TKR Mickimouse’s Recovery Thread - Need Support

[Mickimouse]

Thanks everyone for your support….i really felt I was going to breeze through this TKR, but the last couple days reminds me of my last TKR in 2022…. Sleeping in recliner, pain, etc… 3 weeks out I should have known better. My state, Ohio, has strict opioid laws and I have 10 more pills left then that’s it….don't know what I am going to do. Making me stressed that I won’t be out of pain . Last TKR I had oxy for at least 2 months.

 

[Lisako76]

Hi Everyone! I am 15 hours in of having a new knee! Doc said all went good, but I am in the hospital over night and this is not a good experience this time around….. have a roommate that snores, the night staff is nowhere to be found….. I could not have gone home because surgery was afternoon and PT had gone home…. 1 hours of sleep….. hey but the food was good!

Hospitals are no place for sick people because you rarely are able to get much sleep!

 

[EalingGran]

don’t remember this….one day feeling accomplished, next day feel like I haven’t made any progress or worse,

Absolutely normal to feel up and down. Hang in there!

 

[Layla]

I have 10 more pills left then that’s it….don't know what I am going to do. Making me stressed that I won’t be out of pain

Hi Mickimouse, I am sorry that you're dealing with pain and stressed at the thought of running out of meds.
I suggest you contact your surgeon's office before you're completely out, they may have advice for you on how to adjust meds, suggest alternatives or give guidance on tapering off. You can also discuss non-opioid options, like NSAIDS for one. Make use of icing, routinely, if you're not already and hopefully it will help also.
I wish you the best. Please keep us posted, we're here for you!

 

[Jamie]

Speak with your surgeon now about the need for something to help control pain. If he won’t prescribe opioids, ask if he would prescribe Tramadol as a step down to eventually getting to Tylenol. If your surgeon won’t do this, then contact your GP and ask for assistance with your pain.

NSAIDs do work on swelling (which you may not see looking at your knee) because inflammation and swelling cause pain, but Extra Strength Tylenol is more effective. If you’re off prescription pain meds, you can take a combination of an NSAID and Tylenol together on a schedule to help with pain. We can give you a schedule for that if your doctor doesn’t provide one.

Let us know what your surgeon has to say about renewing your prescription. According to what I read in Ohio’s very strict laws, a physician can extend the 7-day supply if he justifies it for a medical reason. So the law doesn’t prohibit a refill beyond 7 days, it just means the surgeon has to do some work to write the justification and place it in your records.

 

[Mickimouse]

Have another stressor, has anyone dealt with leg/knee buckling at times? When walking I have this happen at least 2 times per day…. PT says it’s my brain not connecting with my thigh muscle, told me to do a certain exercise…. Just frustrating……

 

[mendogal]

@Mickimouse We have had enough of our knee members report buckling to consider it a part of recovery. It does indeed seem to be partly weakness and partly what your PT says:

It takes quite a while - sometimes, for some of us, a good couple of months - for the tiny motor nerves that stimulate the tiny muscle bundles to fire in proper coordination for the entire muscle to contract effectively.

This is also a large part of our difficulty in going up or down stairs sequentially.

It does get easier with "tincture of time"!

 

[Jamie]

Sometimes this occurs when you’re trying to do too much too soon. Tell me what a typical day looks like for you in terms of exercise, activity, rest, and household chores or errands. It could be that you just need to scale back a little. You’re just one month out and I’m afraid you may have underestimated what recovery would be like.

It also can be from muscle weakness, but this is still related to your activity. If the muscle is weakness and you’re trying to do too much, It will just give up when it’s pushed beyond its strength level. What assistive devices are you using to support your leg when walking in the house and outside the home?

 

[Mickimouse]

My typical day is doing my PT exercises 3xs per day, walk 5 mins around the house no more than 3 times a day, I do normal stuff like getting a glass of water, bathroom breaks..I am still on a walker because if the buckling…

 

[Jamie]

Good. I’m glad to hear you’re using the walker. What specific exercises are you doing? Tell me the exercise, number of reps and number of sets that you do 3 times a day.

 

[Mickimouse]

10 calf raises, standing marching 10 of those, 10 standing knee kick backs, 10 standing hip abductions, 10 seated long arc quads, 10 sitting knee flexion, 10 sitting knee extension stretch, 30 quad tightening sets, 10 long sitting quad set with towel under heel, 10 short arc quad, 10 heel slides, 10 straight leg raises

 

[Jockette]

@Mickimouse That is an excessive amount of exercises for only once a day, let alone 3 times a day. No wonder your knee is buckling. At one month post op you have not healed enough to do all this.

 

[Mickimouse]

I see my Physical Therapist tomorrow and will address this….I have read here in BoneSmart to not push the exercise….thank you!

 

[mendogal]

I agree with @Jockette that even doing all that once a day is way too much.

I would absolutely NOT do long and short arc quads, which are strengthening exercises, until 12 weeks postop. It takes that long for tendons to heal. That much overuse too early by some of our TKR members has resulted in acute tendonitis!

 

[Jockette]

Some PTs don’t understand the recovery of a joint replacement and they give way too many exercises.

 

[Jamie]

Yep.....it's too much too soon and you're just causing your knee to become overtired. My recommendation would be to do one set of the exercises once every other day. And I would even cut back on some of the exercises as mendogal suggested. On the off days, just do one set of gentle bends and stretches that keep the knee moving along with your walks around the house every couple of hours.

Your body is still healing and this much exercise can be counter productive. Doing them every other day gives your body a chance to bounce back a little before going at it again.

I hope your therapist will understand this and support you in cutting way back for at least a month or so. Each time you do any exercises, they should challenge your knee to the point of mild discomfort, but not actual pain. As Jockette mentioned there are still a lot of therapists out there who were taught that a knee needed aggressive therapy starting right after surgery. Things have changed now. Based on a number of studies, surgeons are finally recognizing what we have known for decades that most people recover best if their knee is allowed some time up front to heal before serious exercises are introduced.

 

[Mickimouse]

Thank you for info! I will discuss this with my therapist today…. He seems to listen and seems open to my thoughts! Will let you know how therapy turns out!

 

[sistersinhim]

I was one of those who chose to not take PT or do any exercises after my TKR. I just used my knee normally doing my daily activities. Walking to the kitchen, bathroom, and/or bedroom is PT, it's natural PT. The first 6 weeks I did as little as possible, but being single, I still had to take care of me and my daily needs. For my first shower during my 2nd week of recovery, I had a neighbor come over and help me. It felt like heaven to finally wash my hair and have that warm water flow over me! Of course, that was extremely tiring, but was worth it!

As I was able, I would do an extra chore one day, then rest the next. Icing and elevating was a constant thing every time I sat or laid down. Recovering this way kept my pain and swelling more manageable. I recovered this way after 6 surgeries on each knee, and I am doing just fine!

 

[Shea]

I’m writing to reinforce that one can reach proper flexion and extension measurements without PT, at least I could. 125 flexion with 13 month knee, 0 extension.

 

[Mickimouse]

Hi everyone! I really like my PT, Adam! He listened and agreed if I am hurting etc back off! He agreed….good news is my flexion is 115, extension -2. My last surgery took me over a month to get to 108 flexion… so feel good about that…. Adam said the cane will come in time and stop being hard on myself….i do tend to beat myself up when I think I am behind. Anyway, this is why BoneSmart is invaluable when going through this type of surgery for valuable input from those who have been there! Thanks everyone!