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TKR SusaninChicago’s recovery thread

SusaninChicago

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I had my surgery on 4/12 and my recovery is going smoothly. Much less pain than last time, and hence I am using fewer painkillers and feeling alert. I’ve been going downstairs for meals and doing my PT exercises three times a day.
 

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Hi and welcome to recovery again!

Go easy on “the exercises” as you only need gentle moments this early in recovery.

Here’s a refresher course for you:

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.

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

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
ice
take your pain meds by prescription schedule (not when pain starts!)​

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 to 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 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.
 
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SusaninChicago

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One week anniversary is tomorrow! Everything is going ok. I did a couple of hours of work today and plan to try to keep this up and gradually extend my time over the next few weeks. PT is fine, nothing too strenuous or painful. My daughter went home today after filling up the freezer with Trader Joe’s favorites, so I should be fine. Not a lot of appetite.
 

sistersinhim

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Not a lot of appetite.
I couldn't eat much after my tkr either. I had to force myself, which is very unusual for me! I existed on mixed nuts, dark chocolate, and protein drinks for about a month. After I got off of the pain meds, my appetite slowly came back.

Make sure what you eat has plenty of protein. You need that to help build yourself back up.
 
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SusaninChicago

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Thank you, sistersinhim, for the advice. I am trying to make good choices.

Does anyone have advice about the walker? I was told to always use it but it is sometimes a bit awkward in my small house (with stairs!) and I find the cane is easier to use.
 

sistersinhim

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As long as you have something to hold on to in your house it's perfectly fine to dump the walker. But, you will need it for a while yet outside and in the public. One little misstep or bump and you could be on the floor. That's a fear we all have been through.
 
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SusaninChicago

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Has anyone else had a bad experience with home health care? My doctor ordered a nurse to come twice a week. I am 10 days out and have seen her once. She didn’t show on Monday when she was supposed to change my waterproof bandage, although I am told she may come today. I don’t see the point of this, since all she does is take my vitals which the PT person does anyway, and I found her really disrespectful. For example, she asked me if I was depressed, when I said no, she replied well, why are you taking an antidepressant? Duh, so I won’t be depressed?
Can I just end this or do I need to go through my doctor?
 

sistersinhim

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I would call my doctor and tell him about this person. He won't know if you don't tell him. If he knows he can make sure the company that hires the home health is notified about it.
 
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SusaninChicago

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Thank you sistersinhim. I talked to my dr. who agreed the home visits are unnecessary. A quick question to all, I have had very little pain and am taking meds (Tylenol plus tramadol every 6 hours) On schedule. I am not sure if it is the drugs or just healing but I am very sleepy and “foggy.” Is it too soon to start tapering off to see if I can improve on alertness without increase in pain?
 

MARYCOOL

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I stopped my daytime pain meds at 2 weeks, just took them at night. I, too, felt foggy.
I did take just tylenol during the day.
You can try that and see where your pain level is!
Best wishes to you in your recovery! I am 8 weeks out!
 

FCBayern

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Is it too soon to start tapering off to see if I can improve on alertness without increase in pain?
That's a very individual question @SusaninChicago. Some like MARYCOOL can stop early, but I needed the pain meds for more like 6 weeks. You can try lengthening the time between doses and see how it goes. But listen to your body, foggy may not be pleasant, but it's probably better than being in pain.
 
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SusaninChicago

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Dear Marycool and FC,
Thank you for sharing your experiences. I am trying to go with just Tylenol today, after sleeping/dozing for 18 out of 24 hours yesterday. Definitely there is a bit more discomfort but not super painful. I am still sleepy so it may take some time to get the opiates out of my system. Sleepiness aside, I am managing well on my own, although I will be happy to see the cleaning service tomorrow. It occurred to me that maybe the solitary recovery is more stressful that I am conscious of and that is contributing to my fatigue. Two week anniversary tomorrow!
SinC
 

kneeper

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^Very true. You can experiment with stretching the time. I wasn't able to do my first change for couple of weeks. My doc had set it up to "step down" to a weaker med after a couple of weeks and then it took a couple of weeks after that before I could stretch the time.
The other thing is that napping is good for you when you're healing. :sleep:

ETA: we apparently posted at the same time @SusaninChicago. I'm not sure how much I slept but I do know in the first two weeks I dozed a lot. You may take more purposeful "naps" rather than being groggy if this decreasing the meds works for you.
 

sistersinhim

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Sleeping is actually very good for you and your knee's healing journey. When you are asleep, your body can concentrate more on repairing all that damage that was done to your knee. I slept whenever I felt sleepy. It didn't matter if it was morning, afternoon, evening, or night. This surgery is extremely traumatic for your whole body. Rest and sleep are restorative.
 
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SusaninChicago

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Thank you kneeper and sistersinhim. Ironically, I’ve struggled with insomnia for years and now I can fall asleep anywhere and anytime. I guess I shouldn’t complain. I just need to be able to get 3-4 hours of work done a day and then sleep!

Two weeks postop today and I measured at 120 degrees flexion. After my right knee. was replaced, I took a trip to Ireland at 10 weeks, my last trip before the pandemic. I am going to start planning a trip some where to motivate myself!
 
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SusaninChicago

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I've successfully cut down on my pain meds and as a result I am much more alert. I am not sure if I have a high pain tolerance or just not much pain, but I am just taking two tylenol at eight hour intervals. I am still taking an afternoon nap, but I've managed to work 4 hours a day everyday this week. Very happy to get closer my normal routine. Yesterday I had my postop appointment and got the bandage removed. What a relief! So much less itchy. Also I am approved to start outpatient physio next week and managed to score an appointment with the therapist who I worked with after my right knee replacement.
 

sistersinhim

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You are doing really well for two weeks out! It is nice to have the same PT. Now, you know what to expect.
 
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SusaninChicago

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Thank you, sisterinhim! I am truly grateful that everything is going well. I am trying to pace myself, since I realize now that skipping my nap just means I am more tired the next day. Moreover, my cats and I really enjoy enjoy snoozing together for a couple of hours!

I am curious though about differing postop experiences and outcomes. Does it come down to the skill of the surgeon or are other factors involved? While I am relatively young for a knee replacement, I am totally out of shape because of the pandemic lockdown and my arthritis pain. I am also carrying about 20 extra pounds, so I don’t think I was an especially good candidate. The doctor said my knee was a mess with large femoral and tibial osteophytes That had to be remove.

If anyone is in the Chicago area, I definitely recommend Dr. Balach at University of Chicago hospital.
 

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Sisterpat

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Gorgeous cats!
I, too, had a golf ball size osteophyte behind my 1st knee, largest one doc has ever seen! I think that contributed to the pre-op flexion contracture which likely has made recovery a bit slower. So be patient.
 

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