TKR Sabad's Recovery Is Underway!<

[Celle]

I agree with KarriB. You only need to do a little exercise right now. Your ROM is great for so early in recovery.

It's much too early to be doing any strengthening exercises. Your knee needs time to heal more before you start those. It's better to leave strengthening exercises until about 12 weeks post op. Your thigh will strengthen gradually by itself until then, just by being used.

 

[Josephine]

Don't think I'm pushing myself. But I might be. How do I know if I'm doing to much?

I could advise you if you want but it will require you to answer a few questions first. Would you be willing for me to do that?

 

[Red's Mom]

Welcome fellow Illinois friend! It sounds like you're having a great recovery. And it seems like you have a great can-do attitude I hope things continue to go well for you my only advice is listen to your knee it's your best guide.


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[sabad52]

I could advise you if you want but it will require you to answer a few questions first. Would you be willing for me to do that?

Sure! I see my doctor again Monday. He wants another set of X-rays. I will talk to him to see what he expects at this point. And am I doing to much to early. He said in the beginning 6 weeks before I can drive and 12 weeks if all is going well before I can get back to work. Whether that is limited. I don't know. So any help at this time would be welcome.


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[sabad52]

Thank you Reds mom I believe doctor did a great job. I am very happy with out come. My progress has been good. My knee has never hurt that much so I'm not sure what my knee is telling me. I think since there is not much pain that I'm doing the right things. If I do feel pain I stop. If I have stiffness I get up and walk. Have you had knee surgery? How long A go? And how has your recovery been?


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[Red's Mom]

Yes, I has two knees replaced the first on 11/1/16 the second 4 weeks later on 11/28/16. I feel that my recovery has been quite straightforward I followed the bonesmart mantra not doing much physical therapy at all never doing anything that was painful and now three and four months out I'm back to riding my horse and living my life I still ice and elevate at least once a day per my doctor's request but in general I've got my life back and now it's a pain-free life. The only thing I'm still missing is my energy level I still tire out after 6 to 8 hours of activities a day. If you're bored you can read other people's recovery threads it's actually kind of fun and educational just click on their name and then go to postings and then go to threads and it's like reading our diaries

 

[Josephine]

I'd like to ask you some questions if you don't mind, and it would be very helpful if you would answer each one individually - numbered as I have done - 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 swollen is your leg compared to these?

4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

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

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[sabad52]

1. My pain level has been around 2-3 at the most.
2 hydrocodone7.5-325, celecoxib, twice daily 9-10 am 9-10 pm there has been twice where I took third hydrocodone for pain.
3 swelling is less then moderate. See my pics.
4 110 - 3
5 I ice my knee daily I was given a nice ice pack. I'd say I ice 4-6 times daily 30-40 minutes. If not more.
6 I try to elevate most of day but there are times elevating hurts more than not elevating.
7 at this time my activity is: I will cook for myself at least breakfast, lunch ect. Dinner if my daughter doesn't fix it for me I fix myself. I get food from where I work also. Can't get out to do shopping. Can't do laundry too many steps to go down. Cleaning my daughter has been doing. My routine every time I go to bathroom I walk around the house for 5-10 minutes. I bath myself. I help feed animals. I'd like to walk outside but at this time where I live I can't all I have is gravel and grass. I hope when I go to cane and able to drive I will be able to walk more. Outside.
8 exercises at home.
Ankle pumps 30 2 times a day
Glut sets and quad sets 30 times 2 times daily
Slide heels up and down using a belt 30 twice daily
Short arc quads I taped 2 # 10 cans together and wrapped a towel around them I put under knee do 30 twice daily.
Had problems with this one first week or so. Not they're a Breeze
Straight leg raises. 3 sets of 10 twice daily. Also
Had problems with this one at first. Now not a problem

At PT 3 times a week.
Same as I do at home same amount. They do a little flexing for me.
The last 2 weeks been doing
Squats while standing 10-20 not pushing me on these.
Lunges
riding stationary bike just too loosen up a little for 5-10 minutes. Not pushing my knee
Able to go around backwards but not forewords
Then they ice and out electrodes on knee for 10 minutes.

There has only been one time I left PT hurting. Most times has been the same as when I got there about a 2. Today I almost didn't go cause I was having back pains all weekend. But I went thinking getting out and doing exercising would help which it did. There is one other exercise I do I lay on my stomach and do glut and quad sets pushing off with my foot. Seems to work better then the other with very little pain.

In discussing my pain levels we may have decided my pain levels were so high on bad days that now the pain is less so it doesn't bother me as much. Also my left knee was almost as bad as right knee. Right now left knee seems stronger and pain free. May be able to put surgery off on left knee till I retire.

I hope that answers your questions.


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[Josephine]

1. My pain level has been around 2-3 at the most.

Is that really all? Have you factored in the other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness?

2 hydrocodone7.5-325, celecoxib 200, twice daily 9-10 am 9-10 pm there has been twice where I took third hydrocodone for pain.

At three weeks you need more than twice a day. Doesn't the label on the box/jar say 4-6 times a day? In which case you should be taking the hydrocodone 4 times a day. What you need to remember is that these medications only last in your system for about 4-5 hours, so if you are only taking them once ever 12 hours, you are going 6-7 hours with no medication cover at all.

3 swelling is less than moderate. See my pics.

YOu pics are a bit old and they look on the 'huge' side to me.

4 110 - 3

That is excellent for less than three weeks

5 I ice my knee daily I was given a nice ice pack. I'd say I ice 4-6 times daily 30-40 minutes. If not more.

Jolly good!

6 I try to elevate most of day but there are times elevating hurts more than not elevating.

Why is this? Are you elevating with your leg totally straight? Like this

Because that will cause you pain. You need to have a little bit of a bend in your knee for it not to do this. Like these ...

7 at this time my activity is: I will cook for myself at least breakfast, lunch etc. Dinner if my daughter doesn't fix it for me I fix myself. I get food from where I work also.

Good.

I go to bathroom I walk around the house for 5-10 minutes. I bath myself. I help feed animals.

Good

My comments in bold
exercises at home twice a day - you would be better doing them once a day and none at all at the weekends
Ankle pumps 30 - these are just anti-clot exercises and since you are so mobile, you don't need to do them any more
Glut sets and quad sets 30 times - this is too much 2 or 3 is plenty
Slide heels using a belt 30 - don't use a belt and read this to see how to do the properly Heel slides and how to do them properly.
Short arc quads I taped 2 # 10 cans together and wrapped a towel around them I put under knee do 30, straight leg raises. 3 sets of 10 - both these are a) too many and b) unnecessary because once you can do them you don't need to do them any more!

At PT 3 times a week.
Same as I do at home same amount - same reductions as above
They do a little flexing for me - never ever allow this. What you can achieve on your own is much more important
Squats while standing 10-20 not pushing me on these - glad to hear if as these aren't very good for your muscles. They can cause a lot of tendinitis and pain
Lunges - same with these
riding stationary bike just too loosen up a little for 5-10 minutes. Not pushing my knee - that's fine
Able to go around backwards but not forwards - that's very usual but you will be able to in a few weeks time.

You will see that I have crossed out some of these exercises because they are not good for you and you actually don't need them with a ROM of 110/3 which is amazing for three weeks! But if you keep on with those exercises, you will risk seeing that start to regress as the swelling gets worse.

I suggest you read this BoneSmart philosophy for sensible post op therapy

 

[sabad52]

1. Most days my pain is minimal. I was having some back pain last weekend. Which I relieved with heating pad. I did very little exercises last weekend. I find it hard to believe my pain has been so minimal. I believe it's because before surgery I had pain all the time both knees if I was having a busy day and on my knees a lot the pain was 6-7. I was going to have surgery done in summer but decided to do it as soon as I could. My left knee is pain free right now granted I'm not doing any physical work.

2. Hydrocodone is every six hours or as needed. The celecoxib 2 times a day. I try to take my meds same time every day. If I feeling unusual pain I will take another dose of hydrocodone. I am not a person that took a lot of meds for pain before surgery. Just my high blood pressure meds.

3. The second pic without the staples was taken Sunday. I am a big man and have big thighs. I just took another picture showing both legs side by side. That's why I believe it's moderate at most.

4. I've been working on my elevation today tried it a little and it's working better. Yes I try to keep it straight.

5. Before surgery I believe it was 3 weeks before. The hospital had a class to go over the procedure. A book was given to us with all we needed to know about the surgery. Part of the book were pictures of the exercises and how to do them and how many to do. They also suggested starting them right away to get you knee used to them and making the muscles stronger before surgery.

I did the exercises as suggested. I did them when I got up in the morning and before I went to bed. I think that helped a lot. I had 4 sessions of PT in the hospital before my release. And did a lot of walking. The physical therapist agreed doing the exercises before surgery was a help when doing them after.

She was impressed of my pain level and what I was able to do. But she did not push me. Just wanted to see what I could do. I started PT 4 days after surgery. There has only been one time where I hurt after my session. Tuesday I felt better after then when I went in. I will talk to my doctor Monday to see how he feels about the physical therapy whether I'm doing too much or not.

At home I do not do anything that's hurting my body. I do not believe I'm doing any harm to my body. And I won't let the physical therapist do any either.

Am I trying too hard probably. That's my make up, it's what my dad instilled in me when I first started working. I been working college food service all my life I don't know how to take it easy. But I'm trying.

One thing I do I will not go back early. I am scheduled to be off 12 weeks I will take full 12 weeks. By the time I get back to work we will be going into summer schedule which is another 12 weeks of taking it easy. Which leads up to first semester which is very busy. Then after the new year I will through February and then retire.

Just a little background about me. Maybe that will help a little.

Once again thank you for your help. I will try and cut back. I believe everything else I'm doing is spot on.

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[sabad52]

For the elevation I misread. I do not keep it straight. Today I added another pillow seems to have helped a lot.


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[sabad52]

PT going well. Doing regular exercises. Squats going much better. Keeping body straight. No back pain. ROM straight 3 bent 115. Doing it on my own no pushing by therapist. They have been massaging the knee. Feels good. Stationary bike Friday was a breeze. Able to do a complete revolution without a problem. Both forward and backward. Feeling barely any pain today (Saturday march 11). Just 3 weeks and 1 day following surgery. I'm very happy with progress. Appointment with doctor on Monday. Hoping to get word on when I can drive. Been using cane around the house. Get his official approval Monday. Still taking it easy but quite happy with new knee. Left knee the non surgical knee is feeling much better also. I'm guessing pain meds helping it also. But it is feeling stronger. Maybe the rest has helped. All and all I'm a very happy knee patient.


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[sabad52]

PT going well. Doing regular exercises. Squats going much better. Keeping body straight. No back pain. ROM straight 3 bent 115. Doing it on my own no pushing by therapist. They have been massaging the knee. Feels good. Stationary bike Friday was a breeze. Able to do a complete revolution without a problem. Both forward and backward. Feeling barely any pain today (Saturday march 11). Just 3 weeks and 1 day following surgery. I'm very happy with progress. Appointment with doctor on Monday. Hoping to get word on when I can drive. Been using cane around the house. Get his official approval Monday. Still taking it easy but quite happy with new knee. Left knee the non surgical knee is feeling much better also. I'm guessing pain meds helping it also. But it is feeling stronger. Maybe the rest has helped. All and all I'm a very happy knee patient.


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Had doctors appointment today. Filled my prescription. But suggested only take it when you need. If you're not in pain don't take it. Next appointment in 4 weeks. Said I can switch to cane. Still 3 more weeks till I can drive and 9 till I return to work. He said physical therapy is going good. Do not skip a day of physical therapy or you will get behind. Doctor cannot stress how important PT is. Checked the leg to see how straight I could get it. He was happy but said there was still a ways to go. Had an X-ray Thursday. Said everything looked good in X-ray. So three and a couple days after surgery and everything is looking on schedule.


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[Celle]

He said physical therapy is going good. Do not skip a day of physical therapy or you will get behind. Doctor cannot stress how important PT is.

My surgeon would totally disagree with yours. He does not allow any formal PT until at lest a month after a knee replacement. He says that your knee needs that time, so it can begin its journey of healing. HIs patient's don't just lie around like logs, though. We walk around the house and gradually increase the amount of walking.
All his patients do well, as I did, and he hasn't needed to do a manipulation to help with ROM for the past 4 years.

I did no PT at all after my last TKR and only minimal PT for the one before that. Both my knees are strong and reliable. They straighten fully and bend to over 125 degrees. I am active and have traveled extensively with them.

@KarriB had to have her knee in a splint for a month, so she could not do any PT. Her knee works fine now.

It's not exercising that gets you your ROM, it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.

 

[KarriB]

As Celle said, my TKR was in an imbolizer brace a month after surgery. I kept it on 24 hours a day. On each OS visit (2 a week for a month) I asked if my knee would ever bend again and he always said, "the knee will bend when we tell it to bend". And it did! The knee was stiff for a while, but he wrote a script for non-aggressive PT because my soft tissue did not do well with aggressive therapy. After another month I was pedaling a recumbent bike with a full rotation (2.5 months). While I would never encourage a brace for a month after TKR surgery and my nightmare was that I would walk around like a pirate with a peg leg, I am a able to swim 15-20 laps a day as well as ride 8 miles a day (just finished today's ride).

When I have my left knee done I won't be doing any formal PT for the first month or two. It's important to give the leg/knee time to heal before working it too hard.

 

[sabad52]

I guess it all works different for different individuals. And all doctors are not the same. I guess it's what works. PT works well for me. I'm doing good. And I feel good. I'm not critical how you all did your recovery I think it's great. But mine is working well for me. I do my walking along with my PT. I'm happy with my healing and my progress. As long as doctor is happy PT is going well and I'm feeling minimal pain and my ROM is good. I'm a happy camper.


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[KarriB]

If your ROM is good and you aren't feeling any pain, all is good with the world!

 

[Caly]

sabad52,

It is very encouraging to read your posts. I am happy to hear about your progress.

I just had my RTKR on March 3, 2017 and I am progressing nicely.

Keep up the great work!

Caly

 

[newlybionic]

We are all individuals for sure. There is a large number of variables during recovery. As long as you are progressing well and not experiencing increasing pain or swelling you have found what's best for you. I hope you continue to do well.

 

[Celle]

I'm not critical how you all did your recovery I think it's great. But mine is working well for me. I do my walking along with my PT. I'm happy with my healing and my progress. As long as doctor is happy PT is going well and I'm feeling minimal pain and my ROM is good. I'm a happy camper.

I'm glad it's working well for you. We are all different.
I just wanted to point out that it really doesn't matter if you miss a day or two of PT. It won't set back your recovery.