TKR So exhausted - is this normal?

[pdx]

Laura, I'm with you. My poor hamstrings were tight tight tight after years of being shortened because I couldn't straighten my leg pre-surgery. The operation doesn't touch the back side of your leg (except the tournequit, if one's been used). While it hurt like the devil at first to do extension exercises, they worked.
As for Vicodin fog, all the opioids do that. All. I hated the feeling more than I hated the pain, so I experimented with cutting back. It worked -- I took 1/2 a 5 mg Vicodin plus a full-strength aspirin and sometimes another half a Tylenol, which is also in the Vicodin. At night I took more V, at least at first. I found I could exercise more, not less, when I wasn't in a fog, even if the exercise was just getting up and walking around a bit. Bonus: I got better faster.

 

[pdx]

Oh, forgot to add: Cutting back the Vicodin also decreased the blues. At least for me, probably because I felt more in control.

 

[referee54]

As for Vicodin fog, all the opioids do that.

I used to say that I felt like I was walking around in a "giant cotton ball."

My poor hamstrings were tight tight tight after years of being shortened because I couldn't straighten my leg pre-surgery.

I think that stretching the hammies is a very difficult thing for many of us to do---and they are naturally tight, anyway. I know that, as a cyclist, I have to make sure now, after over five years post BTKR, that I make an effort to stretch my hamstrings. I think that the quads, through our natural walking motion, can be loosened up and stretched easier---but those infernal hamstrings---for some reason, they are normally tight on many people.

 

[referee54]

I used to stretch like crazy when I reffed college basketball. I stretched before the game; I stretched at half-time, and I stretched after the game. However, one day, when I had a four-hour drive home, I must have popped a hamstring---I got through the game fine and got into the car for the drive home. I always "gas up" before the drive home, so I do not have to stop---I went to get out of the car after four hours, and I could not lift my leg!!!

I lost thousands of dollars that year because I lost over two months of reffing fees.

If you can get into a whirlpool, stretching the hamstring is much, much easier---the gentle turbulence and the warm, aquatic heat help lengthen the muscle fibers.

 

[Brian6u]

Now 25 days post surgery and I still find myself riding a roller coaster. I am able to work more than I did before. Most days from about 830 in the morning until about three in the afternoon. My knee continues to be severely swollen after PT. I can go the day without much pain relief, but I need painkillers at night in order to sleep. That leaves me in a fog when I wake up in the morning, and the cycle begins all over again. Still having a hard time getting past the mindset that I should be better than I am right now after about four weeks. Here in Florida, they made us go through a series of classes before we had our knee joint replaced. Even with those classes, I had no idea what I would be up against in the recovery process. With the benefit of hindsight, it almost seems unfair. Nevertheless, I am here now and I intend to fight my way through this. But the journey is no fun, and I only hope that when I arrive where I'm supposed to be that this will have all been worth it.

 

[Josephine]

Still having a hard time getting past the mindset that I should be better than I am right now after about four weeks. they made us go through a series of classes before we had our knee joint replaced. Even with those classes, I had no idea what I would be up against in the recovery process.

Brian, I don't know what to say to you. You are only in this state because you didn't give yourself time to recover properly and this is the payback you get for that. If you read my article Energy drain for TKRs then you'd have a bit of an idea what you are fighting against. That and the fact that this VERY major surgery causes significant pain for about 10 weeks minimum. You can't have your cake and eat it. You had the surgery but you insisted on going back to work so soon - there is nothing you can do but bite the bullet and hope your body copes somehow.

With the benefit of hindsight, it almost seems unfair.

I think the organisers of those classes rather assumed that their clients would be doing the sensible thing and resting and recuperating for the appropriate period of time! That's the 'unfair' part of it.

 

[Brian6u]

Josephine...actually, The hospital I used ran regular seminars telling people how quickly they could bounce back from surgery. In their required classes, they said that it would be no problem returning to work after about two weeks. After almost 4 weeks that seems ridiculous to me now. Also, as a person that owns a business and has people who rely upon them to make their own living, I feel an obligation to be there to keep my business moving forward. Had I known that it would take me 6 to 10 weeks to get healthy, I would likely have not had the surgery. You are correct… I made the mess that I'm in. And I'm trying as hard as I can to make myself better.

 

[Josephine]

Really? Oh my goodness! That's really bad - fancy encouraging people to think that. I bet they have an awful lot of very unhappy patients and that they sing a different tune when they have their knees done! I couldn't have imagined even going shopping at two weeks much less back to work. They really did you a disservice there, my friend, and I am extremely sorry I was so snippy with you.

As a matter of interest, what is your business? Can you not take a half day here and there to rest up a bit? I know it's hard when you're self-employed and have a business to run.

 

[Brian6u]

I raise money for charities...about $20 million a year...and many people in need depend upon our work in their behalf. Truly, having had 3 knee surgeries already, I had no idea the pan and exhaustion that TKR brings.

 

[referee54]

am able to work more than I did before. Most days from about 830 in the morning until about three in the afternoon.

There is a physical and an emotional roller coaster in a "normal" recovery, but I have to tell you, at 25 days out, you are doing waaaaay too much. No wonder you are exhausted and feeling depressed. Your knee is still in the healing stage, and your body is demanding large amounts of energy to heal the crucial trauma that was done to it.

the way that I see it, you can either A) cut back and feel better---perhaps get a little work done here and there, or, B) continue on the path that you are taking and feel exhausted for even longer periods of time and slow down your recovery to an even greater extent.

Perhaps yo can only work part tie and from home---but I went back to the classroom at eight weeks, and I can tell you---even that was way too early.

You have to let your surgical knee heal---and those pain meds--which are necessary---can cause the depressed feelings too and leave you in a fog.

Hang in there and ice/elevate and rest.

 

[referee54]

Nevertheless, I am here now and I intend to fight my way through this.

The more you fight it, the more it will fight back---better to "roll with the punches" as they say. Josephine has a great saying: "Recovery is something that happens"---you do not process it any faster by working harder. Just let the recovery come to you and take it in the time that it deems necessary to recover.

 

[forevergimpy]

Brian you certainly are in a hard place it seems. I commend you for believing in your work and caring for those that depend on you for their livelihood. I have no doubt that you are right when you say that if you had known exactly how much this would take out of you and the length of time needed for you to recover you would have not had surgery at this point. But....you did have surgery and now it's you that needs to depend and count on you too.

I hope that you are able to ice, and elevate during the day. Maybe you can try to take some of the pain meds throughout the day to try to keep the pain and swelling from building towards night time?

You mentioned that your knee swells a lot after PT. Could this new PT be a bit too aggressive as well? I've not yet had my surgery so I'm not speaking from personal experience, but part of the mantra is to not repeat anything that causes your knee to swell within 24 hours.

I wish you well and I hope that things start to look up for you soon. Remember that as tough as it is, every day is a day closer to reclaiming your life.

 

[Jamie]

Brian, is there some way you could take an hour break at work, lie down somewhere with some ice and elevate? You maybe could bring in a foldup lounge chair to use and keep gel packs in a freezer. Or possibly purchase an ice machine to run on your knee continuously. There may be options like this to help you be more comfortable.

 

[referee54]

This is an excellent post!!! :iagree:

 

[Roy Gardiner]

Rock and a hard place isn't it Brian?

So, as has been said, roll with the punch (well said Jamie, I agree too). You also could cut out completely any training-type PT, you only need ROM stretches at the stage you are.

Delegation is good, can you get others to take on work?

Anything like this will help -- your knee won't be forced into submission, you have to finesse it. Easy, no brain material in the knee*

*(I am a biological marvel, my brains are in my ar.. oh never mind)

 

[pglickenhaus]

Brian,
Not to be mean but you really need to chill. Yes it sucks, yes it hurts, yes it's gonna hurt allot longer, Yes it's gonna swell and yes it sucks. I have never heard a doctor tell anyone that they would return to work after 2 weeks after a tkr. So I believe you were sitting in on the wrong seminar. Maybe it's time for your employees to step up a little and help.
Your gonna be hurting for months to come. My advice(not that you should care) work hard on pt on your new knee and take some time off. Sitting at a desk all day is the worst thing you can do.

 

[Brian6u]

PG... I am very well-educated and not delusional. I attended very in-depth seminars, that I was required to attend in order to have my knee replaced. At each of these seminars they told me that I could likely return to work in two weeks. While I appreciate your frankness, it doesn't help me at this moment.

 

[pglickenhaus]

Only hard work and time will help at this point............

 

[Brian6u]

Agreed...and I can assure you I have never worked this hard at anything physical. Here in the US, this is a profitable surgery. I expect that is why the pain and suffering are downplayed.

 

[Mutley]

Hi Brian. Me again! Your not quite 4 weeks out yet & for some reason unknown to us, the 4 week mark can be A KILLER You've just said your working really hard with your pt to try & get better, quicker but believe me, it's not happening & it's not going to happen. Your knee has now spent near on 4 weeks desperately trying to recover from the trauma of the operation itself AND the added insult of trying to do pt while the poor thing is still swollen, sore & probably damn well angry if you'll excuse my swearing! All the while it's not getting the adequate time to rest, ice, elevate & recharge it's batteries, your not going to see any progress being made & possibly you may actually be setting yourself backwards. I was emailing someone else last night & said to them, your knee problem didn't happen overnight, therefore why do we expect that we can recover from one of the more MAJOR SURGERIES in say 2,3 weeks or in my case 3 months? The other day I did a small shop in the supermarket & decided I would take the dogs for a walk. It's ok, I thought, I'm 3 months post op, SHOULD be able to do this now...WRONG I have been paying for my "Expectations all night & most of today. I'm now back on my well worn sofa, leg elevated and bag of frozen sweetcorn moulded to my knee! What I THINK I SHOULD be able to do and what my KNEE is telling me I can do are 2 very different things. I'm still having trouble accepting this but I have no choice. Now this sounds rude but please don't think I am being BUT the sooner you accept that you have to reverse your day :- More REST, ICE, ELEVATION & GENTLY EXERCISES & a little bit of your charity fundraising job, the sooner your recovery will get back on track & then you will start to see & feel progress is actually happening!
Sorry this is long but it's just because I/WE CARE!