TKR Sept. 21 total knee replacement

[Freestyle]

I had my knee replacement yesterday, Monday Sept. 21. Came home at around 4 pm on Tuesday. I just can' get comortable--the .elevation is painful and the ice doesn't seem to be doing much. I am in a lot of pain and only th pain meds seem to make a difference. Help! Any advice would be appreciated... I've seen the link on elevation and the stacked pillows aren't doing the tick.

 

[Celle]

Hello @Freestyle - and to recovery.

When you're elevating your leg, you don't have to keep your knee completely straight - that can hurt a lot. Elevating is to try and help reduce swelling, but it doesn't actually help to reduce pain much.

Have you tried icing your knee? Ice is a great pain killer. You need to ice for at least 45 minutes each time, but you can ice for much longer, as long as you have something like a tea towel or dish cloth between the icing medium and your skin.
I used to ice all the time I was elevating.

There are articles about icing and elevating in the recovery guidelines, which I will give you, below.

Also, watch your activity. At this very early stage, you don't need to do a lot of exercises - just walking to and from the bathroom and kitchen is enough exercise for your new knee right now.

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​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

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

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. Try to follow this

Activity progression for TKRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications​

Wound Care In Hospital​

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.

 

[Gramalita98]

Another tip is don’t wait for the pain and if you need to take your meds sooner do it! I will definitely do that when I have my other knee done as I could not get my pain under control the first 2 weeks. Stay ahead of the pain.
Best of luck!

 

[Sara61]

@Freestyle it takes a few days to get settled after surgery, the after surgery pain No one tells you about prior so it does rather come as a shock to our system, make sure you take your pain medication and do not skip or taker later than you should all you will do is increase the pain, Ice needs to become your 2nd best friend, some people use ice machines, I used frozen peas, Ice packs, wine coolers etc, I also iced to the back, front and to the sides of my knee for at least 45 minutes several times a day and often at night too. Always make sure you have a protective layer between your skin and the ice. I used cushions for elevating my knee but always bent my knee slightly and after learning here on BoneSmart that it was ok to sleep with a pillow between my legs and my knee slightly bent, I was able to get a few hours of sleep if you find sleep is evading you at night then keep your mind busy, play games, read of just chat here on BoneSmart, for the 1st couple of weeks it's ok to sleep daytime, sleeping helps us heal faster.
It really does get better and the awful pain we suffer at the beginning does slowly go away, I'm almost one year post surgery and can honestly say I would do it again, the freedom I now have makes it all worth while.
Sending a virtual hug from Portugal xxx
Ps. What beautiful Doggies you have

 

[Peaches0000]

Your doing great just being able to write a post so soon after your surgery! You are in the hardest days and it does improve in increments every day, every week, every month. Try to buy a Lounge Dr on Amazon or something similar for elevation. I wish I would have bought one for my first surgery in January . it made my second knee TKR in May improve quicker. Great advice from Grammalita- don't ever miss even one dose of medication. Good luck on your recovery journey, it's hard to see the light at this stage, but someday you will be really glad that you did it. I sure am!

 

[leejaa]

Stay on schedule with your pain medication - it is there for the pain especially this early post surgery. I iced almost non stop except for walking for a long time. It really helps to keep the swelling down. I even put fresh ice packs on during the night. Also, try to set an alarm and take your meds with a schedule even at night so you do not get behind. Good pain control is important and helps us to heal.

 

[Oregon mom]

I had tremendous breathtaking pain when I got home. I called the on-call anesthesia line and the nurse line several times in those early days. I was close to calling an ambulance at one point.
In hindsight, I wish I'd started with a much higher dose of oxycodone and tapered down from there. My instructions for pain meds were rather nebulous, and I was left to kind of figure it out myself once I was at home. And then the inflammation really started. I can say I got to a 10 on the pain scale. It literally took my breath away. (In a way I'm kind of proud that I got to a 10 on the pain scale. Not everyone gets to do that. .)
Yes, icing was a tremendous help. I iced my knees like a couple of frozen hams.
Other folks on the forum told me loud and clear to get on a med schedule and stick to it even if you aren't feeling pain at med time. I found a great app that reminds me every 6 hours and that's helped a ton.
The first week I felt helpless. Nothing was working for me. It was a constant struggle. I'm a side sleeper and sleeping on my back is horrible... But then I get sleepy enough that I fall asleep eventually...
I'm starting to think that the first week is just that way. But then you get to the second week and you have better coping skills.
Communicate with your medical team. Advocate for yourself. Organize and schedule your meds. Try to keep the ice going during this inflammatory phase. Lay flat and get your legs up.
Try to distract yourself with writing a letter or lurking around this incredible forum.
Reading and rereading articles here and getting sound, caring advice from the incredible moderators is priceless.
You'll be ok. Hang in there!

 

[KnitChica]

Nothing (and nobody) prepares us for that post op pain from TKR! As far as advise, I echo what everyone here is saying.....ICE (and ice,ice, ice!), ELEVATE if it’s comfortable (for me it was more comfortable w/the wedge type cushion recommended/advertised here), DRUGS (don’t miss a dose during these 1st two weeks!), REST (don’t worry about exercise, etc. except for ankle pumps & butt squeezes), HYDRATE (make sure you’re drinking more than enough fluids).
You're not alone with this! We’ve all been there. I’m in week 5 of my 2nd TKR.
Hang in there & reach out in the forum.

 

[Freestyle]

Thanks for your encouragement and advice, everybody. I had a miscommunication at the hospital--they kept bringing me all my other pills and I just assumed they would bring the pain meds too. But they were waiting for me to tell them I needed them. As the nerve block wore off, I felt waves of staggering pain and finally my roommate told me to get help.

When I got home, I immediately began to elevate and ice--but found both surprisingly uncomfortable. I have a wedge and it just didn't feel right. I started taking my meds every four hours (that's the minimum time between doses allowed) but again - it's "a take when needed" prescription. Reading your advice here convinced me not to mess around, it is "needed".

Oregon Mom--I hit 8, so I can't imagine 10. I understand about the" instructions being nebulous"--it's clear that hospitals don't want people taking too many pain killers and I was surprised that I have to be the one keep pushing to take the meds. But this forum has helped me understand how crucial that is.
And thanks Sara61 for the tip about icing--when I started icing the back of my knee, I felt great relief (icing the front didn't do anything for me). Amazing how a little adjustment like that can work wonders.

I know there are better days ahead, I just want to get through these ones first. Today (two days after surgery) is already better and I was able to get some sleep.

 

[Jaycey]

Yes indeed - your pain meds are needed as prescribed, around the clock for now. The trick is to stay ahead of the pain. You will only be on the heavier meds for a short time so please don't worry about needing them. The first few days are tough - but you are doing great!

 

[Zara]

I had my knee surgery on September 17th so only a few days ahead of you. The first two days after my nerve block wore off were the worse. The oxycontin did not help with pain. I called my doctor and talked with his nurse. I figured out Norco 10-325mg plus a tramadol did the best to treat my pain. I had to take them sooner than what the label indicated but my nurse was great in working with me on this. Ice and elevate was a constant for me. Just know the pain gets better slowly and you may have some set backs but they are only temporary. Hang in there!

 

[Sara61]

@Freestyle take each day as it comes, just allow yourself in the next week or two plenty of "me" time allow other family members to spoil and look after you xx

 

[DJL1967]

@Freestyle welcome to the forum and congrats on the surgery. I'm still waiting for a date for my bilaterals which will be done in London. I was expecting to have them done this past June but now the earliest date I've been told is between March and June of next year. With Ontario's covid numbers on the rise that date will for sure be moved again. Good luck on your recovery and pain management. This forum has a wealth of information and great people that are willing to share their experiences. Keep us posted on your progress.

 

[babycatcher]

@Freestyle the wait until you’re in pain to take painkillers is a very old fashioned way of doing things. We know that it’s best to keep on top of pain by taking regular meds even if you aren’t actually in that much pain at the time. I found I had to write mine down as otherwise I lost track if what I was taking. For the first 2-3 weeks at least max out on everything and take by the clock. It really is the only way. I’m now 6 weeks from TKR and I’m taking minimal analgesia now. It does get better. I found it easier to elevate in bed rather than in a chair and used a wedge and then pillows on top - any pressure on the knee or side or back of it caused pain initially. Ice will settle the swelling and help with pain. It’s a long road but you’ll be pleased in the long run

 

[Freestyle]

Well, it's been five days since the surgery. I found a great app to remind me to take my medications--it even overrides the sleep function on my phone and wakes me up at night. Everything has gotten infinitely more comfortable. I had my first little "rebellion" yesterday--I did my first physio session yesterday by Zoom. These were strengthening exercises, not just range of motion. When I finished, I noticed that my ankle was swollen--I hadn't had any ankle swelling before then. So instead of dutifully doing my ROM sets later, I elevated and iced for the rest of the day. The swelling went down and today I am ready to resume the ROM exercises at my own pace. BS has given me the strength to trust my instincts.

What's interesting is how much the soreness, when I get it, resembles the soreness I had before my TKR. In other words, it's inflammation--a very familiar feeling. My knee had gotten so bad before the surgery that standing for ten minutes was hellishly painful. I'd been listening to my body for a long time, so I'm not going to change doing that now.

I do have a question for forum users--are there any Masters swimmers here? Masters swimming was a lifesaver for me--you can compete at a high level even with bad knees. I'm not rushing to get back to the pool but I am looking forward to it. Any advice/stories about resuming swimming would be greatly appreciated. Our local pool has a ramp into the water and, because of Covid, allows only one swimmer per lane (for 30 minutes). I've seen mentions of "water walking" but I am more interested in swimming laps, freestyle, for the cardio (and the zen). But I am ready to be patient as necessary. Would love to hear from other swimmers!
P.S. The dogs have been in exile and come home in three days. So any rehab/dog stories would be appreciated too. The young one is seven months old. But the older one is five, very attached to me and has been evolving into a service dog. He always watches me when I walk and waits for me--knowing him as I do, he is going to spend the next six months by my side comforting me...

 

[leejaa]

Not a real swimmer but definitely a dog lover. My 16yo passed away in between my knee surgeries and we had a new to us 90# 2yo (from a shelter) love bug when I had my second knee. He was actually fine especially with the walker around and then he was more used to giving me space when I went to cane. I was home alone all day so my husband would tie him out in the morning and then once I was up and more with it I would go and unclip him from his run. Luckily he was not a jumper.

I am sure your older dog will be great company as mine was for the first knee and very mellow but attentive. It is nice to have 4 legged company. They are such great listeners and never disagree.

 

[Freestyle]

Well tomorrow marks the first week since surgery--a milestone of sorts. It's beginning to dawn on me how slow this is all going to be. My knee remains swollen--like stuffed sausage--but my ankle and calf are okay unless I overdo it. I'm walking a bit more every day--I can go downstairs for meals and spend a little time in the living room. I have backed off on the exercises. I do one round in the morning and then see how I am doing in the afternoon. I do the strength exercises intermittently but not all of them. I am getting stronger on my feet, but the swelling remains painful (4-5 at worst). I keep thinking that this is a wound that has to heel and I can't do anything to aggravate it. I am icing plenty. Sounds pretty normal but I can see how frustrated someone can become without clear linear progress. Dressing comes off tomorrow, dogs come home on Tuesday!

 

[Oregon mom]

@Freestyle I'm so glad to hear things are smoothing out. Your journey sounds familiar to me. It even sounds like we have the same med minder app!
It also sounds like you are pretty well in touch with your gut and a good advocate for yourself. Don't hesitate to call your surgeon's office to talk about pain. You have a right to good pain management and you will be listened to.
Your story about the pain meds in hospital made me think about how you have to ask for a glass of water in some restaurants and if you expect them to bring you one without a request you'll be thirsty.

 

[nettie]

@Freestyle - Congratulations for making it through week 1!! Yay!! It must feel good to have the first week in the rear view mirror. You are correct - recovery from TKR is slow going. So many people on this forum can relate to your experience. I am 6 weeks out today, and things do get better, but not quickly. For me the only thing that happened suddenly (although not quickly) was that one day my quad muscles turned back on and started working again. Literally one day I could barely lift my leg an inch off the bed, and the next day I could do the leg lifts with ease. Unfortunately, the swelling does not resolve like that, as far as I can tell. It takes time. A lot of time. Hang in there! Take your victories wherever you can find them. Best to you as you recover!

 

[Fran55]

Hi @Freestyle Yes sadly recovery really isn’t linear. You will have good days and bad. I am four and a half months on from a Bilateral TKR. Thank goodness these early days are now a bit of a blur for me.

I named my own recovery thread “It does get better” because it does. Sometimes in that fog of pain we don’t realise when we begin to improve and are able to do things a bit better. In the first week sometimes I would struggle to get into bed and my husband would help by lifting the second leg in. By the next week my husband commented that I was getting into bed more easily. All I was noticing was the pain not the fact that my knees were moving just that bit better.

Backing off the exercises is a good idea at this stage. I had some therapy ( stretching mainly) in hospital but no ongoing therapy as per my surgeon’s protocols. I did some stretching exercises but mostly I got on with normal daily things ....and walking, it is the best thing for my knees. They still feel a bit tight but they don’t hurt when I walk.

You will still have pain and swelling for a while yet but treasure those days when you just know the knee is feeling a bit better. Those days WILL come. That means you are on your way to better things. It is a long recovery but worth it. I am only a third of the way through the 12 months my surgeon says it can take and I know things are only going to get better day by day week by week, month by month.

You’ve got this! Hang in there