TKR Pam’s TKR PO journey

Shewolf38

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Checked into the hospital at 7:30 am on 8/29/19. I was scared, nervous and excited about finally getting the first TKR done on my right knee. My summer consisted of one local baseball game where I had to sit in the bottom row of seats because I can’t climb stairs, going to the racetrack but not being able to walk around, even to the bathroom because of the pain. Went to look at Lake Michigan but couldn’t walk to or on the beach, so We sat in the car. I would go to work and come directly home to ice my knee and either take pain meds or have a few drinks. I remember getting the spinal in the operating room and the doctor telling me to lie down quickly. After that I was waking up in recovery. I was still numb but I was so happy that my healing journey had begun. When I was able to move my legs and had most of the feeling back, I was sent to my room. I was helped to bed, my vitals were taken and I asked for lunch. I was starving! My nurse called down to the cafeteria and they sent me a turkey sandwich with a fruit cup! My husband and son were brought to my room and they surprised me with fries and some bacon. I added the bacon to my sandwich and it was the best tasting thing that I’ve eaten in months. LOL. I called for help to go to the bathroom. As the nurse was helping me up, I started peeing all over. I couldn’t hold it in! I wasn’t expecting that but the nurses were very kind and told me that it very common when patients have a spinal and no catheter. My husband helped me get cleaned up and get my shorts on, and then back to bed. Later PT came in to check my range of motion. The rest of the night was spent watching tv, getting vitals taken, taking medication and trying to sleep.


8/30. Didn’t sleep much at all. Stomach is upset from the medication so I asked for some crackers. I ate about 1/3 of my breakfast. Before I was done eating, PT came in to take me for a walk down the hall to the PT room for training on the walker and stretching exercises. She said that I passed the PT part and that occupational therapy would be in for some more training and if I pass that, I would be discharged. As soon as we got back to my room, OT was there. Another walk to the OT room where I was trained to use my walker to get into the house, how to get in/out of the shower and up/down from the toilet. I graduated therapy and my doctor came in to talk to me. I was told that I could go home around 11 so I should arrange for my ride to be there at 10:45. Needless to say, I didn’t get out until about 3. Got home and set up with my ice machine and everything I needed nearby. That day finished with dinner, tv, meds and vet little sleep.

8/31. Lots of swelling, pain level rising. I can barely lift my leg and I shuffle when I walk to the bathroom. Craving sweets. Pain meds every 3.5 -4 hours. Day consisted of tv, meds, lots of water and very little sleep.

9/1. Extreme pain. Swelling not too bad but the pain is totally out of control. I’m wondering to myself what the hell did I do to myself? I break down crying from frustration and exhaustion. Husband is so supportive. I wouldn’t have been able to get through this without him and our son. The dogs know that something isn’t right and are being really good and careful around me. Day spent taking meds, tv, FB games, reading and no sleep.

9/2. Woke up with very little pain. I’m so happy about that. I decided to try to make coffee myself since I’ve been getting up around 4 am and son doesn’t get up until later. I was so happy to be able to make my own coffee and carry it to my nesting area without a spill. Day spent with tv, FB games, binge watching Netflix with my husband and very little sleep.

9/3. Woke up in major pain. Was supposed to start OP PT today but appointment changed until tomorrow. Day spent with meds, sleep, tv and FB games.

9/4. First PT appointment. I was very scared that I was going to be put through a bunch of pain. I took a Percocet before the appointment. My son drove me to the PT office. We had to walk quite a ways to get inside and my knee was swollen when I walked in. My PT walked me back and I told him that I wouldn’t be able to do much because I was so swelled up. He was so understanding and gentle. I asked him to please not hurt me. He assured me that he wouldn’t. We filled out a bunch of paperwork and he did some stretching on my knee. It was a bit uncomfortable at times but he didn’t hurt me. Then ROM measurements were taken. 88/0. He said that I was doing great for being less than a week out of surgery. I will be going to see him twice a week. My son drove me home and I immediately put ice on my knee and heat on my thigh. It felt wonderful. The rest of my day was tv, FB and I finally slept 4 hours straight!

9/5. Woke up with a lot less pain! Did my stretching exercises, started using my cane instead of depending on my walker the entire time. Day spent stretching, tv, FB walking around the house, trying to straighten up the living room. Slept from 11:30 - 7!! No appetite and nausea.

9/6. Woke up with bad swelling and stiffness. Made coffee and iced/elevated knee. Watched the news and made myself a bowl of cereal. I’m celebrating the small successes. Took a nap from noon - 2:45. I’m finally catching up on some sleep. The pain is getting much less. Noticed that I had no pain at one point while watching tv with my leg elevated. I can’t remember the last time that I had zero pain!! If I could do a happy dance I would.
 
Bless you! It reads as though you have been on that roller coaster of pain. But you have persevered and beginning to pull ahead of the pain. The schedule of pain meds vs only when you need it is very important especially the first week or so.
I bet the zero pain was a blessing! Hopefully you will have more of those moments soon! Keep celebrating the small accomplishments! Remember to not overdo! You sound like you are doing great! Congratulations on your new knee and I hope you will be able to enjoy walking around the lake soon!
 
Welcome to Recovery!

Slow and steady wins this marathon recovery. Be careful at PT. With a long walk like that, that’s all the PT you need at this point. Ask for some gentle massage. Remember, you can control the session and only do what you feel is in your best interest. You have a lot of healing to do and that should come before a list of exercises.

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.
 
9/8. I literally slept yesterday away. The exhaustion must have finally kicked in. I was up around 8:30, had coffee, back in bed at 10 for a nap, up at 2:30 for bathroom and snack, back to bed at 5, up at 8 for a snack and bathroom. Watched some tv, then back to bed around 11. I’m feeling better today, alert at 5:30 am. I woke up sleeping on my side! I have no idea how I got that way, but my knee didn’t appreciate it at all! It’s going to be a busy week. Monday PT, Tuesday first PO appointment, Thursday PT. Exercises every day and watching my protein level in my food.
 
Your body needed the rest in order to heal. Glad you are feeling better! Just keep doing what your body says and try not to over do it this busy week!
 
Sleep is good for healing. Wishing you more good :sleep:
 
PT #2 appointment in the books. It really hurt this time but I did it! Clenched teeth, eyes closed pain bearing. I walked out of there much better today with a lot less pain. Graduated from using a walker to using a cane. I’m so proud of myself.
 
PT #2 appointment in the books. It really hurt this time but I did it! Clenched teeth, eyes closed pain bearing.
PT is not supposed to hurt. Discomfort is OK. Having to clench your teeth and close your eyes to bare it is only going to anger your knee and cause extra swelling and pain later on. I hope it doesn't, but if it does, you'll know it came from that painful PT.

Many of us never took formal PT or did exercises. I am one of them. I had 11 knee surgeries, 2 of them kneecap removals and 1 tkr. Even after those I never took PT. But, I didn't just sit around and do nothing. I took care of myself, my house and yard as my knee allowed me to do. As I healed, I did more. But, my knee was always in control. This was enough therapy for me and would be for any tkr patient. All the awful pain of PT is so unnecessary.

All you have to do is use it in your daily living. Your knee knows how to rehab itself and doesn't need anyone telling it how. Just use it and it will come back like new. You have to be patient, though, it doesn't happen quickly. ADL,(activities of daily living), going to the bathroom, brushing your teeth and bathing, fixing a light meal, getting something to drink and or a snack, those kinds of things will be all the exercise your knee needs. If you just use it daily in your living, you can have a less painful recovery. We know what works, we've been there:yes:.
 
I understand that you are very proud you got through a tough session. It’s a good feeling to come through a difficult situation.

But I agree with @sistersinhim that you don’t
need to do that kind of painful PT and you shouldn’t. All that kind of PT does is stress our knee and upset it and often causes a set back. “No pain, no gain” is wrong for this recovery.
https://bonesmart.org/forum/threads/myth-busting-no-pain-no-gain.14317/

At 11 days post op you should be resting, icing and elevating so your knee can heal, not stressing it with someone else’s poor idea of “therapy.”

Please don’t allow your PT do encourage you do do painful things, it is not necessary. You will heal better and with less additional pain if you treat your knee gently.
 
PT #2 appointment in the books. It really hurt this time but I did it! Clenched teeth, eyes closed pain bearing. I walked out of there much better today with a lot less pain. Graduated from using a walker to using a cane. I’m so proud of myself.
I know you're proud of yourself for being brave, but PT should not be painful. If it's painful, it's asking too much of your knee at this stage of recovery.

Pushing through the pain will do more harm than good, as it will upset your healing knee tissues, making them hot and inflamed. That could slow down recovery. Please don't allow painful PT again. It's harmful and unnecessary.
Myth busting: no pain, no gain
Saying no to therapy - am I allowed to?

Remember what we advised when we gave you the recovery reading and guidelines:
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.
At this early stage of recovery, your knee will get enough exercise, just by walking around your house.

Just in case you've been told you have to work hard to get a good Range of Motion (ROM) within a certain time, know that ROM can continue to improve for at least a year after a TKR.
Myth busting: the "window of opportunity" in TKR
 
Wow. Thank you all for your words of experience! I won’t let that happen again!
 
Day 12. Still having a lot of sleep issues. I decided to just roll with it last night. I binged watched Grays anatomy until about 2 am, and went to bed because I was ready to fall asleep. I got about 6 hours! Got up, made coffee, iced my knee then did my PT exercises. Now I’m icing again and drinking another cup of coffee. Later I plan to take a cold beverage outside to sit for awhile and just enjoy the peaceful setting. (If I can sit for a while, I have a hard time sitting for any length of time with my leg down). Maybe I’ll try the lounge instead.....
 
It’s too early to sit with your foot on the floor. Definitely try the lounge chair but if that’s uncomfortable take something that you can rest your leg up on. Sitting outside in a peaceful setting will be very nice for you.
 
I couldn't enjoy sitting with my leg down for any length of time until about 7 weeks. That seems to be quite common.
 
9/12. Woke up with a terrible headache and feeling nauseous. Cancelled PT appointment. Knee doesn’t feel bad today. Very little pain, maybe at a 2. Walked around a lot yesterday. I’m thinking that I should take it easy today and get rested. If I still feel like this tomorrow, I’m going to call my doctor.
 
I'm sorry you aren't feeling well today. I live in Texas and have horrible environmental allergies, which cause bad headaches. I hope you feel better soon!
 
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9/15. Went to bed around 1 am, got up at 7:30 am, made coffee and watched the news until 9 am. Went back to bed and got up at 1:30! I only have one tight spot on my knee remaining. It’s right over my kneecap. I’m mostly pain free! Yesterday my husband took me out for a late lunch. I sat at a table for just over an hour and my leg was so sore from it. I know that it’s healing and I am so happy that I had the surgery!
 
Wow, you are doing so well! Great job on that sleeping. You can't buy a good night's sleep.
 
9/16. PT this morning. 98/5. I have to start “hanging” my leg more so the weight of my knee straightens it more. Started exercises with resistance bands, walked up and down one step and started pulling my leg further back with a strap while doing heel slides. I’m so proud of myself for putting in 110% on healing. I’m elevating and icing now. I’m feeling totally exhausted and want a nap but my son asked me to go to the dentist with him. After that I will be home taking a nap! Yesterday I took a shower with no help and I forgot about pain meds because I didn’t have enough pain to need them! Small steps to a great recovery experience!!
 
Started exercises with resistance bands, walked up and down one step and started pulling my leg further back with a strap while doing heel slides.
Bands are a no no for a knee as young as yours is. They will cause inflammation, pain and swelling. Bend your knee only as much as you can do without pain. Using your knee normally is the best way to rehab it. As time goes on, you will be able to bend more as your knee heals. Right now, healing is your number one job.
 

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