Bilateral TKR Six weeks post surgery and struggling
- Thread starter catlady
- Start date
- Status
Pretty someone someone will stop by with information on the Bonesmart mantra and some reading material. In the mean time, ice, elevate, keep up with your pain meds, and rest as needed.
Josephine
NURSE DIRECTOR EMERITA
Both aspirin and Celebrex are NSAIDs and should not be taken together. There is a warning in the Library NSAIDs, acetaminophen (Tylenol, paracetamol) differences and dangers.
No such thing! or to put it another way THERE IS NO SUCH THING!
Myth busting: the "window of opportunity" in TKR
Myth busting: the "window of opportunity" JBJS
First: as has already been said, 113 is BRILLIANT for 6 weeks. You're there, no more need for pushing or crying or anything else like that. Just proceed with gentle stretches and some short walks and read the recovery articles.
Second: note second line of the BoneSmart Mantra
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
And then read these very crucial articles
The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Activity progression for TKRs
Healing: how long does it take?
Chart representation of TKR recovery
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Home physio (PT) and activity progress: suggestions
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
And wise words from members who have shared their experiences ...
Where are you in recovery?? (TKR)
Five “P’s” of knee recovery
TKR: work “smarter” and not “harder”
Recovering a knee - from one who knows!
It's never too late to get more ROM!
It's worth the wait for ROM
OP
OP
catlady
junior member
- Joined
- Jul 6, 2013
- Messages
- 37
- Age
- 69
- Gender
- Female
- Country
United States
Thanks, Josephine -
I will be reading through all of the articles. I was on the Celebrex and aspirin together as the aspirin was in place of Cumadin or Warfarin - just lucky that I wasn't on one of those.
Thanks for the encouragement - off to read and do my GENTLE stretches. You guys are wonderful!!
Linda
I will be reading through all of the articles. I was on the Celebrex and aspirin together as the aspirin was in place of Cumadin or Warfarin - just lucky that I wasn't on one of those.
Thanks for the encouragement - off to read and do my GENTLE stretches. You guys are wonderful!!
Linda
Nomorepain67
member
- Joined
- Jul 23, 2013
- Messages
- 165
- Age
- 59
- Gender
- Female
- Country
- United States
Hi Linda
Sorry to hear you had a set back, but glad to hear you are back on your way to recovery. I had my BTKR 2 weeks after you did so glad we can connect to compare notes. Both my OS and PT think 90 degrees at 3-4 weeks post-op is right where you want to be. I have to say I have found out the hard way that the more I push to try to get more movement, the more I set myself back. I have learned that after an intense PT session, I need to really take it easy 1-2 days with just gentle stretches. My ROM in both knees tends to be improving in small increments of 2-3 degrees. I had a big day on Friday with a trip to the OS, PT and then a stop at Walgreens. Here I am on Sunday very stiff and needing to really take it easy. I find I need to do alot of coaching to myself to try to minimize frustration and stay positive.
Take care,
Stacie
Sorry to hear you had a set back, but glad to hear you are back on your way to recovery. I had my BTKR 2 weeks after you did so glad we can connect to compare notes. Both my OS and PT think 90 degrees at 3-4 weeks post-op is right where you want to be. I have to say I have found out the hard way that the more I push to try to get more movement, the more I set myself back. I have learned that after an intense PT session, I need to really take it easy 1-2 days with just gentle stretches. My ROM in both knees tends to be improving in small increments of 2-3 degrees. I had a big day on Friday with a trip to the OS, PT and then a stop at Walgreens. Here I am on Sunday very stiff and needing to really take it easy. I find I need to do alot of coaching to myself to try to minimize frustration and stay positive.
Take care,
Stacie
OP
OP
catlady
junior member
- Joined
- Jul 6, 2013
- Messages
- 37
- Age
- 69
- Gender
- Female
- Country
- United States
Hi Stacie -
Trying to figure out how much is too much is definitely my biggest challenge! My PT says I'll get the ROM in the left knee, but he seems to think more aggressive is the way to go. After he really pushed me last week (with tears streaming down my face), I felt like I should be more aggressive at home, so the next day I tried to push really hard. He says I should be doing 100 stretches (with the strap around my ankle, pulling) each leg, each day. I got to 70 that day. Then the next day I could hardly walk and my poor left knee didn't want to bend as far as it had been before the big push. It hurt all weekend - today, finally, it feels a little better.
I'm so torn between thinking that with scar tissue you have to be super aggressive, or whether slow and gentle is the way to go. It just seems that every time I do push really hard, the knees get inflamed, which I'm afraid can cause more scar tissue. Geez - I think this recovery thing gives me too much time to think!!
Linda
Trying to figure out how much is too much is definitely my biggest challenge! My PT says I'll get the ROM in the left knee, but he seems to think more aggressive is the way to go. After he really pushed me last week (with tears streaming down my face), I felt like I should be more aggressive at home, so the next day I tried to push really hard. He says I should be doing 100 stretches (with the strap around my ankle, pulling) each leg, each day. I got to 70 that day. Then the next day I could hardly walk and my poor left knee didn't want to bend as far as it had been before the big push. It hurt all weekend - today, finally, it feels a little better.
I'm so torn between thinking that with scar tissue you have to be super aggressive, or whether slow and gentle is the way to go. It just seems that every time I do push really hard, the knees get inflamed, which I'm afraid can cause more scar tissue. Geez - I think this recovery thing gives me too much time to think!!
Linda
My way
graduate
- Joined
- Mar 31, 2013
- Messages
- 756
- Age
- 67
- Gender
- Female
- Country
- Canada
catlady I think the answer to your question is the way aggressive PT makes your knees feel. You can see how much more difficult it is to bend after "therapy". When it has had a chance to recover from the "onslaught" it is looser,easier to bend and less painful. I would do gentle exercises more often rather than aggressive exercises that take me a couple of days to get over before I can do them again. Please read my recovery thread "And I'm Off" and you will see that slow, gentle and listening to my knees worked for me.
Wanda
Wanda
OP
OP
catlady
junior member
- Joined
- Jul 6, 2013
- Messages
- 37
- Age
- 69
- Gender
- Female
- Country
- United States
Thank you, Wanda-
I just spent time reading through your recovery thread and it helped a lot. You are right - I need to just listen to my knees. I also need to stop obsessing about my ROM numbers. This isn't going to happen overnight (or in 2 - 3 months) - it's going to be a long haul, so I can't push it any faster. (Easy for me to say...). I see my OS Thursday and I've had it in my mind that I needed to get as much ROM as possible. But I now see that it is what it is - I honestly can't do more than I'm doing - and think I need to be doing less...
Linda
I just spent time reading through your recovery thread and it helped a lot. You are right - I need to just listen to my knees. I also need to stop obsessing about my ROM numbers. This isn't going to happen overnight (or in 2 - 3 months) - it's going to be a long haul, so I can't push it any faster. (Easy for me to say...). I see my OS Thursday and I've had it in my mind that I needed to get as much ROM as possible. But I now see that it is what it is - I honestly can't do more than I'm doing - and think I need to be doing less...
Linda
I am a nurse, and as a nursing student I watched a BTKR. I'm a late-life nurse so I was close to having my own TKR when I watched this surgery. Well the patient happens to be a neighbor. I know that one of his knees healed more easily than the other, and I knew from watching the surgery that the slower knee was the first one they operated on. They opened up the knee, did the cuts, tried on components, tested the leg, tried different size components, etc. before that knee was good to go. Which involves lots of traumatic manipulation of the soft tissues. The other leg was straightforward. So not sure if this was true of yours but I wonder . . .
Anyhow, it all takes too much time, hurts too much, and we never feel quite prepared. But keep it gentle. Be kind, loving, and understanding with the "slower" knee and all will be well.
Anyhow, it all takes too much time, hurts too much, and we never feel quite prepared. But keep it gentle. Be kind, loving, and understanding with the "slower" knee and all will be well.
OP
OP
catlady
junior member
- Joined
- Jul 6, 2013
- Messages
- 37
- Age
- 69
- Gender
- Female
- Country
- United States
Thanks, Maryo52 -
That's really interesting. I'm seeing my OS this week and might ask him which he did first. I'm sure he won't remember, but it should be in my file. I see that you had a MUA and additional adhesion surgery. What was your ROM and how did that go? I'm not thinking I'll need that, but I'm curious what happened.
I had a good milestone today - first shower not using the shower chair! I'm sure I could have done it earlier, but it was a confidence thing. I'm going to try a bath tonight. We have a very deep tub, so I've been afraid I wouldn't be able to get out, but I did a "dry" run today and think I can do it. I'm hoping the warm water and jets will help my problem knee...
Linda
That's really interesting. I'm seeing my OS this week and might ask him which he did first. I'm sure he won't remember, but it should be in my file. I see that you had a MUA and additional adhesion surgery. What was your ROM and how did that go? I'm not thinking I'll need that, but I'm curious what happened.
I had a good milestone today - first shower not using the shower chair! I'm sure I could have done it earlier, but it was a confidence thing. I'm going to try a bath tonight. We have a very deep tub, so I've been afraid I wouldn't be able to get out, but I did a "dry" run today and think I can do it. I'm hoping the warm water and jets will help my problem knee...
Linda
The main thing that helps problem knees is time.
My ROM never rose above 85. At one point it went backward. The MUA was initially successful but the scar tissue re-established itself in about two weeks. The arthroscopic intervention finally did the trick, but then it was weeks before we knew that. The amount of patience needed for this business is usually beyond our ability!
My ROM never rose above 85. At one point it went backward. The MUA was initially successful but the scar tissue re-established itself in about two weeks. The arthroscopic intervention finally did the trick, but then it was weeks before we knew that. The amount of patience needed for this business is usually beyond our ability!
OP
OP
catlady
junior member
- Joined
- Jul 6, 2013
- Messages
- 37
- Age
- 69
- Gender
- Female
- Country
- United States
Going to PT today after the long weekend and I have to admit I'm scared about how it will turn out. I was faithful to the Bonesmart mantra and only did gentle stretches and lots of ice and elevation. I know I'm not supposed to be caught up in numbers, but it's hard to not worry that I will have gone backwards. I'm still struggling with how gentle to go - and feeling like I'm not doing enough to stretch the scar tissue. This patience thing is tough...
I'm also really struggling with my appetite - I've lost about 10 pounds since the surgery (on top of almost 20 I lost on purpose before the surgery to help my knees). I can't believe I can actually say this, but I don't need to lose anymore, but am having a problem eating. Does anyone else have this problem? I've cut back to 2 Norco a day, supplimenting with Tylenol but the appetite hasn't come back. I feel like good nutrition is vital for good recovery...
Linda
I'm also really struggling with my appetite - I've lost about 10 pounds since the surgery (on top of almost 20 I lost on purpose before the surgery to help my knees). I can't believe I can actually say this, but I don't need to lose anymore, but am having a problem eating. Does anyone else have this problem? I've cut back to 2 Norco a day, supplimenting with Tylenol but the appetite hasn't come back. I feel like good nutrition is vital for good recovery...
Linda
Linda, Yeah, the loss of appetite is common. Narcotics' affect on GI system.
You do not need to stretch the scar tissue. Yeah it feels tight. And yes, I understand the worrying part. I'm not sure we have any control over the worrying either! But what you can do is to try to keep up positive self talk. Reassure your worried self. I used the pain scale to measure where to stop. I once read that all activity, PT, etc. should be 3 or below on the pain scale, so that's what I went by.
You do not need to stretch the scar tissue. Yeah it feels tight. And yes, I understand the worrying part. I'm not sure we have any control over the worrying either! But what you can do is to try to keep up positive self talk. Reassure your worried self. I used the pain scale to measure where to stop. I once read that all activity, PT, etc. should be 3 or below on the pain scale, so that's what I went by.
- Joined
- Jul 23, 2011
- Messages
- 9,651
- Age
- 74
- Location
- Essex and London
- Gender
- Male
- Country
- United Kingdom
If what you do hurts, or if your knee swells in the next 24 hours
wrong...
...as your experience shows.
Slow and gentle is the way to go
Exactly!!!!
Doing 100 stretches is good BUT gently, never past the point of pain, and not if the knee swells afterwards.
I personally think 100 stretches is too much. I beat scar tissue (meaning, I got my leg bending before internal scar tissue re-grew) by doing 10 stretches three times a day. That is plenty. And they were gentle and slow, and I held them.
This process really causes us to do a lot of soul searching. Somewhere inside of you there is a voice that knows the ortho is wrong and yet you feel conflicted because he's the one with the degree written out in the fanciest script.
This process really causes us to do a lot of soul searching. Somewhere inside of you there is a voice that knows the ortho is wrong and yet you feel conflicted because he's the one with the degree written out in the fanciest script.
Nomorepain67
member
- Joined
- Jul 23, 2013
- Messages
- 165
- Age
- 59
- Gender
- Female
- Country
- United States
Hi Linda
Try to listen to what your heart and head tell you is best. I try hard not to worry about the numbers even though I write them down every visit. After a very busy Friday last week, it took all weekend to try to relax my knees and even begin to feel like I could do my stretches. Saw the PT today and right was several degrees less which I knew it would be. His advice was to do at least a few stretches every day to keep it bending and loose. He reminded me that there are many layers of tissue that need to heal and their preference is to stick together. He now wants me directly massaging my scars to try to loosen the layers. Doing 100 of anything sounds excruciating. Even though I was nervous about seeing my OS, turned out I was worrying for nothing. I am a firm believer in the slow and steady even though I have to constantly remind myself of that. Hang in there, our sunshine days are coming.
Stacie
Try to listen to what your heart and head tell you is best. I try hard not to worry about the numbers even though I write them down every visit. After a very busy Friday last week, it took all weekend to try to relax my knees and even begin to feel like I could do my stretches. Saw the PT today and right was several degrees less which I knew it would be. His advice was to do at least a few stretches every day to keep it bending and loose. He reminded me that there are many layers of tissue that need to heal and their preference is to stick together. He now wants me directly massaging my scars to try to loosen the layers. Doing 100 of anything sounds excruciating. Even though I was nervous about seeing my OS, turned out I was worrying for nothing. I am a firm believer in the slow and steady even though I have to constantly remind myself of that. Hang in there, our sunshine days are coming.
Stacie
- Status
