TKR Panic after surgery<

[Booboo55]

I also almost backed out at the last minute. If it wasn't for my consultant coming into the room when he did. I would have left. After he told me about the hole in one of the bones, I knew then that if I hadn't done it, it would have had to have been done later anyway

 

[eliza61nyc]

lol @ booboo55 as much as I love youtube there are times I'm better off NOT knowing.

 

[agarrett]

Ooh big mistake! Someone suggested I do it but I'm far too chicken for that!

I watched the video a week before my surgery, I needed a little perspective. Glad I know but there are some places that wow interesting what they actually do.


Right TKR 27 December 2016

 

[lmb]

Thank goodness my surgeon does not use staples anymore. I waited until I found a Surgeon that uses the glue instead. I had a horrible experience with staples in my knee following a post op knee infection about 14 yrs ago.

 

[Laurenkate]

I had surgery the same day as you and my flexion is only 83 although it's perfectly straight at extension. Care to pass along any tips about how to get to 115 degrees in such a short amount of time? All surgeries and knees are different & this website is so helpful but sometimes I feel like a wimp in comparison. It's wonderful you're doing so well!

 

[Booboo55]

Still trying to recover and while doing exercises it feels as there is rubber bands on top of the knee and just bellow. Making exercises more difficult. When I get up have the same feeling. I know it's not quite 3 weeks yet but really getting frustrated with recovery. Have alway been a quick healer. I was walking normally after my last arthroscopic procedure. But this doesn't even feel right. I still keep asking myself if I did the right thing to have tkr done. We'll see what the physio says tomorrow as I'm starting to have problems with my stomach again taking the anti inflammatory meds.

 

[newlybionic]

You can call your GP to get some medication to help your stomach. In the meantime try to have a bit of food in your stomach when you take the Ned's.

The rubber band feeling is quite normal and is caused by some swelling within the knee. Make sure you are elevating toes above nose and use ice as much as possible.
The tight band feeling is normal. It will fade gradually, but it can take some time:
"Tight band" feeling across the front of my knee

 

[eliza61nyc]

@Booboo55 Please search my tag and read my journey (lol or anyone elses), boyfriend believe me your experience is so similar.

I too had arthroscopic surgery on both my knees, lol, compare the pain levels to taking a flight in a crop duster than getting to ride F-18. Oy Vey

Don't compare. Definitely try to eat when taking meds. I take oxycotin at night, I keep some ritz crackers on my night stand. doesn't take much, two or three with some water keeps the nausea down. good luck

 

[KarriB]

At just 3 weeks in this recovery that tight band feeling is very normal. Patience is required for this recovery as many go into it not unaware of how long it will take until you feel yourself again. My OS was very honest, telling me it would be a good 12 weeks before I'd feel ready to return to work and he was absolutely right.

You're at the beginning of this journey, in another month you'll feel a bit better about TKR, but many are still aren't happy they had it done until a few more months down the road. This is very different than an arthroscopic procedure and will take months to recover, but in the end most are happy with a new lease on life.

 

[Josephine]

I was walking normally after my last arthroscopic procedure. But this doesn't even feel right.

Well I'm sure you now realise that a replacement is vastly different to an arthroscopy! They are chalk and cheese!

I would like to offer you some advice pertinent to you but to do that, I need to ask you some questions. Would you be willing for me to do that?

 

[kneeper]

In the first few weeks you are in what many of us call the "angry tissue stage." It sounds like you're actually doing pretty well, so don't get discouraged.

 

[Booboo55]

I am an open book. Anybody can ask me anything and I'll answer the best I can.

 

[Josephine]

LOL!That's what I like - a compliant patient! So here they are ...

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine)

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?

4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[Booboo55]

1 mostly 3-4 can get up 6-7. Especially in the morning.
2 OxyContin 20mg 2x a day paracetamol 500mg 4x day ibuprofen 200mg 3x day.
3 swelling is moderate.
4 starts at 80-90 then after physio uses curapulse goes to 90-105.
5 ice first thing in morning half hour before exercises then 20 mi after exercises which I do 3x day.
6 always elevated except when sleeping. Which is another issue all together.
7 Activity level is low right now with trips to toilet and walks down hallway. Still on crutches.
8 I'm taking these from the book the physio gave me.
Sitting heel slide 10x
static quads 10x
straight leg raises 10x
lying heel slides 10x
inner range quads 10x
stretching 5min
hamstring knee flexion 10x
calf/ heel raises 10x
mini squats 10x
back against wall and squat 10x
All done 3x day

Pt just flexion and working muscle with curapulse for 10-15 min then he checks how far back I can get knee.

As far as medication goes I only took the OxyContin for a day out of hospital and stopped cause didn't like what they did to me. And ibuprofen starting to affect my stomach. Going to see go tomorrow to see if he can give something for the inflammation that is easier on stomach.

 

[newlybionic]

Paracetamol (Tylenol) is best taken four times a day with each dose being 1,000 mg. That will keep you at a therapeutic level throughout the day. You can ask your OS for a step down pain med, tram ado like, that works very well with Tylenol. You need to ice and elevate more often and for at least 45 to 60 minutes or more to bring down the swelling. I would also recommend cutting back on exercises and not doing any squats at all for a couple of more months. They are very tough on new knees.

 

[Celle]

And ibuprofen starting to affect my stomach. Going to see go tomorrow to see if he can give something for the inflammation that is easier on stomach.

Very wise of you. Ibuprofen is an anti-inflammatory and these medications can cause your stomach to bleed. Since you are already experiencing stomach symptoms, you need to stop taking it.

I see, from your answers to Josephine's questions, that you need to ice your knee for longer. You should ice for at least 45 minutes every session, - a shorter time does not do a lot of good - and ice as many times a day as you can. That, along with elevation, will help with the swelling.

 

[Josephine]

1 mostly 3-4 can get up 6-7. Especially in the morning.

I see

2 OxyContin 20mg 2x a day paracetamol 500mg 4x day ibuprofen 200mg 3x day. As far as medication goes I only took the OxyContin for a day out of hospital and stopped cause didn't like what they did to me. And ibuprofen starting to affect my stomach. Going to see go tomorrow to see if he can give something for the inflammation that is easier on stomach.

Considering you are only 3 weeks out, you really need a stronger medication but perhaps a smaller dose and back it up with Tylenol 1,000mg 4 times a day. Ibuprofen is not a pain killer as such (despite advertising to the contrary) plus it has very dangerous side effects of which you seem to be aware. So rather than getting 'something to protect your stomach' I'd recommend that you don't take them at all. Sometimes what the stronger pain meds do to us is worth it to obtain adequate pain management. Besides which, it would only be for 2-3 weeks.

3 swelling is moderate.

About what I'd expect but do remember that swelling is a form of pain.

4 starts at 80-90 then after physio uses curapulse goes to 90-105.

Okay - more on that later!

5 ice first thing in morning half hour before exercises then 20 mi after exercises which I do 3x day.

I do hope you are not letting him/her push on your leg to obtain more flexion. This is counter-productive to good progress and pain and swelling management.

6 always elevated except when sleeping. Which is another issue all together.

I can imagine. You never mentioned icing or how long and how often you elevate/ice which were parts of this question.

Activity level is low right now with trips to toilet and walks down hallway. Still on crutches.

okay

My comments in bold
All done 3x day - you'd be better doing them just once a day and none at all at the weekend
Sitting heel slide 10x
lying heel slides 10x
mini squats 10x
back against wall and squat 10x
all these are for flexion - you really don't need them all. Besides which at present you are doing 120 reps of these per day which is excessive and it's not going to improve your flexion. If you must do one, do heel slides but read this first Heel slides and how to do them properly.

static quads 10x - not necessary as your quads are not weak, they are injured and need to be treated gently!
inner range quads 10x - same with this
stretching 5min - stretching is okay though you failed to tell me 'stretching what'!
hamstring knee flexion 10x - hamstring knee flexion? That seems a contradiction in terms to me. I've had tight hamstrings and the stretch wasn't a flexion, it was an extension exercise.
calf/heel raises 10x - these are going to give you calf pain eventually
straight leg raises 10x - tip about straight leg raises, once you can do them, you don't need to do them any more!

Thing is that all this exercising is, in my opinion, vastly over done and very often achieves the opposite of what is intended. It's been our experience on this forum that a lot of people end up with lots of pains and tendinitis because of it and that when they stopped it, their symptoms abated and they improved remarkably well. I noticed that the Mayo Clinic has recently adopted this philosophy and no longer has their joint replacement patients do any of it.

You see, it's not the exercising that gets you your ROM, it's time. Time to recover, time for swelling and pain to settle and time to heal. One thing that seems to be missing from all the PT's protocols is that all your ROM is there right from the start, just waiting for all that to happen so it can show itself. In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Exercise as in strength training is counter-productive and does more harm than good. Normal activity is the key to success.

I also suggest you read this BoneSmart philosophy for sensible post op therapy

 

[Pontoon]

Mine didn't hurt either. It was a big relief to have them removed.

 

[Booboo55]

Just following advise in book that hospital gave me. It's not the pain that's getting to me. It's not being able to do things for myself. Which my partner has been very good about. (Can't stop singing her praises). I want to return to work after the 12th week. It can be a very physically demanding job at times. But used to working to get back. I used to be athletic when I was younger. That's how I hurt the knee in the first place by tearing cartridge back in the 70's. when they removed it instead of repairing.

 

[Booboo55]

We are planning on going n a trip to Spain in 4 weeks time. Hope I'm recovered enough to fly for 2hours. Without the knee acting up