TKR Six days down…

[discobee]

Found the forum at 1 am after googling to see if I would ever sleep again.

TKR on 2/23 after almost 30 years of knee scopes and an elusive meniscus tear. I’m on the “younger” side at 49 and have known this day would come for about 10 years.

Surgery was performed at 9 in the morning and I was home by 5 that evening only to realize that either (a) nerve block wasn’t correct or (b) I was having massive calf cramps. Regardless, a follow up femoral nerve block and loads of calf massages later, I’ve lived to tell the tale.

Starting to think I was a bit too cavalier going into this even though I’ve witnessed both parents have TKRs as well. This is not for the faint of heart.

I’ve got a preschooler and am looking forward to adventures with my kiddo and skiing vacations again someday, but at six days in, it all seems like a pipe dream….

 

[Layla]

Hello and Welcome to BoneSmart! We're happy you found us. Congrats on your new knee!
Please identify which knee was replaced so we're able to add that information to your signature.

I am sorry you were off to a bit of a rough start. Sounds like you had a long history with your knee.
You're still in the very early days of a recovery that can take a full year for many. Thankfully your focus is on your child and the brighter days soon coming your way.

As for sleep, many experience the same. Some of the suggestions shared here have been melatonin and also some of the various sleep teas you're able to purchase from most large grocers. Magnesium is also something you may want to consider.

Magnesium supports the following:
Bone health
Healthy blood sugar
Cardiovascular health
Muscle relaxation and nerves
Promotes healthy sleep (falling asleep and staying asleep)

An article on Magnesium -
https://bonesmart.org/forum/threads/magnesium-is-a-star.20301/

I wish you well on the journey. Thanks for joining us!

 

[Layla]

Following are some guidelines you may find beneficial -

KNEE RECOVERY GUIDELINES

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

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. At week 4 and after you should follow this

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 a 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 history before providing advice. @discobee

 

[selketine]

Welcome to the forum! You're in very early days and with a preschooler to boot so I'm sure it's hard to get the rest some of us got as our kids are out of the house. I just passed week 7 and I'd say I have a slower recovery than some people as I'm having trouble walking - but my knees were bad for so long I had loads of trouble before surgery. I just have to retrain my muscles for walking and build strength - and get my left knee done which is still very bad. My goal involves one of my kids as well - we had long planned a trip to Japan that we postponed as I just couldn't walk. We're hoping to go next year. Plus I love theme parks so I need some good knee bend to get into those roller coasters - haha!

I think sleep is one of the most common problems. Some other posters here have good tips for that so I'm sure they'll chime in. (Sleep was about the only thing I had no trouble with - no idea why - I had trouble pre-surgery). I'll just throw out there that I didn't need to take the stronger pain med at night after a few days - I have a feeling those tend to interfere with sleep for me. Of course I'd choose to take them if the pain was bad - and most say don't back off on your pain meds too soon.

The best thing you can do is get as much rest as you can and don't try to stay on your feet too much at this point. Get some little walks in - like to the restroom or getting something from the kitchen - and the stretches the PT gives. Let us know how you're doing!

 

[discobee]

Thank you so much for the encouragement. Bright side is that my little guy thinks the walker is HILARIOUS!

I was actually in the midst of researching magnesium for other reasons, but this incentivizes the search for real. There are many mag variants (oxide? glycinate?) which is best?

To answer @Layla above, I’m LTKR.

Looking forward to new friends and much widsom here!

 

[MSuki]

If you have a walker with 1 inch tubes on the back you can further entertain him by getting some glides for it that look like tennis shoes or flip flops on amazon. They replace the rubber covers at the bottom of the tube. I had a collection of these between my two knee surgeries, and also had some glide covers that looked like house shoes for inside. The glides can get roughed up outside.

Although may not be worth it if you only use the walker for a short time.

 

[Rugbylion]

Hey Disco- I’m also 49 and had a PKR about 5 months ago and was in the same exact place as you. My calf was hurting so bad I thought I might have had a clot but after a quick visit to the dr, we’re both convinced now it was a residual effect (maybe calf was resting on something in awkward position) from the surgery.

The overall pain was pretty intense for a few days and I’m not one to take medications so once I started the regiment, things got better and I was able to focus on therapy. Ice and elevation were very helpful for me. If/when you do end of taking the pain meds, don’t forget your fiber supplements!

I didn’t push therapy too hard, only to the point things got uncomfortable, then I would slow down and repeat several times a day. Repetition was key for me to get ROM.

Lastly, things will get better, the body is amazing and will definitely heal.

 

[EalingGran]

think sleep is one of the most common problems. Some other posters here have good tips for that so I'm sure they'll chime in

Sleep was really difficult for me post op.
I am not a good sleeper anyway and the slightest discomfort made sleep impossible. I managed to get my GP to prescribe a month's worth of zopiclone which I used sparingly. I rang the changes with herbal valerian and an over the counter sedative antihistamine ( Nytol in the UK).

 

[WFD]

Magnesium oxide is cheap but not absorbed well. The citrate and glucinate forms are both absorbed well, but last time I checked, citrate was cheaper so I've gone with that.

 

[Layla]

The only form of Magnesium I can speak to personally is Glycinate because that's all I've ever taken.
From research I did awhile back it is less likely to cause gastrointestinal side effects than other forms.
I find this to be true, in addition it can keep you regular. It can also have a calming effect and while I sometimes take it twice a day, morning and evening. I mainly only take it in the evenings. There are many resources online that explain the different forms, and there are quite a few.
Have a great day @discobee and WFD.

 

[mendogal]

@Rugbylion - thank you for chiming in! We'd love to have you start your own Recovery thread - it's a great way to track your own milestones as well as ask questions, vent, etc.

 

[mendogal]

Insomnia is a real bummer for many of us in the initial weeks after knee surgery. Definitely sleep whenever (and wherever it's safe and comfy!)

Icing, elevating, napping.... All help, but for some of us it was endangering our mental health. Before it gets there consider some nonprescription remedies....

If you're lactose tolerant, a glass of warm milk! If you're not diabetic, a teeny bit of honey makes it even more comforting... plus milk is high in magnesium! Helps us relax!

If you aren't a milk drinker, or want an easier way to, an evening magnesium supplement has been very helpful for some members.

OTC diphenhydramine, an antihistamine also used as a sleep aid (Benadryl) because it makes you drowsy; it's also included in some cold, flu, etc "nighttime" combination meds.

Low dose melatonin, sustained release - not for long term use but I have used for a week at a time without ill effect. It should be taken an hour to hour and a half before going to bed, and during that time stay in a dimly lit area to allow this hormone to activate.

Valerian root - an herbal remedy, it can be taken in capsule form but that dose might be high compared to my preference, herbal "sleep" blends that include a smaller dose of valerian and make me pleasantly drowsy. Plus the other tea flavorings make it nice tasting! Celestial Seasonings and Traditional Medicinals sell teabags by the box. Their sleep blends without valerian have never ever made me sleepy.

Be aware: even benign herbals and supplements can interact with your routine or post op prescription meds, either making their effects weaker or stronger. If you're on meds you may want to check with your doctor or pharmacist, or even check online for interactions.

 

[selketine]

There are many mag variants (oxide? glycinate?) which is best?

Based on a recommendation a few months ago, I ordered one from amazon - name of it is below, and it kinda seemed to work for me as I had a lot of trouble pre-surgery with sleeping because of the knee pain. At the very least, it didn't have any negative affect. I haven't taken it post-surgery. My co-worker uses it and finds it to be helpful with sleep as well. A few nights I used the "Tylenol PM" and that will definitely make me sleep - especially if I take two. Of course it has Tylenol in it so be careful not to not take regular Tylenol. I only took it a couple of times - if you need something every night I'd suggest asking the doctor. I had forgotten I took it a couple of times. I kept waking up super early and getting like 4-5 hours sleep so that knocked me back to sleeping 5-6 hours is why I used it.

Doctor's Best High Absorption Magnesium Glycinate Lysinate​

That's really cute that your preschooler loves the walker. How fun is that? I have a rowdy cat that thinks the best thing ever is to hook his paws around the back leg and let me drag him down the hallway. He's a little road hazard.

 

[mendogal]

@selketine Tylenol PM is merely a combo of acetaminophen with diphenhydramine.

For those of us using acetaminophen regularly, it's safer and easier to just buy diphenhydramine.

It also lets us select the dose we need (25 vs 50 mg) without recomputing acetaminophen dosage!

 

[discobee]

Thank you all for the encouragement here!

Today, I’m little freaked out about CONTINUING PAIN.

I’m now 3 weeks and 2 days past surgery and have been alternating Tylenol and Advil every three hours for pain. I’m trying to ween off of those as much as tolerable,

I tore my ACL two months before surgery and wasn’t able to bend my knee (should have done pre-hab, I know now). Also developed a “severe” valgus deformity. From what I’ve read both of these could be contributing to my pain.

I’m struggling to get extension. Understand this is because of ACL problems and the guarded position I was in. I couldn’t straighten the leg pre-op. Lots of pain tightness in calf still which I attribute to the injury.

Also, tons of discomfort at lateral knee. Feels like IT band syndrome which makes sense because of valgus deformity. Spoke with PT about all of this a couple of days ago and we’ve begun scraping around the knee. She found lots of tight spots.

I’ve started gently rolling calf on foam roller. Not brave enough for IT work.

I guess I’m just looking for someone who may have had one or both of these issues and lived to tell the tell the tale and offer and tips????

 

[mendogal]

At three weeks, four weeks, six weeks, etc pain is still normal for most of us. Some people require prescription pain meds for a few months. This is normal.

Even a minor sprain or strain from an athletic injury needs 6-8 weeks to heal. A TKA, even without a recently torn ACL, is closer to a significant car accident than to a sprain or strain.

So there was the trauma of surgery. Plus everything about your structure was reset in the relatively short time you were in OR.

Be kind to your new knee. It was given good range of motion in OR. Now what it most needs is to slowly heal - no forcing of bend or of straightening, no painful repetitions - just walking and gentle stretching that may be uncomfortable but absolutely shouldn't hurt.

 

[Layla]

Hope you're feeling better as the week progressed.
You've hit the one month post op milestone.
Happy One Month Anniversary! May the next month be better than the last.
@discobee

 

[Layla]

Hi discobee,
It's been awhile since we heard from you. How are you doing?
Please let us know and remember we are available for support if you feel the need.
Hope to hear from you soon. Happy Two Month Anniversary!
@discobee