TKR One month out from surgery, what should a typical day look like?

[Knee2016]

@Clipless, ah geez, I forgot and did a new post! I keep thinking if it's something different, I need to create a new one so people will see the new topic and reply. How does anyone see the new question in the old thread? Anyway, I am scheduled to have a steroid shot in my back. Have you had those and did it help? Have you tried deep tissue massage? Any meds that helped?

 

[Clipless]

No worries! BS moderators (& lots of members) are curious and read everything. Or you can ask one of the mods to change your thread title to reflect your latest concern/question. I did that a few times after my first knee.

I have severe scoliosis, almost afraid to know what's going on down there but when it hurts badly I take a muscle relaxer. I do not allow ANYONE to massage or adjust my back due to serious risk of harm. I should have had surgery to straighten this when I was young, but we didn't know. I was diagnosed when I was 39. My shoulders are level, but my ribcage has twisted. If my spine was straight I'd be 2" taller!

 

[Celle]

I keep thinking if it's something different, I need to create a new one so people will see the new topic and reply. How does anyone see the new question in the old thread?

If you want to ask a new question, post it in your old thread and tag one of the staff - either a Moderator or a Forum Adviser. You'll recognise who are staff, because we have a designation below our avatar (picture). It will say Moderator or FA. Here's how to tag someone:
How to tag another member; how to answer when someone tags you
Tag me if you like. If your question is something I can't answer, I'll ask another member of staff, or ask another member who I know has experienced that problem.

Incidentally, between all of us, the staff will read all of the new posts every day.

 

[Knee2016]

@Celle Thank you for explaining how posts work! I don't know whether to say I'm frustrated or discouraged. I was 5 weeks out yesterday. Went to the surgeon who said I was doing great. He told me to move it and walk as much as possible. Went to my first outpt PT session and was able to do all of the exercises but my flexion and straightening weren't where she wanted them to be. It's the swelling that's preventing me from bending. I'm walking great with no assistance but the more I'm up and moving, the more swollen my knee becomes! Today, was out at church for a couple of hours. I kept my leg propped up on a chair. Then went and ran errands for a few hours. By the time I got home, my knee was awful. Elevating and icing have still not gotten it down all of these hours later. I keep reading about and hearing of people who are back at work by now. When does the swelling start to go down? I keep my leg straight when I sit. Should I be sitting with it bent more? Just discouraged I guess...

 

[Celle]

The swelling will last quite a long while and only go away gradually. For months from now, your knee will still swell if you do too much activity for it. You certainly did too much in one day for your poor knee! Rest, ice and elevation will help, but it will take several days before your knee is back to what it was. In short, you joined the ODIC (the Over Did It Club). Most of us have done that and usually no long-term harm is done.

Actually, it stands to reason that when you're up and about your knee is going to swell more than when you're resting. The trick is not to do more activity than what causes slight and temporary swelling.

Your surgeon was happy. That's the important thing to remember.

Don't worry about your therapist not being happy. PTs tend to get a bit obsessive about ROM (Range of Motion) numbers, because that's the way the insurance companies judge their performance. Because of that, it sometimes seems as if common sense flies out the window. They forget that swelling is going to impede your ROM and they push for fast progress.

It's only 5 weeks since your surgery and you're doing fine. This recovery is more like a marathon than a sprint. It takes a full year for you to achieve 100% recovery, although you will feel much better long before that.

There's no need to rush to achieve ROM. There's no "window of opportunity". In fact, ROM can continue to improve for a year, or even longer, after a TKR.

Oh yes, the "miracle babes" who go back to work early! There are a few (very few) who genuinely have a fast recovery, but they are the exception. Most people find that, if they do go back to work early, they suffer increased pain and swelling.

Just yesterday, I read someone's comment, thus: "Went back to work at 3 weeks. Still paying for it now, at 4 months."
It's better to let your knee take its time than to try and rush it. Of course, some people just can't afford to stay home for the optimum time, and I feel very sad for them.

I have a friend who went back to work one week after a TKR, and he boasts about it. What he doesn't say is that he went in a wheelchair, he only did about 3 hours a day, his wife drove him to and from work, and did everything else for him. He went from his bed to the shower, dressed, and then went to his wheelchair and work. When he came home, he went straight back to bed, took his pain pills and rested for another 20 hours. He doesn't tell anyone all that, but just talks about how he went back to work a week after major surgery.

 

[Clipless]

You did waaay too much in a day. I would strongly advise you to turn down most social engagements for a while, and let someone else run errands. Simply say you are recovering from surgery...it's true! Also, why are you trying to keep your leg straight? Is someone instructing you to do this, or are you afraid to move for some reason? When I was about 5 weeks out I either reclined on the sofa or bed with my leg elevated (and iced) on a wedge or, if I was actually sitting I'd shift and change position frequently- leg bent, stretched out, bent, up, down, bent, stretched, up, down, bent, etc. Frequent position changes help decrease stiffness, at least that has been my experience. I'm almost 4 months post op and I still frequently move both of my legs (bend, straighten, bend, straighten) until I'm ready to fall asleep.

Again, very few people attempt to go back to work soon after TKR. Those who do are in for many unpleasant days and nights. Undoubtedly some, like Celle's friend, skew their story to sound more heroic than they are.

 

[Knee2016]

Thank you both for taking the time to reply! Going to take it easy today and see if I can get it feeling better! I'm also going to move it more when I'm sitting. So thankful for this site!

 

[kneeper]

I think the problem is often when a doc says something like "walk as much as possible" we interpret that literally.
I think they just don't want us lying around like slugs. At 5-6 weeks I took about a 10 minute walk a day and did a little walking around the house every few hours just to keep from being too stiff. Maybe a short errand, but not a couple of hours on my feet!

 

[Knee2016]

I dread going to bed at night because I know it will take forever to get comfortable. So I stay up much later than usual and go to bed around 11:30. I get up for breakfast with my family and then go back to bed until around 11 everyday. Then I am up for the rest of the day. I feel good when I get up and am able to do the dishes, sweep the floor, prepare meals, and do a little laundry. I do this in small stages, trying to do something every hour for a little while. As the day goes on, my knee becomes more swollen and tight. When i ice my leg, it becomes more stiff and more sore afterwards. Yesterday, I didn't I ice it at all and did not notice a measurable difference in the amount of swelling. What are your thoughts on using heat rather than ice? I have thought about trying it but have been afraid to. Walking, moving around, and doing things is not difficult at all. What is is this swelling! I can't seem to find a way to get it down and even if I lessen the amount of activity, it still swells as the day goes along. Any advice?

 

[Celle]

The swelling can take months to go away completely and even then you could find that your knee swells after a day when you've done more than usual.

Even if you break up the housework into short spells, you're still doing rather more than is ideal. Doing too much will prolong the swelling.
You won't notice a difference in swelling from day to day, and certainly not after just one day of resting, icing and elevating. It's not a case of getting instant results.

When you're icing, how long are you doing it for? Are you doing it with your leg kept straight? Because that can cause stiffness, too.

You do know that you should still be spending most of your time resting, in bed or on a couch, with your leg elevated and preferably iced, don't you?
You need to spend 2 hours resting for every hour you are up.

You shouldn't be up and about most of the day and you need to be in bed long before 11:30. If you can't get comfortable in bed, sleep where you can get comfortable, and do make sure that you're taking adequate pain relief.

We don't recommend using heat on your knee, although you can use it on your muscles.

 

[Knee2016]

Just like at the beginning, I can't seem to find any place where I am comfortable. Either my back hurts or the outside of my leg where he corrected my bowed leg hurts. If I elevate, my lower back really is sore. I use heat on my back which has helped some. Ironically, when I am most comfortable is when I am up walking and moving. I have been icing my leg straight because kept being told not to put any pillows or anything behind my knee. How do you recommend bending the knee and icing? I also noticed that sometimes the weight of the ice pack bothers my me too.

 

[sleepilu]

This pic is the one I found most helpful

If you think about all that has been done to your knee during surgery less than 6 weeks ago, it's really hardly surprising that you're swollen! It's your body's natural way of protecting what is underneath.
I am an acupuncturist and therefore an advocate of traditional Chinese Medicine, the Chinese say you should only ever use warmth, never ice and whilst I would most definitely use warmth on your back and other muscles I think you will find that Ice is most helpful for reducing swelling in this kind of trauma.
BUT having said that occasionally, like yesterday when I spent too long out in the cold, I have listened to what my knee wanted ("Owww, I am turning into a frozen tree trunk" it said) and I warmed it up! It did feel better for it!

 

[Knee2016]

The picture looks perfect for elevating and icing. Problem is, it kills my lower back to do that. I've tried all different ways....

 

[Pumpkin]

Frustrating, just do your best. Keep it up and level if that is what you can do without killing your lower back.

 

[Gigi32]

@Knee2016 - I can sympathize with your problem with elevation. With my first knee I loved having my knee elevated and even bought one of those wedge pillows before my second surgery so it would be easier. Well, let me tell you the second knee was a whole different experience. I had sciatica on that side a few years ago and as soon as I got home from the hospital it flared up. It finally settled down, but I still to this day can't tolerate putting that knee up like I can the first one. In fact I sleep with one of those memory foam wave shaped pillows under my first knee because it still feels better when it's slightly elevated, but the other one is flat. You may also find it works better to put the ice pack under your knee instead of on top. I also couldn't tolerate ice on top with my second knee but you could wrap my whole leg in ice the first time and it was wonderful. Sounds weird I know but you just have to find what works best for you and go with it.