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[TKR] My Knee Odyssey<

Discussion in 'Knee Replacement Recovery Area' started by Murry, Jan 29, 2018.

  1. Murry

    Murry junior member
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    I’m seven weeks out and while I’m progressing through rehab , I still cannot sit in a normal chair for more than 15 minutes without increasing, crampy pain around my knee. My PT and doc seemed stumped. I also continue to have abnormally high pain. Any suggestions?
     
  2. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Welcome to Bonesmart!

    Do you mean sitting in a chair with your feet on the floor? That took a long time for me, and at 10 months, I still have problems with certain chairs, and in any chair, I like to stretch my leg out as my knee is not crazy about sitting in a 90 degree angle.
     
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  3. Pumpkln

    Pumpkln FORUM ADVISOR Forum Advisor

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    Murry,
    Welcome to BoneSmart, glad you found us!
    You are still very early in this yearlong+ recovery, your knee is still healing. The pain you are feeling is from inflammation and swelling, even if you cannot see it, the swelling is inside your knee.
    Suggest you elevate your knee when ever you can. You are going to need patience to get through this phase of healing.
    We all think we are further along than we actually are: Where are you in recovery?? (TKR)

    I suspect you are doing too much, suggest you slow down and let your knee heal. I am going to tag our forum Director and Nurse @jsoephine to address your concerns.

    Please post your surgery date, a moderator will add it to your signature for you. Thanks!

    Here are the recovery guidelines, the articles are short and will not take long to read.

    Knee Recovery: The Guidelines

    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
    5. At week 4 and after you should follow this

    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.
     
  4. Jajakio

    Jajakio senior

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    Add that to the list of things I wish someone had told me before surgery. I knew it would take a while before I was able to be on my feet all day, but I assumed sitting would be okay fairly soon. I was so wrong.

    I was looking over my recovery journal and at seven weeks it was easier for me to walk for 20 minutes than sit for 20 minutes. It eventually came out fine , but in the beginning it was a real struggle for me to sit feet on the floor for long. Elevate and ice as much as you can. At least prop your leg up on the couch or rig pillows or a sling under your desk if you can. For what its worth, this seems to be normal and you will be able to gradually sit longer at a time. Im nearly 7 months out and can work a full day on my desk days. You will get there too.
     
  5. Murry

    Murry junior member
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    Someone asked me to post my surgery date, so here it is: 12-12-17. Today is my 7-week “anniversary.”

    I go back to my surgeon tomorrow for my second post-op visit. I plan to discuss with him the cramping pain I experience while sitting, but I’m not optimistic he’ll have a solution. He has an excellent reputation for his surgical skills, but like many surgeons, he doesn’t seem to like to deal with post-surgery problems.

    I’m working hard at PT - I go 3x/week, do my exercises at home on off days. Have 110 degrees ROM. My PT is one of my best friends, so I can be honest with her, but she is under a lot of pressure from the docs to get her knee patients to reach certain goals.

    I saw a different PT in the hospital, and he was, honestly, incompetent. Pushed me extremely hard and set me up, I think, for ingoing issues with inflammation. My other frustration is that my surgeon wants me off pain meds (for understandable reasons with all the media attention on opioid addiction) but I am still in a lot of pain and am sure I couldn’t do my PT without the medication. I’m wondering how long most TKR patients remain on prescription pain meds?
     
  6. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    And there it is in a nutshell!

    Our individual knee does not care, nor does it recognize, other people’s goals for it. Our knee is on its own schedule and our body has its own healing schedule and there’s nothing we can do to make it heal faster.

    Treat it gently and keep the knee happy. If you push the knee, the knee will push back, and the knee will always win.

    Why should we put up with extra pain caused by someone else’s goal when it is not necessary. Our knee will heal, the swelling will go down and THEN we will be able to bend and straighten it. Yes we have pain/discomfort along the way, we’ve had major trauma done to our knee so it can be fixed. But to have extra pain from PT is unnecessary. Contrary to what most of us have been led to believe.
     
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  7. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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  8. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    @Murry Can you give me some additional information please?
    Country
    State
    Gender
    Surgery date


    I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
     
  9. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    There's still plenty of time for you to continue to improve. Recovery from a knee replacement takes as long as a full year, sometimes even longer. It's a marathon, not a sprint, so you're in for the long haul.

    There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
    Myth busting: the "window of opportunity" in TKR
    We even have one member who found out by chance that her ROM had improved at 3 years post-op.

    From now on, though, it's a matter of letting your knee make progress on its own. You can't speed that up by working at it. In fact, working too hard could actually slow down its progress. Just keep using your knee in your normal daily activities. Even PT isn't really necessary any longer.
    It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.

    Here are a few articles that may help you:
    TKR: work “smarter” and not “harder”
    Knee recovery - Lose the Work Ethic!!
    TKRs and our fast food society
    Life in the slow lane
     
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  10. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    O-er!

    I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
     
  11. Murry

    Murry junior member
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    Yes, I’d be glad to answer any questions. Here are answers to those you listed above:
    country: USA
    state: South Carolina
    gender: female
    surgery date: Dec 12,2017
     
  12. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    Oh I forgot - and your date of birth too!
     
  13. Murry

    Murry junior member
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    Birthdate: 5-14-57
     
  14. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    Thank you
     
  15. Murry

    Murry junior member
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    Will be glad to provide more information, as requested. Please just let me know what you'd like to know about me or my surgery.

    Here's an update on my recovery: I saw my OS this week, 7 weeks out from surgery and basically, he said the knee itself looked stable and "good" and although I'm definitely recovering more slowly than most of his other patients (I'm rolling my eyes), he's confident that it's just a matter of time.

    Unfortunately, he didn't seem to take my comments about my high pain levels very seriously and although he agreed to renew an Rx for pain meds, when I got the medication from the pharmacy I realized it was a lower dose even though my pain levels remain consistently high.

    I know American surgeons are under tremendous pressure to wean patients off of pain meds asap, but I have no history of drug abuse (through 22 surgeries!) and it drives me crazy that they treat all patients the same, regardless of our symptoms and history. I am just praying that this lower dose doesn't make it impossible for me to increase my activity levels.

    The other momentous thing about this week is that with the doctor's emphasis on time, time, time as the great healer of my knee, and what I've read on this forum, and in talking to my PT friend, I have decided to stop formal PT to see if that helps the pain and inflammation issues I'm battling.

    Sitting in a normal chair continues to be the most difficult and frustrating challenge for me, as it keeps me from resuming anything close to normal life for me. I really miss going to church, out to eat, and to other gatherings that are held in places where I can't lean back and prop up my knee (the only position that seems tolerable for any length of time). I continue to time how long I can stand to sit in a normal position and after 20 minutes, my knee begins to cramp, burn and ache.

    So, that's the update from here. At least the sun is shining, I have a comfy house to be cooped up in, and many, many blessings to thank God for!
     
  16. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    I made it to church on the fourth Sunday after my surgery. I took an ice pack and a large pillow, then sat in the back of the church on a pew where I could elevate and ice. Our church is about 25 minutes away, so that added to my day. But, I made it! I got back home and slept 2 hours, while elevated and icing. It was worth it, getting back to church!

    You can probably make it back if you do the same. Icing and elevating are the key! Your fellow church members will be glad to see you and won't think a thing about how you are taking care of your knee there!
     
  17. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    Yayyy!! :yay: :yay:
     
  18. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    You need to stop PT for at least 2 or 3 weeks before you'll see a big improvement. Spend that time resting and icing as much as possible and I'm sure you'll see good results.
     
  19. Murry

    Murry junior member
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    Question related to posting on Bonesmart: When I wrote my first post and titled it “Pain While Sitting,” I didn’t know that all my future posts would need to be written on that same thread. Is there any way for me to retitle my thread to something more general, like “My Knee Odyssey” or something?
     
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  20. GingerP

    GingerP senior

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    @Murry , I am on my second knee recovery and I must say it is much different from the first. I know I had a lot of different pains with #1 than I have had with this second one.
    I thought I could deal with pain, but with #1, it wasn't easy backing off potent pain pills. Now on #2, I'm at nearly 3 weeks and only on Tylenol. Oh my!
    First one I did pt 3x a week, this one I'm doing pt 2 x a week and I must say I'm not very vigilant about doing daily exercises on non pt days and I'm progressing with my bend and straight leg as well as I did or better with #1.
    Patience is hard. I do steps, then I ice and elevate. Do kitchen chores, then ice and elevate. Those exercises called active daily living DO count as exercise! I have more of an achy type pain with this knee which may be bone pain, I'm not certain. I do massage my thigh and calf a lot every day and it feels so good.
    Be good to yourself. I know that sitting on low chairs before were my worst nightmare. People got used to me bringing a chair cushion when I went anywhere. Just a little boost to get up and it helped soften the sitting too!
    I'm only about 3 weeks (not quite) , but learning to take it one day at a time and embrace the good things that I can do today I couldn't yesterday. Now if I can get my bed sleep worked out, that's my next challenge.
    You are coming along well. Keep asking questions and good luck to you in your pain control. I'm not certain if you have an opportunity to add Tylenol to your pain management, but it is working well for me.
    Blessings to you in your healing.
     

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