TKR Roller coaster recovery

vwolfvoa

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Hi!

I had a left TKR on March 28, 2 weeks ago today. I had a right TKR 7 years ago, which was very successful, but this recovery is reminding me how tough the first was…I think it’s like giving birth, your memory protects you from the worst! I’m home with my husband, who is taking great care of me. I know that slow and steady is the key…my only big goal is to be able to enjoy a fairly physical vacation scheduled for November…but I’m impatient to get my life back!

Now, while I am comfortable walking without a cane, I’m using it as much for improving my gait as for supporting my left leg; I thought I had kicked the Dilaudid the other day, but last night I had enough pain that I had to take one…I didn’t think I’d done anything extraordinary yesterday, but I guess it’s easy to overdo things! I’m having home PT through this week, then I’ll go to out patient, and assume I’ll be able to drive myself. I have exercises for flexing and straightening each day, but I really hate causing myself pain, so I do them just so I don’t have to lie to the therapist! I take great comfort in the advice here to trust that my body will heal, and that I don’t have to push myself mercilessly. I try to elevate and ice a few hours a day, but even though I have nothing to do except recover, the day can get away from me! I can’t remember my ROM numbers, but I am so nervous about not making the progress my therapist wants to see!

it feels like 2 steps forward, 1 step back, physically as well as emotionally. I had continuous pain reduction for a few days, then a really bad night; I feel on top of everything one day (or perhaps one hour), and am fighting back tears the next!

I know no 2 knees are alike, but I think im pretty much where I was post surgery 7 years ago, although I do feel 7 years older, and try to respect that as I recover! I’m an actor, and have committed to a few projects starting mid-May, and hope the brain fog will lift for memorizing lines, and I can manage evening rehearsals given my limited energy reserves. I may have been a bit too optimistic, although I made the commitments based on how I got my life back 7 years ago, when I was 7 years younger. I’m counseling a friend who is considering the surgery to pretty much pull out of all commitments for the first couple of months… you don’t need the stress of following through on top of the stress of recovery!
 

FourCats

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Welcome! You sound like you’re doing well overall. The ups and downs are one of the hardest parts of recovery. My first knee is almost a year old and it occasionally still throws me for a loop and I become frustrated. Then I remember “before“ and realize how much better life is now. Keep visiting here and sharing your experience with folks who really do understand.
 

Jaycey

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@vwolfvoa Welcome to BoneSmart!

First things first - your PT might have expectations. But this is your knee and you are in charge. Do not get hung up on timeframes. There are absolutely no set timeframes for ROM goals.

If any of the exercises are causing discomfort - please stop doing them. There is plenty of time for building strength when that knee is healed. You are not in training, you are in recovery.
I’m an actor, and have committed to a few projects starting mid-May, and hope the brain fog will lift for memorizing lines, and I can manage evening rehearsals given my limited energy reserves.
A bit aggressive I am afraid. Concentration is tough in the early days. Then there is the Energy Drain. You can't fight it. Luckily it's all temporary.

You are yet more proof that every recovery is different even on the same person.

Here's a bit of reading for you in case you need a refresher:
Knee Recovery: The Guidelines
We are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart are here to help. But you have the final decision as to what approach you use.

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
ice
take your pain meds by prescription schedule (not when pain starts!)​

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 Activity progression for TKRs

6. Access 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.
 

benne68

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Welcome @vwolfvoa! :wave:

You are right -- recovery from a TKR really IS a roller coaster! But it sounds like you are encountering the normal challenges at this very early point in yours. Pain, fatigue, mood swings are all a part of the process. As you know from your other TKR, they all do resolve with time.
I’m an actor, and have committed to a few projects starting mid-May, and hope the brain fog will lift for memorizing lines, and I can manage evening rehearsals given my limited energy reserves.
I agree that you may have been a bit overly optimistic with this schedule, but we are all different and you have another month to figure it out. Just be careful not to overdo it, which could set you back. Resting, elevating and icing now will help you bounce back later.

Good luck and keep us posted!
 
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vwolfvoa

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3 weeks post op tomorrow…I had hoped to have been off pain meds by now, but I absolutely need them to sleep. Pain/discomfort during the day ranges from minor to excessive, but I want to be clear headed, so try to manage with Tylenol, elevation and icing. Its exhausting, that constant ache! I’m happiest lying with my knee elevated above my heart, good book in hand!

I know there’s still a good amount of swelling, but can tell ROM gets a little better each day as I try to do stairs like “a regular person”…it’s a little easier each day!

My home physical therapist was delighted by my progress, and discharged me to out patient pt starting tomorrow. After reading a lot of these posts, I’m going to make sure no one hurts me or pushes me too far just because I’m getting around so well!

Carefully getting back to evening rehearsals, protecting my energy during those days, but it’s certainly good for my mental health!

Reading all your posts and forums is so helpful!
 

glidefloss

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Hi @vwolfvoa , @ski_bum , good to see you're both doing well! It's amazing how much of a rollercoaster ride the early days of recovery can be - physically and mentally!! I definitely agree that reading postings on this forum has been very helpful.

All the best on your recoveries!!
 
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vwolfvoa

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Baby knee 4 weeks old yesterday…and this is getting old! Pain is not awful, but nagging, and nothing seems to help, so I’m not sleeping well. I think I’m immune to all the pain killers! Lots of ice and elevation, which feels great while I’m doing it, but I can’t spend all day lounging! I did invest in a Polar ice machine, which is so much better than constantly replacing freezer packs!

I know I’m making progress-I’ve ditched the cane except for long stairs; I’m going up stairs the regular way, although going down is tougher; my energy is returning a little; I’m driving.

But I don’t feel like my ROM is improving, although I know I shouldn’t obsess about it, based on all I read here. My pt is most concerned about straightening…it’s been so long since it’s been straight! So, he’s doing different stretching exercises that aren’t pleasant, but aren’t too painful, and he’s good about checking to make sure it’s not too much. I’m only having pt twice a week, so I have lots of time in between to recover the Bonesmart way…I’m not doing lots of formal exercise, but focusing on gentle stretching and going about daily living.

So, I’m not really discouraged, because I know it’s early, but I am feeling a little overwhelmed. I had my right knee replaced 7 years ago, which is long enough ago that I don’t remember every detail of my recovery, but I’ve always assumed that this time I’ll recover just as well and completely; now I’m worried that I may not. I felt completely recovered at 6 months the first time! Now, a Different knee and 7 years older, it’s hard to imagine I’ll ever feel as good as I did back then.

And I need sleep, or else everything looks bleak! One thing I’m considering is trying a little cannabis to help…for those of you who live where it is legal, has anyone tried it for sleep or pain? Not sure that’s something that can be discussed here, so let me know!
 

glidefloss

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Hi @vwolfvoa, you pretty much captured a lot of some of the feelings of impatience/frustration that I too have been going through. If there was a Fast Forward button, I'd have hit it long ago!

The experiences between my right knee (20 weeks yesterday) and my left (day 12 today) have a lot of similarities but also a lot of differences. For one thing, I was in a lot less pain/discomfort with my right than with my left - something I sort of anticipated given how knock kneed my left one was. I didn't expect the near constant back ache (which I attribute to the body adjusting to the new alignment) and to the deep seated ache in the medial quad and thigh ... which my go to Tylenol/Advil/Aleve doesn't seem to always reach.

Since I'm in Colorado, cannabis is legal and easy to purchase and I know a number of folks who swear by it (CBD). If my back ache persists through next week maybe I'll visit a dispensary to see what they have.

Hopefully you'll find something that works for you! All the best!!
 
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vwolfvoa

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A happy post!

I feel like I’ve turned a little corner this week, just over 4 weeks post op, and it makes me happy! Pain is lower, although there are all sorts of twinges and pangs at night, like a little person is inside my knee with a little pick ax, randomly swinging it around! The pain meds haven't been all that effective since the first week, for eliminating pain or inducing sleep, so I’m trying different things, avoiding the narcotics since they don’t make much of a difference.

I did invest in a Polar ice machine, and I’m so glad… the large pad wraps completely around my knee, stays put when I’m elevating my knee, and provides great cold relief! So much better than dealing with an assortment of ice pads in the freezer. 6 frozen water bottles keep the water cold all day! I figure my husband will need it for his shoulder in the not too distant future, and I can lend it out to friends.

I am going to PT 2 days a week…they aren’t too aggressive, although they do push extension stretches that are uncomfortable. But I’m not in worse shape afterwards, and I follow the Bonesmart way on the off days. I am impatient for improvement, but it’s coming!

Energy is returning, and I’m making it through nighttime rehearsals, although not going out for drinks afterwards yet! I keep the cane in the car in case my travels bring me to a lot of stairs, but don’t need it otherwise. I’m very aware of my gate, very careful about the heel to toe walk whenever I’m walking.

Of course, I probably still burst into tears once a day… this recovery does take its toll, making us fragile in so many ways! Tomorrow I may feel discouraged and depressed, but I can look at this post and remind myself that it will pass!

Very grateful for this website and forum!
 

sistersinhim

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I had my right knee replaced 7 years ago,
You remember that your right knee was close to normal at 6 months. This new year has had 7 more years of damage that the doctor had to correct. Your body is also 7 years older, taking a little longer to heal than it did with your first knee. It could also be that you are not remembering correctly about your first knee's recovery. Your new baby is only a month old and you are doing fantastic at this stage! Take joy in knowing that you are ahead of the average healer.
 
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vwolfvoa

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Wow..amazing how a small thing can set you back!

I’ve been feeling great, little pain, slow but steady progress with the ROM. Overall, PT was going well…they were smart not to push my knee , but encouraging mobility.

But on Monday, it was very busy, and one of the underlings was working with me. We did all the regular stuff, and then she suggested 5 minutes pedaling backwards on the elliptical, something we’d never done. I started, and it was HARD! I felt muscles that hadn’t been used for a while, but I thought that was a good thing. However, I only managed 3 minutes, realizing that it was irritating my knee.

Well, it has set me back a couple of weeks! The next day my leg was swollen, the knee stiff, the skin is so sensitive I can‘t stand having anything rub against it. I’m icing and elevating much more than I have time for, and I am really annoyed. My bad that I didn’t just say no to something so radically different at the end of a PT session, but I’m upset with them that she was allowed to direct me, unsupervised. I cancelled upcoming sessions so I can baby my baby knee, and I’ll make sure they know what happened. I’ll be fine, but didn't need this!
 

marcarooni

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Had TKR my right knee on March 14. (TKR on left knee December, 2019). Both used the Conformis custom replacement. Recovery and healing are superior with a custom as opposed to "off the shelf" unit. Costs more -- definitely worth it!

Key advice for recovery: take the pain meds as directed and don't wait for the pain to start. Stay ahead of the pain. Slow and steady on PT is much better than overexertion. Yes it hurts. Trust me, it gets better over time.

The good news: tomorrow I am playing my sixth round of golf since my surgery. Very minimal pain. My game is not any better; there is only so much that a surgeon can do!
 

benne68

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I cancelled upcoming sessions so I can baby my baby knee, and I’ll make sure they know what happened.
You are wise to cancel PT until your knee fully recovers from this episode.

But don't beat yourself up. I think we've all done something similar -- either on our own or under a PT's guidance. The better we feel as we recovery, the more likely we are too push ourselves a bit too far and end up with a small setback.

This recovery is a 2-steps-forward-1-step-backwards dance! But, you are right, you WILL be fine!

:console2:
 

DEL2022Jun-25

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I’m counseling a friend who is considering the surgery to pretty much pull out of all commitments for the first couple of months… you don’t need the stress of following through on top of the stress of recovery!
Boy, I wish someone had told me. I don't know what planet I was in prior to the surgery. I'm so used to bopping back from things, I was floored when I woke up and couldn't pick up my leg!!

What pain meds are you on now? I cut out the opiates because they were just gutting me. So it's tylenol now, and Voltaren (NSAID) rub, since I can't take oral Celebrex because of how hard it hits the kidneys. (Kidneys are forever).

Yes, I agree, the polar ice machine is essential. I got mine when my knees were just bad, and wondered why I didn't have it when my son was a teen age skateboarder. This is a machine that's essential for anyone with kids in sports!
 
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vwolfvoa

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No more meds except the occasional Motrin 9 weeks out. I’m doing just about everything I want without worrying about stressing my knee, but know when I’m overdoing it…the knee sure barks at you! I’m probably done with out patient PT…it seems to set me back a few days each time. They aren’t doing anything all that extreme, but agree with me that maybe my knee just needs to take over on its own! ROM is probably at 105/2 (not sure that’s the right way to express it, but you know what I mean!), so while I have a ways to go, I feel pretty confident that it’ll keep improving. I just have to be patient!
 
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vwolfvoa

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Well, a downside to getting back to life is, after 2+ years of extreme caution, I tested positive for Covid last Sunday.

Luckily, I’m vaxxed and double boosted, but I can’t help but think the TKR made me a bit more vulnerable. It hit me as a bad cold; I took the Paxlovid and isolated in the guest room, and tested negative 5 days later…my poor husband had thought he was done being Florence Nightingale!

Now energy drain is a bit worse, but I don’t think my knee suffered from 5 days of inactivity. I’ll just listen to my body and respect that I’m still in recovery, although it’s hard not to blame myself for being lazy when I’m exhausted by midday!
 

Jaycey

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@vwolfvoa So sorry you got hit with Covid. I too had it end of March and agree - energy drain was the worst part. Be good to yourself for the next couple of weeks. The tired feeling does linger a bit. Short walks and lots of naps!
 

Cbet

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Boy, I wish someone had told me. I don't know what planet I was in prior to the surgery. I'm so used to bopping back from things, I was floored when I woke up and couldn't pick up my leg!!
@CalmAlice Not being able to lift my leg had me freaked out as well.... it took a good 2 weeks for me to comfortably lift it which is bizarre when you don't expect it.
 

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