TKR LTKR

[Hendy]

Hi everyone,I had my LTKR on 31st Jan and have been reading about everyone's recovery but didn't have the courage to post!!I'm finding the swelling and total discomfort really hard to deal with as I'm really impatient and have been used to being very active even with my arthritis!I have been able to walk with no aids since day 4 but find the bending really hard due to all the swelling,have actually got a cankle!!I'm walking around the house and outside everyday as well as stairs due to an upstairs toilet but don't know if this is enough or too much??I'm elevating and icing but the swelling is really getting me down,also lack of sleep as I just can't seem to get comfortable!Does anyone have any advice?

 

[Layla]

Hello and Welcome to BoneSmart and recovery. Thanks for joining us!
As for the swelling, it's normal. Ice and elevation will help per direction in the Recovery Guidelines. As far as activity, it is finding a perfect balance between not enough and too much. Use the Activity Progression for TKR from the Recovery Guidelines as a rough gauge. Lack of sleep is another common complaint. The best advice is to sleep when you're able until your sleep regulates once again and it will. Energy is being used for healing first, not leaving a lot for the regular activities of daily living. Recovery does take patience.

Best wishes for your comfort and a smooth recovery! Stop back often so we can follow your progress and cheer you on along the way.

KNEE RECOVERY GUIDELINES

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

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​

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.

 

[Hendy]

Thank you for your advice, I'm really, really impatient and think I had far too many unrealistic expectations of myself and my new knee (Neville) and I will try to reign myself in!! Nobody really prepares you for the sheer scale of this procedure and the steps that are needed to overcome both it and your own mental attitude!!

 

[FourCats]

My initial thought is that you’re doing too much, asking way more of your baby knee that it’s able to give. You’re just a few weeks into a yearlong process and need to be treating yourself with lots of time elevating, icing, and resting.

 

[InkedMarie]

Hi @Hendy . I believe you are doing too much too soon. You‘re only a couple weeks out; you should be icing & elevating most of the time. You should be keeping well hydrated meaning you’ll be visiting the toilet often. After going, take a short walk around your home. Are you icing & elevating while trying to sleep?

You‘re correct, this surgery is tough and many are unprepared. Sleep is hard for many. It took me a few months to get a few hours, uninterrupted, for both knees.

Marie

 

[EalingGran]

cankle!!I'm walking around the house and outside everyday as well as stairs due to an upstairs toilet but don't know if this is enough or too much

I don't have a toilet on the ground floor either. You are probably doing loads just having to use stairs so much - so go easy on yourself. Be really organised to limit the number of times you use the stairs.
I remember having a set back about ( ? 10 weeks) with more pain and swelling again. At first I couldn't work out what had happened until I looked at my fitbit data and realised I had tripled my number of flights of stairs to 18! In the first few weeks I had had no problem asking my family to fetch things for me from upstairs but felt guilty by that stage and was going upstairs myself if I forgot my reading glasses etc.
Stairs are really tough on new knees.
Lack of sleep is absolutely normal too.
I am only now ( 16 weeks) starting to sleep better. Although admittedly I have been a poor sleeper for several years.
I asked my GP for some zopiclone ( just emailed and said I had had a partial knee replacement and couldn't sleep due to pain. No problem getting a month's supply on that basis. I use it sparingly and also use herbal valerian and a sedative antihistamine ( called Nytol in the UK) that you can buy at the chemist. I also have some melatonin I bought on a trip to the US.
I find varying what I use prevents tolerance. Also I still use iced water for pain relief and rest the jacket of my cryocuff on my knee at night. It is very soothing and helps me to go off to sleep.

 

[Layla]

Nobody really prepares you for the sheer scale of this procedure and the steps that are needed to overcome both it and your own mental attitude!

There is a saying that floats around the forum and it is - "Just because you can, doesn't mean you should."
Sometimes the activity we engage in is too much for the phase of recovery we're in. In our quest to return to normal, it's difficult to see that the very thing we can do once again, may be what's stalling our recovery.

It sounds like navigating stairs is necessary since that's where the bathroom is and you're also likely engaging in the activities of daily living, so....you may want to eliminate the outdoor walks for a time, at least until the swelling and discomfort eases more. Then when you start up again, go s-l-o-w.
Try it and see if you notice an improvement.

 

[beachy]

Welcome to you and Neville! My new right knee is named PIA...Pain In A$@. She says hello to Neville.
You are doing too much too soon without realizing it. We aren't prepared for the pain and how long this recovery takes. I found Bonesmart prior to my first tkr and credit a good recovery then and now to that.
Your activity should be what is absolutely necessary...like stairs to bathroom. Every other part of your day (and night) needs to be ice, rest, elevation, pain meds. Its unconventional compared to what the docs and PT tell you. But, it works.
You've done the best thing for recovery by finding Bonesmart.

 

[EalingGran]

Welcome to you and Neville! My new right knee is named PIA...Pain In A$@. She says hello to Neville.

 

[Hendy]

Thanks to you all for your advice,I know I'm probs doing too much but have had so much conflicting advice(my manager being one!)that I'm worried about meeting certain criteria that's needed to get me back to work!I have a sick note for 10 weeks but I know my employer will be referring me to occupational health at 6 weeks to speed up my return to work which at the min seems a total impossibility!

 

[FourCats]

Returning to work is impacted by the kind of work you do. Are you sitting or standing? Is there much walking involved? Will you be able to elevate and ice your knee? Lots of things to take into consideration.

 

[Hendy]

I'm a cook and spend at least 8 hours on my feet,it's a really heavy job and I'm worried that I'll be pushed in too soon!!My manager apparently was horse riding at 4 weeks and ice skating at 5 so feel that I have a lot to live up to!!

 

[beachy]

Your 2 1/2 weeks post op. Pia was most unhappy at that point. I was most unhappy and had a few meltdowns. It was still a time to ice constantly, elevate, stay ahead of the pain and rest. But, you're done, cooked, over it and just want to feel better. You will. For me (and Pia) I began to notice a little improvement around 4 weeks. That searing post op pain was replaced with tightness from swelling....most uncomfortable, but not quite as bad.
Neville will begin to behave if you take it very easy and realize that you have a lot of healing to do.
Does your surgeon's 10 week note trump your manager's 6 week plan?

 

[Hendy]

@beachy,yes my surgeons note does top trump my managers 6 week plan but unfortunately I live in the UK and my employer has a right to send me to occupational health who also have the right to override my surgeon!!Crazy but true

 

[JusticeRider]

My manager apparently was horse riding at 4 weeks

I rode my horse at 4 weeks and here’s what that looked like: sitting on my horse bareback (no stirrups to put pressure in the knee) at a walk for 20 minutes. Yes, I could say I was riding at 4 weeks. But to me, that is not riding. Who knows what your manager’s riding was like.

and ice skating at 5

Ok, well that’s just ridiculous. That is absolutely not realistic for 99% of us!

Don’t pressure yourself, read lots on BoneSmart and exercise that patience muscle as much as you can! We’ll be here to support you!

 

[Jockette]

My manager apparently was horse riding at 4 weeks

Whenever we hear something like this, we picture the person fully recovered.

I was in a bowling league when I had my surgery. While I wasn’t bowling at 4 weeks I did start back at 3 months.

However: I only bowled one game, not our usual 3, my first time back. For a couple of months my husband carried my bowling ball for me. He helped me get my shoes on because I couldn’t bend enough to do it myself. It took me 2 months to work up to bowling 3 games, and I still could not approach the throw line the same way I did before surgery.

So, I could honestly tell people I was bowling at 3 months, and I was, but it’s not the whole story.

 

[EalingGran]

I'm a cook and spend at least 8 hours on my feet,it's a really heavy job and I'm worried that I'll be pushed in too soon!!My manager apparently was horse riding at 4 weeks and ice skating at 5 so feel that I have a lot to live up to!!

I don't totally believe your manager.
I made myself miserable comparing myself to others. My daughter in law's father was golfing at 6 weeks, for example. People's recovery varies and he may have only been on the horse for 5 minutes or on the ice for a similarly short period of time!
Either way , these activities don't compare to standing for long periods. Even at 16 weeks I find that the situation that causes my knee to ache and slightly swell. I can happily walk for 3 miles but standing, say in an art gallery is definitely harder.
As for going back to work, most occupational health staff are fairly cautious, in my experience and reluctant to overide a GP or specialist opinion. The phrase to use is "reasonable adjustments" Maybe you needed a seated work station and special breaks to ice and elevate, and a phased return when you do go back to work. Don't be rushed and don't be bullied. I am in the UK and our HR department was terrified of litigation. There are disability discrimination laws and you could sue fir constructive dismissal and win if your firm has not made reasonable adjustments to help you return to work.

 

[Hendy]

Thanks to all for the replies and advice,I've decided to give neville a bit of a rest and try to just take each day as it comes without stressing about exercise(or lack of!)and definitely to not worry about returning to work or my manager's 6 week plan!!

 

[beachy]

That's too bad about your employer over riding your surgeon. But, you're doing the right thing by resting Neville. You will start to feel better sooner. Please ice and elevate for long periods if you can. I'll be 6 weeks on Wed and can't imagine being on my feet for 8 hrs. And I also think your manager is full of it with his horse riding and skating. Sounds like intimidation.
Hang in there!

 

[Hendy]

Hi everyone, I haven't posted for a while but have been reading about everyone's journey, I'm so grateful to have found this site as it made me realize that we all have a different recovery and no one person is the same! I can definitely see a glimmer of light (tiny) at the end of this really long recovery tunnel, I'm nearly 5 weeks since surgery and can honestly say it's only been the last couple of days that I've seen any kind of progress, totally baby steps!! The one question that I do have is that my leg is quite pink compared to the unoperated one, is this normal?