TKR RTKR - November 6, 2023

406Gypsy

new member
Joined
Nov 22, 2023
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11
Age
58
Location
Montana
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Greetings! Found like site and thought I should join since I'm just beginning the road to recovery on my 1st TKR (right). Surgery was performed by surgeon on 11/6 and I was discharged home the next day. Unfortunately, they couldn't get a nerve block in so just had general anesthesia. I've managed the pain fairly well with the Robaxin and Dilaudid and OTC Tylenol - I'm down to just taking the Robxin and Dilaudid at night prior to bed unless I've over-done it earlier in the day, in which case I take an earlier dose as well. I've been using a cane since last Saturday and that's when I also started - slowly - going up/down stairs - one leg at a time...lol.

I saw the surgeon and PT for my first follow-up yesterday and they were very pleased with my range of motion. I'm better on straitening the leg than the 90 degree position - I can get there, but it's still slightly painful. They want me to schedule 2 visits per week with my local PT, but only to keep what I'm already doing on track and perhaps helping with other stretching exercises.

My main issue is with my right sciatic nerve - it's been really painful ever since the surgery. I realize sitting/laying in one place isn't helping that, but even now that I get up and move around a little more, it's still not resolving. I'm wondering if any of you had similar issues and, if so, any suggestions?

I'm working remotely as of this past Monday - I have a great employer! I have a desk job and am wondering how long I should wait until I try to get back to the office. I was thinking I would continue to work remotely for another couple of weeks - do you think it would be okay after that to be at my desk for 8 hours - although I know I'd need to get up and make a lap around the office every couple of hours?

I'm 57(f) - about to be 58 :). Thanks in advance!!
 
Welcome to BoneSmart. Here, 1st of all, is our general reading

Knee Recovery: The Guidelines

We are all different, as are the approaches to recovery. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart will offer advice and are there to help. The advice may vary, but YOU are the final judge as to the recovery approach you choose.

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

6. Access these pages on the website

The Recovery articles:

There are also some cautionary articles here


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.
 
I'm working remotely as of this past Monday - I have a great employer! I have a desk job and am wondering how long I should wait until I try to get back to the office. I was thinking I would continue to work remotely for another couple of weeks - do you think it would be okay after that to be at my desk for 8 hours - although I know I'd need to get up and make a lap around the office every couple of hours?
In my opinion this is a very ambitious work schedule. BoneSmart usually suggests 12 weeks off work entirely - some contrast!

I'd say to stay at home as long as you can, and not to do too much. You may be surprised at how tired you are and how little you can do. The body takes over and mobilises all resources to healing.

Having said that, it's what works for YOU that counts. All recoveries are different.
 
Hi! I'm sorry I can't address the sciatica question - others here definitely have experienced it and I hope some will pipe up! - my feedback is on returning to the office.

You were probably given a specific protocol by your ortho team. Mine was to elevate and ice like crazy and to walk ever hour while awake.

Elevation doesn't mean feet up on a hassock or even being in a recliner. It means regular sessions of "feet above nose" throughout the day. Most of us in the initial several weeks are icing throughout the day except when up and about.

Assuming you have the stamina to return to work, and transport there and back, will you be able to meet the priorities of your knee while in the office all day? Is it feasible to do an open ended trial of four hours, then six, if you're eager to get back?
 
Thanks for the response. I would love to be able to take an entire 12 weeks off. Unfortunately, here in the US, that's not an option for me. I used up all my paid time off just so I could take the 2 weeks following the surgery. Working remotely for a longer period is a possibility - only my sanity might suffer...lol.
 
Hi Mendogal - yes, they were pretty much telling me it's up to how I'm feeling, but not to push myself. I even discussed with my employer returning to the office for a few hours in the morning, then coming home and working remotely for the rest of the day - that way I can have my leg elevated and turn on my ice machine. They are awesome though and aren't pushing for me to return to the office right away. As long as I can work remotely, I think they'll let me take as much time as I need - it's more my desire to return to the office as I feel I get more done in that setting. I know that I'll work remotely for at least another couple of weeks - I'll have had some PT sessions by then as well and can better judge how the knee will hold up and what I can tolerate. Thanks for your feedback!
 
When returning to work you need to take into account the time and effort it takes to get ready, drive there, do your daily job, then come back home to take care of things there. Then, turn around and do it the very next day, every day for a week.

I think waiting as long as you can will benefit your overall health, healing, and recovery. You are blessed that you have the ability to work from home. Most people don't.
 
I'd encourage you to work remotely for as long as possible. Post-op fatigue is a real thing and can last for several months. After a surgery like this our bodies need almost all of the energy it produces for healing.

You might want to take a look at the illustration here (scroll down to the second post), which explains this: Energy drain for TKRs
 
Hello and Welcome to BoneSmart!
In addition to the Energy Drain, often times concentration is a temporary issue. With that said, it sounds like you're targeting the one month post op date as a target date for your return to the office full time. It may be a bit ambitious, but if you have the flexibility to try it, then adjust accordingly if you're not ready, that will be best.
Happy Healing and Happy Thanksgiving! Thanks for joining us!
Phased return to work
@406NastyWoman
 
Thanks everybody. After my first (short) week working remotely last week, I certainly understand your mentions of an energy drain/fatigue - I certainly didn't think sitting in a recliner using my brain and typing would tire me out so much!! I'll take a look at the info on that.

Since the firm I work for is willing to be so accommodating, I think I will probably take everyone's advice and push out the actual return to the office. I set up my first few PT appointments with the first being this coming Friday - no strength training, just more of what I've been doing at home and maybe other stretching exercises. Then 2 appointments each week after that - we'll see how much that tires me out!

I'm 3 weeks post-op today and have 3 weeks of PT scheduled. I think I'll work remotely through then and then re-assess how I'm feeling. My plan is still to just return for a few hours in the mornings and work remotely in the afternoon (plus I work completely remotely two days a week anyway, even prior to surgery). If that is still too much, I'm sure the firm will allow me to go back to remote for another couple of weeks and then try again.

Again - I appreciate everyone's tips and advice.
 
Hi there! :wave:
I hope you had a nice Thanksgiving. Happy Three Weeks post op!
You're blessed to have options in regard to your return to work, many sadly don't. I think your decision is a wise one and any advice you can share along the way will benefit others. I hope you have a nice week and best wishes as you begin PT!
@406NastyWoman
 
Since the firm I work for is willing to be so accommodating, I think I will probably take everyone's advice and push out the actual return to the office.

My plan is still to just return for a few hours in the mornings and work remotely in the afternoon (plus I work completely remotely two days a week anyway, even prior to surgery). If that is still too much, I'm sure the firm will allow me to go back to remote for another couple of weeks and then try again.
You are so blessed to be working for such an awesome company. Many do not have the luxury that you have. It sounds like you have a good plan for the future.
 
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I have been having sciatica also. Started out using a heating pad which was competing with the ice on my knee. I thought it helped but then decided it was getting worse. I’ve had better luck the last few days using ice on lower back and/or hip in between icing knee - I have an ice machine so I just switch the pad around.
 
Took my first real shower yesterday - never thought washing my hair would feel so good!! Had to maneuver carefully to get my leg over the edge of the tub, but went slowly and everything was fine. We've had a grab bar in the shower since we bought the house and I was happy to have it there - it helped steady me a lot. I didn't linger, but by the time I was done with the shower, getting dried off and re-dressed - I was pooped!! Knee was also a bit achy at that point as well.

The incision looks great - I patted it dry and then just let it air-dry. Haven't put the compression thing back on yet - not really sure if I will - it's not TED hose or anything as tight as a compression sock - just a tube that provides a bit of compression - like a loosely wrapped Ace bandage. Thoughts?

I used the cane to get around a bit after the shower, since I was tired and the knee was a bit sore, but for the most part, I'm able to get around the house (slowly) without it. I'm going to drive myself to my PT appointment tomorrow since I've stopped taking the dilaudid and only take a Robaxin at bedtime. It's only about a mile from my house and we live on a pretty rural road with little traffic. Definitely plan on using the cane outside the house for stability - especially since we're expecting our first real snow of the year!
 
just a tube that provides a bit of compression - like a loosely wrapped Ace bandage. Thoughts?
Let your knee be your guide. If you see extra swelling and elevating doesn't relieve it, then the TEDS might be needed, but I think the tube would be fine if not.
Took my first real shower yesterday - never thought washing my hair would feel so good!!
Oh yes, yes, yes! I remember how good that felt! Good for you!
 
First showers are the best! Regaining our independence with the ability to drive again is a great feeling also.
Best Wishes for your PT appointment tomorrow. I hope you have a nice weekend!
@406Gypsy
 
4 weeks post-op - second PT appointment yesterday - went for about 45 minutes this time and did more weight-bearing exercises this time. Nothing too intense, just doing some of the exercises I've been doing in a seated or reclined position while standing up to try to start engaging the quads a bit more. Also used a 3" step (in between parallel bars) to go up/back down leading with my right knee - I was surprised (and a bit elated) that it wasn't painful at all. I've forgotten a couple of times going up/down my stairs at the house and used my right leg to lead and man, did I feel that!! Granted, my steps are normal height, but still, lol. Anyway, very pleased to start using the muscles in a different motion and start building up the strength.

We also got on an exercise bike - not for the typical exercise, but to just go around as much as my knee would allow, then reverse the direction, again to the position my knee would allow. Basically a different way to stretch the knee muscles - I'm able to get about 3/4 of the way around which I think is good progress.

Definitely had to ice when I got home for about 3 hours, plus OTC Tylenol and a Robaxin at bedtime. This morning it seems to be fine. I am working remotely and need to try to remind myself to take a break every couple of hours to get up and walk around. I"m finding that if I don't do that, when I do manage to get up, my knee is really stiff and takes a lot longer to get in the groove.

Hope you all have a great day!
 
I'm able to get about 3/4 of the way around which I think is good progress.
That is fantastic at one month out!
I am working remotely and need to try to remind myself to take a break every couple of hours to get up and walk around. It's finding that if I don't do that, when I do manage to get up, my knee is really stiff and takes a lot longer to get in the groove.
That is pretty normal. Keeping it moving is keeping it better lubricated. With my older body, I have to move most of my joints even during the night or I'll be stiff when I get up. Walking every few hours is much better for your knee than not. You have found that out for yourself. Experience is the best teacher!
 

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