TKR Please: Some advice for one week out..

[leslie01]

Again, I am so thankful! It is 2:30 am (seems to be my majic hour every night), so going to read over some of the articles sent..and was delighted to read some more posts from people..The first week, I might have iced it about 2x day, this last week I am doing way more of that..I keep the mantra in my head, rest, ice, elevate...and in between there I do the exercises. I am off to the physio tomorrow..she had me scared last time as the swelling was so bad my movement was not good..The swelling has not gone down much and I do the exercises as best I can..hope that is good enough.
Thanks again to everybody here..so appreciative..

 

[bottomshollow]

DO NOT be scared. If your knee is still pretty swollen and won't bend much----then don't bend it more than it will bend. Remember that your therapist works for you----not the other way around. It's YOUR that's insurance that is paying the bill. All you can do is the best you can do----but DO NOT allow the therapist to cause you any pain---that will only make the knee angry and it will swell even more.

It may be that you need to stop PT for the time being until you can get the swelling down and keep it down most of the time. You have plenty of time for PT. Remember, this recovery takes up to 12 months and for some slow healers even longer.

You can't rush things no matter how much you want to. The knee is in charge, and I can assure you that it WILL NOT be rushed. Pushing too hard almost invariably leads to longer recovery time. So just take it slow and easy.

And the not being able to sleep in the wee hours of the morning is very common for the first couple of months after surgery. Here's a link to an article from the library about that:
so pleased you have joined us here on the forum. I am going to give you links to articles from our Library that are essential reading for anyone who has had or is planning to have a THR: Sleep deprivation is pretty much inevitable - but what causes it?

Take care and keep us posted. We care.

 

[leslie01]

Three weeks today! Therapist feels I should have a better range of motion..Getting to 65 (I think she said)..Should I be worried?? I do all the exercises faithfully and push myself when I do them...

 

[leslie01]

Three weeks today! Therapist feels I should have a better range of motion..Getting to 65 (I think she said)..Should I be worried?? I do all the exercises faithfully and push myself when I do them...

Could somebody give me some advice! Please. Not sure if I am posting on the place where people would see it..
I am not moving from 65 - 70..One month today..There was talk of a manipulation..What to do to make this knee bend..? Should I be worried, or will it come? HELP??

 

[leslie01]

Anybody hear of a Dynasplint? Good, not so good?

 

[bottomshollow]

Josephine, I think this member could use some of your wisdom and attention.

 

[Josephine]

Leslie, at so short a time out, only 4 weeks, it's far too early to be getting fretful about your ROM.

First tell me some things about your present condition:
1. what medications have you been prescribed, how much are you taking and how often?
2. how much pain are you experiencing right now - on a scale of 1-10?
3. how swollen is your leg/knee? Hugely swollen, moderately swollen, slightly swollen
4. how often are you icing your knee?
5. how often and how high are you elevating your leg?
6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and PT?

When you've answered these questions, I will come back and answer ....

 

[Creeker13]

Hi Leslie.... I am at 4 months post RTKR and just about to return to work. I spent the first month in my bed with my leg elevated and iced, getting up only to go to the bathroom and wander out to the kitchen for lunch or a snack. In the second month I moved back into the living room by day and bed at night or when I was too tired to deal with life.
I have had an easy (if that is possible ) recovery compared to many of the other Bonesmarties. I think the key was not doing much, let alone too much. When my knee felt stiff from one position I flexed it and streched it some before finding another position.... no weight on it... less stress to cause it swell more. I believe this helped with my range of movement numbers. Relax and let the new baby in the house (your new knee) rule. If you have some where to lay with your leg up a wall it helps a lot with the swelling. Less swelling, better numbers. At about 6 weeks I found that moving around some, not overdoing, would help get the swelling in my whole leg down but would backfire if I did too much. The swelling would get worse. Everyone is different.... listen to your body.... it will tell you what you need to do.
Check out other members posts for the information and experiences with manipulation under anistetic, MUA, or any other questions you have.... 'search' will help you there, it can hook you up with just a key word of the info you need. There is always someone who has or is going through the same thing.
If you follow the BS Mantra... rest, ice, elevation and pain meds on schedule.... Things will get better. Some times it will seem like forever but it will get better.
Take care of yourself.

 

[bottomshollow]

Creeker! I just love a real live BoneSmartie mantra follower who has had a relatively easy recovery because the believed in and lived the mantra. It does work and you are living proof. You make a great role model---sure hope our other members can fall in line behind you.

Take care and keep us posted. We care.

 

[robynhood]

Hi Leslie. Welcome to Bonesmart. 4 weeks out is really early in recovery and Im sure a lot of people would agree its too early for MUA yet. Give your knee a chance. You wont get a good bend if your are swollen. Best thing you can do is stop worrying, keep icing anf elevating and just taking it easy. There are a lot of people as Joy said that have had MUA and Im sure they will share their experiences. I spent the first few months post op just going thru all the threads reading about different experiences and it really does help. Take care

 

[Recycled]

Leslie, call the Doc and tell him your coming in to see him.........and your bringing a 50lb sledge hammer which you will procede to pound on his legs till he can't walk. But not to worry because you brought the tylenol 3 with you. No really.....call him....express in no uncertain terms you must have stronger pain meds. If he refuses......make an emergency appointment with a Pain Specialist. There is no reason for you to be in that much pain and Tylenol 3 is useless for this.

 

[leslie01]

Thank you so much for all the care and the feedback..I am almost to the point of depression..can feel it in my bones..I am going to answer the questions that Josephine asked me:
l. I am taking hydromorphone 2mg. before bed and during the night. I usually wake up once in the night, sometimes twice depending on pain level and take it. I take tramadol 37.5/325 mg during the day if needed. I seem to need it in the evenings about 6 to get me to bedtime..
2. When I do my exercises (trying to get the bend), I am at about a 12 in terms of pain..my therapist said that I had to push myself to the point of tears to break down the scar tissue, so that is what I am doing..
3. My knee measures 20 inches around..I would say that is moderately swollen, only because it has gone down some from before. If I compare to the other knee, then it is quite a bit larger..
4.I do my exercises every 2 hours or close to it. I ice after every exercise session, so I am icing 5 times a day or so..
5. I elevate my leg when I am icing it..My toes are higher than my head, but not much higher..I saw somebody said to lie on the floor and put my leg up a wall..is higher the better??
6. My activiity level is such that I am concentrating only on the PT. I have not tried to do housework of any kind..I have tried to concentrate on getting better..I do my exercises first thing in the morning, ice and elevate...read, watch tv, do my exercises, ice and elevate, etc.

Thankyou to everybody who cared and wrote..
Has anybody heard of Dynasplint? Knee flexion one is supposed to help with range of motion..but expensive to rent..worth it if it would keep me from a manipulation..Hoping that I am worrying too early..Will wait for a response ..Thanks Josephine..

 

[Poof]

Hi Leslie, I'm at day 10 of my LTKR. The pain for me is also so much worse at night. The PT asked me to go back to the doc and let him know how I am feeling. The OS calmed my fears that there was no infection. He also prescribed a time-released pain killer to take in addition to my other meds. I just started that, so we will see if it helps. He also suggested moist heat before excercises and ice after. I'm also a side sleeper, so I feel your discouragement with getting any sleep on your back. I was told to try and sleep with a pillow between my legs when sleeping on my side. Sometimes it feels ok and other times I can't tolerate it. It helps me to try and remember that this pain is only going to be temporary and we will feel better down the road. When I'm having the hysterical crying jags, I try to do some deep breathing to calm down. I could really feel your pain when I was reading your posts. Just remember, you are not alone. There are a lot of us feeling the same things and want to help. Vickie.

 

[speccybecky]

It was weeks before I could sleep on my side, even with a pillow. I could get to sleep but would waken up in pain. I had to try and turn over before I could straighten my leg out. It did get better.

 

[kneeper]

Hang in there leslie. No need to panic about your ROM. Good for you for not doing housework at this stage. Sounds like you are icing throughout the day, but could probably do more. Keeping your leg up and ice on just about whenever you're not moving will help with the swelling. As someone else said, the swelling will impede the knee from bending no matter how much you try. And that just takes time. Pushing to the point of tears is not good. A bit past your comfort zone is ok.

 

[leslie01]

kneeper, thanks! I need to try to get my leg higher too! Off to ice..I gained some ROM - went from 75 to 85..more to go, but it is mildly encouraging..so painful tho as my swelling is still quite apparent..

 

[Josephine]

Leslie, you don't need to quote a post to reply to it. Just scoot on down to the bottom of the page and make your reply in the box.

 

[referee54]

gained some ROM - went from 75 to 85..more to go, but it is mildly encouraging..so painful tho as my swelling is still quite apparent..

Progress may be slow---but it is progress, all the same!! 10* is quite a victory in this case---we fight these battles and win by slim margins---but eventually those slim margins turn into one HUGE victory!!!


Hang in there---patience is required, and you are making definite progress!

 

[Josephine]

l. I am taking hydromorphone 2mg. before bed and during the night. I usually wake up once in the night, sometimes twice depending on pain level and take it. I take tramadol 37.5/325 mg during the day if needed. I seem to need it in the evenings about 6 to get me to bedtime..

That's nowhere near enough. Take it as prescribed which is most likely 4 hrly. And that dose of Tramadol is pathetic. Even two tablets would be only 75mg. I was taking 100mg four times a day with 1,000mg paracetamol (Tylenol). No wonder you are in so much pain.

2. When I do my exercises (trying to get the bend), I am at about a 12 in terms of pain..my therapist said that I had to push myself to the point of tears to break down the scar tissue, so that is what I am doing..

Oh please don't do that! She couldn't be more wrong. Making yourself hurt causes the tissues to become hot and angry and sticky instead of nice and moist. That's the best way to get adhesions. Only ever go to the point of discomfort and not one jot further. Read the article Myth busting: no pain, no gain.

3. My knee measures 20 inches around..I would say that is moderately swollen, only because it has gone down some from before. If I compare to the other knee, then it is quite a bit larger..

With all you've told me, I am not surprised! Inadequate pain meds and hurting yourself. Of course it's going to swell. And the swelling is the only thing that's limiting your flexion. Did you read those articles Jamie left for you in post #10? Especially this one which explains it all Swollen and stiff knee: what causes it?

4.I do my exercises every 2 hours or close to it. I ice after every exercise session, so I am icing 5 times a day or so..

Far too much. Do them twice a day tops. You really don't need any more than that and certainly not if you are going to get your pain and swelling under control.

5. I elevate my leg when I am icing it..My toes are higher than my head, but not much higher..I saw somebody said to lie on the floor and put my leg up a wall..is higher the better??

Much is made of the 'toes above nose' but it's not really that crucial. As long as you foot is higher than your hip so the fluid has an angle to encourage drainage, that's all you need. The key is to rest, elevate and ice for a couple of hours at a time.

6. My activiity level is such that I am concentrating only on the PT. I have not tried to do housework of any kind..I have tried to concentrate on getting better..I do my exercises first thing in the morning, ice and elevate...read, watch tv, do my exercises, ice and elevate, etc.

Concentrating on getting better is resting, not killing yourself with exercises! Exercise gently twice a day for 20-30 mins and spend the rest of the time resting and all that goes with it. Every hour or so, get up and take a little walk around the house or out into the garden (assuming it's appropriate weather!).

And READ THOSE ARTICLES!

I'll check back to see how you are doing. I bet in one week you will be a different person and your swelling will have reduced and your flexion increased.

 

[referee54]

2. When I do my exercises (trying to get the bend), I am at about a 12 in terms of pain..my therapist said that I had to push myself to the point of tears to break down the scar tissue, so that is what I am doing..

I agree with Josephine---PT should never take you to the point of pain---and #12 is absolutely unacceptable. Go only to the point of discomfort and no further! Tell the PT to push herself out the door. Remember---it is not, "No pain, no gain" , but rather, "no pain, more gain."

Do not try to work harder---work smarter. Hard work on PT will not reap benefits---it will only bring frustration and more pain and swelling.