TKR Runningfree’s Recovery Journey

[Jockette]

I had a very rough recovery, physically and emotionally!

You’re right, every person’s recovery is unique, yet similar. Our body really does know how to heal itself. If your inner voice says don’t do something, then don’t do it.

You don’t even have to highlight a line in a post, just start typing your reply in the reply box.

 

[Runningfree]

9 days post op. I am fairly happy with my progress although I haven’t seen a PT yet so I am unsure what the PT will think. The one exercise I do find painful is the knee bend, I’m at 45 degree only. My pain is well controlled by one 30 mg codeine and two paracetamols every 6 hours. I have adopted BoneSmart advice and let my knee heel, I don’t put it into pain, I walk round the house comfortably and can do the stairs with ease. I’ve started walking outside with crutches now. Getting in and out of a car is much easier too. I am doing more round the house ie some preparing and cooking meals, light cleaning etc.,
Because I had it firmly in my head, before I found BoneSmart, that exercises had to be done regularly regardless of pain for a successful knee change I do have a nagging doubt that I should have done more. I also do get at least 5 hours sound sleep followed by good cat naps at night which I am grateful for.

 

[Jockette]

You are doing very well! These are all wonderful milestones that your recovery is going well. Doing painful exercises could prevent you from achieving and maintaining these milestones.

I do have a nagging doubt that I should have done more.

Tell that little voice of doubt that you are doing fine!

 

[Runningfree]

Thank you, I love this site with help and encouragement. I hope I can give some help and encouragement out when I’m through this and the next knee. X

 

[Runningfree]

After reading some bad posts about PTs my first appointment is next Friday, 2 weeks post Knee change. I did question the long wait when the appointment came through, as I noticed how quickly the others on this site get their first appt. I worried it would set me back. I was told I was very lucky to get one that early as there is a huge backlog of people waiting for PT. on the NHS. Maybe this has worked in my favour. I can’t do a 90 degree bend yet but I do have a straight leg and and can do straight leg lifts. I sleep on my side with a slight bend in my leg. I also walk about without crutches in the house. Do light housework and can walk up and down my street. I do hope I don’t get a hard time at the PTs on Friday.

 

[Hey Jude]

l wouldn’t worry. The UK seems to take the gentle approach to physio after surgery. My first appointment was also 2 weeks after TKR and at that appointment the physio was just checking to find out how I was doing (bending, straightening, walking) and suggested some additional exercises for me to do at home. At no point did she manipulate my knee - it was entirely up to me to see how much I could achieve. The physio was very approachable and answered lots of my concerns too. I was then invited to fortnightly physio classes commencing two weeks later where I was encouraged to push myself… but not excessively. I think I got a bit over enthusiastic with the first class as the next day I was very sore. But it was all very sensible. The most important thing to remember is to speak up/don’t do it if it is very painful!

 

[Jockette]

@Runningfree @Hey Jude
I moved both your posts, above, to runningfree’s thread.

 

[sistersinhim]

I do have a straight leg and and can do straight leg lifts. I sleep on my side with a slight bend in my leg. I also walk about without crutches in the house. Do light housework and can walk up and down my street. I do hope I don’t get a hard time at the PTs on Friday.

Shoot, you're doing great without PT! You've already been doing your own. Be sure to not let PT push you and cause you to have setbacks. You are the one in control, not them!

 

[Jockette]

I agree, you are doing very well!

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.

 

[Runningfree]

My PT and clips were removed yesterday, I was feeling so sick and tired that I really didn’t want to attend even tho I had been looking forward to getting to these milestones. My problem was and has been throughout this procedure, Codeine! I had excellent pain control and seemed to breeze through the first week. So I stopped my meds during the day and only take the odd paracetamol, I changed Codeine for Ibuprofen at night because of the side affects I was getting from Codeine.. It didn’t control the pain and I had a very uncomfortable sleepless night, even resorted to morphine so went back onto the Codeine at night to control the pain and help me sleep before my PT appointment. The result next day was nausea, lethargy, weekness and sweating. Not to mention a full bowel of cement. The PT was very nice when she saw how I was feeling. She seemed impressed with my ROM and overall strength in my leg/knee on resistance to her holding my leg. My knee bend was 100 degree and she said by 28/9 she wants to see a 90 degree.bend. Fair enough I thought. I went from there to the clinic to have staples removed. That made a significant difference to my knee bend my knee felt much freer immediately. I was told I could join the knee clinic as soon as I’ve seen the specialist next week because my ROM is good. Any advice on night time pain management? Pharmacist recommended Nurophen super. I started them last night, pain relief for 4 hours, sleep is still hard to come by. Just when you think your sailing through this.!!!


Sorry if this is in the wrong place. I see it’s in a reply thread instead of new post?

 

[Jockette]

Sorry if this is in the wrong place. I see it’s in a reply thread instead of new post?

I moved your post to your thread for you.

Any advice on night time pain management?

I didn’t like the side effects of the dilaudud I was taking, so I switched to a combination of tylenol and ibuprofen. I took each individual medication 6 hours apart, but staggered it so I took one or the other every 3 hours. It did not take away a lot of the pain, especially in the early weeks, but it did help.

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.

 

[Runningfree]

Thank you so much for quick reply.

 

[Jamie]

@Runningfree .... many people do well on a combination of acetaminophen (Tylenol or Paracetamol) and Tramadol. You might ask your GP about trying the Tramadol. Gabapentin is also sometimes used temporarily.

 

[Jockette]

I’m on a new exercise from PT I have to sit down and stand up with buttocks clenched and feet firmly on the ground. I must sit firmly on both buttocks. This also is painful, normally I like to put my operated leg forward before sitting.

I was never told to do this exercise. At 2.5 weeks post op, it’s early in your recovery to force yourself to do this. If it was me, I wouldn’t do it.

For months I sat down putting my operated foot forward, like you do. Eventually, as I healed, I didn’t have to do that.

Keep in mind, all the exercises we are told to do are optional. Not every exercise works for every person. And too many are given to us before we are healed enough to do them. Only do the ones you like, and that don’t cause you pain.

 

[Runningfree]

Thanks Jockette, I will give it a miss until my knee is more healed.

 

[Runningfree]

I saw the surgeon yesterday, 3 weeks 1day post op. He was very kind and encouraging as I showed him my ROM and exercises. I had been worried my knee bend was not 90 degrees. He was happy with my progress and gave me a couple of tips on improving knee bend. I was so tired, like many other people on BoneSmart nights are dreadful. He listened as I explained Codeine upset my system and that Paracetamol was the only thing Ive found that I can tolerate. Once the heavy pain is in at night no amount of paracetamols help. He asked why I hadn’t used the Morphine I was given. I’m ‘old school’ and I suppose I was worried about using such a drug so had steered clear. He suggested I take it before I go to sleep and during the night if I wake up. I did this last night and slept from 10.30 to 1.20. Woke with a very heavy dead leg, took some more 1.30am and slept until. 7 am. I can’t tell you how good that feels to have slept all those hours. Maybe this can help others on BoneSmart I do hope so.

 

[hawk2go]

I understand the concerns. Early on, I negotiated with my OS to give me 15 more oxy tabs that I used when woke in the middle of the night. He said that will cover me for 2 weeks meaning I was not to use them according to the original schedule. I took one at 2 or 3am and did not need them every night. I felt like Gollum and the ring, they were my precious, and I horded a few. I believe they saved my sanity as oxy knocks me right out. Use the morphine if you have it, the pain and sleeplessness will fade and you'll not need them forever.

 

[Runningfree]

At 4 weeks 1day I was admitted to hospital as an emergency with heart problems. AF and difficulty breathing. I spend 4 weeks in the coronary care unit with no PT for my new 4 week old knee.

The PT now want a letter from heart specialist before they will let me have appointments to their gym sessions. They did advise some simple exercises and that is all. I was too weak to do much and gradually my knee without any exercises has got to a stage where I feel, ( reading these posts) I’m not too far behind.

I’m 13 weeks post op and haven’t needed any pain killers since week 4. Once I was in hospital off my feet my leg was comfortable and I believe the surgery side of my leg did a lot of healing in the 4 weeks I was in hospital not using it. Of course I worried I was going to have a bad knee after this inaction. However, today 13 weeks post op my biggest problem is muscle wastage and tiredness through being in bed or not mobile. As my heart condition stopped me exercising as I would like to. I do now walk my dog and shop but that does tire me. I do still get some discomfort in the knee but it’s relieved by sitting or icing. My knee does get stiff, painful and warm but i ice it when that happens. I walk well without any aids albeit much slower strides.

I have a good knee knee bend and straight leg. It will be interesting to see what the surgeon says about it at the end of this month.

At 78 I do wonder if my legs will ever get the muscle back to climb stairs properly and walk without feeling heavy legged.

 

[Jaycey]

@Runningfree So sorry to read you are having heart problems. Of course these issues take priority over any knee recovery. Please don't stress about TKR rehab. There is no window for TKR recovery. You will regain all your strength and stamina once your heart issue are addressed. For now walking is just the ticket to get you back on track.

Have you been offered cardiac rehab sessions? Here in the UK, the NHS runs session for patients recovering from heart issues. You are monitored while doing exercises and eventually go back into a gym setting for regular sessions. Ask your GP to refer you - it's a great program!

 

[Runningfree]

Thank you for your speedy reply and advice. Once all my tests are complete I think I will be offered rehab. Hopefully I will get my fitness back then.