PKR partial knee replacement x2, swelling<<

[Jersey Steve]

I am 7 weeks post surgery for a right partial knee (Makoplasty). Your experience sounds very familiar to me, and I had most of the problems that you describe. If you take your meds, ice, and elevate, you'll get through it. I had good ROM from the start. I started driving soon after the staples and stitches came out. I went back to work part-time after 3 weeks, full-time after 5 weeks. The knee is no longer painful, but it gets stiff if left in one position too long. I still have minor swelling in the evenings.

I can tell that this knee is going to be great. I can do things already that would have caused me agony pre-surgery. Hang in, and it WILL get a lot better.

 

[xyxex_kayn]

To me i had a setback today. Basically all i have done today is walk to bathroom with a walker and sleep all day. But i sat in a a different recliner today to see if it would work better for elevation of my leg and icing it. This recliner sits lower and is a regular recliner were my other is a lift chair. So the problem i had was getting up and out of this different recliner, it caused a pop and a shot pain to go through my knee.

So now i have a TENS unit going to help with the pain, it helps for a bit atleast. I know the elevate, ice and rest mantra to help with the swelling and pain issues. The nurse gives me a look like im lieing to her and everyone here may not believe me. When i go to bed at night or if im reclining in the recliners i try to keep elevated and iced. But, my legs all the way done to my foot will swell and start hurting more and i get a burning sensation underneath the ice pad (have something between skin and pad) and i will have to sit normal with feet on the floor to releave the pain in my knee and will also reduce the swelling.

Im at a lost as to why it seems to work in reverse. im not going to stop elevating or iceing, but damn if i can understand what is going on. i am walking more and walking better so that is good. I just had second surgery scheduled for Feb 3 2016. so hopeing over the next month there will be dramatic improvements. and have another week before they remove the zipline over surgical site.

Just going to keep my head up, but feeling frustrated

 

[newlybionic]

Don't get frustrated. It seems like any little thing we change can seem to cause a problem especially early in recovery. You've got to find the best position for your leg to feel comfortable. Try using a different combination of pillows in different positions. It seemed what worked for me for a few days would change and then I had to figure it out all over again. It's great that you're walking better. I hope the pain you felt subsides quickly and you can get some sleep.

 

[shrdlu]

Everyone in PT (when I did the first knee) was sleeping in their recliner for 2 weeks to as long as 2 months. Laying in a bed was difficult, as you tend to try to roll over (which the knee objects to) and it is hard lifting the knee in and out of bed. I have a foam cushion that I used on the recliner's foot rest to help with the pressure that the footrest was putting on my calf. (On the lift recliner, the foot rest is angled and uncomfortable). And most recliners have too much bend in them from the seat to the footrest, so the cushion helps make the foot rest more in line with the seat. Then I have a foam wedge on top of the cushion for elevating. I figured out that I needed to elevate (at a minimum) twice as much as I was standing up or sitting. If the leg was bent (sitting) or if I was standing, then the knee would swell quickly. So if I got up for 10 minutes to fix a sandwich, then I would expect 20 minutes or more of elevation to counteract that. Anytime I stood or sat with the knee bent, I could feel it swell. Swelling = pain. Swelling = less bend. And if my knee was too swollen, then when elevated it would also hurt while it was draining. For example, at one month post surgery, I had to take my daughter to the next town for oral surgery. I was out all day, but was able to place the leg on a couch (but I was not able to elevate). The end result was a very swollen knee that took about 2 days elevation and icing to reduce the pain and swelling. The first month, the knee would swell at the drop of a hat. At 2 months, the knee quit swelling quite so fast. At 3 months, it would still swell slightly after driving or walking, but it wasn't too bad.

The first week after the PKR, I took pain meds around the clock. The second week, I realized that I was forgetting to take them until I only took them at bedtime or before physical therapy, as the pain level had gone down (unless I was up on the leg too long). I had a partial 6 months ago and then another partial a few days after your surgery date, so if any of this helps with what to expect...
YMMV, of course.

 

[Maddi's Eeyore]

@xyxex_kayn, I can really relate to the struggles you're having and the worry it's causing you. Hang in there, you are doing all the right things and it will get better. i found the pain quite manageable but the swelling was a going concern all the time. Rest assured, the swelling is normal (and frustrating!). I'm 5 weeks out from a bilateral TKR and am still battling the swelling by late afternoon/evening. But I found a couple of things that made a complete difference for me in starting to reducing the amount of swelling and also deal with pain and swelling overnight. Maybe the same things will work for you.

1. It sounds weird, but wrapping your knee in cling wrap (yes, like Saran Wrap) at night is amazingly effective! Here is a bonesmart link to the video that explains how to do it and why it works. I suspect part of why it works is also because it's applying gentle compression which really does help. It doesn't hurt your scar and the first night I did it I slept like a baby! I've been doing it every night since I found out about it around week 2 and swear by it:

https://bonesmart.org/forum/threads/night-pain-solutions-using-moist-heat-and-clingfilm.12794/

2. Compression is the other BIG key to helping with swelling, I found. My docs don't use compression so it didn't occur to me at first. Then I started reading protocols from various other hospitals and several mentioned that they send patients home with Ace Bandages to apply compression. So that is what I did. I used two bandages on each leg, one slightly below and one slightly above the knee (leaving about an inch free so I cold still bend it ). I wrapped them snugly but was very careful not to wrapp so tight that it affected my circulation. What a difference! I started this a couple of weeks ago and now after 5 weeks since surgery and a couple of weeks wrapping my knees, I can feel the difference in such a big way. I was nervous about doing it at first because I'm a "play by the rules" (most of the time!) kind of person and my doc had not told me to do this. But I reasoned that if doctors in other hospitals are sending the Ace bandages home wit h TKR patients, that it is clearly simply surgeon's personal preference. (Aside: I prefer the sports wraps as they are self adhesive and seem to apply a much nicer compression). I put them on first thing in the morning when the swelling is the lowest as that is the most effective, and leave them on for most of the day and then cling wrap at night!

Between these two tricks I am now able to bend my knees, am seeing the swelling get less every day and am sleeping well. But of course this is what worked for me, through trial and error you will find what works for you. What everyone is saying is true, the first couple of weeks are the hardest and the worry factor was huge for me. My leg was literally double its normal size and the swelling went from thigh to foot. But after a while, you will begin to see some of the improvements coming day to day and you'll start to feel better about it. You start to see that things are working, that you are improving and then one day you realize that you're really ok and it's going to work out. It just takes time and you working it in your way, with what feels right to you. I will echo what everyone is telling you here as well, don't worry to much about the other exersises that are not done in bed right now. It's impossible to bend when swelling is such an issue. Once the swelling goes down you will be able to bend.

Sorry for the long message, I might have gotten a bit carried away! Lol. Wishing you the best of luck and the gift of patience and peace.

Jackie

 

[xyxex_kayn]

It's great that you're walking better. I hope the pain you felt subsides quickly and you can get some sleep.

its taking its own sweet time to subside, to get it to subside i have to sit on the side of my bed. like i said earlier, if i elevate and ice, my legs swell and if i have them down the swelling and pain subside. very odd.

The first week after the PKR, I took pain meds around the clock. The second week, I realized that I was forgetting to take them until I only took them at bedtime or before physical therapy, as the pain level had gone down (unless I was up on the leg too long). I had a partial 6 months ago and then another partial a few days after your surgery date, so if any of this helps with what to expect...
YMMV, of course.

im taking pain meds around the clock, but sometimes i think im taking to much, one of the reasons i think i was sleeping so much today, but then on other days, i forget to take them on a timely manner or forget when i actually take them. With not have a good sleep routine yet i think is contributing to my problems on when to take my meds. Hoping i get this under control because i have next knee done feb 3,

 

[shrdlu]

Hi! Make a chart for your meds. Write down when you take them. I have the same problem with forgetting, as it is all part of inevitable sleep deprivation. And since I know that I can take up to 2 of the pain meds, I also stagger them, if needed. So, for example, take one pill at noon, take a second at 3pm (if the dosage is every 6 hours), then a third at 6pm, etc. This means that I don't feel the last pill wearing off before the new one kicks in. (Check with your doctor's office as to the dosage you can take, as you probably have different meds than I do.) If you aren't allowed 2 pills, you can do the same thing by taking 1/2 pill, then wait 2 to 3 hours and take the second half. Wait 2 to 3 hours and take another half....etc. This means that you have a full pill dosage in your system, but with the half pills overlapping so that you don't feel the meds wearing off before you take the next half pill. (Legal disclaimer-- I am not a doctor and this is not medical advice.)

I have found that I naturally forget to take the pain meds when I don't hurt that much. So they are decreased naturally and without any withdrawal symptoms. You know your own body, so if you have had the meds before without any problems, I wouldn't worry too much about taking them the first week or two.

 

[xyxex_kayn]

yeah i tried the chart and forgot it to as for the meds i have alot to take, some that dont anything to do with the surgery two that i took for pain before the surger and two they gave after surgery and told me to take three as prescribe and one to bridge: since im never truely out of pain that bridge one doesnt make senses

the following is the pain meds and directions

Oxycod/apap 5-325mg 1 to 2 tablets every 4 to 6 hours as needed for pain
Oxycodone 5mg 1 to 2 tablets every 4 to 6 hours as needed for breakthru pain
Also told to resume my current med list the following are for pain and inflamation
Tramadol HCL 50mg 1 tablet every 4 to 6 hours as needed for pain
Meloxicam 7.5 ng twice a day as need for pain

and with all that im still in pain,

 

[skigirl]

It is frustrating to work on pain meds---I think you need help from your doctor's office. sometimes one pain med will work better than anther. For instance, my husband is morphine resistant and only Diluaded works on his pain. I use Percoset--hydrocodone (5/325) post surgery.

I switched to Tramadol and Tylenol 3 at about one month. If you need to take the pain meds regularily and it seems you do since you are in pain, try setting the alarm on your phone so that you don't forget. There are some apps to help you take pills.

 

[shrdlu]

Your pill for breakthrough pain is doing what I am doing with staggering the hydrocodone. I only have hydrocodone 7.5/325APAP and aspirin (for blood thinning) for pain. The good news is that after you get through week 1, then sometime in week 2 you will realize that the pain is not quite as bad as it was just a few days ago. But with my knee #1, somewhere at the end of week 1 (about where you are currently), I was thinking that the pain would never end and that I was so tired of it all. So hang in there. It is just a waiting game until the pain begins easing off a bit and you can see that there really is a light at the end of the pain tunnel. (As you see, it is 4am and I am awake again. My ice melted and the pain pill wore off.) So don't worry if all you do is sleep in short bouts and sit and only get up for the bathroom-- that is normal for this stage. Your body is putting all of its energy towards the knee right now. Give yourself permission to just do nothing for the first month.

 

[xyxex_kayn]

I switched to Tramadol and Tylenol 3 at about one month. If you need to take the pain meds regularily and it seems you do since you are in pain, try setting the alarm on your phone so that you don't forget. There are some apps to help you take pills.

i spent 30 minutes last night, well early this morning setting up alarms on my phone, so will see how it works

sometime in week 2 you will realize that the pain is not quite as bad as it was just a few days ago. But with my knee #1, somewhere at the end of week 1 (about where you are currently), I was thinking that the pain would never end and that I was so tired of it all.

yeah i understand this part, the only problem is i think i might have injured my knee. sat in a different recliner that happens to sit lower than my normal one(lift chair for ease of getting out) and trying to get out of this other recliner and had to put pressure on the new knee, was a sharp pain in the joint has been really bad pain since. i can still walk, but when sitting and have knee bent it tends to hurt more and pain radiates down the leg

 

[skigirl]

it is most likely that you have a soft tissue injury. So, rest, elevation and ice are the solutions===sounds like a broken record doesn't it!

 

[xyxex_kayn]

it is most likely that you have a soft tissue injury. So, rest, elevation and ice are the solutions===sounds like a broken record doesn't it!

and i keep doing rest elevation and ice.

Even though i had a TENS unit. my doctor had ordered one the came in today. This one had better directions with it and actually had legible writing and pictures on how to place the electrodes. so with that in mind im using the TENS unit right now the correct way, we will see if it works any better for pain relief and soft tissue healing

 

[SuperSnapper]

Hi, you do sound very fed up but as the others have said it is very early days for you yet.

I had a partial over a year ago ( it is absolutely amazing!) but about a month ago I thought I had a big problem with it but it was only a soft tissue problem causing a sharp pain behind my knee. I was really worried for a few days but with a bit of rest and ice, the knee recovered and I am absolutely fine now and back to forgetting I even had a new knee! It's that good We are off winter walking in the snow in Austria on for a week so that will really test it out!

Even at a year after, you can still have the odd niggle. So please don't lose heart. With time, rest, meds, elevation icing and minimal exercise your knee will recover and in a few weeks you won't believe how much you have improved. This site is really good for information and support and the odd shoulder to cry on too.

Best wishes for your recovery and a Happy New Year!

 

[xyxex_kayn]

Even at a year after, you can still have the odd niggle. So please don't lose heart. With time, rest, meds, elevation icing and minimal exercise your knee will recover and in a few weeks you won't believe how much you have improved. This site is really good for information and support and the odd shoulder to cry on too.

even though i sound like a old whiney man, its because i do have worries about getting back to work, after going thru four months of no paycheck and almost losing everything because of health issues, i tend to panic when it comes to that. As for support, i definately get that from this group and glad i came across it when i was looking up information on recovery.

I should have some fun in a little when the PT shows up, found out she will be here tomorrow as well, which i think will be to much if i cant get her to back off if things hurt. But after calling my Doctors office today to get information as to how to actually use the TENS unit they ordered for me, and getting the equipment rep to call me to explain everything to me as to settings that i should be using and the placement of the electrodes. I will have another way to help rid my self of pain and swell.

One setting will be use on the muscle above the knee, to help strengthen it, has same affect as doing one of my excerises (leg lift) were i adjust the juice where im comfortable, and i do it 2x a day for 30 minutes

the second setting will actually be a TENS setting for pain relief, and its done as often as needed for pain. and after doing excerises i can attach the electrodes around my knee to box it in and then use my Polar care cube at the same time to get even more relief from pain and swelling,

so will get to find out how this all works out starting after PT puts me thru the paces. Going to try and do as little as possible of that if they get painful.

 

[SuperSnapper]

I found ice, ice and more ice was the way forward for me. I also found TENS helpful. Hope your PT goes well but don't let anyone cause you pain.

 

[skigirl]

Really, the PT works for you---after all you are paying the bill. If you don't like what they are doing, just tell them to stop. You are the employer and they are the employee.

 

[ljm]

I haven't read all the replies, but I had a PKR 3 1/2 years ago. From what I have learned here and from my personal experience, the doctors don't give you realistic recovery times. They told me 6-8 weeks, and when 6-8 weeks came and I was still in pain and stiff, I thought something was terribly wrong and I was very depressed. I found this forum and was relieved to hear I was normal. Sleeping was a big problem, which it seems to be for many. My family Dr. finally prescribed some ambien for me. It took a good 4 months for me to feel like I could really start to have my normal life back. I feel great now and I'm so happy I had the surgery, but I am not like brand new. Knee replacements are not promised to be like your knee was in your 20s. There is still some stiffness at times when I over do, and a slight pain that is very brief from time to time. I would absolutely do it again, but next time I would know what to expect. I found ice and elevation as much as possible was the best thing for me to relieve swelling and pain. I made more progress when I was more gentle with therapy. Even after stopping therapy, my degree of bend improved over the year post-op. Good luck to you...you will be fine. Just realize that this is something that takes time.

 

[xyxex_kayn]

7 hours after some PT excersises, nothing caused pain nothing excessive. Elavated my leg, used tens unit and ice pack 2 and 4 hours repectively, and my leg and foot is more swollen and in pain than it has ever been. sorry about complain so much, but damn, seems like nothing is helping with the swelling

 

[SuperSnapper]

Your swelling is because you had bones sawed and hammered and flesh cut and stitched only 10 days ago. I did not do any PT at this stage but just simple heel slides and walking round the house for a couple of minutes every couple of hours. That's pretty much what I did for about 3/4 weeks. The rest of the time I just rested iced, elevated and took painkillers. I know you said you were worried about returning to work but you cannot rush these early days. @ljm is quite right about surgeons' unrealistic expectations. This all takes time. I had a really good recovery but was very cautious about doing anything in the early days and I think it really benefited my recovery.

I do feel for you, it is frustrating but it won't last for ever.