TKR Post surgery - Finally!

[Layla]

Hi there,
It is good reading that your pain has eased, your sleep has improved and you're feeling more clear headed. Those are great milestones at just eleven days post op.

I think its common to see flexion drop in this early stage of recovery. There's swelling and stiffness that do limit flexion. Hopefully you're icing often in an effort to control the swelling. You're doing really well and you seem motivated to get back full strength, but sadly we can't push it, especially this early on, doing so can set things back rather than help. Jotting it all down may help you realize you're doing more than your knee can handle, like walking, exercises, even the little things like getting up and down, making meals or moving around the house count as activity. Give your body the time it needs to heal now, so you can do more later.

A great week to you, BarabooProud!
@BarabooProud

 

[BarabooProud]

I definitely ice often. I do, however, wonder if I'm doing more than I realize I'm doing.

 

[Jamie]

That’s certainly possible. If you record a typical day here, we can help you adjust the balance between rest and activity/exercise.

 

[Layla]

however, wonder if I'm doing more than I realize I'm doing.

Listing activity can be useful. Normally swelling that increases after activity or lingers longer than before is a good sign that you're pushing it. Minimal discomfort is expected, but pain that ramps up post PT, or activity, often indicates you're doing too much. You don't want pain interfering with rest or sleep either. If it does consistently, you likely need to scale back. Thankfully you mentioned you're sleeping better these days.
A great Tuesday to you!

 

[BarabooProud]

So I kept track of my activity today. This is pretty typical, although there have been a couple of days that I probably did a bit more, but not much more. I was on day 12 today. Is this too much activity?

5:30-6:20 - Get up, ice, leg up
6:20-6:30 - make breakfast, take meds
6:30-7:15 - rest, ice, leg up
7:15-7:35 - PT exercises
7:35-9:05 - elevate, ice, nap
9:05-9:17 - walk driveway and get ice
9:17-11:20 - rest, elevate, ice
11:20-11:50 - lunch, empty dishwasher
11:50-1:00 - rest, elevate, ice
1:00-1:20 - household chores
1:20-2:16 - elevate, ice, rest
2:16 - 3:07 - PT exercises, household chores
3:07-3:30 - rest, elevate, ice
3:30-4 - cook dinner
4:00-5:30 - rest, elevate, ice
5:30 - 6:00 finish cooking dinner and eat
6:00 - 8:00 - rest on couch, elevate, ice - up and down several times getting things and letting dog out
8:00 - bed, elevate, ice (continue to ice and elevate throughout night)

 

[Jamie]

Yes, it’s too much. Even without you listing what your exercises consist of, you are up on your feet way too much for this early in your recovery. This is hard on a new knee and can give you pain and swelling.

Does someone else live with you or who could come by and help with household chores that absolutely must be done? Leave the ones that aren’t mandatory for later in your recovery.

Are you really “cooking” dinner every day or just heating things up? This is the time to rely on frozen meals or takeout. Arrange for grocery delivery when you need to get things. Pick items you don’t have to do a lot of prep with. Or, if someone can assist you with cooking, that would be good.

You are plenty active during the day and don’t need to do PT exercises on the days you aren’t with the therapist. Instead just do about 5 minutes of gentle bends and stretches every hour or two to keep your joint mobile.

If you try what I’m suggesting for a full week, you should see a difference in your knee.

 

[sistersinhim]

I can't believe you are doing this much at only 2 weeks out from your TKR! With all the household things you are doing, you don't even need to do any PT exercises. You are already doing natural PT! Most of your time should be spent resting and icing, letting others take care of the household duties. Think of your knee as an infant, because that is what it is!

 

[BarabooProud]

Yesterday was the first day I actually put something together for a meal, to be honest. Most of the time I'm just heating things up. My husband can absolutely help me more. I was just trying to take some things off his plate since he works so much. It makes sense that I'm doing too much since my knee ROM was going backwards. I'll try to take it easy more. It's so hard just sitting around all the time!!!

I have to say this news is quite depressing. The only household chores I did yesterday was empty the dishwasher, water my house plants, pick up the kitchen counter, and take the garbage out. Hardly anything. I'm going to have to get even more used to my bed and sofa! :(

 

[EalingGran]

Agree with @Jamie and others that those chores are too much.
Even heating up food involves a lot of standing which I found painful ( and swelling inducing) at your early stage.
I really didn't do any chores for 3-4 months but I was lucky having a lot of support.

 

[benne68]

The only household chores I did yesterday was empty the dishwasher, water my house plants, pick up the kitchen counter, and take the garbage out.

No wonder you are swollen! That is much too much for someone who is only two weeks post-op.

Here's the schedule my surgical team (from Hospital for Special Surgery, the world leader in orthopedics) recommended for me at your stage of recovery:
- Ice and elevate for 45-50 minutes.
- Get up for 5-10 minutes for bathroom visit, something to eat and/or a very brief walk around the house to prevent blood clots.
- Repeat every hour during the day.
- Elevate -- and ice as much as possible -- during the night.

My surgeon warned me that the people who end up unhappy with the outcomes a year or two down the road are the ones push to do too much too soon.

Remember that are NOT "just sitting around", you are actively doing what's best for your knee -- giving it the time it needs to heal.

 

[BarabooProud]

@benne68, for how many weeks did they recommend that schedule?

 

[sistersinhim]

Here is what we recommend while recovering from a joint replacement.

Activity Progression

 

[eaglemom]

I realize you think the news is depressing that your doing too much, and we certainly don't want to upset you. We want what's best for you and your knee to heal the best way we know. You are seeing that you are doing too much, don't beat yourself up over it. We all did it and learned. Sometimes we don't even realize all that we're doing, which I think might be your case. Just to empty the dishwasher, your standing, bending, reaching and walking around the kitchen. That's a lot at this stage, later its fine. Even things like letting the dog in / out - count that as your PT.

We want to help you on this path and not upset you. Rest, elevate, ice are really your best friends right now, as much as you want to do other things. You will get these, it just takes some time.

 

[BarabooProud]

@sistersinhim - I've read this article before and it confuses me a bit. Could you clarify for me? It seems like Week 1 says a 5-6 min walk every 3-4 hours and then Week 2 says walks 3-4 times a day for 5 min. Does this mean that in week 2 there should be twice as many 5 min walks since it says "add this to previous instructions in Week 1?"

Week 1
Just walking around the house - trips to the bathroom and kitchen are enough. No cooking or cleaning! Do your ankle pumps and gentle knee bends. The main thing is to keep your blood moving to help prevent clots.

Week 2 - add this to previous instructions in Week 1
Start on a plan of walks around the house 3-4 times a day for about 5 minutes, but don't

a) get obsessive about it
b) get into too much pain and
c) get too tired. Stop before you get to that point.

 

[sistersinhim]

Thank you for bringing this up. You are correct, it is very confusing. I have restated it to conform to our suggestions. Have a blessed day!

 

[Layla]

and Happy Thursday BarabooProud.
Sorry you found the article confusing and it's great you brought it to our attention, thank you!
We want to ensure the articles are clear, accurate and useful to all.

I often share the Activity Progression article and remind members to view it as a rough gauge. Some may excel and some will lag behind. Neither is right, or wrong. Your body will set the pace for healing. We all heal differently. Some days you may feel stronger than others, which is normal. Always keep in mind that this is a marathon, not a sprint.

At two weeks post op, you've obviously been taking walks around your home with trips to the bathroom or to the kitchen for a drink or snack. Hopefully you've been comfortably mobile.

Continue to refrain from cooking or cleaning, which often involves standing for long periods of time, twisting, bending and lifting. All are a strain on your healing knee. Rest, Ice and Elevate for the majority of the day.
Walk short distances frequently throughout the day without getting into pain, or getting too fatigued. Avoid prolonged sitting or standing. Focus on managing pain well by taking meds on schedule and doing any simple PT exercises within your comfort level.

Don't become discouraged if you feel your progress doesn't match what's reflected on the article. Healing is not linear. Each small gain counts and staying consistent will get you to the finish line.
I hope you have a great day!
@BarabooProud

 

[BarabooProud]

Thank you for bringing this up. You are correct, it is very confusing. I have restated it to conform to our suggestions. Have a blessed day!

Could you reshare the article/changes? It seems like the link you shared earlier is the same. Thank you!!

 

[sistersinhim]

I changed it in your post #54 and on the complete article in post #52.

 

[BarabooProud]

Thank you so much! Makes so much more sense. I appreciate you making the changes.

 

[Jamie]

Thank you for noticing this about our article. I was prepared some time ago by Josephine, our (now retired) Nurse Director and it was due for a review and update. We get so busy helping our BoneSmarties and keeping up on their progress that sometimes our administrative work can fall behind. So it is much appreciated when members tell us that something needs our attention. We’re reviewing the BoneSmart Library article now and it will be changed shortly. I’m glad our interim guidance is more clear for you.