TKR suejan's recovery thread

[suejan]

Hello all
I had a RTKR on May 30th 2019. Overall I have done ok-Im at+6 for extension and just over 100 (bend)
I am walking without a cane in the house, use the cane when I go out. I progressed from the walker about 11 days ago. I do my (light) exercises at home, except for going to my surgeons clinic PT unit every Friday, since day 7.
8 days in I woke to a different calf pain and I knew it was wrong. Ended up at Hospital, with a calf area DVT. I was put on an oral blood thinner.
I do not see my surgeon until the end of July. In the meantime I am supposed to hear from a hematologist, and have an assessment done. I will need to be on the blood thinners for 6 months to a year.
Its early morning my time right now (120 am) and I am trying to sleep, always a challenge these days, but my calf DVT area is throbbing. Sometimes I get so scared, worried it will move to my heart or lung. Its hard to concentrate on my actual surgery recovery when the DVT pain can ache worse than the knee.
Anyone else with a DVT issue? Other than icing what can you do when its hurting? It feels like a hard tough ball, even though theres nothing to the touch. It goes sore, numb, kinda tingly and there is no way to get comfortable when laying down with it!
I would appreciate any feedback or suggestions,
Thanks
Suejan

 

[Jockette]

Hi and Welcome to Bonesmart.

I’ve never had a DVT so I am going to tag @Josephine , our forum administrator and nurse director, to come and advise you. I’m sorry you have that added complication, this recovery is hard enough without that.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

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 to 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.

 

[kneeper]

Sorry about your DVT. I'm glad you have been able to get it treated promptly.

 

[suejan]

Hi all,
Moderators- would you please change my thread title to a generic recovery format, thanks.

I am now just over 6 weeks. Still waiting for an appointment with a hematologist The DVT area still hurts, my GP said I can use topicals creams on it- I do at bedtime as it is really sensitive and sore.

I started PT on day 7- my surgeon belongs to a practice that has their own physio, so I go once a week for about 45 minutes. First week I was at +10 for extension and 86 Flexion. By the second week I was at +6 extension and 98 ROM.

Week 5 was bad for me, lots of pain, DVT really sore,no sleep and my numbers went down. Back over +6 extension and 97 Flexion. I saw all these folks older than me (I'm 56) just bopping around and having 110 and 115 Flexion, and I just broke into tears in front of everyone. Felt like a fool and a failure. I was really down, though my PT said it was ok and that this happens:(

By the next week (a few days ago) I was at +4 extension and 103 Flexion!! Finally! Much better. I think I feel better if there is any progress! Still on pain meds, but greatly reduced. Sleep would be horrible without! I have slept in bed from night 1.

I now ice one a day, about 2 hours. Occasional night time ice pack, more for DVT than knee though. My knee is doing ok, but it's a constant aching pain. I really hope to have an end to the discomfort in the near future.

I use a cane when I go out and nothing in house. Off work for 6 more weeks. It's been a tough year for me. Lost my Dad a year ago, my Mom 3 months ago, and just moved. I kinda feel like I was in a fog going into this surgery, and was NOT really prepared!!

I think I am more or less on track, with the exception of the DVT.

Thanks for “listening”
SueJan

 

[Jockette]

Very few of us were prepared for this recovery, I sure wasn’t!

Week 5 was bad for me- lots of pain- DVT really sore- no sleep- and My numbers went down

Try not to worry about your ROM. Whether it comes back quickly or slowly, there’s no window of opportunity. I’m more than 2 years out and recently noticed more improvement.

You are very early in recovery with a DVT. Treat your knee gently. I’m going to ask @Josephine to come advise you.

 

[suejan]

Thanks for updating my thread title

 

[TrueNorth]

You’re just a couple weeks ahead of me. I’m still quite concerned about my low ROM but trying to be patient. This is week 5 and I’ve noticed an increase in strength as I’ve been able to walk further with the cane and have started walking around the house without any aids at times. Have been considering external PT as have been relying on the home exercise plan provided by the hospital so far and wonder if maybe some different targeted ones would help more.

 

[suejan]

TrueNorth
I really Like going to PT once a week. It’s about 45 minutes and they have been great with me. I just got out of PT and I’m now at 106 and 4, So decent enough.
He said my walking is great, I don’t use a cane at home, but he said to take it when I go out because I could get overtired start to limp and then need it.
As per bone smart I have done very little exercising at home. A few a day very lightly, Together with the outside PT has me in a good spot. They said next week if my numbers are the same or better it might be my last required PT visit- I will miss it.
I am trying to notice the little accomplishments. The first couple weeks my legs itched like crazy I thought I go out of my mind. I noticed the other day that was all gone. My knee looks good. My every day use is decent. I can do stairs OK , and can bend better than on my original knee. (My surgeon never wants you to bend with your knee on the floor.). I bet there are lots of small accomplishments you have made that you’re not recognizing !
What part of Canada are you in? I’m on Vancouver Island .
Susan

 

[marieltha]

Glad to hear you are improving.

I still ice 4 times a day (left PKR Mar& right shoulder RCR) and feel it helps just as much as I get more active as it did right after.
I see it as part of pain management.

PS Hey and Bienvenue/Bonjour! I lived for many years (warmer months) in Montreal. Love love love Canada. (Tadoussac, Tremblant, Georgian Bay, Stratford, Ottowa, ....)

 

[suejan]

I’m hoping someone might have had something similar to this. I get a lot of groin pain On my right side, which is the same side I had my knee replacement on.
I’ve had the groin pain for a couple of years, and was told it was from the hip. I had a hip x-ray which showed arthritis. From there they did the knee x-ray that showed the really bad arthritis that required my knee replacement.
I’m just at eight weeks now, but getting a lot of that groin pain again. It’s when I’m walking and when I am at rest. It, along with an aching ankle keep me up all night lately.
Could it be my new knee is making me walk differently and aggravating my hip, and causing severe groin pain? And is it better to ice or apply heat to that?
If I could get my groin pain to settle down and my ankle pain to settle down I might catch up on my sleep. Any help appreciated

 

[kneeper]

It is entirely possible that the changes in your walking that go with recovery could be aggravating the hip. I'd say to try ice first, but heat may help if it's more of a muscular thing. Experiment and see what helps.

 

[suejan]

Thanks Kneeper,
I realized my outer hip was pretty sore too.
I have been using heat.
For my ankle, I bought this sport wrap/brace that I’m putting on to sleep with. It has helped a lot, for the last two nights ankle pain is suppressed.
When I don’t have it on in the day The ankle pain is there, but the brace Stops the pain overnight. I’ve managed to get two nights of decent sleep so that’s feeling a lot better!

 

[suejan]

I have just passed the 10 week mark. My knee is still sore. I can walk ok, but sometimes my groin/hip goes out.
I still cannot sleep well. Here it us 2:20 am and I have been trying to sleep since 11:00 pm—no luck. My leg just aches at night. Pain above my knee, at knee, calf (esp inside where my DVT is), and my ankle and foot hurt. I have been going to bed with an ankle support on.
I just cant get comfortable. I still take a Tramadol when I go to sleep (or try to) and Tylenol during the day if/as needed.
I have had sleep problems for maybe 5 years now, and I am down to 1/2 sleeping pill at night as it is not a great mix with the Tramadol. (I also take 10mg daily of blood thinner
Xarelto, for my DVT.)
When does the leg stop aching so much and allow some sleep?
I was supposed to go back to work in two weeks, Ive extended it to 3 weeks, but If I cant sleep at night how do I drive and work???
Really worried about it
Appreciate some shares about when you were able to both lay down comfortably and sleep
Thanks Susan

 

[Rockgirl4]

Hi @suejan. I'm am 11.5 wks post-op and also having sleep issues. The main thing I've discovered so far is I can't drink any caffeine nor can I take any more afternoon catnaps. Both just ruin my night and sleep won't come until 4 in the morning. I have days where I tire easily or just want to lay down and prop/ice the knee, but I often fall asleep in no time. Then I'm messed up for the night every single time.

My other problem is getting tired enough to sleep. I still can't walk far or stand too long, and I have lower back issue to manage, so regular exercise that I'M used to just isn't happening yet.

So here I am at 5:20 AM because of falling asleep on the couch at 4 PM.At least we all have each other to keep ourselves company

 

[suejan]

Rockgirl4- 5:20, that stinks too!
I never nap in the day, I kinda wish I could so that would be some sleep anyway!!
I do get how that would contribute yo the issue though
I only have 1 coffee/day, in the morning. All I drink rest if day is water-and lots of it. That alone gets me up a few times a night, but since Im not asleep anyway??!!?!? Doesn't matter.

Yesterday I was on my feet a lot, and I find days that I do that I really pay for it more at night. It’s like my leg Is electric and it just won’t settle down.
By spending a lot of time on my feet, I mean I had grocery shopping, some house shopping and a couple other errands to run. Really just normal life . If I can’t handle that, how do I handle going back to work soon. I’m a general manager of a large big box store, so my time is alternated between administration and physical on my feet time .
I just can’t see things changing so much in the next two weeks but I guess I’ll see.
My mom had a TKR On one leg and a partial on the other, maybe 7/8 years ago And she made it look so easy. I remember helping her taking her to PT, and my dad doing their driving (usually was her), But other than that I don’t remember her complaining not sleeping or any of that stuff. I don’t know if she didn’t go through it or she was just way better at suffering in silence. She passed away the month before I Had surgery so all the questions I would’ve loved to of asked her I couldn’t.
Having lost both her and my dad with in the last year has affected me greatly of course, so Im sure depression and grief are not helping this recovery!!

 

[kneeper]

I remember worrying about going back to work when my sleep patterns were still wacky. You've probably heard the advice that if you can't sleep to get up for a while and then try again. I did a lot of sleeping in installments. I'd get up and ice (maybe take some tylenol-- depending on how long it was since my last med), watch a show or read for a bit and then go back to bed.

I was sleeping much better by the time I went back to work than say, 3 weeks before, but it wasn't always solid. I'd say within a few weeks it was pretty normal.

How much activity are you doing? Often that night pain is a sign of that your activity has "caught up" with you.

 

[suejan]

Kneeper,
I believe it’s true when I’ve been on my leg too much I have a worse night like last night. But what I am terming being on my leg too much, is not that much!.
Just EDL stuff, stuff that should be pretty easy by week 10 I would think. It’s not exercise or anything it’s strictly walking and standing. I did PT for six weeks once a week, until they said I was at an OK point to stop. That was only 45 minutes once a week and never bothered me. But I find my leg goes crazy if I sit too long it feels like it’s swollen and it aches, even though it doesn’t look swollen.
When I’ve been on my feet too much in a day it aches at night.
My surgeon is done with me unless I have an actual surgery issue.
I see my GP again this week and get my back to work forms filled out and I’ll go over it with him. But as much as I like him he is a super young guy who’s never had any kind of surgery like this and the one time I’ve seen him since surgery I felt he had no understanding at all of how I was feeling.:( made me sad because usually I feel he’s pretty empathetic.
I’ve been on my feet a fair bit today too, and it’s only the fourth time I’ve driven and I’ve just spent over an hour in the car coming to pick my son up at the ferry terminal. I’ll probably pay for it tonight too!!
Every time I’ve talk to my boss she just keeps saying how happy she is going to be to have me coming back to work fully able-bodied and ready to go. Not feeling able-bodied and not feeling ready to go at this point. Guaranteed to be setting us all up for disappointment if that’s the expectation !
Have a good weekend .

 

[Jockette]

But what I am terming being on my leg too much, is not that much!.

stuff that should be pretty easy by week 10 I would think.

You don’t think it’s too much, but your knee does, and unfortunately, the knee’s opinion is the one that counts.

This recovery takes a year for complete healing. (on average) That’s 52 weeks and you are 10.

Recently I compared this recovery to baking cookies. My chocolate chip cookies take 12 minutes to completely bake. If I take them out earlier, at 2 minutes, 4, 8 or whatever, they will only be partially baked, and not all that tasty, because they’re not done yet.

The same is true of our knee at 2 months, or 3 months, etc. It needs time to finish healing.

Every time I’ve talk to my boss she just keeps saying how happy she is going to be to have me coming back to work fully able-bodied and ready to go. Not feeling able-bodied and not feeling ready to go at this point.

I think you should have an honest talk with your boss and explain how long this recovery is, and that you will not be fully able bodied when you return to work.

You will be fully able bodied in the future if you take care of your knee now and give it the time it needs to heal.

 

[kneeper]

Kneeper,
I believe it’s true when I’ve been on my leg too much I have a worse night like last night. But what I am terming being on my leg too much, is not that much!.
Just EDL stuff, stuff that should be pretty easy by week 10 I would think. It’s not exercise or anything it’s strictly walking and standing.... But I find my leg goes crazy if I sit too long it feels like it’s swollen and it aches, even though it doesn’t look swollen.
When I’ve been on my feet too much in a day it aches at night..

Unfortunately I'd say this is all pretty normal at 10 weeks. But it will get better. I found that if I was sitting for more than an hour it really helped to get up and walk around for a couple of minutes (literally 2-3 minutes) about every hour. After standing for an hour (at 12 weeks) it would feel like log leg. But would start to loosen up after walking or sitting for a few minutes. Gradually the "recovery" time got faster and faster.

I agree with Jockette that it would be useful to talk to your boss about possibly needing some adjustments, such as breaks to sit down and/or making sure you can ice at lunch. You might find you need to work a slightly shorter day when you first come back. Hopefully your boss would be open to that. At the least, if you're like me, be prepared to come home and flop on the couch with your ice pack.