TKR RTKR Done Looking Forward to the Future

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@jul
Going down stairs for me at 8 weeks post op is still a struggle and I have 41 steps from ground floor to the top of the house !
Time to think of a bungalow for the future!

Hope things improve for you.
Take care,
Cathie
 
@marmora Cathy You poor thing my house is one level thank goodness. It made me a bit annoyed with myself for not trying harder and keeping up with the excises.

I am up at 5.30 catch a train that is about 40 min ride then walk down a hill to work if there is no transport down on crutches. I havent attemted going up the hill yet but i have a liitle and it is a bit hard. I get home between 5.10 and 5.30 depending on delays even though you sit on the train its still seems draining. I get home sit for a min get rady for tea thanks goodness my husband cooks eat sit ice a bit then go to bed as im am ussally falling a sleep on the couch. And all i think about is exicses exicise.
If I wake I do a couple of leg slides then fall a sleep again.

But I just think the pain is different from th pain I had before the op.

J
 
Hi J @jul

I'm tired just reading about your day.

Walking with crutches is so tiring and with your travel time to & from work, let alone a working day, it's no wonder you fall into bed after tea.

The weekends can't come fast enough for you.

Take care,
Cathie
 
Jul.....I've just re-read your thread and I can truly understand why you are having problems with fatigue and pain. You returned to work sooner than you should have (at about 4 weeks out) and your schedule is putting a tremendous strain on you. Is there any way you can back off this schedule?

If not, then you must be realistic about your physical capabilities at this early point in your recovery. At 6 weeks out, you are in early recovery. We usually don't recommend that people try to go back to work until 10-12 weeks and then on a phased in schedule. Most people just can't handle work before that time.

In your case, you're pushing your body to do a full 12 hours by getting up at 5:30 a.m., getting ready for work, traveling there, walking to the job, doing your job, then walking back to transportation, riding 40 minutes home and arriving around 5:30 p.m. It's no wonder you are exhausted and in pain!

Please don't think you need to do any exercise on top of all this. You don't! What you do need to do is to find a way (if you must keep this work schedule) to incorporate some rest, icing and elevation into those 12 hours. Is it possible to take 2-3 breaks during the work day and get your knee up and iced? If you have access to a freezer at work, can you take some gel packs so you could ice on the 40 minutes to and from work?

If you must maintain this schedule, I suggest you immediately ice and elevate for an hour when you get home. Have hubby prepare your dinner, eat, and then then get to bed as early as you can. Use ice all through the night as you sleep and maybe take something like 1000mg of acetaminophen to help you relax and sleep.

When you are at work, do not sit for longer than an hour. If you cannot get up and walk around for 5 minutes out of every hour, at least stand and stretch for a few minutes at your desk. Try not to roll around on the chair too much as that gives your knee quite a workout. At least 3 times during the work day, do some gentle bends and stretches on with your knee just to the point of discomfort....not pain. This will help with your ROM. If you have access to stairs, put your operated knee up on a step comfortably and lean into it for the bends. For the stretches, put your operated leg up on a chair seat with the heel on te seat itself and straighten your leg. Hold that for a few minutes.

You must stop feeling guilty for not doing more. Constantly pushing yourself can actually cause you more problems than not doing "enough." Don't let anyone "guilt" you into thinking you aren't working hard enough at your recovery. At 6 weeks, your body is still healing! Most people don't begin to feel normal until at least 6 months out. And a full recovery takes a year or more.

Your surgeon did you a great disservice by suggesting you would be skipping and jumping right after surgery. What bunk! This is a major procedure and it takes time to recover. I'm going to post a couple of our recovery article links that I'd like you to read again so that you can appreciate what your body is going through.

The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Activity progression for TKRs
Healing: how long does it take?
Chart representation of TKR recovery
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling

Please don't feel like I'm beating up on you....I am actually very, very concerned about the level of activity you are trying to endure at just 6 weeks out from your surgery. Your new knee is strong and you will not harm it. But....your extreme fatigue is a signal to me that the rest of your body is saying it's being pushed to the max. That is never a good idea.

Please post after you have read the links I've given you and let me know if there are any of my suggestions that you can incorporate into your recovery. Ideally, I'd love to hear that you could take a couple of weeks off from work and focus on getting yourself back on solid footing with lots and lots of rest. If that's not possible....let's see what can be done to help you feel better. We can work on a solution. I'm also going to tag our forum nurse, @Josephine to see if she has any additional ideas for you.
 
I concur with everything Jamie has said.

I would add that I too read your entire thread and you have not once mentioned pain meds. Thus far you're only 8 weeks and all that you've been doing far exceeds what I would have preferred to be done at 10-12 weeks out!

As for you not doing enough exercises you might like to read the potted version of my recovery to see how little exercising I did! Knee recovery - UK style


So I'm also going to ask you some questions and it would be very helpful if you would answer each one individually - numbered point by point as I have done and in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine)

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how often are you icing your knee and for how long?

4. are you elevating your leg, how often and for how long?

5. What is your ROM - that's flexion (bend) and extension (straightness)

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. what kind of PT/exercises are you doing? How much and how often? (and detailed details would be appreciated, please! Reps, sets and session and all that)

Note:
If you're not familiar with this, it goes like so:
1 lift of a 500kg bell bar = 1 rep or repetition.
Doing 5 reps and then a brief rest = 1 set of 5.
And doing 5 sets and finishing = a session.
 
@Jamie hi thanks for your comment and concern i am 8 weeks yesterday sorry if there was any confusion about weeks. Just reading your comment has made me feel better. I will read your links and let you no.

I do try to get up a few times and sometimes I don't have a choice as I have to attend to people.

I try to ice but sometimes it's just not convenient but I do when I get home I try to ice during the night but sometimes I feel it wakes me up from my sleep so I don't do it as much so I can get a bit of a sleep.


I do try to stretch or bend but not what you have suggested so I will try them today at work.

I'm on the train now trying to reply I will again later when I'm at work.

Again thank you so much for your support and please don't feel like you are beating on me not at all you are just showing concern.

I wil share one thing with you though. I have a work colleague that assists my supervisor they work else were to me she had come to assist me with some work as it was a busy day. During the day I said to her that one of our other workers has taking 3 months of to have a hip done and I said I think I would rather that than the knee as I didn't think it was as evasive and the fact I had to come back to work on the 5th week of my op and she quickly shut me down and said I have no idea what I am talking about and that the one is nothing compared to a hip replacement

I told her that I don't think that is true so then she proceeded to tell me that she has has a knee reconstruction and that was worse than what I have had and I just looked at her and then I don't think so which then she said I don't know what I'm talking about her knee reco was a lot worse than what I had done I looked at her and said my bones have been sawed hammered pushed shoved all sort of things and she still gave a bit of a smart look and grunt like you just don't get it. Then she proceeded to tell me to stop using the crutches or I will start to rely on them. Even my supervisor said do to worry my mum had both done she is in Greece now you will be right.

I couldn't believe it that is the support I get of them my work place.

J
 
Clueless clods!
I agree with Jamie--letting your husband cook and put your leg up and ice after work is good. If icing bothers you overnight just ice right up until you go to sleep. I'm cooking very simple and putting my leg up after work and I'm much farther out than you. You need to take care of yourself. Do you have any sick days you can take due to a "cold?" :wink:
 
How about enlisting the aid of your GP to deal with your supervisors at work? I am not completely sure how your national health system works in Australia, but it may be possible for your doctor to write something for your work that allows you to have additional time off to recover.....or to require that your job make some accommodations for you to have some time during the day to rest, ice and elevate your knee.

Your coworkers are quite right that there is no comparison between a hip replacement and a knee replacement. But...they have it completely backwards. Knees are a much more complex joint and recovery from a TKR is much more than a hip replacement. I'm assuming that your other coworker who was talking about a "knee reconstructon" did not have a knee replacement. I can assure you that any other type of knee surgery will never equal what is done in with a knee replacement. It's like comparing apples and oranges and the TKR wins out every time as a more difficult procedure to recover from. Good for you for standing up to that person! It always amazes me how people with no medical qualifications at all speak as though they know about these things! This is where I think a nicely worded document from your GP could put this all in proper perspective for these delusional folks.

In any case, I'm sure you are not listening to the advice to not use your crutches. As long as you need whatever walking aid you have (walker, crutches or cane), use it. It is far worse to try and limp through the day. That will throw your whole body out of alignment and make things even worse.

I see that Josephine asked you some specific questions. If you can find time to answer them it will help her provide suggestions for you too. She is especially concerned about the pain you're in and the fact that you're not mentioning any pain meds you're taking. So I hope you can give her some additional information soon.
 
I would like to say my husband does all the cooking and cleaning so I am lucky there I do try help with a few things but I think he thought it was going to be a bit quicker in recovering.

@kneeper That is part of my problem I dont have many sick day left but I do have long service leave which I am saving for my other knee as I will take off at least 2 months next time around.

@Jamie I hear what you are saying but they just dont get it so I will just battle on and for the leave i think if I need i i could have more time of but I just cant at this stage I do have a light duties letter but that doest seem to help much either.

@Josephine

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine)2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often? It can range from 1 to about a 4 I think some days are worse than others and night its seems t hurt more depending on the way I am laying.

3. how often are you icing your knee and for how long? I try to ice at work at least once but its hard this week I have done it once at work fo about 45 min and then of and on at home and sometimes in bed.

4. are you elevating your leg, how often and for how long? When I get home I try to at the same time I ice it but not all the time and when I am in bed I try most of the night until I am uncomfertable then turn for a while then back on my back again.

5. What is your ROM - that's flexion (bend) and extension (straightness) I dont know as I havent had it meassered for a while My surgeon said to jsut walk for a week due to the fact we thought I had an infectin but I thik it turned out to be that I pushed it to hrd in te pool one day. The last time I went to PT I think it was between 95 and 100 ROM and extension was about a 1

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and
Not much I help a little around the house on the week end fold cloths somtimes hang them up and get them of the line. I help wash up dishes and on the week end go to shops with hubby and just odds and ends


7. what kind of PT/exercises are you doing? How much and how often? (and detailed details would be appreciated, please! Reps, sets and session and all that) I havent been doing a lot I may try to f omnight as that seem
 
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@Josephine sorry PC froze
7. what kind of PT/exercises are you doing? How much and how often? (and detailed details would be appreciated, please! Reps, sets and session and all that) I dont do as much as I did when I got home. I try to do some while I am in bed at night as that seems to be the time i get a min to concentrate. I try to do leg lift while laying down about 10 X 2 sets and same for side leg lift and about 10 knee slides as it is a bit sore and stiff by then

I hope this helps.

J
 
@Josephine sorry I missed number 2 I take endone 5mg a couple if times a day and sometimes 2 at night and in between I take panadine occasionally.

I also forgot to say I get on the bike sometimes and get full rotation but if it's sore I don't do it.

J
 
Where's the emoticon for clueless supervisors being offered a last cigarette in front of the firing squad? I am so sorry you are going through this. Please squeeze some extra icing and elevation into your day. Also I am pretty sure you have a Tylenol deficiency. All the best.
 
Thanks for your answers. However, when I say I want details I really DO want details! I even gave you an example at the bottom of the kind of detail I need.

As for you medications, you're only 8 weeks out and should still be taking them. So what are you actually prescribed, meaning that's written on the box? It should be something like 1-2 every 4-6 hrs. Is that what it says?
 
Might I suggest you take a total knee-cation this weekend and let your husband do the shopping by himself? I know you want to help, but a letting him help a little more in the short run may help you in the long run.
 
@kneeper I will try. He is working both days so I have said to him I am sleeping in an resting.

@jeano Lol I couldnt find it but that is exactly how I feel.

@Josephine I am sorry if I wasnt clear enough but I thought I answered the exicises one ok. I dnt do a lot as every day is different but when I do do some most of the time it is when I go to bed at night.
10 X leg lifts at 2 reps and 10 X heel slides 1 Rep depending on how the knee feels. I was doing bike at 15 min but one of the other guys said 2 min often is enough so I only do that when I get home I try to do 2 or 3 min at night if I feel good I will do a little more time.

My medication does say (Endone)1 or 2 four times a day. I was getting into a habit of forgetting. They are hard to get so I have them when I feel I need them. I did also have Oxicontin 5mg slow release for the night 1 Or 2 at night but I finshed the box and didnt get any more but maybe I should.

Yesterday my knee and leg was a bit sore so I iced at work for aout 1\2 and Hour and then when I got home o and of so that I could eat tea and then I fell alseep so I must have been exhausted.

J
 
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@jul

Yes you are doing to much without taking the proper levels of meds. As for hip vs knee...everyone heals at their own speed!

Cheryl
 
@CanukTriMom yes I think I am starting to relies this being back at work the walk alone is tiring to get my train and it swells a bit and is not real painful but enough to annoy. It's just the docs are like how many are you taking do you need that much so you think well I'm not in agony so try and have less bit I don't think that is the right thing to do I am finding out.

J
 
Hi everyone who will listen I have woken from sleep due to my knee just being annoying its like a bit of a tooth ache when I stand its not to bad but I just can't get comfortable in bed if I lay on either side for to long that wakes me up and I have to turn so then I lay on my back with a pillow under my knee to my foot but not very high that is ok for a while but then my back gets a little sore I just can't seem to win at the momment.

I don't have any other pain relief I can take I was going to take tramadole but I'm not sure about the side affects as It says not to take with anything else and can cause slow breathing.

These hot and cold feelings at nights to are driving me crazy.

Oh well that was my sook for tonight here I might take some pannadine which is panadole and codine and hope that will work for a bit. and try some ice for a while.

J
 
Please don't fear taking your prescribed pain medications!! You need them right now. Everything you were feeling last night is the result of unmanaged pain. The longer you let it go untreated, the more difficult it's going to be to get (and stay) on top of it once you finally reach the point where you do start taking meds again.

The warnings on meds are cautions. Legally the drug companies must tell you about them. But the risks for any of that happening to you are very small. Tramadol is a good medication and it can help you if you'll take it on a regular schedule. Taking pain meds only when you hurt will not work. You must do it on a planned schedule every 4-6 hours through the day and night so that you constantly have medication available in your system to counter pain that develops as you move about through the day.

Your doctor will always question your need for the meds because they don't want to overprescribe them. But, if you have pain, you need the medication and you must be firm about that with your doctor. You are not functioning well right now because of uncontrolled pain and an activity level that is too much for you at this point.
 
Well said Jamie

Last night I had an awful nights sleep because someone cut my pain meds in half on my 2nd day post op. Needless to say I was not happy and let it be known that I wanted my my meds back to full scale for today and discharge. As a result I had a great days sleep and am going home with what I need to effectively manage my pain.

Cheryl
 
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