TKR Mom's post op thread<

[MyMamaTKR]

Thank you. You all are so very helpful. Right now some days are better. Others are not. I just got up to check on her and found her sitting here crying. Broke my heart. Nothing is necissarily wrong, she said she's just so tired of this already and tired of feeling bad and hurting. She is doing more for herself which zaps her energy even more, which makes her feel worse. Although I feel she's doing better and on the right track, I'm so discouraged and sad For her.

 

[lmb]

I could not imagine going through the first month after TKR alone. I read from others who did it all by them selves But for me I was blessed to have my husband and son to help me through the worst. I took care of my Mom like you are for years. She is so lucky to have you for a daughter.

 

[Josephine]

@MyMamaTKR, did you see my post?

I'd like to give you some personal, structured advice for her but in order to do that, I need to ask you some questions. Are you willing for me to post them?

 

[MyMamaTKR]

@Josephine .. I didn't see this I'm sorry.. Sure

 

[Josephine]

No worries

I'd like to ask you some questions if you don't mind, and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine)

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?

4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[MyMamaTKR]

@Josephine ... Her pain levels are anywhere from 3-7 like I said just depends on her level of activity and time between pain meds

She was prescribed and takes oxycodone every 6 hours. She takes valium once every 8 hours, but does take it every day.

She has slight swelling at this point. Her swelling has gone down considerably since being on anti inflammatory. She said of course it feels tight inside.

She is at a 88 degrees bend and can flatten her leg out completely. And do leg raises.

She has a bad incontinence problem therefore she is up and down all the time and walking around the house throughout the day as well.

We follow up with ice and elevating for 15-20 minutes at a time.

She's doing exercises for 15 minutes at a time twice a day
PT comes 3 times a week and they work together for about 30 minutes per session.
She does
mini squats (10)
leg bends (2 sets of 10)
slides 2 sets of 10.
tip toes 2 sets of 10.
Leg presses 2 sets of 10.
Stand up sit downs 10,
kick out 10,
kick backs 10,
leg lifts 10

 

[RMasano]

Welcome!!! It sounds like your mom is pretty much on track. It is a very difficult recovery. I iced whenever I was sitting. Sometimes an hour at a time, with getting up and moving in between. The tightness lasts a long time and gradually gets better.

As far as the exercises, there are others here, who are better equipped to give you answers.

And remember to take of yourself. Us moms are stronger than we appear sometimes!!! You are a good daughter. And remember, ultimately, your help is great, but, like me and all of us on here, the journey is our own.

Good luck and take care.

 

[newlybionic]

I would have your mom cut back on all those exercises. Squats of any kind will cause her to have increased pain. If her leg feels tight that means there is still some swelling within the knee itself. She needs to ice and elevate at least 4 times a day for 45 or more minutes. She is getting enough exercise lately just walking to the bathroom and back. Make sure that she is taking the pain meds around the clock as they are prescribed. It's too early to try to cut back.

 

[Celle]

Don't forget , too that almost everyone gets a bit depressed after this surgery:
Post op blues is a reality - be prepared for it

I know it's upsetting to see your mother crying, but tears are healing, so it's better for her if she has a good crying session than if she tries to act brave all the time. The blues will pass.
Give her a hug and sympathise, but remind her that things are slowly getting better all the time.

 

[Josephine]

@MyMamaTKR - thanks for your answers though I had to edit your post as I specifically asked for it to "answer each one individually" and "please make a list and not an essay" but I coped anyway!

Her pain levels are anywhere from 3-7 like I said just depends on her level of activity and time between pain meds.

okay ....

She was prescribed and takes oxycodone every 6 hours.

But what DOSE. I specifically asked you to tell me in mgs.

She has slight swelling at this point. Her swelling has gone down considerably since being on anti inflammatory. She said of course it feels tight inside.

Well, 'feeling tight' is also swelling. Swelling doesn't always appear externally. Quite a lot of swelling occurs internally which can cause quite a lot of pain. Actually, swelling is also a form of pain.

She is at a 88 degrees bend and can flatten her leg out completely

Not bad for 3 weeks out. Not bad at all.

She has a bad incontinence problem therefore she is up and down all the time and walking around the house throughout the day as well.

Here again, I did ask for details. Can you be more specific please?

We follow up with ice and elevating for 15-20 minutes at a time.

You accomplish little or nothing in 20 minutes. Ice and elevate for at least 40-60mins and more than 4 times a day. For elevating it needs to be 'toes above nose' but - and it's a big but - she must not have her leg straight when elevating as it will cause pain. Look here for good and bad ways to elevate Elevation is the key

My comments in bold
exercises for 15 minutes twice a day- she'd be better doing them once a day and none at all at the weekends
PT comes 3 times a week and they work together for about 30 minutes per session - how about cancelling that?

mini squats (10) - okay but make sure they are proper mini squats and not full ones
leg bends (2 sets of 10)
heel slides 2 sets of 10.
these are both for flexion and she only needs to do one of them. Best one is heel slides but read this to learn Heel slides and how to do them properly
leg lifts 10 - tip about straight leg raises: once she can do them, she doesn't need to do them any more.

tip toes 2 sets of 10 - I don't recommend these
Leg presses 2 sets of 10 - or these
Stand up sit downs 10 - or these
kick out 10 - or these
kick backs 10 - or these

I suggest you and she read this article BoneSmart philosophy for sensible post op therapy

So long as she is active about the house, she doesn't really need these exercises. There are many on this forum who did almost no exercises and some who even did none at all! I was one of them. And we all got excellent outcomes and very little pain. I recommend you read my recovery thread to see how little exercising I did for either knee! Knee recoveries UK style Parts I & II (Josephine)

 

[sistersinhim]

I also, did no exercising. Just my daily living rehabbed my knee. I've an 11 knee surgeries without pt and am doing great after my tkr! There is no need at all for your mom to suffer through therapy. Her body knows how to rehab her knee. As she uses it, it will get stronger and bend easier. But, it takes lots of time. I had stiffness for up to four months. It is normal to be stiff and sore. But, it does go away in time. She'll have good days and bad days. We all did and do.

 

[kneeper]

I just got up to check on her and found her sitting here crying. Broke my heart. Nothing is necessarily wrong, she said she's just so tired of this already and tired of feeling bad and hurting.

This is so normal with this surgery. These first weeks are hard. Heck, in the first couple of weeks just taking a shower was a bit of an "event." At least one nap, especially about mid afternoon was the norm. That's when I had my crash and often was cranky, frustrated and sometimes teary.
Sometimes I even laid down for a while in the morning. It's your body telling you it needs the rest. And the pain meds make you drowsy. That's ok because it makes you rest.

It's a long haul but it does get better.

 

[sistersinhim]

Oh yeah, and about naps...your body heals even more when you're sleeping, so let her sleep as much as she will. Let her know that it's very good for her to sleep and let her body heal.

 

[MyMamaTKR]

i hope everyone is doing well!
So my mother is now 6 weeks post op, and things have gotten better. She has done great with her in home physical therapy which today is her last session of that. She goes to the dr on Tuesday for her 6 week appt.. She's still in quite a bit of pain, and her energy level is very low, VERY low. The bend on her knee is excellent she has been at 115 degrees since week 4! She gets very discouraged and depressed when she thinks about having to return to work because of her low endurance. She's also very nervous about outpatient pt which I guess the dr will be sending her to after her appt on Tuesday. I keep telling her one day at a time, but I know that just makes her want to smack me! Haha. I hope she's on the right track still

 

[KarriB]

The energy drain can hang on for quite a while. When is your mother planning of returning to work? As far as out patient PT, make sure no one pushes or pulls on your mother's knee. She has great ROM for 6 weeks post op and aggressive PT could hurt that. She should also not be doing any PT that involves weights or resistance at 6 weeks. All of that should wait until 3-4 months post op.

https://bonesmart.org/forum/threads/energy-drain-for-tkrs.11953/

 

[Jaycey]

@MyMamaTKR you will notice that I have merged your two threads together as we prefer that members in recovery only have one thread.

This is for three reasons:
1. if you keep starting new threads, you miss the posts others have left you in the old threads
2. it often ends up that information is unnecessarily repeated
3. it's best if we can keep all your recovery story in one place so it's easily accessed if we need to advise you.

Please keep all your questions and updates on this thread. I changed the title slightly. If you would like a new thread title just give a shout.

 

[MyMamaTKR]

Thank you for your post! We aren't too sure when she will return to work. Waiting for the Dr to tell her when she should next Tuesday really.
We have heard the same thing abou the outpatient pt. About not letting them push or pull or hurt her knee and the weights. But what if she goes in and that's exactly what they want her to do? Does she just tell them no? Does she just leave? How do you handle that? I know some of those places can be kind of bullies about just do what they say. Sounds silly but she's really worried about what to do and she has come so far with her at home pt even on her own.

 

[Jaycey]

But what if she goes in and that's exactly what they want her to do?

Then she just says NO! It's her knee and ultimately she is paying for the service. It goes the way she wants or it doesn't proceed. She may need to be firm but it's to her benefit.

 

[PolarBear60]

Hopefully, your Mom's therapist won't do any of those things. What you hope will happen is they will ask her what her goals are for PT (I was unprepared for this question for my first knee, but I was ready for my second, and my therapist designed everything to meet my goals, so have her give it some thought before she goes in). Hopefully, they will also have a philosophy of "if it hurts don't do it" and "let's try another way." She should have an opportunity to discuss things during the initial evaluation session, and I recommend she ask about their philosophy. She should listen to the therapist doing the evaluation, express any concerns she has, and they should respond in a way that she is comfortable with. If she is NOT comfortable with them, she should try to work things out, but if that is not going to happen, she should seek another therapy place. I hope she gets a good one, because there are plenty out there.

I checked out a local nursing home as a possible therapy place after my first knee. The therapist there, when I asked about their philosophy said, "Well, you know rehabbing a knee is hard work." That and the lack of any appropriate therapy materials in their "gym" told me I was looking at the wrong place. When I went to the therapy place recommended by my surgeon, I was immediately thankful I'd gone there. They were professional, capable, and had a hands-off, if it hurts don't do it that way philosophy. They weren't exactly in line with the BoneSmart way, but they were close enough.

Finally, if anything they ask your mom to do hurts, make sure she tells them. They should tell her to stop and have another alternative that won't hurt for her to do. Smart therapists realize pain indicates the knee isn't ready yet for what they've asked it to do. I maintained a dialog with my therapist about what I was experiencing at any given time. This dialog helped me understand what was happening with my knee and helped me know if it was on track or not.

Oh, yes. The energy drain takes a while to overcome. She will get her energy back -- probably over the next month or so.

 

[sistersinhim]

With her ROM, your mom doesn't even need PT. But, if she goes, she has to be in total control of her knee. Don't let her do anything that hurts. A little discomfort is ok, but no pain. That's very important. If they hurt her, then her recovery is slowed way down. If doing pt gives her pain and swelling afterwards, then she's doing too much. Each day she can do little things for herself and use her knee. That in itself is PT. Aggressive exercising is not needed and just slows the healing down.