TKR RTKR Mar 4th 2022. My journey

[sistersinhim]

Here's another example of what's going on inside your body:
Energy drain for TKRs

 

[Rubybegonia]

Well day 19 post op and I'll try and be positive. Saw OS yesterday for staple removal and he said all looks good on the X-ray and that I have work to do to get my knee to bend and I'll see him again in three weeks.
Saw my PT. she is very supportive in terms of thst I'll get there but the measurement yesterday was 87 degrees which if I read others this is pretty bad. She is going to have me come twice a week now. As well as my at home exercises
After that big day and a short stop for five things at the grocery store my knee was so swollen and painful. Almost like early days.
How am I to do the stuff needed to get the bend when I am swollen and have pain?
I had stopped all pain meds except at night was taking tramadol but I'm considering going back despite the professionals all saying it's best to get off the drugs as soon as possible.
I'm really struggling g like I had no idea I would.
End rant.

 

[FourCats]

Rant away! We get it! It sounds like right now you need to be icing, icing, and icing. You’re so early in your recovery and today showed how doing too much too soon is not helpful. Personally, I would not go to PT until you get the swelling down which means elevating and icing. Moving around the house to use the bathroom and quick food prep is more than enough exercise for right now. I hear your frustration and understand.

 

[Jockette]

Well, you can’t over exercise a swollen knee into submission, it doesn't work that way.

How am I to do the stuff needed to get the bend when I am swollen and have pain?

Continue to do your gentle bends, and spend a lot of time resting, icing and elevating, as these are the things that will help your swelling go down. It is pain and swelling that is preventing your knee from bending more, as that‘s the nature of this recovery. It is not that you aren’t exercising enough.

Day 19 is very early days, your body is still trying to figure out what happened to it. It really is way too early to worry about ROM numbers. I‘m sorry your medical team doesn’t see it that way.

It really would be in your best interest, all the way around, to take some type of pain medication. Did you feel the tramadol helped? If Tylenol agrees with you, you can add that. Many of our members did a combination of tramadol and Tylenol with good results.

The most effective way to take Tylenol is 2 x 500 mg tablets every 6 hours, to a total of 4,000 mg (4 doses) in 24 hours. You need to take it regularly, to keep up the levels in your bloodstream. If you just take the odd dose now and then, it's far less effective.

Check all other medications you're taking, to make sure there is no Tylenol/Acetaminophen/Paracetamol in them. If there is, scale back one or two of your regular Tylenol doses, so you stay within that safe 24 hour limit of 4,000 mg.

 

[Jockette]

This is what one of our members, TortiTabby, experienced:

(Just so you know, ADL means Activities of Daily Living.)

“At my six week appointment this is what my OS wrote in my visit summary: "She reads an online website called Bone Smart which states to not push through pain following knee replacement. If she were to follow this direction, she will have to learn to live with a knee that only reaches to 85 degrees of flexion. I believe this website is very misleading."
It has now been 20 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks (where I am today): 110
I am so thrilled it keeps improving and improving and I know now that I will get to my goal of 120 (or even better, dare I say!)
So, if a OS or PT bullies you into thinking your ROM will not improve over time they are wrong. By the way, I haven't been back to see the OS since that horrible appointment at 6 weeks, but I sure am going back when I reach 120 just to say, "Ha! You were wrong, BoneSmart was right!" “

And,

“Just an update for those who are apprehensive about gaining ROM:
It has now been 26 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better. “

 

[Rubybegonia]

@FourCats Thank you for your words. Ranting sometimes helps
@Jockette thank you for all the encouragement I just need to follow it.
Went to physio again today. It was a pretty positive experience. Mostly spent on the recumbent bike and attempted the stairs.
Got myself to 93 degrees. So I'm very happy. I'll ride this little high for now.

 

[Rubybegonia]

Well here I am again feeling very much like a failure and very frustrated. Had physio again this morning. Still at mostly just 90 degrees.
Knee feels incredibly swollen so much so that trying bend it to just walk properly isn't happening. Never mind trying to do prescribed physio.
I continue to ice and elevate and still have to take Tylenol at times altho it doesn't really help much.
I'm just so sad about this. Worried thst I may never be able to do stairs or tie my shoes properly never mind hike and bike.
At what stage is a MUa suggested and how successful are they?
I wish I'd stuck with my old wonky leg.

 

[Jockette]

Oh, Ruby, please, please, please don’t do this to yourself.

You will heal, you will regain your ROM. You aren’t even a month out of surgery. What you’re going through is par for the course. It is way too early to think about MUA. This recovery takes an average of a full year. So, you are one month out of 12 in your recovery.

Recently I compared this recovery to baking cookies. My chocolate chip cookies take 12 minutes to completely bake. If I take them out earlier, at 2 minutes, 4, 8 or whatever, they will only be partially baked, and not all that tasty, because they’re not done yet.

The same is true of our knee at 2 months, or 3 months, etc. It needs time to finish healing.

 

[Rubybegonia]

Oh thank you for your words. I'm just so so discouraged tonight.

 

[MarkTKR]

Take it easy Ruby... Recovery is not easy. Don't let anyone push you to pain and more swelling.

Heck the swelling alone, even if you don't do a single lick of exercise is enough at times to drive you crazy. So rest, take it easy. You will get there.

Gosh, I've posted about my LTKR followed by tendon rupture... I'd kill for 60 degrees of motion LOL. I mean today I was on the bike, I can't go around and I just have to push into the stretch and it just seems like so little bend.

But hey I can walk and that is saying something. Now to get rid of this damned leg brace... sigh... always something.

 

[Jockette]

If you haven’t read this, now is a good time. If you have read it, read it again.

Post op blues is a reality - be prepared for it

Post op blues is feeling depressed, weepy, nervy, shaky, fearful of the future, anxious, overwhelmed by what is happening to you, convinced it's never going to get any better and finally, uttering that most intense of all cries "I wish I never had this done!" It arises out of a variety of...

bonesmart.org

 

[FourCats]

@Rubybegonia it is so easy to get caught in the trap of thinking we should be getting better faster than we are. Your new knee is just a wee baby, needing lots of rest, elevation, and ice. My first knee is almost a year old and I still have to occasionally ice it when I’ve done more than it is able to. Knee #2 is less than two months old and I elevate and ice at least twice a day. The blues are normal and to be expected. Be good to yourself and keep us posted on how you’re doing.

 

[sistersinhim]

Knee feels incredibly swollen so much so that trying bend it to just walk properly isn't happening. Never mind trying to do prescribed physio.

Can you bend a water hose full of water with the nozzle shut off? Nope. Your knee is the same way. Being swollen means it's full of fluid and is hard to bend. Ice and elevate as much as you can and that fluid will go down and your ROM will improve. Gentle movements is all the PT you should be doing at your stage in recovery. Anything that causes pain and/or swelling is a setback in your healing. Slow and easy wins this recovery!

Still at mostly just 90 degrees.

At one month out, this is a great bend. Most OSs don't look for this until 6 weeks out. Enjoy your success here, it is definitely not a failure!

 

[Rubybegonia]

Going into week five and I'm so sick of this and wished I'd never had it done.
Physio said to take three days off and let the swelling and pain calm down, which I did and it did.
Still was up and doing g things around d the house , a couple short walks and a few sessions on my spin bike. Oh to be able to make a rotation. Feel like my days of spinning are done. .
This morning I did the exercises from
Physio and I can't even do
Some of them
Or complete the number of sets without excruciating pain on the outside of my knee and radiating down into my lower leg.
So now I'm laying feeling sorry for myself (elevating and icing)
I'm at my wits end. I truly don't know what to do now.
And now I see this. Hmmm

 

[jaspa]

@Rubybegonia you are only a month out IMO you are doing too much. Take it easy on yourself and elevate and ice that knee so you can get the swelling to go down to make it feel better. I know as with my second TKR I have vein problems which produced extreme swelling and I just now this week were able to do a complete spin on the bike. I also have to wear a compression stocking on the LTKR due to the vein problem but I can tell the swelling is going down as the thigh high compression goes on easier each day. Take care of yourself.

 

[Jockette]

I agree with jaspa.

Physio said to take three days off and let the swelling and pain calm down, which I did and it did.

Since pain and swelling improved when you slowed down, this proves you are doing too much. Just do some very gentle bends and some activities around the house. Don’t worry about the bike, you will be able to do it better when you are more healed. It is definitely not the end of your spinning.

Is your incision opening up? If that’s what I’m seeing, call your surgeon, he may want to look at it.

 

[Rubybegonia]

Yes it's the in incision. The last of the steri strips fell
Off last night and then today after exercising it looked like this !
I really appreciate your words. It's how I feel
Intellectually , however I have this nagging in my head that if I am not meeting the criteria of goals at each step , as laid out be the hospital booklet , I'm failing. Ugh

 

[Jockette]

however I have this nagging in my head that if I am not meeting the criteria of goals at each step , as laid out be the hospital booklet , I'm failing. Ugh

There is no fail in this recovery. And, those booklets are written to people in general and are one size fits all. We all got them. They do not account for each of our individual recoveries.

Please don’t worry and/ or think you have to do every exercise in that booklet, or the amount of reps they say. They don’t know you.

And, if your knee did open up, you don’t want to stress it with any exercises. It needs to rest so it can heal.

Take charge of your recovery and let your common sense tell you to back off all these painful exercises. As @sistersinhim likes to say, our knee knows how to recover without being told what to do.

 

[sistersinhim]

This morning I did the exercises from
Physio and I can't even do
Some of them
Or complete the number of sets without excruciating pain on the outside of my knee and radiating down into my lower leg.

With the way your incision looks, you should be resting your knee, not trying to do exercises. There is no timeframe for you to resume your ROM. It will come naturally as your knee heals and the swelling goes down. Concentrate on getting and keeping that swelling down.

 

[Rubybegonia]

Today's update.
I went to physio therapy today and was unable to do much due to pain on the side of my knee. She tried some massage and we tried the TENS machine and the measurement of the day was 50 degrees down from a high of 92 a couple of weeks ago.
She suggested I might want to try and see the surgeon sooner than at my scheduled appointment in two weeks.
So I called and was able to see my surgeon and he said everything looks great, pain is normal and thst I should just continue to work thru it and he would see me in two weeks. I had a little cry which he didn't seem to care about.
As I was leaving he said we will see what your range of motion is then and we might have to do a MUA, but that is rarely necessary.
So I'm home feeling depressed, defeated and feeling like everyone else can do this recovery, why can't I?
They shoot horses, don't they?