TKR shamann98's recovery thread

[shamann98]

Hello fellow TKR buddies,

I had my left knee replaced on January 2 and it seems to be healing normally. I just happened upon this forum while looking up TKR expectations. I limp and have some stiffness but have 0/120 ROM. I use a cane for the most part. The first week was super rough due to constipation (I thought I'd die!) Thank goodness that's in the rearview mirror! I am totally off the Norco and take 600-800 mg of ibuprofen 2x/day for inflammation. I don't do Tylenol well.

It feels great to read other's experience and know I'm not alone in this journey!

Many thanks to BoneSmart!

 

[Jockette]

Hi and Welcome to Bonesmart!

I’m glad you’re coming along well and that we have already been a help to you. It is always nice to know we are not alone, especially in this Replacement journey.

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.

Knee Recovery: 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. Here is a week-by-week guide for

Activity progression for TKRs​

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.

 

[Lindylee]

You're definitely not alone. You're a little ahead of me, looking forward to seeing how you progress. Constipation does not help, glad it's sorted. I've been careful to keep the opiates low for that reason and have been adding linseeds to my yoghurt on the recommendation of a dietician. It really helps.

 

[donnag1108]

Constipation is some serious stuff. I ended up in the er after my surgery due to the opiods. I had an impacted bowel. It was horrible!! Now I know how to control it, glad you are feeling better.

 

[Spex10]

An acquaintance told me that his constipation was so bad after his TKR that the coastguard had to be notified of a new danger to shipping after his bowels finally moved! Sorry for vulgarity but I knew what he meant and having a laugh about it sure helped!

 

[shamann98]

Thanks for your responses!

Has anyone had experience with rehabilitating in a swimming pool? My cousin walked in a pool after his TKR and swore it was the only way to go. Thoughts?

 

[Jockette]

Pools can be good if you’re healed enough and start out slowly for short periods of time.

PT put me in the pool at 4 weeks for a 50 minute session with countless exercises and way too much walking. It took me 3 days to recover. It was obviously too early for me to do that.

 

[Celle]

Has anyone had experience with rehabilitating in a swimming pool? My cousin walked in a pool after his TKR and swore it was the only way to go. Thoughts?

Exercising in a pool is good, with two pieces of warning:

1. Don't go in a pool or submerge your knee in any other way until your incision is completely healed, with no open areas or scabs. If you submerge your knee before that, you risk introducing infection.
2. Beware of overdoing exercises and time in the pool. Because the water bears most of your weight, it's easy to overdo things without realising, until you get back on dry land and feel exhausted, or your knee complains later.

 

[shamann98]

I am also reading about using a TENS machine. I have one that has two electrodes not four. Should they be placed opposite one another? Should I invest in a TENS with 4 electrodes?

 

[maryo52]

I do not have personal experience with TENS machines, but the forum has an article on the topic: https://bonesmart.org/forum/threads/tens-machine-for-pain-management.9770/

 

[shamann98]

Tomorrow I will 7 weeks post-op and am doing pretty well; however, I'm struggling in a few areas.

My ROM is 0/120 (after warming up) and I'm on Naproxen 2x/day and 1000 mg Tylenol 3x/day.

I am able to walk normally until the swelling sets in, which doesn't take long, and then I start walking stiff legged. Do you have any suggestions to help with that? It feels like there's a wide band below the kneecap which inhibits fluid motion. (My swelling is minimal.) Could a pain relief cream help with that?

I am struggling with depression like I never have in my life. I know that the cold, dark winter weather hasn't helped. My DH has been a jewel but he's ready for me to be over this, even though I really don't need a lot of assistance. I don't feel like I'm doing enough or moving enough.

I'm trying to set goals with little things to make forward progress and have been doing things to distract me from hyperfocusing on my knee: reading a great book, watching some Grace & Frankie... I've scheduled a massage for tomorrow since I'm able to drive. I hope to start some pool walking soon.

It seems like my head thinks I'm ready to be back to normal, but my leg says otherwise. I'm sure that patience is what I need most...

 

[Roy Gardiner]

I am able to walk normally until the swelling sets in, which doesn't take long,

Stop before swelling starts, it's not the reaction you want.

I don't feel like I'm doing enough or moving enough.

No, see above, if you get pain or swelling you're doing too much. It's not exercise and/or movement that cause recovery, it's simply time.

It seems like my head thinks I'm ready to be back to normal, but my leg says otherwise. I'm sure that patience is what I need most...

Yes and Yes. Your leg is right, your head (sorry!) is wrong. Patience, indeed, is such a virtue.

When you are icing and elevating and watching telly you are not 'dossing around' you are 'engaging a carefully considered proactively designed heuristically programmed dynamically structured recovery programme'. And that's only slightly a joke; your knee needs time to heal.

 

[Josephine]

I don't do Tylenol well.

May I ask why not?

Has anyone had experience with rehabilitating in a swimming pool?

Sounds good but the temptation to do too much as always there!


I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?

 

[shamann98]

Sure, I'd be happy to help you help me!

 

[Josephine]

Here y'go then!

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. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

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.

 

[shamann98]

1. Pain levels: about 2 or 3 when walking, tightness; 4-5 when experiencing zingers
2. Pain medications: Naproxen 220 mg 2x/day and Tylenol 1000 mg 3x/day
3. Slight swelling
4. ROM: Flexion 120, Extension 0
5. Icing: 2 or 3x/day, at least an hour if possible
6. Elevating: several times/day, when icing and at least 50% of the time I'm sitting
7. Activity level: work around the house until I tire out, very moderate
8. Exercises at home (not much): leg lifts for quads- hold 5 seconds 15 reps/set, 2 sets (sometimes with a 2#ankle weight); squats at the kitchen sink 10 reps; 2 or 3 minutes on the recumbent bike with no resistance, forward and back; walking 5 minutes continuously 3x/day
9. PT- 2x/week: leg lifts 15 reps/set, 2 sets with 2# weight; squats at a bar, 20 reps; flexion stretches sitting down; hamstring stretches with a strap- 15 reps (balance on a thing 15 seconds eyes open/15 seconds eyes closed/ 10 reps (This may be my last week... only a few more sessions, if that)

 

[Josephine]

9. PT- 2x/week: leg lifts 15 reps/set, 2 sets with 2# weight; squats at a bar, 20 reps; flexion stretches sitting down; hamstring stretches with a strap- 15 reps (balance on a thing 15 seconds eyes open/15 seconds eyes closed/ 10 reps

I did ask please make a list and not an essay!

 

[shamann98]

Many thanks to you, Josephine and other forum administrators, for helping me get through my TKR! At nearly 8 weeks post-op, I feel that I've turned the corner and can see a light at the end of the tunnel. When I was at my lowest point a few weeks ago, I was able to read other member's experiences and your thoughtful replies, always emphasizing that everyone heals at their own pace. You gave me hope and reassurance. Thank you so much!

 

[maryo52]

You know, I've had two of these surgeries. The first time, every little pain (and there were many) concerned me. I had some other serious issues as well. This time, every little pain, to me, is just part of the process and I ignore them. I no longer have expectations. Try to not have fewer goals and more distractions.

I'm feeling a little down as well. It's a combo of aging, the time of year, limitations, (politics!), and my birthday is this week and my sons don't return my calls (I guess that falls under the category of self pity).

 

[shamann98]

Happy Birthday to you this week! I, too, have been on the pity pot but I think that's just a part of the process. Finding gratitude in the little things has helped lift my spirits. Having this surgery in the dead of winter has had its pros and cons, but at this point I am so ready for warmth and sunshine and spring.

Thanks for the words of advice! Hang in there and let me know how you're doing.