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TKR Recovering in Canada

Lindylee

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It sounds as if you're doing well. I have to say I've been surprised at how quickly the knee stiffens. When sitting with my legs elevated I try to remember to throw in a couple of gentle knee slides every now and again. Having said that, it's already so much easier to go from seated to standing and then moving than it was before the surgery.
 
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SnowHare

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@Lindylee - I am a born fidgiter. I can't keep in one position for very long. Right now I'm doing a lot of icing and elevating, so I take fidgit time to bend my knee.

The stiffness is just bad, before I get up to walk, so I take some time to do some bending of knee before moving. First thing in the morning is the worst. I hobble with the walker for the first couple of minutes. My other knee is equally stiff.
 

Lindylee

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I was quite worried before surgery as to how my other leg would stand up as that needs doing too, but it's been behaving beautifully - hope I haven't jinxed it now! It is the sitting, or lying, to standing where I feel it and I take a few seconds to balance myself before moving. I'm quite happy wandering around with one, sometimes none, stick during the day, but resort to two when getting up in the night as stiffness and sleepiness together could be a disaster!
 

SusieShoes

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My knees were stiff for months following replacement. In the early weeks I did what you do, fidget-bend them. A little here, a little there. Bend before getting up. Balance a bit before walking.

All that busy-bending goes away eventually, and so does the stiffness. Just don’t be surprised if it takes months and not just weeks. Humans are impatient souls. Knees take their jolly time with the stiffness.
 

sistersinhim

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If I remember correctly, stiffness was my last major complaint. I wasn't in any pain, just stiff for many months after the pain went away.
 

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Hi SnowHare,

Sharon here. I see we're the same age and had our TKR on the same day. I hope you are doing well. I was very fortunate in that I did not have stitches or staples. I'm only taking ibuprofen a couple times a day-- morning and night. I use a cane since every so often my knee feels like it'll buckle. Swelling is minimal. I took my first bath today and it was heavenly. I shall be taking one every single day since I can massage the entire leg which feels so good.

I have my 6 week post op appointment on Wednesday and hope to get the green light to drive and start pool exercises. Please keep me posted on your progress!
 
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SnowHare

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@shamann98

Cool, and we are the same age!!

Did you have steri strips?

My healing, according to my physiotherapist, is right spang on the middle of the bell curve. My knee was a real mess to start with, one of the worst my surgeon had ever seen, so I figure if I'm doing this well, everything is splendid.

Were you in massively good shape before surgery?

Me? Not the least bit. I had been off my feet for 3 months, and then had 3 months of physio on my ankle. Tendons. I'm to use my walker until I see the surgeon on the 25th. It's a bit later for the 6 week check-up, but the team wants to make sure I am very steady. My other knee is super bad too, and it gives out unexpectedly.

I will be honest. I want an ENVY button. Your recovery sounds incredible. envy envy envy

But it's not a competition.

I'm weaning myself off the hydromorphone. I'm down to 2 mg every 12 hours. That's because I sometimes forget to take it. I forget to take the Tylenol as well, so I'm trying harder to not be so distracted. I sometimes wake up in pain, but I think it's because I likely twisted my leg in my sleep.
 
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SnowHare

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I had a turnaround day on Saturday.

I felt like myself, or at least myself in my brain. Feeling more optimistic, happier, and certainly more alert.

My physio is very worried about my leg's refusal to straighten. He says I have to do the stretch and straightening with the belt every 2 hours. My calves are super tight too. Well, that lasted a few days, and then I had to have a recovery day, which stretched into 3 recovery days. He made the rule about exercising every 2 hours, because he knows I do my exercises at weird times during the day. I'll be sitting/lying and decide to do a leg straightening or 5.

My calves at least feel great.
 

Lindylee

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Really good to hear you're feeling more like you. I can relate to that feeling following major surgery 10 years ago when I woke one day and thought 'I'm me again!' A friend who had difficulty straightening his leg found gentle hydrotherapy helped, he only needed a couple of sessions. Just a thought ...... good luck.
 

BluesmanVT

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Hi SnowHare,

Congratulations on your Turnaround Day. I had one on Friday. They are truly gifts.
Regarding stiffness/straightening ... My PT applies heat to my leg before we begin exercises. I've found that it relaxes the muscles. So I've started doing it at home as well. I still ice, but generally after walk or exercises. Also, you may want to consider gentle massage either by a partner or a professional.

Good luck!
 

shamann98

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Hi SnowHare,

I had a bandage down the middle of the incision removed at two weeks and they put steri-strips on then, which fell off after showering within the next 3 or 4 days. They used some sort of glue on the incision so there's very little scarring.

This left leg has been compromised for a long time since I had surgery in 1976 to remove bone chips when I dislocated it and chipped my knee cap, but I walked and swam with minimal pain. I've had a few cortisone shots in the last few years to help with pain, but that ended in November when I took my last 2-mile walk and was in so much pain I knew it was time for a TKR. So no, I wasn't in good shape before surgery, just okay shape. My other knee is bone-on-bone and will need surgery someday. In the meantime I am getting cortisone shots a few times a year and will work hard to keep the knee cap tracking in the middle.

I got off the hydrocodone because it made me horribly constipated and, I think, contributed to depression. This gloomy time of the year isn't the greatest for me anyway, especially since I haven't been able to walk daily.

My PT told me to stop hyper-focusing on my knee and making it the center of all things! She said having a TKR is like childbirth, every mother goes through a totally different experience but (hopefully) in the end comes out with baby. And we too will each have a totally different path to healing but in the end we will (hopefully) come out with a pain-free knee. So I will send loving thoughts your way and pray you have many more Turnaround Days!
 
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SnowHare

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Lindylee, BluesmanVT, shamann98

So, last night, just to get even with me for having a turnaround day, my knee kept waking me up with excruciating pain. We had company yesterday afternoon, and I think I sat up too long. That, and the muscles felt like they were doing the spasm thing, while they were sorting themselves out.

I still feel like me, and I plan to stay me forever.
 

Celle

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My physio is very worried about my leg's refusal to straighten. He says I have to do the stretch and straightening with the belt every 2 hours. My calves are super tight too. Well, that lasted a few days, and then I had to have a recovery day, which stretched into 3 recovery days. He made the rule about exercising every 2 hours, because he knows I do my exercises at weird times during the day.
There's no need to worry about your leg not straightening yet. It's not at all unusual for extension (straightening) to take longer to achieve than flexion (bending). It's because the large muscles and tendons at the back of your leg have to be stretched slowly and gently.

Your physio has an agenda, but it's obviously not the same as your knee's agenda. Don't let the physio's concern become your concern. You have plenty of time.
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

I suggest you stop doing most of your exercises, especially those using a strap. We recommend that you don't use either straps or weights. They're not necessary and they can do harm.
Your muscles are tight and continuing to use a strap and exercise frequently will keep them that way. They need to take some time to relax.

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.

One of the best ways to naturally help with extension is to increase the length of your stride while you're walking.
This article has an image of how to walk correctly:
Extension: how to estimate it and ways to improve it
 
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SnowHare

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@Celle I believe my physio's agenda is that he meets the standards that are set by whomever sets these standards - the medical association? As the government is paying for my physio for now, he probably is a bit constrained by that. So far, he's been really good about not pushing past pain, as in, when it hurts, stop. He wanted me using the strap, as my calf was super tight. That's resolved.

I'm giving myself permission to not do much of anything, in terms of exercises, unless the desire moves me. I'm heating, sitting up, and icing with elevation. Sometimes I can't get comfortable in any position, which I think is because everything is getting re-aligned.

My walking is coming along well. My phsyio said to stop the limping. I walk with a walker. I now can walk smoothly, with the walker, but only after having some time to warm up. I've always had a really short stride, but I have really short legs.

By and large, my physio says my recovery is pretty much in the middle of a bell curve, which he is pleased with, because he was treating me for other issues on the same leg before the surgery and knew what I've been dealing with.
 

Tasmania

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Hello Snowhare! I had both knees replaced on a January third, but I’m zooming along. My physio cut me loose today, said I know what to do, and to keep doing it. I was in reasonable shape (apart from the extra forty pounds!) and a bit younger than you, before the surgery, which gave me a big headstart on recovery - I was regularly riding fourteen miles on my bike, (albeit with my right heel on the pedal, because I couldn’t bend the right leg to 90 degrees) until three days before the big chop. I’d say work on strengthening those thigh muscles as much as you can. Nights are the hardest, as I’m a side sleeper, and it seems much harder to move my legs when I’m on my side than on my back! But last night I managed without taking ibuprofen - my first 24 hours without medication! Hope things start improving for you soon!
 

Jamie

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Sometimes I can't get comfortable in any position, which I think is because everything is getting re-aligned.
That discomfort is a form of pain and it will improve if you do something for it. If icing doesn't do the trick, you can take 1000mg of acetaminophen (Tylenol) every 6 hours or a prescription medication. Allowing yourself to stay in this state of discomfort does not do your recovery any good.
 
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SnowHare

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@Tasmania Most days are an improvement over the previous days!

Yes, I totally agree with you about the quads. I was doing tai chi - did it for years, which kept me out of the surgeon's office - and I had great quads. Then I suffered an injury to my ankle tendons and was not allowed to go to tai chi, and I was put on 3 months of feet up only. I lost a lot of muscle tone. My physio has me doing thigh tightening, when it occurs to me, just to work on those muscles. We start quad work sometime in March.

I have read that the better shape you were in before surgery means you will likely have a much easier recovery.

I too am a side sleeper, and I only sleep on one side, the side where my operated knee is on the bottom. I use a body pillow for the other side which helps a bit. The body pillow is too heavy for me to use on my normal sleeping side.

Congrats for first 24 hours without meds! I am slowly coming off the hydromorphone. I have a feeling I'm going to have a bunch of pills left over!
 

Celle

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@Celle I believe my physio's agenda is that he meets the standards that are set by whomever sets these standards - the medical association? As the government is paying for my physio for now, he probably is a bit constrained by that. So far, he's been really good about not pushing past pain, as in, when it hurts, stop. He wanted me using the strap, as my calf was super tight. That's resolved.
No. He's following a set of standards that he has been taught during his physio training. Not even all physio training is the same. Some physios believe in achieving set numbers by certain dates. Others don't.

Since there is even no consensus among surgeons as to what stage you should be at, and when, there cannot be one set of standards for all. No two knees recover exactly the same way, so they can't all be treated the same.

One set of standards for all knees is just not applicable - and you do not have to comply with anything that upsets your knee. Even though the government is paying for your care, you still have rights.

I grew up in England and I now live in New Zealand and health care in both those countries is also public funded, unless one chooses to go privately; but that doesn't alter the fact that, as a patient, we still have rights - and so do you, in Canada.
CONSENT: what it means and how it can be used
 
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SnowHare

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@Jamie I am taking acetominophen every 6 hours and I'm trying to reduce the hydromorphone. I am most comfortable on my back, with a roll in the small of my back, and my feet elevated, but sometimes, my body just wants to lie sideways, feet elevated, as a comfortable position. I'm not sure the meds are doing much of anything, as things hurt almost the same either way. I have a very high tolerance to meds, so I prefer not taking too much at any given time.

The discomfort is a more recent thing, and I think it may be tied to being too aggressive with walking around the house. Yesterday, I made scones with help with the lifting, and even with the little standing, both my knees froze up from not moving.

I know part of my pain is from my back, as I have had back issues for many years. The comfiest position is curled up in a fetal position, which I don't think does me any good at this juncture.

I just want to dance, but I'm not there... yet
 

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