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[TKR] sugarjo TKR May 6

Discussion in 'Knee Replacement Recovery Area' started by sugarjo369, May 15, 2019.

  1. sugarjo369

    sugarjo369 junior member
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    Hi - I stumbled on this website today. Wow wish I had found it before my surgery so much great information. My LTKR was May 6. I left the hospital May 7 with 95 degree bend, on a walker, no issues doind stairs. In home PT started the next by. By Friday my flexion was 64 degrees, massive continued swelling. Spent the weekend with an upset stomach and could barely eat all weekend. Was miserable, doing PT exercises and not progressing. Monday and Tuesday PT, pain, increase swelling, extreme increased in pain at night. Called my doctor for follow up advice on the PT and it seems he can't even remember what he told me in the hospital. 8| Now I am reading the protocol here and thinking I have screwed everything up!! Reading about recovery in the UK and wishing I had had my surgery there fhs. My PT person is happy to have me sobbing during PT and tells me I will have an increase in swelling the next day. None of this makes any sense to me.
    Further I broke both legs in college - both tibia and fibia - which is part of the problem with the knee. Some of the bruising has settled around that scar plus pain in the bones there. This knee used to hyper extend due to that extended every step I took basically - any time it hit full extension. I have alot of pain behind the knee when I'm straight and a little bend gives it relief. I'd love any feedback or thoughts any one has. And thanks to the many stories I have already read so helpful!! Really appreciate this site!
     
  2. Pumpkln

    Pumpkln FORUM ADVISOR Forum Advisor

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    @sugarjo369
    Welcome to BoneSmart, glad you joined us!
    Your PT is pushing your recently injured knee too hard too soon, you can either stop PT, or ask for a gentler PT.
    Saying no to therapy - am I allowed to?
    It is your right to stop PT, you can withdraw consent at anytime.

    Looks like you had fantastic ROM in the hospital, suspect all the exercising, pushing, and shoving has caused increased swelling and inflammation, blocking your ROM.
    Suggest you stop all exercise, the walking you do around your house, and a couple of the below gentle activities are all you knee right now.
    Heel slides and how to do them and Extension: how to estimate it and ways to improve it .

    Knees do not like to be perfectly straight, they like to have a soft bend, just as you have discovered.

    You can restart your recovery, and begin your journey to recovery.

    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
    5. At week 4 and after you should follow this
    6. Access these pages on the website

    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.
     
  3. lovetocookandsew

    lovetocookandsew FORUM ADVISOR Forum Advisor

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    Welcome to BS! I'm sorry you're having a difficult time, but if you make some changes in your recovery you should see improvement over time. Someone will be along soon with some reading material for you, but here's my suggestions. Stop the aggressive PT, and don't allow your therapist to cause pain and swelling. If you decide to continue PT, take charge of YOUR recovery and set limits. No aggressive therapy, no allowing the therapist to touch or bend your knee, no heavy duty exercises.

    Your knee has been through a trauma and needs time to heal. I suggest you spend hours each day icing and elevating that knee, and just doing normal daily activities such as going to the restroom, showering, making tea, coffee, a sandwich, etc. You're only days out from a major surgery and your knee just needs to be allowed to recover. You haven't "screwed up", PT has led you astray, and now you have the right to say no, and do it your way! Good luck and keep us posted!
     
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  4. kneeper

    kneeper FORUM ADVISOR Forum Advisor

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    Give your knee a "knee-cation"--lots of ice and elevation with gentle movement and activities as lovetocookandsew said. As the swelling comes down you'll naturally do more.
     
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  5. sugarjo369

    sugarjo369 junior member
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    Thanks so much for the replies and encouragement. Today I get to have the conversation with the therapist. Took Pumpkin's advice and started the Bonesmart way yesterday. i had a lot of pain last night, meds every 2 hours. Today super stiff but less pain and knee is loosening. Was able to take a few steps with no assistance - yay win - overall feeling better. Am putting a towel folded once under the knee at times for support. I think my bed topper is just to soft and this may be increasing the pain. Have not entirely figured out navigating the forum but getting there. Thanks again!
     
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  6. kneeper

    kneeper FORUM ADVISOR Forum Advisor

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    I would put a pillow under the length of my leg from about thigh to ankle. That takes the pressure off the back of your knee without compressing anything.
     
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  7. sugarjo369

    sugarjo369 junior member
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    @kneeper Thanks much for that tip! I have been experimenting with that and wondering!
     
  8. sugarjo369

    sugarjo369 junior member
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    Day 12 Reflections - It's the 12 day of my journey. I decided this morning I am a slow healer, nowhere near being off of my walker - possibly close to being off my rocker though!!:heehee:
    I changed surgeons 3 weeks prior to surgery by divine intervention. My first surgeon had said I would be able to return to my job as a real estate appraiser within a month...:rofsign: as he handed me a pamphlet about knees and sent me on my way. So I came in to this somewhat unprepared for how extreme it is as that kind of became my vision. My actual surgeon doesn't even see me again until June 6 - 4 weeks later!! He said prepare for 8 weeks off work minimum. Still.. I'm having to process a bit of disappointment at where I am getting close to the 2 week mark. Finding Bonesmart has been more divine intervention and has really helped with my mindset though so grateful.

    Today I am celebrating the little improvements as opposed to getting hung up on the BIG "setbacks". The little improvements don't really come undone but the setbacks do so they are LITTLE improvements and little set backs now.
    Yesterday my ankle started to swell and is giving me pain like it is sprained. I believe I read on here this is normal as muscles and things readjust? I'm going with win here..:heehee: I suspect icing will help - stretching too?

    I've had an issue with the inside of the knee tightening massively. No matter how I stretch it it just seems to continue to tighten up though since adopting the more Bonesmart way - today there may be a slight change. Just baffled as to the cause. Wondering if I am over stretching as I am somewhat limber and can put compression socks on both feet by bending at the waist on the bed or could it be the Plasma things the DR wants me wearing on my calves for clot prevention? These tighten and release creating a squeeze and a bit of "pulling" mostly on the right side. I did not wear them last night to test that out. Anyway - any ideas on helping the extreme tightness on the inside of the knee?

    Also - 2 huge red now more bruise colored spots appeared on the top of my knee a few days ago. They are so sensitive to touch it's like they are burnt! Was worried about infection and the Dr called in an antibiotic but now I am not so sure - any ideas on this? It's uncomfortable to try to ice because they are so sensitive though the ice eventually deadens the.

    Willing to continue with my PT as she seemed to be reasonable about my request for no pushing and an easeful approach. My main helper is my poor 17 yr old daughter who has school, work and soccer so it's also mentally nice to have the PT coming in. Hopefully that will hold up next week. I have 3 full days of solely doing the Bonesmart way but for work purposes I am going to have to do all I can to try to get mobile enough to drive and work by mid-June when leave runs out so feel blending the two is a good idea as long as I am listening to my body - so far we are all in agreement.

    Lastly - I am not naming the knee. I am loving reading some of the super cute names and have named other parts of my body over the years. However, the knee is a part of ME and though there has been a change, integration and total acceptance mentally, emotionally and physically are super important to me. I am nothing but atoms and molecules - same as the knee - just configured differently still the same stuff so important that I don't separate her identity for my own recovery and return to fully healed.

    I confess that I am ready to be able to get in and out of bed without such production!:)
    Thank for the space to journal and integrate Bonesmart!!! :flwrysmile:
     
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  9. lovetocookandsew

    lovetocookandsew FORUM ADVISOR Forum Advisor

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    I used my walker for approx. 3 weeks, then switched to a cane for another 3 weeks. When I started forgetting to grab my cane I knew I was done with it, although I did use it when going out for a while longer as needed. Being only 12 days out, you are not healing "slowly"-you are not even two weeks into a 52 week (on average) healing journey, so you really are barely getting started.

    Keep icing and elevating as much as you possibly can-that really helped me with any pain I did experience, plus it helped keep the swelling down. Bruising is a normal occurrence and will fade away with time. I never had any compression stockings or those tightening things on my leg at home, although I did have them in the hospital for a few days until I was up and around more. If my doctor had sent me home with either I guarantee they'd have been in the trash can the same day! lol.....

    As long as you're not on painkillers driving 5 or 6 weeks out shouldn't be a problem, but if there's any way to lengthen your leave to closer to three months that would be ideal. If not, try to ice and elevate at work as much as possible, if it's at all possible.

    One of these mornings you'll get out of bed automatically without thought; until then the hassle is part of the journey to healing. Little by little everything will get easier and more natural, and one day you'll become aware of how far you've come and how much better your knee is than before the surgery. Sending good wishes your way, and keep us posted on your progress! Kim
     
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  10. sugarjo369

    sugarjo369 junior member
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  11. sugarjo369

    sugarjo369 junior member
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    Does anybody's Dr give them gabapentin? I am day 11 and take 3 or 4 a day. These wipeout the nerve pain that comes up at night which none of the pain meds seem to touch. I take 200 mg at night before I go to sleep and this has stopped the night pains.
     
  12. Jamie

    Jamie ADMINISTRATOR Administrator

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    @sugarjo369 .... you'll notice that I've moved this post into your recovery thread. You had posted this question about your recovery in someone else's recovery thread which can derail their thread. Please be sure to post questions or concerns about your recovery here. If you have difficulty finding your threads, you can always look in the How To Use This Forum link under the HELP & INFORMATION tab at the top of the page. Here is the article on finding your thread:

    How can I find my threads and posts?

    Gabapentin is frequently used these days to combat pain after joint replacement surgery and it can be quite effective.
     
  13. sugarjo369

    sugarjo369 junior member
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    @Jamie Hi Jamie - It was intended as a suggestion for her to try Gabapentin as I was prescribed it and it works well for me. I can see how I could have phrased it differently to avoid confusion :unsure: - thanks.
     
  14. Jamie

    Jamie ADMINISTRATOR Administrator

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    Thanks for understanding. When a member makes a "suggestion" to another member about medication, it's really easy for that to become medical advice. If you read our forum rules, you'll see we don't allow members to do that. So in this case, if you wanted to put the idea out there that Gabapentin can work for pain relief, you would say something like, "Here is what has worked for me for nerve pain....."

    It's a subtle difference, but by tying your words only to what has worked for you, you're not dispensing medical advice to someone.
     
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  15. sugarjo369

    sugarjo369 junior member
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    @Jamie got you! thanks much for the helpful tip!!
     
  16. sugarjo369

    sugarjo369 junior member
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    2 week update - coming along! managed to get the PT to work more gently with me and seems to be working. Leg getting much stronger and I am seem to be able to walk with support on one side only though I am still using my walker am practicing right support only. Have some weird discoloration on the top of my knee and bumps or pockets of swelling just in that area. Started as red patches on either side of my incision right over the knee cap now very bruised. Started Cipro as a precaution on Saturday but the PT was concerned today so going to see the Dr tomorrow morning so they can look at it. It was painful to the slightest touch, like a burn, for several days but that has improved. We shall see. My original follow up appointment was not scheduled until June 6th.

    Since implementing the bonesmart concepts I have only improved!! careful after PT days to just rest, elevate, ice and only walk with light stretching. This has led to an improvement in flexion from 75 degrees to 90 degrees today. Feeling really good about my process there. I feel that the idea to move the leg to is best flex point before pain then bend forward from the waist - which I saw on here somewhere - has been really helpful. Just nice gentle stretching. Leg is bearing a good amount of weight and gait has improved.

    Still have down days - have dropped any oxy using only Tramadol plus Tylenol, Ibuprofen, and gabapentin as perscribed. Sometimes get a little achy and nausea and feel frustrated. Was not mentally prepared for the level of incapacitation. Looking forward to what the 3 week mark looks like as I hear it's a big tuning point.

    All in all though really I am improving, feeling better with no more oxy, and getting around the house so overall happy!
     
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  17. eelainea65

    eelainea65 junior member

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    Envious. Six days ahead of you and still reliant on the Oxy. Have spread it out to 5 mg every 8-9 hrs, but body definitely lets me know when it’s time for more. >_>
     
  18. sugarjo369

    sugarjo369 junior member
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    @eelainea65 that's not much you are getting close! I just don't do well on the oxy at all - don't feel good and makes me sleepy so not hard to let go of!! Also have gabapentin which has really worked well for me. Will check out your thread - see how you are doing!
     
  19. winemama

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    I’m a week ahead of you, I’m having the pain in my ankle and calf, Dr said it is from strighting my leg, it takes time. This is my 2nd TKR, in 5 months slow and steady BS has been a savior this time around. Good luck
     
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  20. sugarjo369

    sugarjo369 junior member
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    At the top of week 4. Suddenly on Friday and Saturday started walking with the cane only and some with no aid. Today noticing a significant decrease in the need for Tramadol so stretching that out to once every 6 hours to see how it goes. Noticing that the Tylenol is finally having a significant impact. Still have quite a bit of swelling which comes and goes. Got to 96 degrees bend yesterday and about 5 extension but still incredibly stiff - especially after stretching. Not comfortable for long in any one position but not sure if it's best to lie down most of the time or alternate around. Trying to do alot of walking around the house. My Dr doesn't have a follow up for one full month so no release to drive or walk outside. Mostly just wondering if it's best to keep the leg up most of the time or change around from sitting to laying or having leg stretched out.
     
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