Guest viewing is limited

TKR Nov 18th TKR & Peroneal Nerve Decompression..recovery road

Status
Not open for further replies.
:thumb: Yep!!! You're right!
 
Arghhh! Just when I thought I had found the magic routine...another night of little sleep. I'm petrified that my pain may be elevated due to RSD -a diagnosis of exclusion that a couple docs had tossed around. I guess I just don't know how much pain is normal.

So as a "preventative measure" I started taking 2000mg of Vitamin C and I also started taking 20 mg Cymbalta (an anti-depressant also used to curb neuropathic pain). And I'm making sure I keep my leg moving. I am hesitant to use ice since ice tends to aggravate RSD but I do elevate every so often. So I'm still very swollen and I am wondering if I should add Aleve/NSAID to my meds routine; I already take Celebrex. I guess I should really watch my sodium intake!

One week out today, 7 day post-op, and I don't have nearly as much stamina as other knee buddies it would seem. My pain is still agonizing. There are a few hours in the day when the pain is tolerable then my body takes advantage of that time by sleeping.
 
Last edited by a moderator:
I'm glad you found us. I'm sorry your pain control hasn't been good. With your other issues, it sounds like you are having a particularly challenging time.
Definitely elevate a lot even if you can't ice. And take every opportunity to :sleep: when your body lets you---sleep is tough for most of us in the first weeks (especially at night).
 
Thank you Kneeper (love that name)! I'm not sure if I'm having it any worse than anyone else!! That's my problem. I have no idea how to gauge my pain levels. I discontinued the Cymbalta as it provided relief for just one day and that was all. But I'll continue with the vitamin c.

My pain appears to coincide with how swollen I am. Yesterday was fairly okay until I ate the dinner my 6,8 and 9 year old made!! I knew it was salty but couldn't say no since they try so hard to take care of me. My knee immediately swelled up! I also managed to stay up and about for 4 hours...didn't use my walker nor crutches. And I have ROM of 90, can do leg lifts and heel slides. But I'm still laying down for most of the day..I'm just so tired!!

Of course I now have something new to worry about...whether my new knee Stryker Marathon has nickel in it? I completely forgot to mention that I have a mild nickel allergy. Didn't even think of it!!
 
A 'mild' nickel allergy won't be a worry for you, have no fear.

You've also mentioned doing leg lifts and heel slides. How many of those are you doing per day? And are you doing any other exercises?
 
Thanks for the reassurance Josephine! I do quad sets (pressing into mattress) at least 3x5 most every hour. I do 2-3 clamshells twice a day; 10 straight leg lifts twice a day (and a few here and there throughout the day);about 40 heel slides total in a day as well as point toes and flex. But nothing when I'm really swollen..just elevation. Nor do I have a set regimen as my doc did not want me doing PT outside my home for 3 weeks. He doesn't want me to overdo it...and I really don't know what that means but I hear it often!
 
quad sets (pressing into mattress) at least 3x5 most every hour
I do 2-3 clamshells twice a day
10 straight leg lifts twice a day (and a few here and there throughout the day)
about 40 heel slides total in a day as well as point toes and flex.
Well, in my professional opinion, that's doing too much!

- quad sets do 3 twice a day at most
- clamshells are very hard on your knee and considering your history, you shouldn't be doing them at all. They're not necessary/beneficial for knee surgery, anyway.
- do 2 leg lifts once a day at most, first thing in the morning is best
- heel slides: do about 5 every couple of hours during the day but NEVER go past the point of mild discomfort Heel slides and how to do them
- no pointing or flexing toes, it benefits nothing in a knee surgery

You should also read this, it's scary but necessary to understand what overdoing exercise can do
PT: the seriously grave consequences of doing too much of it
 
BTW, my dear, you don't have to quote a person's post to reply to them. Just scoot on down to the message box and start typing! If you want to nominate a specific person your post is addressed to, just mention their name at the start. Or you can call them to your post by tagging them - this just means putting the @ sign in front of their name but you have to be careful to spell it properly or it won't work. If it's worked, you will see that the name goes blue when posted, like this @Katfin

Incidentally, that's a very curious name - how/why did you choose that?
 
When you say you were up for 4 hours do you mean up out of bed or up with your leg down? I know early on one of the worst things for me was to have my leg down in a regular chair. Oh the pain and swelling with my first knee when I sat in a chair trying to be "sociable." This time I was sociable with my leg up. :)
 
@Josephine and @kneeper Thanks for feedback! I did start trying to do less (very frustrating) and it may have helped my swelling tremendously. Or maybe it was the icing, elevating and resting per Bonesmart's advice/articles.

This has been the most frustratingThanksgiving and Holiday season ever!! Last year I could muster up the energy and drive necessary to ignite the holiday cheer; even gleefully bought Santa's gifts as well as planned my December babies birthday parties (2 born a couple days before Christmas); and also decorated our home though I was still in recovery and pain from ACL/chondroplasty/microfracture done in August. And I did so joyfully as I was positive my life with knees could only get better.

This year I'm just waiting for the holidays to be over so that I won't be reminded daily of all the holiday fun stuff I could enjoy if it weren't for my knee!! Trying super hard not to hate this knee but it's hard -no pun intended. Now I spend my days agonizing over my various choices so as to try and improve the outcome of my knee. Yet I don't/can't have a date in mind to shoot for because my knee is in charge! So frustrating. And of course, now I know that there's a chance my surgery though "successful' could still it get rid of pain completely. Bah Hambug!!

Day 6 post-op I vomited 1x but also lost my voice.
Day 7 post-op I vomited a couple of times. Voice got worse.
Day 9/10 post-op had me vomiting pretty non-stop all day. Finally at midnight I called the surgeon on call. So I started promethazine and proceeded to sleep for 14 hours straight.

My pain has continued to subside (or I am just doing less). But I'm still walking around with my walker a few minutes every hour. Sometimes I use crutches and sometimes just a can. Amazingly my ROM has gotten better since I stopped my exercises. So there's something to. Fe said about doing nothing...it works!

I also think my 2000mg Vitamin C supplements help. And research does show it speeds up surgical recovery. So my fears of RSD are shrinking and my optimism is returning. And I'm getting a bit excited at the thought of a full recovery -a life without incapacitating pain would be so nice. Still as for the most part I'm resigned to the couch and am no longer able to dictate orders. Might as well call me Napolean.

@Josephine my name was first uttered by a neighborhood friend as a taunt since my names are not common. Unfortunately for him I loved the new "nickname" as it immediately conjured an image in my brain that I liked.

@kneeper yes!! My legs down (from sitting upright) for more than 15 minutes is very uncomfortable. Makes me wonder about driving. Or going to the movies. Or flying.

And I should note that this was the first Black Friday that I didn't shop...not online as I did last year nor at stores. It's also the first year I didn't cook the turkey! Or anything. Bless my hubby...he tried but no one wanted to eat seconds. Lol
 
I also think my 2000mg Vitamin C supplements help. And research does show it speeds up surgical recovery.
Not exactly - it does enhance (not speed up) healing but it has no influence on recovery which is a whole other thing. You should go back and read the articles in post#2 that Celle left you. Specially the one about the energy drain!
 
Thanks @Josephine for the tip! Did re-read the Energy Drain article. So I'm now 12 days post-op and had to take minimal painkillers throughout the day but as soon as I lay down to sleep (with memories and holes for another 14- hour uninterrupted sleep session) pain decides to as hello! And remarkably my knee is more swollen. Huh?

I don't get it! Day 11 I had a great day walking around -even pushed a sofa to another wall to clear a spot for our tree! It was a great day...I got up, I showered and I dressed...needed minimal painkillers (1 dose oxy at 8am), sat at the dining table, walked around my house (very small - 1600 SQ ft), baked cookies and...it was a good day. Of course it was hard for me to get to sleep since it's hard to get comfortable!

But sheesh! Enough already! Why did pain (level 6) have to come back? Then hubby massaged my leg and pain fled. Yay! But nooooo it's decided to come back again! And my 10 mg oxycodone , 10 mg of Drobinol, 50 mg of promethazine, 200 mg of Celebrex seem to have lost their power ...grrrrr!

Pondering various contributing factors leaves me wondering about the role of emotions during recovery ...and perhaps my disrespect for timed medication management is biting me in the butt!!!!! But alas I also now remember why opiates and narcotics are not good for me....they make me wired!!!!and intense!!! But I absolutely abhor walking around emotionally numbed of fogged up; and the only way for me to take these meds and keep them down is too use the Phenergen (promethazine) which does make me sluggish.

Day 12 and I feel like my leg is tight, that my knee is tight too..and that I can't walk normally!! I can't walk normally!!! I tried tricking my leg into thinking it had to be the supportive one and my stability was great but to achieve a smooth heel-toe gait was impossible? How long does it take before one can walk "normally" ?

So grateful for this board since my saga started 18 months ago my immediate and second circle friends are bored to death about my daily struggles...yep I am too.
 
I think you're really expecting way too much too soon in your recovery. You've had major surgery and you cannot expect to be getting back to normal just a couple of weeks out. Frankly, you should be "zoning out" and sleeping a lot through the day and night, courtesy of pain meds taken on a regular schedule. If you're not keeping meds in your system, you'll always be chasing the pain. In the end when you do that, you tend to take more medication and it does a much poorer job of pain management.

It's quite normal to have more pain at night. Most people need to take a pain dose at bedtime and another during the night. You might even need to get up out of bed during the night and do some stretches or a few turns on the exercise bike. I did that for months. Your sleep may be in bits through the day and night, but that is normal.

I know this seems frustrating to go through but it just is.....

However, it's a temporary problem and things will get better!!! So try and keep looking forward to the days when your knee does not rule your life any longer. They are coming!
 
So I'm now 12 days post-op and had to take minimal painkillers throughout the day but as soon as I lay down to sleep (with memories and holes for another 14- hour uninterrupted sleep session) pain decides to as hello! And remarkably my knee is more swollen. Huh?
Did you not see this: "other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness apply". Swelling causes pain and pain causes swelling. Please read this again The importance of managing pain after a TKR and the pain chart

So why are you taking 'minimal' pain killers?
Pondering various contributing factors leaves me wondering about the role of emotions during recovery
I suggest you ponder the sense of taking 'minima;' pain meds when not even 2 weeks out!
Why did pain (level 6) have to come back?
Cound;t possible have been anything to do with all the stuff you did the day before - like baking cookies! Read this again
Activity progression for TKRs

At this risk of sounding snarky - because honestly, I really don't mean to be - when you said you read the article on the Energy Drain, was that the only one you read? Or did you just skim through the others. Because from your latest post, it almost seems like you've never read them. :reading: :SUNsmile:
 
Baking cookies?! :yikes: I think you accidentally joined the ODIC (Overdid it club). You probably got overconfident since you were feeling pretty good. Increasing activity in very slow increments is generally the way to avoid increased pain and swelling. Walking normally will take what feels like forever. That's just the process.
Listen to the boss--the knee--:bow:and you'll be ok.
 
Well..the weirdest thing...I slowed down and then started to feel better...I seriously spent the last two days in bed and my swelling went way down!!! It almost looks normal! And I can tell my ROM is better!

So I'm feeling pretty good now!! Day 14 and I didn't need any pain meds after 4am until 7pm!!! I'm psyched! I walked around the house a bit more than usual...showered, met the kids after school..we did homework and I heated up our dinner and served it!! Oh and I had also even got up for breakfast with the kids before school. Yay! And I wasn't so out if it...so thankful!

Now that I'm trying to sleep I feel the discomfort a bit more but it's also my first night not taking oxycodone. I used tramadol instead and I think it wires me :( or I just cannot get comfortable. The leg/knee is still stiff.

Yet my doctor does not want me doing formal PT ...which in consideration of my history I understand..but it would still be nice to have someone to encourage me. I don't know. Ugh, I should not haven taken tramadol. I guess I kind of forgot how it wires me. It's almost like being high. I hate it.

So 2-weeks post-op and I'm way more confident with my knee. Much less pain then pre-operatively. And I can also see a glimmer of my calf. Plus the atrophied look is not as much. And I don't have to hear that awful grinding clunking noise when I walk. Serious relief. But still very very tight. And an unnatural gait.
 
Day 17 Post-Op:
ROM def over 90 -possibly at 110;
I walked upstairs "normally" in the last two days...did more heel slides, attempted some hip thrusts and now leg is sore but not swollen lek before..much less swelling but ironically I needed to use tramadol throughout the day yesterday and apparently today;
I slept through the night last night -took my reg Marinol 10 mg dose, 1 oxycodone, 1 Benadryl and 25 mg Elavil;
I started on Elavil last night (have never really taken or needed ant-depressants before) in hopes that I could sleep at night as well as to ward of my post-op blues which I was/am developing;
I'm still worried about the potential Nickel allergy being my obstacle to a pain free life;
I'm scared that this pain/soreness I now feel will never go away;
I'm thankful that it's not the same burning, wooden sensations I used to have but worry nonetheless;
I've yet to leave my home but intend to today;
Docs still dont want me doing formal PT or driving until I'm 6 weeks out;
Which kinda depresses me and worries me as I feel like I'm losing the race to recovery;
And yet I do know my case was a bit complicated and they're trying to optimize my results since they were not too hopeful prior to surgery that they could fix everything that had gone wrong with my knee -zee specially if it was a minor case of RSD;
So I feel weirdly jealous when I read about others great recovery...
But yet I am having a great recovery considering;
I had no muscle left in my left leg prior to surgery and we can now see some muscle in my quads and calves..they are still small but they are there firing..and maybe that's what most of my soreness might actually be from..muscles working after being stagnant for 15 months;
I can walk without my walker or cane; If I want to walk without a limp I have to walk super slow; which I do as I really want to have a smooth regular gait but it's easier to walk fast but with a limp now...so I now have to concentrate to walk regular;
Finally I've noticed my new knee added about half and inch to my leg length and that it's really straight compared to my knock-kneed right leg.
So Day 17 Post-Op sees me with lots of discomfort but more mobility and a return of strength. I wish there was an easy way to rule out a nickel allergy.
 
[Bonesmart.org] Nov 18th TKR & Peroneal Nerve Decompression..recovery road
Dear @Katfin, please realize that you are only 17 days into a 365 day recovery. You still have a very long way to go, and things WILL continue to get better as you more along. Oh, yes, there will be set backs (most of which we cause ourselves by overdoing) along the way, but for the most part you will see fairly steady improvement.

It's going to be at least 3 months before you can believe that "normal" is possible. At 6 months you'll know that "normal" is possible. At 9 months you'll mostly feel "normal". And at 12 months, life should be pretty much back to "normal". I know a year seems like a very long time; but when you consider how long it took your knee to need replacing, a year is really nothing.

Please follow the BoneSmart mantras: Following them to the letter will assure you of the best possible recovery.
-
rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!


They really DO work! This is going to take a lot of TIME & PATIENCE on your part, but in the end it will all have been more than worth it.

Take care and keep us posted. We care.
 
Docs still dont want me doing formal PT or driving until I'm 6 weeks out;
Which kinda depresses me and worries me as I feel like I'm losing the race to recovery;

While having the right PT can be a help, it is perfectly possible to recover without any PT at all, and waiting for a few weeks will not slow down your recovery. My surgeon routinely forbids all PT until at least 4 weeks after surgery and his patients all do well.

I am 11 weeks out from a knee replacement and I have had no formal PT whatsoever, apart from being shown a few simple exercises in hospital.

Guess what? My knee is doing just fine!
  • I have been walking without any aids for the last 6 weeks.
  • My knee bends to about 120 degrees (still improving) and I can straighten it completely.
  • I can go up and down stairs normally, as long as the treads are not too high.
  • I did take regular pain medication, but now I only need to take Tylenol at bed time.
  • I am finally getting back into a normal sleeping pattern.
  • I have been driving for the last 4 weeks.
  • I have resumed all my normal activities, although I do still get tired and I have to pace myself.
  • I am aware that my recovery is still not complete and my knee reminds me (by aching) if I do too much.

Recovery from a knee replacement is indeed a race, but it is a marathon, not a sprint. I believe that you are thinking of it more as a short race than a long one.
 
Day 20 post-op

Thank you @Celle and @bottomshollow for your supportive words. I am trying to drop the "competitive attitude" (my own words) as I recognized it comes from trying to prove to my husband that I'm not lazy or crazy with made up stories about pain. I just don't like feeling like a burden! And I'm not used to resting! But I will and I am now for I do not want to jeopardize my chances of a great full recovery.

I ventured out of the house this past weekend! Gosh was it hard sitting in a car for more than 15 minutes! And I did swell up when the days were done. Ice, elevation and ibuprofen took care of the swelling fairly quick. I now see that my days are going to vary depending on my level of activity as well as type of activity.

I'm happy to see some muscle peeking out in my severely atrophied leg. I think if my leg had been strong prior to surgery then my recovery would be much easier.

I wish I could take pain meds on a scheduled basis but they make me so sick that I have to always take Phenergen first which basically conks me out. So I'm happy that 800mg ibuprofen seems to be enough to carry me through the day. Nighttime is a totally different story!!

I tried just taking my Marinol last night but had to reach for a 7.5 hydrocodone at 2am. Not real severe pain but discomfort, stiffness and a nagging throb.

Today I have to drive as my mom has left. Kinda funny that my Mom (over 70 yrs) had to be my legs for the last 3 weeks! I'm a little anxious about driving though I'll only drive 3 miles. My knee just gets so bothered when I sit in a car!

I'm wondering about how much time to give myself before I travel via plane? When have others attempted travel after a TKR and what was their experiences?
 
Status
Not open for further replies.

Members online

No members online now.
Back
Top Bottom