TKR LTKR - My First Ever!

Question - anyone tried acupuncture, and is it helpful?

Have a friend on FB urging me to go. I live in Asia so plenty choice of needle-pokers around here; I'm just wondering if it would actually help in any way?
 
Bonus question - have any y'all tried heat, rather than ice, to get things moving? I have some socializing to do tonight but tomorrow I'm gonna try microwaving my ice pack and try heat instead of cold.

Ice is good for brand new injuries with major swelling and pain (so you can get a foot back inside a shoe for example) but I have my doubts over the longer term. Usually if I hurt something hiking or off-road motorcycling I use a hot pack, not a cold pack.

Worth an experiment I reckon...
 
have any y'all tried heat, rather than ice, to get things moving?
Please do not use heat on a surgical wound. It invites infection and will do nothing to reduce the swelling that is causing pain. Ice on and around the incision. Heat is OK for any sore muscles away from the surgical area.
 
So not directly on the incision area? Hokay....

*slyly slides hot pad off the incision

I have a couple of big infra-red lamps that are great for healing. I'll wait couple of weeks for the suture area to heal, as once before I found they healed a cut so fast the sutures got stuck... :heehee: Can't wait to try those lamps on New Lefty.

Still unsure about acupuncture? Guess it could reduce pain but pain is for reasons, right? To tell your mind and your body 'This bit needs some help'. So reducing pain seems somewhat counterproductive?

Was a lazy day today, tomorrow will try another 1 km walk :walking:
 
Still unsure about acupuncture?
I would wait on the acupuncture. You would need to be 100% sure that the practitioner took the right steps in terms of hygiene. And yes, pain is there for a reason - especially post op.

I had acupuncture after my 6 week followup appointment post op. It was for on-going back pain. For me it does work but you need to have complete trust in the person doing it.
 
Question - anyone tried acupuncture, and is it helpful?
I would stay away from acupuncture. Any time your skin surface is punctured, you run the risk of introducing infection. I know that those little acupuncture needles are sterilised, but you'd still risk introducing any bacteria that are on your own skin surface.

have any y'all tried heat, rather than ice, to get things moving?
No. Keep heat off your knee. It is likely to increase blood flow for sure, but it will also increase swelling.

I have a couple of big infra-red lamps that are great for healing. I'll wait couple of weeks for the suture area to heal, as once before I found they healed a cut so fast the sutures got stuck... :heehee: Can't wait to try those lamps on New Lefty.
You're doing very well in your recovery and you're now able to do things that many people.can't achieve for weeks yet. But please beware of trying to rush recovery too fast.

Complete recovery from a knee replacement does take a full year, no matter how much you'd like it to take less time. Even though you're doing so well, you knee was put through major surgery that caused a lot of trauma. It needs time to heal properly. even when it seems to be healed on the surface, there is still lots of healing going on beneath your skin.

There's no way you can speed up recovery. Your knee is going to take all the time it needs to do a good job. Age and previous fitness don't make any difference. Recovery takes just as long for someone who is 18 as it does for someone who is 80.

But - and here's the catch - if you try to make your knee do too much, too soon, it is possible to slow down recovery. Overdoing things early in recovery can lead to all your wounded tissues getting hot, angry and swollen. That not only makes you feel more discomfort, stiffness and pain - it also slows down healing.

That's the end of my lecture! :heehee:
 
It is likely to increase blood flow for sure, but it will also increase swelling.
Well I tried it last night near but not on the incision. It has noticeably reduced the bruising on both the inside and outside of my leg, also seems to have removed that deep ache I mentioned before.

Yep, did swell up a bit but only for awhile. Wouldn't recommend it longer-term but for the odd session to help clear things out it seems to have worked. Next time I'll try it with extra-high elevation, help it clear out the bad stuff, then go for a little walk to help the muscles pump the lymph system.

One big improvement today - tried pedaling backwards on my mountain bike again... still a bit painful at the peak of pedal movement but a definite improvement. So much so that I got my little 12v pump and a boat battery, pumped both tires up. I actually pedaled from my dining room into the living room, though was a bit wobbly and scary, so won't do that again just yet :unsure: But yeah, I reckon I'll be able to ride it soon! Wahoo!

Right, gonna get dressed (the joys of working at home!) and head for the park again. This time alone but I think I'll be OK, just the same circuit as last time.

Will be back later to report how it went... :eyebrows:
 
Still Day 12...

The walk in the park went fine, though began to ache around the 1.6 km mark, I completed the longer, full-length 2.4 km route (which doesn't have any tricky bridges!) Was happy to reach my truck but by no means in agony or anything, just about at my limit I think.

Have attached the Android app screen from my Garmin hiking watch (Fenix 5x) for proof and inspiration!

I did have a crutch with me, in case anything began to really hurt but it was fine. Sure, uncomfortable but you have to go beyond your comfort zone to progress, in anything.

I'm progressing :) :-) (:
 

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Very good going! I'm glad the heat didn't harm you. Just be careful with it. Inflammation loves heat!
 
  • Agree
Reactions: Suz
Very good going!
Thankyouverymuch :) :-) (:

So, how's New Lefty today? A little sore but I was having quite a wrestling match with the covers last night (Note: if having such issues, don't struggle, just turn the light on and sort things out! I did eventually but should have done much earlier)

Really I'd say the main thing is Lefty and the leg in general just feel tired, rather than sore or hurt. And I've only just taken this morning's painkillers, so there's no extra pain hiding anywhere.

To me tired is good. It's the exercise it needs, after I've been limping on it for a few months, then just lying in bed etc. When not swollen it's positively skinny, heck even Righty looks a bit scrawny, for despite working for both legs the limp meant I didn't do much of anything for a while.

Yes, it's healing and growing, but babies need exercise too, right?

Way I figure it we have 3 important systems at work:
  • Blood flow, in and out
  • Lymph system
  • Pain

Swelling (I think) is mostly lymph nodes and things, acting like a natural plaster-of-paris cast, but also a sign the body is sending a lot of blood to that area, hence the heat. Pain is a signal.

So to me, ice is a temporary thing to dull the pain and reduce swelling. Sometimes you really need that, but like a tourniquet you use it when you have to, not as a treatment for healing.

Your body's natural reaction is to make it swollen and hot, with pain signals, so compression and cold are the exact opposite of what your body is trying to do. That FEELS good but I can't help thinking that's just slowing things down, constricting when your body wants to open up, cooling when your body wants to heat that area, and repressing the pain.

I know what I'm doing and saying is somewhat heresy on this forum, yet is it not where we can learn from each other?

It's not just here; it seems everyone I talk to knows someone who had a knee replacement, and ALL of them are saying their friend/uncle/wife/cousin/coworker etc took weeks to get off crutches, couldn't bend their leg properly, complained for a long time about pain etc. I came into this dreading all that, prepared for that, we bought a walker and crutches and arranged time off work etc.

So what's so different about me, that I was shopping and eating out on the day of my release, within 4 days I was limping around without crutches, walking almost normally by 6 days, able to walk up stairs within 10 days - and yesterday, day 12, actually hit my normal 'steps target' on my Garmin, for a normal day!? I intended re-setting that target down to something like 500 or 1000 as I recovered but never got around to it and yesterday exceeded my standard 6,500 steps target.

What's different?

Let me get my thoughts together and I'll scribble up my own approach about what I did/do.

Coming soon for the low, low price of $99... ;)
 
I think this knee journey is sooooo different for everyone. I had a high ROM at my first PT and had not done anything, other than lots of "pre-hab" before the surgery...

I still have had painful moments that were very achy in the bones, but I am a person who has to move often and I really struggle with sitting too long, so I set my fitbit for 250 steps every hour and I would just be sure to get up and move around the house or outside on our deck.... What works well for one person, might not be so good for someone else.

As for heat, my OS told me at my 12 week check up that heat (where we get single digit Farenheit temperatures every evening) is OK for short spells, just watch for swelling....

So I'm definitely far enough along according to OS, but I still just use my circulating ice water pump every day and it is wonderful. I haven't had much swelling so far in this recovery either. I think the swelling is the biggest pain producing part of the recovery.

Your "argument" about letting the knee swell MAY have some theoretical validity, however, the practice of letting any body part swell and get overheated (i.e broken bones or sprained ankles and wrists) is never encouraged. All treatment of those wounded body parts works on relieving swelling and elevating above the heart! One of the reasons this forum is so very intuitive to me. I would really listen to the forum moderators and administrators.
 
I'm just tossing this out here after reading Bonesmart threads over the last 15 months.....It's astounding to see the range of TKR recoveries, from easy to brutal.....The one common theme seems to be L.U.C.K.! Some of us are lucky, and some of us just aren't. I've had 11 knee surgeries in 20 years, some major and some minor. I followed instructions to the letter, sought alternative treatment at times, and have definitely learned my body inside and out (what it likes, what it hates, what I CAN control, and what I CAN'T control). No matter what some of us try, or change, or learn over time----Lady Luck never, EVER, comes to visit.

I've learned and made my peace with the fact I'm one of the unlucky ones----I ALWAYS take longer to heal, take longer for swelling to diminish, have lots of "odd" stuff to handle post-op, the list goes on. I'm super healthy and fit, but my body absolutely HATES my knees. :headbang:

I am thrilled YOU are having a good recovery so far:cheers::spin:, and I know some of it is in our control......but if I had a dollar for all the times someone told me to "do this instead of that" or "this worked for me, so try it." Well, I'd definitely be a rich woman by now. :) I truly believe half of recovery is out of our control and comes down to dumb luck. Even with highly skilled surgeons, modern pain management, new technology, etc---many of us struggle horribly for absolutely no reason. What's left other than luck??!!:gaah:The human body has secrets she just refuses to give up!:bored:
 
So what's so different about me, that I was shopping and eating out on the day of my release, within 4 days I was limping around without crutches, walking almost normally by 6 days, able to walk up stairs within 10 days - and yesterday, day 12, actually hit my normal 'steps target' on my Garmin, for a normal day!?
What's different?
What's different @Bigs , is that you are one of the very few, fortunate people who are having a faster-than-usual recovery. Most people who undertake as much activity as you are experience set-backs. We've seen that a lot here on BoneSmart.
So to me, ice is a temporary thing to dull the pain and reduce swelling. Sometimes you really need that, but like a tourniquet you use it when you have to, not as a treatment for healing.

Your body's natural reaction is to make it swollen and hot, with pain signals, so compression and cold are the exact opposite of what your body is trying to do. That FEELS good but I can't help thinking that's just slowing things down, constricting when your body wants to open up, cooling when your body wants to heat that area, and repressing the pain.
That appears to make sense, but it's really not correct.

Apart from helping to control pain, one of the main purposes of icing and not over-exercising is to cool those hot soft tissues.

Why is that? Because hot tissues are drier than normal tissues and dry tissues tend to stick together more easily than normal tissues. Thus, by keeping those wounded tissues hot, you could be increasing the risk of developing adhesions (often called bad scar tissue by the physios/PTs.)
 
@Celle that is so good to know! I didn't realize the dry tissues and adhesions were part of the reason we ice??? I just know it has worked so well for me! Thanks for the explanation and information!
 
I didn't realize the dry tissues and adhesions were part of the reason we ice???
I think they are part of the reason. (Another reason is that icing often just feels so good, because it reduces the pain)
The other thing we advise against doing is over-exercising in the early days, because that can also irritate the healing tissues and make them hot and dry.
 
I'm back! :loveshwr:

Had my 1st physio session the other day, left me hobbling around in pain for 2 days :gaah:

She was a pretty little thing, gentle, didn't try to push me past pain barriers or anything. But these people are all about the numbers, and when she tried to measure the flexion she was confused due to the general damage to that leg. At every moment I kept presuming she'd announce some number and be done with it, but it was literally about a minute and a half later before she finally decided it was 100 degrees.

That was way, way too long to leave it at maximum flexion like that, and boy did I pay for it that night and the next day! In fact yesterday I couldn't even get 90 degrees and had to be really careful sitting down. Next time I'll let her borrow my phone to take a photo, and she can measure the photo instead! Anyway...

I tried to tease them by hobbling in on crutches but everyone laughed and said they'd seen the video or seen me walking around town, so I wasn't fooling anyone. Seems I'm a celebrity for healing so fast, which brings me back to the question of 'Why?'

Some say just good fortune, luck?

I don't buy that. I was the kid who couldn't read the blackboard and needed glasses, the kid that sometimes couldn't breath good and needed an asthma inhaler. I'm the guy that loves dogs, and turned out to be allergic to them... Heck, I'm the guy that got sideswiped and had a wonky knee for the last 34 years. If I have a guardian angel they need firing.

I'm also the guy that dreamed of living on a tropical island with his own boat, making his living as a writer while travelling the world - and that's my life. Little luck involved, just relentless working towards goals. Some golfer hit a hole-in-one, to which someone else declared he was lucky. I forget the exact quote but something like "It's funny; the harder I practice, the luckier I seem to get."

To some extent we make our own luck, and I don't think luck can explain the difference between "6 weeks on average" and 6 days.

The other day I said I'd put pen to paper, as a thinking exercise and see if I could explain things...

Well that quickly turned into 5 pages long, so let me read it again and give a quick summary...

Bummer. Wrong computer. OK, I'll wing it...

In essence I think it comes down to about 3 or 4 points:

1. I needed a knee due to accident damage, not old age, being overweight, poor diet or other medical issues. My other knee is fine.

2. I've been through the same trauma before - but worse. No instant-setting cement, nothing that could take my weight for months, indeed I needed a 2nd op' to remove bone from my hip to try to get the healing process started. Even then the leg was wonky, and having been laid up so long it was painful just to lower it at all, let alone try to walk on it.

I'd also suffered "foot drop" and knew the only thing that really got my recovery going was once I could bear to stand up and MOVE, even if a shuffling hobble. Once I was up and moving things rapidly got better.

So throughout this knee thing, my #1 concern has always been "When can I move? When can I put weight on it? How long does the cement take to set? When can I walk?"

The moment the doc said "The cement is immediate and fixed already, you can move it around today, it can already take your weight, it's just that the soft tissues.... blah blah blah blah.."

The moment I heard it could already take my weight I lost track of what he was saying - I could walk now? NOW?

And I did. At first a tentative step with less weight on my crutches, then.. no weight. It held. Another step, left leg again, full weight.. it held. I asked the 2 physio guys to leave me alone as I'd finally reached the toilet, thanks very much, see you later, totally confident I could hop back again later, so they left.

I walked back. Slowly, a bit painful, both crutches ready, and I'm sure I looked damn silly, but I walked from the loo back to the bed.

5 more steps that night, while my wife was asleep.

And I've just kept going, because I know last time that was what set me free - walking! Moving around, NOT letting my leg get used to being raised, NOT letting my good leg get used to laying around, NOT just sitting around waiting to heal but to get up and WALK.

3. Paleo/Keto lifestyle. I go out of my way to eat naturally. Not necessarily organic but I avoid processed food, carbohydrates such as rice, pasta, bread, potatoes etc. Basically I try to only eat meat, organs, above-ground veggies, nuts, eggs, dairy and seafood. No "vegetable oils" (which are actually rancid seed oils). The keto way of life is famous for low inflammation, which has probably helped.

4. High expectations. A classic example of willpower! See, my wife's colleague said her husband has both his knees done, and he was soon up and walking around, didn't complain of pain, was quite alright with it, and now he enjoys playing tennis...

Well if he could do that, so could I, right?

So despite (mostly) everyone telling me to stop healing and recovering so fast, to stay a cripple a bit longer, dammit, I've just kept powering ahead.

NOT to the point of serious pain - see what happened with the physio? 2 days of lost progress. I'm human. But constantly pushing beyond my comfort zone, just living life and refusing to be some bedridden cripple. Did that before, it took me 3 months to walk again. I don't do that now.

Just now I realized I got in and out of my wife's little Subaru, slowly, awkwardly, but this time without powering the seat right back. I just got in, drove and later just got out.

Remember the video in the park, where I was doing great until going down the steep little bridge? I did the same walk today, just a walking stick, not a crutch, and came to that bridge...

Walked down it fine. Barely a twinge and didn't need my stick, let alone a crutch.


I'm not a doctor, I'm no expert, and I'm just using my own experience from before. The day I could actually stand up for 3 or 4 minutes at a time, before my leg went purple and the pain was too much, was the day I rapidly started getting better.

I've done the same here. The moment I could walk, I walked. Always pushing a little beyond my comfort level, always careful not to actually hurt anything but to push myself a bit.

Just keep pushing.

Take it for what it is, my own journey, so far. Maybe I am crazy, maybe I'll have a whole heap of setbacks later. Maybe. What I DO know is I'm walking around with a tender knee, I still need painkillers and that's about it, other than that I'm back to normal.

I need to strengthen that leg, a lot. The Physio has me sitting on the end of a bed, raising my leg up and holding it up for 10 seconds. OK... but how does that compare to a 30 minute walk? To daily activity?

Let me check my Garmin... Tis a gimmick but a fun one... around 300 minutes of walking around today, at around 900 calories. Or I can sit on the end of the bed and raise my foot up and down?

I say if you can, get up and walk. Do stuff, live life as normally as possible, and you'll heal all by yourself.

But that's just my opinion, man?
 
PS: The more questions I ask, the more convinced I am that my wife's colleague's husband had 2 partial knee replacements, which explains his rapid recovery!

Happily, nobody told me that :tada:
 
Attitude is part of it too...I wrote in one of my previous posts that this leg/knee journey is like life's journey, with peaks and valleys. If you can remember that you'll come to another mountain top, you can get through the valleys. It is like you say, just keep moving forward!
 
I walked a lot prior to my surgery and I started walking about a week after my surgery. I can’t go as far or as fast as before my surgery but I am getting better. I’m 25 days PO and I was able to walk 2 miles today. I am icing and elevating still. It does seems to help me. I stopped pain meds after the first week. I believe being active prior to my surgery helped a lot.
 
Question about the video in the house, wasn't the left knee replaced? Why is the compression sleeve on the right?

Ken
 

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