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TKR RTKR December 9, 2019

Love2cycle

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Had my RTKR on 12/9. Had no idea of what to expect and everyone who had a horror story made sure to tell me not to do it. I am 50 and have been dealing with arthritis in my left knee for 15 years. I favored my right leg for so long that I ended up with large bone spurs in the joint that kept breaking pieces off and ended up making it difficult to walk. When I could no longer ride my bike with my husband or walk normally I knew it was time.
I am 6 days post op today and overall things have gone well. I was sent home the same day as my surgery about 5 hours after surgery. I was up and walking before discharge. I took the advice of This site and took pain meds on a schedule.

Nights have been the most difficult and sleep about 3-4 hours at a time. I am sure that will get better as time goes by. I am very mobile with crutches. Sitting to standing is difficult without assistance helping get my leg on floor slowly. PT has been helpful and more about learning to evenly weight bear. Today I am dealing with more stiffness and swelling.
The biggest challenge I have had has been the fear of running out of pain meds. Taking them every four hours I ran out on day 5 and my insurance company refused to refill until day 7. I just filled and paid cash but the refill was not enough for a week. I will see my surgeon this week and get a refill but it is very challenging to get the meds you need. I know there are rules due to the opioid crisis but frustrating for situations like this!
 

Jaycey

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@Love2cycle Welcome to the other side of surgery. Sorry you are dealing with the pain meds issue. Are you icing and elevating several time per day. That may ease some of the swelling that is causing you pain.

Based on your username I'm going to tag my colleague @Roy Gardiner who has first hand experience with TKR and is an avid cycler.

Here are some basic guidelines for your recovery.
Knee Recovery: The Guidelines
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.
 

Sara61

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Once you get your pain medication under control your life will get better, knee pain is soul destroying and debilitating, it seems worldwide we all had problems with our prescriptions at the beginning. Once under control you can concentrate yourself and your healing. Swelling and stiffness takes for most of us forever to disappear - but if you read some of the older Bonesmarties posts it does go eventually, my surgeon told me it can take up to 12-18 months x
Wishing you a good recovery xx
 
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Love2cycle

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Thank for the advice. I have been using my ice machine almost around the clock and elevating using the lounge pillow. For the most part it has been under control until I had to cut down the dose to make sure I did not run out before my next appt. I increased the Tylenol and it seems to be tolerable for now. One day at a time
 

Helizabug

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Not a doctor, but I switched out my Oxycodone with ibuprofen because the Oxycodone was messing with my bowels. Stuck with the Acetaminophen, which does a pretty good job of sheer pain relief for me.I found the ibuprofen helped a lot, maybe because of its anti-inflammatory qualities. Might have eased some swelling and angry soft tissue. Maybe that could help you? Ask your doctor if it’s okay, though. There are strains on your kidneys to think about and blood thinning to worry about.
 
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Love2cycle

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Got my pain management worked out and adding extra Tylenol has helped. Day 7 and down to one crutch! Beautiful day here in Florida so hobbled outside and put my leg up in the sunshine. Fresh air makes everything feel better!

Surprised that my leg feels better standing upright than it does sitting.
Sitting with my leg elevated is causing me pain especially on the kneecap. Any suggestions for how to prop my leg that may help? I think it is due to the stiffness and swelling around my knee.
 

Jockette

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Love2cycle

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Wondering if anyone has any suggestions for spasms. Today started feeling what I can only describe as brief but painful spasms in my knee. They only last a few moments. I am icing it and that seems to calm things down. I was out a lot today with knee down in car going to post op appt and stitches out etc... I think it may just be from doing too much, but wonder if anyone else has experienced this.
 

Seatides

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Hi @Love2cycle! I've had occasional brief but sharp twitchy spasms of my knee or leg too, but they've definitely decreased in frequency to the point that I think they're gone now. I had my surgery about 5 weeks ago, but those odd twitches and hypersensitive painful spots in my leg, especially when I'm trying to sleep, have only now greatly diminished. Like you, I did find that icing helped settle things down.

I know what you mean about how our doctors underprescribe opioid pain meds, despite the fact that we truly need them. That stressed me out more than anything the first couple of weeks. I'm off Percocet and would like to supplement all the Tylenol with Advil or Aleve, but my surgeon doesn't want me to yet; apparently some studies have shown that NSAIDs can interfere with bone healing.
 
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Love2cycle

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Thanks! Glad to know they get better. Relaxing more today and so far none. I think my body is telling me to sit down!!
 
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Love2cycle

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So update at the two week mark today. What a difference a week can make. I actually slept through the majority of the night last night. I took it very easy for a few day and lots of icing. I am down to oxy only before bed. Tylenol during the day.
I felt like I hit a milestone today when I could lift my own leg into the car without help! It’s the little things. This recovery is definitely a marathon and not a sprint.
 

jaybird

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It’s definitely the little things! I’m only four days ahead of you and discovered today that I can get into the car like a normal person - no more sitting down and swinging my legs around.
 
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Love2cycle

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I was so excited yesterday. I was able to pedal the stationary bike forward and go all the way around. Only two and a half weeks ...PT told me it would be several more weeks. I was just rocking back and forth and knew I could do it and it wasn’t painful. Wasn’t easy either but manageable.
Not ready for the road yet, but I guess all those long rides Pre-op are paying off. Now if I could just sleep this wouldn’t be so bad!
 

Helizabug

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Wow! Wow! Wow! Maybe in the Spring you’ll be on the trails!

I got on the bike at my last PT visit, and I was stuck at the back and forth, but my heart was racing because I was so psyched to even try!

Yay for progress!
 

Helizabug

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Yup. It feels great! We’re all moving along!
 

skill1234

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Really enjoying watching everyone's recovery! It's very encouraging and supportive. Way to go!!!
 
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Love2cycle

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This recovery is definitely a roller coaster ride. There are good days and bad days. On the bad days I sit with my cryocuff ice machine on all day. Is it possible to ice too much? Can that make my knee stiffen up? Seems like some days my ROM is great and the next stiff and hard to bend.
 

sistersinhim

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For the first month or so I iced the whole time I was sitting or laying down, making sure I always had a thin cloth between my knee and the ice pack. The ice helped to keep the swelling and pain down. So, no, I don't think you can ice too much. Only make sure you don't have the ice pack directly on your knee. A cloth between them is necessary.
 

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