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TKR My TKR 12/16/19: Easier Than I Thought - THEN AGAIN!

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Greetings All (I hope I am posting this in the correct area):

I had a right knee TKR 12/16. Zimmer implant by way of surgeon and robotics. Surgical area closed with glue (no stitching). I have no distinct sports background or severe injury outside of recreational cycling and some gym work. Both knees started showing osteo deterioration about 2009 or so. Pretty manageable up thru the last 24 months/ no shots. I became aware of the TKR option about 2016 and started to head that way directly 2017 by way of talking to friends with similar issues, information online, and talking to my gen. orthopedic doctor. The last 12-16 months cast increasing pain, decline in ability to work out at the gym. With extended walking/ standing getting harder.

2018-19, the Osteoarthritis progressed to the point of planning work/ activities/ events/ shopping around how much walking/ standing would be required/ would there be a shopping cart available to lean on/ close parking spot etc. Including using a cane for some events/ travel. And finally pain at night! The planning was long as along with minor issues to resolve such as dental work as advised by my surgeon. The trillion prep items went forth as an endless checklist! Ah, the obvious things you think of (get a walker); the things forgotten (as basket for the walker!). And what of that favorite lip balm?

Anyway, the surgery itself was easier than I thought in some ways, yet far harder than in other ways. It's still too early to kick up my heals, but I'm thankful that (only 2.5 weeks) I do not have constant pain. Mainly episodic pain depending on what I am doing (or trying to do) or how I am positioning or bending the knee. The basic prescribed meds are all I take (though I did have the nerve block catheter the first few days). My main challenge is being able to sleep at night ala bed positioning as the biggest problem - and getting the TKR leg fully flattened. I'm anticipating some not great times now that my full on on-sight PT is starting -- beyond lighter home PT sessions I've had.

So, sometimes I think the worse is over, other times I think and know it's ahead as well somewhat.

You have to be committed to the PT. I liked gym work, so that will be plus. From my short time here I appreciate the perspective that you can get thru some TKR things fast, even returning to work. But, it can take full year to fully heal. I believe that, even at my stage. So much came together for me fast such as good flexion. Yet, a TKR is a huge undertaking with so many things going on at the physical level as the knee (never the same as the one you're born with) implant becomes part of you; with you learning new paths of movement.

It's funny you cannot 'baby' the replaced knee, yet you have to listen to how it is responding to what you do. PT is good but it can be a numbers game that can be discouraging I hear.

I am hoping for better sleep over the next few days as my body adapts and heals. I look forward to sharing more and learning more. Thank you for providing such a community of care and concern.
 
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Jaycey

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@LD of Michigan So good to see you started your own thread. Sounds like you are doing really well for so early out! And your approach is spot on - listen to that knee. It will quickly tell you when you have gone too far.

Sorry you are having sleep problems. All a part of this recovery I am afraid (see article below). Nap if you can during the day. This will all ease with time.

I'll leave your recovery articles here for you.
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
ice
take your pain meds by prescription schedule (not when pain starts!)​

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 Activity progression for TKRs

6. Access these pages on the website

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.
 

sistersinhim

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It's funny you cannot 'baby' the replaced knee, yet you have to listen to how it is responding to what you do.
Yes, you can baby your knee and actually need to. Listening to its complaints and not repeating the things that caused the complaint leads to a less painful recovery. You don't even need PT. Just use your knee the way it was created to be used. But, you have to start this slowly. Aggressive PT actually slows down recovery by increasing inflammation, swelling and pain. Swelling is what hinders ROM. As your knee becomes less swollen and inflamed, your ROM naturally improves. You can not exercise to improve ROM, only time and less swelling improves it.
 
OP
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Yes, I think what I meant is to not be afraid to try to use the new knee. In a way I was terrified to even stand up, initially. Hah. I am already learning of the 'numbers' game some PT's play per the things they must record to justify what they are doing in some cases.

So yes I'll be listening to my knee carefully and pushing back on the one-sizes-fits all force/ approach if it comes up in my rehab as applicable.

Indeed time and true healing seems sensible. Thanks.
 
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OP
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I edited my main story. Between the slight medicine-head (smile) and my poor typing skills there were many typos! Thanks.
 

Helizabug

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Like you, I like working out at the gym, so I’ve built a whole workout that includes my PT exercises, but also works on upper body strength, with mini bands, core strength, and mobility in my other joints. It’s a different kind of workout, not so much sweat, but still structured and self-affirming.

You don’t need to work your knee too hard to accomplish recovery. Let it rest and heal before you fret too much about getting your knee flat or flexed. We’re all different, but that approach has worked for a lot of folks on BoneSmart.
 
OP
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20 days or so in, so I know it's early, but in a way I'm surprised how normal the implant feels in regards to weight bearing the small gaps I have between the walker and the cane.

I DO feel/ detect some clunking at the front of knee when changing position of leg standing, lifting the leg, sitting or moving leg in bed. But less as times goes on. Perhaps the muscles and tendons are starting to pull things into place around/ about the implant?

Over time, say months out, do you start to forget the replacement itself is there?
 
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Jaycey

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@LD of Michigan 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. If you would like a new thread title just give a shout.

In answer to your question, yes soft tissues, muscles and tendons do firm up around the implant. This does take a bit of time. Some people do forget about their implant. Sounds like you might be one of them in the future!
 

Jaycey

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Yes the clunking is normal. This will soon fade. It just takes a bit of time.
 
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Some friends and family say I should avoid going outside beyond my PT appointments I'm driven to due to the risks of infections. Not planning to go dancing or a track meet, but would like to go to (be driven) to the drug and grocery store this evening.

20 days out from surgery, is this safe re. germs upon my wound (which is closed and dry)?
 

Jaycey

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20 days out from surgery, is this safe re. germs upon my wound (which is closed and dry)?
Absolutely fine to get out if you feel up to it. Just remember that you body is in healing mode. All the energy is going to that area. Just short trips may result in major fatigue. It's best to do half as much as you think you can do and then try again another day.
 
OP
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Yep. That 'half as much' sounds like a good formula for a while. I seem to teeter totter on my energy level. Which has all just gone. Staying in today! LOL!! Thanks :good-bad:
 
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Jockette

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You are going to hear all kinds of advice throughout this recovery. What makes your PT facility any more germ free than a store? There are still people in it.

Mostly you should limit visits to stores because they wear you out, this early in recovery, but sometimes a short trip out for “normal life” is uplifting for us.

Keep outings short and maintain the caution you would any other time you wouldn’t want to get sick.
 
OP
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"What makes your PT facility any more germ free than a store?" Great point!

Thank you for your comments. I'll let my body tell me. Now it's saying go LAY DOWN and sleep. Go out another day. Hah!
 

kneeper

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20 days or so in, so I know it's early, but in a way I'm surprised how normal the implant feels in regards to weight bearing the small gaps I have between the walker and the cane.

I DO feel/ detect some clunking at the front of knee when changing position of leg standing, lifting the leg, sitting or moving leg in bed. But less as times goes on. Perhaps the muscles and tendons are starting to pull things into place around/ about the implant?
Yes, that's very normal and as you've noticed, will diminish as you heal.

Over time, say months out, do you start to forget the replacement itself is there?
It does happen. I'm not sure when it happened but over time I thought about the knee(s) less and less. My OS said it would take a year for me to feel "normal" and I'd say that was about right. But the knee felt like "me" much sooner than that.
 
OP
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Well here's an update day 24! Sleep is improving - FINALLY!

I've reduced my meds greatly. Swelling minimal from day 12 or so. I am walking a few steps in PT w/o a cane, loving the giant ball extension/ flexion exercise sets. Not so happy with the extension work of which I'm now sluggishly 10% but attempting to ignore the numbers game I try not to worry. Flexion was always great from day five or so 90%.

My PT listens to my feedback and concerns re. the techniques used and my progress. I feel we are on the same page.

I still use a walker about the house, a few steps here with/ without cane. Cane for certain down and up stairs. A TKR is a BIG surgery - you can feel all your bodies resources alerted towards healing. I think that speaks to the tiredness many feel initially or ongoing. But as I said before, in a way it was much easier than I thought it would be.

Having said that, it believe recovery from a TKR is a PACED process to heal evenly, and effectively.

I now know from loosing weight from reduced appetite right after surgery that I LIKE being lighter! So the TKR increased my will to exercise and watch my food intake-weight to preserve the implant and feel more fit. A happy bi-product of the TKR aside from the problematic knee.

I was in the hospital two full days. Not sure I agree with the TKR as an 'outpatient' procedure. I think an over night stay is best, which I opted for in no uncertain terms. Blood clots are dangerous - I'd want that extra hospital time to make sure that my vitals were consistently stable.

Loving the stretch exercises I am doing on my own towards flexion and extension. Looking forward to meeting with doctor for follow up. And to be able to resume driving soon!
 
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sistersinhim

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What a joy it was to read your uplifting post! You are rocking this recovery! It sounds like common sense and a good PT has enabled you to recover with less pain. Oh, and congratulations on your weight-loss. I'm jealous!
 

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