TKR One Year Post Surgery

[Sara61]

Was invited out to dinner last night at a friend's house accepted as I was desperately needing a bit of social company however my knee had an agenda of its own - moments after arriving it swelled and the pain was indescribable which in turn made sitting at a table impossible so spent the entire evening on their sofa but as all the activity and merriment was at their table I kinda missed out... Home by 10pm ( early for us) but the knee just was not wanting to socialise and certainly made me aware of it
The rest of the night despite medication was not fun so the moral to my post is don't try to speed things along as the price is just too high ....
All good things come to those whom are patient.

 

[sistersinhim]

We want to rush to get back to our normal things, but the knees aren't ready for normal yet. At least you got out for a while! You learned that it was too soon, but you still were able to do something normal. How are you feeling today?

 

[Sara61]

@sistersinhim After a rough night had a relaxing shower this morning - which made me feel so much better- just had another 30 minute gentle PT session using again the cpm machine and have been told my Rom is now at 120 which he seems pleased about however he wants me to take it very slowly and not "run before I can walk"
Also be told me to use 1 elbow crutch until my legs are stronger so not to end up with a limp or a bad walk. So far am incredibly impressed with their attitude which is totally in alignment with BoneSmarts.

 

[sistersinhim]

Great news that you are feeling better today! Your bend is amazing. That gentle PT really seems to be helping your recovery along. He sounds very sensible.

I found the elbow crutch to be very helpful since I can't use the underarm crutches.

 

[Macknit]

Wow...ROM is great and you are so early still! Sorry for your social life interruption....we all have gone a bit stir crazy with the "cabin fever" syndrome!! Hang in there until you've healed more, the social life returns with a bang!

Here in the States the CPM is rarely prescribed any more...Some studies nixed any improvement at 4 or 12 weeks, so most of the OSs don't use it any longer. I do wonder if that is a mistake!?

Slow is very good, you seem to be progressing well, unfortunately I had to return to work part-time at 6 weeks, full-time next week...now I'm at 8 weeks and have stalled....meaning I don't feel or see much improvement. However, my activity increased substantially, so I'm guessing my "little friend/special knee" is slowly adapting by regressing before progressing!

 

[Sara61]

@Macknit Thank you, I seem to be lucky in the healing process keeping my fingers n toes crossed that it will continue to do so.

Here in Portugal they are firm believers that the cpm machine is a good way to start your mrehabilitation, usually in the public hospital it is brought to you a few hours after your surgery to help get the leg moving, then for the following days whilst in hospital it would be brought to you twice daily, once discharged you then progress to other types gentle of exercises.
Although I was originally booked to be operated in a public hospital due to overload of surgeries I was admitted to a private hospital at no expense to myself other than the local taxes, unfortunately this hospital did not have same policy so I'm only now using the cpm I must admit I like it as there is no hard pressure on the knee.

Is it usual to be back at work at 6 weeks?

I have a part-time job in a Tennis club however as it's low season I'll probably only go back to work next year.

It must feel good to being active again and I'm sure your new knee is progressing on its own terms.

Hopefully I will soon be allowed to drive as I have a automatic car so left leg not needed... I do miss not being able to pop out and buy tasty goodies, my husband just gets the necessities haha.

Wishing you continued success with your knee

 

[sondrals]

@Sara61 my surgeon prescribed a CPM for the first 3 weeks after surgery, I guess it’s not that common anymore here. I found it really relaxing and was to use it 8 hours a day split up into at least 3 sessions. It was about the only time I could sleep, I’d strap myself into it and take a nap. I got my ROM back fairly quickly and kinda wonder if the CPM is why. I hope when my other is done I get to have it again.

 

[Macknit]

@sara 61 and @sondrals Many of my neighbors have had to have MUAs and all of them said they wished they would have had the CPM!!! I started out pretty good with my ROM, so I probably was fine, but it really does seem to be a (k)need (no pun intended ) for so many people...

Work at 6 weeks, even part time, isn't the norm and my knee has given me grief over it. I was stuck with this time frame because I'm trying to retire from my "second career" in 14 months. Our retirement program has a minimum of 5 years to be vested (all the $ you pay in is returned to you), which is where I'll be in 14 months.

So this year I ended up needing 2 surgeries... and every year we only get 12 weeks of approved Family Medical Leave Act (meaning you are guaranteed to return to your job!) So, I had to split my return to work time to 6 weeks for each surgery... I honestly had no clue about this recovery....

Driving has been good, but I do think it is part of my knee issue, because mine is a RTKR and I only use my R leg to drive....for 35 minutes one way. Luckily, I haven't had a lot of braking because it is mostly highway driving.

Best of Luck with your continued recovery!

 

[Izabel]

Sarah, so sorry your outing was not as anticipated as you were so looking forward to it. You are really in the roller coaster aspect of healing and it can be so frustrating. But you are doing very well in a short space of time so take things easy.

Catch up with you soon.

Izzy xx

 

[Celle]

Many of my neighbors have had to have MUAs and all of them said they wished they would have had the CPM!!!

The point is that your use of the CPM was gentle. Unfortunately, many people used it too hard and tried to gain ROM too fast, which was not good for their new knees.
During the same time frame, studies showed that., while some people did experience an earlier increase in ROM, that increase was not sustained over a full year and the people whose ROM had increased slowly had caught up with the early-starters by the end of the year.

I suspect that, in the case of at least some of your friends, their PT was originally too demanding, which set up increased inflammation in their wounded tissues and prevented the decrease in swelling that is necessary before ROM can increase.

It's the difference between gentle treatment and overworking the new joint that will have made the difference, not the use of the CPM.

Another factor is that some surgeons and PTs expect a fast increase in ROM and are a bit too keen to do an MUA early, without waiting for the knee to heal and swelling and inflammation to decrease.

 

[Macknit]

@Celle I really like your explanation....it all boils down to that common denominator of gentle, doesn't it?

Sadly, so many OSs here in the States do not critically evaluate when these studies are sent out and unfortunately, their conclusions are long-reaching! Decisions are often made without the critical thinking skills that some of the research doctors use to break apart the facts...and guess who suffers as a result of not dissecting the research? Yes, the patients.
So here I am, learning from BS...and having it reinforced before my very eyes....so sad
and frustrating! I say this based on your suspicions about my neighbor's aggressive PT, there is no need to suspect... the tales I have for these neighbors are tragic and, in some cases, their PT choices are even self-induced.

I suspect that, in the case of at lest some of your friends, their PT was originally too demanding, which set up increased inflammation in their wounded tissues and prevented the decrease in swelling that is necessary before ROM can increase.

Thanks for the enlightening post Celle!

 

[Tykey]

I also overdid it yesterday, after 7 weeks of great recovery, packing cases and loading the car, fetching and carrying, shopping etc etc - I'm off on my holidays tomorrow. I can't believe I got the bag of peas out again because the swelling was back.
There's always a limit!
Still, a 200 mile drive awaits today, but I'm sure a couple of paracetamols and regular stops for teas, burgers and strolls will be fine.

 

[Sara61]

@sondrals likewise if in the future my right knee needs replacing I think I would be more insistent in the hospital as I think the 1st 48-72 hours it's good for a gentle movement.

@Celle Understandably and totally agree - if used in the wrong hands the cpm machine could do a lot more damage than good.

@Macknit
Different Countries have different approaches you would think there after all this time would be a world wide standard in approach to after care for Knee surgery ..
The local hospital (Faro) has a fully equipped PT facilities and a gentle approach towards recovery which is ideal - PT and cpm is ofdered as soon as the patient is able usually within several hours after the operation here it is standard to spend minimum mm 3-4 nights in local hospital ( I m not sure I would want to go home hours after ) unfortunately some of the private hospitals it appears their aim is to get you home as fast as possible, ( 2 -3 nights) this is fine if you are young and disciplined however many elderly patients have never or rarely participated in any form of physical activity previously and to be given a list of exercises to do at home simply in my opinion isn't good enough many of them don't get the full advantage their knee(s) have to offer and rarely progress from their zimmer frame or crutches.

@Tykey Sorry to hear about your swelling but how exciting ...off on holidays anywhere nice ? Are you doing the Alpaca trex ?
Regular coffee stop on the way will be good for your knees.
Have a brill time, looking forward to being amused with your updates xxxx

 

[Tykey]

Nowhere exciting, Sara, but to our beautiful North East coast.
No alpacas this trip.
The fun has already started. I've got a small trailer on the back, and got 100 yards when the wheel bearing collapsed!! So now just waiting for it to be repaired. We'll still get there today

 

[Sara61]

@Tykey Beautiful North East Coast is wonderful too xx
Safe travels x

 

[Sara61]

3 weeks today am progressing nicely unfortunately not off pain meds (I'm a wimp) but have reduced in take - not doing anything over strenuous or weight baring- like everyone there are great days and awful days but that's all part of the healing xx

Sleeping is better - last night got a full 6 hours bliss - I was tired going to bed as I went food shopping yesterday evening with hubby as he although thinks well hasn't got a clue shopping wise ha ha plus
I'm fed up waiting for takeaway food as he can only get home from work late afternoons so decided I can now cook the odd meal for myself.

Hoping to be allowed to drive soon even just to the village shop and back (fingers crossed)

Hope everyone is having a good day xxx

 

[marieltha]

Prudent, not wimpy, in my opinion.

 

[Macknit]

unfortunately not off pain meds (I'm a wimp)

I agree with @marieltha very wise to keep using the pain meds, not a wimp in my book! I didn't stop until just before my part time work arrangement at 6 weeks! I was able to sleep better and get the hang of working again.... I start back FT on Monday 11/4 and I'm sure I'll have some flare ups from the longer day and would even want to use pain meds at times....but really my alternating of ibuprofen and acetaminophen are doing the job, just fine!

have a great weekend!

 

[Sara61]

@Macknit Yes taking pain meds just help me move, however am thinking of taking myself off the tramadol at some stage so was wondering what exactly do you take you mentioned Iberbrufen and acetaminophen
Is this paracetamol?
At the moment I'm taking Tramadol every 12 hours and paracetamol every 10 hours alternating between the two however if I could find something equally as good I would probably prefer to come off tramadol as I'm not sure I will be allowed to drive whilst taking this.
Likewise have a good weekend and all the best for next week hope your working days isn't to stressful or to tiring on your knee xxx

 

[Tykey]

Acitaminophen is paracetamol.