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[TKR] POCTDB recovery thread

Discussion in 'Knee Replacement Recovery Area' started by Poctdb, Jun 23, 2019.

  1. Poctdb

    Poctdb member
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    I am posting a bit early as surgery is tomorrow. I just want to have this bookmarked....sometimes my technology skills are lacking....but with drugs on board..HA! I am taking no chances.
    Thanks to all for the information. I am looking forward to June 24.....especially since I have all of you with me.
     
  2. Benay

    Benay graduate

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    Sending good thoughts, see you on the other side :welome:
     
  3. Lucy1

    Lucy1 junior member

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    You'll be in my thoughts as well tomorrow and will see you on the recovery side on Wednesday. L
     
  4. TimeBuster

    TimeBuster member

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    Sending thoughts and prayers your way. Good luck tomorrow see you on the other side.
     
  5. luvcats

    luvcats senior

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    Break a leg!
    Wait, no, wrong forum. lol
    Good luck and see you here soon.
     
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  6. dogwalker2

    dogwalker2 member

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    Sending healing vibes and good thoughts your way xx
     
  7. Celle

    Celle FORUM ADVISOR Forum Advisor

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    Here's an advance copy of your Recovery Reading:
    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 a 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 history before providing advice.
     
  8. Poctdb

    Poctdb member
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    An eventful 36 hours. The surgery went well after the insurance authorization was located. (90 minutes) The leg was corrected to normal from 27 degrees valgus.

    Everybody visited (OT, PT, case worker) while I was still stupid from the anesthesia. So about 3 hours later, I recovered enough to track mentally. 90 degree bend without nerve block while sitting. Probably 3 degrees extension. All guesses, no measurements.

    Today, first day post op pain is at about a 6. Walked 200 feet and the OS came in. The OS says “ you will do the blue block extension 20 minutes 3xday.” PT then assisted me with some exercises as I can’t lift my foot off of the chair but can do the motions after that.

    Then the blue block extension exercise. I lasted 10 minutes and was crying. I tried to sleep, no go, and then had to go to a class for safe ADL. The PT wanted to do the exercises again. I told him not now but maybe later as I was not leaving in the next 20 minutes.

    The nurse calls the pain doc for drugs for breakthrough pain. A shot of Toradol and the pain was at a 7. The pain rehab doc comes in and tells me that if I do not do the exercises today that the knee will be stiff and unusable. They do this all the time and this is how you get a useable knee. He said that he did not mean to sound unsympathetic but the blue block is brutal but has to be done. The meds were changed and given.

    20 minutes later my phone rings, a case worker from the OS office. She is sorry I am having a hard time and she will talk to the OS.

    I am supposed to go home tomorrow. The OS is coming to talk to me prior to that. And the blue block is going home with me.

    Wow...
     
  9. jeffjob

    jeffjob junior member

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    I am amazed (and upset) when I read these stories. I just had two TKRs done in the states and never had pain levels near a 7 while in the hospital and no one threatened a stiff leg if I did not do exercises, extension or not. Yes, I was encouraged but never felt threatened.

    Once I started outpatient PT I had a therapist that started that mess with me and he was no longer allowed to work on me. This was after he tried to push my leg, telling me I can do better then that. Well, the whole rehab center heard me tell him to not touch me. Speaking to my better therapy people even they admit there are still some old school inconsiderate and misinformed people around.

    None of your PT should bring you to tears, unless they are tears of happiness!

    Hang in there and stand up for yourself!
     
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  10. winemama

    winemama senior

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    Be your own advocate, Drs are not gods. You know what is best, and people here to help. Sending you good thoughts from Ohio USA
     
  11. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    I’m sorry your hospital medical team is so pro exercise and their way only.

    It is your knee and as hard as it is to say no to your medical team, you do have that right. I would struggle with that, too, but hopefully I’ve been a part of Bonesmart long enough to defend my knee. I also suffered a lot of set backs from my PT and I won’t allow that to happen again.

    Once you are home you will be totally in control. Especially with any PT who comes to your home. Don’t allow them to do anything you don’t want them to do.

    I would probably comply and bring that blue block home with me but it wouldn’t get used or kept.

    One of my favorite mantras I learned here is:

    It’s not exercising that gets our range of motion back, it’s Time:

    Time to recover.
    Time for pain and swelling to settle.
    Time to heal.

    Our range of motion is right there all
    along just waiting for 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 in the early weeks does more harm than good. Normal activity is the key to success.
     
  12. newpartial

    newpartial junior member

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    It totally dumbfounds me that you medical team say thing like if you do not do this you will not get a usable knee. By that comment do they think that all the OS and PT around the world who use gentler techniques are churning out numerous patients that are hobbling around for the rest of their lives!!! My team OS and PT are very much a gently gently approach (pretty much the BS way) and they have even had people run marathons after TKR so I would drive past the dump and pop the ‘blue block’ there on your way home :).
     
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  13. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    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:.
     
  14. Poctdb

    Poctdb member
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    I am now home and can’t get comfortable. My left hip hurts and my knee and quad are so swollen it feels as if they are encased in a lead pipe. I can’t lift my leg as of yet.
    Of course PT is coming tomorrow and the OS said Blue block 3x a day for 20 minutes in the discharge information.
     
  15. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    I couldn’t lift my leg myself for a couple of weeks. Without “working on it” I was able to lift my leg with no problems as it healed. Don’t worry about it and don’t let anyone pressure you about it.

    You don’t have to use that block if it makes you uncomfortable, no matter who tells you to. It’s only your surgeon’s personal opinion that you should use it. Use your common sense about what you do or don’t do.

    You are allowed to postpone/cancel PT appointments if you are not up to it. I sure wish I had known this back then. Not only did I have PT 48 hours after surgery, but I had to go to an outpatient facility for it. :doh:That won’t ever happen again.
    Saying no to therapy, am I allowed to:
    https://bonesmart.org/forum/threads/saying-no-to-therapy-am-i-allowed-to.36688/
     
  16. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    I’m going to ask @Josephine to advise you.
     
  17. Celle

    Celle FORUM ADVISOR Forum Advisor

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    I've never heard of the blue block extension exercise. Please will you explain?

    What he said was a load of rubbish. Try not to take any notice of it.

    In spite of what you were told, there's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
    Myth busting: the "window of opportunity" in TKR

    In any case, it's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.

    This is your knee and you are the only person with the right to say what will happen to it. Your surgeon has done your operation, but he/she doesn't own your knee. He/she can recommend what you do, but you have the right to choose whether or not to accept that advice.
    Saying no to therapy - am I allowed to?

    Since the blue block exercise causes you so much pain, don't do it.
    Your knee is wounded and it needs gentle treatment, so it can start to heal. Remember the advice given to you in Post #7 -
    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.

    Myth busting: no pain, no gain
     
  18. Poctdb

    Poctdb member
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  19. Poctdb

    Poctdb member
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    @Celle the blue block is 24” by 18” (approx) with a foot sized square cut from the top. On your back, you place your foot in the square and leave it there for 20 minutes 3 x per day. Theoretically, it is to get you all the extension that you have.
    I would take a picture of it but I have called it ugly names and have thrown it in the corner.....
     
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  20. Celle

    Celle FORUM ADVISOR Forum Advisor

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    Thank you for explaining. It's an instrument of torture.

    No
    extension exercise should be continued for 20 minutes - only until you feel pain, then it should be stopped.

    Get home as soon as you can, and then you can do thin gs as you want to.

    I know it's hard to get your own way in hospital, but hold firm and don;t allow yourself to be persuaded into thsi torture.
     

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