TKR Back again in 2021 ☺

Thank you all. To answer:

Josephine. Yes I would love some structured advice, so happy to answer all questions☺

No, I had mine done under NHS choice at the Chiltern in Great Missenden so I could get the same surgeon who did such a brilliant job of my hip (he is also very good at knees!!).

Wycombe has been neglected a bit sadly as it no longer has an A&E or trauma care as that is now all done at Stoke Mandeville but Wycombe staff are brilliant,as always.

Sistersinhim & Rockgirl: Yes, 13 year olds can certainly surprise you!! My daughter turned into a 5 year old when I went into hospital, but now I am out she is helping beautifully ☺
 
Doesn't matter if you did have it done at a private facility, it's still all under the Wycombe Health Authority and the same surgeons work in both places.
 
Yes true, I know he works at the Shelborne in Wycombe hospital and elsewhere too and, as you say, all under the banner of Wycombe health authority. ☺☺
 
Hi there. Excellent physio appt. She was a lovely, gentle lady who does not believe in forcing the pace. "The wound needs time to heal" was her approach. She has given me some gentle exercises for home to do 2 or 3 times a day. She also swapped my dressing for a much longer one and that has made a real difference too! My ROM is 85 flexion. Forgot to ask for straightening figure.
 
That's great to hear. Glad it went well.
 
Thanks Benay. I see you are about 4 weeks ahead of me. How did you find your pain levels at night in the early weeks? I am reasonably ok during the day and I sleep well from 11.30 to 4.30 but then it is really painful when I wake up. My pain meds arent due till 6 or 7am so I get up and walk around a bit, ice my knee and doze on and off for a couple more hours. I am taking 4 x 1000mg of paracetamol a day (last dose at 11pm) and 3 x 400mg ibuprofen (last dose 9 to 10pm). First dose in morning is 1000mg paracetamol scheduled for 6 to 7 am.
 
Meant to say that I was prescribed Tramadol for night time but they made me feel really nauseous and dizzy so I had to stop them. What do you use at night??
 
@dogwalker - You have such a long gap overnight between doses of Tylenol. Could you stretch the daytime doses to more like 6 hours apart, so that you can take a dose when you wake up first thing in the morning?
 
Hi Celle. Is Tylenol the same thing as Paracetamol? I did wonder about extending the dose interval in the afternoon. I currently take them at 6-7am, 12.30, 6-7pm and 11pm. Or I could try 5am, 11am, 5pm and 11pm. Would that be better? Also wondering whether to try co-codamol...
 
@dogwalker2 I'm ok during the day but at night it's bad. I take a Tramadol 50mg and one Tylenol PM about 8 or 9. (I sleep really early). I keep 2 regular Tylenols by the bed and it is rare that I don't wake to take then at 3 or 4. The pain is bad at that time. So bad that the Tylenol doesn't help it really but I persevere. In have no idea why it's that bad at night. Inner knee really painful and knee cap.

I'm taking it as it comes trying to be patient. I'm just at six weeks and I have a ways to go, I keep reminding myself.

As regards now vs earlier weeks I'd say it had improved, definitely during the day. No more zingers or stabbing pain but I tend to forget. Hope this helps. Tagging @RAD too as a catch up. We're close in op dates.

Frequently miss a Tylenol for at mid day. I'm busy and don't feel much discomfort. It's the nights that are troublesome.
 
Nighttime pain is usually an indication that you are doing too much during the day. Cut back on your activities and see if your nighttime pain is less. It won't happen overnight. It's going to take a week or so to see a difference, but it does work!
 
Hi! I take Tylenol ES every 6 hours, nothing else. I would say that I wake up once or twice to change positions and/or go to the bathroom room, and that I’m more uncomfortable than in pain. It’s slowly improving, but as @Benay says, we have a ways to go!
 
I am on day 12 postop and restless legs being a realnuisance at night. Will try heat pack on thigh☺

Have you talked to your doctor about restless leg? I can't imagine it's helping your recovery. Did you know that there are medications that can really, really help? I've been on prampexole for about a year now and I get so much more, better sleep.

If you can't get medication for it, the other thing that helped me was a low carb diet, and minimal carbs after 3pm.
 
Hi all. Thanks for your replies. Yes, I think I am doing too much - I find it SO hard to take it easy!!! My knee seems to like gentle activity and complains when I stay laying down for too long. Sorted the restless legs last night by playing a relaxation tape, hopefully it will work as well tonight!!! I get the staples (all 28 of them!!) out tomorrow. Knee pain seems to crystallising into side of kneecap pain (inner side) which is stillvreally painful to touch and a strange stabbing pain right in the kneecap. Bruising going down well and swelling reducing. Just the knee itself swollen now. Cryo cuff ice machine is wonderful!! I am slowly reducing my 2pm dose of ibuprofen with the aim of taking just two doses by end of weekend. Sticking with my 4doses of x1000mg paracetamol a day. wish I could take Tylenol but it makes me shook nauseous.
 
Hi Celle. Is Tylenol the same thing as Paracetamol? I did wonder about extending the dose interval in the afternoon. I currently take them at 6-7am, 12.30, 6-7pm and 11pm. Or I could try 5am, 11am, 5pm and 11pm. Would that be better? Also wondering whether to try co-codamol...
Yes, it's the same thing. They call it Tylenol in the USA.
Work out what schedule suits you best, but whatever it is, don't leave yourself with no pain cover for longer than 6 hours at night. You shouldn't have to wait for pain relief when you wake up.
 
Good idea. Am trying to hold off taking my last paracetamol dose till 11.30 tonight by using ice more. That will take me to 5.30am.. I will take a dose when I wake and then try and adjust the rest of the day round it. I feel i need somethingcekse to take at night, but am at a loss as to what it could be. I see the practice nurse tomorrow so will ask her for any ideas...
 
I am off to get all 28 staples removed tomorrow (eek), and will ask nurse about any nightime pain relief ideas. I want to lose the ibuprofen, but must have something to put in its place...tricky. I feel like I havent really got the pain under control yet, which is frustrating. Also I am not good at being patient. Hubby is now back at work and I get frustrated just sitting there. I start doing just one little thing (pruning the rose Bush in the front garden which has been battered by rain) and then find I have done 2 loads of washing, prepared dinner, Fed the dogs, done 2 sets of pt, done a five minute walk and wonder why I am tired when my daughter gets back at 3pm. Katy knee LIKES activity but I MUST pace myself better. Then i wonder why I lose the pain battle by 7pm every night. Grr ...
 
You are only 2 weeks post op, you are doing waaaaayyyyy too much activity.

Take a look at this:
https://bonesmart.org/forum/threads/activity-progression-for-tkrs.14334/

When you slow down your activity, don’t look at it as doing nothing, look at it as giving your knee the best circumstance in which to heal.

If you don’t slow down you are going to cause a bigger set back, and then you’ll have to heal through that, making your recovery longer in the long run. Take this time to heal.
 

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