TKR Montecresto’s Recovery

[Montecresto]

Had my knee replacement on Tuesday June 28th
Hope this is the correct place to post this…..

This is a way bigger deal than I was expecting…..

 

[Layla]

Congrats!
You’ve graduated to Knee Recovery side now. Would you like to start a thread over there, or would you prefer we do it for you? We will leave our Recovery Guidelines there once a thread is started.
@Montecresto

 

[Layla]

Which knee was replaced? Will add the date to create a signature for you along with R or L knee, whichever it is?

 

[Montecresto]

Thank you, either way, I just don’t know where to go start it. Thought I was doing that here….lol

Right knee….

 

[Layla]

No worries at all. I’ll start it for you and title it Montecresto’s Recovery unless there is another title you prefer. Thanks for the info to add to your signature!

 

[Layla]

Welcome to the bright side!
I’m sorry if you’re having a rough start. I’m thinking that may be the case considering your initial post. We’re happy you joined us and hope you’ll share your healing journey so we can support and encourage you along the way. I’ll leave our Recovery Guidelines with best wishes for your comfort. Stop back often, we’ll be here!

Knee Recovery: The 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
6. Access these pages on the website
Oral And Intravenous Pain Medications
Wound Care In Hospital


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.
@Montecresto

 

[InkedMarie]

Welcome! It can be a hard recovery. Are you icing & elevating most of the time? Icing can help with pain. When elevating, toes above nose!

Marie

 

[Montecresto]

Welcome! It can be a hard recovery. Are you icing & elevating most of the time? Icing can help with pain. When elevating, toes above nose!

Marie

Thank you. Yes, I have a Temperpedic bed and I keep my leg elevated accept for when I’m in the CPM
I am regularly on ice. I purchased an ice machine but find it uncomfortable to use, so I returned to the ice packs though I hope to be able to return to the ice machine.

 

[Montecresto]

Thank you @Layla
So this is now my thread I presume? I can post commentary and questions now about my surgery etc?

 

[Jaycey]

@Montecresto Welcome to the other side. Yes, this is where you can post questions or comments about your recovery. Looking forward to following your journey.

 

[Montecresto]

Ok, thank you.

 

[Montecresto]

So my surgery was Tuesday, late morning, June 28 th.
After I left post op recovery and got to my room, the doctor visited and told me that he found an excessive amount of scar tissue in my knee area and he told me that he observed that my leg would not achieve full extension going into the surgery. So, he also had to go to the back of my knee and do a release he called it. Apparently there was something going on back there that would not allow me to fully extend my leg. Btw, I also was aware of this going in because it had been that way since a laparoscopic surgery I’d had on it in January of 2021……Not only did I not gain any benefit from that procedure, I was left worse off….

Anyway, I’m 60 and my degeneration is a result of a lifetime of construction work and my right knee was always the one that took the brunt of things. If I was going down on a knee, whether to install baseboard or set tile, that was the knee most likely to be under me…

Then there is the few different occupational injuries that this knee has suffered.

The doctor said the extra efforts kept him in their longer than the average one hour 15 minutes and he said that due to the additional, cutting and scraping, recovery would be a bit more intense and longer.

I’m experiencing this now…..and suffering.

 

[Montecresto]

In the recovery guidelines I don’t see anything in the subject of pain medicine related constipation…..

WOW, that crept up on me in the biggest way. Apparently I should have been eating a high fiber diet and taking stool softeners, Miralax and prune juice. Of course I didn’t do any of that and am now paying the price. So this is my current emergency….

As a result, due to unbelievable discomfort I quite eating. 24 hours now, and I quite my pain medicine, been 12 hours since last taking that. I know those two things will draw the forums wrath lol but I’m in trouble and hurting…

I have a nurse practitioner friend that works ICU who is walking me through this. Enemas, laxatives, suppositories, magnesium citrate, “Oklahoma Thunder” a mixture of warm milk, warm prune juice and milk of magnesia…

So far, moderate results, but no break through moment….yet

 

[Jockette]

So far, moderate results, but no break through moment….yet

Be patient. If you take too many options, they can all work at once and you could have the opposite problem. Give them time to do their job.

 

[Layla]

Ugh, I’m so sorry. That is miserable! I’m really surprised you weren’t prescribed stool softeners. While I understand your thought process on stopping pain meds and not eating. I hate to see you exchange one discomfort for another. A rumbling tummy, starvation, or increased pain. You should be able to take your pain meds with all of the helpful hints shared by your friend that works in the ICU. Oklahoma Thunder Now that is funny. Good Luck!
@Montecresto

 

[Montecresto]

Ugh, I’m so sorry. That is miserable! I’m really surprised you weren’t prescribed stool softeners. While I understand your thought process on stopping pain meds and not eating. I hate to see you exchange one discomfort for another. A rumbling tummy, starvation, or increased pain. You should be able to take your pain meds with all of the helpful hints shared by your friend that works in the ICU. Oklahoma Thunder Now that is funny. Good Luck!
@Montecresto

Haha, well she works in a Tulsa hospital so I suppose that’s the reason for the name. I’m in Arkansas and I’d bet there’s an “Arkansas Thunder”, in fact mamas out gathering ingredients now so I know there will be. Also, I was prescribed stool softeners, one a day. A couple days ago my wife was reading the Ducolax bottle and it said not to continue use beyond 7 days. That’s why we quit. My NP friend said no, take the max dosage (which is 3) daily and not to worry about that….

Actually the constipation related problems and symptoms have left me without an appetite and feeling like a tic. Thinking of eating has zero appeal presently, and so far, I’m not suffering having not been eating. And I’m really hoping to put this problem away this afternoon for good and then I will proceed according to my NP friends guidance so I don’t get back into this trouble. I did just take my pain medicine again however, had to……

Oh, and I’m drinking plenty of water and juices all along!!

 

[Layla]

Sounds like you’re doing all that you can. You’re not alone with the “no appetite”. I read it here often. You know our bodies are pretty amazing, maybe the appetite naturally wanes as the digestive tract slows from the opioids. I hope you find relief soon.
We don’t want you feeling like a tic, lol.
@Montecresto

 

[Montecresto]

Now there’s the issue of rehab/therapy…
Clearly what the surgeon prescribes and the advice given here is not a big match lol.

The doctor started rehab before I left the hospital. And ordered it as soon as I got home, Monday, Wednesday and Friday's. To continue for 6 weeks….

So dutifully I scheduled and showed up to my first day of PT, Friday, the day following my release from the hospital. It was an hour and most of the reps I was instructed to do, from the knee slides, leg lifts and traction with weight hurt me, bad. Near tears. And I really hurt going home. The next two times only got harder and I was about in tears with many of the reps they instructed me to do. The second and third days at PT resulted in my knee swelling up and a loss of ROM. So I was really discouraged coming home from PT on Friday.

I talked to the manager about it and he assured me that it would be ok, I could not hurt myself, and occasional setbacks are normal…I came home and my knee blew up. The pain medicine provided no relief and we had to really stay diligent with the ice therapy to get it back down.

Then my wife found this forum. And we’re calling the PT clinic Monday morning and canceling until further notice. Going to call my doctors office also Monday morning and tell them and explain why, and see what they say….

I’m really worried about not getting back my ROM and particularly full extension…Not sure how I’m going to get there, but it seems not in the direction I was heading…..

 

[Jockette]

I’m really worried about not getting back my ROM and particularly full extension…Not sure how I’m going to get there, but it seems not in the direction I was heading…..

Please don’t worry about regaining your ROM. Yes, you will regain it, even if you never go to a PT office again. Right now swelling is blocking your ROM, as the swelling goes down, and as you heal, your ROM will improve by default.

You are wise to cancel your appointments at this location, as they are giving you inappropriate PT. They have you in ”training” mode, ignoring the fact that you are in “healing“ mode.
Saying no to therapy - am I allowed to?

This early in recovery all you need are gentle bending movements to give your knee mobility. Short walks in the house are fine. You need lots of rest, ice and elevation. Check our Recovery Guidelines for articles about those.

 

[sistersinhim]

Have you tried suppositories? They helped me have a 'breakthrough'. After that, I took fiber laxatives until I got back to normal.

The PT you had has really set you back in your recovery. It's a shame you have to recover from PT before you can get back to your knee's surgical recovery. You are doing the right thing by canceling it. I wouldn't even bother calling your OS and telling him. It's your knee and your decision, not his.

I was blessed to have a surgeon that never pushed PT. He gave me a prescription for it, which I threw away and never went. When I went for my 3 return checkups, all he was interested in was to see what my knee would do and never measured. He never even asked about PT! Of course, he knew I was a single lady that had to take care of myself and obviously trusted that I would not be just laying around all the time.

After 12 knee surgeries, I know that I do not need formal PT, and neither do many others if they do their own daily activities and not just sit around all day and night. My knee recovered just fine all on its own with only my daily activities. I didn't have the terrible swelling or agonizing pain that so many have after taking formal PT. I knew the Bonesmart way worked before Bonesmart was even thought of. My knee surgeries started in the early 80s and I never went to PT even back then. I just didn't see the need for it. Bonesmart was formed around 2004. By then I had already had 6 knee surgeries and rehabbed the Bonesmart way!