TKR Needy Knee's Recovery

[Needy Knee]

My baby knee is now 1 week old. I have a very fussy baby. All it wants to do is swell and keep me up at night. My pain meds are starting to make me feel ill so I have eased up on them a bit. But the ice machine is continuing to run, and run, and run.

 

[L.I.T]

Hang in there and swaddle that little baby with love! ha ha!

Week 1, I thought was the worst. Week 2 still had a lot of surgical and swelling pain, but I slept more, and the swelling gradually decreased. Week three was when I *started* to be just a slight bit more normal - that is, if you can call anything about me normal!!!!

Remember, if your pain meds are making you feel ill, you can always ask your OS for some anti-nausea meds. The one's I have seen mentioned are zofran, phenergan, and scopalomine patches. You may need those pain meds for a time, yet!

Keep on keepin' on!

 

[Needy Knee]

Week 2 still had a lot of surgical and swelling pain

Were you able to do any PT with the swelling?

I look forward to feeling normal again! Thanks for the boost. I needed it!

 

[Needy Knee]

A good easy exercise I was taught by a physio long ago was to sit on a table and very gently swing my leg backwards and forwards,

I will try this and see if I can get anywhere with it. I just can't get this swelling down...

 

[jaschembra]

Good to see you recovering. Yes! Live with that ice!! I agree with LIT on the weeks 1, 2, 3. I just finished week 3 and I'm still sleeping with my ice machine running at night. Jus these last few days I've let up for an hour here and there with ice, but otherwise I'm using pads during the day and the machine at night since it lasts longer. At 4 in the a.m. It gets new frozen water bottles

I don't think you can rush the swelling. Keep it elevated.
I did just minimal PT. I consider my knee to swell easily. Swelling for me will be around for a long time and I'm on a prescription for inflammation

Keep up the good work. You're doing great!

 

[baclectic]

Make sure you eat something (crackers) when you take your pain Meds. They can make you feel sickly.

 

[L.I.T]

@Needy Knee, I basically laid in bed, iced, elevated, and slept unless the home health PT guy came around (which was basically 4 times in the first 2 weeks). I felt like my leg was a sausage. So we would go through the short arc quad, leg lifts, and heel slides - we only did 10 of each, and that was more than enough! After that, they released me for outpatient.

Interestingly, my mom had her rtkr a month before me (in a different state) - she did all of her PT exercises 3 times a day, religiously. I (obviously) did not. We are both pretty much at the same spot now - around 0 to 5 on extension, and around 130 on flexion. Similar genetics, totally different PT philosophy, same results

My PT says weeks 1-4 are the post surgical pain and swelling phases - the goal is to manage both. He also has been doing this for 30 years and said every surgeon has a different PT philosophy... And basically, they all end up with the same results.

So, do what works for you - if the swelling is really horrible, work on icing and elevating. I maybe would do one or two extensions and one or two flexions just to make sure my leg was still capable of moving. The rest of week 1 and 2 were sleeping *when* I could!

It does get better - not quickly, but definitely better.

 

[Needy Knee]

I did just minimal PT. I consider my knee to swell easily. Swelling for me will be around for a long time and I'm on a prescription for inflammation

My doc has me taking meloxicam for inflammation. And I feel I will be with you with this swelling. It started on the 3rd day and hasn't fully let up. I think it is mostly in my knee and thigh now and the calf is looking normal.

Uggh! If I could just go to sleep and wake up when I can feel normal again. lol

 

[Needy Knee]

Make sure you eat something (crackers) when you take your pain Meds. They can make you feel sickly.

Great idea! Going to grab something to keep handy on my next venture to the kitchen.

 

[Celle]

I will try this and see if I can get anywhere with it. I just can't get this swelling down...

Don't worry about doing exercises. It's only just over a week since you had this major surgery. That swelling is going to be with you for weeks yet, and even after a few months it will come back if you do too much.
Your main job right now is to rest, ice, elevate and medicate on time, as well as walk to and from the bathroom. That's all you need to do.
You see, 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.

My surgeon does not allow any PT or exercises for the first month after a knee replacement. He says that your knee needs that time to start on its journey of healing.
His patients all do well and regain good ROM. He hasn't had to do a manipulation to help with ROM for the past 4 years.

 

[Red's Mom]

@Needy Knee it sounds like your doing very well for your first week! Don't overdo anything. Except elevate and ice that is!

 

[Needy Knee]

I had a wonderful day yesterday. My swelling was down some, hardly any pain. I straightened up my kitchen a little bit, felt clear headed enough to work on a few things for my job, even did some mild stretching exercises!

Then night time came and I couldn't get to sleep. I know I was up until after 4 am. I had the ice machine running, and finally gave in and took half of a pain pill. Woke up about 3 hours later, aching all over, took the other half. Needless to say, I have been in bed all day. So much for having a good day when you get a bad day the next!

 

[newlybionic]

Many people find that taking the full dose of pain medications before bed and when they are due over night to be helpful to manage getting some sleep. I did that for a few months while only taking Tylenol during the day.

 

[SuperSnapper]

@Needy Knee I think you may have overdone the activities yesterday. Even though it only felt like a little bit of activity, your knee is very, very new and your tissues are still angry and swollen and will react very quickly to overuse. The fact that you had little pain at the time means perhaps you did a bit more than you should. I think you are expecting a bit much too early in your recovery. And I know it's boring and tedious but rest now will really pay off later on. Read books, knit, watch TV do anything that keeps you resting that knee. And don't forget the ice!!!!!!!!! Best wishes

 

[Needy Knee]

I have learned so much from everyone and want to thank all of you for helping me along with my recovery. I really feel if this swelling would just go down, my knee would bend and my pain would lessen.

 

[Needy Knee]

@SuperSnapper I keep feeling that I need more activity to get this knee to bend. My ROM is only 65 and physio wasn't happy with that. I don't want to force it, or push it any more than it will go, but just figured normal activity may help. I fully agree with you that my tissue is angry and swollen. Why is ROM so important at this stage? Why do the PT's expect so much? My first post surgery appointment is Monday, and my second outpatient PT is Tuesday. I'm just wondering if they will both be in agreement with each other.... I have been reading books like crazy, watched a little TV and play computer games. Your suggestion of knitting was wonderful. I have not knitted anything in many years. Maybe I will pull those old knitting needles out and see if I can remember how. LOL

 

[SuperSnapper]

@Needy Knee I do sympathise with you and the whole process is really frustrating, but your knee won't bend if it is swollen and your PT should know that. So s/he wasn't happy but it's a fact, a swollen knee won't bend and no amount of pushing you will help. In the UK we seem to place less emphasis on aggressive PT- I only saw one 3 times in my whole recovery and she never touched my knee. I told here the first time I saw her that I was not willing to do anything that caused me pain and she was fine with that.That's doesn't mean that I did nothing but I didn't do anything that hurt just caused discomfort.

You could try that approach with your PT and that should be respected. For now all you can do is rest, ice, rest ice, go for short walks , do a few heel slides and then more rest and more ice. You are so very early on in recovery - is it just over a week and a half? and your knee will improve but only in its own timescale. Honestly for the first three or four weeks that was pretty much it for me plus the odd quad stretch. After 2/3 weeks my leg was starting to bend on its own really well and the silly thing is that I found my knee doing its own exercises when I was in bed or one the almost like I had no control over what it did!

In the meantime give the knitting a go and try to forget normal activity - there is no normal at the moment just a knee that needs babying.

Best wishes from the other side of the pond.

 

[newlybionic]

@SuperSnapper

Needy you just need more time to let that swelling go down and doing exercises that hurt only cause more swelling. It's the body's way of telling you to stop doing them by swelling more to make it impossible to do. Lots of ice and elevation is definitely the way to go.

 

[Needy Knee]

My 2 week old knee actually got to a 98 ROM yesterday! I was so excited.

Went to the doc Monday. They took exrays. Everything looks good. He measured my ROM at 90. He was happy and I was elated. He told me that when I do my bending exercises to just give it a little more push and the ROM will come. Not so much as to cause pain, but a nice stretch.

Tuesday was physical therapy. She gave me lots of gentle stretching exercises and worked with me on going up and down stairs. She hooked a TENS unit up to my knee, one pad on the side and one above the kneecap. When I felt the TENS tingle, I was supposed to do a leg lift and hold it until the tingling went away. Then lower and wait for the tingle again. If I couldn't do the leg lift, I was just supposed to tighten my quad muscle during the tingle.

I felt good when I left physical therapy. I listened to all of you and I took a week off doing pretty much nothing. Icing and elevating, not much exercise at all. My swelling went down some, but the most important thing to me was that my ROM increased! I had good days, and bad days, but stayed down and iced for the most part.

Thanks everyone for helping me get through this tough time in my recovery! I know it's not over yet, but since I reached my personal goal of 90 I FEEL GREAT!

 

[Spex10]

That's fantastic! Its a wonderful feeling isn't it. I liked your post when you said you'd managed to get a few things done. That's quite a turning point even though there was a price to pay in swelling. Good luck!