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[TKR] Painful Recovery So Far

DOCCUKE

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Greetings
Just curious how many folks are as unhappy with having done a TKR? I had mine done 7 weeks ago tomorrow, and so far every day have regretted it!! I have done my PT, got my ROM to 130 degrees after 3 weeks, as of yesterday at 2 degrees straightening my leg but the pain levels are still crazy. I took a month off work, unpaid as I do not have disability, and for the last few weeks been working from home. This is my last week at home, Monday I go back to work.

I know that my size makes it worse, I am 6'4" and 299 pounds, down from 395 pounds last year, but still I get that 299 pounds is still allot of weight!! Both of my knees have been bone on bone for a long time. I am 61 years old and have had knee issues since I was 32.

But what honestly makes me angry is the fact that as bad as my pain was before surgery, it is worse now by far! I believe these doctors are to willing to do this surgery! After having done my left knee I will say that as long as I can still walk they will not ever touch my right knee!!

Anyway sorry about the rant, just really feeling like this was the worst decision I ever made in my life!

The fact that I am missing all this great weather and can't ride my motorcycles doesn't help!! LOL

Also did not find out until after that I am not supposed to ever run or jump again. I was also told not to work on anything that would require me to kneel for at least a year and that this will probably need replacement in 20 years!! So now if I live past 80, I get to do this again?? Kinda hoping I don't make it that long!! I can't even imagine what this would be like to deal with in my 80s!!

Hope you are all well and pain free!!

PEACE
DOC
 

Lexus05

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Sorry you feel this way! Everyone has a different experience with joint replacement. No two are alike. Your other knee replacement could and will be different than this one you had replaced. I am 9 weeks post op and just came in from mowing the yard and using the trimmer. I feel that my surgeon did a great job and I would do it all over again.
 
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DOCCUKE

DOCCUKE

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I am glad that your procedure went well!
I think in my case as bad as my knees are that it was maybe premature. My right knee is actually worse in terms of bone on bone, but my left knee also had a torn meniscus and damaged ACL. It also had a nasty habit of collapsing without warning!! Even so that was better than what I have now!

I do all my PT even though it is painful as I heard enough horror stories of folks getting a TKR and not doing PT ending up way worse off then they were pre op.

I think that if you still have to work for a living, which I do, and you can walk without a cane you are better to just deal with what you have. That is definitely how I feel about my right knee. If I can still walk, I am keeping it intact!!

Kind of hoping that they make progress with stem cell research, although it probably won't happen in my lifetime, I believe eventually we will be able to have that done as an alternative and have health insurance cover it. Right now there are facilities in NH where I live that do it, but it is out of pocket!! My pockets are not that deep unfortunately!!
 

Jockette

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Hello @DOCCUKE and Welcome!

I do all my PT even though it is painful as I heard enough horror stories of folks getting a TKR and not doing PT ending up way worse off then they were pre op.
And there are also horror stories of those who have continued painful exercises and had problems because the knee was never allowed to rest and heal.

Your overall pain level will be reduced if you cut way back on painful PT.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
3. Do what you want to do BUT
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.​
4. PT or exercise can be useful BUT take note of these
5. At week 4 and after you should follow this
6. Access to these pages on the website

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?

Energy drain for TKRs

Elevation is the key

Ice to control pain and swelling

Heel slides and how to do them properly

Chart representation of TKR recovery

Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 
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DOCCUKE

DOCCUKE

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Thanks, I will look through all these links
As for pain meds, they are useless to me. They make me drowsy and nauseous, but do not help with my pain at all, literally no advantage to taking them. I was taking Tylenol extra strength but I have issues with my colon and after 4 weeks of that I was passing massive blood clots in my stool, so that is a no go.

It is difficult to navigate as some folks tell me "Oh do the PT no matter what or you will be crippled" Some tell me "If it hurts don't do it" If I went by that I would not get out of bed as I am in considerable pain 24/7

Aside from both knees I have neuropathy in both feet that is unrelenting , my right shoulder is a mess, tore my rotator cuff years ago in Arm wrestling tournaments. So pain seems to be a part of life. I would be happy to only be in pain as much as I was before surgery!
 

Jockette

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I know how you feel about post surgery pain bring much worse than pre surgery. I felt the same way. But, pre surgery arthritis pain gets worse, post op pain eventually gets better as we heal.

Your ROM is fabulous so there’s no need to work so hard on the exercises. Do you still have a lot of swelling? That alone causes pain. Elevate and ice to reduce the swelling. Ice is also a good pain reliever.

I’m sorry you’re missing this great weather. I’m sure it’s beautiful in NH and more so in the fall! My husband had a motorcycle years ago when I met him when I was 19. I did enjoy those rides!

Seriously considering cutting back on some things and rest more. It won’t reduce your progress and you’ll feel better.

This is a very tough recovery. I’m not in any hurry to do it again, either.
 
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DOCCUKE

DOCCUKE

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Hi Jockette
Yea riding is addictive. I got out a little last Sunday on my sidecar bike since I don't have to hold that up, plus then I could take my fog for a ride!

PT lady gave me a new excercise Monday. Freakin brutal
Stepping up & down using the knee that was operated on backwards!! I think that set me back a bit pain wise
I seem to have swelling issues all of the time. I use a cryo cuff but it does not seem to help much.

I wonder if I have too much weight for this joint!! I have never regretted doing something as much as I regret this!!

I have to work for a living, & I will be going back full-time Monday. Not looking forward to how much more pain this will bring!

Well I am going to bed & try to sleep. At least when I can sleep I not aware of the pain. Getting so that sleeping is the best part of the day

Have a great evening and thanks for the response

DOC
 

mainegirl1

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Whoa on the PT! If it hurts dont do it!
Sometimes you have to work smarter not harder so to speak
I can run and did about six weeks of gentle non touching PT.
Swelling is pain as you will see if you read the articles here.
More PT will lead to more swelling Especially combined with early return to work Ice and elevate several things times a day for 45 min each is what is recommended here and it works
Just step back and think about why you are doing PT ROM not dependent on it. Its not like use it or lose it.
I am curious as to if you are icing and elevating?
I met a chap last month who felt the same as you. I mentioned icing snd elevating and he had done neither All his surgeon wanted was for him to do PT. He was in awful pain and his knee was so swollen he could not sit normally
 

Chemist

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Hello @DOCCUKE:

For the first few months after my first TKR I swore I would never have the second. Things slowly improved and I did have the 2nd surgery.

Try to be patient. You are very early in your recovery.

Take care
Chemist
 
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Jamie

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@DOCCUKE .... I've moved your post and the comments that followed it to create a recovery thread for you. Please post your exact surgery date and we'll create a signature for you. That information helps when we need to post advice for you. If you'd like a different thread title, just post what you want it to be and we'll get it changed for you. This will be the place where you'll post your updates and let us know about and questions or concerns you might have.

I'm so sorry to hear that you're having such pain and problems with your recovery. It sounds like you may not have be given a good picture of what recovery from a knee replacement involves. At 7 weeks, you are still in the beginning stages. If you read the articles that were posted above for you, you'll see that your body is still healing.

Since you've had knee problems for such a long time, it is more likely that you might take a bit longer to fully recover. Most surgeons will tell you that it takes a full year or more to completely recover from a knee replacement. Of course, you are not incapacitated all that time, but there are aspects of recovery that involve the adjustment of your soft tissues that can take some time to resolve. This can give you some pain and discomfort for a while.

Please try not to perform any exercise to the point of serious pain. This is counter-productive and causes additional pain and swelling. It can even become a chronic pain problem if you don't get it under control. You really don't want that to happen. It sounds as though you are not ready for that new exercise your therapist gave you. It would help if you stop all the exercises for a week or two and just do gentle bends and stretches throughout the day along with your short walks around the house.

Your first priority is to get your pain under control. What pain medications were prescribed for you (name of medication, strength, recommended dosage and your schedule for taking them)? You say you ended up with blood clots in your stool when taking Tylenol Extra Strength.....how much of that were you taking and how often? Was it on a set schedule? What you describe is possible with Tylenol, but it is very rare. Did you discuss this with your GP? If not, you should.

Are you icing at all? Ice can provide significant pain relief. You do it when you are elevating your leg (toes above the nose). You can ice as much as you like providing you keep a towel between you and the ice source to prevent freezer burn to your skin. At a minimum you should be icing 5 times a day for at least 45 minutes each time.

As long as you are in serious pain (not just mild discomfort), you should try to keep your exercise or activity to a minimum. All that is required to keep your knee mobile is to get up and walk around the house for 5 minutes or so every hour. Keep in mind, your goal is to reduce your pain and swelling. Once the pain subsides a bit, you can do some gentle exercises or additional walking - starting slow and working up to longer times of activity.
 
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ApricotPie

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A few random thoughts.

It took me about 10 weeks to reach the point where I broke even on the surgery. That is my surgical knee was no longer overall worse that it was the day before surgery.

I wish I had 130 degrees of ROM.

Yes, your excess weight is a burden to healing. There is no way to sugar coat that.

The medical community does a lousy job of informing people how brutal the surgery is, and how long and tough recovery is.

Everybody I know who has had the surgery at least two years earlier is happy they did it.


RTKR July 15, 2019
 
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DOCCUKE

DOCCUKE

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Hi Jamie
Pain meds tried were oxycodone 5 mg & tramadol 50 mg. Both helped the first few weeks with sleeping a bit but never really touched the pain to be truthful.

My bleeding issue is not new. Eating pork , excessive stress & other factors have caused this over the last 30 years. I have had tests & the procedure where you drink that stuff that cleans you out so they go and check out the colon. Have had a few polyps but not cancer.

I was taking 1000 mg of Tylenol 3 times a day up until a week ago. Since I stopped there is only a trace amount of blood in my stool & the pain in my lower left has mostly subsided

Yes it is safe to say that I was not informed as well as I should have been going in to this process which of course is largely my own fault!! I should know better than to count on the surgeon for information!

There is no way I can ice that often & work during the day, just not possible.

Given that I have to work is one of the reasons I consider this process a huge mistake!! But what is done is done!!

I will have to do my best to get through it as there is no other option now obviously!

I lost over 90 pounds in the last year getting ready for this, it helped but not enough. Still intend to drop at least another 40 pounds. Doing light dumbbell curls & press to keep my metabolism up.

I use my cryo cuff after work on my recliner for an hour or so after work. Still pretty sore. My quad is burning pretty good from PT when she was pushing on my knee to get my leg straight. I literally saw stars!! LoL

Anyway thanks for the input, I will look at the links tomorrow. I want to try to sleep as I am about at my limit for pain today & just do not want to be awake!

Thanks
DOC
 

Celle

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Hello @DOCCUKE - and :welome:

Please will you tell us the full date of your knee replacement and which knee it is, so we can make a signature for you? Being able to see your surgery date will help us to advise you appropriately as your recovery progresses. Thank you.:flwrysmile:
 

Tykey

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Hi DOCCUKE.

You mention that you are aware of horror stories of people not doing PT, finishing off worse than they were before.
I think you need to make a proper distinction between rehab and overenthusiastic PT.
If you don't rehab properly, then you don't improve. But rehab isn't abusing our poor damaged joints, it's about gently bringing the healing along by not abusing it, but by doing lots of gentle things. My new knee is as good as it was before on the pain scale, and I'm only in week 4.

I've never met anyone who has suffered from no PT, where have you heard this?
In the UK, PT is never done, and it's virtually never a problem.

Now you are obviously struggling with pain, despite PT, so it's not working for you. Your knee is giving you a message.
Try being gentle, and rehab yourself.
 
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DOCCUKE

DOCCUKE

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Hi Celle

My surgery date was August 14th 2019 and it was a TKR on my left knee. I had bone on bone on both knees, still do on my right knee obviously, and my left also had a torn meniscus and damaged ACL.

Hi Tykey
My neighbor Jim had approached me the first time he saw me walking my dog with a cane 3 weeks after surgery, he said his Dad had a TKR, never did any PT and can now barely walk at all. I am 61, his Dad is 65. He is a big guy also. As stated before I am 6'4", last year I was 390 pounds, after 1 year on keto and working out I got down to 299 pounds. Still not small by any means but better than I was before.

Trying to find the distinction between "Good pain" and "bad pain" is tricky with this rehab! All working out causes some level of pain but with this knee so far, EVERYTHING causes me pain!!

I have had more than my share of pain in my life and will push through what I have to, but so far this has been just a completely negative experience!!

I was better off by far before, at least I knew what to expect from my knees before! I am not at all convinced that the actual joint they used was the best possible device to use for me because of my weight. Also not convinced that this is a good plan for anyone around 300 pounds!!

I am never going to be 200 pounds! At 15 years old I was the same height with a 32" waist and 248 pounds! At that time no body fat at all. My goal is to get to 260, but that is still significant weight!!

The fact that according to my Doctor that the most I can expect from this joint is 20 years also means when I am in my 80s I get to do this again?? YIKES!! Let's hope I do not make it to my 80s!!

I have to get to work, you all have a great day

DOC
 

Carole4815

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I am so truly sorry to read about your high level of pain after TKR.

It seems to me that many who post on this forum weigh as much, or nearly as much as you do and did not experience the excruciating pain that you have suffered, so I think you are being awfully tough on yourself by shouldering so much of the blame.

Personally, I am not strong or stoic but simply have not experienced much pain at all, and have not really needed my pain medication at all since the first week or two. I took two hydrocodones in September, each 5 mg (half strength), one not for pain but to put me to sleep (not a good reason) and the other on a day when I did slightly too much and was experiencing some muscle cramps. And why do I have so little pain and you had so much? LUCK. I am no skinny minnie; my BMI was 40 on the day of my TKR. Also there was really nothing virtuous that I did that could explain it; I am convinced that this was just due to luck. Well, plus I give my surgeon a great deal of credit for it, too.
 
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mainegirl1

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The trouble with comparing recoveries of different people is that no two have the same circumstances.
My father in law had a THR and aside from relieving pain he said it did no good. Now why would that be? Well he never moved out of his chair. Walking? Never . Of course his muscles wasted away.

There is a continuum of activity from none at all to too much. Neither will give good results.
No one here advocates doing nothing but start at rest and build activity gradually . My surgeon insists on non painful PT as he says aggressive PT prevents healing for as long as that PT goes on
 
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DOCCUKE

DOCCUKE

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Hi Carole4815
I suspect luck is a factor as well. My surgeon has a good reputation, although he is quite young, kind of a Doogie Howser type !! LOL

My wife said the entire procedure was barely 90 minutes. I do not know if that is average, slow or fast.

Probably part of the issue is back to work too soon. While I am working from home at the moment, I am still quite busy and cannot elevate or ice it until I am done for the day!

I think anyone planning this should plan on a few months of just taking care of the knee! I am not in a position to do that unfortunately!! I took one month of, unpaid, it was actually 3.5 weeks, then I started working from home. This coming Monday I will be back in my office.

I may have set myself up for an impossible situation here!! If I could afford to retire I would, but not possible!! REALLY wish I did not do this because so far it is making life much worse than it was!! I am not sure there is any way to improve this

I will start taking it easier on the PT and ice when I can after work

Just really frustrated and angry at this point!!

Thanks for your thoughts and suggestions

DOC
 

luvcats

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I'm sorry you're having such a rough experience. I'm more inclined to blame a lot of PT over your weight. I'm huge. I'm 5'8 and my weigh in the morning of my second replacement was 360 and I'm completely delighted with my new knees.

If you are back to work and you can't ice or elevate while you work, then consider limiting your exercise to more gentle range of motion things like climbing stairs in your house, walking around, things like that. In the US we tend to want everything yesterday and I think the PT philosophy reflects that without reference to the reality of healing, swollen tissues.
 
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DOCCUKE

DOCCUKE

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I gotta say that going up the step backwards on my TKR is BEYOND painful!
After having done that Monday at PT now just going up stairs normal is excruciating to the point that I can barely do it.

Just took this pic, knee on the left is the knee replaced
 

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