TKR Reader's Left TKR Spacer Exchange

[Reader525]

@benne68 , I so agree, and those of us who jump to conclusions are the most easily hurt by this. @Layla I see the importance of being among the walking living and breathing the not so fresh air together. Haha. Today is my first day driving myself. I’m not on any pain medication so I’m focusing fine. I’m going to get in and out of the car extremely slowly, walk like Tim Conway on Carol Burnett and get it done.

 

[sistersinhim]

Today is my first day driving myself. I’m not on any pain medication so I’m focusing fine. I’m going to get in and out of the car extremely slowly, walk like Tim Conway on Carol Burnett and get it done.

Yay, freedom!! It was such an emotional boost for me when I could finally drive alone. I'm sure you feel the same way. I love the Tim Conway reference, it perfectly describes the way we all walked at first. Now, we can have a nice little chuckle about it!

 

[eaglemom]

The Tim Conway comment made me laugh and made my day. Its something I can totally relate to. Perfect illustration.

When you and your knee get home, remember to elevate and ice.

 

[Reader525]

I’m home! Boy, sitting in my little 2-seater was tough on the knee, it hurt what with the bend I needed to drive. Sean again reiterated how that thing I read was a series of codes that are used to get covered by insurance. He showed me the actual operative report and the X-rays they took today. I went from a size 12 spacer to a 16. He said 3 other size spacers were tried before the decision was made. And that my leg was capable of moving in every direction in all degrees so with exercise I will be fine. He said I’m about at 100 now which is really good because last week I couldn’t bend at all.
Furthermore, as we know, there are several schools of thought…one is aggressive physical therapy with forced bending and then there is a moderate one, and then there is the one where you don’t have to do anything, it will come back on it’s own. I’m between two and three, I don’t think you should do nothing, but I don’t know how much you need to stress about it. He said he can tell I don’t need motivation, I’m good with my own drive. Lastly, he said, Jenny, you’re 75 years old, you may look and feel younger, but it’s still 75 years old and you’ve had 2 major surgeries in the last 4 months on the same leg. Your hip and thigh muscles are still recovering. Be careful with yourself. I promise you will have a full recovery within a couple of months.
I can see how much that outing took out of me, my thigh hurts too. So I’m using a cold pack. I’ve found I am so miserable with a true ice pack, it’s too much. I’ve lost weight and need to get back to normal.

 

[benne68]

Sean sounds like a keeper, @Reader525! Is he your surgeon's PA?

 

[Reader525]

@benne68 yes, and he’s a doll. He’s been a PA in orthopedics for 26 years, so no spring chicken. I really lucked out with him.

 

[myglasshalffull]

Reader,
All great news and happy you are now in a better place. Yes, we are older and unfortunately does take more time for some of us to get past the hurdles in recovery.
I had my hip replaced when I was 70 but I wasn’t a rocking chair 70, I was a very busy active 70. But didn’t make my recovery any easier!
We read stuff online and immediately think we have same issue! It’s crazy what we do to ourselves.
My friend texted me a little paragraph about “sitting with your phone for a few minutes.” Ended up saying by the end of the few minutes the person had 4 new ailments and was watching wild animals and finally someone remodeling their kitchen! The internet can be a very useful tool but it can also make us crazy!

 

[Reader525]

@myglasshalffull that is sooo funny and soooo true. I feel like I’m in perpetual scan mode, always watching and listening to my body for every nuance. What does this mean, what does that mean?? It’s a heavy burden for me because I don’t relax. I wasn’t really like this but having my first husband diagnosed seemingly out of nowhere with end stage renal failure when I was 34 years old changed me. It’s not what happens to us it’s how we handle it. I think I handled it pretty well but it changed me.

I need some reassurance and support with my pain, which is manageable, and also what do I do about my physical therapy. Sean asked me yesterday when I am having PT and I said 6/11, he didn’t look happy. I can’t get in before then. I want to know, when I do heel slides, if I feel pain, do I stop , just hold the bend, or push further. My inclination is if it hurts, not discomfort, but hurts, I should stop. But I don’t know!

 

[Layla]

I am sorry you had to experience such a serious illness with your first husband at such a very young age.
These life events can change us and cause a heightened fear around health, illness and even your latest recovery. I am not surprised you feel the need for reassurance. You experienced a lot at an age when we still feel pretty invincible.

Thankfully your pain at only two weeks post op is normal and "manageable", which is what you want so you're able to remain comfortably mobile. Sean sounds like a friend aside from being your PT. You have trust in him and that's important.

Heel slides - I think your inclination to stop, not holding the bend or pushing further is a safe one. Listen to your body. To me, pain means STOP. "Pain Is Your Body Asking For Change". Engage in gentle motion and you can hold at the point of discomfort, but I wouldn't go any further. Forcing movements your body isn't ready for can increase swelling, worsen inflammation, make your knee stiffer.

I hope you had some restorative rest overnight and recovered from yesterdays outing. May today be a good one!
You're doing just fine, Reader, have confidence in that.
@Reader525

 

[Reader525]

@Layla You have boosted my mood with your reply. I seem to be in an emotional slump right now and I can see how I am soothed reading what you wrote, omg thank you.

I am going to try this approach to my heel slides. Isn’t it odd how even though some of us have gone through this before, we seem to forget the lessons we learned the last time? I am just raw.

Last night I did fall asleep a little better, I have looked at my bed as The Torture Chamber because I’m so restless and unable to sleep well. I get into what I think is a comfortable position only to wake up in pain and have to move. I know in my heart this will get better, so why can’t I handle this better?

There is a beautiful opinion piece in The New York Times from 5/25 by Roger Rosenblatt called HOW TO BE OLD, it’s a tonic for all that troubles us as the years pass. It was a balm for the mind.

 

[Layla]

I know in my heart this will get better, so why can’t I handle this better?

This is major surgery and it's natural for recovery to feel threatening at times. You're hurting, sleep deprived inflamed, dependent on others and it can feel emotionally exhausting. You want to climb into bed at the end of a seemingly normal day and have that feeling of bliss - "aah, I love my bed." However currently you're associating it with discomfort or pain, stiffness and dread that you won't fall asleep, or sleep for long if you do. Also, you experienced a revision surgery, not what you planned on going into your TKR. That can also cause a hyper awareness to every pain or thing that feels off. I feel very confident in your recovery given what both your OS and PT have shared with you. If I didn't, I wouldn't type that I do. I wish you could too. Just know we're here for emotional support no matter how often you need it. We do care!

Thanks for highlighting that article in the NYT, I'm going to look it up.

 

[alex_mom]

I need some reassurance and support with my pain, which is manageable, and also what do I do about my physical therapy. Sean asked me yesterday when I am having PT and I said 6/11, he didn’t look happy. I can’t get in before then. I want to know, when I do heel slides, if I feel pain, do I stop , just hold the bend, or push further. My inclination is if it hurts, not discomfort, but hurts, I should stop. But I don’t know!

I'm so sorry about your first husband. That can't have been easy and things like that do shape us. Like you said, it is how we respond and continue on that makes the difference.

How nice that you are off the Rx pain meds and driving! You've made fast progress.

As for myself and the PT, I followed the bonesmart idea of not pushing myself through the pain. (this is how I interpreted everything I have read here) My physical therapist was fine with that and is not an advocate of painful PT, either. Whenever I felt the pressure/resistance but not to the point of true pain, I held the heel slide for five seconds, then slid back to a straight leg. I challenged the stiffness but am not a glutton for punishment and more pain. I still do a lot of seated heel slides now and hold for five seconds, to maintain the ROM.

 

[Reader525]

Any chance of getting a link to the guidelines Bonesmart has for TKR again?
I think it would really help me. Thanks, everyone .

 

[sistersinhim]

I'm not sure what you are referring to so I'll leave you the Recovery Guidelines.

Following are BoneSmart's Knee Recovery Guidelines. Each article is short, but informative. Following these guidelines will help you have a less painful recovery. Just keep in mind we are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.” Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

KNEE RECOVERY GUIDELINES
(Note to Basic Members: The links below are a premium service available only to Insiders Club Members. To learn about membership, click here).

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 your new knee.

3. Do what you want to do BUT
If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you.
If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.

4. Good Nutrition is essential for successful recovery:
Dietary Tips for Recovery
Nutrition Basics

4. PT or exercise can be useful BUT take note of these
BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy
and please also read the Recovery myths below.

5. At week 4 and after you should follow this
Activity progression for TKRs

7. If you want something to assist with incision healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

8. Still need recovery aids? The BoneSmart Recovery Shop offers BoneSmarties best-loved recovery products at great prices.

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?

Recovery myths:
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.

 

[myglasshalffull]

Reader,
So sorry to read about your first husband. That’s a lot to go through at such a young age. Definitely would alter your life for a very long time. And even though many years have passed it’s still a trauma & resurfaces now and then.
I’ll agree with Layla on your heel slides. If it hurts stop.
I wish you a peaceful day.

 

[Reader525]

@myglasshalffull thank you. Isn’t it funny how different PT therapists view what we should do? One of my friends had her therapist come to the house and actually pulled her knee to a full bend. She screamed like she had been shot, and her husband went into the bathroom and got sick. Can you imagine? I know if you go back in the forum for my original knee replacement in 2021, 2 days after the surgery my 22 year old physical therapist overwhelmed me with pulling my leg back and forth. The next day I was swollen and red. You would think maybe that was then and it’s different now, but I’m not sure. I believe in gentle bending, but right now my incision area is tight and the excess pressure hurts. I think a lot of it is the glue that’s pulling my skin. Sean told me whatever I do, DON’T PULL IT OFF. I hope it falls off soon.

 

[benne68]

Isn’t it funny how different PT therapists view what we should do?

The reason is that the vast majority of physical therapists never get any training or take any classes in how to work with joint replacement patients. Since they just don't know any better, they treat their patients as they would treat someone recovering from a sport injury. Apples and oranges.

Given the aging population and the huge growth in joint replacement surgery, you would think teaching folks the proper way to help us recover should be part of the curriculum or, at least, professional development classes. My PT (who does have the specialized training) has been advocating for this change without much success.

So, we need to educate ourselves about the right way to recover and them attempt to educate our PTs -- or at least avoid those who don't want to learn about the best way to help us recover.

Stepping off my soapbox now....

 

[Reader525]

@benne68 Wow, I did not know that they don’t get trained in joint replacement therapy. That’s crazy to me. As you say, aging population and the improvement in joint replacement means so many people are going to need help. I am a little worried about what my PT is going to say to me on 6/11. I am going to stay grounded in my own ideas and not do anything that makes me uncomfortable. I’ll be informing them about what I’ve learned through experience and what I don’t want.

 

[Reader525]

@benne68 , @myglasshalffull @Jockette @Legseleven @alex_mom , @Layla Okay everyone, I know I must be a little tiresome, but I have another question…today I did a little, changed the sheets. Did a load of laundry, general light puttering, then, I lay down on the couch and watched the French Open with my husband, dosed and pretty much did nothing else. I did some heel slides a few times too. I feel lazy, is this kind of inactivity bad for my recovery or is it maybe good for me right now. Thank you so much!

 

[Layla]

No, not bad at all. You're only fifteen days post op and you're going to have days like this as your body uses energy for healing first, not leaving a lot for much else. You did engage in activity through doing laundry, changing sheets and puttering around. If you're tired, or feeling lazy, you should rest...without guilt.

I am a little worried about what my PT is going to say to me on 6/11. I am going to stay grounded in my own ideas and not do anything that makes me uncomfortable. I’ll be informing them about what I’ve learned through experience and what I don’t want.

It seems you have a very good relationship with your PT. I'm sure he knows you trust his expertise and like working with him. There's nothing wrong with making it clear that you're going to listen to your body and if something hurts more than you think it should, you're going to stop and see if you can discuss another approach, or skip the exercise and do another in its place. It's about you staying within limits that feel safe for you.

Have a relaxing weekend, Reader!