Hypotensiin...sudden drop in BP). I had to stay an extra night since I couldn’t stand to “pass” my OT or PT. Turns out I had a weird reaction to oxycodone (by far the most common painkiller for TKRs). I’d never had trouble with Hydrocodone, so we switched it and within a day I was fine and could go home. But PLEASE stay ahead of the pain. My doctor actually scolded me for trying to “tough it out”. Glad I finally listened. I had mine in March 8 and finally over the worst of what you’re feeling now — all normal feelings! You’ve got this!!!
 
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SkiBikeHikeDude

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Wow, thank you all so much for the help and support! I feel so much better today, both emotionally and physically.

The ice machine stopped working again so I've been using ice packs, which help a lot. The medical supply company is rushing me a new one to arrive Monday -- I'll just use ice packs until then. The hospital barely iced my knee and didn't elevate it at all. Now that I am doing both it feels so much better.
 
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AussieRodney

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Wow, thank you all so much for the help and support! I feel so much better today, both emotionally and physically.
That's what this forum does best.

I'm glad you mentioned elevation. It helps to drain the excess fluid out of your leg.

This was my setup for the first week or so.
2102187034.jpg


This gives you an idea of the angle. Whatever works for you!
2102257085.jpg


Everything I needed was in easy reach, including cat, water, urinal, walking frame, meds, .....
2103117119.jpg


Totally agree on the concept of maintaining the level of pain relief over the 24-hour period. One piece of advice I received was to alternate Tylenol and Advil every 3 hours. One covers the pain, the other works on the swelling.
 
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SkiBikeHikeDude

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I got a great night's sleep last night, but woke up and my knee was really stiff. My foot had slid off the pillow I was using to elevate it and was in an awkward position all night, and everything seemed to stiffen in that position. I got up to go to the bathroom and walking was more painful again. I got back in bed and put my leg into the Continuous Passive Motion machine the doctor wanted me to have, and it is really helping work out the stiffness. The surgeon and I both have seen all the studies that say using one doesn't make a difference in the long run, but for me, at least, it is really helping loosen up my knee and cutting down the pain. Thought I'd share that in case someone is wondering whether to use one or not.
 

Lobsterman

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I got real good at picking up the bad leg with the good one. Took a couple of weeks before I could lift the new leg up by itself
 

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Had my 2nd TKR one day before yours and I still cannot come close to lifting my leg, though I did it pretty well in the hospital! Be patient - it will come. I am also stiff every morning upon awakening.
 
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SkiBikeHikeDude

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Lobsterman, yes, I've found that works for me too. I can pick up my bad leg with the good one. Still can't pick up the bad one by itself though.

Sisterpat, I hope your recovery is going well!
 

Emelbee21

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Congratulations on your knee surgery. I had my done on April 1 too. My leg is heavy and it is challenging to lift it. I am also sore all over and feel a bit depressed today. The emotional rollercoaster I really didn’t want ride on.
 
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SkiBikeHikeDude

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Congratulations on your knee surgery. I had my done on April 1 too. My leg is heavy and it is challenging to lift it. I am also sore all over and feel a bit depressed today. The emotional rollercoaster I really didn’t want ride on.
We're twins! I too feel sore all over and have been running a low fever of around 100 degrees. I'm sorry you are depressed. Hang in there and reach out if you want to commiserate with someone.
 
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SkiBikeHikeDude

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The first night I could pick up my leg no problem, but yesterday I couldn't move it. Trying to lift it is excruciating as the front of my thigh really hurts.
I am still very swollen today and I can't lift my leg. Bending it hurts too.
It's very normal to not be able to lift your leg. It was about 5 days before I could lift mine. Part of the reason is because your femoral nerve has to kick in again.

Meanwhile, have you tried lifting your leg with a belt, dressing gown cord, or leg lifter? (I used an old dog-lead.)
You can find one illustrated here, in Section 11, and order it through Amazon - follow the link in the article.
Recovery Aids: A comprehensive list for hospital and home

It's also normal for swelling to increase for a few days after you get home. You're doing the
right thing in icing as much as possible.

My question is if it is ok if I don't walk for a few days, or should I push through the pain to try to lift and bend my leg?
The BoneSmart view is that you should never push through pain.
Is it ok if I just lie around in bed for a few days and don't try to get up unless I have to? Or is it important to walk around some?
While we do tell people not to push through the pain, we also don't want you to lie in bed like a log, doing nothing. It is important to walk a little, to reduce the possibility of getting a blood clot (Deep Vein Thrombosis, or DVT). So when you get up to go to the bathroom, take a little walk around the house before going back to bed.

Also, do make sure you're doing your ankle pumps exercise, as that's good for helping to prevent blood clots.

I did just get out of bed to go the bathroom and it was way less painful than yesterday, so that is a good sign. Yesterday just sitting up with my legs over the side of the bed was pretty painful. Today hardly any pain when doing that.
That's great! Things are improving already.

Have you tried taking Tylenol for pain relief? Even though it doesn't seem to do much before surgery, it works quite well afterwards.
The most effective way to take Tylenol is 2 x 500 mg tablets 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.
I am going to go the acetaminophen route tomorrow, unless I feel really lousy when I wake up. I keep finding that the safe daily limit has been lowered to 3,000 mg. Is 4,000 still considered safe?
 

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