TKR Recovery not the cake walk I thought

[referee54]

Am working as hard as I can.

As others have said---and I will re-iterate---the harder you work, the slower your recovery. I know it is difficult, but you do no "work at recovery" It is something that happens, and the harder you work at it, the more your surgical knee will rebel and slow things down---and then the frustration sets in, and you work even harder.

3x/week at a close-by facility

Again---too much, too soon---twice a week, maybe---it worked for me, but again, the harder you work, the more behind you will get.

Thought the routines would be a cake walk, but they are grueling and by the end of the routines I am physically exhausted.

It is a very tiring experience, but you also have to remember that your body is consuming large amounts of energy and focusing that energy on the ehaling process in the surgical knee.

I would skip the grueling routines and focus on taking it easy---while this seems contrary to what we have been taught and conflicts with our work ethic, it will actually make your recovery easier, you will have more energy, and you will be less frustrated.

 

[Roy Gardiner]

:iagree:

The PT should be stretching exercises, which are not difficult and should not hurt. It is certainly too early to be doing any training that involves the knee, perhaps too early to be doing any at all bearing in mind the body is low in energy already.

 

[Diesellily]

Why do people think a desk job won't effect the knee? I have a desk job and spend the majority of my working day on a computer but at 8 weeks post op there is no way I could sit 20 mins with my leg down. I've tried it at home and it just balloons. I'm keeping in touch with work and they keep asking when I'm coming back and I tell them as soon as I'm able I. I've planted the seed of part time for a while too.

 

[Nanners]

fiberlady I used the walker for a long time, as I felt more stable with it. Couldn't figure the cane out so didn't use it much. I just focused on walking heel to toe....kept repeating it in my head. If I have overdone it on a day, I still on occasion limp. But that's only with when I over do! But if you are comfortable with the cane, then by all means use it!

 

[referee54]

Why do people think a desk job won't effect the knee?

An excellent point! I teach, and I am very active in the classroom. After my BTKR, I tried to temporarily change that---sitting at a table or my desk---but one also has to consider the logistics.

You have to get up and get ready for work. You normally eat breakfast and drive to work. Then, during the day, there are normally little errands that you have to run---then, even if you have tried to sit at your desk all day, there is this thing called "Gravity" that will allow the knee to become somewhat swollen and stiff. Then, there is the drive home---and what if yo take public transportation? You have to walk there, wait, and then walk again, right?

I was lucky---I was able to ice and elevate during my planning period and my lunch period, but even that was not enough.

 

[mgdurand1]

Why do people think a desk job won't effect the knee? I have a desk job and spend the majority of my working day on a computer but at 8 weeks post op there is no way I could sit 20 mins with my leg down. I've tried it at home and it just balloons. I'm keeping in touch with work and they keep asking when I'm coming back and I tell them as soon as I'm able I. I've planted the seed of part time for a while too.

Hi, Diesellily. I was not suggesting that a desk job won't effect someone with a TKR like myself. My expectation is that it will. My plans are to go back part time @ 4-5 weeks after the surgery and to go back full time about 6-7 weeks post surgery. I have a "desk" job (well, kinda sorta) that does involve movement (lawyer). I fully expect that working will cause swelling and pain in my knee and leg, especially once I am back in the courtroom. However, for me there was pain and swelling in my knee and leg before the surgery. In fact, that is what motivated me to have the surgery in the first place. My plan is to get up and walk a bit every hour and keep the knee slightly elevated when I am able. Right now, the problem I have with swelling is primarily is I sit around without moving for 4 or 5 hours or don't walk. Even at 3 weeks post-surgery, I can tell that in a few more weeks the recovery will have me at a point that will hopefully be close to where I was pain-wise before the surgery. Right now, am doing the exercises, PT, rest, walking, ice and prayer. All seem to have their benefit! Best of luck to you and all here (including myself!) on that up and down hilly road to recovery.

 

[mgdurand1]

As others have said---and I will re-iterate---the harder you work, the slower your recovery. I know it is difficult, but you do no "work at recovery" It is something that happens, and the harder you work at it, the more your surgical knee will rebel and slow things down---and then the frustration sets in, and you work even harder.


Again---too much, too soon---twice a week, maybe---it worked for me, but again, the harder you work, the more behind you will get.


It is a very tiring experience, but you also have to remember that your body is consuming large amounts of energy and focusing that energy on the ehaling process in the surgical knee.

I would skip the grueling routines and focus on taking it easy---while this seems contrary to what we have been taught and conflicts with our work ethic, it will actually make your recovery easier, you will have more energy, and you will be less frustrated.

_____

My PT agreed with you and in fact while I am still working hard I am not pushing it to the point of excruciating pain. When the pain gets to the point where it is noticeable I stop. The PT told me that "no pain, no gain" is NOT the rule in knee replacement recovery. I think your comments are right on point.

 

[50yrold]

I am conflicted by this. I've been through two previous major knee surgery postop PT/rehabs, and the regimen pbeing prescribed me this time is very similar to those. But, for some reason, i a, getting exasperated after only 2 wks ofmrehab with the constant cycle of renewed pain and inflammation after PT. maybe its because I am older now, or because i set my postop rehab expectations too high. But to be told by my professionals, who have doctorates in PT, and specialize in knees, to do my ever expanding PT twice a day, and wearing myself out doing so, is in direct conflict with what I am reading here, which is a much more laissez-fairre approach. I do feel knee getting better, but I also have to admit that cutting back to once a day for the last twomdays has been somewhat of a relief. I think I will discuss it at todays appt.

 

[mgdurand1]

I am conflicted by this. I've been through two previous major knee surgery postop PT/rehabs, and the regimen pbeing prescribed me this time is very similar to those. But, for some reason, i a, getting exasperated after only 2 wks ofmrehab with the constant cycle of renewed pain and inflammation after PT. maybe its because I am older now, or because i set my postop rehab expectations too high. But to be told by my professionals, who have doctorates in PT, and specialize in knees, to do my ever expanding PT twice a day, and wearing myself out doing so, is in direct conflict with what I am reading here, which is a much more laissez-fairre approach. I do feel knee getting better, but I also have to admit that cutting back to once a day for the last twomdays has been somewhat of a relief. I think I will discuss it at todays appt.

___

I have to admit it is difficult to come to a complete understanding of the situation as it is applicable to each of us because each of us is different and react differently to exercise, pain meds, etc. I am on Dilaudid every time I go to therapy and much less powerful meds when I am not and just trying to keep the pain cycle from running away. I met a woman yesterday who had taken no opiates and was recovering nicely with minimal pain and I met a man who could not do the exercises and is basically in a wheelchair. All I can offer is my own experience and a few generalizations gleaned from here and my medical care providers. No pain no gain is not the applicable maxim. But there must be hard work every day IMHO. When I am finished the exercises I am completely worn out, and my wife/RN tells me that is completely normal. Yesterday, I did no exercises during the day (I am 3 weeks post surgery) because my friend was having surgery for bladder cancer and I was going to be there at the hospital for him. The 1 set of exercises I tried to do at night was much more difficult and the ones this morning were still difficult but were somewhat easier. My guess, and I am no physician, is that daily work on the knee is essential during the recovery period, gradual weight bearing is a requirement, pain will be there but needs to be tempered by medication and common sense, and time is required. This is not a procedure where after a few weeks everything will be better than new and pain free. It will get there, but that will take months, maybe a year. In the interim, getting back to part time work during short term recovery and then to full time work during full term recovery is the goal. The best ally I have had is optimism (well, and maybe the Dilaudid). My knee to me feels almost as good (bad?) as it did before the surgery. My hope is that in 2 weeks I will be walking in pain with a walker and that 3 weeks after that I will be walking without any assistance. It will hurt. It will swell. But it will continue to recover. I know I am repeating myself from an earlier post but my knee hurt every day before the surgery and I could barely walk and when I could was good for only about a quarter of a block. With the walker I am way past that already and am hopeful that my transition to a cane in the next week will yield similar results. Hope I am not getting too much off topic but I really sympathized with your comment about being conflicted a lot of the time. Like the pain from the surgery, it is just something we have to work through with common sense and an optimistic, realistic viewpoint. Heck, I know my recovery could stall at any time (possible but unlikely), but I refuse to believe that is going to happen in my case. Good luck! For myself, I had my staples removed yesterday and am off to have a real honest to God shower! A banner day for me as well as all the other members of the household! <g>.

 

[Diesellily]

Hi, Diesellily. I was not suggesting that a desk job won't effect someone with a TKR like myself. My expectation is that it will. My plans are to go back part time @ 4-5 weeks after the surgery and to go back full time about 6-7 weeks post surgery. I have a "desk" job (well, kinda sorta) that does involve movement (lawyer). I fully expect that working will cause swelling and pain in my knee and leg, especially once I am back in the courtroom. However, for me there was pain and swelling in my knee and leg before the surgery. In fact, that is what motivated me to have the surgery in the first place. My plan is to get up and walk a bit every hour and keep the knee slightly elevated when I am able. Right now, the problem I have with swelling is primarily is I sit around without moving for 4 or 5 hours or don't walk. Even at 3 weeks post-surgery, I can tell that in a few more weeks the recovery will have me at a point that will hopefully be close to where I was pain-wise before the surgery. Right now, am doing the exercises, PT, rest, walking, ice and prayer. All seem to have their benefit! Best of luck to you and all here (including myself!) on that up and down hilly road to recovery.

Hi mgdurand1

You're expectations of swelling are likely to be fulfilled sadly, and the plan to return to work 4-5 weeks post op albeit part time, is perhaps a little ambitious. Can I suggest that you don't make any plans until you are further down the recovery route as once you do return, you will be committed. I had so many plans at the beginning and the only one to remain intact is the revised one - not to plan anything. 8 weeks down the line and I still get exhausted so quickly. I don't sleep. I have swelling aggravated by getting around the house and little snippets of PT.

All I'm saying is give yourself time it's a very traumatic operation

 

[50yrold]

Thank you, mgdurand1, for your thoughtful response. You get what I mean. I was in regular, daily pain with my knee, but I could also manage a painfree day if I didnt do anything and the weather cooperated. I could have gone anther 5 or somyears on the old knee, but would have still been limited in walking less than a mile, standing as little as possible, and pain meds depleting my focus and concentration almost daily. I must be at a plateau. I am 2.5 wks postop, and havent used any walking aid for a week now. But, my extension seems to have stopped a 0 or 1 when my good knee goes to prob -5. Flexion is 115 without help, but the knee still bloats up almost immediately with standing, and any physical exercise. So, its worse than preop. I am also numb on the knee to the touch, as well as the right side of my leg. It seems imshould hav a more specific regimen for my weaknesses, and i am under a general PT regimen.

Thanks again. Off to PT now.

 

[Nanners]

50yrold you both are still in the very early days. I am 10 1/2 months out of a LTKR, I still have that numbness and I still swell and get stiff. This isn't like other surgeries where at 6 weeks you are all but recovered. This is something that literally takes a full year or more to recover from. You both barely had surgery, you need to slow your roll down a bit, you have a long way to go! Hugs!

 

[mgdurand1]

Thank you, mgdurand1, for your thoughtful response. You get what I mean. I was in regular, daily pain with my knee, but I could also manage a painfree day if I didnt do anything and the weather cooperated. I could have gone anther 5 or somyears on the old knee, but would have still been limited in walking less than a mile, standing as little as possible, and pain meds depleting my focus and concentration almost daily. I must be at a plateau. I am 2.5 wks postop, and havent used any walking aid for a week now. But, my extension seems to have stopped a 0 or 1 when my good knee goes to prob -5. Flexion is 115 without help, but the knee still bloats up almost immediately with standing, and any physical exercise. So, its worse than preop. I am also numb on the knee to the touch, as well as the right side of my leg. It seems imshould hav a more specific regimen for my weaknesses, and i am under a general PT regimen.

Thanks again. Off to PT now.

___

My friend, I envy you in many ways! We are both about 2 1/2 weeks post op and you are not using any walking aids? Man, I picture you with red tights and a cape! No, seriously, from what you are telling me your numbers are very good for this stage of your recovery. I know it is not as good as pre-op yet but I believe that if you keep up as you are now you will be in great shape in a few months. Congrats on your recovery so far! I am off to PT as well.

 

[referee54]

I am conflicted by this. I've been through two previous major knee surgery postop PT/rehabs, and the regimen pbeing prescribed me this time is very similar to those. But, for some reason, i a, getting exasperated after only 2 wks ofmrehab with the constant cycle of renewed pain and inflammation after PT. maybe its because I am older now, or because i set my postop rehab expectations too high. But to be told by my professionals, who have doctorates in PT, and specialize in knees, to do my ever expanding PT twice a day, and wearing myself out doing so, is in direct conflict with what I am reading here, which is a much more laissez-fairre approach. I do feel knee getting better, but I also have to admit that cutting back to once a day for the last twomdays has been somewhat of a relief. I think I will discuss it at todays appt.

Many of us were in the same boat, so to speak. We thought that our recovery would have been faster. I see by your signature that yo had a TKR on 7/02---so you are just a tad over three weeks removed from surgery.

Please consider what has been done to your knee---sliced open, sawed off in two places, pounded, manipulated, glued, etc---then closed up. OF course this is very invasive surgery and causes a great deal of surgical trauma on the surgical knee.

Usually the first four weeks are the "dark days" of recovery---at six weeks, things get a little better, and then things slowly climb upward (not without some issues, however---backsliding here or there.

You really must be patient. This surgery is unlike any other surgery that you have had---knee surgery, that is---and your body is busy right now trying to heal. If it hurts, do not do it. Take your PT to the point of discomfort and no further. I would only do one set of PT per day---and then rest/ice/elevate.

AS for the PhD. in PT---I have found, unfortunately, that many of those folk do not have a clue as to how to correctly run a rehab assignment for a TKR---I was lucky---mine did, but many still think that it is an arthroscopic surgery or an ACL repair.

 

[referee54]

The PT told me that "no pain, no gain" is NOT the rule in knee replacement recovery.

Now, this PT is a "keeper"! I wish more ---many more---were like him/her!

 

[referee54]

If you ever wonder why things move so slowly and why the need to be gentle is so significant, please take a look at these pictures---but they are not for the faint of heart! After you view what has been done to your knee, you will then understand why recovery is so slow and that patience is so greatly needed.

TKR surgery - WARNING: real life photos

 

[Diesellily]

Just showed these pics to my 14 yr boy. He was fed up of the total situation of his Mum being out of action. He just apologised to me as he didn't realise the significance of this operation. I wasn't trying to prove anything except that it is taking longer than anyone (especially me) to recover.......

Please note i did explain the gory detail prior to showing.

 

[referee54]

I am glad that they helped out---sorry for the gore, but its an open and honest visualization of something that many people do not understand.

 

[mgdurand1]

Now, this PT is a "keeper"! I wish more ---many more---were like him/her!

I will pass that on to him next week! And you are right - he is a keeper. Hard PT day today, but I took my first steps with my cane as opposed to my walker. First jaunt around the place was a bit painful but later did two more and it was fine. He told me to try using the cane around the house in "safe" areas (no rugs, walls or furniture present to hold onto if needed) and to only use it about 25% of the time as long as no significant pain. Again, I am pumped!

 

[daughter stalker]

Good for you, Mgdurand1! Sounds like you are doing quite well. Please don't rush it. Take your time and take it one day at a time. Take it from a hard head! I have one step forward then one step back because I think that I can do more than I actually can. I am four weeks and one day on this side of surgery.