TKR ski_bum's Recovery Thread

[ski_bum]

I am very happy to have found this Forum and thank you for accepting me.
June 10, 2021 I had a R TKR. One night in hospital.

I started with Tylenol 3 but switched to Tylenol Arthritis & Advil after 4 days as I broke out in hives and was so nauseated. Had no problem doing basic exercise,
Staples removed June 23rd., OS said I did not need PT yet, but I had already booked appointment so went there. PT pushed for 110 knee and end result, - incision opened 1 inch. Disinfected & taped incision, healed up.
Have not over exercised in order to protect incision.

I am reducing medication even though have some pain. Cold Therapy & ice has reduce swelling.

My problem is the knee & part of calf is so sensitives I can't sleep. Could some of the sensitivity be hair growth?

My next OS & PT appointment is July 14th.

 

[Celle]

Hello @ski_bum - and

I've moved your post from someone else's thread and used it to start a recovery thread for you.

On BoneSmart, each person has their own recovery thread, where the main focus is their recovery.

So please post any updates or questions about your recovery in this, your own, thread. We will see them there, as someone checks all the new posts every day.
If you need an urgent response to a question, just tag a member of staff.
Tagging other members and answering tags

If you prefer a different thread title, just post what you want and we'll get it changed for you.

Just in case you couldn't find your thread, here are the instructions on finding your thread,
How can I find my threads and posts .

A helpful hint - Many members have found it useful to bookmark their thread so they don't lose it.

Best wishes,
Celle

 

[Celle]

Staples removed June 23rd., OS said I did not need PT yet, but I had already booked appointment so went there. PT pushed for 110 knee and end result, - incision opened 1 inch. Disinfected & taped incision, healed up.
Have not over exercised in order to protect incision.

Please don't ever let your PT therapist push on your knee to increase its flexion. It's unnecessary and its bad for your new knee. What it does is increase inflammation and swelling in your knee, which is counter-productive, because it's swelling that prevents your knee from bending.
Saying no to therapy - am I allowed to?

Your surgeon was right - you didn't need PT yet. Your knee needs to start healing before you subject it to therapy, especially aggressive therapy like you therapist performed.

There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

In any case, it's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your knee has the potential to achieve good ROM right from the start, but it's prevented from doing so by swelling and pain. As it heals and the swelling goes down, your ROM (both flexion and extension) will increase spontaneously, whether you do formal PT or just let your normal Activities of Daily Living (ADLs) be your exercise.

Recovery from a knee replacement takes a long time and nothing you do can speed up recovery, no matter how much we'd like it to. You can set back recovery, though, by doing too much, too soon.

 

[Celle]

Here are our recovery guidelines, with lots of short articles to help you.
Knee Recovery: The Guidelines

People are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart are here to help, but YOU are the final judge as to the recovery approach you choose.

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.

 

[Celle]

My problem is the knee & part of calf is so sensitives I can't sleep. Could some of the sensitivity be hair growth?

No. I don't think it's hair growth.
It's probably because you overdid things.
Your main job right now is to rest, ice and elevate your leg, and take your pain medications on time.

That doesn't mean lie like a log, unmoving for hours. It means going gently and taking a little walk around your house about every hour to 90 minutes. Walking is good exercise.

I started with Tylenol 3 but switched to Tylenol Arthritis & Advil after 4 days as I broke out in hives and was so nauseated.

If you're still taking blood thinners, it's not a good idea to also take Advil, which is a non-steroidal anti-inflammatory (NSAID) unless your surgeon is aware. NSAIDs can also increase the tendency to bleed, so taking them with an anticoagulant is probably not a good idea.

The most effective way to take Tylenol is 2 x 500 mg tablets (Tylenol Extra Strength) 6-hourly, to a total of 4,000 mg (4 doses) in 24 hours. You need to take it regularly, to keep up the levels in your bloodstream. If you just take the odd dose now and then, it's far less effective.

Check all other medications you're taking, to make sure there is no Tylenol/Acetaminophen/Paracetamol in them. If there is, scale back one or two of your regular doses, so you stay within that safe 24 hour limit of 4,000 mg.

 

[Sisterpat]

Welcome ski_bum! Congratulations on that new knee! Read the guidelines, follow the advice. Celle is right: that PT should never have forced your leg! It won’t happen again, right? You are in charge.
‘Ice and elevation will help ease the pain/discomfort/sensitivity. Do that routine frequently.
Sleep is elusive for many of us, including myself. Many months of restless nights for some. This is a year-long recovery. It can’t be rushed. Time is your friend. Keep us posted.

 

[ski_bum]

I had started a post and had been following others but I got moved and I'm not seeing others posts.
I had surgery June 10 R TKR.
Have been icing & elevating steady, swelling is pretty much gone.
Pain is light with Zingers.
Today walked into store, easy pushing a shopping cart.
Just did 5 full cycles on stationary bike.
Used some Voltarian and very comfortable.
Have not been doing very much stretching after PT pushed and opened incision. It's healed nicely.
Have always bent past 90 to 105, less than 2 finger on straight knee.
Still can't sleep, sheets on knee so sensitive it stops sleep.

Can't wait to Hot Tub.
July 14 visit OS & second PT. I will not let her push past my comfort zone.

Take 4 Advil a day, 3 Tylenol Arthritis a day

 

[Sisterpat]

Hot tub is going to have to wait for a while - especially with a recently opened incision. Heat will not help your knee at this point. Icing is recommended.

 

[ski_bum]

June 10th surgery.
I have had so much sensitivity around my knee & down calf so when I saw the surgeon on Wednesday he gave me a prescription for Gabapentin 300mg. It's for nerve damage and restless leg syndrome plus many other things.
I took one pill last night and I have not sleep that good in many years.
Woke up with very minor blurry vision, and light headed but gone after first cup of coffee.
My knee / leg felt so nice, just like my own. No selling, very little pain.
I am completely off pain medication since Wednesday AM.
Hope this is posted to help others. Sorry if not as Computer and myself aren't a god mix, lol.

 

[Pumpkin]

@ski_bum


You'll notice that I have moved your newest post from the June Sunbeams and started your recovery thread. For several reasons, we prefer that you have your own recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• With your own recovery thread, you will see the posts and advice others have left for you.
• Having only one thread will act as a diary of your progress that you can look back on.

So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

Here are the instructions on finding your thread, How can I find my threads and posts?Many members bookmark their thread, so they can find it when they log on.

Thanks,
Chris

 

[Pumpkin]

Glad you received benefit from the Gabapentin and are feeling much better.

Here is your copy of the Knee Recovery Guidelines, the articles are short and will not take long to read.

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. At week 4 and after you should follow this

​

Activity progression for TKRs​

6. Access these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

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.

OneStep App Request

Since December, BoneSmart has offered a number of pilot tests and special promotions with our partner, OneStep. Members were allowed to use this unique app at no charge to help us evaluate the program’s effectiveness for prehab and recovery for joint replacement patients. Feedback has been...

bonesmart.org

 

[ski_bum]

Thank you.
I have clicking in my knee. Don't have swelling.

 

[Jockette]

Clicking is very normal, and may lessen with time:
Here’s an article about the clicking/clunking:

Clicking/clunking knee joint after surgery

Revised March 9, 2021 by Jamie Many patients who undergo knee replacement surgery will describe noises that come from their replaced joint. People commonly mention a clicking or clunking coming from their knee replacement when they walk, and they often worry that something is wrong with their...

bonesmart.org

 

[ski_bum]

Jockette Thank you. Very informative.

 

[ski_bum]

Ah, yes, Rain Dancer, the insomnia has bit me both TKR recoveries, too, so I'm sympathetic... I react poorly to opioids so Tramadol was the relief I sought first time in recovery in 2016. Good for you to stand up for your new baby knee, too! I'm so thankful you found Bonesmart pre-surgery, too... it DOES make a difference!

I don't know if I can ask a question here but will try. Did you have any insomnia before surgery? I'm 6 weeks out completely of pain meds for 12 days. When I move my leg at night I wake up. Then off to the couch. Thanks.

 

[Jockette]

@ski_bum
I moved your post to your own recovery thread so we could answer your question and keep a record of it in your thread. This way your whole recovery is documented here like a journal. In the future, it’s best to ask your questions here in this thread. Many members bookmark it so they can find it easily.

Sleep disruptions are very common to most of us in the early months. Here’s an article about it from the Recovery Guidelines:

Sleep deprivation is pretty much inevitable - but what causes it?

Time and again members complain about not being able to sleep and after a while, that it gets to making them feel frustrated, despairing, depressed and even ill. I thought perhaps a short treatise on the reasons for disturbance of sleep patterns was long overdue. It won't help you to sleep but...

bonesmart.org

 

[Rain Dancer]

@ski_bum I had mild insomnia before the surgery because of anxiety over the procedure. In the best of times, I can sleep between floors on an elevator! I am a side sleeper, so the adjustment to sleeping on my back has been challenging. Side sleeping isn’t comfortable yet. The Tramadol was keeping me from sleeping—6 hours sleep in 72 hours, so I just took myself off of it on the second day. I am lucky because I can sleep through the pain. You aren’t on pain meds, so I don’t know what might help. Some have suggested melatonin. Have you ever tried putting yourself back to sleep with music? That has helped me at times. Are you comfortable in bed? Are you constricted by clothing, too hot, too cold? These can all keep you from sleeping. Also might want to look at diet. Are you drinking or eating anything with caffeine, such as coffee, tea, cola sodas, or chocolate? I have eliminated caffeine for now. I hope that this resolves for you soon. Good luck.

 

[BBCG]

Hi Skibum, welcome here to Bonesmart! It's a wonderful group of helpful folks who've been there and done that!

Yes, I did have some insomnia prior to the TKR, but it may have just been that I was already having a fair bit of pain then.

What has worked for me, and you may be able to find something similar in Canada, is an herbal salve (mine has some CBD in it) that I put directly on the leg in the sore areas, before bed or before walking, etc. It seems to calm the sore areas down some. I've also used a magnesium gel, too, that a massage therapist used on me after TKR #1 in 2016. That helps my zingers and that kind of nervy ache that I sometimes get.

I do still take Tylenol before bed, to help lessen the tactile tenderness of the incision, too. I've tried to stop taking it, but I tend to wake up more, so am still doing it for now... am at 12.5 weeks out now.

For the first 8 weeks I also took some Melatonin, as well before bed, and that seemed to help me get back to sleep if I woke up in the middle of the night... I don't seem to nee that now, so stopped it back around week 8...

Are you still going to PT, too? Mine sometimes does ultrasound on my knee, right near the incision and it tends to help decrease the touch sensitivity, too. I also have one friend who had a double TKR and used to put ace bandages over her incisions at night, telling me it helped them not feel every touch by the sheets.

Hopefully, you'll hear from some others as well, who found useful techniques to aid their sleep, too!

 

[Sisterpat]

Ski bum, you are just about 2 months post TKR. Sleep did not return to me for about 4-6 months. I had been sleeping pretty well before surgery (after long periods of insomnia), so it was a disappointment being back in the counting sheep mode. But now sleep has returNed in the last few weeks. I think it’s just a matter of time for you.

 

[MTBinNC]

Hi Ski Bum- I'm at 9 weeks post TKR.
Re: sleep- I didn't sleep through the night until day 40. It about drove me nuts! Now I find that I often wake up in the middle of the night with some discomfort, but I walk around the house a bit and can go back to sleep.
Re: sensitivity- I was given Gabapentin sometime in my first week- I had terrible burning in my foot. The gaba did the trick. I still have sensitive skin near the incision, but I assume it's just nerve disruption that'll heal over time (it seems to be improving). I've been putting a CBD product on it
Hang in there!