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TKR Swelling the more I walk at work

Newkneelabmom

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Im 5 1/2 and 6 months bilateral knee replacement. I’m back to work full time as a nurse case manager in a large hospital. My assignment changed due to construction issues and with the new assignment I walk about 7000-10000 per day and often carry another 1/2 an assignment. The more I walk the more I swell. No opportunity to elevate till I get home. The more swelling, the more stiffness and pain. Had follow up with my surgeon and he said I have done everything I needed to do but my body just needs to heal. How do you get through another 3-6 months to heal and recover when your Job demands that you be not at just 100% but like 150%?
 

Celle

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Hello @Newkneelabmom - and :welome: to BoneSmart.

Please will you tell us the full dates of both your knee replacements and which knee was done when, so we can make a signature for you? Thank you.:flwrysmile:

You've had to go back to a very demanding job too early. That's the crux of your problem. We usually recommend taking about 12 weeks off work and then doing a Phased return to work , if possible. For a physically demanding job like nursing, it may take even longer.

Recovery from a knee replacement isn't like recovery from most other surgeries, where you can bounce back again in about 6 weeks. This recovery takes as long as a full year before all your tissues have completely recovered, although most people can return to normal life after about 3 months. You've had both knees done just a few days apart, so you have a double whammy of the surgery after-effects.

Almost everyone experiences increased pain and swelling when they first go back to work. You, my dear, have made that worse, by having both knees done and by going back too early to a physically demanding job. That's asking too much, too soon of your new knees.

I realise that taking more time off was probably not possible and I'm not blaming you, but just trying to explain. Is there any way that you could take more time off work, or work fewer days? At least don't do more than one shift - no additional time at work.
You see, in asking too much, too soon, of your new knees, you could run the risk of developing a chronic inflammation of the soft tissues around them.

Had follow up with my surgeon and he said I have done everything I needed to do but my body just needs to heal.
Your surgeon is right. Time to heal is what your knees need. That, and more rest, if at all possible.
Doing a demanding job like yours so early after having both knees replaced is just not compatible with having less swelling, pain and stiffness. I think you've already realised that. :console2:

You say you can't elevate at all while at work. If you get a meal break, can you do it then, and ice as well? Even if it's for even a short while, every little bit helps.

When you aren't at work, try to do the absolute minimum that you can get by with, and spend almost all your time resting, icing and elevating your legs.
Do you live with someone who could still do some of the things you normally do at home, such as shopping, cleaning, washing, so that you can rest for longer?

PS: Although it seems you had both knees replaced just a few days apart, here on BoneSmart we reserve the description "Bilateral" for knee replacements both done on the same day. That sounds a bit "picky", I know, but I think it's for statistical reasons, so please humour us. We'll call your TKRs sequential.
 
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Celle

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I'll give you the BoneSmart Recovery Guidelines and helpful articles in this post, since my previosu post was getting a bit long. Here they are:

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 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.
 
OP
OP
N

Newkneelabmom

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Thanks for the reassurance. My right knee was done 4/15 and my left 5/6. Having to worry about keeping your job on top of recovery is challenging. The subtle comments from others expecting you to be recovered because you have returned to work is also difficult to endure. Asking for work accommodations is an area that is not frequently addressed. It is very helpful to this added support to advocate for myself. I’m hoping to see if I can cut down a day in middle of week to get rest.
 

Jockette

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The subtle comments from others expecting you to be recovered because you have returned to work is also difficult to endure
This happens even to us who are retired. It caused me a lot of stress in my recovery. I felt so embarrassed that I couldn’t do certain things. So I overdid, trying to appear recovered, which was a joke, as my friends could obviously see that I wasn’t, which of course brought me back to feeling embarrassed. It was a vicious circle.

Somehow we eventually manage to get through this recovery.
 

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