TKR So happy Surgery is behind me!

[Bridgy]

I’m waking up this morning feeling pretty good from 8am surgery yesterday. I’ve been taking the Percocet prescribed every 4 hours and trying to ice and elevate. I hope my current almost pain free state isn’t because the nerve block hasn’t worn off yet?
Also my leg is wrapped in a tight ace bandage from top to bottom. I’m to wear a brace over that for 2 days postop morning and night. By tmo I graduate to TED hose on both legs in the daytime. I will say that my leg feels like a swollen log. I’m having difficulty lifting it on my own. Also everything is too tight for me to bend it. Maybe tmo will be better when I move to the thigh high hose vs ace wrap.
But all-in-all I feel great and am not in pain while resting. Walking (with the walker) is surprisingly easy and low pain as well

 

[Zanza]

I certainly hope you keep feeling pain free but once the nerve block wears off, your knee might hurt. Don't be discouraged. Just keep icing and elevating and moving around as you feel like it. You've come to the right place for help and support!

 

[Jaycey]

@Bridgy Welcome to the other side! Easy does it now. Be sure and stay ahead of the post op pain.

I'll leave your recovery guidelines here for you:

Knee Recovery: The Guidelines
We 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 have the final decision as to what approach you use.

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. Here is a very general week-by-week guide. 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 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.

 

[Bridgy]

I certainly hope you keep feeling pain free but once the nerve block wears off, your knee might hurt. Don't be discouraged. Just keep icing and elevating and moving around as you feel like it. You've come to the right place for help and support!

@Zanza you were correct. This was a painful day. The worst is trying to get my leg back up on the bed after walking. I have quite a bit of swelling too

 

[Zanza]

Easy does it now, Bridgy. It might be tough for a few days, or even a couple of weeks. The important thing is to keep icing your knee and elevating your leg and rest yourself. And take your pain pills on schedule so you keep the pain knocked down! It's harder to get rid of pain when it gets bad than it is to take the pain pills on schedule so it doesn't get too bad. You should check out all the material in Jaycey's post and if you don't feel like doing that, just remember the most important thing - your knee will get better on its own time, so don't let any physical therapists bully you or try to force your knee into a move it's not ready for. I'm praying for you.

 

[benne68]

Congratulations on being on the recovery side, @Bridgy

I have quite a bit of swelling too

Swelling is normal in the early days, so please don't be concerned. When you think about everything the surgeon did to that poor leg of yours, it's no surprise that it's inflamed. Icing and elevating will help. Give it time.

The worst is trying to get my leg back up on the bed after walking.

This is also normal. Many BoneSmarties refer to it as "log leg". It will improve as the swelling goes down.
We're here for you.

 

[Reiner]

@Bridgy Not sure if you're still having difficulty getting your operated leg into the bed, but I used my good leg to hook the log leg behind the ankle and assist it onto the bed. Hope you're feeling as well as can be expected, and keeping in front of the pain.

 

[Bridgy]

Thanks for the tip! I’ve been using a yoga strap around my foot. Next up is trying to take a shower

 

[Bridgy]

Could you please add me to the September surgery list? I am having my right TKR on 9/15.

Good morning How are you holding up postop? I hope everything went well.

 

[sistersinhim]

Next up is trying to take a shower

Oh, you will love that! It feels so good you won't want to get out. But, you will be exhausted when you are done. That is normal. Go take a nap afterward and that will help.

 

[Jockette]

@Bridgy

I‘ve moved your post above (post 9) out of the Monthly team thread as we reserve that thread for surgery date information, and so members can see who else has surgery the same month. We prefer all other comments and discussion to take place in a pre op or recovery thread, such as this one. I moved your post here to your thread, since HoneyMcG doesn’t have a recovery thread yet.

Enjoy interacting with others who are on the same journey, here in this thread, or their thread.

 

[Zanza]

Thanks for the tip! I’ve been using a yoga strap around my foot. Next up is trying to take a shower

Oooh, you should get a shower chair! My son got one for me so it was easy for me to get in and out of the shower and I love it so much I still use it even though I don't need it. For some reason it feels really luxurious to me to just sit there and let the water cascade down on me, like a mermaid under a waterfall.

 

[Bridgy]

I now have completed week one! My sister who is a nurse came and changed my dressing. Saw the incision for the first time‍. All in all my leg doesn’t look too bad. Here is my worry: the week was a blur of pain and pain pills. At no point did I feel capable of pt exercises (I’ve just gone once last week but go back tmo) To my horror I realize my knee won’t bend at all. It’s not that swollen anymore. My partner says it’s time for some grit and start bending. Is it normal or have I babied it too much? I am now feeling ready to get serious about getting more movement even though it doesn’t seem to want to?

 

[Jockette]

You were wise to baby the knee. Just walking to and from the bathroom is good mobility for it. There is no need for “grit and start bending.” You just had major surgery, your knee was surgically assaulted, it’s very upset, that’s why it won’t bend. It is not necessary to force it to bend more than it wants to. The bend will improve, all by itself, as you heal.

When you go to PT, do not allow them to bend it for you, as that will increase your pain and swelling.
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR

Regaining our ROM does not require forceful bending or painful exercises.
Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.

 

[Bridgy]

Thanks for your encouraging words. Are there any good research articles I can use to back up the “no forcing” concept when I’m at PT? I’ve looked at PubMed and found a couple articles but wondered if you or anyone else have some references?

 

[Jockette]

Mostly the information about “less is more” when it come to PT of any sort, is the thousands of testimonials of our members here.

Remember, it’s your knee, not your doctor’s, not your PT’s, and not your partner’s knee. You decide how you are going to “rehab.”
Saying no to therapy - am I allowed to?

This is what one of our members, TortiTabby, experienced:

(Just so you know, ADL means Activities of Daily Living.)

“At my six week appointment this is what my OS wrote in my visit summary: "She reads an online website called Bone Smart which states to not push through pain following knee replacement. If she were to follow this direction, she will have to learn to live with a knee that only reaches to 85 degrees of flexion. I believe this website is very misleading."

It has now been 20 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks (where I am today): 110
I am so thrilled it keeps improving and improving and I know now that I will get to my goal of 120 (or even better, dare I say!)
So, if a OS or PT bullies you into thinking your ROM will not improve over time they are wrong. By the way, I haven't been back to see the OS since that horrible appointment at 6 weeks, but I sure am going back when I reach 120 just to say, "Ha! You were wrong, BoneSmart was right!" “

And,

“Just an update for those who are apprehensive about gaining ROM:
It has now been 26 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better. “

 

[Jockette]

Are there any good research articles I can use to back up the “no forcing” concept when I’m at PT?

I’ll repeat these articles:
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Saying no to therapy - am I allowed to?
The woman who wrote the above articles had more than 60 years in the orthopedic nursing field, including more than 10 years with BoneSmart. She also wrote text books for training in the orthopedic field. That’s a lot of experience and qualifications to write the above articles. Personally, I trust her guidance more than I did my medical team.

 

[Bridgy]

Thanks and sorry I missed the links you sent the first time.

 

[Jockette]

I editd my post (#17) to add Josephine’s qualifications, since you posted your response, so please take a look at it again.

To be honest, you probably won’t convince a PT to agree with Bonesmart‘s ideas of being gentle and listening to your body, if they believe in the no pain, no gain approach, no matter how authoritative an article is. It’s the way they were trained. It’s “their opinion.” But that’s all it is, an opinion. We do have surgeons who agree with Bonesmart’s gentler approach.

Again, it’s your knee, and you have the right to choose how you will recover, and how you will rehab. I’ve had the more aggressive “therapy” and I will never consent to it again in the future.

As one of our staff members likes to say, this recovery is a long journey but if you stick with the BoneSmart approach the journey will be less painful and you will still reach the same final destination. Ultimately you get to choose the path, the tough rocky road through painful PT, or the BoneSmart path through the meadow with the pretty wild flowers.

 

[Zanza]

Are there any good research articles I can use to back up the “no forcing” concept when I’m at PT?

Here's my two cents. When I went to PT, I took my son for backup in case the physical therapist wanted to get aggressive and wouldn't listen to me. You are at one week in a process that takes approximately 52 weeks. Your knee is not happy right now after what happened to it, and if you try to force it to do things it is not ready to do, it's going to get really angry and take even longer to get better. Ice it, elevate it, and rest it. And don't let a physical therapist hurt it, or scare you with numbers about range of motion, or threaten you with manipulation under anesthesia if you don't reach a goal that they want to check off when they want to check it off. It's your knee, you call the shots.