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TKR Macknit's recovery thread

@Didot I'm sorry to hear your PT issues, so far I've been very lucky, and I'm pleased at how well the PTs listen. The one with her Doctorate in PT listens so well, which gives me hope for the type of training that can be out there! As an example of training: I have degenerative disk disorder and scoliosis....I had one surgeon who kept talking about all this hardware and fusing of the vertebrae...I went for a second opinion and the 2nd surgeon had a completely different philosophy!! I still needed a surgery, but her technique and approach were minimally invasive. The recovery was short and simple and the pain issues I had with my back disappeared!!!

I think it is the same with our PT, it depends on their training and the philosopy of the clinic you go to! Just look for a wholisitic approach to healing, there are so many clinics out there today! The PTs have me do what I can do and only do gentle massaging of the whole leg, which feels soooo good and relaxes me. Good luck as you investigate and advocate for yourself!
 
I'm wondering how or if people use the recumbent bike in their PT, no revolutions, just back and forth? I found it is pretty helpful at relaxing my knee and moving my flexion. I still have pain and stiffness, but each day is different. Hopefully the recumbent work isn't hurting anything...
 
Going back and forth on the recumbent bike won't do any harm, as long as it doesn't hurt.
 
I found the "rocking" on the bike a nice way to loosen up the knee. Just listen to the knee--it will tell you if you're doing too much. I found I really only needed a few minutes at a time.

I also wanted to check in with you on pain control. Is it any better? I don't think you'll get complete pain relief but for me the pain meds knocked it back to a "background" level, which was ok.
 
@kneeper: I have started to notice that I can live with the"background" level of pain, finally. With the new opioid regulations, I was surprised that they will only prescribe 1 week of the 10mg Oxycodone every 4-6 hours and then the second week the refill is for 5 mg every 6-8 hours. I had to write a dissertation to get 20 extra 5mg pills, since my pain level was still needing 10 mg every 4 hours when I hit my 10 day mark. They did give me an interim Rx, but my frustration overall is that in all 8 surgeries I've had since 2014...I never had this level of pain!? It is discouraging that the government applies a blanket regulation to someone who has never had addiction issues. I have since started to minimally taper off and I now alternate with Tylenol and Ibuprofen which is allowing me to stretch out my dosing to every 7 hours at this point. Regardless, I am getting better with understand that this level of pain control is as good as it gets! Thanks for asking!
 
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Isnt it completely ridiculous how stingy they are with meds so quickly after something known to be horrifically painful? I was horribly undermedicated for most of the first 2 weeks after my first replacement and only the fact that I've been working with a pain specialist for years fixed that for the second knee. She wrote the prescription for post surgery at 7.5 instead of 5 and it was so much more tolerable.

The best news for you is that most people find somewhere between 2 and 3 weeks the constant pain level drops a bit. You're almost there. I hope it is true for you. Then you'll be much more comfortable.
 
@luvcats: It is absolutely tragic, for those of us who have these knee issues and surgeries, because it is such a painful, long-term recovery. One of the things my PA mentioned at my post-op was I had quite a significant deformity, meaning my right knee was angling inward (knocked kneed or valgus deformity), which most likely is a source of my pain levels during recovery...

Yes, it is good news that almost 3 weeks out now. I'm seeing (feeling) this means different pain now, and I'm having more wake-up pains that take a few hours to calm down. I even had to try the Saran Wrap trick that Josephine mentions in one of her posts....interestingly, it did calm down significantly!

Since you are just one day behind me, how is your recovery now? PS...is that a baby tiger you are holding???:roseshwr:or some special breed that I now want!!
 
Last time I got quickly to a place where I could ignore daytime discomfort and save the good drugs for night time, otherwise I didnt sleep.

I dont think I saw the saran wrap post. Is that for scar sensitivity? I'm glad so far I haven't had to deal with that.

So far this recovery has been much easier than the first. That is quite a relief, but it worries me that I will have more trouble staying out of the ODIC, which I wasnt any good at before either!

That is, in fact, a real live baby tiger!! I used to live very close to a big cat sanctuary. One year they had cubs that coincided with the Fair and they had a booth. For what I thought was a very reasonable donation, during certain hours you could have your picture taken with a sleepy tiger cub!!!! It was a once in a lifetime experience. I was very surprised how coarse their fur really is, nothing like the silky softness of their little cousins who run my life.
 
Yes, just search the site for Saran Wrap and then Josephine shares a video...it is for superficial nerve sensitivity not just the scar. I had so much bruising it still is very, very sensitive!

I'm not familiar with the acronym ODIC, I googled it and it didn't fit in the context of what you were saying...what do you mean by
luvcats said:
it worries me that I will have more trouble staying out of the ODIC, which I wasnt any good at before either!
Click to expand...
??
 
ODIC=Over Did It Club. Meaning that I tend to do more than I should and wind up extra sore for a few days. During recovery the line between doing and over-doing is very thin and often a moving target.

Patience in recovery isn't something I'm any good at.
 
Oh I agree, that is very well said....I also found a little chart that @Celle had posted awhile ago that showed our recovery expectations (a straight upward climbing arrow) and our recovery reality ( a squiggly line that eventually starts moving upward!!). Recovery is a bit like life, but packed into a condensed time frame so we can get pretty overwhelmed with it all!
 
And here is that drawing:
[Bonesmart.org] Macknit's recovery thread
 
Thank you Celle! I love that visual! It humorous and true at the same time!
 
Thanks Celle, it helps to know the acronyms and abbreviations!

I also wanted to report that my PT today was absolutely wonderful...I can't rave enough about this clinic. I had gentle lymph and IT band massage and then slow gentle stretches for my back (from all the sitting I've been doing) then leg stretching. No pain whatsoever in my knee!! My IT band and hamstrings are all confused because of the deformity I had developed over time with the arthritis and valgus angle....now they are so tight and are the source of my night time pain (knee still has some too of course), With each exercise the PT asked how is it feeling? You don't have any knee pain right?? I am just so grateful!!!

I'm at the insomnia stage of this now, the last 3 nights I've only been getting 3-4 hours of sleep. I'm partially blaming pain meds, because I do tend to get energized on that stuff. I'm hoping as I continue to taper off I will be getting better sleep!? I'm reading this insomnia thing is quite common!
 
Ugh. The insomnia thing is very common. It seems to be common for many kinds of surgery, not just replacements. My Beloved got a lecture on it after he had bypass surgery. I read a lot about it after my first replacement. (in the middle of the night, up with insomnia.) Lots and lots of discussion about how it is common, but I couldn't find anything concrete about why and that's what I really wanted to know. What is going on in the body that causes us to be up in the middle of the night? It isn't because I'm napping too much during the day, because generally I don't nap at all.

I'm so glad you have a great PT clinic. I'm really pleased with mine as well. I'm envious of your massage and stretches though. I would have loved a lot more of that with my first leg, which, like yours had gotten really deformed and caused all sorts of cramps and unhappiness. It seems this one is going to give me more trouble through the hip muscles.
 
Yes the insomnia is something else and I haven't read anything about "why" either....though in our recovery articles Josephine did post, in 2012, an article about that address a bit of the "why" behind sleep deprivation.

I've recently had a visit our local sleep doctors and, just this summer after a sleep test, found I had a mild case of restless leg syndrome. Well guess what has kicked into overdrive with this TKR recovery??? Yup, the RLS, I've reviewed the articles that Celle sent to me and this too is rather common. So, last week I started one of the dopamine agonists that is supposed to help. So far, I haven't noticed any change :unsure:.
 
I have had diagnosed restless leg for several years. I take Mirapex for it. So far it is working for me. I don't notice that the surgery has made it any worse, but it doesn't help any either! lol I hope whatever you are on kicks in quickly to help.

Another thing that has helped me over the years is to be very strict about what I eat when. Type 2 insomnia, the inability to stay asleep as opposed to trouble falling asleep, can be a reflection of low cortisol. So I have a strict policy of no caffeine after lunch and no sweets after 3pm with my expected bed time of 9:30. This seems to help me. I have to say, narcotics really helps with this one. In the early stages, I sleep really well! lol Not a good long term strategy though.
 
@ luvcats, Thanks for sharing the information. I too have been prescribed the Mirapex; I only started it last week and it may take more time to get to the level of truly helping me. Type 2 insomnia is what I have also, I fall asleep but then always wake up at 3 or 3:30. The insomnia I've been struggling with during this recovery is quite different though and as I said earlier the RLS is crazy!! Just another thing to be patient with I guess??

I like your practice of managing the cortisol with no caffeine and sweets. I too manage bed time, but I need to see what to do to help with the sleep now....narcotics help a lot of things but I agree...they're not a long term strategy:heehee:!
 
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