Shouldn't I be further on at 11 days?

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carolward

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Hi there
I had a PKR 11 days ago. I am bending my knee to about 80 degrees and went to see my PT yesterday. She said my bending and walking was good but I am having alot of trouble with leg lifts. She did put two rolled towels under my knee and I managed to lift it but very minimal. The pain is really bad over the kneecap - kind of feels like it is dislocated. Kicking out from a sitting position is also very painful with the same kind of pain. Has anyone else had this pain. All other pain I have experienced has been in the muscles - quad and thigh. Should I be further ahead at this stage. I am getting very disappointed and frustrated.
Thanks
Carol
 
Carol, I moved your post into a thread of it's own to ensure you get the attention of the other members. Welcome to BoneSmart!

But - 11 days and you're disappointed at your progress! If you'd said this at 3 weeks I would have said the same as well! Be patient. You've had a BIG operation on the biggest, most complex and sensitive joint in your body. You can't expect it to all be done and dusted in less than two weeks! Even an ingrown toenail takes longer than that!

Just keep plugging away at the physio and things will get together eventually. Keep a journal; note in it every day what your ROMs are and what your pain score is, what you've taken in the way of pain meds. You'll be amazed at the progress you ARE making despite 'evidence' to the contrary.

BTW - you are taking enough pain meds, aren't you? Or are you trying to limit yourself? I have found that to be the biggest issue with folk who have such a story. They think that they should be off them by the end of a couple of weeks. Especially people who had PKRs and/or MIS - they are the worst as they get the impression that recovery - and therefore not needing pain meds - will be a very short term thing. Nothing could be further from the truth.

Do let me know what regimen of pain meds you are on and what your expectations have been. We can work from there.
 
Hi, Carol! Just a few words of encouragement to echo what Josephine has told you. Recovery from knee surgery is NOT a walk in the park. It takes time and hard work at therapy to get back to full use of your knee. The key to making it all work is the right combination of determination and effort on your part (which it sounds like you are already mastering), patience, and proper pain management. Most of us (I'm 9 months out) took our pain meds regularly for months. Some need them longer and that is okay. You will know when you don't need them anymore for pain when you "forget" to take them during the day. Right now the most important thing you can do in your life is listen to your body and take care of it, putting all your energy into resting, healing and restoration of your knee joint movement. Trust me....in time you will be so improved you will be amazed. In the meantime, post ANYTIME you have a question, feel down, or have reached a personal milestone in your recovery. Everyone here will truly understand what you write because we've all been there! Hugs to you....Jamie
 
Hi Carol.

I can't speak for a partial, but I have had two TKRs and the pain you describe sounds very familiar. Once the quads get back in action, it gets better.

The leg lifts were really hard for me, especially with the first knee. Just keep doing them every day and it gets better in a few weeks.

And what Jo & Jamie said :)
 
Hi, Carol,

I had to chuckle when I read your post as it called to mind the many like it, my own included, wondering about out progress in the early days after surgery. You came through a surgery that is one of the most difficult, your knees were dismantled, honed, sawed, God knows what else and then the OS drilled holes in the ends and/or pounded the prosthesis into the ends and sewed you back up. The fact that we could walk at all after all that was done to us is a wonder.

You are in early, early, early days after surgery. The recovery is a long, slow process even for those who are fortunate enough to be on the quick end of recovery. There will be times when you feel like someone had to be kidding when they told you that the day would come when you wouldn't think about your knees. Then, one day, sometime between two months and a two years I think is a good time frame, you wake up and the first thing you think about is NOT your knees. And each day from then on becomes easier and better and you realise it was worth it after all. You are at the beginning of a very long process. There is a lot of work that you will have to do and a lot of days when you are going to wonder if it is all worth it and a few days when you will probably wonder why you bothered. That is why this forum is so invaluable. Without the people who post here and Jo most of us don't know what we would have done. I am seven months post having both knees done at the same time and I still come here daily to see who is posting and what is going on. There is a comraderie here that you aren't likely to find at any other site on the WWW and that, in my opinion, really says a lot about the way the people who come here support one another. They have seen me through way more than just my knees and I cannot recommend to you anything that will help you more than posting here daily. We vent and we sympathise and we care about each other and Jo is there to help us and guide us and be our friend every step of the way.

To answer your question though, I think you are doing great. You will find your own pace, your body will dictate that and you have little to do but listen. The three or four most important things are ice, elevate, rest and do the exercises that the OS or PT want you to do and try to stay as active as you can. Like I said, it is different for each one of us. The fact you found this site and posted here tells me you are going to be just fine. Oh, yes, one more thing, if you haven't discovered it already is stool softeners while you are taking the pain medication. How could I have almost forgotten that one?

Good luck and I hope we hear from you often. Rowdy
 
Carol,
From one PKR to another--- welcome and forget about any of the propaganda you read on those knee replacement websites that promised you near-instant relief and a two week recovery. For most of us that just isn't reality.

The reality is that you have had major surgery on one of the most complex joints in your body and even though they "only" replaced 1/2 of your knee it is going to take a long time and a lot of hard work to recover. You need to follow the same regiment of rest, elevation, ice, physical therapy, and adequate pain control as the TKR folks. We are all individual in our recovery, but most do recover and find it very much worth it.

I am nearly 1 year post-PKR and would be glad to share my experiences and answer any questions you would like answered by someone who has "been there- done that".

Good luck to you in your recovery and keep posting!

Beach
 
Carol
I had a tkr 4 weeks ago. I to had that pain in my kneecap. Just after the 3 week mark I was able to do that exersise without screeming. Now it hurts but the pain is tolerable. be patient.....I am in the early stages myself,but have learned much from these fantastic people here.

chuck
 
Thank you so much everyone for your replies to my post. It was so encouraging to read and made me feel heaps better. I was wondering whether I had done the right thing and if it was all worth it.
The pain meds they gave me on discharge from the hospital only lasted two days so I am now taking 2 Panadeine Extra which as 10mg codeine per tablet, every four hours. I have times when the knee is quite painful but most of the time it is quiet bearable.
Today, Day 14 I was able, with the help of a rolled handtowel under my knee, lift my leg around 10 times. No far off the bed, but I did lift it. So I am very happy.
My daughter who had a lateral release and arthroscopy, also had a hard time doing leg lifts so she gave me a few pointers she got from her personal trainer and with her encouragement, I DID IT.
I find that I am walking ok with the crutches but there is still the fear there of putting my weight onto my knee but I suppose that will disappear soon.
My ROM seems to be at about 85 degrees.
I see my PT on Friday and will not see my OS until 17th December as I do not have staples or stitches to come out.
I just want to thank everyone once again for your encouragement.
Regards to all
Carol
 
Carol
The ROM will come. At 2 weeks I was at 60-65. Yesterday at 4 weeks I was at 100.
Keep up the good work. Once I had gotten out of the dark days (1st 2 weeks), Things started improving everyday.

chuck
 
Carol,
I am glad the forum has helped you. That's why we are here. That is good news about the leg lifts!

Are you putting weight on your knee when you are using your crutches? It is okay to really *walk* and just use your crutches to provide "insurance". It is actually good for you to do that and will help your muscles and ROM get back to normal. At Day 10 I could walk around the house with only a cane for occasional support and on sort of a dare (from my OS)--- walked the very short distance from my car into my OS's office to get my staples removed without even the cane. ( I had a PKR too)

We all heal at our own rate, but your knee is tougher than you think and moving it and really using it will help with your recovery. Keep icing and elevating and you will continue to see improvement.

Keep us posted.

Beach
 
You should be on more effective pain meds that that. Go see your own doctor and get him to prescibe you something a little more effective.

I made this graphic to explain how pain can inhibit your progress and recovery

[Bonesmart.org] Shouldn't I be further on at 11 days?


And now the famous pain management chart!

[Bonesmart.org] Shouldn't I be further on at 11 days?

 
Jo,
Your charts are getting better and better! I really like the footnote explanation on the pain chart.

Carol,
Better pain control will help you be more active and make it easier to move you knee and get around better. As usual, Josephine has the "gold standard" of advice.

Best to you,
Beach
 
Carol, I was just reading your last post about the meds and was going to write about talking with your doctor about proper pain management. But our wonderful nurse, Josephine, came through with her famous "meds talk." Most of us here at some time or other think we should be tougher than we are and that we should be able to cut back on or stop pain meds early in the recovery process. Jo has taught us that belief is counterproductive in almost all cases. You NEED the prescription pain meds to facilitate more movement which equals faster recovery. Jo's chart on pain is SOOOOO CORRECT!!! I am living proof that when you wait to take the meds and don't stay on a schedule in the early recovery (where you are), you will have a more difficult time getting them to work properly for you so you can do your therapy. Please get in touch with your doctor as soon as possible and write again so we know how things are going for you! We care about you and want to help you through the difficult times. We all had them!!! ((((HUGS))))
 
At 11 days I was just laying around living on pain meds (Darvocet). I called doc to ask what is with all this horrible pain, he said you're right on schedule...the high pain usually lasts till day 10 or 11. Which it did.

It continued to be quite painful but not near as debilitating as those first 10-12 days.

Don't expect to much of yourself at this point...and it gets much better.

Hollie
 
Thanks alot for your continued support.

Last night all of a sudden I was able to leg lift about 12 inches off the bed and hold and this morning was able to to do 20. I can't believe the difference between now and 4 days ago.

I seem to be able to walk normally with very little pressure on the crutches.
Is it best to go onto one crutch or onto a cane?

Thanks again
 
I'd say whatever you feel comfortable with.
 
Hi everyone
I have just come back from my doctor who prescribed Di-Gesic, 8 per day, and Endone to be taken 1 tablet at night. These are the same meds as I was on in the hospital.
I am abit confused about the time I should be spending walking. My physio last week told me half an hour was ample because of the swelling and between exercising to keep my leg elevated with occasional icing. I have also been told that if I don't walk more then the muscles around the knee can shorten and cause problems later on.
I am now at Day 16. Your advice would be appreciated.
Thanks
Carol
 
Why not alternate the days? 20 mins one day, longer the next and then a light day and so on.
 
Hi everyone

Just an update on my progress. It is three weeks tomorrow since the operation. I am now onto one crutch around the house. Exercises were going ok until today when I seem to have increased pain in the front of the knee. I am wondering if it is because I have been on one crutch instead of two. Leg lifts are going well, ROM not progressing very well but I am keeping up the bending every day.
Having alot of trouble getting comfortable at night. Is it ok to have a pillow under my leg (not just the knee but the full length of the leg).
Thanks

Carol
 
It's not uncommon to have various aches and pains as a result of PT and increased activity. If it's very bad, up your pain meds a bit and/or add some anti-inflammatories short term.

As for the pillow, that's okay so long as you don't apply pressure under the back of the knee or the calf which could facilitate thrombosis which you're still slightly at risk of.
 
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