TKR New left knee

[Jockette]

I’m sorry you’re struggling so much right now with pain and the emotional stress of a family member’s death. I find even as far along as I am stressful situations can make my knee feel worse.

 

[Suzette]

Hi
Sistersinhim..unfortunately the only way to get one of the ice pumps you mention is to buy one and they are very expensive :(
I did wake up with no pain, until I stood up to go to the loo....with in 5 mins it was back again.

So today I am going to be doing nothing at all other than rest, ice and elevate. Also medicate on time which has always been the way due to my back.

KarriB..I actually managed 8 hours sleep. Well it was broken up into 2 hour segments but added up to about 8 hours. I took my meds at the correct time too. After I had my THR my sleep pattern was terrible then , unfortunately it was still terrible by the time I had my TKR! So potentially I may have to put up with what I have had for over 2.5 yrs . I am hoping this does change though

Thanks Jockette, and Thanks everyone for all your advice.

 

[SusieShoes]

It took a few months for my knees to become reliably (meaning most days, though not yet all days) pain-free on waking. At your early point in recovery, movement still arouses pain, and not just the swelling. You have the best battle plan in place, which is to rest, elevate, and ice. The more time spent doing that, the more quickly your body can rid itself of the swelling and so decrease your pain.

Sorry to hear you’ve had such a long spell of sleep disruption. Ack! I’m crossing my fingers your TKR helps you get back to better sleeping eventually. Nothing does as much good for the soul and body as a good night’s sleep!

 

[Suzette]

Thanks susieshoes. Did you ever experience pain going away when weight is was put on the knee but comes on again once relaxing and elevating?

Also along my incision line I have little purple blood blister type bumps. They are very painful and swollen. The physio lady said she thinks they may be external stitches underneath the skin trying to break through and to discuss with surgeon, but I am not seeing him for another 3 weeks . Not sure if the photo I have inserted will work. Any idea what these are and whether I visit to the Dr is required.

Thank you very much.

 

[SusieShoes]

I often find (still) that when my knee hurts, say in bed because of a position I'm in, that pain will go away entirely when I stand and walk. Even in earlier recovery that was true. Standing and walking became the least painful, and bending or changing leg position while resting (on my ottoman, for example) produced the most pain. Just resting, not moving, was not painful after about six weeks. You're still in early recovery, so some pain from swelling is not unusual.

The bumps in your photo look a lot like stitches working out. I had one of those and it looked a lot like yours. Don't be afraid to call your OS and send the photo, especially if the bumps become inflamed. I called mine! He said to swab with hydrogen peroxide, which I did, and the stitch eventually came out in the shower (I was by then running a soft, wet washcloth over my incisions every day). Many members have reported these and you may get other suggestions for things to do. The main thing is they're nothing to worry about --but if you are concerned don't feel at all bad about calling your OS. Having peace of mind matters.

You have a fine-looking incision, by the way!

 

[Suzette]

Oh thank you SusieShoes. Your reply is really reassuring both about the pain when resting versus standing and also those little bumps.

I am going to monitor these over the weekend and if they seem to be getting more inflamed and painful I will give the GP a call. I will give them careful wipes in the shower too and get some hydrogen peroxide the weekend.

Thank you, I am quite surprised with my incision looking so neat too, I was expecting a wider redder one to be honest. So I am quite chuffed

Thanks again x

 

[Jockette]

My friend knows my surgeon and knows that I quilt, and she said his stitches on my knee looked like quilting!

 

[Suzette]

Maybe he is a secret quilter!

 

[sistersinhim]

I agree! That's a mighty handsome scar you have for so early in your recovery!

 

[Suzette]

Oh thank you Sistersinhim, I feel lucky it is so neat x

 

[Suzette]

I am now at week 5. I haven't posted for a few days now. I am on a downer. .

I have such a hot throb in my knee most of the time, sometimes reaching an 8, no position gives me relief, sitting and lying down actually makes it worse, standing eases the throb. Most weird! !

I haven't followed any PT since I went to physio last Tuesday, but being under the NHS physio dept, I went to my 2nd physio session today. I feel obliged to go because it's NHS...

I did tell the lady that I have had a lot of pain since last week, up to an 8 and requiring morphine. She said that is normal and I am to work through the pain. I didn't tell her I actually hadn't!!

There were 2 other physio patients in there with me. One lady 16 wks in, had just had an MUA and also started to tell me no pain no gain and that I would end up like her if I didn't push my knee. I did feel slightly intimidated. The other lady reiterated her opinion!

I felt doomed from then on. I had 10 mins on exercise bike where I could peddle backwards and forwards, at a push and not in total pain more if a quick burn feeling on each turn. After that 10 mins rolling myself back and forth on one of those big exercise balls, pushing the knee to bend. No idea what these balls are called !! Then 15 minutes on a weight machine where you sit and push the legs out straight and back to bent and out again. No idea what that's called either. You may notice I don't go to a gym normally ! I did cheat on this as I had to use my good leg to push as my left knee by this time was not feeling good.

My flexion is now 115. But it was actually 115 before I got to physio, so exercises did not get it to this as I hadn't done anything other than walk about the house.

My knee is now on fire and the throb is awful. I am elevating , icing and medicating. I don't want to go to physio but somehow feel I will let the NHS down if I don't go. There's also that thought/fear that if anything goes wrong in the future they will say 'well you didn't go to physio, so what do you expect. ..'

I did tell the physio lady that I didn't want to do any more repetitions on the bike and the weights and she and the 2 other patients said of that I must continue to push through it...mmmm.

I feel I need permission off my GP not to go anymore. So will book an appointment. I need to discuss pain meds anyway so will bring it up at the same time.

Last night I discovered something I could do, I can walk down stairs leg over leg. I did this by accident on the last few steps. No pain . That's how I realised my flexion had changed and so measured it.

So what I have noticed this last week, I have had an awful lot of pain, I have not exercised other than walk round the house, my skin on the right/inner side if the incision has been itching a lot, and even though all this pain and itching I have increased flexion without doing anything! !

Does the pain and itching represent the knee healing and repairing itself? Tonight the numb side of my knee is itching, so am I getting feeling back in that now?

I am also tearful, moody, I keep shouting, I am irritated and I feel I have no patience with anyone even with Arnie the frenchie bulldog , I don't sleep too well, I can't get motivated, I have no appetite and have put weight on, which isn't fair !

I have even become a grandmother for the first time 2 days a go, to a beautiful little girl and I don't even want to leave the house to go and visit. I have been to see her in hospital though, she has a chest infection , poor little thing.

I want to be normal again and leave the house but can't be bothered. I am concerned now I have depression setting in.

This is a learning curve that sure is a difficult one and I feel I have just dumped a weeks worth of emotions in one go.

Thanks for listening xx

 

[KarriB]

Congratulations on the new grand Baby! How exciting! More good news...you have excellent ROM at just a few days past a month post op! I was released from PT with a ROM of 109! Why don’t you take a few weeks off from PT and see how your pain is. I’m not surprised you have some pain at 5 weeks post op, but with a ROM of 113-115 there’s no need to push at all and I’d put money it’s all that exercise causing you pain. Your ROM will continue to improve with just living your life. Mine improved a year post op and beyond.

I’m sorry to hear you’re feeling a bit depressed. Unfortunately, many TKRs get a touch of the blues in the months after surgery. This recovery can be long, but it is important to rest your body and knee to enable the healing process. Going out for lunch once a week or visiting friends helped me feel normal and I was still able to prop my leg up at the same time.

 

[Jockette]

There's also that thought/fear that if anything goes wrong in the future they will say 'well you didn't go to physio, so what do you expect. ..'

I have always felt this way also. I still do, even though I know better. It’s so hard to chose to oppose my surgeon. But I am following Bonesmart and know it’s the better way to recover. I don’t even tell most of my friends because they believe exercise and PT are the only way to recover.

 

[SusieShoes]

Would it help if you told your doctor, "I'm doing really well. Look at my great flexion already. I just know I could improve on it and strengthening my knee at home on my own." That's pretty much the spiel I gave my OS at my six week check-up and he said, "Sure." No more PT ordered. I'd only been doing it because he wanted me to. Most surgeons are interested in results, like your ability to function. Your flexion of 115 is great this early on. I also had 115 flexion when my OS released me. I never did another stitch of PT type exercise and my ROM has continued to improve. You won't lose what you have, so why not rest and see if that doesn't help your pain?

This recovery takes so long it's natural to get teary and worn down. Getting out of the house would probably be good for your spirit. Can you do so and have icing/elevating where you visit? At five weeks I started taking trips to family (big Italian family means mandatory Saturdays together) for which I brought along my ice packs. They let me use pillows and their recliner. All went well and the visits were a great break from my routine.

Congratulations on the new grandbaby!

 

[Jockette]

I agree, a careful visit to see that new baby will do wonders, if she’s close by. Just holding her will perk you up a bit.

I got a bit depressed months after my surgery, I think it’s inevitable. The long slow painful, then uncomfortable recovery takes quite a toll on us.

 

[Celle]

I did tell the physio lady that I didn't want to do any more repetitions on the bike and the weights and she and the 2 other patients said of that I must continue to push through it...mmmm.

I feel I need permission off my GP not to go anymore. So will book an appointment. I need to discuss pain meds anyway so will bring it up at the same time.

Do remember that it's your body and your knee and you are the only one who has the right to say what will happen to it. There's no reason why you have to put yourself through pain, just because you're with the NHS.
You can control what you do at PT, so don't do anything that hurts, at the time or later.
Saying no to therapy - am I allowed to?
CONSENT: what it means and how it can be used

You don't have to push through the pain - it's counter-productive:
Myth busting: no pain, no gain

Remember this:

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.​

Does the pain and itching represent the knee healing and repairing itself? Tonight the numb side of my knee is itching, so am I getting feeling back in that now?

The itching can represent healing, but you should try to keep pain to a minimum.

That numb feeling may linger for quite a long time.
Numb area after TKR: how long will it last?

I am also tearful, moody, I keep shouting, I am irritated and I feel I have no patience with anyone even with Arnie the frenchie bulldog , I don't sleep too well, I can't get motivated, I have no appetite and have put weight on, which isn't fair !

This recovery does play havoc with your emotions and they may be unstable for a while. As well as getting tearful, I also used to get angry and shout at my poor husband. We've both survived it!
Post op blues is a reality - be prepared for it

 

[Suzette]

Oh thank you everyone for your replies. I feel more normal now knowing that others have been through all the ups and downs and come through the other side.

Sometimes everything's seems to be just too much and becomes controlled by the knee.

I am not doing any more physio therapy and I will see my Dr this week too, about pain relief and the physio issues. I will get out the house tomorrow and go and see my grand child and give her a big cuddle.

I hope I will shake off the down feeling and start to feel more positive about my progress.

Thank you all again xx

 

[kneeper]

I think you're doing great if you're doing full revolutions on the exercise bike and can go up and down stairs. I would not be surprised if using the weight machine is what made your knee angry.

I know they think it's good for bend and strengthening, and one of my PTs had me use it, but I think it is too early to use it in the first 3 months. Once your knee is more healed you can work on strengthening.

For what it's worth, I was only using the bike for about 10 minutes at a time at your point in recovery.

 

[sistersinhim]

I don't want to go to physio but somehow feel I will let the NHS down if I don't go.

What about letting your knee and yourself down by doing the pt that causes pain. You are doing great and don't need to go to pt anymore. Your knee knows how to rehab itself. Just use it normally in your day to day life!

 

[Arttie]

Progress is small and incremental at times. Tying your own shoe, driving the truck, the full revolution on the bike, just this week I did not have to move the drivers seat all the way back to get my foot in the door in fact I did not have to move it at all. You'll start seeing more moments like this. There is a new normal for us each day going forward.