TKR Seatides Right TKR Recovery

Seatides

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Hi everyone! I just wanted to post a little bit about how I'm doing so far. I had my right TKR four days ago and spent 2 nights in the hospital. Even though I took iron supplements for a month before the surgery, I've become anemic again (I was anemic after the left TKR too, in 11/2019). But I compared my numbers this time to last time and they're a little higher this time, so that's good.

Pain during the day has been manageable; but last night it was bad and I couldn't sleep most of the night. For pain, the surgeon prescribed me tramadol and gabapentin. I can also take acetaminophen 500-mg tablets if needed (but no more than 3000 mg in 24 hours).

I saw home PT yesterday and am doing some exercises today, and am also doing a little walking around the house. But mostly today I've been resting because I feel very tired. I'm trying to listen to my body and not overdo it. Since I've done this before, I know it's a long, slow process that can't be rushed. That's about it for now!
 

Jockette

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@Seatides Welcome back to Recovery. It sounds like things are going well and you are making wise choices! Well done!

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Knee Recovery: The Guidelines
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 to these pages on the website

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 
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Seatides

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PT Yesterday, Throbbing and Swollen Today

Maybe it's the drugs and/or the lack of sleep, but I don't know if I'm posting this in the right place or not. Yesteday I had a full session of home PT, which actually felt pretty good for the most part. But I pushed pretty hard to bend my knee a few times (it hurt), but the PT was pleased that I'd reached 90 degrees. Today I've been paying for overdoing it yesterday. My knee is stiff and swollen and painful. So I've done very little today except rest, ice, and elevate. i also walked around a little bit and did my stairs (short flight -- split-level house) a few times.

I guess I'm just posting this here to remind myself that it's so easy to overdo it, especially in the very early days after the TKR. My knee has been so swollen and painful today and pain meds and ice don't seem to be helping much. It really is better to do a little less; "less is more." Sometimes the therapist would say I could stop at a lower number of repetitions than he'd originally said and I'd feel like, no, I can do this. I'd get this feeling that it would seem as though I wasn't trying hard enough. But I don't have to prove anything to anyone! I'm going to do what I can do without causing myself pain. Doing that only sets me back the next day. You can't rush this process; in fact, overdoing it only slows it down.
 

benne68

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But I pushed pretty hard to bend my knee a few times (it hurt), but the PT was pleased
Oh no! Pleasing your therapist isn't going to help you recover -- especially if you are being pushed to pain. If you have to push that hard to please him/her, you have the wrong therapist.

You are less than a week out of surgery -- much too soon to be thinking about ROM! Your body hasn't had time to heal from the trauma of the sawing and hammering and pushing and pulling that your surgeon did.
Most surgeons advise patients to do little but rest, elevate and ice for the first two weeks post surgery to give the knee a chance to heal.

But I don't have to prove anything to anyone! I'm going to do what I can do without causing myself pain. Doing that only sets me back the next day. You can't rush this process; in fact, overdoing it only slows it down.
Exactly! Pushing hard to meet a PT's flexion goal this soon after surgery will only set you back and delay your recovery.

This is a race won be the tortoise -- slow and steady is the trick!
 
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Seatides

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Thank you, @benne68! I know this, but somehow I was thinking, I feel pretty good, I can do this (meanwhile I was grimacing while pushing my knee to bend). I now remember everything you're saying about needing to allow those recently damaged tissues to heal. I won't be causing myself pain -- or allowing someone else to cause me pain -- from now on.
 

InkedMarie

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Thank you, @benne68! I know this, but somehow I was thinking, I feel pretty good, I can do this (meanwhile I was grimacing while pushing my knee to bend). I now remember everything you're saying about needing to allow those recently damaged tissues to heal. I won't be causing myself pain -- or allowing someone else to cause me pain -- from now on.
One of my problems was that my physical therapist was gentle & we only went to the start of discomfort but it would be the next day that I felt it.

Marie
 
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Seatides

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Why Do Health Care Providers Resist Prescribing Stronger Pain Meds?

I've been having trouble with all-night pain that keeps me awake, and with pain the day after PT. I asked the surgeon what else they can give me for the pain. I've been taking tramadol 50 mg every 6 hours and gabapentin 300 mg twice a day. They want me to add celecoxib 200 mg twice a day and Tylenol Extra Strength 1000 mg every 8 hours, but to take tramadol (1 or 2 tablets) only for "breakthrough pain" (i.e., if pain isn't controlled with gabapentin, celecoxib, and Tylenol). I always though it was better to take pain meds before the pain flares up because then it takes longer for the medication to work (i.e., you won't get pain relief right away). Does this regimen sound like it'll be effective? I feel that they're so afraid to prescribe a stronger opioid (for example). I took NSAIDs for years for my osteoarthritis (and they weren't always helpful). Are they really effective for post-TKR pain? The surgeon who did my left knee wouldn't even let me take an NSAID for a long time because he said they interfere with healing. I haven't taken gabapentin before so I assume it's helping. And Tylenol never did much for my OA pain.

I was prescribed oxycodone after a wisdom tooth extraction last year. I didn't even use it. I don"t think it's more painful to have a tooth pulled than to have a knee replaced!

It's been 2 3/4 years since my first knee was done, so maybe pain management regimens have "evolved" since then. But I know I was prescribed oxycodone (but not a lot) for that knee.

It's just so irritating to think that these docs are OK with us not being able to sleep at night because of the pain. Or do they think we're exaggerating? Thanks for any thoughts or information anyone would care to share.
 

Jockette

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I've been having trouble with all-night pain that keeps me awake, and with pain the day after PT.
You‘re right, these days many doctors are not prescribing as much pain medication as they used to.

So, cut back on the things that increase your pain, like PT. Then, you won’t need more heavier pain medication.

More pain at night usually indicates too much activity, or activity we are not yet healed enough to do, during the day.
 
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Seatides

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"Activity Progression for TKRs" and the Second TKR and Not Getting Ahead of Myself

Hi everyone! It's been 26 days (almost 4 weeks) since my right TKR and so far, I've been finding this one a lot easier. Both the in-home PTs (finished last week) and the outpatient PTs (just finished the first week) have told me how great I'm doing. I drove myself to PT three days ago; that was two weeks earlier than I drove last time, and this is my driving knee. Except for the night discomfort and difficulty getting comfortable so I can sleep, I've been feeling really good.

But I've been catching up on my reading at this site, particularly the "Activity Progression for TKRs," and I think I've been feeling so (relatively) good that I've inadvertently been overdoing it. At O/P PT, they have this recumbent cycle with arms (it's very similar to the Teeter FreeStep, which I bought for home use a few months ago) and I did 10-12 minutes on it two days in a row; I NEVER do PT two days in a row, but they were apparently the only two slots available this past week. I also did some tougher exercises there than I'd done in home PT (and by "tougher" I don't mean painful, but harder to do; I was pushing myself).

I rested and iced and elevated the next day, but yesterday I found myself wanting to see if I could refill and hang my bird feeders, and move the sprinklers around to water the grass and flowers (I could). To make a long (but familiar, I'm sure) story short, my knee feels stiffer and more swollen and hurts more today than it has in awhile (so I've been icing and elevating and resting all day). That's why I wanted to review the activity progression guidelines and I think that, especially after two consecutive days of the more challenging PT, I did do more than is recommended for Week 4.

I just wanted to write this because I'm a little mad at myself and a little disappointed. I didn't realize how easily my mind could be tricked into thinking that I can do whatever I want, whenever I want, that this TKR recovery could be simple and quick. It's fine, though; although this one's definitely going more smoothly, I've been reminded today that my new knee is the boss for now, not me.
 

sistersinhim

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You are doing this recovery the smart way. You are listening to your knee, thus having a less painful and less swollen recovery. We all have done too much at the times when we feel better, then suffer afterward. We learn from these mistakes and give our knees the time it needs to recover from our joining the ODIC. You are doing well!
 

kneeper

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"Activity Progression for TKRs" and the Second TKR and Not Getting Ahead of Myself



I just wanted to write this because I'm a little mad at myself and a little disappointed. I didn't realize how easily my mind could be tricked into thinking that I can do whatever I want, whenever I want, that this TKR recovery could be simple and quick. It's fine, though; although this one's definitely going more smoothly, I've been reminded today that my new knee is the boss for now, not me.
Hey, we've all been there. Hang in there.
 
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Seatides

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LOL! Thanks, @benne68! I want to say, "Time flies when you're having fun," but...
1662085155305.png
 

benne68

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So you don't consider this roller-coaster ride of a recovery fun?

rollercoasterexample-gif.74641


Hang in there, @Seatides! We are here for support whenever it's needed.
 

beachy

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@Seatides
Most, if not all, of us have been to the ODIC. I think at one time I was Madam President. Don't beat yourself up, but learn from it. My left knee is almost 4 yrs old. About 5-6 month post op I had great ROM with very little PT, but plenty of activity on my own. It happens.
 

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